How Long Does Suboxone Block Opioid Cravings?

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Suboxone is a prescription medication doctors use to treat opioid use disorder (OUD). The right dose will block cravings and limit withdrawal symptoms. A too-strong dose might make you feel sick or sedated. Therefore, finding the right dose is critical to success. 

Suboxone typically blocks opioid cravings for about 24-48 hours.  However, everybody is different, and some people may requires more frequent dosing, sometimes up to 2 or 3 times a day. 

How Does Suboxone Work?

Suboxone is a prescription medication containing the following:

  • Buprenorphine, a partial opioid agonist that can limit cravings and block withdrawal symptoms. It is the active ingredient in Suboxone, entering the body by being placed under the tongue. 
  • Naloxone, an opioid antagonist that is included in the formulation and is not absorbed orally, and only becomes activated if the person attempts to misuse the medication by injecting it. 

Buprenorphine can be provided in doctors’ offices.[1] Before it was part of a doctor's toolkit, people had to go to clinics every day to get methadone, which was the only treatment available. Now, Suboxone makes it a lot easier to get treatment for OUD without having to attend a methadone clinic. 

Patients on Suboxone are less likely to use opioids. And if they do slip and use, the medication could keep them from overdosing.

How Long Does It Last?

Suboxone comes in multiple doses ranging from 1 mg to 16 mg. Doctors search for a dose that keeps people from feeling sick from withdrawal but alert enough to focus on recovery.

To understand how long Suboxone lasts, understanding the concept of “half-life” is critical. A half-life is a measurement of how long the body needs to remove half of the drug from the body. 

In general, a medication is considered processed and ineffective after four half-lives, when about 6.25% of the original dose is still in the body.[3-6] However, this varies greatly depending on the medication. 

Suboxone has a half life of 12-24 hours.[4] This varies by individual. In general, this means that it can control withdrawal cravings for as short as a few hours to as long as a few days, depending on the individual.

What Factors Influence How Long Suboxone Blocks Opioid Withdrawal?

While a drug's half life is a good place to start to get a sense of how long it will work, it is only one factor. Other factors also affect how long Suboxone works in the body, including:

  • The severity of your opioid use disorder: If you are using a high strength, quantity or frequency of other opioids, you might need a higher dose of Suboxone 
  • The type of opioids used: These days, with the development of extremely potent opioids such as fentanyl, a lot of doctors are finding that patients are needing higher and more frequent doses of Suboxone if they are misusing these opioids. 
  • Genetics/Biology: Some people find that they just need higher doses or more frequent doses of Suboxone to control their cravings for unknown reasons, likely due to their specific genetics or biology
  • Liver health: Suboxone is processed through the liver. Patients with poor liver function may need different doses or more frequent doses of Suboxone.[7] 

How Does Suboxone Block Opioid Cravings?

Buprenorphine (the active ingredient in Suboxone) is a partial opioid agonist. This means it fills up opioid receptors the same way that full opioids like heroin or fentanyl do, preventing the withdrawal that would otherwise occur.[7] At the same time, it is only a “partial” agonist, meaning it doesn't turn on those receptors as strongly as a full opioid agonist. It therefore has a much lower likelihood of getting the patient “high” or putting them at risk of an overdose. Instead, they simply function normally.

What Happens If You Use Suboxone & Opioids Together?

Suboxone misuse is relatively rare.[8] When people do take their prescription more often than they are supposed to, it is usually a well meaning attempt to control their withdrawal symptoms and to function, and not as an attempt to “get high”.

But some people do relapse to opioids while using Suboxone. Relapse is a part of recovery, and it's not a sign of weakness.

If you use opioids while taking Suboxone, the Suboxone will partially block those opioid receptors and partially prevent you from getting high. This will help protect against an overdose to a certain extent.

Bear in mind, this protective effect is partial and not at all fool-proof. If you continue to take very high doses of opioids, the protective effect of Suboxone can be overcome, and you can overdose and even die. Do not make the mistake of thinking that you cannot overdose on opioids just because you have Suboxone in your system.

If you are tempted to use additional opioids while taking Suboxone, call your doctor immediately before you do. They can adjust your Suboxone dose and otherwise help you to control cravings before you relapse and potentially put yourself at risk of an overdose.

Sources

  1. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. September 2022. Accessed November 2022.
  2. U.S. Overdose Deaths in 2021 Increased Half as Much in 2020, But Are Still Up 15%. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm. May 2022. Accessed November 2022.
  3. What Is the Half Life of a Drug? News Medical Life Sciences. https://www.news-medical.net/health/What-is-the-Half-Life-of-a-Drug.aspx. May 2021. Accessed November 2022.
  4. How Long Does Suboxone Stay in Your System? Drugs.com. https://www.drugs.com/medical-answers/long-suboxone-stay-system-3535350/. March 2022. Accessed November 2022.
  5. Medicine Half Life Calculator. MD App. https://www.mdapp.co/medicine-half-life-calculator-81/. Accessed November 2022.
  6. Drug Half-Life Calculator. Omni Calculator. https://www.omnicalculator.com/health/drug-half-life. August 2022. Accessed November 2022.
  7. Buprenorphine. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. https://www.ncbi.nlm.nih.gov/books/NBK548871/. November 2022. Accessed November 2022.
  8. Trends in and Characteristics of Buprenorphine Misuse Among Adults in the U.S. JAMA. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785011. October 2021. Accessed November 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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