Suboxone is made up of buprenorphine and naloxone. Buprenorphine is the parent compound in Suboxone. Buprenorphine was originally discovered as a synthetic pain medication and was first used in the vein (IV) in the 1960s to treat pain related to cardiac arrest. Today buprenorphine is used to treat pain as well as opioid addiction and opioid use disorder (OUD). The dynamism of buprenorphine lies in its ability to provide pain relief akin to morphine without the risk of resulting side effects such as respiratory depression. Its analgesic properties are unique; buprenorphine provides relief from chronic pain as well as pain associated with the use of opioids, i.e., nausea, constipation, vomiting, etc. Importantly, different brand name versions of buprenorphine correspond to these different uses.
In 2002 buprenorphine was approved as an office-based treatment for OUD. Initially the medication had to be administered under direct medical observation, but now home induction is common.
The presence of naloxone in Suboxone acts to block stimulation of the brain’s opiate receptors if the drug is injected or misused, preventing diversion of the medication. Naloxone is absorbed negligibly from the gastrointestinal tract when absorbed sublingually (under the tongue). If the combination medicine is injected, the full hindering effect of naloxone is released, this stops the opioid effect of the buprenorphine.
What does Suboxone do to Your Brain?
Suboxone works in the brain to combat the effects of full opioid agonist consumption. Opioids such as heroin, oxycodone, and fentanyl function in the brain to alter how a person feels and responds to pain. See Suboxone Ingredients: All You Need to Know for more on the effects of full opioid agonists.
Opioids fundamentally target and block your body’s pain receptors to alleviate pain; however, the body builds tolerance over time, and more and more opioid is needed to manage the same quantities of pain. As a result, opioid doses escalate, tolerance builds, addiction ensues, and the risk of overdose increases. While buprenorphine is also an opioid, it is a partial opioid agonist that possesses a ‘ceiling effect.’ Meaning buprenorphine does not necessitate dosage escalation and does not build tolerance.
This combined with Suboxone’s sublingual delivery system controls the distribution of the opioid in the body to avert full opioid cause and effect. If the drug is injected, a full opioid effect is established. This is when the naloxone will activate to antagonize the buprenorphine, as discussed in the paragraph above, meaning there is no opioid effect and instead this may cause withdrawal.