Suboxone is a prescription medication approved in 2002 by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD). Each dose contains two elements: buprenorphine to ease withdrawal and cravings, and naloxone to reduce abuse risks.
Key Facts About Suboxone
- Buprenorphine, an active ingredient in Suboxone, was developed as a pain medication in the 1970s, but researchers quickly learned it could also help to ease OUD symptoms.
- Naloxone can reverse an opioid overdose for up to 90 minutes. Inside Suboxone, naloxone is inert unless people take too much or otherwise misuse their medication.
- The most common Suboxone side effects are insomnia, constipation, nausea, sweating and headaches.
- Suboxone treatment statistics suggest this medication is effective in addressing OUD, and few people misuse their doses.
- Research suggests starting Suboxone at home is just as safe and effective as going through the induction process in a hospital or clinic.
How Does Suboxone Work?
In 2002, Suboxone was approved by the FDA for the treatment of OUD. Since then, it’s saved countless lives.
Suboxone contains two ingredients in the following ratios: buprenorphine (80%) and naloxone (20%). For maintenance treatment, the FDA recommends a daily dose of 16 mg of buprenorphine and 4 mg of naloxone.
Buprenorphine: How Does It Work?
How does buprenorphine work in the brain? It’s a common question with a relatively simple answer.
Buprenorphine is a partial opioid agonist that links to the same receptors used by drugs like heroin and Vicodin. Those stronger drugs link tightly, producing strong chemical changes. Buprenorphine has a loose link, relieving cravings and withdrawal symptoms without producing a high.
Buprenorphine also has a ceiling effect, meaning stronger doses don’t always produce bigger highs. Instead, taking too much can push people into uncomfortable withdrawal symptoms.
Naloxone: How Does It Work?
While buprenorphine is a partial opioid agonist, naloxone is an opioid antagonist. Instead of latching to receptors, it blocks them completely.
How does naloxone work? If you’re taking the proper Suboxone dose, it doesn’t work at all and passes out of your body. But if you take too much, it kicks in and blocks your opioid receptors, preventing strong overdose symptoms.
Naloxone is a misuse deterrent, designed to ensure that you don’t try to misuse your doses by smoking or snorting them.
Learn more: What is Naloxone?
How Effective Is Suboxone for the Treatment of Opioid Use Disorder?
For decades, doctors have found that medications like Suboxone can save lives.
Close to 50% of people using Suboxone reduced their painkiller misuse within 12 weeks
In one of the first studies of Medication for Addiction Treatment (MAT) programs published in 2011, researchers found that close to 50% of people using Suboxone reduced their painkiller misuse within 12 weeks, and that success rate dropped to lower than 9% when Suboxone was discontinued.
In a separate study published in 2003, researchers found that 75% of people taking a medication like Suboxone produced clear urine drug tests compared to none of the people using a placebo.
Suboxone success rates are typically attributed to the medication’s ability to ease drug cravings. When people can resist the temptation to return to drug misuse, they produce clean urine screenings and objectively prove that they’re not misusing drugs. Suboxone makes it easier to resist drug misuse.
Learn more: Suboxone Success Rates
When Should I Start Taking Suboxone?
Many people with OUD develop physical dependence and feel sick between drug doses. Using Suboxone too early can make this problem worse through a syndrome known as precipitated withdrawal.
Take the medication too soon, and it will inactivate all the drugs in your system and cause withdrawal symptoms such as these:
- Muscle aches
Researchers say Suboxone-precipitated withdrawal symptoms are typically more severe than those people with OUD experience naturally.
To avoid precipitated withdrawal, doctors ask their patients to wait until they’re experiencing mild withdrawal symptoms caused by their drug of choice. Then, they’re ready to use Suboxone.
When to start Suboxone varies by the type of opioids you took. Doctors follow these general guidelines.
|Type of Opioids||Examples||Recommended Wait Time|
|Short-acting opioids||Heroin, Vicodin, Dilaudid or Percocet||6–12 hours*|
|Intermediate-acting opioids||Sustained-release OxyContin, MS Contin or morphine||12–24 hours|
|Long-acting opioids||Methadone||48–72 hours|
These are estimates, and your timeframe can vary. Talk to your doctor about your drug history and symptoms, and develop a start time that’s right for you.
