Answers to your Suboxone questions
Suboxone (buprenorphine/naloxone) reduces opioid cravings and withdrawal symptoms to help you recover from opioid addiction. Do you have questions about Suboxone? Here are answers to many FAQs.
Quick Links
- What is Suboxone?
- Suboxone side effects
- How long does Suboxone stay in your system?
- What is Suboxone used for?
- What's the difference between methadone and Suboxone?
- Is Suboxone an opioid?
- Is Suboxone addictive?
- How is Suboxone used?
- Does Suboxone show up on a drug test?
- Signs Suboxone dose is too low
- Is Suboxone a controlled substance?
- Subutex vs Suboxone
- Zubsolv vs Suboxone
- Can you overdose on Suboxone?
- How long does Suboxone withdrawal last?
- Does Suboxone get you high?
- How does Suboxone make you feel?
- Suboxone and alcohol
- How long does it take for Suboxone to kick in
- What does Suboxone look like?
- Suboxone vs naltrexone
What is Suboxone?
Suboxone is a brand name for buprenorphine/naloxone, which is prescribed to treat opioid use disorder. Buprenorphine is a partial opioid agonist. This means that it bonds with the opioid receptors in the brain, but doesn’t fully activate them. This partial activation allows buprenorphine to provide relief from cravings and opioid withdrawal symptoms without creating the euphoria or the drive to take more that characterize the use of opioids like heroin, fentanyl, oxycodone, and morphine. Suboxone also includes another medication: naloxone. Naloxone does not activate opioid receptors at all, but it is very good at bonding to them and blocking them off so that opioids can’t stimulate them. Naloxone is included as a safety measure against misuse.
Suboxone side effects
Common side effects of Suboxone include:
- numbness in the mouth
- mouth redness
- dizziness
- headache
- numbness or tingling
- sleep problems
- stomach pain
- vomiting
- constipation
- drowsiness
- difficulty concentrating
- mouth pain or dental problems
Suboxone may also contribute to liver problems, so tell your provider right away if you experience:
- yellowing of your skin or the white part of your eyes (jaundice)
- dark or “tea-colored” urine
- light colored stools (bowel movements)
loss of appetite - pain, aching, or tenderness on the right side of your stomach area
- eyes (jaundice)
- loss of appetite pain, aching, or tenderness on the right side of your stomach area
How long does Suboxone stay in your system?
The effects of Suboxone usually last between 24-60 hours. Your provider will help you determine whether to take Suboxone multiple times per day, once a day, or every other day to maintain the optimum level for your personal needs.
What is Suboxone used for?
Suboxone (buprenorphine/naloxone) is approved by the FDA to treat opioid use disorder. It relieves cravings and withdrawal symptoms so that people with opioid use disorder can recover physically, psychologically, and emotionally.
What's the difference between methadone and Suboxone?
Buprenorphine (the primary medication in Suboxone) and methadone are both approved by the FDA, categorized as opioids, and demonstrated by scientific research to be effective treatments for opioid use disorder. However, they function somewhat differently in the brain. Methadone is a full opioid agonist, bonding with the opioid receptors in the brain and activating them fully. The buprenorphine in Suboxone is a partial opioid agonist, so it only partially activates the opioid receptors, and is unlikely to create euphoria in a person with opioid use disorder. For this reason, buprenorphine is considered to be at lower risk of misuse. Buprenorphine is a schedule III controlled substance, while methadone is a schedule II controlled substance.
Is Suboxone an opioid?
Yes, the buprenorphine in Suboxone is an opioid. Buprenorphine is a kind of opioid called a partial opioid agonist. This means that it bonds with the opioid receptors in the brain, but unlike most other opioids, it only partially activates them. This allows buprenorphine to relieve withdrawal symptoms and cravings without creating euphoria or “high” in people with opioid use disorder. Buprenorphine’s effects last longer than many other opioids, so most people don’t have the feeling of “crashing” from buprenorphine when taking it as directed.
Is Suboxone addictive?
Any substance that affects your brain chemistry has the potential to be addicting. As a partial opioid agonist, Suboxone’s potential for misuse is considered to be lower than that of other opioids (full opioid agonists) when taken as directed to treat opioid use disorder. When on the right dose of Suboxone or another buprenorphine/naloxone medication, most individuals find that they no longer have the cravings or obsession which typically define addiction.
How is Suboxone used?
Suboxone and other buprenorphine/naloxone medications are taken by being dissolved in the mouth sublingually or buccally. Sublingual means “under the tongue,” and buccal means “against the inside of the cheek.” Buprenorphine is absorbed very well into the body through this method, but is NOT absorbed well through the stomach. If you swallow Suboxone, you will not receive the benefits of the medication.
Does Suboxone show up on a drug test?
Suboxone won’t show up on a standard 5-panel drug test (the type employers most commonly use). However, if you are being screened as part of your treatment program, they may be checking specifically to ensure you’re taking the medication that they’re prescribing. In this case, the test will likely be a multi-panel test that include BUPE or a test specifically looking for the buprenorphine metabolites. Read more: Suboxone might show up on a drug test
Signs Suboxone dose is too low
The most common indication of your Suboxone (buprenorphine/naloxone) dose being too low is if you are experiencing opioid withdrawal symptoms despite taking your dose as directed.
These are common symptoms of opioid withdrawal:
- Rapid pulse
- Joint pain
- Excessive sweating
- Runny nose/watery eyes
- Restlessness
- Digestive distress (stomach cramps, diarrhea, nausea, vomiting)
- Dilated pupils
- Body tremors
- Excessive yawning
- Anxiety/irritability
- Goosebumps
If you experience these while taking your Suboxone dose as prescribed, talk to your provider.
Is Suboxone a controlled substance?
