Table of ContentsView AllTable of ContentsUnderstanding Opioid DependenceWhat Is Buprenorphine?What Is Suboxone?Safe Usage GuidelinesSide EffectsInteractionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Understanding Opioid Dependence
What Is Buprenorphine?
What Is Suboxone?
Safe Usage Guidelines
Side Effects
Interactions
Frequently Asked Questions
People withopioid use disorder (OUD),oropioid dependence, have a pattern of using opioids in an addictive fashion that can become potentially life-threatening.
Buprenorphineis a generic prescription drug classified as a partial opioid agonist. It is used along withdrug counselingand other measures to treat OUD.
Suboxone is a brand-name drug used alongside counseling to treat OUD. It contains two active ingredients: buprenorphine andnaloxone. Naloxone is an opioid antagonist.
Buprenorphine alone may be used, though, in individuals who are starting therapy or who cannot take naloxone for some reason—for example, someone who is allergic to naloxone cannot take Suboxone
This article will provide an in-depth comparison of buprenorphine and Suboxone.
The Washington Post / Getty Images
Opioids, also referred to as narcotics, are a type of strong pain medication. Examples includeXtampza ER (oxycodone)andfentanyl.Heroin is an illegal opioid.
Know, however, that OUD is also associated with heroin use.
Treatment Options
Opioid dependence may be treated in various ways, including medications, counseling, behavioral therapy, and residential or hospital-based treatment.
A combination treatment effort for OUD is called psychosocial support, which addresses the psychological and social needs of individuals, families, and the community.
Beyond psychological support, medication-assisted treatment (MAT) uses certain medicines (in combination with therapy) to treat opioid use disorders and help people recover.
Notable Statistics
According to the World Health Organization (WHO), in 2019, approximately 600,000 people died due to drug use, with about 80% of these deaths related to opioids.
Furthermore, according to the Centers for Disease Control and Prevention (CDC), from 1999 until 2021, opioid overdose deaths have increased annually.
Opioid dependence in the United States is highest in West Virginia, Tennessee, Louisiana, Kentucky, and Delaware.
Buprenorphine is Food and Drug Administration (FDA)–approved to treat OUD as part of a treatment plan that includes psychosocial support. Buprenorphine comes as a sublingual tablet (a tablet that is placed under the tongue to dissolve), a subdermal implant, and as extended-release injection. Brand-names include Brixadi and Sublocade, which are injections given weekly or monthly.
Buprenorphine is the preferred medicine for the induction of treatment under the supervision of a healthcare provider.
Modes of Administration
Generic buprenorphine used in OUD is given as a sublingual tablet.
Off-Label Uses
Sometimes, healthcare providers prescribe a drug for a use that it was not initially approved for. This is called “off-label” prescribing.
NAS usually results from a person taking opioids for some time during pregnancy.
Brand-name forms of buprenorphine used to treatchronic pain(not for OUD) that is severe enough to require opioid pain relief include:
Like buprenorphine, Suboxone is FDA-approved to treat opioid dependence as part of a treatment plan that includes other measures, such as psychosocial support.
Suboxone contains two medications: buprenorphine and naloxone. It is available as a film dissolved under the tongue or between the gum and cheek.
After initial treatment, healthcare providers generally will switch to Suboxone because the medication will not be taken under direct supervision.
Naloxone is used as a safety feature that helps discourage people from dissolving and injecting the medication.
With Suboxone, naloxone, a medication that treats opioid overdose, is added to buprenorphine, making it less likely to be misused and injected.
The naloxone in Suboxone is only absorbed in the body if an individual injects the medication instead of dissolving it in the mouth as directed. If naloxone is injected, it will cause uncomfortable withdrawal symptoms.
So, this combination is a safety feature that helps discourage people who depend on injected opioids from dissolving and injecting Suboxone.
Generic forms of the brand-name Suboxone are administered as sublingual tablets.
Some healthcare providers prescribe Suboxone off-label forchronic painin people with opioid dependence.
Zubsolv is another brand-name product that contains buprenorphine and naloxone and is also used to treat opioid dependence.
Buprenorphine and Suboxone carry several vital warnings to be aware of:
Like all drugs, buprenorphine and Suboxone have the potential for adverse effects in users, including mild, common side effects and rare but more severe effects.
Monitor yourself or a loved one carefully for the emergence of side effects. And if side effects worsen or fail to dissipate, contact your healthcare provider immediately.
Common Side Effects
Common side effects of both buprenorphine and Suboxone include:
Severe Side Effects
Serious side effects and their symptoms can include, but are not limited to, the following:
Additionally, dental problems have been associated with buprenorphine medications that dissolve in the mouth. These dental-related issues may includetooth decayor loss,cavities, and infections and can be severe.
Despite these drawbacks, the FDA notes that buprenorphine is an essential medication for OUD, and the benefits outweigh the risks.
Potential for Interaction
Tell your healthcare provider about all your medicines, including prescription and over-the-counter (OTC) drugs, as well as vitamins or supplements.
