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The National Alliance of Advocates
for Buprenorphine Treatment

Buprenorphine (Suboxone®, Subutex®3, Zubsolv®4, Bunavail™5, Probuphine®6) is an opioid medication used to treat opioid addiction in the privacy of a physician's office.1 Buprenorphine can be dispensed for take-home use, by prescription.1 This, in addition to the pharmacological and safety profile of buprenorphine, makes it an attractive treatment for patients addicted to opioids.2

What are the pros and cons of detoxification under anesthesia (Rapid Detox)?


Pros: Treatment is administered in the intensive care unit where there are experts available to mange the intense symptoms of the induced withdrawal such as seizures. The medical professionals who perform this method of detox are experienced in it.

Cons: It is not sufficient treatment for the brain disease of addiction. Detoxification is only the first step of a recovery, removing the opioids from the body does not do anything to treat the brain disease of addiction. Changes to the structure and function of the brain due to addiction may persist for months and if not treated usually result in relapse. Detox does not eliminate the cravings, and does not address the problems that lead to the addiction in the first place, unless psychosocial care is employed after the actual detoxification. It is physically dangerous, which is why it is done in an intensive care unit, and it is very expensive making it unavailable for most people. Modern addiction treatments have made a detoxification phase obsolete and not necessary, instead patients can transition directly to the treatment medications. It is difficult to find data that reports the long-term outcomes of patients who are treated with inpatient detoxification. Proponents offer their own selected patient survey results as their only evidence as to efficacy. This method of detoxification is often a high profit private enterprise. Real data as to actual efficacy especially over time is extremely difficult to obtain or validate. There is credible data that shows reasons not to use rapid detox.

In 2005 this was printed in the prestigious Journal of the American Medical association: "Rapid opioid detoxification with opioid antagonist induction using general anesthesia has emerged as an expensive, potentially dangerous, unproven approach to treat opioid dependence." (JAMA. 2005;294:903-913)

"In general, the data do not support using general anesthesia during detoxification," said Herbert Kleber, M.D., vice chair of APA's Council on Addiction Psychiatry and a coauthor of the report. "The critical thing is not what happens during detox, but what happens after, and we found no difference between the groups. In addition, there were serious life-threatening adverse effects in the anesthesia group."(Psychiatry News October 7, 2005)

"Anesthesia-assisted detoxification should have no significant role in the treatment of opioid dependence," wrote Patrick G. O'Connor, M.D., M.P.H., in an editorial accompanying the JAMA report..."When detoxification is provided to patients, other approaches using clonidine, methadone, or buprenorphine are likely to be at least as effective as anesthesia-assisted detoxification and also are safer and far less costly." (Psychiatry News October 7, 2005)

CDC warns against dangers of UROD 2013

Also see: naabt.org/UROD.cfm

9/13



Back to FAQs

The Purpose of Buprenorphine Treatment:

To suppress the debilitating symptoms of cravings and withdrawal, enabling the patient to engage in therapy, counseling and support, so they can implement positive long-term changes in their lives which develops into the new healthy patterns of behavior necessary to achieve sustained addiction remission. - explain -

The National Alliance of Advocates for Buprenorphine Treatment is a non-profit organization charged with the mission to:

  1. U.S. Food and Drug Administration, FDA Talk Paper, T0238, October 8, 2002, Subutex and Suboxone approved to treat opiate dependence.
  2. Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40. DHHS Publication No. (SMA) 04-3939. Rockville, Md: Substance Abuse and Mental Health Services Administration, 2004.
  3. Subutex Discontinued in the US market in late 2011.
  4. Zubsolv (bup/nx sublingual tablet) FDA approved 7/3/2013 see buprenorphine pipeline graphic -in pharmacies now.
  5. Bunavail (bup/nx bucal film) FDA approved 6/6/2014 see buprenorphine pipeline graphic -in pharmacies now.
  6. Probuphine FDA approved 5/26/2016 - FDA Probuphine press release