Suboxone Uses, Dosage, Side Effects & Warnings

Suboxone is an FDA-approved medical drug intended for the treatment of opioid use disorder. The drug combines buprenorphine and naloxone to prevent cravings, reduce the impact of taking opioids, and reduce the risk of dependence or abuse on the buprenorphine.

Today, Suboxone is considered an essential medicine by the World Health Organization (WHO). That’s because it’s used to save tens of thousands of lives. In fact, suboxone paired with behavioral therapy treatment significantly improves outcomes over behavioral therapy alone – making Suboxone a powerful tool for medical health professionals trying to treat opioid addiction.

At the same time, most people have no idea what to expect when they first receive Suboxone. Whether you or a loved one is likely to or is getting the drug, Suboxone has a mixed reputation and is the subject of controversy. After all, it’s partially made of buprenorphine, an opioid drug.

Learning how Suboxone works how it’s administered, and its effects can help.

What is Suboxone?

Suboxone is an FDA-approved drug used to treat opioid addiction by counteracting the effect of opioids taken by injection and limiting abuse potential. The drug is prescription-only and normally available as an oral tablet or film, to be taken under the tongue.

It combines two other FDA-approved drugs. These including the opioid agonist buprenorphine and the opioid antagonist, Naloxone.

Buprenorphine is an opioid drug with a light abuse and dependency profile. In light doses, buprenorphine does not cause sedation or euphoria. It does bind to the opioid receptors in the brain, effectively preventing opioid withdrawal symptoms and cravings. If injected, buprenorphine can be abused as a euphoric drug. However, when taken as directed, it does not.
Naloxone – Naloxone is used to limit the abuse-potential of buprenorphine. This opioid antagonist is most commonly known as the anti-overdose drug. It’s also poorly digested and used when taken orally. This means that when mixed with buprenorphine, patients won’t get most of the impacts of Naloxone when taking the drug as directed. If they attempt to snort or inject the buprenorphine to get high, the Naloxone kicks in. Naloxone is an opioid antagonist, which causes opioid receptors to “unbind” from opioids, reducing the impact of any drugs that person has taken and potentially pushing them into withdrawal symptoms.

Suboxone mixes these two drugs to create an abuse-resistant drug that allows individuals with an opioid use disorder to get treatment without having to go through cravings and withdrawal symptoms. That effectively allows those individuals to build the skills and stability to face those cravings before having to actually face them.

Suboxone Dosing and Use

Suboxone is normally available as a sublingual tablet, or a film which dissolves under the tongue. Here, dosing starts at 8mg/2mg on day one. Most clinicians will use supervised dosage throughout the day, with a 4mg/1mg dose followed by increasing doses every 2 hours, until withdrawal symptoms stop.

Afterwards, users normally stay on a daily dose of 16mg/4mg of Suboxone for maintenance treatment.

However, your clinician my adjust your dosage up or down to see where withdrawal symptoms and cravings start. For example, the clinically approved range is 4mg/1mg up to 24mg/6mg. Your doctor may choose to give you a prescription at any point on this scale. Most will attempt to either give you the recommended dose or the minimum dose they can. This means you can expect 16mg/4mg or lower. However, if you don’t respond to this dose, your doctor may choose for a larger dose.

Suboxone is also available as a sublingual tablet. However, this is taken and dosed in the same way. In addition, it’s also only taken once per day.

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What are the Side Effects of Suboxone?

Suboxone takes effect 20-60 minutes after administration and lasts for as long for 12-60 hours. For most users, doses are started out small and built up over the course of a day – until withdrawal symptoms are gone.

Here, you normally don’t see any immediate side-effects, unless you’re going through withdrawal. If you are in withdrawal, the first noticeable effect will be those symptoms going away. This should happen as soon as the drug starts to kick in. And, for many doctors, whether or not withdrawal symptoms fully vanish or not is an indication of whether the dose should be increased or not.

If you take a very large dose, such as 24mg/6mg, you may experience mild lethargy, confusion, nausea, and euphoria. However, Suboxone is almost never administered in doses this large.

Over the long-term, Suboxone can have many other side effects. For example, you may have persistent cold and flu symptoms. Most users also experience some nausea and stomach pain. In addition, nausea can be bad enough that you occasionally throw up. In addition, your blood pressure could reduce. For this reason, it’s important to discuss any history of low blood pressure with your doctor before you receive a prescription.

In addition, in very rare cases, users will start to experience symptoms including confusion, hallucinations, and seizures. If this occurs to you or your loved one, you should call your doctor immediately. In this case, it’s unlikely that you’ll be able to continue using the medication.

Finally, nearly everyone who uses Suboxone for an extended period of time develops physical dependency. This is a normal part of using a drug over a longer period of time. Here, you will experience withdrawal symptoms when you quit the drug. At the same time, your doctor may give you a tapering schedule instead to reduce those symptoms.

Suboxone Warnings

It’s important that anyone using Suboxone understand that it can be dangerous to try to abuse it. Naloxone can cause you to go into withdrawal when it hits your system. That’s bad enough if you’re just using buprenorphine. But, if you’re also still addicted to other opioids, your withdrawal symptoms may be severe. If you snort or inject Suboxone, you will likely need medical attention.

Getting Suboxone

If you or a loved one is struggling with an opioid use disorder, Suboxone can help. If your clinician or doctor prescribe it, it can improve outcomes for therapy and counseling. However, it does not replace either. Here, you’ll receive medication-assisted treatment, or a MAT program, in which Suboxone is used to supplement the primary therapy. Suboxone prescriptions can last anywhere from a few months to several years depending on how you respond to therapy and your mental health when you walk in. However, the average duration of a prescription is about 6-12 months. That gives you time to go to treatment, figure out coping mechanisms, and then begin to ease off of medication helping you to do that.

Suboxone can help you to stabilize your physical health and to reduce cravings while you work on your mental health. That makes it extremely valuable to anyone looking to recover from an opioid use disorder.

Asana Recovery offers detox, residential, and outpatient addiction treatment services at our center located in Orange County, California. Please contact us today to speak with one of our experienced addiction treatment team if you have any questions about our programs.