What is Buprenorphine/Naloxone (Suboxone®) and How Does it Work?
Buprenorphine is a pill medication that doctors have prescribed to treat opioid use disorder since its approval in 2002. Buprenorphine is often used on its own to alleviate the symptoms of opioid withdrawal and relieve cravings. It is also commonly combined with another medication, naloxone, to create a product most widely known as Suboxone®.
As a partial opioid agonist, buprenorphine attaches to receptors in the brain and prevents other opioids from taking effect. This process reduces cravings and withdrawal symptoms, encouraging recovery among people with OUD. Physicians recommend that patients be in mild withdrawal before starting buprenorphine treatment. In addition, this medication has a ceiling effect — its effects will not continually increase with the dosage, decreasing the risk of overdose.
If you’re struggling with opioid use disorder (OUD) and are ready to get help, reach out to Canadian Addiction Treatment Centres. We offer a variety of treatment options for opioid addiction at our facilities, including buprenorphine treatment programs. Learn more about buprenorphine/naloxone and how this medication can help you today.
How is Suboxone® Taken?
Combination buprenorphine and naloxone come in a tablet taken “sublingually,” meaning it is placed under the tongue or in the cheek to dissolve. Drinking water before taking this medication can soften the inside of your mouth and help the tablet dissolve.
What Are the Side Effects of Buprenorphine/Naloxone?
Most people experience few, if any, side effects when taking buprenorphine. Mild side effects include:
- Cold or flu-like symptoms
- Sleep disturbances
- Upset stomach or vomiting
Suboxone®, or any buprenorphine medication, should not be taken with benzodiazepines or alcohol as there is a danger of significant respiratory depression. If you take benzodiazepines or other medications, speak with your medical provider before starting a Suboxone® treatment program.
What is Suboxone® Precipitated Withdrawal?
Precipitated withdrawal takes place when patients with other opioids in their system take their first dose of buprenorphine/naloxone and experience severe withdrawal symptoms. There are two reasons why this might occur:
- Buprenorphine/naloxone has low intrinsic activity because it is a partial opioid agonist. When the molecule attaches to a brain receptor, it doesn’t activate the brain in the way other opioids do.
- Buprenorphine/naloxone also has a high affinity. Once it attaches to the receptor, it resists coming off. Buprenorphine is a long-acting medication.
What does this have to do with precipitating withdrawal? If an individual who takes buprenorphine/naloxone for the first time also has other opioids in their system, the buprenorphine/naloxone competes with the other opioid for the receptor. Because of its high affinity, buprenorphine wins the battle, throwing the other opioid off the receptor site and taking its place.
The severe symptoms may last for hours. Patients receiving their first dose of buprenorphine/naloxone must be in a state of mild to moderate withdrawal to avoid the possibility of unnecessary discomfort.
How Long Should You Wait After Your Last Opioid Use Before Starting Suboxone®?
In order to start Suboxone treatment, you have to be in active withdrawal. Initial withdrawal symptoms generally include yawning, sneezing, sweating, nausea, and muscle cramping. Our treatment centre care providers can help you determine if you are in withdrawal or not. In general, most short-acting opioids (like heroin, fentanyl, morphine, and oxycodone) result in withdrawal symptoms starting about 6 hours after consumption, but this varies by individual. If you have used a long-acting opioid (like Methadone), you will need to wait much longer to enter withdrawal.
If you’re struggling with opioid use disorder and think a buprenorphine/naloxone treatment program could help you, contact Canadian Addiction Treatment Centres today. Our compassionate care team will work with you to determine the best treatment plan for your needs. Reach out to us online at the form below or call us at 1-877-937-2282 to start the recovery process.