Suboxone is not an opiate, although it does contain an opioid, buprenorphine. We will explain below the difference between an opiate and an opioid. Suboxone is a partial synthetic opioid. It is a medication that can be a vital part of successful addiction treatment for opioid use disorder.
Suboxone is a brand-name drug that combines buprenorphine and naloxone.[1] It is one of the most commonly used medications as part of Medication for Addiction Treatment (MAT) for opioid use disorders (OUDs).
The terms opioids and opiates are often used interchangeably, but technically, they are not the same.
Opiates are drugs naturally derived from the poppy plant. Opioids are synthetic drugs that act like opiates, but chemists have adjusted them to make them stronger or more potent.
Both opioids and opiates are narcotics.[1] They both cause sedation and sleepiness. These days, the most accepted term to describe both opioids and opiates is opioids because most available opioid products are synthetic.
Don't let the terminology confuse you. Know that both opiates and opioids are dangerous. An opiate is any product produced directly from the Poppy plant, or “non-synthetic”. Don’t be fooled into thinking that just because opiates are “natural” or non-synthetic that this means they are “safer” than synthetic opioids. For example, heroin is a natural opiate, however it is one of the most potent and dangerous opioid-like drugs available.
Suboxone (Buprenorphine) is a partial synthetic opioid, meaning it is entirely synthesized in a lab, and not a derivative of the poppy plant (not an opiate).
Buprenorphine is a long-acting partial opioid agonist that acts on the same receptors full opioid agonists like heroin do. This helps to eliminate drug cravings and stops withdrawal from occurring.
As a partial agonist, it also fits imperfectly onto these receptors, producing a less intense euphoric high than is typically associated with “full” opioids. While it has some misuse potential, it has been shown numerous times in research to represent an overall benefit in terms of helping people effectively recover from opioid use disorder and avoid adverse outcomes like dropping out treatment or having a dangerous relapse.
Buprenorphine also helps block the ability of other opioids to cause an intense high in a person with the drug in their system, further reducing their risk of drug misuse.
Suboxone also contains naloxone, which is an opioid antagonist. This drug can counteract the effects of opioids if Suboxone is injected rather than taken orally as intended, including reversing the effects of the buprenorphine in Suboxone. This means it helps to further reduce the drug’s misuse potential, as it discourages a user from trying to inject the drug in an attempt to intensify the mild high buprenorphine can produce.
Historically, Suboxone prescriptions have typically been avoided for pregnant people, as the effects of naloxone on pregnancy were under-researched. Pregnant women instead received pure Buprenorphine products like Subutex. Nowadays however, we have more studies that show that Suboxone is largely safe in pregnancy [2]. Most providers these days encourage women to continue Suboxone during pregnancy.
While Suboxone is considered to have some misuse potential (albeit very low), it isn’t generally considered to have a major misuse risk. Because buprenorphine is a long-acting partial agonist that doesn’t cause a particularly intense high, most people aren’t driven to intentionally misuse it for the purpose of getting high. It tends to make opioid experienced individuals simply feel “normal”.
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