The problem is that Subutex itself, being a partial opioid agonist, has addictive potential and prolonged use of which inevitably leads to addiction. Uncontrolled intake of Subutex causes typical opioid dependence, which in its turn requires a second detox.

The person may get rid of heroin addiction but become a subutex addictinstead. Characteristics of Subutex addiction are pretty much the the same of any other opioid addiction. Subutex is a long-acting opioid. It remains effective in the body for up to 48 hours.

Subutex Withdrawal symptoms are comparable to those from other opioids: muscle pain, headache, cold sweats, stomach pain, diarrhea, fever, insomnia, emotional disturbances such as depression and rapid mood swing. Intensity of subutex withdrawal usually is less than that of other opioids, but it lasts much longer (up to several weeks), making the process of detoxification excruciating, very annoying for the patient.

Subutex withdrawal

Longevity and persistence of subutex withdrawal often is a cause of relapse. The residual depression, insomnia and weakness may persist for months. The fact that Subutex costs less than heroin and its availability have spired illegal use in various countries (Europe, India, South Africa, Australia).

Self medication often results in treatment failure, relapse or developing addiction on Subutex.

The whole process of subutex treatment consists of three phases. The first phase is a phase of “increasing” doses. To avoid effect precipitated withdrawal Subutex must be taken only when a patient starts experiencing moderate withdrawal from other opioids, usually 18-24 hours after the last use of Heroin, or 48 hours after the last use Methadone. Before starting Subutex treatment, the dose of Methadone must be decreased at least to 30mg a day. Initial dose of Subutex is 2mg under the tongue and then it should be taken 2mg every two hours up 16-32mg totally. The patient must be constantly observed during that time. When the total dose of Subutex reaches up 16 mg , the patient is being left without Subutex for the next 4-6 hours.

No symptoms of withdrawal during that time means that dose of Subutex is enough and the patient goes into the next phase of treatment – the phase of “ plateau” doses. The following 4 days the patient receives the maximum dose of Subutex to stabilize his physical and psychological condition. And then the long way of “tapering” doses off (the third phase of treatment) begins. Over time, the dose of Subutex is gradually reduced until it will be stopped completely. Ideally 2mg of Subutex must be cut off every fourth day until the total daily dose reaches 2mg. Then another 4 days of 1mg of Subutex a day and treatment is over. However, in practice Subutex treatment isn’t so idealistic.