What is Suboxone?
Suboxone is a prescription drug used to treat opioid use disorder. It is an all-in-one pill with two active ingredients: buprenorphine and naloxone. Buprenorphine is an opioid, sometimes called a narcotic, and naloxone is a chemical that blocks the effects of opioids, such as the sense of well-being and pain relief that may make people use opioids [1, 2].
What Does Suboxone Do?
Suboxone can be used in two different ways. It acts like a partial agonist, which reduces cravings and withdrawal pains by inducing mild opioid effects. Second, it obstructs full agonists like heroin or oxycodone from binding to receptors and giving the "high" [3].
Suboxone’s naloxone ingredient is an opioid antagonist, that works by attaching to opioid receptors, blocking and reversing the effects of other opioids. The use of naloxone in Suboxone is intended to prevent abuse of the drug [3] - if Suboxone is not taken as it should, the naloxone can precipitate withdrawal symptoms.
There are two types of suboxone: a sublingual tablet you swallow under your tongue and a film that dissolves in your cheek or under your tongue [3, 2].
Benefits of Suboxone
Suboxone is a combination of buprenorphine and naloxone, used to treat opioid use disorder. Several advantages make it effective in treating this condition.
One of the most compelling aspects of Suboxone is its effectiveness in curing cravings and withdrawal symptoms related to opioid addiction. It does this by eliciting moderate opioid effects that can assist people in treating their addiction and gradually withdrawing from opioids [3].
Suboxone, too, prevents full agonists, such as heroin or oxycodone, from binding to receptors. That is because these drugs do not give a "high" and help with opioid use disorder [3].
Another benefit of Suboxone, is that the presence of naloxone prevents misuse of the medication. When someone tries to inject Suboxone, the naloxone in Suboxone results in withdrawal symptoms, which is very uncomfortable [3].
Suboxone has also proven helpful in treating opioid use disorder over the long term. It is generally used in behavioural therapy, social support, and counselling as part of a total approach to the disorder [4].
Last but not least, Suboxone can be administered at home or in the office, which is more convenient and flexible for the patient [5].
Risks of Suboxone
There may be risk factors for taking suboxone, an opioid addiction disorder drug.
Prevalence is most often caused by medical disorders. Suboxone patients, for example, may have an increased risk of respiratory depression if they suffer from breathing disorders like COPD or sleep apnea [6].
An added risk factor is having suffered a recent head or brain injury. Suboxone can increase the pressure in your brain and spinal cord, causing you to die if you suffer a head or brain injury [6].
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Additionally, Suboxone can damage the liver, causing liver inflammation and liver failure. Suboxone will make your liver progressively worse if you already have liver damage [4, 6].
Problems with the gallbladder may also be incompatible with Suboxone and exacerbate the problem [6].
It’s also linked to pregnancy. Suboxone used during pregnancy may result in a newborn developing neonatal opioid withdrawal syndrome [4, 6].
Milk-producing women must be especially vigilant as Suboxone enters breast milk in small amounts [4, 6].
Finally, if you’ve experienced an allergic reaction to Suboxone or its ingredients, your doctor will most likely not prescribe Suboxone to prevent complications [4, 6].
How is Suboxone Microdosed?
Suboxone microdosing, or micro-induction, involves administering small, frequent doses of Suboxone over several days to gradually transition patients to full treatment. It is feasible to supplement the continuing intake of other illicit and prescription opioids and is intended to bypass the needed period of opioid cessation before drug induction [7].
Microdosing usually starts with a small dose of Suboxone (0.5 mg once daily, say) and gradually increases over the days. The standard treatment, for instance, could be 0.5 mg twice daily on the second day, 1 mg twice daily on the third day, and so on until the dose is met each day [7].
How is Suboxone Microdosed for pain?
Suboxone microdosing for pain works similarly. The most frequently used microdosing strategy involves taking divided doses of sublingual Suboxone products, alternating with partial tablets or films (1/8 to 1/2 of a 2 mg product) at different stages during induction [8].
Please remember that Suboxone is primarily prescribed to treat opioid use disorder and is off-label for pain control. This is not FDA-approved for this use. However, physicians might also prescribe it to treat acute or persistent pain in some individuals [1, 2].
This should, as always, be determined depending on the local guidelines and the patient's condition. Medication modifications must be made under the medical supervision of a healthcare professional [8].