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Suboxone: Definition, Uses, Effects Treatment

Last Updated: January 30, 2025

Suboxone is a prescription medication that combines buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist, to treat opioid use disorder (OUD). Buprenorphine works by reducing withdrawal symptoms and cravings associated with opioid addiction, while naloxone helps prevent misuse of the drug. It is widely used as part of a comprehensive treatment strategy for individuals struggling with opioid addiction, particularly in outpatient settings where qualified healthcare providers prescribe it.

Suboxone is primarily used for the treatment of opioid dependence, helping patients reduce or eliminate opioid cravings and manage withdrawal symptoms. It also serves as a maintenance therapy for long-term management of opioid use disorder, preventing relapse and promoting recovery. In clinical practice, Suboxone is part of a broader treatment program that includes counseling and behavioral support. In a study by the European Medicines Agency (EMA), 17.8% of patients taking Suboxone had no trace of opioids in their urine after four weeks, compared to only 5.8% of those on a placebo.

While Suboxone is effective for many patients, it comes with potential side effects. Common side effects include nausea (15%), constipation (12%), headaches, and dizziness. Severe reactions include respiratory depression (~10%), confusion, and allergic reactions. The likelihood and severity of these effects depend on individual factors such as dosage and the presence of other health conditions. Long-term use also results in physical dependence, leading to withdrawal symptoms if the medication is suddenly stopped.

Table Of Contents:

What is the Definition of Suboxone?
What is Suboxone Used For?
How Does Suboxone Work?
How is Suboxone Made?
What are the Effects of Suboxone?
What is Suboxone Addiction?
What is Suboxone Treatment?

The main treatment approach for Suboxone includes its use in combination with therapy, such as cognitive-behavioral therapy (CBT) or contingency management. The goal of treatment is not only to reduce opioid use but also to support patients in managing their addiction over time. This holistic approach has been shown to improve outcomes, with research from Bicycle Health in “Suboxone Success Rates & Opioid Use Disorder Medications” highlighting that Suboxone is approximately 1.8 times more effective than non-medicated addiction recovery programs in helping patients stay engaged in treatment. Suboxone’s role in opioid addiction treatment is an integral part of the ongoing efforts to combat the opioid crisis, offering an evidence-based solution for individuals seeking to break free from opioid dependence.

What is the Definition of Suboxone?

More About Opioids:

Suboxone is a medication commonly used in the treatment of opioid addiction and opioid dependence. It is a combination of two active compounds: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that reduces withdrawal symptoms and cravings, while naloxone acts as an opioid antagonist to block the effects of opioids and discourage misuse by injection. Suboxone is primarily used in medication-assisted treatment (MAT) to support recovery and help individuals manage opioid addiction by minimizing the risk of relapse.

Suboxone is classified as a synthetic opioid, specifically a partial agonist. This means it binds to opioid receptors in the brain but activates them less strongly compared to full agonists like heroin or oxycodone. It has a “ceiling effect,” meaning that after a certain dose, increasing the amount of Suboxone will no longer increase its effects, which helps limit the potential for misuse or overdose.

According to the latest statistics, Suboxone has become a cornerstone in opioid addiction treatment programs. In the United States alone, approximately 1.5 million people are receiving treatment with Suboxone as part of MAT programs, as reported by the National Institute for Drug Abuse (NIDA). Reports suggest that its use has expanded steadily, particularly as the opioid crisis has escalated, with an estimated 2.5 million people aged 18 years or older in the US having opioid use disorder in 2022. Its efficacy lies in its ability to reduce withdrawal symptoms and cravings while maintaining patient safety, thanks to its low risk of misuse compared to methadone, a previous MAT standard. However, it’s also important to note that misuse, though rare, occurs, particularly if taken inappropriately.

Suboxone is widely regarded as a highly effective part of recovery plans, though it is not a standalone treatment. Counseling and behavioral support are important components of a comprehensive recovery plan, combining medication, mental health counseling, and support groups.

What is Suboxone Used For?

Suboxone is used for a variety of medical purposes related to opioid use disorder (OUD) and its associated complications. Its combination of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist, makes it a unique, evidence-based medication that reduces withdrawal symptoms, cravings, and the risk of relapse. Suboxone has been shown to help patients maintain long-term recovery by addressing the physiological and behavioral aspects of addiction. Below are the specific medical uses of Suboxone, its application to each disorder, and the respective prevalence rates in the United States.

Suboxone is used for the following medical purposes:

