In March 2020, more than 216,000 people filled a prescription for Buprenorphine. Buprenorphine is one of 3 FDA approved medications for opioid use disorder (OUD).
Buprenorphine acts on opioid receptors in the brain - the same receptors used by drugs like heroin and Vicodin. By binding to those receptors, it prevents the withdrawal symptoms from discontinuing opioid use, helping physically stabilize people so they can work on long term abstinence.
If you're struggling with OUD, Buprenorphine can be life saving.
Suboxone contains Buprenorphine (the active opioid component) and Naltrexone (which is not absorbed by the body but prevents medication misuse).
Buprenorphine is a long-acting partial opioid agonist. It binds to opioid receptors in the brain instead of other opioids, and suppresses withdrawal and cravings. In this way, it acts to treat OUD both acutely and on a long-term basis.
At the same time, it displays what is called a ceiling effect. Unlike other full opioids, it does not continue to turn on opioid receptors at higher and higher doses, meaning that there is a limit to how “high” a person can get off Suboxone and an upper limit to how much it can suppress the respiratory drive.
Buprenorphine allows patients to carry out their everyday activities without experiencing opioid withdrawal or cravings. In this way, it treats opioid use disorder and restores a person to physiologic normal while they focus on other aspects of their recovery.
Naltrexone is an opiate antagonist, meaning it blocks drugs like heroin and Vicodin from latching to receptors and causing euphoria.
In an overdose emergency, naltrexone can be a lifesaving drug. It displaces opioids on opioid receptors in the event of an overdose, “sobering them up” immediately and reversing respiratory depression.
Adding Naltrexone to Suboxone provides overdose protection. If people attempt to misuse their Suboxone (via snorting or injecting), Naltrexone will prevent overdose. This can be lifesaving, which is why Naltrexone has been added to Buprenorphine in the combination of Suboxone.
Buprenorphine is poorly absorbed in the stomach, but much more readily absorbed sublingually (under the tongue) which is why Suboxone is sold as a dissolving strip or tablet. It absorbs directly through the oral mucosa into the bloodstream.
Once Suboxone enters the bloodstream, it binds to opioid receptors for hours to even days, blocking withdrawal symptoms and cravings for other opioids. 
Eventually it unbinds and its effects wear off. It is then processed by the liver into inactive metabolites, which travel to the kidney and are excreted in the urine.
At proper doses, Buprenorphine acts as a substitute for other opioids, binding to opioid receptors in the brain and preventing withdrawal symptoms and cravings.
Suboxone is very effective in helping people recover from OUD. In one study, 75% of people taking Suboxone had negative urine drug tests a year later compared to 0% of people taking a placebo drug. People taking 16 mg of buprenorphine or more per day are 1.82 times more likely to stay in treatment compared to those taking a placebo. For this reason, it has been approved by the FDA as a first line treatment for OUD.
Almost anybody who meets criteria for an OUD is potentially a candidate for Suboxone. In addition, there are very few medical reasons why a person cannot take Suboxone. It is overall very safe for most patients, particularly under the supervision of a licensed Suboxone provider.
If you're struggling with an OUD and you're ready to comply with a treatment program, Suboxone could be a good choice for you. The medication is safe and effective when used under the care of a medical team.
Talk with your doctor and ask if Suboxone is right for you.