Suboxone was developed as an alternative to methadone to ease the severe symptoms of opioid withdrawal and help with ongoing cravings. If an individual has a strong desire to stop taking opioids but has intense cravings, they are likely a candidate for a Suboxone program.
What Is Suboxone?
Suboxone has been FDA-approved to treat opioid use disorder since 2002. It is a sublingual film that dissolves under the tongue with a combination of two medications – buprenorphine and naloxone. Suboxone diminishes withdrawal symptoms and cravings for opioids.
Suboxone Is A Partial Opioid
- NOTE: Suboxone is not the same medication as methadone or Vivitrol (Naltrexone). See Suboxone vs. Methadone or Vivitrol vs. Suboxone.
FAQs: What is Suboxone?
Is Suboxone An Opioid?
Yes, Suboxone is an opioid because it attaches to opioid receptors in the brain, but it does not fully activate them. Suboxone is safer than other opioids like oxycodone or heroin since it is only a partial opioid agonist.
Is Suboxone a Controlled Substance?
Yes, Suboxone is a Schedule III controlled substance because it has a “moderate to low” potential for abuse and addiction.
Suboxone doctors must have a specific license and are monitored by the D.E.A.
How Does Suboxone Work?
Suboxone works by blocking the receptors in the brain that crave opioids, without activating these receptors to create a “high.”
Blocking opioid receptors stops the brain from sending signals that cause withdrawal symptoms and cravings for opioids.
If drugs like heroin or prescription pain pills are used, the opioid receptors are blocked, so these drugs will not give off the “high” either.
Suboxone Ingredients
Suboxone contains 80% buprenorphine and 20% naloxone.
- Buprenorphine, the main ingredient, is an opioid partial agonist. That means that it affects the same part of the brain as opioids like oxycodone, heroin or methadone, but in a more targeted way. Think of the opioid receptors in the brain as a door. Your brain throws the door wide open for most opioids but only partly open for buprenorphine.
- Naloxone is an opioid antagonist or blocker. It prevents the high if the buprenorphine is abused or if other opioids are used. Without the high, the incentive to abuse Suboxone or relapse is much lower.
FAQs: Suboxone Names
Does Suboxone Have a Generic?
Suboxone is a brand name but the same medication is available as a generic. The generic name is Buprenorphine-Naloxone.
Is Zubsolv The Same As Suboxone?
Zubsolv is another brand name for Buprenorphine-Naloxone with higher bioavailability than Suboxone. That means the body is able to absorb more Zubsolv, so lower doses are needed. Zubsolv is also available in six different dosages, whereas Suboxone only has four dose options.
Zubsolv tends to be more expensive than Suboxone and the generic. But, some patients prefer the taste, feel or ease of use of Zubsolv instead.
What Are Other Names for Suboxone?
Suboxone is sold illicitly using names like Buse, Sobos, Strips, Oranges, Big Whites, Small Whites, Stops, Sub or Subs.
When buying illegal drugs, anything could be mixed in or made to look like Suboxone. Always get Suboxone from a medical professional to be sure of the ingredients.
Buprenorphine without naloxone is sometimes referred to as Subutex.
Is Suboxone Substituting One Drug for Another?
No! Suboxone is a medication people need to manage a disease. A person with diabetes requires insulin daily and we don’t say that they’re addicted to insulin.
Research shows Suboxone improves brain function. If you interviewed a group of people, you’d never be able to tell who is taking Suboxone and who isn’t.
Starting Suboxone
Suboxone can’t be taken right after drug use because it can make withdrawal symptoms worse, but can be continued for months or years as needed.
- Suboxone is started after early withdrawal symptoms already set in, usually between 12-48 hours. (Dosing at the incorrect time can lead to immediate and severe withdrawal symptoms called Precipitated Withdrawals)
- Dosages on days one and two are fairly standardized when withdrawal symptoms are worst. You should be monitored by a medical professional when starting Suboxone to stay safe. (See also: Suboxone Dosing)
- Day 3 and onward the dosage is adjusted to a level that keeps the patient in treatment. Suboxone can be taken for months or years.
- To stop, a Suboxone taper is used to slowly decrease the dose over time to prevent withdrawal symptoms.
How Do I Take Suboxone?
Suboxone comes in the form of a sublingual film, which means it is placed under the tongue and allowed to dissolve.
Where To Place a Suboxone Film
A Suboxone film should be placed under your tongue on the bottom.
What Suboxone Looks Like Being Placed Under Tongue
How Long Does Suboxone Take to Dissolve?
Typically, a Suboxone film will dissolve in about 30 minutes.
Avoid chewing, swallowing or moving the film around in your mouth until the film dissolves completely, including eating or drinking anything.