Treatment of Opioid Dependence: Opioid dependence involves a chronic pattern of opioid misuse characterized by a strong urge to consume opioids, an inability to control use, and an increased reliance on the drug. According to the National Institute on Drug Abuse (NIDA), approximately 2.7 million people in the United States had opioid use disorder (OUD) in 2020 alone. Suboxone has proven effective in treating opioid dependence by stabilizing opioid receptor activity without producing the full effects of opioids. The partial agonist action of buprenorphine (the active ingredient in Suboxone) reduces withdrawal symptoms and cravings while minimizing the risk of overdose compared to full opioid agonists. Suboxone supports long-term treatment plans and prevents relapse by targeting both physiological and psychological aspects of opioid addiction.
Reduction of Opioid Cravings: Approximately 80% of individuals with opioid use disorder report experiencing persistent cravings, according to a study by Psychiatry.org in “Opioid Use Disorder,” making cravings a significant barrier to recovery. Suboxone helps reduce these cravings by binding to opioid receptors in the brain, thereby modulating the neurochemical pathways involved in the reward system. This effect lowers the risk of relapse by satisfying the brain’s opioid receptor needs without inducing the euphoria associated with opioid misuse. Through regular Suboxone administration, the intensity and frequency of cravings are significantly reduced, improving treatment adherence.
Management of Opioid Withdrawal Symptoms: Opioid withdrawal symptoms are unpleasant and include nausea, vomiting, diarrhea, sweating, muscle pain, anxiety, and insomnia. These symptoms are so severe that they lead to relapse. In the United States, thousands of individuals attempt detoxification from opioids each year, with withdrawal symptoms being a common reason for treatment failure. Suboxone alleviates withdrawal by binding to opioid receptors and stabilizing their activity without delivering the full effects of opioids. This allows patients to transition through detoxification with significantly reduced symptoms and improved chances of successful recovery. A scientific study by Adams, K.K., Machnicz, M. & Sobieraj, D.M. et al. 2021, titled “Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: a systematic review,” demonstrates that Suboxone’s partial agonist properties effectively mitigate withdrawal, supporting patients in the detoxification phase.
Maintenance Therapy for Opioid Use Disorder: Suboxone maintenance is now a widely recognized treatment strategy for OUD, and about 1.5 million individuals in the U.S. are estimated to receive Suboxone for maintenance therapy, as reported by the National Institute for Drug Abuse (NIDA). This approach involves daily Suboxone use over months or years, depending on individual needs, allowing patients to maintain stability, manage cravings, and reduce the risk of relapse without the dangers of illicit opioid use. Scientific evidence supports Suboxone’s effectiveness for maintenance therapy, especially for individuals with chronic opioid dependence. A study of office-based Suboxone (buprenorphine-naloxone) treatment involving 71 opioid-dependent patients by Finch JW, Kamien JB, Amass L. et al. 2007, titled “Two-year Experience with Buprenorphine-naloxone (Suboxone) for Maintenance Treatment of Opioid Dependence Within a Private Practice Setting,” found that over 80% of urine tests showed opioid-negative results, demonstrating reduced opioid use. Additionally, 75% of participants had successful treatment outcomes, with 43% remaining in Suboxone maintenance, 21% tapering successfully, and 7% transitioning to methadone or inpatient treatment. The ability of Suboxone to maintain stable opioid receptor activity reduces withdrawal, enhances treatment adherence, and supports long-term recovery.
Prevention of Opioid Relapse: Relapse is a common and challenging occurrence in recovery, with about 40-60% of individuals with opioid use disorder relapsing after treatment, as studied by Guenzel N, McChargue D., et al. 2023, titled “Addiction Relapse Prevention.” Suboxone is effective in preventing relapse by blocking the euphoric effects of opioids through naloxone’s opioid antagonist properties. Naloxone prevents opioids from binding to opioid receptors, thereby eliminating the “reward” effect that triggers relapse. Additionally, Suboxone’s ability to stabilize cravings reduces the likelihood of seeking opioids for relief. This dual mechanism — the combination of buprenorphine’s partial agonist effects and naloxone’s blocking properties — creates a comprehensive treatment strategy that supports sustained recovery.
Support During Opioid Detoxification: Detoxification is an important first step in recovery but is hindered by intense withdrawal symptoms and psychological distress. In the U.S., thousands of individuals struggle with opioid detoxification each year. Suboxone provides medical support during detoxification by reducing the severity of withdrawal symptoms while simultaneously addressing cravings, as studied by Gowing L, Ali R, White JM, Mbewe D., et al. 2017, titled “Buprenorphine for managing opioid withdrawal.” This controlled and medically supervised detoxification allows patients to safely transition away from opioids under the supervision of healthcare providers. Suboxone’s combination of buprenorphine and naloxone ensures that detoxification is safer, less painful, and more likely to lead to long-term recovery success.
Decrease in Opioid-Related Mortality: The opioid epidemic has led to alarmingly high rates of overdose deaths. In the United States, in 2021 alone, nearly 108,000 deaths were attributed to drug overdoses, with opioids — particularly fentanyl — as the primary driver, according to a report by the Federal Communications Commission (FCC) in “Focus on Opioids.” Suboxone has been shown to significantly reduce the risk of opioid-related mortality by stabilizing opioid receptor activity and preventing opioid misuse. The combination of buprenorphine and naloxone not only blocks the euphoric effects of opioids but also reduces the likelihood of overdose by lowering the risk of respiratory depression (a common cause of opioid deaths). A study by the Recovery Research Institute in “Buprenorphine, but not naltrexone or its extended-release version Vivitrol, is associated with reduced overdose risk” shows that Suboxone therapy decreases opioid overdose rates by ensuring safer treatment options for patients in recovery. Overdose incidence and risk were significantly lower during periods of active Suboxone treatment. Compared to periods spent without any medication treatment (4.98 overdoses per 100 person-years), overdose incidence during Suboxone treatment was significantly lower (2.08 overdoses per 100 person-years).

How Effective is Suboxone for Opioid Use Disorder?

