Sublocade: The “Suboxone Shot”

What is Sublocade?

Sublocade is a brand of buprenorphine given as a monthly injection. It is used to treat moderate to severe opioid addiction (opioid use disorder).

Is Suboxone the same as Sublocade?

Both Suboxone and Sublocade contain the medication buprenorphine.  But, Suboxone also containes naloxone to prevent misuse and is administered differently. 

Because Sublocade continuously releases buprenorphine throughout the month, there are less “ups and downs” that can sometimes happen with the daily Suboxone dosing.

A potential trade-off when using Sublocade is less flexibility with dosing, including the inability to make dose adjustments between injections. Sublocade also may not be as effective for patients needing higher doses of buprenorphine.

What is Sublocade FAQ

Sublocade doesn’t contain the opioid blocker naloxone. Because Sublocade is given by a medical professional, there is no risk of the medication being misused by patients.

Naloxone (Narcan) is part of Suboxone’s formulation to prevent misuse. When used as directed, the naloxone does not have any clinical effect.

Never inject Suboxone films! “ Not only is it dangerous but “shooting up” Suboxone will likely cause sudden and severe opioid withdrawal.

Patients misusing Suboxone in this way can experience cravings, muscle pain, vomiting and other symptoms of withdrawal. It can also cause a fatal overdose, life-threatening blood clots or infection.  Studies show taking the medication as directed leads to longer-lasting effects.

No, but Sublocade is often called the Suboxone shot by non-medical professionals because it uses the same anti-craving medication buprenorphine. 

Sublocade is an injectable, long-acting form of buprenorphine. Suboxone is a daily-use, sublingual form of buprenorphine that also includes naloxone.

Sublocade doesn’t block opioid receptors like Naltrexone (Vivitrol). Instead, Sublocade partially activates opioid receptors to eliminate symptoms of craving and withdrawal.

Sublocade and Vivitrol are different medications. Though, both are given as a monthly shot to help with opioid addiction.

Sublocade treats and eliminates cravings and withdrawal symptoms. Vivitrol treats cravings but must be given after all withdrawal symptoms have passed, often many days after the last use of any opioid.

Because the active ingredient in Sublocade is buprenorphine (the same active ingredient as Suboxone), you can learn more about the differences between Sublocade and Vivitrol in the article Suboxone vs. Vivitrol.

How Sublocade Works

After injection, liquid Sublocade medication turns into a gel solid under the skin, releasing buprenorphine slowly at sustained levels throughout the month.

The level of buprenorphine in the blood peaks at about 24 hours, then remains fairly consistent during the weeks that follow. The solid that forms after injection is broken down completely by the body over time.

Right After Sublocade Injection

Sublocade After Injection Illistration

Sublocade Releasing Throughout the Month

How Buprenorphine Works

Buprenorphine is a partial opioid agonist. It binds to those same opioid receptors but activates them less strongly than full agonists like prescription painkillers or heroin.

To learn more about how buprenorphine works in the brain in general, see the How does Suboxone work? article.

Is Sublocade Right for Me?

Sublocade is worth considering for those that:

Sublocade Disadvantages

Price: Most health insurance plans cover Suboxone, but many do not cover Sublocade. The retail cost for just the medication is $1,829, in addition to medical appointments and required labs.

Control: Sublocade does not offer much flexibility in dosing. The medication is administered every 4 weeks in one of two available strengths. For those requiring higher than average daily doses of sublingual buprenorphine, Sublocade will often not deliver enough medication to effectively eliminate cravings and withdrawal. 

Availability: Sublocade requires special training and complex ordering which can take up to four weeks. Many treatment programs Suboxone clinics do not offer Sublocade.

Sublocade Reviews

Sublocade was only approved by the FDA at the end of 2017, so it’s relatively new. The reviews are typically positive for those previously on low to moderate daily doses of Suboxone. 

“I got my shot 9 days ago. I haven't felt this normal in so long. I wake up at a decent time. I have energy throughout the day, and I haven't had any cravings or felt the need to dose. Sublocade is seriously a miracle. Once in a while I'll have WD symptoms but it lasts a few minutes. My legs will hurt or my nose will run but that's it and It goes away almost immediately. I feel stable and without the highs and lows that come with daily dosing I feel so much relief.”

“Being on Sublocade was a dream come true because I could finally be stable and feel normal 24 hours a day, not just after I take my subs. I've been on it for the last 10 months, and I haven't felt sick.“

“I still felt cravings on Sublocade and ended up on a higher dose of Suboxone after the first shot. Doing well though.“

What is the success rate of Sublocade?​

A follow-up study of the clinical trials for Sublocade found that 75% of patients were abstinent from illicit opioids for a year after completing one year of Sublocade injections.

Starting Sublocade

Subclade is meant to be used after initial withdrawal symptoms are under control and can be given for years.

  1. Patients must be receiving Suboxone for at least 7 days, with good management of withdrawal symptoms and cravings, before receiving the Sublocade injection.
  2. Patients typically start with a 300 mg dose of Sublocade to help the body reach adequate medication levels.
  3. The Sublocade dose will be lowered to 100 mg after the first or second injection, depending in part on the initial daily buprenorphine dose required.

Starting Sublocade FAQ

Yes. All patients start with Suboxone for at least 7 days before switching to Sublocade. Patients can also switch to Sublocade after years of Suboxone use. Sublocade can be used for patients having trouble tapering off low-dose Suboxone.

No, Sublocade does not get you high. Opioid receptors in the brain are activated enough to satisfy cravings, but not enough to cause a high.

How to Get Sublocade

Most general physicians, retail pharmacies and addiction clinics do not offer Sublocade. The injection requires special training of providers and a license from the Drug Enforcement Agency (DEA).  Additionally, special storage equipment is required.

Get the Sublocade Injection in Illinois or Texas

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Symetria doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

Find a Buprenorphine Treatment Provider | SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use (CIII). (2016). Retrieved July 5, 2022, from Sublocade.com website: https://www.sublocade.com/buprenorphine-treatment-provider

Summary of Observational Study. (2019, July). Retrieved July 5, 2022, from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK546453/

White, N., Flaherty, I., Higgs, P., Larance, B., Nielsen, S., Degenhardt, L., … Lintzeris, N. (2015). Injecting buprenorphine-naloxone film: Findings from an explorative qualitative study. Drug and Alcohol Review, 34(6), 623–629. https://doi.org/10.1111/dar.12308

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