Subutex Addiction

Doctors prescribe Subutex to help patients overcome addiction to opioids but it is possible for a person to become addicted to Subutex.

Subutex contains buprenorphine, approved for use in opioid dependence treatment by the FDA in October 2002.

Opioid dependence is a growing problem in the United States. Americans take more opioids than another other nation on earth. Even though Americans represent only about 5 percent of global population, they consume 80 percent of the world's supply of opioids, according to the Institute of Addiction Medicine.

A large number of these Americans seek help for their opioid dependence; some of these individuals subsequently become addicted to medications used to treat this dependence, such as Subutex. The Substance Abuse and Mental Health Services Administration reports the U.S. admission rate for opioids other than heroin jumped up 414 percent in just 10 years. In 1997, about seven people in 100,000 people sought treatment for opioid dependence. In 2007, there were 36 patients per 100,000.

Chronic use of any opioid, even therapeutic drugs such as Subutex can cause opioid dependence and addiction. Anyone can develop a Subutex addiction or dependence if she takes this drug more than a few weeks. Consuming large doses of Subutex, using it longer than prescribed or using Subutex in an unsafe way increases your risk for developing dependence or addiction. Opioid dependence and addiction are serious medical conditions that require the help of a qualified professional.

The Definition of Addiction

Subutex addiction is a neurological disease that changes the brain's reward circuitry. These alterations cause certain physical and behavioral changes characteristic of addiction.

Like other chronic diseases, opioid addiction often involves cycles of relapse and remission. Without rehabilitation, addiction is progressive and can result in disability or premature death.

Addiction versus Dependence

While many use the terms addiction and dependence interchangeably, these two conditions are separate and independent disorders.

Dependence

The human body adapts to foreign substances, such as food, cigarette smoke or drugs like Subutex by adjusting its own chemistry to maintain a safe chemical balance. Long-term use of Subutex, even to cure other substance abuse problems, may cause your body to depend on having a certain level of Subutex to feel "normal." When Subutex levels plummet, your system struggles to maintain chemical stability. You feel this struggle for chemical balance results in unpleasant, flu-like withdrawal symptoms.

A doctor would diagnose you as being opioid dependent if you experience withdrawal symptoms after your opioid levels plummet. This decrease in opioid levels can be the result of a missed dose, an insufficient dose, or as the result of taking some medications such as naloxone. Doctors call this process detoxification.

Subutex withdrawal symptoms include:

  • Abdominal Cramps
  • Anorexia
  • Anxiety
  • Chills Alternating with Hot Flashes
  • Depression
  • Diarrhea
  • Dilated Pupils
  • Goose Bumps
  • Increased Heart Rate and Blood Pressure
  • Insomnia
  • Irritability
  • Muscle Aches
  • Nausea
  • Nervousness
  • Restlessness
  • Runny Nose
  • Salivation
  • Severe Sneezing
  • Sweating
  • Tremor
  • Vomiting
  • Watery Eyes
  • Weakness
  • Yawning

Anyone who takes Subutex for a long time - even to treat addiction to other opioids - can become addicted to Subutex, dependent upon it, or both. Opioid dependence causes unpleasant, flu-like withdrawal symptoms when Subutex levels fall. Subutex addiction causes behavioral symptoms such as cravings and drug seeking when supplies run low.

Addiction

Subutex addiction causes neurological changes that cause certain behavioral symptoms. Physicians look for these behaviors when considering a diagnosis of Subutex addiction.

Symptoms of Subutex addiction include:

  • Inability to Consistently Abstain from Subutex Use
  • Other Behavioral Control Problems
  • Cravings for Subutex
  • An Inability to Recognize Significant Problems with One's Own Behaviors and Interpersonal Relationships
  • Inappropriate Emotional Response

It is possible to be dependent on a substance but not be addicted to it, or vice versa. For instance, a person might depend on insulin to control blood sugar; if she forgets to use insulin after a meal, her blood sugar will rise as her body struggles to maintain chemical stability, but she would not feel cravings for insulin or engage in drug-seeking behaviors.

On the other hand, chronic cocaine use may cause addiction but not dependence. Someone with a cocaine addiction will not suffer the flu-like symptoms typically associated with opioid withdrawal but he will crave cocaine and seek out drugs.

