Suboxone (buprenorphine and naloxone)
Buprenorphine is an opioid medication used to treat pain and opioid addiction.
When used to treat opioid addiction, buprenorphine is combined with naloxone, usually as a pill called Suboxone.
Suboxone is a tablet that dissolves under the tongue (sublingual). Because naloxone can cause withdrawal if it is injected, adding it to buprenorphine prevents people from misusing the drug.
What does Suboxone do?
Suboxone is a long-acting opioid drug used to replace the shorter-acting opioids that someone may be addicted to, such as heroin, oxycodone, fentanyl or hydromorphone. Long-acting means that the drug acts more slowly in the body, for a longer period of time. The effects of buprenorphine last for 24 to 36 hours. In contrast, a person who uses short-acting opioids to avoid withdrawal must use three to four times a day.
When taken at the correct dose, Suboxone prevents withdrawal symptoms and reduces drug cravings without causing the person to feel high (euphoric) or sleepy.
This lowers the harms associated with opioid misuse and gives people who are addicted to opioids a chance to stabilize their lives. This treatment is known as opioid agonist therapy. Suboxone therapy for opioid addiction works similar to methadone, another opioid agonist therapy.
When combined with medical and supportive care, Suboxone and methadone are equally effective treatments for opioid addiction, although one may work better than the other for some people.
Side effects of Suboxone
Side effects can include:
• excessive sweating
• dry mouth
• changes in sex drive
• nausea and vomiting
• weight gain.
How do Suboxone and methadone differ?
Differences between Suboxone and methadone include the following:
• Suboxone is a pill that is absorbed under the tongue, whereas methadone is taken as a drink.
• Suboxone has a lower risk of overdose than methadone.
• Any physician can prescribe Suboxone, but only those who have completed special training can prescribe methadone.
• Methadone is most commonly available through specialized treatment clinics; Suboxone treatment may be easier to access than methadone.
• It can take weeks to reach a fully effective dose with methadone but only a few days with Suboxone,
• Side-effects can be less pronounced with Suboxone.
Can Suboxone interact with other drugs?
Mixing methadone or Suboxone with other drugs that depress the central nervous system can be very dangerous. Avoid other opioids, alcohol and benzodiazepines (e.g., Ativan, Xanax, Restoril, Valium, clonazepam). Taking these is especially risky when you first start opioid agonist therapy. Using other drugs while taking opioid agonist treatment can also cause your dose of Suboxone to wear off more quickly, meaning you could experience withdrawal.
Can you overdose on Suboxone?
All opioids have a risk of overdose, though the risk is higher with methadone than with Suboxone. The risk is especially high when you start treatment, and when you stop taking opioids (Suboxone or other opioids) for a while and then start again. Mixing opioids with other drugs also increases the risk of overdose. If you or someone you know uses opioids, it is a good idea to have a free naloxone kit. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose and allow time for medical help to arrive.