Why is Suboxone Sublingual?
Suboxone is not well absorbed by the digestive system. The medication is absorbed directly into the bloodstream when placed under the tongue.
That’s why it’s not taken as a pill or liquid, though it can be given as a monthly injection, called Sublocade. (It was also previously offered as an implant called Probuphine, though that was discontinued).
Why is Suboxone Prescribed?
Though not a cure for addiction, medications like Suboxone can be life-changing for anyone struggling with opioid addiction. Suboxone helps your body feel and function normally but has some limitations.
1. Suboxone is only meant for opioid addiction.
- Heroin
- Fentanyl
- Codeine
- Morphine
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin, Percocet)
- Methadone
Suboxone wouldn’t be used for substance use issues outside of opioids like alcohol. (Vivitrol could be a better option. See also: Suboxone vs. Vivitrol).
2. Suboxone only treats the physical issues.
Combing Suboxone with therapy helps you tackle the mental aspects of addiction. Usually, there is more that’s fueling the cycle like self-esteem, depression, anxiety or trauma.
Can Suboxone Be Used For Pain?
Suboxone is not FDA-approved to treat pain. But, there is research to support the “off-label” use for patients that struggle with both opioid use and chronic pain.ⓘ
Methadone might better control pain for chronic pain patients. Methadone is a common second-tier option for chronic pain patients and is FDA-approved for pain management.ⓘ
See also: Methadone vs. Suboxone
Side Effects of Suboxone
Both active ingredients of Suboxone (buprenorphine and Naloxone) are considered safe. Buprenorphine is even recommended for opioid-dependent patients who are pregnant and is safe to use long-term. Dangerous side effects like slowed breathing and overdose are extremely rare when the Suboxone interacts with other substances.
The most common side effects of Suboxone are constipation and sleep issues. Usually, these side effects are worse on opioids and can be treated effectively. See: Side Effects of Suboxone
Where to Get Suboxone
Not all doctors prescribe Suboxone. The medication is typically prescribed by addiction-specialized doctors at a Suboxone clinic.
In addition to the medication, Suboxone treatment programs offer more comprehensive treatment plans, including:
- Therapy options: Unlimited cognitive-behavioral therapy (CBT) helps overcome underlying triggers (like depression, anxiety and trauma).
- An understanding environment: A judgment-free environment to share openly and honestly.
- Compassionate support: Never underestimate the power of accountability and support from a full team of people that actually care and will do everything they can to help you.
Symetria Recovery Suboxone Clinics
If you don’t live nearby in Texas or Illinois, the Find a Suboxone Doctor article can help you find a Suboxone Clinic near you. You can do this!
16 Comments
I started today on Suboxone and got bad withdrawal. Will it happen again tomorrow?!
No, you’re in precipitated withdrawal b/c you took it too early. Try again tomorrow and it’ll make you feel better. You got this!
Agreed! This is precipitated withdrawal. If you take Suboxone under the direction of a qualified medical provider, you can avoid triggering precipitated withdrawal again.
Today was my last opiate use. How long should I wait to take this? And how long till it works so I’m not sick?
The longer you can wait, the better. Taking Suboxone too soon (which varies based on each person and their drug use history, especially if using fentanyl) can cause precipitated withdrawal (10/10, nearly immediate withdrawal). I tell patients to wait until they are really uncomfortable, then wait another hour. We can’t always avoid precipitated withdrawal, but this rule of thumb helps. Also, you should only start Suboxone under the guidance of a qualified medical provider as they can help should precipitated withdrawal occur
Do people who have changed from heroin use to fentanyl get worse withdrawal symptoms on Suboxone than if they stayed on heroin?
Patients should not have severe withdrawal symptoms once stabilized on Suboxone whether previously using heroin or fentanyl. More commonly we see minor withdrawal symptoms that may linger, which is called PAWS (Post Acute Withdrawal Syndrome). PAWS is something that resolves over time and you are able to function, but still experiencing symptoms.
It is possible that fentanyl causes a person to experience worse or earlier precipitated withdrawal too if taking Suboxone too soon after use (even if the last use was 24 hours prior). Fentanyl is much stronger and connects to the receptors tighter than heroin. It also has a lot of variabilities depending on what route you take it (e.g., IV versus Lollipop versus transdermal patch), how long you’ve been on it, and how much you take. This all results in Fentanyl being more unpredictable than Heroin when trying to avoid precipitated withdrawals from Suboxone initiation.
Is Suboxone used for pain?
Suboxone is used by some pain specialists for pain control as it sits in the opiate receptors in the same way as traditional narcotic pain medications.
Will I still have all the aches and pains from not having any heroin?
No, Suboxone stops any intense withdrawal symptoms.