Drug seeking activity

Drug-seeking behavior is the hallmark of addiction. Drug-seeking behaviors include presenting fake prescriptions at pharmacies or altering prescriptions to get a stronger dose or more Subutex in each bottle. Another drug-seeking behavior is to place an emergency call or visit just as the doctor's office is closing for the day to pressure the physician to write a prescription so his staff can go home.

A Subutex addict pretends to misplace prescriptions, tampers with written prescriptions to get more pills in a bottle or goes "doctor shopping" to get as many written prescriptions as possible. Some people get Subutex free from other drug addicts. Many individuals buy prescription opioids, even those meant to reduce addiction, on the black market.

The DEA refer to these types of activities as "diversion" because of the way abusers divert drugs from their intended use.

Addiction: What Family Members Should Know

Addiction is a neurological disease. The behavioral changes you see in your loved one is the result of opioid addiction, and not an indication of poor character or upbringing.

Fear of failure and relapse back to opioid use may cause some Subutex users to remain on this replacement drug longer than medically necessary. Family members must remain vigilant in their support of their addicted loved one, as quitting Subutex is the last hurdle in a very long and difficult race.

Nobody is born an addict but scientists think heredity is a predominate factor in whether a person will develop an addiction. While there is not one "addiction gene," a person's biology may make him more vulnerable to addiction. The susceptibility to addiction may be the result of the interaction between many genes. This genetic predisposition means people who use Subutex to treat dependence and addiction to opioids are at increased risk for becoming addicted to Subutex itself, and so are their immediate family members.

Family members should know that, while genetics are an important factor, not everyone related to the addicted individual is doomed to suffer from an addiction later in life. Environmental factors, such as work stress or relationship problems, also influence the development of addiction.

Environmental Stress

People in a stressful work or home environment are at higher risk for developing addiction to opioids. Stress such as constant arguments or violence, financial hardships, unequal workloads or health problems increase addiction risk. This stress may make it more difficult for addicts to let go of replacement drugs, such as Subutex.

Some people are hypersensitive to stress; these individuals may use drugs as a coping mechanism. These people are at higher risk for continued opioid addiction including replacement drugs, such as Subutex.

A hypersensitive parent may pass this trait to an offspring, increasing the child's risk for addictive behaviors later in life. Children learn how to cope with stress by observing their parents; a child may inherit a parent's unhealthy coping mechanisms and do drugs when he is under pressure later in life.

Family members should know that, while they cannot change genetics, they could reduce everyone's risk for addiction by resolving environmental stresses within the home. Counseling gives families the tools they need to communicate more effectively without resorting to arguments or violence. Families can also examine workloads and distribution of household chores and childcare so that no one person feels undue stress.

Collateral Damage

Unlike many other diseases, Subutex addiction puts your entire family in danger. Your spouse, parents and children, suffer from the collateral damage of this disease.

Subutex addiction steals money from your family. Addiction diverts funds that were supposed to buy groceries, medicine or pay the rent to get more drugs. Additionally, Subutex addiction and other substance abuse interfere with job performance. Left untreated, your long-term Subutex addiction may result in reduced hours or even loss of a job.

Subutex addiction drives up medical costs, especially if it results in overdose or an infectious disease commonly associated with drug use. Without insurance, an infectious illness can be financially devastating.

Subutex addiction also robs the family of time and compassion. This disease may prevent you from giving the guidance, support and financial care your child needs.

Subutex addiction might cause you to associate with people you would have previously avoided. Doctor shopping, filing phony prescriptions or other drug-seeking behaviors stop working after a while; eventually your addiction will force you to get Subutex from drug dealers. In the early stages of your addiction, you do not allow drug dealers near your family but, as your disease worsens, you drop your defenses and invite criminals into your home to get high or to buy and sell drugs. This endangers everyone in your home.

Some individuals resort to crime to pay for Subutex. Long-term criminal activity usually ends in arrest, jail time and conviction. Prison takes countless years away from drug addicts.

Caring for a Family Member with a Subutex Addiction

Addiction to Subutex or other opioids is extremely difficult for everyone in the family. It is important to remember that your loved one relies on support for a successful recovery. A family can work together to develop a treatment plan, with every member participating in recovery. The family unit should meet frequently, with or without the addicted individual, to discuss progress.

It is common for the family to have located the treatment facility in which the addicted individual ultimately participates. Family members should encourage the individual to seek and complete treatment for his Subutex addiction.

It is possible to arrest the disease's progress at any time. Continue to urge your loved one to seek out and complete treatment, even when all seems lost. Do not let your loved one hit rock bottom. Addiction causes collateral damage and health hazards that your family can avoid with early treatment. Collateral damage includes job loss, financial disaster, legal trouble and relationship problems.

