Medically Reviewed By
On April 15, 2024
Written By
On November 13, 2023
When you mix buprenorphine and naloxone, you get Suboxone. Both buprenorphine and naloxone on their own are useful for treating opioid withdrawal symptoms. Mixing them creates a very efficient product for this purpose, but it also has addiction potential.
Suboxone has been used for a long time to treat opioid substance abuse. It is technically an opioid medication, but it works differently than the opioid painkillers many people get addicted to. Opioid painkillers are called opioid agonists, which can cause euphoria based on the way the drug’s molecules bind to neurons. Suboxone contains buprenorphine, which is a partial opioid agonist, and naloxone, an opioid antagonist. Buprenorphine partially activates opioid receptors, potentially reducing withdrawal symptoms without producing the full euphoric effect seen with full agonists. Naloxone blocks opioid receptors to deter misuse, primarily active when Suboxone is injected.
Since it targets the same receptors, it can reduce the cravings people might have for opioids. While Suboxone has a low risk of addiction, it is still possible to get addicted to it, especially when it is misused. It is also a very commonly prescribed drug. Out of the 4.3 million people who misused opioids in 2014, many of them used Suboxone to help with their cravings.[1]
Street names for this drug include Boxes, Oranges, Sobos, Stops, and Bupes.
Suboxone is a Schedule III drug, and it goes by many names when sold on the street, including stops, bupes, sobos, and oranges. Its most common side effects include numbness, tingling, nausea, vomiting, insomnia, and headaches. Some may experience tongue pain, back pain, drowsiness, and blurred vision.
Suboxone is almost always taken sublingually in the form of a tablet or film. You must put the film over your tongue and hold it until it dissolves through your lingual membranes and enters the blood. Sublingual administration is faster than the oral route but slower than injecting it. It should take around 20 minutes for the drug to start working.
Some people misuse Suboxone by altering its form to bypass its preventive mechanisms, such as melting and injecting it, which activates naloxone causing immediate withdrawal symptoms rather than providing a high. This method of misuse can lead to complications rather than addiction to the euphoric effects.
Suboxone treatment centers are specialized facilities that offer medication-assisted treatment (MAT) for people who are struggling with opioid addiction. In addition to administering Suboxone to reduce opioid cravings and withdrawal symptoms, these treatment centers often provide counseling, behavioral therapies, and support groups.
Treatment plans are typically tailored to each individual’s needs, and the duration of treatment can vary depending on the severity of the addiction and the patient’s progress. The goal of a Suboxone treatment center isn’t just to reduce physical dependence on opioids but also to address the underlying psychological aspects of opioid addiction. In the context of a treatment center, suboxone can be a useful tool to combat opioid addiction. However, there is potential for misuse of suboxone outside of a clinical setting.
In 2019, three-quarters of people who used buprenorphine did not misuse it.[2] However, just because the percentage that misuses it is small doesn’t mean it’s not a problem. Many people start misusing Suboxone because they can’t stand the feeling of not using real opioids. They may try anything to scratch that itch, including melting Suboxone sublingual films and injecting them or crushing the tablets and snorting them.
While Suboxone can’t cause the same euphoria as regular opioids, it can still cause dependence and addiction. The effects of Suboxone abuse often involve secretiveness. Some may want to hide all the Suboxone they’re taking or how they’re misusing it. They may try getting prescriptions from different doctors to avoid running out.
Those who abuse this drug may lose weight and experience financial problems due to their excessive buying of Suboxone. Some may have drug paraphernalia around the house, such as syringes or pill powder.
While naloxone is included in Suboxone to counteract the effects of opioid overdose when injected, overdose on Suboxone is still possible, especially when taken in large doses or combined with other depressants such as alcohol or benzodiazepines. However, it is still possible to overdose on this medication if you take massive amounts or if you mix it with other substances. Some may mix it with opioid agonists, like painkillers, which may lead to an overdose more than the Suboxone itself.
Suboxone overdoses are very similar to opioid overdoses. They include abdominal pain, nausea, seizures, slowed heartbeat, coma, and sometimes death. Many people who overdose end up unresponsive, even if you make loud noises or inflict pain to try and wake them up.
Since overdosing on Suboxone is potentially fatal, you should call 911 as soon as you can. Once the paramedics arrive, they can try to reverse the overdose and treat the person’s symptoms so they have the best chance of survival.
Suboxone is rarely used for more than a year. If a person uses it longer than that, they may experience symptoms such as anxiety, depression, increased pain sensitivity, confusion, nausea, and fatigue. If taken in very high doses, the medication may eventually damage your liver and kidneys.
Some people will mix Suboxone with alcohol, opioid painkillers, or other drugs. Mixing Suboxone with anything will increase the risk of overdose and other adverse symptoms. It may also make it more likely for an addiction to form.
