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How Long Does Subutex Stay in Your System?

Subutex got approved in 2002 for the treatment of opioid dependence. It is used as an opioid replacement agent to reduce the intensity of withdrawal symptoms of opioidergic drugs such as heroin and Oxycodone. It is a very useful drug during the treatment process of addiction to stronger opiates. An active ingredient of Subutex is Buprenorphine. It acts as a partial agonist on the mu-opioid receptors and also modulates the functions of delta receptors and kappa receptors. Many studies confirmed the addictive nature of Subutex. People taking it for attenuating the withdrawal effects of opiates can become addicted to it. It is important to carefully monitor the doses with respect to its half life and duration of drug stay in the body.

How long does Subutex stay in your system?

When a person quits Subutex, a series of Withdrawal symptoms begin to appear. Medical detox is a useful and safe option to get rid of the drug with a minimum exposure to painful symptoms. Many people contemplate as for how long the drug will stay in their system. Subutex is composed of an active component, Buprenorphine. It is important to consider the half-life of Buprenorphine to establish the time it stays in the system for.

Buprenorphine has a half-life of about 37 hours. So, we can assume that 50% of the drug will be eliminated within 37 hours. For the removal of 100% of the drug, it will take around 8.5 days. In some research studies, a much longer duration of 10 days has also been reported for the complete clearance of the drug. Even by the 10th day, all the components of Subutex are not excreted as Buprenorphine breaks down to form Norbuprenorphine. This metabolite takes a longer duration to get cleared from the system. The estimated half-life of Norbuprenorphine is 57 hours. It means it will take approximately 13 days to get cleared after the last dose.

Factors that influence how long Subutex stays in your system:

The time taken by Subutex to get eliminated from the system is about 8.5 days. This is not an absolute figure and is subjected to individual variations. Some of the factors affecting the Subutex clearance from the body include individual attributes, duration of use, frequency, and the use of other medicines or supplements.

Individual Factors:

  • As the person grows older, the metabolism gets slower. Young people have a more efficient hepatic metabolism.
  • Body Size: Larger people can clear the drug more swiftly. It is based on height and muscle mass. A high-fat percentage acts as on contrary and slows down metabolism to a significant extent.
  • People who have better expression of CYP3A4 enzymes act as ultra rapid metabolizers. This is guided by the genetic makeup of a person.
  • A proper hydration can ensure a fast drug regulation and excretion.
  • Liver functions: Any type of hepatic impairment can attenuate the metabolism of Subutex.
  • Metabolic Rate: A high metabolic rate acts as beneficial factors in improving the rates of drug excretion from the system.
  • Urinary Ph: An acidic or low urine Ph facilitate the excretion of Subutex from the system.

Duration of Use:

The chronic users of Subutex exhibit slower metabolism of the drug. There are two basic reasons behind it.

  • Subutex tends to accumulate in the fat tissues that requires more time to be removed from the system
  • The body develops a physiological adaptation to the presence of drug in the body.

Dosage amounts of the drug:

Higher doses require much longer time to get eliminated compared to lower doses. The load on liver increases and a proportional speed is needed to clear the system. All the enzymes are present in a limited concentration in a human body.

Co administration of Drugs:

Some substances tend to speed up the metabolism by increasing the efficiency of concerned hepatic enzymes. Such medicines include Carbamazepine, Oxcarbazepine, Modafinil, Rifampicin, and Phenobarbital. Some drugs can inactivate the functions of isoenzymes. These include Clarithromycin, Indinavir, Chloramphenicol, Ritonavir, and Ketoconazole. So taking the enzymes inducers can speed up the process of drug removal while on the other hand, enzyme inhibitors can significantly increase the time taken for its removal.

Subutex absorption, metabolism, and excretion:

Subutex is available in the sublingual tablet forms. As soon as it is kept under the tongue, the active ingredients start to diffuse through the mucous membranes and enter the systemic circulation. The absorption is not governed by the time duration for which the tablet is placed under the tongue. It is rapid and the action starts within few minutes.

Buprenorphine undergoes first pass metabolism in the liver. The CYP3A4 isoenzymes facilitate the N-dealkylation to form the Norbuprenorphine. The CYP2C8 enzymes also play some role in the metabolism. Due to first pass effect, the bioavailability of the drug reduces to 31%. The peak concentrations of the drug in the blood are reached within 40 minutes- 3.5 hours.

