What is Suboxone and is it Addictive?
In This Article
If you, or a loved one, are recovering from Suboxone addiction, you’re familiar with the difficulties of overcoming dependency. There are benefits to taking Suboxone for addiction treatment, but it also has serious side effects and risks.
Read on for more information about the symptoms of Suboxone addiction, the potential risks involved, what withdrawal looks like, and available treatment programs to help manage this complex condition.
What is Suboxone?
Suboxone is a Food and Drug Administration (FDA)-approved drug that treats opioid dependence. It curbs cravings while blocking the effects of other opioids.
This drug is a combination of naloxone and buprenorphine. Physicians prescribe Suboxone in film or pill form.
Both forms reverse the effects of opioids and alleviate withdrawal symptoms by preventing opioid receptors in the brain from activating.
It’s also essential to a comprehensive treatment program that incorporates counseling and behavioral therapy.
How Does Suboxone Work?
Suboxone contains four parts buprenorphine and one part naloxone. Buprenorphine deceives the brain into perceiving a full opioid dosage.
Simultaneously, naloxone serves as a powerful shield. It impedes the activation of opioid receptors and effectively counteracts the stimulating effects of buprenorphine.
Suboxone effectively targets the receptors in the brain that dangerous opiates like heroin, morphine, and oxycodone affect. It starts to take effect within 20 to 60 minutes.
These effects include:
- Reduced pleasurable effects from drugs
- Reduced cravings
- Restored sense of stability and security in people’s lives
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The Role of Naloxone and Buprenorphine in Suboxone
The following drugs are combined in Suboxone’s formulation and work together accordingly:
Naloxone is included in Suboxone to counteract the effects of present opium in an addicted person’s system. This gives the brain a clean slate as the initial step in their recovery.
Naloxone binds to opioid receptors in the brain and reverses the respiratory depression caused by opioids. As a standalone drug, it’s the go-to medication to reverse opium’s effects on the brain.
Buprenorphine plays a crucial part in combating continued drug use and relapse. This drug effectively stops the intense physical craving that the body goes through during this time.
As a partial opioid agonist, buprenorphine binds to opioid receptors with moderate activity. It activates opioid receptors to a limited extent, producing milder effects and reducing the risk of respiratory depression and overdose.
How is Suboxone Prescribed?
While the drug Methadone serves the same purpose of combating opioid addiction, it’s only available at specialty methadone clinics.
Suboxone's partial agonist nature, combined with naloxone's antagonist action, offers a safer profile and can be prescribed in outpatient settings. Doctors may prescribe Suboxone as an alternative to Methadone.
First, the prescribing physician must go through an approval process. Moreover, they require users to sign a waiver.
Suboxone Treatment for Opioid Use
Suboxone treatment can effectively manage addiction to both short-acting and long-acting opioids. It's commonly used for opioid use disorder (OUD) regardless of the specific type of opioids that an individual is addicted to.
For short-acting opioids, like heroin or immediate-release prescription opioids, Suboxone can help:
- Manage withdrawal symptoms
- Reduce cravings
- Provide a smoother transition to recovery.
Suboxone can also counteract long-acting opioids, like extended-release prescription pain medications. It can be used to alleviate withdrawal symptoms and cravings, as well as prevent the risk of overdose and other opioid-related complications.
Suboxone Use Beyond the Initial Prescription
Suboxone isn’t a long-term solution for opioid addiction. Once the drug has gotten a user to quit, the doctor will continue to monitor the user’s progress as they progressively reduce the dosage.
After sobriety, doctors strongly advise users to participate in comprehensive treatment programs.
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What are the Side Effects of Suboxone?
Some of the adverse effects associated with Suboxone include:
- Profuse sweating
- Red flushing of the skin
- Pain in the back or abdomen
- Nausea and vomiting
- Issues with concentration
- Warmth or feeling overheated
Severe Side Effects
Immediate medical attention is urgent in the case of critical side effects, such as:
- Rapid or irregular heartbeat
- Strong disorientation or dizziness
- Slowed breathing
Can You Overdose on Suboxone?
Although rare, you can overdose on Suboxone. Suboxone is only a partial opioid agonist; therefore, there’s a limit to how much it can activate opioid receptors.
Life-threatening overdose cases almost always occur when users combine Suboxone with other medicines that suppress the central nervous system. Some of these drugs that slow breathing include benzodiazepines.
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How Does Suboxone Addiction and Dependency Look?
Opioid addiction can be incredibly challenging, as those addicted continue to misuse drugs despite adverse consequences. As a result, they eventually develop dependency and tolerance.
Suboxone dependency occurs when your body requires more drugs to achieve the desired effect. Once dependent, you will crave and abuse the drug.
Consequently, you will experience withdrawal symptoms when you stop taking Suboxone. Withdrawal symptoms can start within just a few hours.