Recovery often begins when the individual recognizes the problems addiction causes. It is often tempting to protect a loved one from pain, but this further enables his addiction. It is critical that the addicted individual become aware of the consequences of Subutex addiction.

The treatment and recovery experience works best when the individual feels physically, emotionally and spiritually safe in his home environment. Family members should recognize addiction as a disease and avoid blaming the individual for his illness.

Symptoms of Addiction

Physical Symptoms

Physical symptoms of drug addiction include:

  • Unexplained Weight Gain or Weight Loss
  • A Change in Sleep Patterns
  • Deteriorating Physical Appearance - Looks Sickly
  • Nagging Cough
  • Diminished Hygiene Care
  • Body or Clothing May Have an Unusual Odor
  • Bloodshot Eyes with Large or Small Pupils
  • Tremors
  • Slurred Speech

Psychological Symptoms

Psychological symptoms of addiction to opioids include:

  • Inability to Abstain Consistently.
  • Impairment in Behavioral Control.
  • Cravings for Drugs or Intense Reward Experiences.
  • Diminished Capacity to Recognize Significant Personal or Relationship Problems.
  • Dysfunctional Emotional Response.

Treatment Options

The American Society of Addictive Medicine warns that addiction can cause "disability or premature death, especially when left untreated or treated inadequately."

Treatment for Subutex addiction has two phases: detoxification and rehabilitation. Detoxification is the process of lowering the level of Subutex in your body. When you go through the detoxification process, you can expect five or more days of intense withdrawal symptoms as your body adjusts to the lack of Subutex.

Rehabilitation addresses the cognitive and behavioral aspects of your Subutex addiction. The rehabilitation phase of your treatment usually includes behavior modification and counseling to help you learn how to live without Subutex.

Detoxification

Many people receive Subutex to help them overcome addiction to other opioids. Just over 5 percent of admissions to publicly funded substance abuse programs were for treatment of opioid abuse; because patients can take Subutex therapy as an outpatient, they do not need to be admitted to an inpatient facility.

Self-Detoxification

After successfully overcoming addiction to the first opioid and participating in some amount of behavioral modification, the individual must then wean himself from Subutex. Many people try to quit alone, without the help of medicine to reduce withdrawal symptoms, in a process known as self-detoxification. This is sometimes called "going cold turkey," named for the cold, clammy, bumpy and pale appearance the skin takes on during detoxification.

During self-detoxification, you will experience uncomfortable withdrawal symptoms commonly associated with opioids, such as diarrhea, abdominal pain, cold sweats and muscle pain. Subutex withdrawal symptoms usually begin several hours after the last dose and peak on or about the sixth day but can last longer.

Without proper medical assistance, you may suffer dangerous complications. For example, she can vomit and inhale stomach contents, a complication known as aspiration. Aspiration may result in pneumonia or lung infections. You also risk dehydration from excessive vomiting and diarrhea. The complications and overwhelming symptoms of withdrawal cause many people who attempt self-detox to relapse to Subutex or other opioid use.

The Thomas Recipe

Other people use a variety of products that reduce the withdrawal symptoms during self-detoxification. Once such homemade treatment plan is The Thomas Recipe, in which a person takes prescription medication to reduce anxiety and induce sleep, a product to ease diarrhea plus vitamins and supplements to soothe muscle aches and fatigue.

While these recipes can reduce withdrawal symptoms associated with Subutex addiction, you face the same dangerous complications as without medication. Furthermore, self-detoxification addresses only the physical aspects of Subutex withdrawal; self-detox does not deal with the behavioral aspects of your addiction. This gap in the treatment plan increases the risk for relapse or overdose of Subutex or other opioids.

Overdose

Relapse is the largest complication associated with quitting Subutex and other opioids. Detoxification process lowers the body's tolerance to the opioid component of Subutex. This means you can accidently overdose on a lower dose of Subutex than you used to take before she attempted detoxification.

Overdose symptoms include:

  • Extreme Drowsiness
  • Pinpoint Pupils
  • Nausea
  • Vomiting
  • Diarrhea
  • Confusion
  • Ringing in the Ears
  • Cold, Clammy Skin
  • Muscle Weakness
  • Fainting
  • Weak Pulse
  • Slow Heart Rate
  • Coma
  • Blue Lips
  • Shallow Breathing or No Breathing

Overdose is a serious, life-threatening emergency that requires professional care. In the emergency department, doctors administer naloxone and other medications to reduce opioids to non-toxic levels quickly. Once your Subutex levels are within safe levels, you can continue your behavioral therapy program as an outpatient.

