Suboxone (Buprenex, Butrans) Side Effects, Dosage and Cost


About Suboxone

Approved by the U.S. Food and Drug Administration in 2002 to be used as part of medication-assisted treatment (MAT),7 Suboxone is one of the most commonly prescribed medications for the treatment of opioid addiction. MAT combines behavioral therapy and medications to treat substance use disorders.

This article will cover:


 

 

What Is Suboxone?

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Suboxone is a combination of buprenorphine (an opioid medication) and naloxone (a medication that blocks the effects of opioid medication) that is used to treat opioid addiction, including addiction to heroin and narcotic painkillers. When taken as prescribed, Suboxone can be safe and effective in treating these addictions.

Suboxone is not a cure for opioid addiction. It should be used as a component of another form of treatment, such as inpatient or outpatient addiction treatment programs that focus on the underlying causes of addiction and reduce the risk of relapse. 1

How Does It Work?

Suboxone is taken as either a sublingual tablet or a film that is placed under the tongue to dissolve. It suppresses withdrawal symptoms and cravings for opioids, which can help prevent relapse.
Suboxone, when used as prescribed, does not cause euphoria. Additionally, a single administration is able to block the euphoric effects of other opioids for at least 24 hours.


Side Effects

The most common side effects of Suboxone are: 1, 3

  • Headache.
  • Cravings.
  • Nausea.
  • Fever.
  • Insomnia.
  • Sweating.
  • Abdominal pain.
  • Back pain.
  • Constipation.
  • Irritability.
  • Anxiety and/or depression.

These effects usually occur at the beginning of treatment and may last a few weeks. 7

Effects for Pregnant Women and Newborns

Pregnant or breastfeeding mothers should consult a physician before taking Suboxone.
It is unclear how Suboxone affects an unborn baby. However, doctors warn that if Suboxone is taken while a woman is pregnant, is it possible for the baby to be born with a drug dependency, leading to life-threatening consequences. The drugs that combine to make up Suboxone can also pass into breast milk and may harm a nursing baby. But there is limited research on the effects on the infant. 8

Pregnant or breastfeeding mothers should consult their physician before taking any medication-assisted therapies such as Suboxone.


Dosage Information

It is important to follow the dosing instructions provided by your doctor. Misuse of Suboxone can lead to breathing problems and other life-threatening consequences.

Suboxone can begin to work within 30 minutes of the first dose and last up to 3 days. The typical course of treatment with Suboxone can last from a month to a year. Studies have shown that the longer someone is on Suboxone treatment, the more effective the medication is. 5

If you miss a dose, take the missed dose as soon as you remember. Do not take the missed dose if it is almost time for your next dose. Never take an extra dose to make up for a missed dose.

Never share your prescription with anyone else. Selling Suboxone is against the law. Misuse of Suboxone, like other narcotic pain medications, can cause addiction, overdose or death, especially in children or in those who have not been evaluated by their physician.


Drug Interactions

Tell your doctor about any medications that you are currently taking, including over-the-counter medications. Some medications may have adverse effects when mixed with Suboxone, including drowsiness or other serious and even life-threatening effects. Sedatives, sleeping pills, narcotic pain relievers
and any medications taken for anxiety, depression and seizures must be discussed with your doctor prior to taking Suboxone.6 >Do not consume alcohol or other illegal drugs that slow breathing while taking Suboxone. This interaction can lead to loss of consciousness or death.1,6


Suboxone Treatment

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Call 1-888-319-2606Who Answers? to get help finding the right treatment program for you or a loved one. A rehab support specialist can offer options based on your insurance coverage.

Induction phase

The initial phase of Suboxone treatment, called "induction," occurs under the supervision of a physician. 3 This phase begins once a person is in the early stages of withdrawal. The physician will prescribe the medication and try to find the lowest dose that will reduce the person's use of other opioids without causing withdrawal symptoms, serious side effects or cravings. 9

If a person takes Suboxone prior to entering the early stages of withdrawal or has other opioids in his or her system, the medication can cause acute feelings of withdrawal. 1

Stabilization phase

This phase begins once cravings for opioids have subsided and side effects have diminished. Adjustments to dosing may occur during this stage under the direction of a prescribing physician. 1

Common side effects of buprenorphine include:10

  • Nausea.
  • Vomiting.
  • Constipation.

Maintenance phase

The stabilization phase is followed by a period called "maintenance." Under direction of your physician, you will continue to take medication as prescribed and seek counseling or other forms of behavioral therapy. 4
Once stabilized, you can also begin a medically supervised withdrawal from Suboxone, slowly tapering off the drug to make the transition smoother and reduce the likelihood of relapse. 1

Recovery

The last stage of treatment is recovery. Aftercare planning under the supervision of a case manager or a counselor is encouraged. Ongoing participation with other forms of outpatient therapy may also be beneficial. This can include 12-step programs , and/or individual or group therapy .