Signs of Suboxone Addiction
Suboxone is a powerful drug, so it’s not surprising that people can become addicted to it. As with any opioid, there are warning signs that you or your loved ones should be aware of if someone has been using Suboxone.
Signs of Suboxone drug addiction include:
- Difficulty functioning without the drug
- Going to extreme lengths to obtain the drug, such as doctor shopping or breaking the law
- Taking higher doses than prescribed or taking it more often than instructed
- Neglecting one’s responsibilities in favor of obtaining and using the drug
- Significant changes in behavior or physical appearance
- Withdrawal symptoms when not using Suboxone
Risks of Suboxone Abuse and Addiction
People can misuse or abuse Suboxone in many ways, including:
- Taking too much at once
- Snorting it instead of taking it orally
- Taking it for longer than prescribed
- Taking it with other opioids or drugs
Suboxone itself is an opioid drug. Taking too much of or misusing it can lead to addiction.
The withdrawal process from Suboxone can be challenging since the drug covers up some of the more severe symptoms. As a result, users may experience more intense withdrawal.
Suboxone Withdrawal Symptoms
The most successful Suboxone treatment results in little to no withdrawal symptoms. But since some users quit the drug abruptly, withdrawal symptoms occur.
They can be unbearable, and many of those addicted are highly fearful of them. In some cases, withdrawal symptoms can be dangerous.
Some of the most common withdrawal symptoms include:
- An intense craving for the drug
- Profuse sweating and clamminess
- Runny nose
- Chills and goosebumps
- Muscle spasms
- Stomach cramps
- Homicidal or suicidal thoughts
- Nausea and vomiting
- Agitation and irritability
How Long Does Suboxone Stay in Your System?
Suboxone takes approximately 7 to 9 days to clear for people in good health. Suboxone can be classified as a long-acting opioid.
Typically, it requires 4 to 5 half-lives for a drug to fully clear from the body. The term "half-life" describes the time it takes for half of a substance's dose to exit the body fully.
Buprenorphine possesses an extended half-life, lasting between 24 and 42 hours. On the other hand, naloxone has a shorter one of approximately 2 to 12 hours.
How Does the Body Metabolize Suboxone?
The liver metabolizes naloxone and excretes in the urine. At the same time, the body processes buprenorphine and eliminates it through urine and feces.
How Can Suboxone Be Detected in a Person’s Body?
Blood tests, urine, and saliva can all detect Suboxone in a person. However, they can’t pinpoint the exact amount of drug taken in a given instance.
Various tests have distinct detection periods for Suboxone, contributing to the variability in how long the medication remains detectable in a person's system.
These are the types of drug tests and their detection period for Suboxone:
|Type of Drug Test||Detection Period|
|Hair||Up to 3 months|
|Urine||Within 9 hours of consumption|
|Saliva||Up to 5 days after the most recent dose|
|Blood||Up to 48 hours post-ingestion|
Factors Influencing Suboxone Presence in Your System
Various factors affect the detection of Suboxone in your body. These factors include:
Age, Weight, and Metabolic Rate
Younger, healthy people with a fast metabolism process can eliminate Suboxone more quickly.
Naloxone's half-life is considerably longer in those with moderate to severe liver disease. Although to a lesser degree, people with liver disease also experience a prolonged half-life of buprenorphine.
Regularity of Use
Some may develop a tolerance or build-up of Suboxone if they take higher doses or take it regularly. As a result, it may take longer for the substance to leave their system than for those who have taken a lower dose of Suboxone.
Interactions with Other Substances
Co-administration of Suboxone with various medications and substances can heighten Suboxone levels in your system. This alters the time it remains in your body.
How Do You Treat Suboxone Addiction?
Many tools and treatment options are readily available for people intending to end their addiction. The first and most crucial step is having the desire to quit. While some can recover on their own, the vast majority of success stories stem from help.
Behavioral therapy is vital to a person's success in overcoming drug abuse and addiction. Usually, underlying issues lead to somebody falling into addiction, such as depression or PTSD.
Behavioral therapy helps address these challenges. Depending on the user’s needs, some long-term support methods may be inpatient or outpatient programs. These include:
This method involves a one-on-one or small group setting to ensure personalized care. Since dealing with addiction is stressful, motivational interviews help people cope and stay focused on the right path.
This program uses positive reinforcement by giving people tangible rewards for their sober moments. It utilizes a "point system" that gives users a sense of gratification for sober living.
Contingency management is a great way to encourage healthy habits after people have received rehabilitative treatment.
CBT aims to get to the bottom of issues that may cause users to relapse. It also helps users know their triggers, maintain realistic expectations, and manage recovery stress.
Additionally, CBT assists in identifying specific behaviors that lead to addiction. This program also tackles outside influence avoidance and internal thought processes.
