Suboxone Detox Treatment Doctor

Stephen Gilman, M.D. - Addiction Psychiatrist in New York



Subutex Buprenorphine Detox

Subutex is the formulation of buprenorphine that does not contain the naloxone (Narcan). It does have advantages over the Suboxone formulation.

If you are addicted to one of the longer acting opiates, such as MS Contin (morphine), Oxycontin (oxycodone) or methadone, then the inital detox is might be done with Subutex as oppossed to Suboxone.

This is because if you are addicted to these longer acting opiates you can be more sensitive initially to the naloxone. And it could potentiate some initial witdrawal symptoms. Since each case is unique, you need to have a thorough initial evaluation to see exactly which of these forms of buprenorphine is right for your circumstance.

Would I Take Subutex The Same As Suboxone?

The answer is yes. The only thing different is the lack of the naloxone.

So you still need to be off your opiate for enough time and start to experience the appropriate amount of withdrawal symptoms. Your treating physician would guide you in when its right to start the medication. And your physician should be available to you during the day for at least the first few days to help determine exactly what your dose should be.

Do I Always Stay On The Subutex, Or Do I Get Switched To Another Form Of Buprenorphine?

Generally speaking, the Subutex would be used just for the initial phase of treatment. If you are just getting a detox (not longer term maintenance treatment), then your physician might just use the subutex for the entire process. Another option might be to switch you to Suboxone near the end once you're stabilized.

If you are going for suboxone maintenance treatment, then the usual course is to switch you from Subutex to Suboxone once you are stabilized on your dose - meaning no more withdrawal symptoms or opiate cravings. The reason that most people are switched is because of that concern the DEA and FDA have about some people trying to divert the buprenorphine for illicit purposes.

In my experience, the transition from one form of buprenorphine to the other is smooth.

I'm pregnant - Is Subutex A Better Choice?

This is actually another case where Subutex would be the better choice - both for detox and longer term treatment. The reason is that the naloxone has the possibility of inducing birth defects. Buprenorphine itself, as Subutex, has a lower risk of causing birth defects - but it is NOT risk free for pregnant women.

This is an important concern, so make sure you thoroughly discuss it with your treating physician. In some cases, buprenorphine treatment might NOT be appropriate if there is the possibility of pregnancy.

How Long Does A Subutex Detox Take?

This also depends on the amount of opiates you are using, and whether they are short acting or long acting. For the shorter acting opiates - Vicodin (hydrocodone), Codeine, Percocet, heroin - a complete detox can be done in few weeks. For them your physician could use either Subutex or Suboxone.

Yes, there are some docs who do it ultra quick - some in just a fews days. I don't recommend this and find that it is uncomfortable for the patient. Think about it. Is there really that much of a rush to get it done? I always recommend taking the extra time and doing the process as comfortably as possible.

For the longer acting opiates - Oxycontin (oxycodone), methadone, MS Contin - it can tale longer to get you fully stabilized on the medication. And for these drugs, it's might be better to use the Subutex form.

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Buprenorphine Treatment