How to Take Suboxone
Two types of Suboxone exist: pills and strips. Both forms dissolve inside your mouth, allowing active ingredients to hit your bloodstream without moving through your digestive system.
Your doctor will tell you how to take Suboxone, but this quick set of instructions can help you understand what’s typically involved in using this important medication.
Learn more: How to Take Suboxone
If your doctor prescribes Suboxone strips, follow these steps:
- Moisten your mouth. Take a sip of water and rinse your mouth.
- Remove the medication. Wash and dry your hands, and tear open the package containing your Suboxone film. Hold it by the edges, not the center.
- Place the film in your mouth. Press the film onto the tissue under your tongue. Make sure it sticks.
- Wait for the film to dissolve completely. Don’t push the film with your tongue or check. Just wait for it to fade away.
- Rinse your mouth. Suboxone strip residue can cause dental problems. When your medication has completely dissolved, take a large sip of water, swish it around your teeth, and swallow. This is known as the Suboxone spit trick. Wait at least an hour before brushing your teeth.
Taking Suboxone strips may seem unusual or uncomfortable at first, but with practice, it gets easier.
Learn more: How to Take Suboxone Strips
If your doctor prescribes Suboxone pills, follow these steps:
- Moisten your mouth. Take a sip of water and rinse your mouth.
- Place your medication in your mouth. Don’t chew, crush or swallow your pill. Put the tablet under your tongue. You may be directed to use multiple tablets, so follow your doctor’s instructions.
- Wait for the pill to dissolve completely. Don’t chew the tablet or use your teeth.
- Rinse your mouth. Suboxone tablet residue can also cause dental problems. When your medication has completely dissolved, take a large sip of water, swish it around your teeth, and swallow. Wait at least an hour before brushing your teeth.
Taking Suboxone tablets can require practice. Remember that you must let the medication dissolve instead of swallowing your dose.
Learn more: How to Take Suboxone Tablets
Comparing Suboxone to Alternatives
The U.S. Food and Drug Administration has approved three medications to treat OUD. They are buprenorphine, naltrexone and methadone. Buprenorphine is the main ingredient in Suboxone that is used to manage OUD symptoms.
If Suboxone isn’t right for you, one of the alternatives in the table below could be a better choice.[10–16]
|What is it?||An opioid agonist||A partial opioid agonist||An opioid antagonist|
|What OUD symptoms does it address?||Cravings and withdrawal symptoms||Cravings and withdrawal symptoms||Cravings; prevents overdose|
|Side effects||Restlessness, nausea, slow breathing, itchy skin, sweating, constipation, sexual problems||Constipation, headache, nausea, vomiting, dizziness, drowsiness, sweating, dry mouth, tooth decay, muscle aches, insomnia, fever, blurry vision, tremors||Sleepiness, nausea lightheadedness, headache, vomiting, reduced appetite, tender joints, muscle cramps, congestion and other cold symptoms, difficulty sleeping, toothaches|
|Pricing||From $15 (per tablet) to $366 (per injection)||From $18 (per tablet) to $55 (per transdermal film)||From about $2 (per tablet) to more than $1,500 (per injection)|
|Forms||Tablet, oral solution, injectable liquid||Tablet, dissolving film, injectable liquid||Tablet and injection for OUD|
|Dosages||20 mg to 80 mg or more||2 mg to 24 mg||50 mg (in tablet form), or 380 mg (in injection form, given once every 4 weeks)|
|Time to work||30–45 minutes (oral dose)||About an hour||Immediate (in injection form) or about an hour (for tablets)|
Don’t make decisions about Suboxone vs. methadone, Suboxone vs. naltrexone or any other combinations without talking to your doctor. Together, you can decide which type of MAT therapy is best for your long-term recovery.
