Is Suboxone Addictive? Myths & Realities

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Suboxone, like many prescription medications, can be addictive. But unlike some notorious drugs (such as Vicodin or OxyContin), it is overall less addictive and much safer.

Buprenorphine, the active ingredient in Suboxone, does trigger mild euphoria in people with no drug use experience, and it is technically considered addictive. It is, after all, an opioid medication, and opioid medications all have the potential to cause addiction. Suboxone can cause withdrawal symptoms if stopped abruptly in the same way as other addictive substances.

However, Suboxone certainly has less addiction potential than full opioids, mostly because it turns on opioid receptors less strongly than full agonists, creating less euphoria/”high” feelings. [1]

How Suboxone Works

Suboxone is a prescription medication containing two active ingredients. These are Suboxone's two active ingredients:

  • Buprenorphine: Buprenorphine is a partial opioid agonist. It attaches to opioid receptors, just like heroin. However, unlike heroin which is a full opioid agonist, Suboxone is a partial opioid agonist, thus it can provide only a small high even if taken in excess and has a much lower risk of overdose than heroin for that reason.
  • Naloxone: Naloxone is not absorbed when a person takes the suboxone sublingually as prescribed. However, were the individual to attempt to inject the Suboxone, the Naloxone is absorbed along with the buprenorphine. It binds to receptors preferentially in the body over the buprenorphine and prevents the individual from getting high or overdosing. In this way, buprenorphine is included in Suboxone as a way of reducing misuse and risk for overdose. [2] 

Side Effects & Risks of Suboxone Treatment

All medications have side effects, and Suboxone is no exception. Most of these side effects occur in the first few days of use and resolve as the body gets used to the medication. However, if you do have persistent side effects, talk to your doctor. These might be easily resolved with an adjustment of your dose.

Some people experience these side effects:[3]

  • Anxiety
  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea
  • Sedation

How Effective Is Suboxone for Opiate Addiction?

Suboxone is one of the most studied, and most effective, medications doctors can use to treat opioid addiction.

Researchers say people taking a medication like Suboxone are almost two times as likely to stay in treatment as those who don't take medications.[5] And taking the medication also reduces your risk of overdose.[6]

Addiction is a chronic, relapsing condition. Some people use Suboxone for the rest of their lives to treat their opioid use disorder. Others use the medication on a shorter schedule.

Only you and your doctor know how long your treatment will last. You will collaborate to find the right answer for you.

If you determine you’d like to stop taking Suboxone, talk to your doctor about the best way to do this. Don’t attempt to stop taking the medication on your own without medical guidance.

References

  1. Is Buprenorphine Addictive? The National Alliance of Advocates for Buprenorphine Treatment. https://www.naabt.org/faq_answers.cfm?ID=33. Accessed June 2022.
  2. Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Current Drug Abuse Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154701/. March 2011. Accessed June 2022. 
  3. Buprenorphine Therapy for Opioid Use Disorder. American Family Physician. https://www.aafp.org/pubs/afp/issues/2018/0301/p313.html. 2018. Accessed June 2022. 
  4. Diversion and Abuse of Buprenorphine. Providers Clinical Support System. https://pcssnow.org/resource/diversion-abuse-buprenorphine/. August 2021. Accessed June 2022. 
  5. Medications to Treat Opioid Use Disorder Research Report. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder. December 2021. Accessed June 2022. 
  6. Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. JAMA. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760032. February 2020. Accessed June 2022.
  7. Opioid Overdose Basics. National Harm Reduction Coalition. https://harmreduction.org/issues/overdose-prevention/overview/overdose-faqs/. Accessed June 2022. 

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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