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What Happens if You Take Too Much Suboxone?

It is much less likely to overdose on Suboxone compared to other opioids if it is taken as prescribed.

Suboxone contains buprenorphine, a partial opioid agonist. Because it weakly activates the opioid receptor, it can cause some euphoria and mild sedation, and it can reduce pain. However, when taken as a treatment for opioid use disorder, the medication will make you feel more normal, and not intoxicated in the same way that you felt when using opioids.

Suboxone also contains naloxone, which prevents the drug from becoming bioavailable if you take too much or if it is tampered with.

Suboxone: A Vital Tool in Overcoming Opioid Use Disorder

Suboxone is a prescription medication combining buprenorphine and naloxone.[1] It is prescribed to ease opioid withdrawals and prevent craving and relapse.

It is a lifesaving medicine for people who want to end their opioid problem, and is often used in  Medication for Addiction Treatment (MAT) programs, often supplemented by behavioral counseling. Simply quitting opioids is, for many, mentally and physically challenging. Relapse, which can lead to overdose, is not uncommon.

Taking a maintenance medication like Suboxone has been proven to reduce relapse and risk of death by overdose in people struggling with opioid use disorder. It can also help people focus on counseling and learning how to maintain an abstinent lifestyle. Taking Suboxone or other MAT treatments renders people much more likely to sustain recovery.

Although it is possible to overdose on buprenorphine, especially if combined with other sedating medications like benzodiazepines or alcohol, the risk is much lower than other opioids. Compared to other medications used during MAT like methadone, therefore, Suboxone is much safer.

How to Safely Take Suboxone

Suboxone is most often prescribed as a sublingual or buccal film — a thin strip of medication that you place underneath your tongue or on the inside of the cheek.[2] The medication dissolves and enters your bloodstream through this mucous membrane rather than being digested.

There are also pill or tablet versions of Suboxone, along with some generic versions of this medication. Generic options may work better for you, be more affordable, or be easier to find in a dose that works for your body.

Your physician is most likely to tell you to take Suboxone once per day, at the same time each day. When you take it, you may want to wet your mouth with a little water to help the film strip dissolve, especially if you regularly experience dry mouth or a bad aftertaste when you take it.

Do not eat, drink, or smoke cigarettes 15 minutes before or after you take Suboxone. Let the film strip or pill dissolve for 15 minutes.

If you have an aftertaste you do not like, you can rinse your mouth with water, eat a breath mint, or chew gum.

Can You Take Too Much Suboxone?

Since Suboxone contains buprenorphine, it is technically possible (though not likely) to take “too much” of this medication. However, people who struggled with opioid addiction and abuse for years are unlikely to either get very high from it or experience extreme sedation.. This is because it is a partial agonist which means that it has a ceiling effect, or its effect plateaus at higher doses.

Plus, naloxone is present in Suboxone to prevent tampering. If too much buprenorphine is taken at once, naloxone will stop the drug’s effects.

People who are opioid-naïve (like children) who take too much buprenorphine may be more likely to experience drowsiness, or they may fall asleep and be unable to be roused.[3] This is a symptom of an overdose, and you should call 911 for help.

Other symptoms include the following:

  • Irregular or shallow breathing
  • Stopped breathing
  • Irregular heart rate
  • Pinpoint pupils

In addition, studies show that when combined with other sedating medications, like benzodiazepines, or alcohol, buprenorphine-containing medications carry an increased risk of overdose.

There is a slightly greater risk of overdose with buprenorphine-only medications like Subutex compared to Suboxone, which is designed to reduce tampering. Again, if taken as prescribed, you are much safer on buprenorphine containing medications than other opioids.

Medical Oversight With Counseling

Overdoses involving buprenorphine medications like Suboxone are more likely if you do not have medical supervision when you take this drug.

You cannot legally acquire Suboxone without a prescription, but some people do in an effort to quit abusing opioids on their own. This means they do not receive behavioral counseling to manage compulsive drug consumption, and they do not have a doctor helping them adjust their dose of Suboxone. While they may not overdose on Suboxone, they may overdose with Suboxone in their system if they use it in combination with other sedating medications or while abusing other opioids like oxycodone, heroin, or fentanyl.

One medical study found that buprenorphine, since it is a partial opioid agonist, was six times safer for detox and MAT compared to methadone, a full opioid agonist that is also used safely and successfully in MAT.[4] Suboxone is becoming the preferred method for helping people overcome OUD due to its success and safety.

SOURCES

  1. Homepage. Suboxone.com. https://www.suboxone.com/. Accessed January 2022. 
  2. Buprenorphine/Naloxone (Suboxone). National Institute on Mental Illness (NAMI). https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). January 2021. Accessed January 2022. 
  3. Buprenorphine. American College of Medical Toxicology (ACMT). https://www.acmt.net/Buprenorphine_FAQ.html#Q2. Accessed January 2022. 
  4. The Relative Risk of Fatal Poisoning by Methadone and Buprenorphine Within the Wider Population of England and Wales. Addiction Research.https://bmjopen.bmj.com/content/5/5/e007629. January 2015. Accessed January 2022.

Medically Reviewed By Claire Wilcox, MD

Claire Wilcox, MD, is a general and addiction psychiatrist in private practice and an associate professor of translational neuroscience at the Mind Research Network in New Mexico; and has completed an addictions fellowship, psychiatry residency, and internal medicine residency. Having done extensive research in the area, she is an expert in the neuroscience of substance use disorders. Although she is interested in several topics in medicine and psychiatry, with a particular focus on substance use disorders, obesity, eating disorders, and chronic pain, her primary career goal is to help promote recovery and wellbeing for people with a range of mental health challenges.

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