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Injecting Suboxone: The Dangers of Shooting Suboxone

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 25, 2024 • 12 cited sources

Injecting (or shooting) Suboxone can lead to unpleasant withdrawal symptoms, infections, blood clots and vein damage. The method also doesn’t produce the high people are looking for. 

Suboxone contains buprenorphine (which stops working at high doses) and naloxone (which blocks high doses of buprenorphine). Shooting the drug is more likely to make you feel sick from precipitated withdrawal than high. 

If you’re tempted to inject or misuse your Suboxone, talk to your doctor. You may need additional help for your opioid use disorder (OUD).

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Can You Inject Suboxone?

It’s technically possible to inject Suboxone. The medication comes in a dissolving strip or tablet. Some people apply Suboxone to liquid, wait for it to dissolve, and inject the fluid. 

Shooting Suboxone is never smart. The drug isn’t designed to enter your body through your veins. Never try this method.

side effects of shooting suboxone

Can You Get High From Injecting Suboxone? 

People who have never used any kind of opioid or OUD medication may achieve a mild high when misusing Suboxone. But it’s very rare for anyone who has previously used any kind of opioid to get a substantial high from injecting Suboxone. 

In one study, people who injected Suboxone said they felt “nothing,” including no euphoria, from the practice.[1] In a second study, people said they had a low “desire to take the drug again” after injecting dissolved Suboxone.[2]

Suboxone won’t get you high due to the naloxone component. Naloxone is an opioid antagonist, meaning that it attaches to opioid receptors in your brain, reversing and blocking the effects of other opioids.[11]

Naloxone products like Narcan are life-saving solutions during an overdose. They effectively kick stronger drugs off their receptors and cap them, stopping an overdose in minutes and restoring breathing rates.[11]

Suboxone contains a very low dose of naloxone that doesn’t do anything at a normal dose. You won’t feel it, and it won’t interfere with the buprenorphine in your dose.[10]

However, if a person injects Suboxone, both the buprenorphine and the naloxone enter the bloodstream. The naloxone “overrules” the buprenorphine, preventing the person from getting high and also preventing an accidental overdose.

What Are the Side Effects of Shooting Suboxone?

Problems associated with injecting Suboxone are serious. Some can be life-threatening. 

Precipitated Withdrawal 

If you inject Suboxone, you will experience precipitated withdrawal, characterized by the following symptoms: [3]

  • Nausea
  • Diarrhea
  • Headaches
  • Flu-like discomfort

People who start Suboxone too early can develop precipitated withdrawal. Typically, doctors recommend a gap of several hours between the last drug dose and your first Suboxone dose to prevent this problem.[7]

However, people who misuse Suboxone may not realize these risks and experience precipitated withdrawal. The symptoms are significant, and case studies suggest they’re sometimes bad enough to require a hospital stay.[7]

Infections

Suboxone should dissolve beneath the tongue and not enter your body through the bloodstream. Injecting the drug can lead to the following complications:[4]

  • Abscesses
  • Soft tissue infections
  • Endocarditis
  • Sepsis
  • HIV infection
  • Hepatitis C infection

Anyone who misuses drugs with a needle can develop infections. Unfortunately, the issue is common. In one study, 97% of people with infections caused by drug injection used opioids, and 80% of the infections were caused by the S. aureus bacteria.[7]

Your risk of infections from injecting Suboxone isn’t necessarily higher or lower than the risk of infection from using any other drug. Anytime you push a needle into the skin to use drugs, an infection is possible.

Overdose

Researchers say buprenorphine products are six times safer than methadone products in terms of overdose risk.[5] But combining Suboxone with medications like benzodiazepines can lead to extreme sedation and overdose.[4]

Symptoms include the following: [3]

  • Extreme sleepiness, drowsiness or grogginess
  • Dizziness and falling over
  • Blurry vision that does not improve
  • Trouble breathing or lack of breathing
  • Shallow or slowed breathing
  • Pinpoint pupils
  • Becoming unresponsive after passing out

Relapse

If your opioid use disorder was previously controlled on Suboxone, injecting the medication indicates you’re not fully in control. It could also lead to problematic opioid use.

Speak with your treatment provider immediately if you’re feeling compelled to inject Suboxone. There’s a chance you may need to return to a treatment program or receive additional support right now.

Is There an Injectable Version of Suboxone?

The prescription medication Sublocade is very similar to Suboxone. It’s an injectable medication designed for OUD. This table explains their differences:[9,10]

 SublocadeSuboxone
Active ingredientsBuprenorphineBuprenorphine and naloxone
Method of administration InjectionDissolving oral medication
Typical dose100 mg monthly16 mg buprenorphine/4 mg naloxone daily
FDA approved useOpioid use disorderOpioid use disorder
Take-home med?NoYes
Misuse potentialVery lowLow
Side effectsConstipation, headache, nausea, injection site complications, vomiting, liver problems and fatigue Oral complications, headache, nausea, vomiting, sweating, constipation, insomnia and swelling of the hands and feet
Potential benefitsReduced temptation to misuse the drug; no potential for household members to misuse the drugNo need for a monthly doctor’s appointment; low misuse potential due to naloxone

Sublocade doesn’t contain naloxone, so it’s not the same as Suboxone. But some people benefit from treatment consisting of only buprenorphine.

