Suboxone Treatment: Benefits, Side Effects & What to Expect

Suboxone treatment is a medication-assisted treatment (MAT) option for individuals recovering from opioid use disorder. It contains two key ingredients, buprenorphine and naloxone, which work together to reduce cravings, prevent withdrawal symptoms, and lower the risk of relapse.

Unlike full opioid agonists such as heroin or oxycodone, Suboxone is a partial opioid agonist, meaning it activates opioid receptors in the brain just enough to alleviate withdrawal symptoms without producing the intense euphoria associated with opioid misuse.

Suboxone is widely used in opioid treatment programs because:

• It relieves severe withdrawal symptoms without causing a high.
• It reduces cravings, making it easier to focus on recovery.
• It blocks the effects of other opioids, discouraging misuse.
• A doctor can prescribe it, allowing individuals to take it home instead of making daily clinic visits.

For many, Suboxone provides a safer and more accessible alternative to other opioid treatment medications like methadone, which must be administered in a licensed clinic.

Suboxone’s effectiveness comes from its two active ingredients: buprenorphine and naloxone. These components work together to ease withdrawal symptoms, reduce cravings, and discourage opioid misuse. Understanding how each one functions can help individuals make informed decisions about their treatment.

Buprenorphine: A Partial Opioid Agonist

Buprenorphine is the primary component in Suboxone and is classified as a partial opioid agonist. This means it binds to the brain’s opioid receptors, much like full agonists such as heroin or oxycodone, but it does so in a more controlled manner.

Key effects of buprenorphine:

• Reduces withdrawal symptoms: By activating opioid receptors at a lower intensity, buprenorphine treatment alleviates withdrawal symptoms without causing a euphoric high.
• Decreases cravings: The steady activation of opioid receptors helps individuals manage cravings, making it easier to focus on recovery.
• Has a ceiling effect: Unlike full opioids, buprenorphine has a limit to how much it can activate opioid receptors. This reduces the risk of overdose and makes it safer than other opioids.
• Long-lasting effects: A single dose can last 24 to 48 hours, meaning fewer doses are needed compared to short-acting opioids.

Because of these properties, buprenorphine provides stability without intoxication, allowing individuals to function normally while receiving treatment for opioid dependence.

Naloxone: The Opioid Blocker

Naloxone is an opioid antagonist, meaning it blocks the effects of opioids in the brain. While naloxone is well known as a life-saving medication for reversing opioid overdoses, its role in Suboxone is different.

What naloxone does in Suboxone:

• Prevents misuse: Naloxone in Suboxone is included primarily as an abuse-deterrent. If someone tries to inject or misuse Suboxone, the naloxone component triggers withdrawal symptoms, discouraging misuse.
• Minimal effects when taken correctly: When Suboxone is taken as prescribed—sublingually (under the tongue)—the naloxone component is absorbed in minimal amounts and has little to no effect on the action of buprenorphine, which is the primary active ingredient responsible for reducing opioid cravings and withdrawal symptoms.
• Serves as an added safety measure: Naloxone ensures that Suboxone remains a safe and controlled medication-assisted treatment option.

Together, buprenorphine and naloxone create a balanced approach to opioid addiction treatment—relieving withdrawal symptoms while discouraging misuse.

The duration Suboxone stays in the body depends on its primary ingredient, buprenorphine. Compared to short-acting opioids, buprenorphine has a long half-life. On average, buprenorphine’s half-life ranges from 24 to 42 hours, meaning it can take several days to entirely leave the system.

Factors That Affect How Long Suboxone Stays in the Body

Several factors influence how long Suboxone remains in a person’s system, including:

• Metabolism – People with faster metabolisms may process Suboxone more quickly.
• Dosage and Frequency – Higher doses or long-term use can extend its presence in the body.
• Liver Function – Since the liver metabolizes buprenorphine, individuals with liver issues may process the medication more slowly.
• Age and Body Composition – Older adults or those with a higher body fat percentage may retain the drug longer.

Even though Suboxone’s effects last about 24 to 48 hours, traces of buprenorphine can be detected in:

• Urine – Up to 7–10 days after the last dose.
• Blood – Up to 2 days after the last dose.
• Saliva – Up to 3 days after the last dose.
• Hair – Up to 90 days, though hair tests are rarely used for Suboxone.

