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What are the Side Effects of Suboxone?

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Opioid addiction is a complex and devastating issue, and when people seek treatment for it, they often need a comprehensive solution. One of the most popular treatments for opioid addiction is medication-assisted treatment (MAT) with medications like Suboxone.

Suboxone, when combined with behavioral therapy and counseling, has been proven effective in helping people overcome opioid addiction. However, like any other medication, Suboxone does not come without potential side effects and risks.

If you are struggling with opioid addiction, understanding the potential side effects of Suboxone can help you determine if the medication is right for you.

How Does Suboxone Work?

Suboxone is a prescription medication that contains buprenorphine and naloxone. Buprenorphine, a partial opioid agonist, binds to opioid receptors and helps curb withdrawal symptoms and cravings. Naloxone, an opioid antagonist, blocks opioid receptors and prevents misuse of the medication. If people try to inject Suboxone, the naloxone in it causes sudden withdrawal symptoms–a mechanism which is thought to reduce the abuse potential of Suboxone.

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Common Side Effects of Suboxone

All medications have the potential to cause side effects. Common side effects of Suboxone are:

  • Nausea and vomiting – Digestive disturbances are common side effects of Suboxone, especially during the initial phases of treatment. These symptoms can vary in intensity and usually subside over time. These are also common symptoms of opioid withdrawal.
  • Headache – Some individuals might experience headaches as their bodies adjust to the medication. Staying hydrated and managing stress can help alleviate this side effect.
  • Constipation – Opioid medications, including the buprenorphine in Suboxone, are known for causing constipation. Eating a high-fiber diet, getting plenty of regular exercise, and staying hydrated can help manage this issue.
  • Insomnia and difficulty sleeping – Sleep disturbances, such as difficulty falling asleep or staying asleep, can occur during Suboxone treatment. However, it’s important to maintain a consistent sleep routine in early recovery, so you should communicate any concerns with your healthcare provider.
  • Sweating – Excessive sweating, particularly at night, can be a side effect of taking Suboxone, however, it can also be a sign that your body is detoxing from opioids. Sweating can be managed through proper hydration and adjusting the temperature in your sleep environment.
  • Anxiety and mood changes – Some individuals might experience shifts in mood, including increased anxiety. Mood changes are common with any medication used in medication-assisted treatment (MAT).
  • Dizziness – Feeling lightheaded or dizzy upon standing up is a possible side effect of Suboxone and is often due to blood pressure changes. Talk to your doctor if your dizziness is severe and make sure to stand up slowly, taking caution when doing so.
  • Lethargy or fatigue – Suboxone, like other opioid medications, can sometimes lead to feelings of tiredness or fatigue. Engaging in regular physical activity, adhering to a routine sleep schedule, and maintaining a balanced diet can help counteract this effect.
  • Decreased libido – Changes in sexual desire or performance can occur while taking Suboxone. Your healthcare provider or therapist can provide individualized guidance on the best ways to manage this issue.
  • Numb or tingling mouth/tongue – Suboxone comes in the form of a sublingual film that dissolves when placed under the tongue. However, it takes time to dissolve, and it may cause numbness, tingling, redness, or even pain in the mouth.

In most people, these side effects are mild and subside after a few days of taking the medication. However, if side effects persist or become more severe, be sure to talk to your healthcare provider about your symptoms. He or she may adjust your dose or prescribe an alternative medication.

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Serious (But Rare) Side Effects and When to Seek Help

While most side effects of Suboxone are manageable and tend to diminish over time, there are serious reactions that warrant immediate medical attention. Severe side effects of Suboxone are rare, but they do happen. These include:

  • Allergic reactions – Signs of an allergic reaction can include difficulty breathing, rash, itching, or swelling of the face, lips, or tongue. Seek medical attention immediately if you believe you are having an allergic reaction to Suboxone.
  • Liver issues – Symptoms such as dark urine, yellowing of the skin or eyes (jaundice), or persistent abdominal pain could indicate liver problems. People who have pre-existing liver conditions should consult with their healthcare provider before starting Suboxone. People who are at an increased risk of liver issues may have their liver enzymes regularly tested while taking Suboxone to prevent harm to the organ.
  • Breathing problems – Suboxone contains buprenorphine, a central nervous system depressant that can slow down breathing. Some people may be more sensitive to its effects. If breathing becomes slow or shallow, the body could be lacking oxygen, so seeking medical help is crucial. Breathing problems are more likely in people who are taking high doses of Suboxone. Respiratory depression only occurs in 1-10% of people who take Suboxone.

Some people experience no side effects at all. If your doctor prescribes Suboxone, it is because the benefits outweigh the potential risks.

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What Alternatives to Suboxone Are Available?

