What happens if you inject subutex

Jump to content. Keep the medication in a place where others cannot get to it. Using this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn. Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

This medication guide provides information about the Buprenex brand of buprenorphine injection. Sublocade is another brand of buprenorphine injection used to treat opioid addiction. If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born.

Babies born dependent on opioids may need medical treatment for several weeks. Buprenex can pass into breast milk and may harm a nursing baby. Do not breast-feed while you are using Buprenex. Buprenex is injected into a muscle or given as an infusion into a vein. A healthcare provider will give you this injection. Buprenex is usually given by injection only if you are unable to take the medicine by mouth or use another form of buprenorphine. Buprenex is usually given at evenly spaced intervals, up to 6 hours apart.

Tell your doctor if Buprenex does not relieve your pain within 1 hour after an injection. This medicine can cause irritation if it gets on your skin. If this occurs, remove any clothing the medicine has spilled onto, and rinse your skin with water. Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. Selling or giving away opioid medicine is against the law.

Seek emergency medical attention or call the Poison Help line at An overdose of Buprenex can be fatal, especially in a person using the medicine without a prescription. Overdose symptoms may include extreme drowsiness or weakness, cold or clammy skin, slow heart rate, weak pulse, very slow breathing, or coma.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Get emergency medical help if you have signs of an allergic reaction : hives; difficult breathing; swelling of your face, lips, tongue, or throat. Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated. Long-term use of opioid medication may affect fertility ability to have children in men or women.

It is not known whether opioid effects on fertility are permanent. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:. This list is not complete. Twenty patients At weeks one, two and three, seven, three and six patients, respectively, showed signs of IV abuse of buprenorphine Subutex or Suboxone.

Three patients who had records of IV-misuse at baseline did not continue misusing during the 4-week follow up period, and three new patients with IV-misuse were observed during this period. Over the 4-week study period, there was no evidence of misuse of other opioids. During the follow-up period the total number of incidents of IV opiate abuse remained at the same, 10 patients were recorded as showing signs of intravenous buprenorphine Subutex or Suboxone misuse and 1 patient informed the investigator that he had used heroin.

One patient tested positive for codeine, which was permitted for a known complaint. Of the buprenorphine IV abuse, Suboxone was misused intravenously once each by 4 patients and twice by 1 patient. These 5 patients all reported that injecting Suboxone was like injecting "nothing" with any euphoria or that it was a bad experience. Four of them reported also that while they tried to inject Suboxone, they would not repeat the experience. The highest rate of compliance occurred at Centre Raahe where all patients used Suboxone treatment throughout the 4-week study period.

During the 4-week observation period, approximately half the patients were satisfied with Suboxone treatment. At centre HDL, patient satisfaction was Clinic visits across the centers varied from once per week to five visits per week. The switch from Subutex to Suboxone did not change the frequency of visits, and frequency did not change over the 4-week study period. Twenty-four patients The 14 other patients Twenty-six of the 27 patients During the four week study period, 32 of the 64 patients Gastrointestinal adverse events were the most commonly reported adverse events.

Nausea and gastrointestinal pain were the most common adverse events, being experienced by 13 Other common adverse events were fatigue 8 patients, During the 4-month follow-up period, 16 patients One patient discontinued treatment with Suboxone during the 4-week study period due to adverse events, and 5 patients discontinued due to adverse events during the follow-up period.

There were no deaths or other serious adverse events reported for patients in the study. There was no apparent relationship between the average Suboxone daily dose taken during the 4-week study period and the reporting of adverse events.

The study has several limitations. Due to the retrospective nature of the study, there were no control groups and the results are only descriptive. However, the patient data were used to assess any general trends associated with the switch to Suboxone, which may provide an insight into the best clinical practices for using Suboxone as a replacement for Subutex. A survival analysis of the client characteristics and history regarding the time to drop out could have been interesting.