Because of its long duration in the body, Suboxone provides steady relief from withdrawal symptoms and cravings, allowing individuals to maintain a stable daily routine without frequent dosing.

Suboxone offers several advantages for individuals recovering from opioid addiction. Unlike other treatments that require daily clinic visits, Suboxone provides a more flexible and accessible approach to recovery.

1. Reduces withdrawal symptoms without causing a high: One of the biggest obstacles in recovery is the severe discomfort of opioid withdrawal. Suboxone relieves these symptoms without triggering the intense euphoria that fuels addiction.
2. Decreases cravings and supports long-term sobriety: By reducing cravings, Suboxone makes it easier to stay focused on recovery and avoid relapse.
3. Can be taken at home: Unlike methadone, which must be administered in a clinic, Suboxone can be prescribed by a doctor and taken at home, making treatment more convenient.
4. Lower risk of overdose compared to full opioids: Because of buprenorphine’s ceiling effect, taking more Suboxone than prescribed does not produce a stronger opioid response, reducing the likelihood of overdose.
5. Contains Naloxone to prevent misuse: The naloxone in Suboxone reduces the risk of misuse, making it a safer alternative to other opioid-based treatments.

Starting Suboxone treatment can be a significant step in recovery. Understanding what to expect can help ease concerns and set realistic expectations for the journey ahead.

Step 1: Initial Assessment and Induction Phase

Before beginning Suboxone, individuals undergo a medical and psychological assessment to determine their treatment needs. Doctors assess:

• Medical history and past opioid use.
• Current withdrawal symptoms.
• Any co-occurring mental health conditions.

The first dose of Suboxone is typically given during the early stages of opioid withdrawal (at least 12-24 hours after the last opioid use). Starting too soon can trigger precipitated withdrawal—a sudden and severe withdrawal reaction.

Step 2: Stabilization Phase

Once an individual has adjusted to Suboxone, the dose is fine-tuned based on withdrawal symptoms and cravings. The goal is to find the lowest effective dose for a comfortable and stable recovery.

During this phase, doctors may recommend counseling and behavioral therapy to help address the psychological aspects of addiction.

Step 3: Maintenance Phase

During maintenance, individuals continue taking Suboxone while focusing on long-term recovery goals. Depending on their progress and individual needs, many remain on Suboxone for months or even years.

Those who choose to taper off Suboxone can work with their doctor to gradually lower their dose over time to minimize withdrawal symptoms.

Despite its effectiveness, some misconceptions about Suboxone persist. Understanding the facts can help individuals make informed decisions about their treatment.

MYTH: “Suboxone is just replacing one addiction with another.”
✅ FACT: Suboxone does not produce the same euphoric high as opioids. It stabilizes the brain, allowing individuals to focus on recovery while reducing cravings and withdrawal symptoms.

MYTH: “You have to take Suboxone forever.”
✅ FACT: While some individuals stay on Suboxone long-term, others gradually taper off under medical supervision. The length of treatment depends on personal recovery goals.

MYTH: “Suboxone isn’t a real recovery method.”
✅ FACT: Medication-assisted treatment (MAT), including Suboxone, is scientifically proven to increase success rates in opioid recovery. It is recommended by the CDC, SAMHSA, and WHO as an effective treatment for opioid use disorder.

Suboxone may be a good fit for individuals who:
✔️ Have experienced opioid withdrawal and relapse in the past.
✔️ Need relief from cravings and withdrawal symptoms to focus on recovery.
✔️ Want a treatment option that does not require daily clinic visits.
✔️ Are committed to counseling and behavioral therapy as part of their recovery.

However, Suboxone may not be the best choice for individuals who:
❌ Have a severe liver condition that affects how medications are processed.
❌ Need a more structured, in-person treatment program (such as methadone maintenance treatment).
❌ Are currently taking medications that interact with buprenorphine.

The best way to determine whether Suboxone is the right choice is to speak with a trusted healthcare provider like Cedar Recovery, who can assess individual needs and recommend the most effective treatment plan.