Tips for Managing Withdrawal Symptoms During Recovery
Withdrawal symptoms can be bothersome and unpleasant. However, there are plenty of things you can do to manage them, including:
- Get enough sleep every night by following a consistent sleep schedule.
- Practice relaxation techniques such as deep breathing exercises.
- Eat nourishing meals high in vitamins, minerals, protein, and fiber.
- Exercise regularly to improve your mood and lessen withdrawal symptoms.
- Engage in activities that distract you from negative thoughts.
- Speak with a therapist to receive professional advice on how to cope with withdrawal symptoms.
- Connect with friends and family who understand what you’re going through.
- Participate in support groups to share your struggles and triumphs with others in recovery.
- Drink lots of water to stay hydrated throughout the day.
- Avoid drugs, alcohol, or any other substance that can hinder your progress in recovery.
Support Groups for Those Struggling with Suboxone Abuse and Addiction
One of the most effective ways to find relief from Suboxone abuse and addiction is by joining support groups. Some excellent examples of such organizations include:
- Narcotics Anonymous (NA)
- SMART Recovery
- Celebrate Recovery
- Refuge Recovery
Support groups provide a safe environment for people to share their stories and get the emotional help they need. They also help develop strategies for staying sober.
Additionally, these types of programs improve the motivation of those in recovery while reducing drug use. They create a sense of community to help you stay on the right path.
What Drugs Can Interact with Suboxone?
Certain prescription drugs and herbal supplements have harmful interactions with Suboxone. Medical professionals advise against using the following medications while on Suboxone:
- Various HIV medications
Cautionary Advice and Success Rates for Suboxone Use
Suboxone is by no means a universal success. Less than 10% of all who try to quit fail, and many risk relapse. Often, people make multiple attempts before achieving long-term success.
Additionally, breastfeeding mothers shouldn’t breastfeed while using the drug. Doing so can pass Suboxone to their babies through breast milk.
A comprehensive approach to treatment is always advised to achieve a successful recovery from addiction.
Can You Drink Alcohol While On Suboxone?
No, you can’t consume alcohol while undergoing Suboxone treatment. Doing so can worsen the common symptoms of Suboxone use, such as dizziness and fatigue.
The effects of Suboxone and alcohol heighten when you combine them. This is especially true when you use Suboxone with other substances.
Combining Suboxone and alcohol can also intensify the body's physical dependence and tolerance. This leads to a need for larger doses of Suboxone to compensate for the enhanced effect.
What are Common Opioid Drugs?
Opioid drugs come from the opium poppy plant. Common types include:
- Prescription painkillers (oxycodone, codeine, fentanyl)
- Illegal opioid drugs (heroin, pure opium)
Can You Get Off Of Suboxone Without Going Through Severe Withdrawal?
No, quitting cold turkey isn’t a good idea. Severe withdrawal symptoms can occur as your body adjusts to the lack of Suboxone.
Withdrawal can be painful and dangerous. Consulting with a healthcare provider is essential before attempting to stop taking Suboxone.
Various tapering methods are available to help you reduce the dose to minimize withdrawal symptoms. Your doctor can help you customize a tapering schedule specifically for your needs. Follow their instructions carefully and always keep in touch with your physician.
Can Suboxone Help Treat Alcohol Addiction?
Suboxone drugs only treat opioid addiction, not alcohol use disorder (AUD). However, a study has shown promising results with high-dose buprenorphine.
Participants who received the medication drank less. Some even quit alcohol entirely. However, Suboxone's effectiveness in reducing alcohol use and its direct impact on alcohol cravings remain uncertain.
Currently, Naltrexone is the top medication for AUD. Acamprosate and Disulfiram are alternative options.
Suboxone is a potent medication used to treat opioid addiction. It works by blocking the brain's opioid receptors and preventing cravings. Unfortunately, it's also addictive.
It’s essential to understand the potential risks and side effects of Suboxone. Professional intervention and therapies are effective strategies and treatment options for tackling addiction issues.
In addition, several tips and support groups can help manage withdrawal symptoms during recovery. If you're struggling with Suboxone abuse and addiction, seek help from these resources. After quitting the drug, you can take the necessary steps to ensure sobriety.
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- Grinspoon, P. “5 Myths about Using Suboxone to Treat Opiate Addiction.” Harvard Health Publishing, 2021.
- LaMotte, S. “Suboxone: What Is It?” Cable News Network (CNN), 2016.
- “Suboxone.” RxList, 2023.
- Dematteis et al. “High-dose buprenorphine: A last resort drug for treatment-resistant alcohol use disorder. preliminary results of a compassionate observational pilot study.” French Journal of Psychiatry, 2018.
- Kumar et al. “Buprenorphine.” StatPearls [Internet], 2023.
- Velander, JR. “Suboxone: Rationale, Science, Misconceptions.” The Ochsner Journal, 2018.