Addiction treatment centers that offer medication-assisted treatment (MAT) may provide alternatives to Suboxone. Some of the most common alternatives are:

  • Methadone – Methadone is a full opioid agonist that blocks the effects of other opioids and alleviates withdrawal symptoms. However, methadone has a greater potential for abuse and addiction than Suboxone, so it is not prescribed as frequently.
  • Sublocade – Sublocade is a once-monthly injection of buprenorphine. It can be prescribed after seven days of oral buprenorphine treatment and can reduce cravings for opioid drugs.
  • Vivitrol – Vivitrol is a once-monthly injection of naltrexone, a medication that can occupy opioid receptors and stabilize brain chemistry, resulting in fewer opioid cravings.

Most insurance providers cover the medications used during detox and treatment.

Learn More About Suboxone Treatment for Opioid Addiction

If you qualify, Suboxone can be a powerful tool in helping you recover from opioid addiction. To learn more about Suboxone treatment or to find out if Suboxone is right for you, please contact our team at Solutions Healthcare today.

Medical Disclaimer: This information is for educational purposes only and does not constitute medical advice. Suboxone should be taken only as prescribed by a qualified healthcare professional. Do not change your dose or stop treatment without consulting your prescriber.

FAQs About Suboxone Side Effects and Safe Use

What are the worst side effects of Suboxone?

Suboxone can cause nausea, constipation, headaches, sweating, dizziness, and drowsiness. Serious risks include slowed breathing, overdose, severe allergic reactions, and precipitated opioid withdrawal if started too soon after other opioids. Mouth-dissolving formulations have also been linked to serious tooth decay and tooth loss.

How long should a person be on Suboxone?

There is no fixed treatment duration for everyone. Some people take Suboxone for months, while others benefit from years of treatment or longer. The duration depends on individual needs, stability, cravings, and relapse risk. Do not stop or taper the medication without guidance from your prescriber.

What does Suboxone do for the body?

Suboxone combines buprenorphine and naloxone. Buprenorphine helps reduce opioid cravings and withdrawal symptoms, while naloxone helps discourage certain forms of misuse. When taken as prescribed, it can support recovery from opioid use disorder, but it can still cause side effects and carries risks when combined with sedatives.

What is the 3-day Suboxone rule?

The “3-day rule” generally refers to a federal exception that allows eligible healthcare practitioners to administer or dispense certain medications, including buprenorphine, for up to three consecutive days while arranging ongoing treatment. It is not a rule limiting how long a person can receive Suboxone for opioid use disorder.

Is Suboxone a lifelong drug?

Suboxone is not necessarily a lifelong medication, but some people benefit from taking it indefinitely. Treatment duration should be individualized. Stopping too quickly can cause withdrawal and increase the risk of returning to opioid use and experiencing an overdose. Discuss any decision to taper with your prescriber.

What is the 15-minute rule for taking Suboxone?

There is no universal, medically established “15-minute rule” for taking Suboxone. The timing of the first dose depends on the opioid previously used and the person’s withdrawal symptoms. Taking it too early can trigger precipitated withdrawal. Follow your prescriber’s instructions rather than relying on a fixed time rule.

What is the maximum amount of Suboxone per day?

The labeled maintenance dose for many patients is generally 4 mg/1 mg to 24 mg/6 mg daily. However, FDA guidance clarifies that doses above 24 mg of buprenorphine may be appropriate for some individuals. The right dose depends on clinical response and must be determined by a prescriber.

What does Suboxone do to your teeth?

Suboxone films that dissolve in the mouth have been associated with cavities, tooth decay, oral infections, and, in severe cases, tooth loss. After the film dissolves, gently rinse your mouth with water and swallow. Wait at least one hour before brushing, and schedule regular dental checkups.

What is the most effective way to take Suboxone?

Take Suboxone exactly as prescribed. Place the film under your tongue or inside your cheek, according to your prescription, and allow it to dissolve completely. Do not chew or swallow the film whole. Follow your prescriber’s instructions about starting treatment, and avoid alcohol or unapproved sedatives.

References
  1. National Library of Medicine: Suboxone: Rationale, Science, Misconceptions, Retrieved August 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
  2. National Library of Medicine: Buprenorphine, Retrieved August 2023 from https://www.ncbi.nlm.nih.gov/books/NBK459126/
  3. Food and Drug Administration (FDA): Suboxone Label, Retrieved August 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf

Chief Clinical Officer & Co-Founder (Ph.D., LHMC, MCAP, CRRA

Dr. Zach Miller, Ph.D., LMHC, MCAP, CRRA, is a dedicated leader in behavioral mental health with over 15 years of experience transforming lives. As a chief clinical officer and co-founder of Solutions Healthcare group (Orlando Treatment Solutions, Deland Treatment Solutions, Palm Coast Treatment Solutions and FACTS Recovery), he has played a pivotal role in developing innovative therapeutic interventions for individuals struggling with mental health and substance use disorders.
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