While taking buprenorphine or Suboxone, do not start any new medications without approval from your healthcare provider.
Examples of drug interactions include but are not limited to the following:
CNS Depression
Drugs/substances that causecentral nervous system (CNS)depression can cause extreme slowed breathing, loss of consciousness, coma, or even death.
Examples includebenzodiazepines, such asValium (diazepam); medications for sleep, such asAmbien (zolpidem); or muscle relaxants, such asFlexeril (cyclobenzaprine).
CYP3A4 Inhibition
Drugs thatinhibitthis enzyme can increase the levels of buprenorphine or Suboxone in the body, leading to increased opioid effects. These drugs include antifungals such asNizoral (ketoconazole), andprotease inhibitorssuch asNorvir (ritonavir).
CYP3A4 Induction
Drugs thatinduceCYP3A4 can decrease the levels of buprenorphine or Suboxone in the body, which could cause withdrawal.
Examples includeanticonvulsants, such as Tegretol (carbamazepine) andDilantin (phenytoin).
Potential for SS
Taking buprenorphine or Suboxone with a medication that increases serotonin levels can lead to a life-threatening condition calledserotonin syndrome (SS).
People who take a combination of buprenorphine or Suboxone and one of the following drugs will need to be closely monitored:
Summary
Buprenorphine and Suboxone are prescription medications for treating OUD alongside other measures, such as counseling.
Buprenorphine, as a single-ingredient drug, is used to start therapy in a supervised environment. It is also sometimes used in individuals who are allergic to naloxone and cannot take Suboxone.
Suboxone contains two ingredients: buprenorphine and naloxone. The naloxone component discourages the drug from being dissolved and injected.
If you are in immediate danger, call911. The988 Suicide & Crisis Lifelineis available for people undergoing a mental health crisis.
Frequently Asked QuestionsStore buprenorphine or Suboxone at room temperature (68-77 F), away from direct light, heat, and moisture. Keep the medication in the original packaging, and keep the bottle tightly closed when not used.Store your medicine in a safe place where no one can get to it, as it can be a target for people who misuse opioids.Learn MoreShould I Take Expired Medications?The Drug Enforcement Administration (DEA) used to enforce a “three-day” rule, which allowed healthcare providers to administer, not prescribe, narcotic drugs for just one day at a time for up to three days to relieve withdrawal symptoms while arrangements were being made to treat opioid use disorder.This required three visits to the healthcare provider.At the same time, arrangements were being made to treat opioid use disorder.In December 2020, the Easy Medication Access and Treatment for Opioid Addiction Act was passed, allowing healthcare providers to dispense up to a three-day supply at once.This helps increase fast access for those suffering from acute withdrawal symptoms as they wait for treatment plans to be arranged. It is also expected to help improve treatment and recovery results and lower relapse rates.
Store buprenorphine or Suboxone at room temperature (68-77 F), away from direct light, heat, and moisture. Keep the medication in the original packaging, and keep the bottle tightly closed when not used.Store your medicine in a safe place where no one can get to it, as it can be a target for people who misuse opioids.Learn MoreShould I Take Expired Medications?
Store buprenorphine or Suboxone at room temperature (68-77 F), away from direct light, heat, and moisture. Keep the medication in the original packaging, and keep the bottle tightly closed when not used.Store your medicine in a safe place where no one can get to it, as it can be a target for people who misuse opioids.
Store buprenorphine or Suboxone at room temperature (68-77 F), away from direct light, heat, and moisture. Keep the medication in the original packaging, and keep the bottle tightly closed when not used.
Store your medicine in a safe place where no one can get to it, as it can be a target for people who misuse opioids.
Learn MoreShould I Take Expired Medications?
The Drug Enforcement Administration (DEA) used to enforce a “three-day” rule, which allowed healthcare providers to administer, not prescribe, narcotic drugs for just one day at a time for up to three days to relieve withdrawal symptoms while arrangements were being made to treat opioid use disorder.This required three visits to the healthcare provider.At the same time, arrangements were being made to treat opioid use disorder.In December 2020, the Easy Medication Access and Treatment for Opioid Addiction Act was passed, allowing healthcare providers to dispense up to a three-day supply at once.This helps increase fast access for those suffering from acute withdrawal symptoms as they wait for treatment plans to be arranged. It is also expected to help improve treatment and recovery results and lower relapse rates.
The Drug Enforcement Administration (DEA) used to enforce a “three-day” rule, which allowed healthcare providers to administer, not prescribe, narcotic drugs for just one day at a time for up to three days to relieve withdrawal symptoms while arrangements were being made to treat opioid use disorder.
This required three visits to the healthcare provider.
At the same time, arrangements were being made to treat opioid use disorder.
In December 2020, the Easy Medication Access and Treatment for Opioid Addiction Act was passed, allowing healthcare providers to dispense up to a three-day supply at once.
This helps increase fast access for those suffering from acute withdrawal symptoms as they wait for treatment plans to be arranged. It is also expected to help improve treatment and recovery results and lower relapse rates.
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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