How Suboxone Works: Understanding How Suboxone Helps Opioid Addiction

November 10, 2023
, Opioids, Suboxone

How Suboxone Works: Understanding the Mechanism of Action

Suboxone is a widely recognized medication used for the treatment of opioid use disorder (OUD). It contains two key ingredients: buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Together, these components work in the brain to alleviate withdrawal symptoms, reduce cravings, and prevent relapse. This article will examine how Suboxone works and its impact on brain chemistry.

The Neurobiology of Opioid Dependence

Before delving into the mechanism of action of Suboxone, it is essential to understand the neurobiology of opioid dependence. Opioid tolerance, dependence, and addiction are all manifestations of brain changes resulting from chronic opioid abuse. The struggle for recovery involves overcoming the effects of these changes. Medications like Suboxone, methadone, LAAM, and naltrexone act on the same brain structures and processes as addictive opioids but with protective or normalizing effects. However, the effectiveness of these medications relies on their use in conjunction with appropriate psychosocial treatments.

How Does Buprenorphine Work?

Buprenorphine, the primary active component of Suboxone, is a long-acting, partial opioid agonist. It binds to opioid receptors in the brain, alleviating withdrawal symptoms and reducing cravings. Unlike full opioids, buprenorphine displays a ceiling effect, meaning there is a limit to how much it can activate opioid receptors and suppress breathing. This characteristic significantly increases the safety profile of the medication and reduces the risk of overdose.

Understanding the Role of Naloxone

Naloxone, the second ingredient in Suboxone, is an opioid antagonist. It blocks the effects of other opioids, such as heroin and Oxy, by binding to the opioid receptors in the brain. Naloxone serves as a deterrent to Suboxone misuse. If someone attempts to inject or snort Suboxone, the naloxone component will send them into precipitated withdrawal, a highly unpleasant experience. However, when taken as directed, naloxone remains inactive and does not interfere with the therapeutic effects of buprenorphine.

How Suboxone Works in the Body

To understand how Suboxone works in the body, it is crucial to understand its absorption and metabolism. Buprenorphine is poorly absorbed in the stomach but readily absorbed when taken sublingually (under the tongue). Therefore, Suboxone is formulated as a dissolving strip or tablet placed under the tongue. Once absorbed, buprenorphine enters the bloodstream and binds to opioid receptors, blocking withdrawal symptoms and cravings for other opioids. Eventually, it is metabolized by the liver into inactive metabolites, which are then excreted in the urine.

The Effectiveness of Suboxone in Treating OUD

Suboxone has been proven to be highly effective in helping people with opioid use disorder recover and maintain abstinence. In a study, 75% of individuals taking Suboxone had negative urine drug tests a year later, compared to 0% of those taking a placebo. Additionally, individuals taking higher doses of buprenorphine (16 mg or more per day) were 1.82 times more likely to stay in treatment than those taking a placebo. These findings highlight the importance of Suboxone as a first-line treatment for OUD.

Who Is a Candidate for Suboxone?

Almost anyone who meets the criteria for opioid use disorder can be a potential candidate for Suboxone treatment. Additionally, there are very few medical reasons why a person cannot take Suboxone. It is generally safe for most patients when taken under the supervision of a licensed Suboxone provider. If you are struggling with OUD and are ready to comply with a treatment program, Suboxone could be a suitable choice for you. It is essential to consult with your doctor to determine if Suboxone is the right option for your individual circumstances.

Frequently Asked Questions About Suboxone

Is Suboxone an Opioid?

Yes, Suboxone is classified as an opioid due to the presence of buprenorphine, which is a partial opioid agonist. However, it is important to note that Suboxone is a much weaker opioid compared to drugs of misuse like heroin, fentanyl, and prescription painkillers. Suboxone does not produce euphoria or an intense high.

What Ingredients Are in Suboxone?

Suboxone contains two key ingredients: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, while naloxone is an opioid antagonist. Together, these ingredients work synergistically to alleviate withdrawal symptoms, reduce cravings, and prevent relapse.

How Does Suboxone Work to Treat Addiction?

Suboxone works by targeting the same receptors in the brain that opioids bind to. The buprenorphine component binds to opioid receptors, displacing other opioids and reducing withdrawal symptoms and cravings. The naloxone component acts as a safeguard, blocking the effects of other opioids and deterring Suboxone misuse.

How is Suboxone Administered?

Suboxone is available in two formulations: sublingual strips and sublingual tablets. Both forms are equally effective at treating opioid use disorder, and the choice between the two largely depends on individual preferences.

How Long Does it Take for Suboxone to Work?

The onset of action for Suboxone typically occurs within 20 minutes to an hour after administration, with peak effects occurring between 1.5 to 3 hours. Individual response times may vary.

Is Suboxone Substituting One Drug for Another?

While Suboxone is classified as an opioid, it is essential to differentiate between addiction and medication-assisted treatment. Addiction is characterized by compulsive drug use despite negative consequences, whereas Suboxone therapy is a structured treatment program used to help individuals stop misusing opioids. Suboxone is not simply trading one addiction for another but rather providing a safer alternative for managing opioid use disorder.

Conclusion

Suboxone, with its combination of buprenorphine and naloxone, works in the brain to correct imbalances caused by chronic opioid abuse. By alleviating withdrawal symptoms, reducing cravings, and preventing relapse, Suboxone offers individuals struggling with opioid use disorder an opportunity to recover and lead productive lives. It is a safe and effective treatment option when used under the care of a medical team. If you or someone you know is battling opioid addiction, consult with a healthcare professional to determine if Suboxone could be the right choice for your recovery journey. Remember, there is hope for a brighter future with the help of Suboxone and comprehensive treatment.

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Dan Karlin

Dr. Daniel Rollings Karlin, MD MA, is the Chief Medical Officer at Recovery Delivered. He is a psychiatrist, addictionologist, and medical informatician working at the intersection of health and technology in the pharmaceutical and biotech industry on psychiatric drug development, novel instruments, data, and analysis-driven strategies for clinical research and in clinical medicine.

Dr. Karlin attended Columbia University where is achieved his BA in Neuroscience and Behavior, and his MA, Clinical Informatics & Cognition, Biomedical Informatics. He went on to achieve his MD at University of Colorado School of Medicine. After his time at university, he did his residency at Tuffs medical center. Where, after just 2 years, he was named Executive Chief Resident.

Dr. Karlin brings his extensive education and experience treating addiction through medication to Recovery Delivered to ensure, we as a firm, are providing the latest and greatest to our patients to help increase outcomes.