How Does Suboxone Affect Your Body?

Suboxone affects the body by reducing drug cravings and preventing withdrawal. These effects can help a person with opioid use disorder (OUD) stop misusing opioids.

While considered safe, Suboxone can cause some side effects, including unpleasant gastrointestinal symptoms like stomach pain and constipation. There are also more serious side effects people may rarely experience, although most of these will primarily affect people ignoring warnings that come with the medication or if they have certain specific health issues.

The Basics of How Suboxone Works in the Body

Suboxone is a medication that combines the drugs buprenorphine and naloxone. Of these two drugs, buprenorphine has the most significant effect on the human body. 

Naloxone isn’t associated with major side effects. It is a type of drug called an opioid antagonist. This means it reverses the effects of opioids. Naloxone is mostly present in Suboxone to reduce its misuse potential, as previous buprenorphine-only Medications for opioid use disorder had enough misuse and addiction potential themselves that it was a significant risk for some patients to be prescribed such a medication.

Meanwhile, buprenorphine is a type of drug called a partial opioid agonist, meaning it acts on opioid receptors in the brain but fits imperfectly.[1] Because of this, it is less potent in effect than full opioid agonists like heroin and fentanyl (opioids typically associated with OUD). 

What makes buprenorphine helpful for OUD treatment is that it suppresses opioid cravings and allows a person to avoid withdrawal while still letting a person stop taking much more dangerous opioids. Drugs like Suboxone don’t cause a significant high. They generally only cause mild euphoria in high doses and then level off in effect even if a person takes more than prescribed.

Buprenorphine is an accepted, evidence-based medication for OUD, with most experts believing modern buprenorphine-naloxone medications (like Suboxone) are superior to buprenorphine-only medications due to lower misuse potential and essentially no downsides compared to buprenorphine alone. These medications cannot cure addiction since there is no cure for this chronic condition. However, they can help a person better avoid drug misuse, and they have been demonstrated to improve treatment retention and drug abstinence. 

As is true of virtually all medications for OUD, Suboxone works best when used as part of a comprehensive treatment plan that uses other types of treatment as well, such as therapy. Medication on its own is never enough to effectively manage OUD. Therapy is needed as well.

Common Side Effects of Suboxone

Suboxone has several unpleasant side effects associated with it, although these usually aren’t severe.[2] For example, it can cause some gastrointestinal issues, with users sometimes experiencing stomach pain and constipation. These issues shouldn’t be as serious as the similar gastrointestinal issues associated with more potent opioids, like heroin or codeine. 

People taking Suboxone may also experience pain in a few other places in the body. Some experience headaches, tongue pain, and back pain. You may also experience mouth numbness or redness.

Like other opioids, Suboxone can cause a person to experience miosis, which is when the pupils constrict more than is typical. This isn’t usually a major concern, but some people on buprenorphine can experience blurred vision.[3] You should talk to your doctor if it is severe enough that you find seeing difficult. 

People on buprenorphine often have difficulty sleeping, although it’s worth noting that many people are also taking drugs like Suboxone at a difficult time in their life, as they try to overcome opioid use disorder. This can sometimes make a person believe their medication is having a more intense effect than it actually is, when in reality, their life has just become more complex and challenging at a time coinciding with them starting on their new medication.[4]

Notable Potential Health Impacts With Suboxone

Suboxone is generally considered a safe prescription drug, with serious complications being relatively rare, especially if the medication is only taken as prescribed. However, there are still some risks and health impacts to be aware of with the medication.[5]

• Allergic reaction: In rare cases, a person can have an allergic reaction to Suboxone, experiencing symptoms like rash, hives, swelling, difficulty breathing, or even loss of consciousness. If this happens, call 911 right away.

• Respiratory issues: Similarly, Suboxone can cause some respiratory depression, weakening a person’s ability to breathe. On its own, this isn’t dangerous to people who can otherwise breathe normally. However, people with certain health conditions or who mix Suboxone with drugs that can also depress breathing, like alcohol, can potentially depress their breathing so much that it becomes an emergency. This is why Suboxone should not be taken with any drug you haven’t confirmed to be safe with a medical professional, including recreational and illicit substances.

• Liver problems: Suboxone can put strain on the liver, although it should not generally be dangerous to a person with relatively good liver health. Signs of a potentially serious liver problem include jaundice (yellowing of the whites of your eyes or your skin), dark or tea-colored urine, light-colored stools, loss of appetite, nausea, and pain or tenderness on the right side of your stomach area.

• Physical dependence: When taken on a long-term basis, Suboxone is going to cause some level of physical dependence. Different from OUD, dependence is when your body adjusts to a drug’s presence and causes withdrawal symptoms in that drug’s absence, as it adjusts back to its normal, drug-abstinent state.
  
  This isn’t normally a major concern when the medication is used as part of addiction treatment, as many patients will already be dependent on opioids when they start treatment. Needing to take this drug on a regular, controlled schedule long term is generally considered a worthwhile tradeoff if it allows a person to stop misusing much more dangerous opioids at what is often a much less controlled rate. 

• Dental issues: The FDA has released warnings that drugs like Suboxone can affect a person’s teeth.[6] While on Suboxone, your risk of cavities, tooth decay, and similar problems is increased. To compensate for this potential issue, make sure to see a dentist regularly, especially if you experience tooth problems or notice other signs that you may have dental issues. In addition, practice good oral hygiene, such as making sure to brush and floss your teeth regularly.
  
  The risk of tooth-related issues does not appear to be serious based on current evidence, but it is still noteworthy and backed by evidence, so it should be kept in mind as you continue your treatment. If you regularly see a dentist, they will monitor your teeth for any issues that may develop related to Suboxone use.

Sources

1. Buprenorphine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459126/. May 2022. Accessed February 2023.
2. Buprenorphine Sublingual and Buccal (Opioid Dependence). National Library of Medicine. https://medlineplus.gov/druginfo/meds/a605002.html. January 2022. Accessed February 2023.
3. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine. January 2023. Accessed February 2023.
4. Sleep Disordered Breathing in Patients Receiving Therapy With Buprenorphine/Naloxone. European Respiratory Journal. https://erj.ersjournals.com/content/42/2/394. August 2013. Accessed February 2023.
5. SUBOXONE Sublingual Film. Indivior, Inc. https://www.suboxone.com/. Accessed February 2023.
6. FDA Warns About Dental Problems With Buprenorphine Medicines Dissolved in the Mouth to Treat Opioid Use Disorder and Pain. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-dental-problems-buprenorphine-medicines-dissolved-mouth-treat-opioid-use-disorder. January 2022. Accessed February 2023.