What is Suboxone? 

Suboxone is a prescribed combination medication used to treat patients with opioid use disorder (OUD). The ingredients in Suboxone include buprenorphine and naloxone. Suboxone is a partial agonist that is ingested sublingually.  

Are Methadone and Suboxone the same? 

Suboxone is not the same as methadone. Suboxone retails as a strip that is placed under the tongue or inside the cheek and absorbed into the bloodstream. Methadone is administered orally and swallowed. Suboxone can be picked up in pharmacies, while methadone must be taken in person at opioid treatment programs. 

These medications are also different in how they work. The primary differentiating component of methadone and Suboxone is the way in which the drugs stimulate the mu opioid receptor. The buprenorphine in Suboxone is a partial agonist of the mu receptor which means it partially occupies the mu-opioid receptor. Methadone is a fully agonist, similar to other opioids like heroin or morphine. This means methadone fully occupies the mu-opioid receptor. Unlike other opioids, methadone is long-acting which is what allows it to help people live stable lives without the ups and downs of cravings.

Suboxone significantly reduces the possibility of respiratory depression or sedation because there is a limit to the level at which the opioid receptors in the brain can be activated by the buprenorphine in the drug, which is only a partial agonist. Heroin, oxycodone, fentanyl, and methadone are all examples of full agonists with much greater side effects than Suboxone. 

What are the Ingredients in Suboxone?

Suboxone is a brand name for the synthesization of buprenorphine (partial opioid agonist) and naloxone (opioid antagonist). Suboxone contains buprenorphine and naloxone. These ingredients are proportioned to 4:1 in the fabrication of the drug, 4  units of buprenorphine to every 1 unit of naloxone. Buprenorphine is the active ingredient in Suboxone. Naloxone is the inactive ingredient in Suboxone. Naloxone only activates in the drug if the medication is misused and/or consumed intravenously or endoscopically through the nose. 

A Detailed Look at Buprenorphine; The Active Ingredient in  Suboxone

Buprenorphine itself is an opioid. Buprenorphine is the active ingredient in Suboxone. It is a partial agonist. Buprenorphine has a ‘ceiling effect.’ After a certain dosage, the effects do not continue to increase with more of the medication. The buprenorphine will only stimulate the receptor up to a certain point.  Higher and higher doses won’t achieve enhanced receptor stimulation.  

The bioavailability of buprenorphine is low if swallowed therefore it must be ingested sublingually and allowed to dissolve to increase its capacity. If buprenorphine is injected, the bioavailability is much higher. This is when naloxone comes into play. 

A Detailed Look at Naloxone; The Inactive Ingredient in Suboxone  

Naloxone is an opioid antagonist or adversary, this means it blocks the opioid receptors and can actually knock other opioids off the receptor and reverse their effects. Naloxone only becomes active if the medication (Suboxone) has been misused i.e., injected or inhaled. Naloxone blocks the opioid from interacting with the opiate receptors in the brain, preventing the buprenorphine from having any effect, and in some cases can cause immediate withdrawal. Naloxone will bind to the receptors and block the buprenorphine from stimulating the neuron. It will fill the receptor site so that nothing can penetrate it. For opioid-dependent patients, the naloxone will precipitate withdrawals and block the euphoric properties of the buprenorphine. An important note: naloxone is not strong enough to block the buprenorphine in opioid naïve patients. 

Suboxone is packaged in a small rectangular strip and costs on average $150USD and may be covered by insurance. It is orange in color and the dose strength is printed on the soluble film to identify the measure. To learn more about Suboxone strips, see How to Use a Suboxone Strip. Speak with a provider at Confidant today to learn if Suboxone is the right treatment for you.