Suboxone is very effective for opioid use disorder (OUD), significantly improving treatment outcomes by reducing illicit opioid use, cravings, and the risk of relapse. A study by Hser YI et al. 2014, titled “Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial,” found that 46% of patients remained in treatment with Suboxone (buprenorphine/naloxone) over 24 weeks compared to 74% for methadone users. Retention rates for Suboxone improved with higher doses, reaching 60% at 30–32mg/day. Additionally, Suboxone use was linked to lower opioid use during the first nine weeks of treatment.

According to the Centers for Disease Control and Prevention (CDC), individuals undergoing Suboxone treatment are approximately 1.82 times more likely to remain in treatment compared to those who don’t use Suboxone, highlighting its role in sustained recovery efforts.

Suboxone treatment has been associated with the stabilization of opioid dependence, with 55.2% of adults needing treatment for opioid use disorder receiving medication for OUD in the United States in 2022, and Suboxone therapy accounted for a significant portion of this medication use, according to a report by CDC. Suboxone’s combination of buprenorphine and naloxone reduces withdrawal symptoms and decreases cravings by binding to opioid receptors in the brain while simultaneously preventing misuse due to naloxone’s blocking effects. This pharmacological mechanism has solidified Suboxone as one of the most successful medications for managing Opioid Use Disorder.

How Does Suboxone Work?

Suboxone works by combining two active ingredients, buprenorphine and naloxone, to treat opioid use disorder (OUD). Buprenorphine is a partial opioid agonist that binds to opioid receptors in the brain to reduce withdrawal symptoms and cravings without causing the full effects of opioids, such as euphoria. Meanwhile, naloxone is an opioid antagonist that blocks opioid effects and prevents misuse by causing withdrawal symptoms if Suboxone is misused through injection. Together, these two components make Suboxone effective for treating opioid dependence by addressing both cravings and the risk of relapse while minimizing the potential for misuse.

Suboxone is administered in the following ways:

Sublingual Tablet: A sublingual tablet is placed under the tongue, allowing the medication to dissolve and enter the bloodstream directly. This method bypasses the digestive system, ensuring the drug is effective without requiring large doses.
Sublingual Film/Strip: Like the tablet, the sublingual strip or film is placed under the tongue until dissolved. This delivery method allows for efficient absorption into the bloodstream and is preferred by many for ease of use.
Injection (less common): While less common, Suboxone is sometimes administered via injection in certain medical contexts. This method allows for quick absorption but is avoided because it increases the risk of misuse and withdrawal symptoms.

How is Suboxone Administered?

Suboxone is administered as a sublingual film or strip that is placed under the tongue, allowing it to dissolve and absorb into the bloodstream through the mucous membranes. This method ensures rapid and effective delivery of its active ingredients, buprenorphine, and naloxone, which work together to reduce opioid cravings and withdrawal symptoms. The sublingual film should be left undisturbed until dissolved, and patients are advised not to eat or drink for at least 30 minutes afterward to maximize absorption, as instructed by Drugs.com. Alternative administration methods include buccal absorption, where the medication is placed in the cheek area and the tablet form for those with difficulty using films or strips. These administration routes allow Suboxone to stabilize opioid withdrawal by maintaining therapeutic levels in the bloodstream while minimizing the risk of opioid misuse.

What is the Typical Dosage of Suboxone?

The typical dosage of Suboxone is between 4 mg/1 mg and 24 mg/6 mg of buprenorphine/naloxone per day, with 16 mg/4 mg being the recommended target dosage as a single daily dose for most patients, as indicated by Drugs.com. Higher dosages beyond 24 mg/6 mg have not demonstrated additional clinical benefits, according to the FDA. Suboxone dosage is adjusted in increments during treatment based on individual withdrawal signs, opioid cravings, and treatment response.

Dosages also vary based on factors like the patient’s body weight, sex, and level of opioid dependence. Men and women respond differently, and body weight affects how Suboxone is metabolized in the system. Suboxone therapy requires careful supervision to avoid overmedication, as excessive doses lead to withdrawal symptoms or other adverse effects. Regular patient assessment, including urine drug screening and clinical monitoring, is important to ensure the medication is effective and administered at appropriate levels without causing harm.

How is Suboxone Made?

Suboxone is made by combining two active ingredients: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that binds to opioid receptors in the brain, reducing opioid cravings while minimizing the euphoria associated with opioids. Naloxone is an opioid antagonist that blocks the effects of opioids and is primarily added to prevent misuse by inducing withdrawal if the drug is injected. Suboxone’s formulation involves a 4:1 ratio of buprenorphine to naloxone, optimizing both its therapeutic effects and safety profile.

Suboxone affects dopamine reuptake by modulating opioid receptors, particularly in the brain’s reward pathway. This leads to a controlled release of dopamine, which reduces cravings and withdrawal symptoms but avoids the intense euphoria of full opioid agonists like heroin or methadone. While Suboxone helps stabilize dopamine levels, excessive use leads to stimulant-like effects, euphoria, and potential dependency, similar to other opioid medications.

What are the Effects of Suboxone?

The effects of Suboxone are nausea, constipation, respiratory depression, and other potential side effects. These symptoms vary in severity and duration depending on individual factors, including dosage, overall health, and length of use. Suboxone combines buprenorphine and naloxone, which interact with the brain’s opioid pathways, leading to these effects.

