Questions & Answers
- What is
Buprenex (Buprenorphine, Suboxone,
Subutrex) is a narcotic drug that was first
introduced as an injectable painkiller. For whatever
reason, Buprenex was not popular in the United States as a
- Buprenex is a
partial agonist and a partial
antagonist. What does this mean?
Buprenex both stimulates the
opiate receptors of the brain producing pain relief, and at the same time, blocks the receptors,
decreasing addiction. Although no one quite
understands how it does this, having agonist and
antagonist properties allows for a more comfortable opiate
- What are the
properties of Buprenex that make
Buprenex has partial agonist and
partial antagonist actions and also a very long duration.
These properties make it a useful drug in some
circumstances. First, it is hard to overdose on it because
the antagonist quality kicks in at higher doses. Second,
Buprenex does not produce as much of a high as heroin
making it less addictive. Third, because of these
properties, it seems to taper itself fairly well meaning
it is easier to taper off than a drug like methadone. Due
to these properties, the FDA has approved Buprenorphine under the trade names Subutex and Suboxone, to be prescribed by specially
trained MDs as both a detoxification drug and a
You have found that you are
unable to just stop using opiates. We can convert you
painlessly from a opiate habit to a Buprenorphine habit and
you will be able to just stop using Buprenorphine without
too much difficulty. The way this is done involves taking
Buprenorphine FOR THREE DAYS. Buprenorphine is
administered by a sublingual tablet or injection. If you use the Buprenorphine
intravenously it may cause or worsen withdrawal symptoms.
It is important that you start the Buprenorphine only after
you are feeling uncomfortable. The preferred
method is not to use any opiates after midnight, and use the
Buprenorphine as your "wake-up" in the morning when you are
Prescription medications are
provided for use with the Buprenorphine, and after the
Buprenorphine is finished, if needed. These pills can lessen
the severity of withdrawal symptoms. For additional
medication, you MUST return to the office. Other
medications are available but you must return to the office
for another visit. DO NOT CALL FOR PRESCRIPTIONS.
After a three to four day
taper of Buprenorphine 80% of opiate withdrawal
symptoms is complete. It is a good idea to continue
smaller doses of Clonidine for the next week or two to help
with very mild withdrawal symptoms and/or sleep. Many
people are able to taper off of their opiate habit with
Suboxone and then are able to maintain their sobriety with
behavioral guidance and counseling. Oftentimes a
significant change to one's habits, lifestyle, and friends
opiate withdrawal, a person can remain opiate free.
Sometimes, even with the best medical care and behavioral
guidance, a person does not remain opiate free.
Possibly secondary to mental addiction, pain, and fatigue a
person finds himself repeatedly relapsing on opiates.
For this person Suboxone maintenance is available.
Suboxone maintenance involves taking a small dose of
Suboxone and a daily basis. The daily dose of Suboxone
helps curb the craving for opiates. Suboxone causes
much less dependence and tolerance towards the opiate.
We have had patients take Suboxone for over two years now
without increasing the dose and without feeling poorly.
Only monthly visits are required to the doctors office.
Unlike methadone, it is very difficult to use other opiates
with Suboxone. Also unlike methadone it is easier to
taper off of Suboxone than off of methadone. The cost
of this treatment averages $300-$500 per month depending
upon the dose of Suboxone required. If only
taking Suboxone, most urine drug screens will be negative
which is good for work-related situations as well as legal