Buprenorphine binds to the plasma proteins. A total of 96% of Subutex binds to the plasma proteins. Due to a lipophilic nature, it is distributed throughout the body. The drug continues to accumulate in blood and the tissues until a steady state concentration is achieved. Buprenorphine undergoes glucuronidation by UGT2B7 and UGT1A1 to produce buprenorphine-3-glucuronide. The glucuronidation of Norbuprenorphine is done by UGT1A3 and UGT1A1 to produce norbuprenorphine-3-glucuronide (N3G). The majority of glucuronides are excreted through bile and feces. Only 10-30% is eliminated through urine.

Different types of Subutex drug tests:

Numerous drug tests are available for the detection of Buprenorphine and Norbuprenorphine in the body. Buprenorphine is not tested via the standard SAMHSA-5 screening and more advanced tests are needed to detect the components of Subutex. Some of the tests that can be utilized for this purpose include urine tests, blood tests, hair tests and salivary tests.

  • Urine Tests:

Buprenorphine does not metabolize into morphine that is why it cannot be detected on the standard SAMHSA-5 screening tests. However, extensive urinalysis can detect the drug levels in the urine. The minimum identifiable value of Buprenorphine is 5 ng/mL. People abusing Subutex over long durations have demonstrated a level of over 160 ng/ml in their urine samples. The liquid chromatography/mass spectrometry (LC/MS) provides the more accurate results of Buprenorphine levels in the urine samples.

Urine tests are the preferred type of drug tests since they are non-invasive and they provide a long window of detection. Buprenorphine becomes detectable in urine within 40 minutes and remains so for up to 2 weeks after the final dose. The chronic users will display more amount of the drug in their samples compared to the short-term users.

  • Blood Tests:

The blood samples are collected from the users for the detection of Subutex and its metabolites. Due to the invasive nature of the blood tests, they are considered as inconvenient and are not utilized on the routine basis. Following the drug administration, the drug content becomes detectable in blood within minutes and stays so for up to a week. The drug is easy to detect when the peak concentrations are reached, which occurs in about 40 minutes-3.5 hours of drug use. The trace amounts of drug have been detected for weeks after the last dose. The high-performance liquid chromatography/mass spectrometry (HPLC/MS) technique can pinpoint even the minute amounts of Buprenorphine in the blood stream. Norbuprenorphine stays for the long duration so the metabolite can be preferred for testing over Buprenorphine.

  • Hair Tests:

Buprenorphine gets accumulated in the hair follicles of long term users so hair tests are another option for the detection of the drug and its metabolites. The only problem is that the drug takes some time for accumulation in hair. The major advantage also comes here; the drug remains detectable for quite a long duration after the last dose. In most cases, it remains detectable for up to 3 months. The research studies confirmed the presence of 105.2pg/mg Buprenorphine and 156.8 pg/mg Norbuprenorphine in the hair follicles of chronic users of drug.

The color and length of hair follicles can influence the results of the hair tests. The proximal segments retain the greatest amount of drug and brown or black color gives more accurate results.

  • Saliva tests:

The oral fluid sampling is another useful technique to detect Subutex. Samples of oral fluid are collected and sent to the laboratory for the analysis. As the route of administration is sublingual, test results are more accurate and yield similar results as the blood samples. The drug remains detectable for about or even longer in case of chronic users. A rapid detection is made as the drug diffuses into the salivary fluid. In the future, many more advancements in salivary testing are expected that will increase the utility of salivary tests. Intoxicated patients can also be checked by the collection of salivary samples.

Tips to clear Subutex from the system faster:

Some tips that can prove to be helpful in increasing the elimination time of Subutex include:

  • Quit taking the drug: A complete stoppage can only ensure that the body can be free of the drug within few days duration.
  • Burn fats as the drug exhibits a lipophilic nature. It gets accumulated in the adipose cells.
  • A CYP3A4 induction with the help of certain substances is another useful way. Though, it must be medically checked before consumption.
  • Activated charcoal helps to bind the unabsorbed drug. It further stops the absorption of any drug particles into the systemic circulation.