Over the last few decades, medication for addiction treatment (MAT) has proven effective for treating individuals with opioid use disorder (OUD), specifically buprenorphine/naloxone (Suboxone). Suboxone greatly reduces a patient’s risk of relapse and helps maintain abstinence. Suboxone has also consistently been shown to work just as well as methadone, without the burden of going to a methadone clinic on a daily basis to get dosed. Learn more about long-term Suboxone treatment.
Patients can get a prescription for Suboxone from a DEA-waivered physician in any treatment setting (like other prescriptions) and can take the medicine in their home. This is in contrast to methadone, for which patients must travel to a highly-regulated specialty clinic (opioid treatment program, aka “methadone clinic”) and have the medicine administered under supervision. Thus, Suboxone often represents an easier, more convenient and less stigmatizing solution for patients seeking access to treatment for OUD.
Looking for a Suboxone provider? Learn more about finding the right one.
If you struggle with dependence or addiction to opioids or opiates (like oxycodone/Percocet, hydrocodone/Vicodin, hydromorphone/Dilaudid, methadone, heroin, or fentanyl), chances are buprenorphine/naloxone (Suboxone) will be a good medication choice to prevent cravings, withdrawals, and overdose. You can also take Suboxone while pregnant.
Patients should be at least 16 years old and meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for opioid use disorder (OUD), determined via a comprehensive medical assessment:
Treatment typically begins with supervised administration, progressing to unsupervised administration as the patient’s clinical stability permits.
You will need to be experiencing withdrawal symptoms when starting Suboxone, and your provider will walk you through that process so that you’re able to start successfully and with minimal discomfort. This phase of treatment is called the initiation phase; learn more about the initial withdrawal symptoms.
Ideally, patients should be seen at reasonable intervals (e.g., at least weekly during the first month of treatment) based upon the individual circumstances of the patient. Medication should be prescribed in consideration of the frequency of visits. Provision of multiple refills is not advised early in treatment or without appropriate patient follow-up visits. Periodic assessment is necessary to determine compliance with the dosing regimen, effectiveness of the treatment plan, and overall patient progress.
Once a stable dosage has been achieved and patient assessment (e.g., urine drug screening) does not indicate illicit drug use, less frequent follow-up visits may be appropriate. A once-monthly visit schedule may be reasonable for patients on a stable dosage of medication who are making progress toward their treatment objectives.
Continuation or modification of pharmacotherapy should be based on the healthcare provider’s evaluation of treatment outcomes and objectives such as:
Generally speaking, it takes 1-3 days to titrate up to a “maintenance” dose (the dose that keeps the person stable without cravings or withdrawal symptoms), and patients often report it can take them 1-2 weeks to get used to this dose and start feeling normal. After a dose change, it usually takes 4-5 days to adjust. When taken appropriately, buprenorphine/naloxone (Suboxone) should NOT make people feel tired or groggy and they should be able to perform all their typical work duties without any restrictions or limitations.
One of my own patients regained stability, normalcy, confidence, and financial security within about four months of beginning Suboxone care. He stopped smoking too, which was an added bonus.
Brian Clear, MD, FASAM, Medical Director at Bicycle Health
Typically, Suboxone treatment duration should be at least 1-6 months. Addiction is a chronic condition, and research shows that patients who stay on Suboxone long-term are more likely to be opioid-free. Conversely, studies demonstrate that within one month of stopping treatment, more than 50% of patients relapse to illicit opioid use. Therefore, it is very safe to stay on Suboxone for many years, particularly if a patient feels it is helping them to sustain abstinence. However, if you desire to taper off Suboxone, consult with your medical provider in order to slowly taper your dose, as this will help prevent buprenorphine/naloxone (Suboxone) withdrawal symptoms.
If you have questions about opioids, opioid use disorders, treatments, or other Suboxone-related questions, be sure to browse through our Suboxone FAQs. To learn whether telemedicine Suboxone treatment is a good fit for you, call us at (844) 943-2514 or schedule an appointment here.