Will I Be Able to Function on Suboxone?

Yes. People taking Suboxone and similar medications are able to live full, productive lives. Research indicates that Suboxone is safe and typically well-tolerated by those taking it. [5]

Just like any medication, Suboxone can have some side effects, but these shouldn’t be debilitating or cause major life disruptions. The most common side effects are nausea, headache, constipation and sedation. [5] Most people who take Suboxone function normally and don’t have any noticeable effects in their everyday lives.

What Is It Like to Take Suboxone?

Suboxone is a medication made up of two drugs: a partial opioid agonist, buprenorphine, and an opioid antagonist, naloxone. 

When you take Suboxone for opioid withdrawal or opioid use disorder (OUD), you will notice the following benefits:

• Reduced opioid cravings
• Decreased opioid withdrawal symptoms
• Reduced risk of relapse

You will take Suboxone under your tongue, either as strips or pills that dissolve within 5-10 minutes. Most patients take Suboxone once per day, although some doctors may prescribe it more frequently, depending on your needs. 

You may notice some side effects but research indicates that most people feel better by the end of their first day.[6]

Active Ingredients and Their Functions

Suboxone is a combination OUD medication that contains the following ingredients:[1]

• Buprenorphine: A partial opioid agonist that binds to opioid receptors in the brain and relieves withdrawal symptoms and cravings without causing a high. It is considered the active ingredient in Suboxone.
• Naloxone: An opioid antagonist that is inactive unless a person attempts to misuse their Suboxone by injecting or snorting it. If they misuse Suboxone, the naloxone will bind to opioid receptors and block the effects of buprenorphine, causing precipitated withdrawal symptoms. If you take the Suboxone as prescribed (under the tongue), the naloxone is not absorbed, and your body only sees the buprenorphine. 

In addition to naloxone being a misuse deterrent in Suboxone, it also provides overdose protection for anyone attempting to misuse it. Naloxone blocks the effects of opioids so if someone injects high doses of Suboxone, they won’t experience an overdose because the naloxone will keep the opioids from binding to receptors.

Understanding Suboxone’s Safety Profile

Suboxone is a safe and effective medication for the treatment of opioid use disorder. Here are some key points: [7]

• Lower overdose risk: Because it is a partial opioid agonist, it provides less respiratory depression and overdose risk than full opioid agonists like methadone.
• Milder withdrawal symptoms: If someone wants to stop taking Suboxone, accidentally misses a dose or loses their medication, Suboxone has milder withdrawal symptoms than full opioids like methadone.
• Versatility: Because of Suboxone’s wide safety margin, it has versatile OUD uses. It can be prescribed in an office, through online providers or in more traditional addiction treatment programs.
• Ceiling Effect: Suboxone, unlike other OUD medications, has a ceiling effect in which respiratory depression plateaus at certain doses.

Because of all of these unique pharmacological effects, Suboxone is generally considered a first-line medication for OUD treatment. [7]

The Ceiling Effect of Suboxone

Because buprenorphine is a partial agonist, it does not continue to cause more and more sedation or dizziness at higher doses the way a full opioid agonist like methadone might. For this reason, it is considered safer than other full opioids since even high doses will not result in a Suboxone overdose. This is referred to as the ceiling effect of Suboxone. 

The major benefit of Suboxone is that it will diminish your physical dependence on opioids, reducing or eliminating withdrawal symptoms and drug cravings. Since you won’t be experiencing the discomfort of withdrawal, you’ll be able to focus on therapy and the other work you are doing toward your recovery.

Side Effects of Suboxone

Suboxone does have some side effects in the minority of patients. Suboxone may cause mild dizziness or sedation, at least at first. These effects are more likely in people who are opioid naive. 

However, most patients taking Suboxone are doing so because they are already taking opioids, in which case the risk of dizziness or sedation is even less pronounced. 

Some of the most common side effects associated with Suboxone and similar medications include the following:[1],[5]

• Constipation
• Drowsiness and fatigue
• Dry mouth
• Nausea or GI upset
• Tooth decay
• Headache
• Erectile dysfunction

There is a stabilization phase of between 1 and 2 months in which your doctor may need to adjust your Suboxone dose in order to effectively treat your OUD symptoms while also minimizing side effects.[5] It’s important to communicate regularly with them so they know how you are feeling.

Rare and Dangerous Suboxone Side Effects

Although Suboxone is generally well-tolerated, some people may still experience dangerous side effects. These tend to be rare but it’s still important to be well-informed about the potential risks. Here are dangerous side effects to be aware of: [1],[8]

• Trouble breathing
• Hives
• Rash
• Itching
• Swelling of face, lips, tongue or throat
• Hallucinations
• Agitation
• Slurred speech
• Blurred vision
• Unusual bruising or bleeding
• Yellowing of eyes or skin (jaundice)
• Pain in the upper right side of the abdomen
• Dark-colored urine
• Severe muscle twitching or stiffness

If you experience any severe or life-threatening side effects, call 911 immediately. 

Precautions to Take While Using Suboxone

Suboxone is widely considered by experts to be a safe drug, especially when considering its benefits.[2] It is considered to have low misuse potential. At the same time, there are some precautions one should take when on Suboxone, such as:

• Don’t mix Suboxone with any other substances unless told it is safe to do so by your doctor.[3] On its own, the buprenorphine in Suboxone is generally safe, but it can put you more at risk for serious complications if you mix it with other drugs, like alcohol. Only use your Suboxone as prescribed.
• You may want to wait to see how Suboxone makes you feel before performing potentially risky activities, like driving. Suboxone can sometimes cause drowsiness and dizziness, especially when first taking the medication. 
• Many experts recommend caution for people on Suboxone regarding tasks like operating heavy machinery. With that said, the majority of people on Suboxone can safely drive. It’s a good idea to see how Suboxone makes you feel initially and determine if you are experiencing any side effects before you begin driving again.
• Be honest with the medical professionals guiding your treatment. If Suboxone is making you feel strange or you’re not sure it’s helping, tell them. They may need to change your dose or even try a different MAT for you, depending on your needs. 

While very uncommon, some people can have a negative reaction to Suboxone.[4] It’s important to alert your doctor to this as soon as possible if you think that might be occurring.