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What Is Suboxone? Uses, Costs & How to Start Suboxone

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Nov 15, 2023 • 17 cited sources

Suboxone is a prescription medication approved in 2002 by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD).[1] Each dose contains two medications: Buprenorphine (the active ingredient) eases withdrawal and cravings for other opioids, and naloxone (inactive, when taking orally as intended) to reduce risk of misuse.

Key Facts About Suboxone

Key Facts

  • 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.[2]
  • Naloxone can reverse an opioid overdose for up to 90 minutes.[3] Inside Suboxone, naloxone is inert unless people take too much or otherwise misuse their medication. 
  • 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.[5]

How Does Suboxone Work?

Suboxone contains two ingredients that work together to help people with OUD. Since its FDA approval in 2002, Suboxone has saved countless lives.

Suboxone contains two ingredients: buprenorphine and naloxone.[1]

Suboxone’s action is based on its two ingredients:

  1. Buprenorphine: This partial opioid agonist links to receptors within the brain, relieving withdrawal symptoms and cravings. 
  2. Naloxone: This opioid antagonist blocks you from getting high if you misuse your Suboxone by injecting. If used properly (sublingually), the Naloxone is not absorbed and is inactive.

Suboxone strips or tablets dissolve within your mouth, delivering medications to your brain while bypassing your stomach. Most people take doses once per day but some may take the medication as frequently as 3 times a day. For maintenance treatment, the FDA recommends a daily dose of anywhere from 2 mg to 24 mg of buprenorphine daily, depending on the needs of the individual. [1]

To gain a deeper understanding of how Suboxone can help OUD, keep reading to learn about its ingredients. 

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 – if taken Sublingually, as intended, the Naloxone is not absorbed by the mucous membranes in the mouth, and is inert/inactive. Naloxone is included in the Suboxone in order to prevent people from overdosing or getting “high” off of Suboxone if they attempt to inject it intravenously. Naloxone is therefore essentially a misuse deterrent.

Learn more: What is Naloxone?

How Much Does Suboxone Cost?

Quick Answer

The cost of Suboxone varies by State and by insurance plan. Without insurance, a one-month supply of Suboxone could cost hundreds of dollars a month. However in most states, with insurance, the medication is covered.  Before you sign up for any insurance plan, you can ask if it covers Suboxone.  If you have Medicaid coverage, your coverage is more complex, as plans can vary from state to state. The best thing to do is to call your insurance company directly and ask if Suboxone is covered. If you have Medicare Part D, your Suboxone is covered.

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 in recent years. [17] 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 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: Patients can 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. 

How long has Suboxone been around?

Suboxone has been around is 2002 (in the United States). For 20 years, this medication has helped people with OUD. 

How long until Suboxone kicks in?

It takes about 20 to 60 minutes for Suboxone to kick in. Multiple factors can make your dose come on faster or slower.

How long does Suboxone stay in your system?

Suboxone usually stays active in your body for about 24 hours. However, the metabolites can remain in your blood for 1–3 days, saliva for 3 days, urine for 6 days and hair for 90 days.

Can you get high on Suboxone?

Not generally. Many people worry about Suboxone “getting you high”. Take the medication as directed and you are very unlikely to get high. Some people do feel some mild euphoria at first. This is much less common in people who are “opioid experienced” meaning they have a history of opioid use in the past, which is the very reason that most people are taking this medication in the first place. In addition, this is more likely the higher dose you take, which is why most doctors aim to provide the lowest dose necessary to avoid these symptoms while still preventing withdrawal symptoms and craving.

Can you overdose on Suboxone?

It’s nearly impossible to overdose on Suboxone if taken sublingually as directed. This is largely due to Suboxone’s “ceiling effect” discussed previously. Additionally, if taken inappropriately by injection, the Naloxone component of the medication becomes active and is there to prevent an overdose. The few documented instances of Suboxone being associated with overdose usually involve the simultaneous use of Suboxone along with other sedating medications such as benzodiazepines or other opioids, but very rarely from Suboxone alone. 

Does Suboxone show up on drug tests?

It depends. The standard drug panel which is what most employers request does not include testing for Suboxone or its metabolites. However your employer or your doctor can order a separate Buprenorphine test that will detect Suboxone. 

Is Suboxone considered an opioid?

Technically yes. The buprenorphine in Suboxone is a synthetic “partial” opioid, but it’s much weaker than full opioids like heroin.

Can people misuse Suboxone?

Misusing Suboxone is very difficult for the reasons described above. Research shows that the vast majority of people take their Suboxone as prescribed and do not “misuse” the medication. 

Where can I get Suboxone for free?

Free Suboxone is possible with some health insurance plans. Check the specifics of your plan to determine how it covers Suboxone. 

How can I get emergency Suboxone?

People wondering how to get emergency Suboxone often find out about online clinics. It is possible to get medication from these clinics the same day. If you need emergency Suboxone, the best thing to do is to arrive at your local emergency room, where you can often be connected to opioid use disorder treatment more expediently. 

Will Suboxone give me a chalky aftertaste?

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

Sources
  1. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. March 2021. Accessed March 2023. 
  2. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. Spring 2018. Accessed March 2023.
  3. Naloxone Drug Facts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/naloxone. January 2022. Accessed March 2023. 
  4. Suboxone. European Medicines Agency. https://www.ema.europa.eu/en/medicines/human/EPAR/suboxone. Accessed March 2023. 
  5. Buprenorphine/Naloxone Recommended Practice Management. The College of Physicians and Surgeons of Manitoba. https://cpsm.mb.ca/assets/PrescribingPracticesProgram/Unwitnessed%20Induction%20Section.pdf. December 2019. Accessed March 2023. 
  6. Painkiller Abuse Treated by Sustained Buprenorphine/Naloxone. National Institutes of Health. https://www.nih.gov/news-events/news-releases/painkiller-abuse-treated-sustained-buprenorphine-naloxone. November 2011. Accessed March 2023. 
  7. A Case of Buprenorphine-Precipitated Withdrawal Managed with High-Dose Buprenorphine. Family Practice. https://pubmed.ncbi.nlm.nih.gov/34173647/. March 2022. Accessed March 2023. 
  8. Buprenorphine: Drug Safety Communication. U.S. Food and Drug Administration. https://www.fda.gov/safety/medical-product-safety-information/buprenorphine-drug-safety-communication-fda-warns-about-dental-problems-buprenorphine-medicines. January 2022. Accessed March 2023. 
  9. Information About Medication-Assisted Treatment (MAT). U.S. Food and Drug Administration. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat. February 2019. Accessed March 2023. 
  10. Methadone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone. January 2023. Accessed March 2023. 
  11. Methadone. Drug Enforcement Administration. https://www.dea.gov/sites/default/files/2020-06/Methadone-2020.pdf. April 2020. Accessed March 2023.
  12. Methadone Maintenance. Providers Clinical Support System. https://pcssnow.org/wp-content/uploads/2018/01/Methadone-Maintenance.pdf. January 2018. Accessed March 2023. 
  13. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine. January 2023. Accessed March 2023. 
  14. Buprenorphine. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf. May 2022. Accessed March 2023. 
  15. Clinical Use of Extended-Release Injectable Naltrexone in the Treatment of Opioid Use Disorder: A Brief Guide. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4892r.pdf. February 2015. Accessed March 2023. 
  16. Naltrexone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naltrexone. January 2023. Accessed March 2023. 
  17. Informational Document. U.S. Department of Justice. https://www.deadiversion.usdoj.gov/pubs/docs/index.html. Accessed March 2023.

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