The duration of the aforementioned recovery phases will vary, and can be adjusted up or down based on the person's needs. The latter 2 stages - medical maintenance and long-term recovery - will be the longest and, in some cases, may persist indefinitely. 1


How Can I Get Suboxone?

Suboxone therapy is more accessible than other medication-assisted treatments, such as methadone treatment. It can be prescribed and/or dispensed in a:

  • Physician's office.
  • Community hospital.
  • Health department.
  • Correctional facility.1

Who Can Prescribe It?

Suboxone can only be prescribed by physicians who meet certain requirements established by the Food and Drug Administration. In order to be qualified, a physician must meet one or more of the following training requirements: 3

  • Hold a board certification in addiction psychiatry from the American Board of Medical Specialties.
  • Hold a subspecialty board certification in addiction medicine from the American Osteopathic Association.
  • Hold an addiction certification from the American Society of Addiction Medicine.
  • Have completed no less than 8 hours of authorized training on the treatment or management of opioid-dependent patients.

The physician must also meet both of the following criteria:3

  • Has the capacity to provide or to refer patients for other necessary services, such as psychosocial therapy.
  • Agrees to treat no more than 30 patients at any one time in his or her individual or group practice.

The ideal candidate for Suboxone is:1

  • Evaluated and diagnosed with opioid dependence by a qualified physician.
  • Willing to follow safety precautions for treatment.
  • Cleared of any health conflicts, such as lung or liver conditions.
  • Has reviewed all other treatment options available before agreeing to medication-assisted treatment.

Long-Term Effects of Suboxone

Long-term use of Suboxone can lead to physical and/or mental health challenges. Suboxone should only be used under the supervision of a qualified physician.

Suboxone is an opioid, and misuse can lead to dependence. You can also build a tolerance to it, which means you will need higher doses to achieve the desired effects.


What Happens If I Overdose?

Contact 911 or your local poison control center (1-800-222-1222) if you suspect an overdose of Suboxone.

Possible signs of an overdose include: 2

  • Pinpoint pupils.
  • Extreme drowsiness.
  • Dizziness.
  • Blurred vision.
  • Slowed breathing or respiratory depression.

Consult your physician before you stop taking Suboxone. Suddenly stopping the use of this mediation can result in severe withdrawal symptoms. 6


Suboxone vs. Methadone Treatment

Several studies have researched the differences between Suboxone and methadone treatment. Studies have shown that the medications are equally effective in treating opioid addiction. 1

However, some studies have demonstrated that Suboxone is a more cost-effective treatment option. In fact, Suboxone has a lower rate of dependence and overdose when compared to methadone. Relapse rates tend to be higher in those under methadone treatment according to one study.5

Switching from methadone treatment to Suboxone is possible. However, since the medications work differently, people may not be satisfied with the results. In addition, those with more severe opioid dependence may be more successful with methadone treatment.1

Always discuss your treatment options with your doctor.


Find an Opioid Recovery Program

Find the right opioid recovery center for yourself or a loved one by calling a treatment support representative anytime at 1-888-319-2606Who Answers? . We can help with verifying insurance coverage and finding the right provider.

If you do not have insurance, call the Substance Abuse and Mental Health Services Administration's (SAMHSA) national helpline at 1-800-662-HELP (4357).

Sources

[1]. Substance Abuse and Mental Health Services Administration. (2004) Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction: Treatment Improvement Protocol 40 .

[2]. U.S. Food and Drug Administration. (2002) Subutex and Suboxone Approved to Treat Opiate Dependence .

[3]. U.S. Food and Drug Administration. (n.d.) Medication Guide: Suboxone .

[4]. Shah As, Young J, Vieira K. (2014) Long-term Suboxone Treatment and its Benefit on Long-Term Remission for Opiate Dependence. J Psychiatry 17: 1000174. doi:10.4172/Psychiatry.1000174

[5]. Suboxone.com. (2016) Treatment with Suboxone Film .

[6]. U.S. Food and Drug Administration (n.d.) Information for Pharmacists: Suboxone and Subutex .

[7]. U.S. National Library of Medicine. (2015) Buprenorphine Sublingual and Buccal .

[8]. Substance Abuse and Mental Health Services Administration. (2016) Buprenorphine .

[9]. Substance Abuse and Mental Health Services Administration. (2016). Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update . SAMHSA Advisory 15(1).

[10]. Substance Abuse and Mental Health Services Administration. (2004). Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiciton .

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