The effects of Suboxone are as follows:

Nausea: Nausea is a very common side effect of Suboxone, reported by approximately 15% of patients, according to Drugs.com. This is linked to the opioid properties of Suboxone, which irritate the gastrointestinal tract and trigger the chemoreceptor trigger zone, causing feelings of nausea. It is considered a short-term side effect that diminishes as the body adjusts to the medication.
Vomiting: Vomiting is another common gastrointestinal effect of Suboxone, particularly during the initial stages of treatment or when the medication is first introduced into the body. The opioid mechanism stimulates the gastrointestinal system, leading to this response. Approximately 10% of patients taking Suboxone experience vomiting, according to Drugs.com. This is also considered short-term and manageable with proper medical guidance.
Constipation: Suboxone causes constipation in about 12.1% of patients, making it one of the most common side effects, as reported by Drugs.com. This occurs because opioids slow the gastrointestinal tract’s natural movement. Prolonged constipation becomes severe if left untreated, requiring lifestyle adjustments or medication interventions.
Headache: Suboxone use has been associated with headaches, which have a short- or long-term effect depending on the patient’s response. Headaches result from changes in brain chemistry, withdrawal effects, or changes in opioid receptor modulation.
Back Pain: Back pain has been reported in patients taking Suboxone. This side effect is linked to prolonged opioid use, changes in body mechanics, or muscle pain as a withdrawal symptom. Its prevalence varies, occurring in 0.1% to 1% of users, but it becomes chronic if not addressed.
Fast or Pounding Heartbeats: This effect occurs because Suboxone interacts with the cardiovascular system, leading to palpitations or other heart-related symptoms. This also stems from underlying stress or opioid withdrawal and is seen in 0.1% to 1% of patients, as reported by Drugs.com.
Increased Sweating: Sweating is reported by about 14% of Suboxone users, according to Drugs.com. This highly common side effect is likely related to changes in the body’s internal opioid balance and temperature regulation mechanisms, although it is rarely life-threatening.
Sleep Problems (Insomnia): Suboxone leads to long-term sleep disturbances, including insomnia. Changes in the brain’s natural chemistry, particularly as it adjusts to Suboxone’s opioid effects, disrupt circadian rhythms, affecting the quality of sleep over time.
Severe Allergic Reactions: Rare but severe allergic reactions have been documented, including swelling in the face and throat and difficulty breathing. These effects are life-threatening if not addressed promptly. Anaphylactic shock occurs, although it is uncommon.
Respiratory Depression: One of the most dangerous effects of Suboxone is respiratory depression, which occurs if Suboxone doses are too high. This leads to slow or shallow breathing and potentially become fatal. It is important to monitor Suboxone doses carefully to minimize this risk.
Severe Drowsiness or Difficulty Staying Awake: Suboxone depresses the central nervous system, which leads to prolonged drowsiness or lethargy. Higher dosages or other medications that interact with Suboxone exacerbate this effect.
Confusion or Unusual Thoughts: Cognitive disturbances are common during Suboxone use, particularly during dose adjustments or in long-term use. They are linked to the drug’s action on opioid pathways in the brain.
Liver Problems: Liver issues arise from Suboxone’s effect on liver enzyme activity, especially in patients with preexisting liver conditions or when Suboxone use is combined with other hepatotoxic medications. According to Drugs.com, 1% to 10% of patients suffer from liver-related issues. Signs of liver dysfunction include yellowing of the skin or eyes and dark urine. These issues are serious and require careful monitoring.

How Does Suboxone Affect the Body?

Suboxone affects the body by interacting with major physiological systems, including the liver, heart, and digestive system, leading to a variety of physical symptoms and potential long-term health risks. Suboxone is a combination of buprenorphine and naloxone, and its effects are primarily mediated by its opioid properties, which impact dopamine levels and other neurotransmitters in the brain. While Suboxone stabilizes opioid withdrawal, it places strain on the body if misused or overused.

Suboxone significantly impacts the liver because the liver metabolizes this medication. Excessive use of Suboxone or preexisting liver conditions leads to hepatotoxicity, with symptoms such as jaundice (yellowing of the skin or eyes), dark or tea-colored urine, and abdominal pain. Liver disease, particularly hepatitis, makes the liver more vulnerable to damage during Suboxone therapy. Routine liver function tests are recommended to monitor liver health in individuals taking Suboxone for prolonged periods.

Suboxone also impacts the heart, with risks such as increased heart rate and palpitations. Though less common, long-term opioid use leads to arrhythmias or other cardiovascular concerns, particularly when combined with other medications or preexisting conditions. Vasodilation and hypertension are common side effects of Suboxone seen in ~10% of patients under Suboxone therapy, as reported by Drugs.com. Heart strain compound risks if the patient has other risk factors such as age, obesity, or preexisting heart disease. Additionally, Suboxone has effects on the digestive system, most notably by causing constipation, a common opioid side effect. Opioids slow down the digestive tract, impairing the natural peristaltic movement that moves food through the system, leading to discomfort and difficulties in regular bowel movements.

Suboxone use also results in physical symptoms such as dehydration, which side effects like vomiting, sweating, and diarrhea exacerbate. These effects place additional strain on vital organs, especially in patients already suffering from underlying conditions.

How Does Suboxone Affect the Mind?

