In This Article
Suboxone, or buprenorphine, is an opioid medication commonly prescribed to patients with opioid use disorder (OUD).
While it has a long track record of helping people overcome their addiction and maintain sobriety in the long-term, there are still various misconceptions regarding suboxone.
This article will review suboxone facts, treatment programs, and myths to dispel confusion about this medication.
What is Suboxone?
Suboxone helps with the recovery of those struggling with opioid addiction. It combines buprenorphine and naloxone, binding the same receptors in the brain as other addictive opiates, such as oxycodone and heroin, to relieve cravings.1
Suboxone helps people transition back into a substance-free lifestyle through MOUD. Short for medications for opioid use disorder, MOUD significantly reduces the risk of fatal and nonfatal overdoses. Utilizing these drugs also lowers incident rates by as much as 50%.
With the opioid dependence crisis showing no signs of slowing down, experts and advocates increasingly turn to suboxone as a solution. The U.S. Government is responding by loosening its regulations and making it easier for healthcare professionals to gain access so everyone can get the medication.
What is Suboxone Prescribed for?
Suboxone prescriptions treat opioid dependence in adults and children over 15 years old in combination with medical, social, and psychological support. It is an easy-to-use film that can dissolve under the tongue or inside the cheek within 5 to 10 minutes.2
Those recovering from opioid use disorder must only get such prescriptions from experienced doctors in addiction management. Physicians provide stricter conditions than usual to ensure responsible use and reduce any potential misuse risk.
Suboxone Abuse and Addiction Statistics
- From June 2019 to June 2021, there was a 3.6% to 2.1% decrease in opioid fatalities related to buprenorphine use.3
- Despite representing just a fraction of those who succumbed to buprenorphine-linked overdoses, only 20% had been prescribed medications used to treat opioid use disorder — suggesting that the majority illegally obtained the drug.3
- Almost 93% of people who died from buprenorphine also had other drugs in their bodies. That means that only 1 in 600 people died solely because of buprenorphine.3
- Nearly three-fourths of American adults who took buprenorphine in 2019 demonstrated responsible use and had not misused it in the previous year.4
- In 2020, the number of people who used buprenorphine as prescribed skyrocketed to 1.7 million — a more than two-fold increase compared to the 700,000 figure from those misusing the medication.4
- For adults suffering from opioid use disorder, the most popular reasons for misusing buprenorphine were to reduce cravings and withdrawal symptoms related to their addiction (27.3%) and physical pain relief (20.5%).4
- A study of 326 heroin-dependent people highlighted that Suboxone significantly improved opioid abstinence; 17.8% had no trace opioids in their urine after four weeks, compared with only 5.8% who got placebo treatment.2
- The same study noted a drop in patients’ craving scores from 62.4 and 65.6 before treatment to 29.8 with Suboxone.2
Why is Suboxone Abused?
Suboxone is a unique form of opiate in that it carries significantly less euphoric effects than other popular narcotics like oxycodone and heroin.
As a partial agonist (a substance that stimulates opioid receptors to cause a biological reaction), people use the drug illegally to self-manage their withdrawal from more potent substances like fentanyl and heroin.
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Numerous misconceptions about this medication persist despite all these benefits and documented successes.1
Myth #1: Suboxone Usage Should Be Limited to a Brief Time
While different specialists hold varied opinions on ideal treatment duration, there is no medical proof to suggest that a short-term approach results in more significant success. The length of medication often comes down to patient preference.
Myth #2: A Suboxone Overdose is as Dangerous As Other Opiate Overdoses
Suboxone is a partial opioid antagonist, making it safer than other opioids due to its built-in "ceiling" effect. Risks associated with slowed breathing and respiratory depression are significantly reduced, and overdose on the drug alone is extremely rare.
Users overdosing on the drug typically use it with sedatives like benzodiazepines or medicines that can slow respiration.
Myth #3: True Progress From Opioid Addiction Excludes Suboxone Use
Medical professionals recognize suboxone treatment as a powerful option, akin to insulin for Type 1 diabetes. Ignoring its effectiveness and viewing it with stigma undermines the valuable role of medical care in addressing substance use disorder recovery.
Myth #4: Suboxone on its Own is Not a Comprehensive Addiction Treatment
Substance abuse treatments should ideally include recovery coaching, therapy, and MOUD, but only about 10 to 20% of people with opioid dependence receive addiction treatment.
Additionally, many users lack access or financial resources to receive care with more than just medication-assisted treatment. Research shows even suboxone alone can significantly help in managing opioid dependency, although further benefits can come from additional supports like peer support groups and psychotherapy.
Myth #5: Suboxone Misuse is a Common Occurrence
Suboxone is a partial opioid antagonist of the mu receptor and can be an effective tool to help manage opiate addiction. Unfortunately, its availability may leave users with few other resources than self-treatment when managing withdrawal symptoms or transitioning off fentanyl or heroin misuse.
Nonetheless, a majority of people use the drug within the terms of the prescription rather than resorting to illegal misuse.4
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Suboxone Drug Interactions
Suboxone is a very safe medication, but several drug interactions warrant monitoring. These substances can negatively affect the efficacy of buprenorphine/naloxone:5
- The opioid “blocker” naltrexone (Revia®, Vivitrol®)
- The antibiotic rifampin (Rifadin®)
- Certain seizure medications such as phenobarbital, carbamazepine (Tegretol®), and phenytoin (Dilantin®)
The following drugs can increase the effectiveness of buprenorphine/naloxone:
- Certain antidepressants such as fluoxetine (Prozac®), phenelzine (Nardil)
- Certain antibiotics such as clarithromycin (Biaxin®) and erythromycin (Ery-Tab®)
- Certain HIV medications known as protease inhibitors: indinavir (Crixivan®), ritonavir (Norvir®), saquinavir (Fortovase®, Invirase®), and lopinavir/ritonavir (Kaletra®)
- Antifungals, such as fluconazole (Diflucan®), ketoconazole (Nizoral®), and itraconazole (Sporanox®)
Taking buprenorphine/naloxone in combination with benzodiazepines like temazepam (Restoril®), alprazolam (Xanax®), lorazepam (Ativan®), diazepam (Valium®), and clonazepam (Klonopin®) without an appropriate prescription can result in severe respiratory depression or death.
Following the prescribed instructions for taking these medications accurately and safely is imperative.
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- Grinspoon, P. “5 myths about using Suboxone to treat opiate addiction.” Harvard Health Publishing, 2021.
- “Suboxone.” European Medicines Agency, 2020.
- Facher, L. “Buprenorphine deaths did not increase despite wider access during pandemic, study shows.” STAT, 2023.
- U.S. Department of Health and Human Services. “Buprenorphine misuse decreased among U.S. adults with opioid use disorder from 2015-2019.” National Institute on Drug Abuse, 2021.
- “Buprenorphine/Naloxone (Suboxone).” National Alliance on Mental Illness, n.d.