How does Suboxone work?
Suboxone is a combination of the two drugs buprenorphine and naloxone. It is used to treat addiction to opioid drugs, including heroin and narcotic painkillers. Suboxone works by binding to the same receptors in the brain as opiates, and prevents cravings for drugs such as:
Buprenorphine is the active drug in Suboxone. It is in a class of medications known as partial opioid agonists. That means the effect of buprenorphine is weaker than the effects of opioid drugs like heroin. The medicine also has a "ceiling," so the opioid effects level off even if the dose is increased. This reduces the risk of dependency, overdose and side effects.
Naloxone, the other drug in Suboxone, is known as an opioid antagonist or "blocker." It is only absorbed and activated in the body if the drug is injected instead of being dissolved in the mouth as prescribed. If you are dependent on opioids and inject naloxone, it will cause uncomfortable withdrawal symptoms. This is to discourage people from injecting Suboxone.
Suboxone is available as a tablet or film that dissolves in your mouth. Doctors usually recommend a starting dose that contains up to 8 mg of buprenorphine and 2 mg of naloxone, with a recommended daily maintenance dose of 16 mg/4 mg taken once per day.
The tablets should be dissolved under the tongue and not swallowed. Do not eat or drink anything until the tablets are completely dissolved. The medication should start working shortly after taking one dose, and its effects last for 24 hours to more than 36 hours.
Like all drugs, Suboxone can have side effects. Common ones include:
- Swelling in the arms and legs
- Numbness or redness of the mouth and tongue pain (if using the film)
It can also cause opioid withdrawal symptoms, such as:
- Stomach cramps
Doctors recommend that Suboxone be used as part of treatment, along with counseling, therapy or other forms of support.
- U.S. National Library of Medicine. Buprenorphine sublingual and buccal (opioid dependence). December 15, 2020. Available at: https://medlineplus.gov/druginfo/meds/a605002.html. [Accessed March 19, 2021].
- Schuckit MA. Treatment of opioid-use disorders. N Engl J Med. 2016 July 28; 375:357-368. https://www.doi.org/10.1056/NEJMra1604339
- National Alliance on Mental Illness (NAMI). Buprenorphine/naloxone (Suboxone). January 2021. Available at: https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). [Accessed March 19, 2021].
- American Society of Addiction Medicine (ASAM). The ASAM national practice guideline for the treatment of opioid use disorder -- 2020 focused update. March 2020. Available at: https://www.asam.org/Quality-Science/quality/2020-national-practice-guideline. [Accessed March 19, 2021].
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