Suboxone affects the mind primarily by interacting with brain chemistry to manage opioid cravings, withdrawal symptoms, and mood stability. Suboxone’s main components, buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist), work synergistically to target the brain’s opioid receptors. Buprenorphine binds to these receptors, reducing cravings and withdrawal symptoms but without triggering the full effects of opioids, such as euphoria. Naloxone blocks other opioids from binding to these receptors, effectively lowering the risk of misuse and overdose. This dual mechanism not only helps with addiction treatment but also impacts cognitive and emotional states.

In the short term, Suboxone influences mood by alleviating anxiety and depressive symptoms, helping to stabilize emotions during the recovery process. However, ~10% of individuals experience mood swings, feelings of depression, or changes in motivation as their brain chemistry adjusts to the medication, as reported by Drugs.com. Over time, the long-term mental health effects of Suboxone include persistent emotional changes, such as continued emotional instability, which highlights the importance of ongoing medical supervision. It is important to note that every individual’s response to Suboxone varies, and some experience greater emotional effects than others.

Suboxone’s effects on mental health contribute to cognitive changes, including sleep disturbances and memory problems, particularly during the initial stages of treatment. Its ability to stabilize mood while addressing opioid dependency shows its benefits in recovery, but it also leads to side effects that impact emotional well-being. These mental effects, both immediate and long-term, underscore the need for therapy and medical guidance as part of a comprehensive addiction recovery program.

What is Suboxone Addiction?

Suboxone addiction is a dependence on Suboxone, a medication designed to treat opioid use disorder. It occurs when Suboxone alters the brain’s reward pathways, particularly through its effects on dopamine release. Suboxone, containing buprenorphine and naloxone, acts on opioid receptors to reduce cravings and withdrawal symptoms. However, the euphoric effects of buprenorphine at higher doses reinforce addictive behaviors by overstimulating dopamine production in the brain’s reward system, creating a cycle of dependency.

Genetic predisposition, psychological factors such as stress or trauma, and environmental influences increase the risk of Suboxone addiction. Those with a history of substance abuse are particularly vulnerable. Prolonged misuse leads to physical and psychological challenges, including withdrawal symptoms, when the drug is reduced or discontinued, despite its role as a treatment tool.

Why is Suboxone Addictive?

Suboxone is addictive because it contains buprenorphine, a partial opioid agonist, which activates opioid receptors in the brain, though less intensely than full opioids like heroin or fentanyl. This activation leads to physical dependence as the brain adjusts to the presence of the drug. At higher doses, buprenorphine produces euphoric effects, increasing the risk of misuse. The psychological reliance on Suboxone also develops, as individuals feel they cannot function without it, particularly if they have a history of substance abuse.

The ceiling effect of buprenorphine, which limits the drug’s maximum opioid effect, creates misconceptions about its safety, potentially leading to overuse. Suboxone withdrawal symptoms, such as anxiety, insomnia, and cravings, make discontinuation challenging, contributing to ongoing use. For those with prior substance use disorders, the risk of addiction to Suboxone increases due to the overlapping mechanisms of addiction, particularly in the brain’s reward and dopamine systems.

What is the Difference Between Suboxone vs. Methadone?

The main difference between Suboxone and methadone is how they interact with opioid receptors and their risk profiles. Suboxone contains buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist), which limit its ability to produce euphoria and make overdose less likely. Methadone, a full opioid agonist, provides stronger opioid effects, making it more effective for severe addiction cases but with higher risks of dependence and overdose. Suboxone is prescribed in outpatient settings due to its safety profile, whereas methadone requires administration in regulated clinics due to its potential for misuse. Methadone is better suited for individuals with high opioid tolerance, while Suboxone is chosen for mild to moderate dependence. Both are effective, but the choice depends on the patient’s history and clinical needs.

What is the Difference Between Suboxone vs. Subutex?

The main difference between Suboxone and Subutex is the presence of naloxone in Suboxone, which helps prevent misuse. Subutex contains only buprenorphine, making it more susceptible to misuse via injection. Suboxone, with its naloxone component, causes withdrawal symptoms if injected, serving as a deterrent against misuse. Subutex is used during the initial stages of treatment or for individuals allergic to naloxone. Both medications are effective for opioid use disorder, but Suboxone’s design addresses safety concerns, especially in outpatient settings.

What is the Difference Between Suboxone vs. Buprenorphine?

The main difference between Suboxone and buprenorphine lies in formulation. Suboxone combines buprenorphine with naloxone, while standalone buprenorphine lacks naloxone. This distinction makes Suboxone safer in preventing misuse, as naloxone discourages injection by causing withdrawal symptoms when tampered with. Both medications work by partially activating opioid receptors to reduce cravings and withdrawal symptoms. Suboxone’s dual formulation is preferred in most outpatient scenarios to mitigate abuse risks, whereas buprenorphine alone is used in certain clinical contexts.

How is Suboxone Classified?

Suboxone is classified as a Schedule III controlled substance under the Controlled Substances Act (CSA) in the United States. This classification, determined by the Drug Enforcement Administration (DEA), indicates that Suboxone has a moderate to low potential for physical and psychological dependence compared to substances in Schedules I and II. The medication is categorized as an opioid partial agonist due to its active ingredient, buprenorphine, which partially activates opioid receptors, and as a combination therapy because it includes naloxone to deter misuse. Other medications similar to Suboxone include Subutex (buprenorphine without naloxone) and methadone, which are also used for opioid dependence. While Suboxone has a lower abuse potential, it is still regulated due to its addictive properties and potential for misuse.