Given the relatively small sample size and the scope of this study, however, this sample may not have sufficient power to detect any but the strongest patterns. Satisfaction and compliance differed significantly amongst the treatment centers, thus site specific issues might account for findings also.

The main aim of this study was to follow the medication dose and adverse events during a transfer from buprenorphine to buprenorphine-naloxone combination.

The possible dose adjustments were decided by the doctors and were based on each individual's weaning, withdrawal symptoms and adverse events. However, only one patient discontinued Suboxone due to adverse events or dissatisfaction, and one patient left the treatment program retention rate of This indicates that the side effects at this point probably might not predict patients' likelihood of staying in treatment.

Indeed, patient records indicate that many of the reported adverse events were interpreted as being the result of anxiety about being forced to switch to Suboxone. However, it is notable that during 4 month follow up period only It should be noted anxiety interpretation is more of a speculation than measured assessment. Interestingly, over half of the patients still on Suboxone during the 4 month follow up asked for a dose reduction of Suboxone. This may indicate that the adverse events could be related to higher buprenorphine serum levels, because buprenorphine in Suboxone has slightly higher sublingual bioavailability than the buprenorphine in Subutex [ 6 ].

The dose reductions of Suboxone were mainly done during the follow-up period which may indicate that bioavailability of high dose of Suboxone in the long term should be more thoroughly investigated. It should be noted, however, that the earlier Australian study [ 5 ] had found a need for a dose increase, rather than a decrease, when switching from buprenorphine to the combination medication, that could be related to the "low" 12 mg average dose of Suboxone in that study.

During the follow-up period relative high number of patients Most of them were either transferred to methadone The most common reason for methadone transfer generally in Finland is polydrug abuse. It is possible that psychiatric distress, when patients did not feel confident with the forced transfer from Subutex to Suboxone, may lead to "illegally top-up" with Subutex, that in turn could lead to medication change to methadone.

It is possible also, that because the high illicit use of buprenorphine in Finland [ 5 ], the treating personnel had a mistrust on patients reports of Suboxone adverse events, and instead of chancing back to Subutex patients were changed to methadone. Thus, the "forced" transfer event could be a unique situation in Finland and may not be present elsewhere i. Switching from Subutex to Suboxone did not increase abuse of other opioids. Based on the retrospective nature and small numbers in the study, no solid conclusions about Suboxone diversion can be done.

However, interestingly during the follow-up period of the 60 opioid dependent patients, only 5 patients attempted to misuse Suboxone. Furthermore, they reported that while they tried to inject Suboxone, they would not repeat the experience, suggesting that the transfer to Suboxone may also serve as part of an overall strategy to curb misuse of buprenorphine. In conclusion, a transfer from Subutex to Suboxone should be carefully discussed and planned in advance with the patients and after the transfer adverse events should be regularly monitored.

With regard to buprenorphine abuse, the combination product seems to have a more favorable safety profile than treatment with buprenorphine alone. The results of this study suggest that in high dose Suboxone treatment, dose adjustments should be considered, especially in the later phase of the treatment, if patients report an unusually high number of adverse events.

Also based on the clinical data gathered it is recommended that transfers should be discussed and planned in advance with the patients to minimize psychiatric distress and lack of compliance leading to lower retention rates. Psychopharmacology Berl. Drug Alcohol Depend. Drug Alcohol Rev. Article PubMed Google Scholar. Download references. We thank the data collecting physicians Drs. You can also search for this author in PubMed Google Scholar. Correspondence to Hannu Alho.

Reprints and Permissions. Simojoki, K. Subst Abuse Treat Prev Policy 3, 16 Download citation. Received : 27 September Accepted : 17 June Published : 17 June Anyone you share the following link with will be able to read this content:.

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Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background In Finland, buprenorphine Subutex is the most abused opioid. Methods Data from a retrospective study involving five different treatment centers, examining the effects of switching patients to Suboxone, were gathered from 64 opioid-dependent patients who had undergone the medication transfer.

Results Most patients