Subutex contains buprenorphine, the active partial agonist used to treat patients with opioid use disorder (OUD). Like all opioids, it can cause withdrawal if stopped abruptly.
Subutex withdrawal should be managed by a doctor. They will likely recommend a Subutex taper until you can stop use without experiencing withdrawal.
Some people take Subutex long-term as part of an ongoing addiction recovery treatment, though Suboxone is more commonly used. Both medications contain the same active ingredient: buprenorphine. The withdrawal syndrome for both medications is the same.
Subutex is a brand name for buprenorphine.[1] Buprenorphine is a partial opioid agonist, acting in many ways like other opioids such as methadone and heroin, but with a milder effect.
While buprenorphine can control withdrawal symptoms and cravings associated with opioids, it is still an opioid medication. It can cause dependence in some people, albeit usually much less severe than that associated with full opioids.
Withdrawal occurs when a person stops taking buprenorphine abruptly after their body develops dependence on it. If the person tapers off the medication, which involves slowly reducing the dose over a period of time, Subutex withdrawal can be largely avoided.
Without proper care from your doctor, quitting Subutex can result in uncomfortable withdrawal symptoms. If you've tried to quit heroin, oxycodone or another opioid cold turkey, you've likely felt these symptoms before.
In one small study of people withdrawing from buprenorphine products, symptoms began within 48 hours, peaked at three days and lasted up to 10 days.[2]
In a separate study of people withdrawing, including people who used other substances, symptoms peaked at 21 days.[3]
While the length of withdrawal varied significantly between the two studies, both sets of people rated their symptoms as mild, not severe.
Your withdrawal could be longer than average due to the following factors:[4]
Subutex tapering involves working with a doctor to slowly reduce your medication dose without enduring significant withdrawal symptoms. Taper length varies from person to person.
Your doctor will start by determining your current dose and cutting that amount just a bit. You’ll keep track of withdrawal symptoms, and if they are tolerable, you’ll take that new dose until they disappear.
For some people, this process is completed in weeks. Other people need months to finish. You must work with your doctor to find a schedule that’s right for you.
Symptoms of Subutex withdrawal can include the following:[5]
These symptoms often don’t occur if a person only takes Subutex as prescribed and follows a doctor-recommended tapering dose when seeking to get off the medication. Withdrawal is much more likely if a person stops taking the medication abruptly rather than tapering their dose.
Typically, buprenorphine withdrawal is avoided by slowly tapering the drug dose instead of stopping it abruptly. However, some patients may experience withdrawal symptoms even with a slow taper.
If this is the case, other medications could help, including the following:
These medications could treat withdrawal symptoms, such as headaches, tremors, stomach cramps, nausea and diarrhea.
Buprenorphine is often used in a Medication for Addiction Treatment (MAT) program to help people stop misusing opioids.
If you experience withdrawal side effects or cravings to return to opioid use upon discontinuing buprenorphine, discontinuation may not be right for you.
Many people stay on buprenorphine therapy long-term (sometimes even all their lives) to prevent cravings for opioids and withdrawal symptoms.
If you decide to continue or discontinue your Subutex, talk to your doctor before trying to stop “cold turkey.” You need help to wean off the medication slowly to make the process as comfortable for you as possible.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