What is the Legal Status of Suboxone?

The legal status of Suboxone is regulated as a prescription-only medication under Schedule III of the CSA. Its use is highly controlled, and it is only prescribed by healthcare providers who have completed training and obtained a waiver under the Drug Addiction Treatment Act (DATA 2000). This ensures that Suboxone is dispensed responsibly to individuals in need of opioid use disorder treatment. In recent years, the federal government has expanded access to Suboxone by increasing the number of patients healthcare providers treat and reducing barriers to training requirements. While these changes aim to address the opioid crisis, misuse and illegal distribution of Suboxone still occur, prompting strict monitoring and penalties for unauthorized use or possession.

What is Suboxone Treatment?

Suboxone treatment is a medical approach to managing opioid use disorder that combines medication with behavioral therapies and support services. Suboxone, a combination of buprenorphine and naloxone, is used to alleviate withdrawal symptoms, reduce cravings, and stabilize individuals in recovery. Suboxone treatment has proven to be highly effective in reducing opioid use and improving treatment retention. In a study by the European Medicines Agency (EMA), 17.8% of patients taking Suboxone had no trace of opioids in their urine after four weeks, compared to only 5.8% of those on a placebo. Additionally, research from Bicycle Health in “Suboxone Success Rates & Opioid Use Disorder Medications” highlights that Suboxone is approximately 1.8 times more effective than non-medicated addiction recovery programs in helping patients stay engaged in treatment, underscoring its role in promoting long-term recovery. Suboxone treatment focuses on both the physiological and psychological aspects of addiction, aiming to restore balance in brain chemistry and provide tools for long-term recovery.

The Primary Components of Suboxone Treatment Are as Follows:

Detoxification: Suboxone is used during the detox phase to ease withdrawal symptoms and make the process safer and more manageable. Buprenorphine in Suboxone binds to opioid receptors, reducing withdrawal effects without creating a full opioid high. This phase is necessary for transitioning patients from dependence to treatment, and Suboxone is effective in stabilizing up to 80% of individuals during detox, according to a study by Ling W et al. 2009, titled “Buprenorphine tapering schedule and illicit opioid use.”
Behavioral Therapy: Therapy is a cornerstone of Suboxone treatment, addressing the psychological aspects of addiction. Cognitive-behavioral therapy (CBT), motivational interviewing, and other modalities help patients understand their addiction, develop coping mechanisms, and set recovery goals. Ray LA et al. 2020, in their study titled “Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis,” shows that combining medication with therapy significantly increases the likelihood of long-term success.
Support Groups: Programs like Narcotics Anonymous or other peer-support groups provide a community of individuals with shared experiences. These groups offer accountability, encouragement, and a sense of belonging, which are required for maintaining sobriety. Suboxone patients who participate in such groups report higher rates of sustained recovery.
Ongoing Medication-Assisted Treatment (MAT): Suboxone is used as a long-term maintenance therapy to prevent relapse. Controlling cravings and withdrawal symptoms helps individuals focus on rebuilding their lives without the distractions of addiction. Ronquest NA et al. 2018, in their study titled “Relationship between buprenorphine adherence and relapse, health care utilization and costs in privately and publicly insured patients with opioid use disorder,” show that patients on Suboxone maintenance therapy are 50-60% less likely to relapse compared to those who receive detox alone.

What is Suboxone Withdrawal Like?

Suboxone withdrawal is like a gradual tapering of opioid effects, accompanied by a range of physical and psychological challenges. The withdrawal process unfolds in distinct stages, according to Bicycle Health: within 72 hours, physical symptoms such as nausea, sweating, and diarrhea are at their peak; after 1 week, bodily aches, insomnia, and mood swings become more pronounced; by the 2-week mark, symptoms like depression set in; and at one month, cravings and lingering depression persist. These symptoms reflect the body’s adjustment to the absence of Suboxone, particularly its effects on opioid receptors and dopamine regulation.

The physical discomforts, such as muscle pain and gastrointestinal upset, are compounded by psychological effects like anxiety, irritability, and intense cravings. These challenges heighten the risk of relapse and emphasize the need for medical supervision during withdrawal. Addressing long-term effects, such as persistent depression and cravings, requires comprehensive support, including therapy and medications, to ease the transition.

Can Treatment Cure Suboxone Addiction?

Yes, treatment can help individuals overcome suboxone addiction, but it is more accurate to say that addictions are effectively managed rather than permanently cured. Suboxone addiction treatment involves addressing both physical dependence and the behavioral and psychological aspects of addiction. Medical approaches, such as supervised tapering of Suboxone, combined with therapy and support groups, significantly reduce dependency and improve outcomes. However, like other chronic conditions, addiction requires ongoing support to maintain recovery and prevent relapse.

Long-term recovery involves a commitment to lifestyle changes, participation in therapy, and continued access to support systems. Addiction alters brain chemistry and reward pathways, so even after physical dependence ends, individuals remain vulnerable to relapse without sustained care. With proper treatment and a strong support network, individuals regain control over their lives and maintain recovery for years, demonstrating that while not “curable,” addiction is manageable with the right resources and dedication.

How is Suboxone Absorbed Through the Body?