In 2009, 340,000 people with opioid use disorders were prescribed Suboxone, while a much smaller percentage preferred to use generic buprenorphine.[3] While long-term use of Suboxone can lead to physical dependence, distinguishing between dependence and addiction is crucial. Dependence is characterized by withdrawal symptoms upon cessation, whereas addiction involves compulsive drug-seeking behavior despite harmful consequences. Treatment centers focus on managing dependence and preventing the transition to addiction through comprehensive support and monitoring.
Many people who become addicted to Suboxone may experience financial problems because they are purchasing the medication from several places. They may get several prescriptions from different doctors, or they may buy the substance off the street. They may also experience social isolation. Instead of benefiting from Suboxone use, they start to reap the disadvantages.
They may block themselves off from others and spend much of their time alone abusing Suboxone.
While prescription Suboxone should not contain additional substances and likely won’t result in a positive result in a drug test, illicit Suboxone obtained from non-medical sources may be adulterated with various additives. These additives can range from benign fillers to harmful substances like other opioids, which could increase the risk of overdose and other adverse effects.
Regular outpatient treatment works well for most people suffering from a Suboxone addiction. If you feel you need some extra support, you can always try an intensive outpatient or trauma-informed care program. Choosing the right program for your needs is essential for your recovery.
DBT, ACT, and CBT are all very useful types of therapy that will help you get beyond your addiction. They will teach you how to solve problems in your life without turning to drug use as a crutch. Hypnotherapy, yoga, and art therapy are also great options for a more holistic approach.
Individuals struggling with Suboxone addiction often have a history of opioid use disorder and may also suffer from co-occurring mental health disorders such as depression or anxiety. Addressing these underlying issues is crucial as they can drive substance misuse as a coping mechanism. Both the addiction and any underlying conditions that may have contributed to the addiction must be addressed at the same time for the best chance at recovery.
Detoxing is a major step in putting your addiction behind you. This process is difficult for many people because the brain has to relearn how to function without Suboxone. Once the drug is out of your system, your recovery will be much smoother from there.
Clonidine may be used to minimize the severity of a person’s withdrawal symptoms, such as cravings. OTC pain medications may also be useful for treating headaches and body aches.
If you or someone you love is struggling with a Suboxone addiction, reach out to our Long Island Rehab Center. Ascendant New York is here to help, offering drug rehab support to all five boroughs within New York City.
Suboxone, which contains buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist), has a lower addiction potential compared to full opioid agonists, especially when taken as prescribed. The buprenorphine component can still lead to dependence and potential misuse, although it is generally less euphoric than full agonists. However, when it is misused or taken with other substances, it becomes far more addictive. This can also lead to dangerous consequences, such as overdose or organ damage.
While some may turn to Suboxone as an alternative when opioid painkillers are unavailable, its primary abuse potential arises from its use among individuals attempting to manage withdrawal symptoms from other opioids or those seeking to avoid detection of opioid use, given its availability and prescription status. While Suboxone has a very different effect than ordinary opioids, it can still scratch the itch a person with an opioid addiction might feel. However, those who misuse Suboxone may soon stop when they find that Suboxone does not produce the same euphoria as opioids. Others may develop a dependence.
Common withdrawal symptoms include excessive sweating, fever, tremors, anxiety, depression, nausea, and abdominal cramps. Severe cases of Suboxone withdrawal are rare, but they may intensify existing withdrawal symptoms like anxiety, depression, and physical discomfort. Seizures or coma are extremely uncommon in Suboxone withdrawal and are more typically associated with withdrawal from other substances like alcohol or benzodiazepines. Severe withdrawal symptoms are more common in those who have used Suboxone for a long time. They are also more common in those who stop using Suboxone suddenly, also known as going cold turkey.
To avoid these side effects, it is best to go through a professional detox. This allows you to slowly wean off the substance so that the process is as safe as possible.
Here at Ascendant New York, we understand the importance of having access to accurate medical information you can trust, especially when you or a loved one is suffering from addiction. Find out more on our policy.
[1] Velander J. R. (2018). Suboxone: Rationale, Science, Misconceptions. The Ochsner journal, 18(1), 23–29. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/ on May 26, 2023.
[2] NIDA. 2021, October 15. Buprenorphine misuse decreased among U.S. adults with opioid use disorder from 2015-2019. Retrieved from https://archives.nida.nih.gov/news-events/news-releases/2021/10/buprenorphine-misuse-decreased-among-us-adults-with-opioid-use-disorder-from-2015-2019 on 2023, May 26.
[3] Ling W. (2012). Buprenorphine implant for opioid addiction. Pain management, 2(4), 345–350. https://doi.org/10.2217/pmt.12.26. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283787/ on May 26, 2023.