Drug Replacement Therapy

Doctors regularly prescribe Subutex as part of outpatient drug replacement therapy, or DRT. Other DRT medications include methadone, Suboxone or buprenorphine. These drugs bind to the same opioid receptors in the central nervous system as opioids and Subutex do in a way that reduces withdrawal symptoms. DRT medications including Subutex last longer than other opioids, such as oxycodone or codeine, and do not produce the euphoric effects. DRT medications allow you to participate in treatment without a hospital stay.

Supporters of using Subutex as DRT recognize the flexibility of outpatient treatment while opponents say it is merely trading one addiction for another. Some patients struggle with their Subutex for years, unable to free themselves from drug addiction. Harvard Medical School cites estimates that 25 percent of DRT methadone patients eventually abstain, another 25 percent continues to take the drug and 50 percent go on and off methadone.

Subutex is just one type of Medically-Assisted Treatment, or MAT, in which physicians administer drugs to lower opioid levels and reduce withdrawal symptoms. Standard detoxification and rapid detox are other types of MAT.

According to the Substance Abuse and Mental Health Services Administration, or SAMSA, Subutex or DRT intervention:

  • Improves Survival Rates
  • Increases Retention in Treatment Programs
  • Decreases Illicit Opioid Use
  • Decreases the Risk for Hepatitis and HIV
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Inpatient MAT programs use medicine that ease withdrawal and facilitate detoxification from Subutex use. During detoxification, physicians administer some medications to decrease the level of Subutex, plus other drugs that relieve the resulting symptoms of withdrawal. Medical personnel observe patients for dangerous complications, such as dehydration or aspiration, and take lifesaving measures whenever necessary. While detox eases the physical aspects of addiction, individuals must still endure the demoralizing process of detoxification from the effects of Subutex.

Rapid detox is the most humane method of detoxification from Subutex addiction. During rapid detox, board-certified anesthesiologists administer standard detoxification and anti-withdrawal medications alongside anesthesia and sedatives so that the patient dozes in a comfortable "twilight sleep" rather than battle uncomfortable withdrawal symptoms. When the patient awakens a few hours later, he will have no memory of the grueling and demoralizing detoxification and withdrawal period. He can now complete the rehabilitation process.

Rehabilitation

Subutex detoxification is only one aspect of treatment for opioid dependence and, by itself, does little to change long-term drug abuse. Successful recovery from Subutex addiction includes continued rehabilitation and behavior modification. Subutex addiction is a complex disease that affects brain function and behavior. Individual, family and group counseling, along with other behavioral therapy are a large part of successful treatment for Subutex addiction. While no single therapy works for everyone, treatment does needs to be readily available to be effective.

The most effective treatment must attend to the complex and multiple needs of the individual, and not just focus on his addiction to Subutex. Many drug-addicted individuals also have other mental disorders that prevent or slow the recovery process.

Subutex is an important element of treatment for many patients, especially when therapists combine Subutex with counseling and other behavioral therapies.

Everyone experiences addiction in a slightly different way - no two addictions are alike - so rehabilitation specialists have developed a wide variety of treatment plans that fit the complex needs of each individual. No single treatment is right for everyone.

Treatment facilities vary from outpatient counseling centers to long-term, residential programs. Most programs will include individual, family and group counseling and other behavioral therapies. Many therapies include medications combined with behavioral modification and counseling. It is common for those facing Subutex addiction also struggle with other mental issues, such as depression, that could benefit from medication. Rehabilitation will address your multiple needs, just your Subutex addiction.

No matter what form of therapy or facility you choose, treatment must be readily available and convenient to encourage you to participate long enough to restore neurological function that results in meaningful physical and behavioral changes.

Your counselor is a valuable asset in your rehabilitation. Your counselor will assess and monitor your condition and modify your treatment plan accordingly. During the course of your treatment, your counselor will continuously monitor for drugs, as relapses do occur.

Your rehabilitation specialist will request testing for the HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. She will also help modify or change behaviors that increase your risk of contracting or spreading infectious diseases.

Treatment does not need to be voluntary to be effective. According to NIDA, individuals under legal coercion tend to remain in treatment longer than and do better than those not under pressure.