A person going through opioid detox talks to a doctor

What is Suboxone?

Suboxone is a medicine for opioid addiction approved in 2002 by the U.S. Food and Drug Administration (FDA). Only certified doctors can prescribe it because it has a moderate risk of dependence. Suboxone will help with your opioid addiction but doesn’t cure it. Treatment usually includes therapy and peer support in addiction to medication for the best results.

If you or someone you know is struggling with opioid addiction, Suboxone can help. It reduces cravings for drugs like heroin, fentanyl, and oxycodone. This article will explain what Suboxone is, how it works, and important things to remember when taking it.

How Does Suboxone Work?

An info card explaining some quick facts about Buprenorphine/Naloxone or Suboxone

Suboxone is made up two drugs: buprenorphine and naloxone. Buprenorphine is a pain reliever that works on the same brain receptors as other strong opioids but is less powerful. This helps reduce cravings and withdrawal symptoms without being as strong as other opioids.

Naloxone blocks opioid effects in the brain. It can quickly reverse an overdose if Suboxone is misused by being crushed and injected. Naloxone is usually used in emergencies to stop an opioid overdose. Together, these two drugs lower the risk of misuse and overdose.

Suboxone is available in several forms:

  • Sublingual tablet (Zubsolv)
  • Sublingual film (Cassipa)
  • Monthly Injection (Sublocade)
  • Transdermal Implant (Probuphine)
  • Buccal film (Bunavail)

Side Effects of Suboxone

While Suboxone is an effective medication for addiction treatment, it does have the risk of side effects. It is important to understand the potential side effects of Suboxone and how to manage them.

The most common side effects of Suboxone include:

  • Weakness or fatigue 
  • Nausea
  • Dizziness 
  • Headache
  • Rapid heartbeat 
  • Back pain 
  • Muscle pain
  • Runny nose
  • Trouble concentrating 
  • Anxiety 
  • Insomnia  

The severe and less common side effects of Suboxone include:

  • Blurred vision 
  • Loss of coordination  
  • Disturbance in attention
  • Shallow breathing
  • Adrenal insufficiency  
  • Respiratory depression
  • Loss of consciousness 
  • Loss of appetite
  • Low blood pressure
  • Liver problems 
  • Severe allergic reactions (the most common signs of an allergic reaction include hives, difficult breathing, or swelling of the face, lips, tongue, or throat)

If you experience any of these severe side effects, seek emergency medical attention immediately.

Suboxone Withdrawal

Long-term use of Suboxone can cause withdrawal symptoms if the medication is abruptly stopped. For this reason, health care practitioners slowly reduce Suboxone doses to avoid the risk of withdrawals. Suboxone withdrawals generally occur within 24 hours of the last dose, peak within 72 hours, and last for approximately a month. 

Suboxone withdrawal is relatively less intense than other opioid withdrawals and includes symptoms such as:

  • Dilated pupils
  • Headache
  • Restlessness 
  • Runny nose 
  • Stomach pain 
  • Tremors or twitching 
  • Muscle aches 
  • Nausea or vomiting 
  • Goosebumps
  • Anxiety 

Ready to get started with Suboxone treatment for opioid addiction?

Is Suboxone Treatment Right for You?

A suboxone doctor will do an evaluation to determine if Suboxone treatment is right for you. During this evaluation, your treatment provider will also consider your recovery goals and medical history to develop a complete treatment plan.

Suboxone may be a good treatment option for individuals who:

If an individual is not able to take Suboxone due to a health issue, the doctor can prescribe alternative medications to combat opioid use disorder.

Who Should Not Take Suboxone?

Suboxone treatment might not be right for people with certain health issues. Make sure to tell your healthcare provider if you have any of these conditions before taking Suboxone: breathing problems, enlarged prostate, trouble urinating, liver or kidney disease, gallbladder, adrenal gland, or thyroid problems, head injury, brain tumor, seizures, allergies to buprenorphine or naloxone, sleep apnea, or if you are pregnant or breastfeeding.

Some medicines and herbal supplements can interact with Suboxone and cause problems. Below is a condensed list of medications that interact with Suboxone.

Inform your health care provider of all medications and supplements you are taking before starting Suboxone treatment.  

Frequently Asked Questions

Common questions you may have about Suboxone treatment.

The buprenorphine in Suboxone stays in the body longer than other opioids. The elimination half-life is the time it takes for half of the drug to leave the body. For buprenorphine, this takes 24 to 42 hours. So, it can take over seven to nine days for Suboxone to leave the body completely.

Many factors can affect how long Suboxone stays in the system. These include:

  • Age
  • Weight
  • Metabolism speed
  • The last dosage taken
  • History of substance misuse
  • Liver health

In addition, depending on the duration of treatment, traces of buprenorphine can remain detectable in the body for longer periods.

The long-term use of any opioid medication, including Suboxone, can lead to physical dependence. However, this possibility is lower than that of other opioids. In addition, Suboxone doesn’t have the same sedative properties as other opioids; therefore, it’s less likely to cause cravings.

Unlike other opioids, buprenorphine in Suboxone contains a “ceiling effect.” As a result, while a person’s tolerance to buprenorphine can grow, they cannot overcome that tolerance by increasing the amount of medication they take. This effect also helps reduce the risk of misuse.

Misusing Suboxone can cause serious side effects, including overdose. Combining Suboxone with other substances like benzodiazepines or alcohol may cancel out the “ceiling effect” and cause an overdose.

Symptoms of Suboxone overdose may include:

  • Dilated pupils
  • Headache
  • Restlessness
  • Runny nose
  • Stomach pain
  • Tremors or twitching
  • Muscle aches
  • Nausea or vomiting
  • Goosebumps
  • Anxiety

If a Suboxone overdose happens, give the person Narcan/naloxone right away. Then call 911, even if the person seems to wake up, because the naloxone might wear off. Stay with them until help arrives. Ask your doctor or pharmacist about how to get Narcan/naloxone.

According to the National Center for Biotechnology Information (NCBI), Suboxone treatment during pregnancy has been proven to be a safe and effective medication for opioid addiction.

However, taking buprenorphine during pregnancy can expose newborn infants to neonatal abstinence syndrome (NAS) after birth and can also be passed into breast milk. For this reason, women who are breastfeeding, pregnant, or planning to get pregnant must inform their healthcare professionals before starting Suboxone treatment. It’s important to note that infants born to mothers who used Suboxone correctly during pregnancy experienced minor fetal distress and other symptoms after birth.

If you miss a dose of Suboxone, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double up on doses to make up for a missed one. Consistency is important in the effectiveness of Suboxone, so try to take it at the same time each day. If you have questions about missed doses, consult your healthcare provider.

Suboxone Treatment at Eleanor Health

Eleanor Health offers online medication-assisted treatment for opioids, alcohol, meth, and more. We create individualized treatment plans that include medications that fit your recovery goals as well as addiction counseling to support lasting sobriety. Fill out our online form or call us today to learn more about our addiction treatment services.

A community member receives a prescription for Medication for Addiction Treatment (MAT)