Suboxone is absorbed through the body primarily via the sublingual route, where it dissolves under the tongue and is absorbed into the bloodstream through the mucous membranes. This method bypasses the digestive system, allowing the active ingredients—buprenorphine and naloxone—to enter directly into circulation. Buprenorphine binds to opioid receptors in the brain and other tissues, providing its therapeutic effects, while naloxone remains largely inactive unless the medication is misused intravenously.

Once absorbed, Suboxone is distributed through the bloodstream to tissues, including the liver, where it is metabolized. The buprenorphine component has a high affinity for opioid receptors, making it effective in blocking other opioids. Its long half-life allows it to remain active in the body for extended periods, which helps stabilize patients and reduce withdrawal symptoms. Proper absorption is necessary to ensure its effectiveness, and taking Suboxone as prescribed maximizes its therapeutic potential while minimizing misuse.

How is Suboxone Metabolized by the Body?

Suboxone is metabolized by the body primarily in the liver, where its active ingredients, buprenorphine, and naloxone, undergo enzymatic processing. Buprenorphine is metabolized mainly by the cytochrome P450 enzymes, particularly CYP3A4, into its metabolites, some of which retain activity on opioid receptors, while others are inactive. Naloxone, on the other hand, is metabolized into inactive compounds, which means it has minimal effects when taken as prescribed but causes withdrawal symptoms if misused intravenously. The metabolism of Suboxone affects both its action and duration in the body, with buprenorphine having a long half-life of approximately 24-60 hours, which supports its role in opioid replacement therapy by providing prolonged relief from withdrawal symptoms.

The slow metabolism of buprenorphine allows it to remain active in the body for extended periods, stabilizing opioid receptors and reducing cravings and withdrawal symptoms over time. This prolonged action is a key reason Suboxone is effective as a maintenance treatment for opioid use disorder, as it helps to maintain steady blood levels and reduce the likelihood of relapse. However, factors like liver function, drug interactions, and individual metabolic rates affect the efficiency and duration of Suboxone’s action.

How is Suboxone Eliminated by the Body?

Suboxone is eliminated by the body primarily through the liver, where its metabolites are processed and then excreted via the kidneys. The active ingredient, buprenorphine, is metabolized in the liver and then eliminated in the urine, while naloxone is also processed similarly, though it has less clinical significance due to its minimal systemic effects when taken as prescribed. The process of elimination involves the gradual breakdown and removal of these compounds, with the half-life of buprenorphine ranging from 24 to 60 hours, allowing for a slow, consistent release of its effects.

The elimination process is important in determining the dosing schedule for Suboxone. Due to its long half-life, Suboxone is administered once a day, maintaining steady blood levels of buprenorphine. This extended elimination time helps to prevent withdrawal symptoms and cravings for patients undergoing treatment for opioid use disorder. However, individual factors such as liver function, kidney health, and metabolic rate affect the rate of elimination and, consequently, how Suboxone works for each patient. Therefore, adjustments in dosing are necessary to optimize treatment effectiveness while minimizing side effects.

What is the Chemical Composition of Suboxone?

The chemical composition of Suboxone is a combination of two active ingredients: buprenorphine and naloxone. Buprenorphine is a partial agonist at the opioid receptors, primarily the mu-opioid receptor, and it helps to alleviate withdrawal symptoms and reduce cravings. Naloxone, an opioid antagonist, is included to deter misuse by precipitating withdrawal symptoms if the medication is injected or misused intravenously. Buprenorphine and naloxone are combined in a specific ratio (commonly 4:1) in Suboxone tablets and films to maximize their therapeutic effects while minimizing the risk of abuse.

Can you Overdose on Suboxone?

Yes, you can overdose on Suboxone, although it is less likely compared to other opioids due to the ceiling effect of buprenorphine, as studied by Drugs.com. When taken in higher doses, buprenorphine reaches a plateau, meaning it does not continue to produce stronger effects, including respiratory depression, beyond a certain point. The recommended daily dose is 16 mg/4 mg buprenorphine/naloxone, and doses higher than 24 mg/6 mg per day lead to an overdose, according to a study by Harvard Health.

However, combining Suboxone with other central nervous system depressants, such as alcohol, benzodiazepines, or other opioids, significantly increases the risk of overdose. Symptoms of Suboxone overdose include extreme drowsiness, slow or difficult breathing, and loss of consciousness, which are fatal without intervention.

What is the History of Suboxone?

The history of Suboxone is marked by its development as a treatment for opioid addiction. It was first introduced in the early 2000s as a combined formulation of buprenorphine and naloxone, specifically to provide a safer alternative to methadone for treating opioid use disorder (OUD). Buprenorphine itself had been in use since the 1980s, but it was the combination with naloxone that made Suboxone particularly effective in reducing misuse and diversion. In 2002, Suboxone received approval from the FDA for the treatment of opioid dependence, revolutionizing addiction treatment by providing a more accessible and flexible option compared to methadone. Over time, Suboxone became widely prescribed in office-based treatment settings, expanding its availability to a broader range of patients.

What Other Drugs Are Similar to Suboxone?

The other drugs similar to Suboxone are methadone, buprenorphine (without naloxone), and naloxone (used alone in emergency treatments). These drugs share a common purpose in the treatment of opioid use disorder (OUD). Methadone is a full opioid agonist, like the opioids that cause addiction, but it is used in a controlled setting to help reduce withdrawal symptoms and cravings. Buprenorphine, like Suboxone, is a partial opioid agonist, but it is prescribed alone for addiction treatment. Naloxone, while included in Suboxone to block the effects of opioids, is also used alone in emergencies to reverse opioid overdose. All these medications target opioid receptors in the brain to alleviate withdrawal and cravings, but they differ in their pharmacological profiles and risk of misuse.

