Key takeaways:

  • Suboxone is a partial opioid agonist, meaning that it binds to the same receptors in the brain that are affected by other opiates, such as opioid painkillers like morphine and oxycodone, as well as heroin
  • Suboxone is first used during the detox phase to manage the often uncomfortable withdrawal symptoms of opioid abuse. Suboxone can alleviate or prevent the common uncomfortable withdrawals that occur when people stop using opioids
  • Though suboxone is far less addictive than other opioid treatment medications, those taking it can form a physical dependence on the medication when used long-term. Also, some people abuse the medication in ways that can heighten this dependence, which can lead to problematic use

Suboxone is an effective and potentially life-saving medication that can help people overcome an addiction to opiate painkillers, heroin, or other synthetic opioids like fentanyl.

What Is Suboxone?

Each year, more people die from opioid overdoses than any other drug overdose, making it the leading cause of accidental death in the US. [1] Suboxone is a medication that can help to prevent uncomfortable withdrawals from opioids, helping to reduce cravings and relapse in people who are trying to overcome an addiction to opioids. Research shows that people who receive Suboxone are more likely to be enrolled in treatment, less likely to relapse, and experience fewer cravings and withdrawals in early recovery. [2] 

Suboxone is a combination medication consisting of buprenorphine and naloxone. It is one of the most widely used medications for medication-assisted therapy (MAT) when treating opioid addiction. Using MATs is proven to reduce the risk of fatal overdose by 50% [3] when treating those in all stages of recovery from opioid use disorder. [2]

Suboxone is a partial opioid agonist, meaning that it binds to the same receptors in the brain that are affected by other opiates, such as opioid painkillers like morphine and oxycodone, as well as heroin. However, it also contains naloxone, which is an opioid antagonist, meaning it prevents intoxication. This is why suboxone can help reduce cravings and withdrawals without making people feel ‘high’. [1, 2, 3]

Unlike similar medications (like methadone) used for MAT, Suboxone has fewer adverse effects and does not cause intoxication. Also, suboxone does not require a person to go to a clinic for daily dosing (unlike methadone), making it a more accessible form of treatment. Combined, these advantages make it the preferred treatment for opioid use disorder. [1, 2]

Suboxone can be used during the detox stage to manage withdrawal symptoms and with the help of a doctor can become part of a treatment program for ongoing recovery. Suboxone, while effective, will not always work on its own and should be incorporated alongside therapy and group support for the best chance of success. [4]

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Get help during Covid-19

At Recovered, we recognize the impact COVID-19 has had and the continued challenges it poses to getting advice and treatment for substance use disorders. SAMHSA has a wealth of information and resources to assist providers, individuals, communities, and states during this difficult time and is ready to help in any way possible.

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How Does Suboxone Help Addiction Treatment?

Suboxone is used to treat addiction and dependence for all opioid addictions, including heroin, prescribed pain medication, and even synthetic opioids like fentanyl. [1]

Suboxone is first used during the detox phase to manage the often uncomfortable withdrawal symptoms of opioid abuse. Suboxone can alleviate or prevent the common uncomfortable withdrawals that occur when people stop using opioids including:

  • Muscle aches and pains

  • Diarrhea and stomach upset

  • Restless legs and insomnia

  • Mood and anxiety problems

  • Sweating and tics

  • Hot and cold chills

  • General flu-like symptoms

Suboxone can also help people who are in later stages of recovery by:

  • Preventing cravings and urges to use

  • Improving treatment adherence

  • Preventing relapse

  • Blocking effects of opioids in the event of relapse

  • Helping to manage chronic pain

  • Helping to improve mood and anxiety

  • Lowering levels of stress

How is Suboxone administered?

While a much safer alternative to other medications such as methadone, suboxone can still only be prescribed by a doctor. If prescribed suboxone, the user should follow their doctor's recommended daily dose and not deviate from or abuse their prescription. The medication is often administered in sublingual tablet form or a thin sheet called Suboxone Film. [3]

If taking the Suboxone Film, it will need to be placed under the tongue and allowed to dissolve on its own in order to produce the correct dosage. If the film is chewed or swallowed before it can dissolve fully then it may not work fully. It is also advised that the person using the film not talk until it has dissolved fully. 

It’s important for people to realize that while Suboxone has helped many people achieve recovery and remission from opioid use disorder, the medication should not be discontinued without medical advice and oversight. Because the medication binds to the same receptors in the brain as other opioids, people form a dependence and need to be slowly tapered off of the medication to avoid withdrawal and prevent their risk of relapse.

Side effects of Suboxone

Though suboxone is far less addictive than other opioid treatment medications, those taking it can form a physical dependence on the medication when used long-term. Also, some people abuse the medication in ways that can heighten this dependence, and even become problematic. 

