Which medications are commonly used in an opioid detox taper?

• A. Buprenorphine alone
• B. Methadone and Subutex
• C. Naltrexone
• D. Methadone and Naloxone

Answer: (B)

In opioid detox tapering, the goal is to ease withdrawal and cravings while gradually reducing opioid exposure using medications that act on the same receptors. Methadone provides a long-acting opioid effect, which helps smooth out withdrawal symptoms as the dose is slowly reduced. Buprenorphine, sold as Subutex, is a partial agonist with a ceiling effect that also eases withdrawal and cravings but carries a lower risk of overdose. Using these two together or in a planned taper gives a medically supervised path off opioids.

Naltrexone, an opioid antagonist, blocks effects but is used after detox to help prevent relapse; if given while opioids are still active, it can trigger withdrawal, so it isn’t used for tapering. Naloxone reverses overdoses and is not a tool for tapering, though it may be present in some formulations to deter misuse. Because of these roles, methadone and buprenorphine remain the standard choices for a detox taper.