Suboxone is available to help people deal with the discomfort of opioid withdrawal, so they can successfully wean themselves off drugs like heroin and prescription painkillers. Usually, Suboxone starts working 45 minutes after it is taken. Suboxone is a brand name for a medication containing buprenorphine and naloxone. The National Institute on Drug Abuse (NIDA) says that to take Suboxone, you must present with at least three symptoms of withdrawal. You must also wait several hours or even days after you have stopped taking opioids before taking Suboxone.
Like any other medication, there are risks and side effects for Suboxone. Your doctor can help you decide whether or not Suboxone is right for you after a medical consultation.
Most people know about Suboxone because it is a popular treatment for withdrawal symptoms for those who want to quit taking opioids. This includes people who are in recovery after misusing drugs like fentanyl or heroin or prescription painkillers that contain opioids, such as OxyContin.
Suboxone is sold as a buccal or sublingual medication. It is a film that you either place inside your cheek or under the tongue until it completely dissolves.
The medication is a U.S. Drug Enforcement Administration (DEA) Schedule III substance, which means you need a prescription to possess it.
Schedule III medications have a legitimate medical purpose, but they also have the potential for misuse and dependency. The Substance Abuse and Mental Health Services Administration (SAMHSA) says that Suboxone and other medication containing buprenorphine can be part of medically assisted therapy for people in recovery who may not be able to use other medication, such as methadone.
In addition to buprenorphine, Suboxone also contains naloxone. As mentioned in The Ochsner Journal, buprenorphine prevents other opioids from binding with the brain’s opioid receptors. Naloxone can prevent the misuse of any opioids regardless of how they are taken.
Suboxone can prevent fatalities among people in recovery and poses far less risk of overdose than other medications used to help people recover from opioid dependency and misuse.
For Suboxone to help you, you must take it correctly. NIDA outlines the following guidelines for the best use of Suboxone.
NIDA also advises patients to wait as long as they can to start taking Suboxone or other medications containing buprenorphine. Waiting as long as possible ensures that withdrawal symptoms do not become worse as you wait for the medicine to start having an effect on you.
As NIDA’s guidelines mention, the average schedule for any buprenorphine-containing treatment starts like this:
Most patients are advised to take between 8 to 12 mg of buprenorphine-containing medication to start. The first dose is usually 4 mg, and it must be taken without food or drink. Suboxone should begin working within 45 minutes. After this, patients can take a second dose of 4 mg if they still feel ill. Users must wait six hours and take their final dose of 4 mg.
Until the next appointment:
From day two until your next appointment, take one 16 mg dose of your medication.
SAMHSA says that treatment buprenorphine-containing medication consists of three phases:
Phase 1 Induction
The patient receives the medicine after an assessment from a doctor or authorized clinic within 12 to 24 hours after abstaining from opioids.
Phase 2 Stabilizing
Once a patient no longer craves opioids or other drugs for which Suboxone treatment was sought, their dose can be modified. Some patients can take Suboxone every other day instead of every day during this phase.
Phase 3 Maintenance
This depends on the patient, but once someone is doing well after taking Suboxone regularly, the doctor and patient may decide to taper from Suboxone and end this part of treatment.
Like any medication, there may be some side effects associated with Suboxone. Speak with your doctor if you feel worse when taking the medication. You do not have to wait until your next appointment or until the symptoms are severe to notify your physician about unexpected reactions.
Healthline mentions that these side effects are common to Suboxone:
More serious side effects exist for Suboxone as well. Though rare, get help right away if experience the following:
As SAMHSA states, everyone is different. Some people may need to use Suboxone for a long time. The drug can be successfully used for up to 24 weeks.
(April 2019) How Long Does Buprenorphine Stay in Your System? Verywell Mind. from https://www.verywellmind.com/how-long-does-buprenorphine-stay-in-your-system-80228
(September 2018) A Guide for Patients Beginning Buprenorphine Treatment at Home. National Institute on Drug abuse. from https://www.drugabuse.gov/nidamed-medical-health-professionals/discipline-specific-resources/initiating-buprenorphine-treatment-in-emergency-department/guide-patients-beginning-buprenorphine-treatment-home
(Spring 2018) Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
(April 2019) Buprenorphine. Substance Abuse and Mental Health Services Association. from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
(October 2018) Suboxone (buprenorphine and naloxone). Healthline. from https://www.healthline.com/health/cdi/suboxone