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Suboxone Side Effects

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 4, 2023 • 6 cited sources

Suboxone is a safe prescription medication that is accepted for use in treating opioid use disorder (OUD). Like all medications, it comes with the potential for some side effects. 

Suboxone’s side effects don’t tend to be extreme, although some people may have a serious negative reaction that warrants talking to a doctor.

What Are the Most Common Side Effects of Taking Suboxone?

The main ingredient of Suboxone, buprenorphine, can cause a variety of side effects including these:[1]

  • Stomach pain
  • Constipation
  • Mouth numbness
  • Dry mouth
  • Tongue pain
  • Blurred vision
  • Back pain
  • Headache
  • Sleep problems

Most of these symptoms aren’t an immediate concern, although you should still talk to a doctor if they significantly impact your quality of life or seem severe. You should also talk to a doctor if any of these side effects are long-lasting, as that isn’t typical.

While not a common side effect if taken as prescribed, Suboxone can sometimes cause a person to go through withdrawal if taken shortly after one has also taken another more powerful opioid, such as fentanyl. This is due to Suboxone’s naloxone component, which can counteract the effects of other opioids. 

The reason this isn’t a typical side effect of prescribed Suboxone use is that doctors are aware of this risk and aim to avoid it. They usually distance a person’s first Suboxone dose in such a way that their body will have had time to process any other opioids that were still in their system. 

What Are the Some Rare Side Effects of Taking Suboxone?

Rarely, a person may experience more serious side effects when taking Suboxone, including allergic reaction, liver complications, and respiratory depression.[2] Side effects that warrant immediately talking to a doctor include the following:

  • Swelling of the face, lips, throat, tongue, legs, hands, feet, ankles, and/or eyes
  • Rash or hives
  • Itching or skin irritation
  • Severe nausea and/or vomiting
  • Loss of appetite
  • Dizziness
  • Confusion and/or severe unexplained agitation
  • Hallucinations
  • Changes to sexual desire
  • A reduced ability to get an erection
  • Irregular menstruation
  • Significantly slowed breathing
  • Extreme fatigue
  • Unexplained bleeding or bruising
  • Dark-colored urine
  • Light-colored stool
  • Yellowing of the skin or eyes (jaundice)
  • Pain in the upper right part of the stomach

Suboxone contains an opioid, so some respiratory depression is normal when taking the drug.[3] However, this respiratory depression won’t typically be life-threatening to a healthy individual if the drug is taken on its own, especially if taken as prescribed. What can make this depression more dangerous is if the drug is taken in combination with other drugs that have a similar effect, such as alcohol, or if a person has health complications that already impact their breathing.

Does Suboxone Cause Mental Health Side Effects?

Major mental health changes aren’t typically associated with Suboxone. However, as touched on in the section above, strange or severe mood swings can be a sign of a serious negative reaction to the drug and warrant talking to a doctor. 

The drug may also cause mild euphoria, especially if misused by those who are opioid naïve, but it cannot typically cause the intense euphoric high associated with more powerful opioids. Also, anyone who is taking Suboxone to treat opioid use disorder will not be opioid naïve.   

Some people may falsely attribute certain negative emotions they feel to taking Suboxone due to the fact that it is typically taken as part of an addiction treatment process. Addiction treatment can be stressful and anxiety-inducing at times, even though it is well worth the effort. If someone starts taking Suboxone early in their treatment, they may think they’re feeling a certain way because of the drug, when in reality, it is the life changes that coincide with starting Suboxone that are making them feel a certain way.

What Are the Long-Term Effects of Taking Suboxone?

If taken on a long-term basis, Suboxone is going to cause physical dependence on the drug, as the body adapts to its continued use. However, this is an accepted part of addiction treatments that include medications. This is because many patients are already opioid dependent, and switching over to Suboxone can help them avoid misuse of much more dangerous opioids. 

This dependence also won’t typically be as intense as other types of opioid dependence. It causes only mild withdrawal that one can generally undergo at home if they decide to stop taking Suboxone.

Suboxone can impact the liver, although it won’t typically cause serious harm if taken as prescribed by an individual who is generally healthy.[4] In individuals who have liver issues, taking Suboxone may not be a good choice long term, although a doctor can sometimes modify the dosing used to help a person avoid a toxic or otherwise dangerous reaction.

Overall, there is substantial evidence that taking Suboxone or similar drugs long-term produces better health outcomes for people recovering from opioid use disorder.[5] It is typical for experts to suggest the drug be taken for at least a year, assuming no serious negative reaction occurs. It helps to suppress drug cravings and withdrawal, which can make resisting opioid misuse much easier. In most cases, there is no reason to stop taking Suboxone, provided it continues to support one’s recovery.

Other Options for Medication for Addiction Treatment

The main alternative medication for opioid use disorder (mOUD) is methadone. Studies comparing buprenorphine-based treatments like Suboxone to methadone typically find the drugs highly comparable.[6] 

Experts generally consider the drugs to be roughly equal in their ability to help a person in opioid addiction recovery, but Suboxone offers certain benefits. For this reason, Suboxone is usually the first-line medication used, as it is easier to access and a partial opioid agonist compared to methadone, which is a full opioid agonist. Suboxone is also less likely to be misused than methadone.

With that said, both are accepted, approved treatments for OUD. If a person doesn’t react well to one, they will often be put on the other to see if they may benefit more from the alternate treatment.

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. Buprenorphine Sublingual and Buccal (opioid dependence). National Library of Medicine. https://medlineplus.gov/druginfo/meds/a605002.html. January 2022. Accessed February 2023.
  2. Patient Information for Suboxone. Indivior UK Limited. https://www.suboxone.com/. Accessed February 2023. 
  3. Opioid-Induced Respiratory Depression in Humans: A Review of Pharmacokinetic-Pharmacodynamic Modelling of Reversal. British Journal of Anaesthesia. https://www.bjanaesthesia.org/article/S0007-0912(19)30008-X/fulltext. January 2019. Accessed February 2023.
  4. Buprenorphine/Naloxone and Methadone Effects on Laboratory Indices of Liver Health: A Randomized Trial. Drug and Alcohol Dependence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543467/. February 2014. Accessed February 2023.
  5. Impact of Long-Term Buprenorphine Treatment on Adverse Health Care Outcomes in Medicaid. Health Affairs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531057/. May 2022. Accessed February 2023.
  6. Buprenorphine vs Methadone Treatment: A Review of Evidence in Both Developed and Developing Worlds. Journal of Neurosciences in Rural Practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271614/. January 2012. Accessed January 2023.

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