It’s designed for oral use, but unfortunately, some people choose to snort, inject, or smoke the drug. Doing so can lead to problems like overdose, infections, and foreign bodies in veins.
Many people use Subutex as it’s prescribed. If you’re one of them, you don’t have to stop taking your medication. However, if you’re tempted to take your pills in any way other than your doctor recommends, talk to your doctor first. You may need a different type of treatment for your opioid use disorder (OUD).
What Are the Dangers?
While Subutex is a helpful medication for people with opioid use disorders, it can be harmful too. Health problems associated with Subutex include respiratory depression, sedation, and overdose.[1] Those risks apply no matter how you take the drug.
However, there are specific risks involved with taking Subutex in ways that it’s not designed to be used. We’ll outline those risks below.
Smoking Subutex
People who smoke Subutex crush the pills, sprinkle the powder on tobacco, roll the substance in papers, and smoke it. In a study of people who abuse opioids, close to 63% prefer to smoke their drugs. Among them, more than 47% preferred to smoke drugs because they thought it was safer to do so.[2]
Some people who smoke drugs think they can control their dose more accurately this way. They believe they’re less likely to overdose if they smoke drugs instead of injecting them.
In reality, far too many people who smoke drugs overdose. In fact, between 2020 and 2022, the percentage of overdose deaths from injection dropped by more than 29%, while the percentage involving smoking increased by 73.7%.[3]
In addition to high overdose risks, smoking drugs can expose your lungs to dangerous chemicals. Adding drugs to tobacco can be even more harmful, as these irritants can lead to problems like chronic coughing or lung disease.
Injecting Subutex
Some people crush their pills, mix them with a solvent like water, and inject the substance. They may believe they can do so safely, but experts disagree.
In one study, researchers crushed Subutex, added sterile water, and filtered the solution through two filters made of cotton pads and other typically used substances. When they examined the solution, they found contaminants like silica and other insoluble particles.[3]
Placing something like this into the veins can lead to catastrophic blockages. Those plugs can stay in the arteries and veins, or they can travel to places like the heart and lungs. Serious health problems can follow.
Injecting drugs can also lead to skin and tissue infections. Researchers say this problem is more common in people who don’t use sterile water or equipment, and those who use injection materials more than once.[5] However, anyone who injects drugs can get an infection, and sometimes, they can be very serious.
Snorting Subutex
Some people crush their Subutex into a fine powder and snort the substance. Researchers say inhaling buprenorphine can lead to desired effects, including euphoria.[6] However, inhaling the drug isn’t healthy.
Crushed pills contain inactive ingredients and coatings that dissolve in the stomach but not in the lungs and throat. Those ingredients can lead to irritation and infections, similar to those seen in people who inject pills.
Snorting the drug can also lead to powerful doses that quickly overwhelm the body. In one study, researchers described people who overdosed and died after snorting pills.[7] A dose that might enter your body very slowly via your digestive tract can be overwhelming when snorted.
Talk to Your Doctor
If you’ve smoked, snorted, or injected your Subutex (buprenorphine), talk to your doctor about other forms of treatment. You may have a better experience with injectable forms of the drug that are provided in doctors’ offices. You may also benefit from a stay in an inpatient clinic, away from the temptations you experience at home. Your doctor can help you determine what to do next.
- Buprenorphine. Drug Enforcement Administration. Published May 2022. Accessed February 27, 2024.
- Kamal A, Ferguson M, Xavier J, et al. Smoking identified as a preferred mode of opioid safe supply use; investigating correlates of smoking preference through a 2021 cross-sectional study in British Columbia. Substance Abuse Treatment, Prevention, and Policy. 2023;18(27).
- Tanz L, Gladden R, Dinwiddie VA, et al. Routes of drug use among drug overdose deaths, United States, 2020-2022. Morbidity and Mortality Weekly Report. 2024;73(6):124-130.
- BouquieR, Wainstein L, Pilet P, et al. Crushed and injected buprenorphine tablets: Characteristics of princeps and generic solutions. PLOS ONE. 2014;9(12):e113991.
- Hrycko A, Mateu-Gelabert P, Ciervo C, et al. Severe bacterial infections in people who inject drugs: The role of injection-related tissue damage. Harm Reduction Journal. 2022;19(41).
- Jones J, Sullivan M, Vosburg S, et al. Abuse potential of intranasal buprenorphine vs. buprenorphine/naloxone in buprenorphine-maintained heroin users. Addiction Biology. 2015;20(4):784-798.
- Ferrant O, Papin F, Clin B, et al. Fatal poisoning due to snorting buprenorphine and alcohol consumption. Forensic Science International. 2011;204(1-3):e8-11.