Sublocade is very hard to misuse, as the drug is administered by doctors in appointments. You aren’t given the drug to take home. Instead, you must go to the doctor to get it. 

What Are the Benefits of Using Suboxone Properly?

Suboxone is a very effective and safe treatment for opioid use disorder when taken as prescribed. There are several benefits of Suboxone that far outweigh the risks that come from injecting the drug. 

Since buprenorphine is a partial opioid agonist, this medication does not cause the potent high that some other opioids (e.g., fentanyl) do. Instead, buprenorphine binds to opioid receptors in the brain for a full day or more, reducing withdrawal symptoms, including anxiety, intense cravings and physical discomfort.

By suppressing withdrawal symptoms and cravings, the individual taking Suboxone can focus on recovery. Often, Suboxone is taken indefinitely since it is so effective at promoting long-term recovery.

Using medications like Suboxone could help you to do the following:[6]

  • Reduce your risk of an early death
  • Improve your social functioning
  • Reduce your risk of criminal activity 
  • Lower your risk of using other drugs
  • Limit your HIV and hepatitis exposure risks

Treatment for Suboxone Misuse 

The majority of people who misuse Suboxone do so to treat an underlying opioid use disorder (OUD).[4] If you’ve been buying Suboxone from dealers and injecting it, there is a better and much safer way forward.

Talk to your doctor about your opioid misuse history, and ask about entering a treatment program or using Suboxone.

If you have a Suboxone prescription and you’ve misused it, talk to your doctor. You may need a stronger dose of medications to keep your OUD under control, or you may need a different recovery setting. 

The more open and honest you can be with your provider, the more likely you are to safely and appropriately use your medications to get the desired results and maintain long-term abstinence.

When to Seek Help for Suboxone Misuse

Suboxone is a powerful prescription medication designed to help people overcome OUD. If you’re using the medication per your doctor’s instructions, you’re not misusing it. However, some symptoms suggest that your drug use is problematic.

You could need help with Suboxone misuse if these signs apply to you:[12]

  • Using Suboxone via a needle or any other method not explicitly recommended by your doctor
  • Using Suboxone to get high rather than to treat OUD
  • Using more Suboxone than your doctor recommended
  • Asking for Suboxone from your family or friends

Talk with your treatment team about how you’re using Suboxone. Together, you can find a solution.

Is Suboxone Treatment Right for You?

Suboxone is a prescription medication proven to help people overcome OUD. If you’re injecting drugs, or considering doing so, it’s time to consider treatment. With help, you could stop withdrawal symptoms and cravings, allowing you to build a healthier life in sobriety. 

Bicycle Health offers online treatment options for people just like you. Find out how our process works and see if it’s right for you.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. A Retrospective Evaluation of Patients Switched from Buprenorphine (Subutex) to the Buprenorphine/Naloxone Combination (Suboxone). Substance Abuse Treatment, Prevention, and Policy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453114/. June 2008. Accessed June 2023.
  2. Abuse Liability of Intravenous Buprenorphine/Naloxone and Buprenorphine Alone in Buprenorphine-Maintained Intravenous Heroin Abusers. Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489277/. November 2022. Accessed June 2023.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  4. Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Current Drug Abuse Reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154701/. March 2011. Accessed June 2023.
  5. The Relative Risk of Fatal Poisoning by Methadone or Buprenorphine Within the Wider Population of England and Wales. BMJ. https://bmjopen.bmj.com/content/5/5/e007629. May 2015. Accessed June 2023.
  6. Buprenorphine: An Overview for Clinicians. California Health Care Foundation. https://www.chcf.org/wp-content/uploads/2019/08/BuprenorphineOverviewClinicians.pdf. August 2019. Accessed June 2023.
  7. Managing Opioid Withdrawal Precipitated by Buprenorphine with Buprenorphine. Drug and Alcohol Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248003/. May 2021. Accessed January 2024.
  8. Bacterial and Fungal Infections in Persons Who Inject Drugs: Western New York, 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/68/wr/mm6826a2.htm. July 2019. Accessed January 2024.
  9. Sublocade Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/209819s017s018lbl.pdf. March 2021. Accessed January 2024.
  10. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. March 2021. Accessed January 2024.
  11. Naloxone DrugFacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/naloxone. January 2022. Accessed January 2024.
  12. Prescription Drug Monitoring Program: Resources for Public. Alabama Public Health. https://www.alabamapublichealth.gov/pdmp/resources-for-public.html. March 2023. Accessed January 2024.

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