What are Subutex and Suboxone?
Subutex and Suboxone are the brand names used for the semi synthetic opiate, buprenorphine. This drug is used to prevent withdrawal symptoms from occurring when heroin or opiate prescription drugs are discontinued and in the treatment of acute and chronic pain.
Buprenorphine acts by attaching to the opioid receptors in the brain but it does not produce the same euphoria as taking other opioids and is long acting. However, just like every opioid it has addictive qualities and the potential for abuse.
Subutex is often misused and people crush the tablets and snort them or inject them. This is reason that Suboxone was developed.
Subutex contains a single active ingredient – buprenorphine while Suboxone contains two active ingredients – buprenorphine and naloxone. The drug is mixed with naloxone to prevent it from being snorted and injected.
Naloxone works as an opiate antagonist. It fills up the opiate receptors in the brain and it won’t let other drugs activate these receptors. Unlike buprenorphine, which fills and activates receptors, naloxone will not activate the receptors. With all receptors full but not activated, a person feels immediate and intense withdrawal pains.
Street Names for Subutex and Suboxone
Subutex and Suboxone have a number of different street names and these often differ from country to country.
- Stop signs
- Box or Boxes
- Sub or Plural subs
History of Subutex and Suboxone
Scientists at Reckitt & Colman, now Reckitt & Benckiser spent 10 years developing an opioid compound that was more complex that morphine.
They hoped that by doing this they would make a drug with pain reliving properties that would not induce physical dependence. Sadly, physical dependence and withdrawal from buprenorphine remains an issue because it is a long-acting opiate.
In 1978, buprenorphine was first launched in the UK as an injection to treat severe pain and a sublingual formulation released in 1982. Subutex and Suboxone started being widely used by doctors for the treatment of heroin addiction in the USA from 2002 and in the European Union from 2006.
What are the effects of Subutex and Suboxone addiction?
Subutex and Suboxone, when prescribed as a replacement medication, mean that the addict possibly also has also the consequences from their primary addiction to contend with. Frequently, these have not been properly dealt with if this is the case relapse is a certainty. Just substituting one drug for another does not work in the long term as a solution to addiction.
Every addict’s path into addiction varies. This is a complex disease with many underlying layers which coupled together with trauma, abuse, depression and anxiety make it difficult to diagnose and treat without effective residential addiction treatment.
- Loss of appetite
- Heart problems, including infection of heart lining and valves if injected
- Infectious diseases spread by shared needles (HIV and hepatitis B and C)
- Blood clots or tissue death resulting from collapsed veins if injected
- Muscle cramps
- Nausea and vomiting
- Changes in the brain chemistry – short term
- Changes in the structure and function of the brain – long term
- Neglecting personal hygiene
- Disturbed sleep
- Unhealthy eating habits/malnutrition
- Lying to yourself/denial
- Apathy /Exhaustion
- Memory loss
- Mood Swings
- Lack of interest in activities once enjoyed
- Lack of interest in work/school
- Lack of interest and ability in maintain relationships/friendships
- Damaged relationships with family members
- Lying to others
- Damaged self-esteem and self-worth
- Damaged relationship with self
- Lack of interest in life
- Inability to function without the drug
- Continued use despite negative consequences
The signs and symptoms of Subutex and Suboxone addiction get progressively worse over time and there will be no resolution until effective addiction treatment and aftercare are sought.
Often Subutex addicts think that because the consequences seem to be far less than that of their primary addiction that they are doing much better.
Subutex and Suboxone Withdrawal
The effects of withdrawal from Subutex and Suboxone are not life threatening but can be very unpleasant
Withdrawal symptoms can include:
- Nausea and diarrhoea
- Abdominal pain
- Nervousness and Paranoia
- Muscle spasms
- Intense Cravings
The Two Stages of Withdrawal – Acute and Post-Acute
There are often two stages of withdrawal from Subutex addiction. The first stage has immediate acute symptoms and these are usually both physical and psychological. During stage two, former users experience post-acute withdrawal symptoms or PAWS.
These refer to a number of psychological symptoms which can last for weeks or months after the user has stopped taking the drug. This is one of many reasons why residential treatment is the most effective way to treat Subutex and Suboxone addiction.
Post-acute withdrawal symptoms can include:
- Difficulty sleeping
- Lack of motivation
- Inability to feel pleasure
- Anger or emotional outbursts