Suboxone is a prescription drug used to treat opioid dependence. It can be used as an induction agent to stabilize someone in withdrawal during the medical detoxification process as well as for maintenance treatment to promote recovery from opioid use disorder. It consists of a combination of two drugs: buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist) and is administered as a dissolvable film placed either under the tongue or in the cheek.
How Does Suboxone Work?
Buprenorphine is what’s known as a partial opioid agonist—an opioid medication that produces relatively weak opioid effects. This means that buprenorphine reduces withdrawal symptoms and cravings without producing the full effect of other opioids (such as heroin, fentanyl, oxycodone, hydrocodone, etc.), which can make it easier for you to stop using your opioid drug of choice.1
With high binding affinity, it may also block other opioids from binding to and activating your opioid receptors, which can deter misuse of other opioids.1,2 As a partial agonist, buprenorphine also has an upper limit to its opioid effects, even with escalating doses. The risk of abuse and overdose due to misuse is lower than with other opioids because there is a limit as to how much your opioid receptors can be activated. This helps reduce the potential for respiratory depression (which means dangerously slowed breathing) which is a key danger and feature of opioid overdose.1,2
Naloxone is an opioid receptor antagonist medication that is combined with buprenorphine in Suboxone and similar generic combination formulations. Though naloxone is used on its own to reverse the deadly effects of opioid overdose, it is instead included in this combo to help discourage intentional misuse of buprenorphine should it be dissolved and injected or inhaled nasally—doing so would result in the rapid onset of withdrawal in opioid-dependent individuals.1,2,3
While it is an effective medication for opioid addiction, Suboxone is often utilized as a part of a comprehensive treatment approach that incorporates not only medications, but behavioral interventions, peer-support groups, and, when needed, treatment for any co-occurring mental health conditions (like depression or anxiety).
Get emergency medical help if you have signs of an allergic reaction to Suboxone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Suboxone can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you are hard to wake up.
Call your doctor at once or seek emergency medical attention if you have:
- weak or shallow breathing, breathing that stops during sleep;
- a light-headed feeling, like you, might pass out;
- confusion, loss of coordination, extreme weakness;
- blurred vision, slurred speech;
- liver problems – upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- high levels of serotonin in the body – agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea;
- low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
- opioid withdrawal symptoms – shivering, goosebumps, increased sweating, feeling hot or cold, runny nose, watery eyes, diarrhea, muscle pain.
Serious breathing problems may be more likely in older adults and those who are debilitated or have a wasting syndrome or chronic breathing disorders.
Common Suboxone side effects may include:
- dizziness, drowsiness, blurred vision, feeling drunk, trouble concentrating;
- withdrawal symptoms;
- tongue pain, redness, or numbness inside your mouth;
- nausea, vomiting, constipation;
- headache, back pain;
- fast or pounding heartbeats, increased sweating; or
- sleep problems (insomnia).