Common Myths About Using Suboxone
Tell people you’re prepared to use medications to address your OUD, and you may hear many common myths about Suboxone. Understanding what people think about the medications you use could help you respond when you hear them.
Below are common myths we’ve heard in the community. They are myths because they’re absolutely untrue.
- People misuse Suboxone to get high.
- People overdose on Suboxone.
- Long-term Suboxone therapy is harmful.
Myths like these foster stigma that prevents people from using life-saving MAT.
Learn more: Common Myths About Suboxone
What Are Suboxone’s Side Effects?
Like most prescription medications, Suboxone comes with side effects. Typically, they are mild and tend to fade as your body adjusts to therapy.
Suboxone side effects include the following:
- Irregular heartbeat
- Sexual side effects
- Urinary retention
If the side effects are severe, talk with your doctor. Together, you can create a plan to help you feel better.
Learn More: Side Effects of Suboxone
How Much Does Suboxone Cost?
The cost of Suboxone varies depending on your insurance type. Even if you don’t have insurance, programs can help you save money.
Without insurance, a one-month supply of Suboxone costs between $166 and $570. Choose a generic form, and you’ll pay between $60 and $200. With insurance, you could pay as little as $5 per month.
Before you sign up for a private insurance plan, you can ask if it covers Suboxone and how much it’ll pay.
If you have Medicaid coverage, your coverage is more complex, as plans can vary from state to state. In some locations, you’ll pay nothing. In others, that’s not true.
If you have Medicare Part D, your Suboxone is covered. If you don’t, you may not have coverage.
Learn more: How much does Suboxone cost?
Where Can I Get Suboxone?
Before December 29, 2022, doctors needed a specific waiver before prescribing drugs like Suboxone. Legislation changed that. Now, any doctor who is capable of prescribing controlled substances can write a prescription for Suboxone.
Visiting a clinic that specializes in MAT may be worthwhile, even if finding one takes a little more time. Clinics like this can offer the following unique benefits:
- Mental health professionals to offer OUD therapy
- Support group facilitation
- Recovery environments
- Knowledge about how recovery works
Can I Get Suboxone Online?
Telehealth companies bring effective MAT programs into homes all across the country. Online Suboxone doctors can write prescriptions, track their patients and manage their recovery — all through computers and connected devices.
Online Suboxone clinic benefits include the following:
- Privacy: No one sees you go in or come out.
- Immediacy: About 90% of the time, patients get same-day access to prescriptions.
- Ease of access: Your appointments, support groups and more all happen via any connected device.
Learn more: Where to Find Online Suboxone Doctors
Frequently Asked Questions About Suboxone
We’ve compiled some of the most frequently asked questions about Suboxone. Click the links to see more detailed information about each answer.
The answer to how long Suboxone has been around is 2002 (in the United States). For 20 years, this medication has helped people with OUD.
It takes about 20 to 60 minutes for Suboxone to kick in. Multiple factors can make your dose come on faster or slower.
The Suboxone in your system isn’t always detectable by your conscious mind. But it can persist in your blood for 1–3 days, saliva for 3 days, urine for 6 days and hair for 90 days.
Many people worry about Suboxone getting you high. Take the medication as directed and you are very unlikely to get high.
It’s nearly impossible to overdose on Suboxone. The naloxone in each dose is protective, as is buprenorphine’s ceiling effect.
The connection between Suboxone and drug tests is complicated. Some versions of tests will highlight it, but others will not.
The buprenorphine in Suboxone is a synthetic opioid, but it’s much weaker than full opioids like heroin.
Misusing Suboxone is very difficult for people with OUD, but people who have never used opioids before (and therefore have a low tolerance) may attempt to misuse Suboxone.
Free Suboxone is possible with some health insurance plans. Check the specifics of your plan to determine how it covers Suboxone.
People wondering how to get emergency Suboxone often find out about online clinics. It’s common to get medication from these clinics the same day.
Many people don’t notice a chalky residue after using Suboxone. But if you do, the Suboxone spit trick may help. Rinse with water and spit it out after the dose dissolves.
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
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