What Does Suboxone Look Like?

Suboxone looks like a small, flat tablet or film that dissolves under the tongue. The tablets are orange or yellow and are embossed with the “S” symbol, while the film is a thin, clear, rectangular strip. Both forms are designed for sublingual administration, meaning they are placed under the tongue to dissolve and be absorbed directly into the bloodstream, ensuring fast relief of withdrawal symptoms and cravings associated with opioid addiction.

Does Suboxone Show up on a Drug Test?

Yes, Suboxone does show up on a drug test if the test specifically includes buprenorphine or its metabolites or naloxone as part of the panel. It will not cause false positives for other opioids. Standard drug tests screen for a set number of substances, such as 5, 7, or 12 substances, but they do not include buprenorphine unless specifically designed to do so. After a single dose of Suboxone, the drug is usually undetectable in healthy individuals after 5 to 8 days, according to a study by Drugs.com. However, in people with severe liver disease, it takes 7 to 14 days for Suboxone to be eliminated.

The elimination half-life of buprenorphine is between 24 to 42 hours, while naloxone’s half-life ranges from 2 to 12 hours. It takes about four to five half-lives for a drug to be completely cleared from the body. Therefore, in most healthy individuals, Suboxone should no longer be detectable after 120 to 210 hours, or roughly 5 to 8 days. The detection window for buprenorphine in urine is between 2 to 4 days, depending on factors such as metabolism, frequency of use, and the sensitivity of the test. For blood tests, buprenorphine is detected for up to 24 hours, while saliva tests detect it for 1-2 days after use.

What is the Difference Between Opioids and Suboxone?

The main difference between opioids and Suboxone is that opioids are full agonists at the opioid receptors, meaning they activate the receptors fully, while Suboxone contains buprenorphine, a partial agonist, which only partially activates the opioid receptors. This partial activation results in reduced cravings and withdrawal symptoms without the intense euphoria or high caused by full opioids. Unlike full opioids, Suboxone has a ceiling effect, meaning that after a certain dose, taking more does not increase its effects, significantly reducing the risk of misuse and overdose. Additionally, Suboxone includes naloxone to deter misuse, making it safer than other opioids.

How Long Do the Effects of Suboxone Last?

The effects of Suboxone last for about 24 to 36 hours, depending on the individual’s metabolism and the dose taken. Because buprenorphine has a long half-life (24-60 hours), it provides prolonged relief from withdrawal symptoms and cravings, allowing for once-daily dosing in most patients. This extended duration is particularly helpful in opioid addiction treatment, as it reduces the need for frequent dosing and helps to stabilize patients’ recovery efforts.

Is Suboxone a Narcotic?

Yes, Suboxone is a narcotic because it contains buprenorphine, which is an opioid, though it is classified as a partial agonist. Narcotics are defined as drugs that relieve pain by acting on the central nervous system, and while Suboxone is used to manage opioid addiction, it is still considered a narcotic due to its opioid component.

Is Suboxone an Opioid?

Yes, Suboxone is an opioid, but it is a partial agonist, meaning it only partially activates opioid receptors in the brain compared to full opioid agonists like heroin or morphine. This characteristic makes Suboxone effective in treating opioid use disorder by reducing cravings and withdrawal symptoms without causing the same high risk of overdose associated with other opioids.

How Do People on Suboxone Act?

People on Suboxone act more stable compared to those actively using illicit opioids. Suboxone reduces cravings and withdrawal symptoms, leading to improved mood, reduced anxiety, and a greater sense of overall well-being. Because Suboxone does not cause the intense euphoria associated with full opioids, people on Suboxone appear more clear-headed, focused, and functional in their day-to-day activities, contributing to their recovery and better management of opioid dependence.

Does Suboxone Make You High?

No, Suboxone does not make you high under normal circumstances when taken as prescribed. Suboxone contains buprenorphine, which is a partial opioid agonist, meaning it activates opioid receptors in the brain to a much lesser extent than full opioids like heroin or morphine. While it does alleviate withdrawal symptoms and reduce cravings, it does not cause the same euphoria or “high” that people experience with other opioids. However, misuse or taking higher-than-prescribed doses leads to some feelings of euphoria.

What is the Suboxone Orange Pill?

Suboxone orange pill is a tablet containing buprenorphine and naloxone. It is orange in color, round, and scored, so it is broken into smaller doses if necessary. The orange pill is part of the Suboxone formulation used to treat opioid addiction. It is prescribed for sublingual administration, meaning it is placed under the tongue to dissolve. This allows the medication to be absorbed directly into the bloodstream, providing relief from withdrawal symptoms and cravings.

What are the Street Names for Suboxone?

The street names for Suboxone are “bupe,” “sub,” “orange,” and “box,” among others. Individuals use these names to refer to the drug in informal or illicit contexts. Some people misuse Suboxone for its opioid-like effects, though naloxone is included to deter abuse, especially in cases where the drug is injected or misused. Despite the deterrents, Suboxone is still subject to misuse in various settings.

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Published on: March 24th, 2017

Updated on: January 30th, 2025