In order to avoid problem use of suboxone, it’s important to:

  • Do not use alcohol or other substances with the medication

  • Only take the medication when prescribed and at the dose prescribed

  • Do not adulterate or change the medication to enhance its effects

  • Talk with your doctor before stopping the medication, as they will likely recommend tapering off it slowly

  • Engage in therapy, rehab, or other addiction treatment to address root causes 

  • Get treatment for any underlying health or mental health conditions

  • Ask questions of your prescriber and get information about the medication, how to use it safely, and possible adverse effects before starting or stopping it

Suboxone withdrawal

If you have been prescribed Suboxone as part of an ongoing recovery plan, it is vital that you do not start, stop or change your dose without talking with your prescriber. Doing so can lead to opioid withdrawal symptoms such as:

  • Joint, muscle pain

  • Irritability or anxiety

  • Dilated pupils

  • Insomnia

  • Feeling jittery

  • Diarrhea and GI upset

  • Hot and cold chills

  • Restless legs and insomnia

  • Flu-like symptoms

Adverse side-effects of Suboxone

In some patients, Suboxone can cause adverse side effects. If you begin to display any of the following symptoms while on a suboxone treatment, then contact your healthcare provider. 

  • Flu-like symptoms

  • Vomiting

  • Sweating

  • Stomach pain

  • Low energy

  • Headache

  • Signs of allergic reactions including skin rash, hives, shortness of breath, or trouble breathing (seek emergency medical care)

Dangerous Suboxone drug combinations

Some other medications and herbal remedies can cause negative side effects when combined with a suboxone treatment. Always make sure you alert your doctor to any existing medications before starting a suboxone treatment program, especially if you are taking any of the following:

  •      Acetaminophen

  •      Cholesterol-lowering medications

  •      Fluoxetine

  •      HIV-treatment drugs

  •      Niacin

  •      Oral contraceptives

  •      Verapamil

Common misconceptions about Suboxone

While Suboxone has a proven record in helping people with opioid addictions to manage withdrawal symptoms safely and aid recovery, there are some popular myths that still exist around the drug and its use. Below is a list of common misconceptions about Suboxone, as compiled by Harvard Medical School.

Misconception 1: You aren’t really in recovery if you’re on Suboxone

Reality: the misconception stems from the increasingly unpopular view that ‘recovery’ from addiction can’t be achieved if replacement medication is used to suppress cravings. This idea is often debunked by modern medicine as addiction is seen as a chronic disease that can and should (where applicable) be treated with medication. [3]

Misconception 2: People frequently abuse Suboxone

Reality: The addition of naloxone to the medication prevents euphoric or pleasurable effects, making suboxone less commonly abused than other opioid agonists. It also reduces the effects of other opiates on the brain and as such can help those with opiate addictions or dependence to manage withdrawal and cravings. Some people do abuse suboxone, but most people take the medication to prevent intoxication or relapse. [3]

Misconception 3: Overdosing on Suboxone is as easy as it is with other opiates

Reality: Suboxone is difficult to overdose on because of its chemical composition. Suboxone is only a partial opioid agonist, and also includes naloxone, which helps to block some of the opioid-like effects, reducing the risk of overdose significantly. In fact, naloxone is used to reverse a fatal opioid overdose and save the lives of people who accidentally take too much of an opioid. Combining suboxone with other sedative drugs, such as benzodiazepines or alcohol can increase the risk for overdose. [2]

Misconception 4 : Suboxone alone is effective in helping people overcome opioid use disorder

Reality: Suboxone helps to address the physical aspects of addiction, but does not address the deeper psychological aspects, which often play a significant role in opioid addiction. This is why most suboxone providers recommend or require patients to seek out therapy or other addiction treatment when taking the medication. Research has proven that a combination of medication and therapy is most effective in preventing relapse and helping people overcome an addiction to opioids.[4]

Misconception 5: Suboxone should only be taken for a short period of time

Reality: There has been debate amongst professionals over the exact length of time suboxone treatment should last, but there is no proof that ongoing use of the medication will have any adverse side effects to the user, or indeed will lead to abuse or dependence. Some people do want to use the medication short-term, but should always consult with their provider before reducing their dose or stopping the medication. Failing to do so greatly increases the likelihood of uncomfortable withdrawals and relapse.

Where is Suboxone available?

Suboxone is only available under prescription from a licensed doctor and should not be acquired by other means. As Suboxone is often used as part of ongoing treatment, regular check-in appointments with your doctor should be attended to ensure that the dose prescribed is still correct. 

Suboxone is not a quick solution for opioid addiction and will only work if the person suffering from addiction wants to get sober. For the best results, it should be taken as part of a combined treatment program, with behavioral therapy and support groups. Finding which type of treatment is right for your opioid use disorder can feel daunting. Contact a treatment center today to begin your journey to recovery.