Yes, the main ingredient in Suboxone—buprenorphine—is a schedule III controlled substance.
Subutex vs Suboxone
Subutex and Suboxone are both buprenorphine medications prescribed to treat opioid use disorder. Suboxone is a sublingual film, while Subutex is a sublingual tablet. The primary difference between the two is that Subutex contains only buprenorphine, while Suboxone also includes naloxone to prevent misuse. For this reason, many doctors are more willing to prescribe Suboxone than Subutex.
Zubsolv vs Suboxone
Zubsolv and Suboxone are both brand-name buprenorphine/naloxone medications prescribed to treat opioid use disorder. Suboxone is a sublingual film with a lime flavor, while Zubsolv is a sublingual tablet with a mint flavor. Their dosage strengths vary slightly: Suboxone ranges from buprenorphine 2 mg/ naloxone 0.5 mg to buprenorphine 12 mg/ naloxone 3 mg. Zubsolv ranges from buprenorphine 0.7 mg /naloxone 0.18 mg to buprenorphine 11.4 mg /naloxone 2.9 mg.
Can you overdose on Suboxone?
It is possible to overdose on Suboxone, especially for a person who has not developed a tolerance for opioids. However, Suboxone is only approved for use by people with opioid use disorder, in whom previous opioid use has created a tolerance. For people who are prescribed Suboxone, overdose is extremely rare and almost only occurs when they also take other drugs (opioids, benzodiazepines, stimulants, etc.). Anyone who uses opioids, including buprenorphine, should keep naloxone (Narcan) on hand in case of overdose.
How long does Suboxone withdrawal last?
Because the half-life of Suboxone is longer than that of many other opioids, the onset of detox can be delayed. This means that it can take longer for withdrawal symptoms to appear if you stop taking it cold-turkey. Physical withdrawal symptoms (like nausea, sweating, headaches) can begin 24-72 hours after the last dose and commonly last for 10-14 days. To avoid withdrawal, providers usually recommend a long, slow taper process in which the Suboxone dose is decreased gradually, rather than stopping all at once.
Does Suboxone get you high?
Suboxone is a partial opioid agonist, only partially activating the opioid receptors in the brain. This means if you do feel any sort of euphoria from it, it will level off as your body adjusts to the medication. Most people with opioid use disorder don’t report experiencing any euphoria from Suboxone. It also has a “ceiling effect,” so that after a certain point, the effects do not intensify even if you increase your dose. By definition, you won’t be able to get high. You’ll be stabilized. As with any medication, it’s important to take it as prescribed and to check-in with your clinician about how you’re feeling. If you are feeling uncomfortable or mood-altered, they can adjust your dose. Most people who are on the right dose of Suboxone report that they feel normal, not inebriated.
How does Suboxone make you feel?
Suboxone has two major physical effects on how you feel: it relieves withdrawal symptoms and also may cause side effects. So it relieves withdrawal symptom like rapid pulse, joint pain and body aches, excessive sweating, runny nose/watery eyes, and digestive distress. It may also cause side effects like numbness in the mouth, dizziness, headache, sleep problems, and stomach pain. For most people, the side effects of Suboxone are significantly milder than opioid withdrawal symptoms.
A major mental effect of Suboxone is that it relieves cravings to provide an opportunity to heal physically, emotionally, and socially from opioid use disorder.
Suboxone and alcohol
Alcohol is a central nervous system depressant. You should not drink alcohol or take medicines that contain alcohol while taking Suboxone. Combining alcohol with buprenorphine can lead to difficulty breathing, loss of consciousness, or even death.
How long does it take for Suboxone to kick in
It usually takes 20-45 min for buprenorphine to begin taking effect, and most doses reach full effect after about 100 minutes (one hour and forty minutes). If you are inducting on Suboxone, your provider will recommend how long you should wait before taking an additional dose—usually between 1-4 hours.
How to take Suboxone
Suboxone is a sublingual film. Place the film under your tongue and let it fully dissolve. Do not swallow the film, as it will not take effect properly. After Suboxone is fully dissolved, swish your mouth gently with a sip of water and swallow that. Then if you like, you may use a candy, breath mint, or flavored beverage to rid yourself of the taste. Wait for at least one full hour before brushing your teeth.
What does Suboxone look like?
Suboxone is a film. It looks like a small, flat, orange-ish rectangle that is almost see-through (much like a very thin piece of chewing gum).
Suboxone vs naltrexone
Suboxone (buprenorphine/naloxone) and naltrexone are both FDA-approved to treat opioid use disorder. The buprenorphine in Suboxone is an opioid that functions as a partial opioid agonist, binding to and partially activating the opioid receptors in the brain. Naltrexone is not an opioid. It is an opioid antagonist that binds to the opioid receptors in the brain without activating them and blocks them from being activated by other substances. Both medications relieve cravings, but naltrexone does not reduce withdrawal symptoms nor does it lower the risk of overdose the way buprenorphine does. Buprenorphine is a schedule III controlled substance, while naltrexone is not a controlled substance.
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Citations
1. Buprenorphine. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. Accessed November 2021.
2. Davis, C. S., & Samuels, E. A. (2021). Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19. The International Journal on Drug Policy, 93: 102905. https://doi.org/10.1016/j.drugpo.2020.102905
3. Does Suboxone show up on a drug test? Drugs.com. https://www.drugs.com/medical-answers/suboxone-show-drug-test-3535355/. Accessed November 2021.
4. Fiellin, D. A., Moore, B. A., Sullivan, L. E., Becker, W. C., Pantalon, M. C., Chawarski, M. C., Barry, D. T., O’Connor, P. G., & Schottenfeld, R. S. (2008) Long-Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years, American Journal on Addictions, 17:2, 116-120, https://doi.org/10.1080/10550490701860971
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