Your plan for starting buprenorphine (Suboxone) at home

Prescribed for you by on .

The following directions have been prescribed by a licensed medical provider for the  individual named above, may not be redistributed, and are not to be used by any other person for any reason.

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Micro induction

Induction Steps

  • Opioid withdrawal calculator

More resources for your plan

Frequently asked questions

How do you prepare for your first dose of Suboxone?

  1. Check the strength of the medication. You have likely received either 8-2 mg or 2-0.5 mg films or tablets. The first number is the amount of buprenorphine,the active component of the medication, and this is the number we use when talking about the dose.
  2. You may need to cut the tablet or film to get  the correct  dose ordered by your Bicycle Health provider. To cut tablets, a pill-cutter works best.  To cut  films, a sharp and completely dry pair of scissors is best.
  3. After cutting the tablet or film to the correct dose, be sure to put the remaining portion back into the bottle or foil package to save for your next dose.

How do you take Suboxone?

Buprenorphine (Suboxone) can only be absorbed through the underside of your tongue and through the inside surfaces of your cheeks.  It cannot be absorbed through the stomach or intestines, so the medication will have NO EFFECT if swallowed.  It must dissolve completely under the tongue (prefered) or between your lower gum and cheek (secondary choice if unable to dissolve under the tongue).
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When ready to take the medication, remember the following:
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  • Do NOT swallow it.
  • Make sure nothing is in your mouth – no gum, no liquids, no food. 
  • Do NOT eat or drink anything until the medication is completely dissolved, which may take up to 15 minutes.
  • After the medication has completely dissolved and can no longer be felt or seen in the mouth, you may either swallow or spit out the remaining saliva, whichever you prefer.

Information about wait times

If there is already active opioid in the body, taking a first dose of buprenorphine (Suboxone) will rapidly suppress the effects of that opioid and cause sudden severe withdrawal. As long as there is no, or extremely little, active opioid in the body, taking a first dose of buprenorphine (Suboxone) will instead relieve withdrawal; this is the intended effect.  

We can safely say there is no, or extremely little, active opioid in your body when you are feeling moderate withdrawal.  It can take anywhere from 12 to 72 hours to develop moderate withdrawal after your last opioid use, and this varies based on your own metabolism, tolerance, and the type of opioid you have been using most recently.  The type of opioid you’ve been using most recently determines the MINIMUM initial wait time your provider will recommend, as per the chart below.  Your own personal metabolism and tolerance are less predictable, so AFTER the MINIMUM wait time passes, we ask you to begin a series a self-assessments (the SOWS scale) to determine when it is truly the right, safest time for you to begin buprenorphine (Suboxone).

The minimum wait time is based on the longest-acting opioid you have used in the past 4 days.  The following table shows minimum wait times based on the type of opioid: 

If You’ve Used the Following Opioid within the Past 4 Days

Short-acting opioids:

  • Heroin
  • morphine
  • Hydrocodone (Norco, Vicodin)
  • Codeine
  • Tramadol (Ultram)
  • xycodone (Percocet)
  • Hydromorphione (Dilaudid)

Then Wait AT LEAST 12 Hours since your last opioid

Intermediate-acting opioids: 

  • oxycodone-sustained release (OxyContin)
  • morphine sustained release (MD Contin

Then Wait AT LEAST 24 Hours since your last opioid

Methadone  (Methadose)

Then Wait AT LEAST 36 Hours since your last opioid

Fentanyl*

*ALMOST ALL STREET-PURCHASED OPIOIDS CONTAIN FENTANYL, or are entirely fentanyl, even though they are often sold as oxycodone, hydromorphone, heroin, blues, M30s, OxyContin, MS Contin, or under other names.  ALWAYS ASSUME THAT YOUR OPIOID SUPPLY IS FENTANYL unless you’ve verified that it comes directly from a pharmacy or pharmaceutical manufacturer.

Then Wait AT LEAST 48-72 Hours since your last opioid

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