Long-Term Use of Suboxone

Suboxone, which might be prescribed to treat someone’s opioid dependence, has both buprenorphine and naloxone in it.1 If it is still contributing to intended treatment objectives and it is still beneficial for individuals, they ought to keep receiving treatment with Suboxone; there is a link between longer duration of treatment with buprenorphine and positive treatment results.1,2

Buprenorphine, one of the components of Suboxone, attaches to mu-opioid receptors and is a partial agonist.1,2,3 The potential for buprenorphine misuse is lowered by having naloxone with buprenorphine, but misuse still is possible.2

Medication-Assisted Treatment Using Suboxone

Medicines as well as behavioral therapy are used in the treatment of substance use disorders in medication-assisted treatment (MAT).4 Medicine options for treating opioid use disorder include buprenorphine, methadone, and naltrexone.2

Suboxone is the name of one product that has buprenorphine in it, and Suboxone has naloxone in it as well.1,2

Buprenorphine is able to decrease cravings as well as decrease opioid withdrawal.2

Buprenorphine can decrease misuse of opioids, can decrease the risk of dying from overdose, and can decrease HIV risk behaviors.2

As long as it is benefiting the individual, buprenorphine treatment ought to continue.2

Potential Negative Effects of Suboxone

Suboxone may produce side effects.1

There are multiple side effects that are common, including:1

  • Heartbeat that is not regular
  • Headache
  • Being drowsy
  • Constipation
  • Nauseousness
  • Throwing up
  • Vision that is blurry
  • Tongue swelling
  • Being dizzy

Serious side effects that might occur include:1

  • Being dizzy
  • Allergic reaction
  • Blood pressure going down
  • Respiratory problems
  • Issues with liver
  • Being drowsy
  • Opioid withdrawal
  • Dependence

Overdosing is possible, and someone who overdoses on Suboxone might have respiratory depression, be sedated, have small pupils, have low blood pressure, and/or die.1

Call 911 right away if you or someone else might have overdosed on Suboxone or another drug.

Using CNS depressants along with buprenorphine raises the risk of issues including overdose as well as death; two examples of CNS depressants are alcohol and benzodiazepines.1 Individuals taking buprenorphine should get guidance from a medical provider before taking any other medicines and should not consume alcohol or use illegal drugs.3

With long-term opioid use, instances of androgen deficiency have happened, and a person with androgen deficiency might have issues such as infertility, absence of menstruation, and/or low libido.1

Opioid Dependence and Opioid Withdrawal

An individual who takes buprenorphine long-term can become dependent on opioids.1,2

  • Suboxone can be utilized to treat someone’s opioid dependence.1 These individuals are obviously already dependent on opioids.
  • Buprenorphine might be given to someone who has had an opioid use disorder but presently does not have opioid dependence.2
  • An individual could misuse buprenorphine, and it could be an individual not already dependent on opioids.3

If buprenorphine is suddenly stopped or the dose is quickly reduced, withdrawal can happen.1 Some possible opioid withdrawal signs and symptoms include:1,2

  • Yawning
  • Fast heart rate
  • Runny nose
  • Nauseousness
  • Throwing up
  • Being restless
  • Goosebumps
  • Sweating
  • Fever
  • Diarrhea
  • High or low blood pressure
  • Trouble sleeping
  • Fast breathing
  • Pain

Because of lessened opioid tolerance, there is a higher risk of overdose in individuals who have gone through opioid withdrawal.5 An opioid overdose can kill a person.2

Contact a healthcare provider if you think you might be experiencing opioid withdrawal. Call 911 right away if you or someone else might have overdosed on an opioid.

Abusing Suboxone

An individual might abuse and/or divert Suboxone.1

It was estimated that in 2018, of individuals 12 years old and older who had used any buprenorphine product at all in the last year, 28.3% had misused a buprenorphine product in the last year.6

If someone is prescribed Suboxone but keeps diverting, abusing, or misusing it or another opioid, this individual ought to be given or referred to treatment that is more structured and intensive.1

 

Sources:
  1. Indivior Inc. (2019). Label: Suboxone- buprenorphine hydrochloride, naloxone hydrochloride film, soluble.
  2. Substance Abuse and Mental Health Services Administration. (2018). Medications for opioid use disorder: For healthcare and addiction professionals, policymakers, patients, and families: Treatment improvement protocol TIP 63.
  3. Substance Abuse and Mental Health Services Administration. (2019). Buprenorphine.
  4. Substance Abuse and Mental Health Services Administration. (2019). Medication-assisted treatment (MAT).
  5. World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings.
  6. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables.
About The Contributor
Sophie Stein, MSN
Clinical Editor
Sophie Stein received her master’s of science in nursing from Vanderbilt University School of Nursing. She previously worked as an advanced practice registered nurse at an outpatient psychiatric practice providing mental health care for children,... Read More
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