Subutex Maintenance Programs

Subutex, whose generic name is buprenorphine, "is an opioid partial agonist," according to the Substance Abuse and Mental Health Services Administration website. It is a prescribed drug used in the treatment of opiate addiction.



Subutex maintenance programs vary according to the severity of addiction and the length of time the addict has ceased abusing opiate drugs, such as morphine and heroin. Administration must be carefully controlled, because there is potential for the Subutex to also be abused.

Induction Phase

• The induction phase begins in the first 12 to 24 hours of opioid withdrawal.

  The induction phase refers to the controlled administration of Subutex during the early stages of opiate withdrawal --- usually 12 to 24 hours. The patient is administered a starting dose of Subutex under a doctor's observation. Relief from withdrawal symptoms can occur within 20 to 40 minutes of taking the drug. A later dose may be administered in the evening, according to the Suboxone website. (The Suboxone website is a useful source of information on Subutex and another buprenorphine preparation called Suboxone.) If the withdrawal symptoms are fully alleviated, the starting dose is kept the same. Otherwise, it may need to be increased by 2 mg or 4 mg. This observation is continued on Days 2 and 3, with the dose either kept the same, or increased if it is not effective in alleviating the withdrawal symptoms.

Stabilization Phase

• The stabilization phase supports the patient in the middle stage of opiate withdrawal.

  The stabilization phase begins when the patient has either completely discontinued or greatly reduced her consumption of the drug that she has been abusing. According to the Substance Abuse and Mental Health Services Administration website, Subutex has a long half life. Because of this, if the withdrawal symptoms are well controlled and the patient reports that her cravings for opioids have ceased, it can be administered on alternate days.

  The stabilization phase should ideally be achieved within one to two weeks of beginning treatment. According to the Suboxone website, there is a risk of overdosing on concurrent abuse of benzodiazepines.

Maintenance Phase

• The maintenance stage supports the patient to completely detoxify.

  The maintenance phase refers to a period of time when the patient is doing well on a steady dose of Subutex, and is not using/has no cravings to abuse other opioid drugs. The length of the maintenance phase is individual, and is the preparatory stage for complete detoxification from opiate-based drugs. Realistic targets for reduction in the dose of Subutex are planned, and the patient is monitored for deterioration in mental health as the dose is tapered off gradually.