Approved by the U.S. Food and Drug Administration in 2002 to be used as part of Medication-Assisted Treatment (MAT), Suboxone is one of the most commonly prescribed medications for the treatment of opioid addiction. MAT combines behavioral therapy and medications to treat substance use disorders. There are several medications that are similar or generic medications to Suboxone, such as Zubsolv, Sublocade (monthly injection), and generic Buprenorphine/Naloxone tablets or films. You and your provider will decide which treatment is best for you.
What Is Suboxone
Suboxone is a combination of buprenorphine (an opioid medication) and naloxone (a medication that blocks the effects of opioid medication) that is used to treat opioid addiction, including addiction to heroin and narcotic painkillers. When taken as prescribed, Suboxone can be safe and effective in treating these addictions.
Suboxone is not a cure for opioid addiction. It should be used as a component of another form of treatment, such as psychiatric care, counseling, group therapy, or intensive outpatient therapy that focuses on the underlying causes of addiction and reduce the risk of relapse.
Suboxone is taken as a film that is placed under the tongue to dissolve. It suppresses withdrawal symptoms and cravings for opioids, which can help prevent relapse. Suboxone, when used as prescribed, does not cause euphoria. Additionally, a single administration is able to block the euphoric effects of other opioids for at least 24 hours.
The most common side effects of Suboxone are:
Anxiety and/or depression
These effects usually occur at the beginning of treatment and may last a few weeks.
Pregnant or breastfeeding mothers should consult their physician before taking any medication-assisted therapies such as Suboxone.
Sublocade is a monthly injection that contains the active ingredient buprenorphine. This medication is used in adults with opiate dependence. If patients are interested in this treatment option they can be assessed by their treatment provider to see if they meet the criteria to receive this injection. This option can be beneficial for the patient who struggles to remember to take daily medication and to help reduce the risk of relapse.
How Does It Work?
Suboxone Dosage Information
It is important to follow the dosing instructions provided by your doctor. Misuse of Suboxone can lead to breathing problems and other life-threatening consequences.
Suboxone can begin to work within 30 minutes of the first dose and last up to 2-3 days. The typical course of treatment with Suboxone can last for months or years. Studies have shown that the longer someone is on Suboxone treatment, the more effective the medication is. Studies have also shown that a patient may need to be on Suboxone longer to reduce the chance of relapsing and allow for more time in recovery.
If you miss a dose, take the missed dose as soon as you remember. Do not take the missed dose if it is almost time for your next dose. Never take an extra dose to make up for a missed dose.
Never share your prescription with anyone else. Selling or giving Suboxone is against the law. Misuse of Suboxone, like other narcotic pain medications, can cause addiction, overdose or death.
Suboxone Drug Interactions
Tell your doctor about any medications that you are currently taking, including over-the-counter medications. Some medications may have adverse effects when mixed with Suboxone, including drowsiness or other serious and even life-threatening effects. Sedatives, sleeping pills, narcotic pain relievers and any medications taken for anxiety, depression and seizures must be discussed with your doctor prior to taking Suboxone.
Do not consume alcohol or other illegal drugs that slow breathing while taking Suboxone. This interaction can lead to loss of consciousness or death
Phases of Suboxone Recovery and Suboxone Treatment Through a Qualified Suboxone Clinic Include:
The initial phase of Suboxone treatment, called “induction,” occurs under the supervision of a physician. This phase begins once a person is in the early stages of withdrawal. Your Suboxone Dr will prescribe the medication and try to find the lowest dose that will reduce the person’s use of other opioids without causing withdrawal symptoms, serious side effects, or cravings.
If a person takes Suboxone prior to entering the early stages of withdrawal or has other opioids in his or her system, the medication can cause acute feelings of suboxone withdrawal.
This phase begins once cravings for opioids have subsided and side effects have diminished. Adjustments to dosing may occur during this stage under the direction of a prescribing physician.
The stabilization phase is followed by a period called “maintenance.” Under the direction of your Suboxone doctors, you will continue to take medication as prescribed and seek counseling or other forms of behavioral therapy. These counseling and/or therapy sessions may take place at your Suboxone Clinic or at other qualified locations as approved by your doctor. This phase may last many months to years.
The last stage of treatment is recovery. You may be weaned off Suboxone with the advice and prescription of your Suboxone Doctor. Aftercare planning under the supervision of a case manager or a counselor is encouraged. Ongoing participation in other forms of outpatient therapy may also be beneficial. This can include 12-step programs, and/or individual or group therapy.
The duration of the aforementioned suboxone recovery phases will vary and can be adjusted up or down based on the person’s needs. The latter 2 stages – medical maintenance and long-term suboxone recovery – will be the longest and, in some cases, may persist for years or indefinitely.
How Can I Get Suboxone?
Suboxone therapy is more accessible than other medication-assisted treatments, such as methadone treatment. It can be prescribed and/or dispensed in a:
Suboxone Clinic or provider
The ideal candidate for the Suboxone Recovery Program is:
Evaluated and diagnosed with opioid dependence by a qualified physician or provider.
Willing to follow safety precautions for treatment and conditions for compliance.
Cleared of any medication or health conflicts, such as lung or liver conditions.
Has reviewed all other treatment options available before agreeing to medication-assisted treatment and its requirements.
What Happens If I Overdose?
Contact 911 or your local poison control center (1-800-222-1222) if you suspect an overdose of Suboxone.
Possible signs of an overdose include:
Slowed breathing or respiratory depression.
Consult your physician before you stop taking Suboxone. Suddenly stopping the use of this mediation can result in severe suboxone withdrawal symptoms.
Suboxone Treatment vs. Methadone
Several studies have researched the differences between Suboxone and methadone treatment. Studies have shown that the medications are equally effective in treating opioid addiction.
However, some studies have demonstrated that Suboxone is a more cost-effective treatment option. In fact, Suboxone has a lower rate of dependence and overdose when compared to methadone. Relapse rates tend to be higher in those under methadone treatment according to one study. However, other studies have shown that methadone maintains patients in long-term treatment and recovery just as well or better than Suboxone.
Switching from methadone treatment to Suboxone is possible. However, since the medications work differently, each individual's results might be different. In addition, those with more severe opioid dependence may be more successful with methadone treatment.
Always discuss your treatment options with your doctor.
Suboxone Withdrawal Symptoms
Suboxone withdrawal can lead to a number of withdrawal symptoms including cold-like symptoms, anxiety, stomach issues, and muscle aches. Typically most symptoms usually peak within five days and largely resolve within a week. Symptoms are the worst in the first 72 hours of Suboxone withdrawal. This is when most physical symptoms are experienced. The first week after discontinuation of Suboxone, symptoms generally subside but some people may feel generalized body aches and muscle pain. Some people may experience mood issues such as anxiety and mild depression and this is important to talk to their provider.
72 hours: Physical symptoms at their worst, possible sweating, body aches, nausea, diarrhea (typical opioid withdrawal symptoms but likely milder)
1 week: Possible bodily aches and pains, insomnia, and mood swings
2 weeks to 1 month: Possible depression and cravings, commonly most symptoms completely resolve at this point