Suboxone is the brand name for an FDA-approved combination medication containing buprenorphine and naloxone. Suboxone is prescribed to combat opioid use disorder (OUD) and opioid withdrawal syndrome. It works by binding to the same brain receptors as opioids to prevent or reduce cravings for drugs such as heroin, morphine, oxycodone, and fentanyl.
Combined with behavioral therapy, family support, and support groups, suboxone can be a potentially life-saving medication, helping rewrite the course of people’s lives.
But like other medications, suboxone has short- and long-term side effects that are important to understand. In this article, we’ll explore the long-term side effects of suboxone use and how to take suboxone safely over the long term.
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Side Effects Of Long-Term Suboxone Use
Suboxone is part of medication-assisted therapy (MAT) for opioid use disorder, especially for short-acting opioids such as heroin and painkillers. It comes in two forms: sublingual tablets and sublingual films, which dissolve in the mouth over several minutes.
Once a patient enters treatment for opioid abuse, withdrawal symptoms will appear, often lasting days or weeks. Opioid withdrawal symptoms can be extremely physically and mentally stressful, increasing the risk of relapsing.
Suboxone helps reduce or even eliminate withdrawal symptoms.
As patients move out of the initial withdrawal window, doctors may decide to reduce suboxone dosage gradually. Suboxone suspension should happen in the context of a comprehensive MAT program.
Taking suboxone for 6 months to a year or even more is common. Long-term suboxone use is associated with long-term sobriety but may make some patients feel like they’ve just traded one addiction for another. The following side effects may appear with prolonged use:
- Anxiety and depression
- Higher sensitivity to pain
- Nausea, drowsiness, confusion, and vomiting
- Social isolation
- Financial problems associated with acquiring suboxone
- Reduced workplace performance
- Damaged relationships
Since buprenorphine is a partial opioid agonist, it produces mild opioid effects, which may lead to psychological dependence and addiction. Although suboxone has a lower risk for abuse and addiction than full agonists such as heroin, it is still possible to become addicted to it, regardless of past opioid use.
Some people may abuse suboxone to temporarily cope with the effects of full opioid agonists (fentanyl, heroin, etc.) and continue abusing said opioids. This leads to a cycle that perpetuates opioid abuse rather than ends it.
It’s also possible to take suboxone long-term as a drug of abuse acquired illegally, with no prior opioid abuse. Its effects may lead to a “high” that some people may enjoy and return to.
This is why suboxone should never be taken without a prescription or outside a MAT program.
Other Side Effects Of Suboxone
In addition to long-term effects, suboxone may cause more immediate side effects on those who take it, including:
- Headache, nausea, and vomiting
- Profuse sweating
- Sleep disruptions
- Swelling in arms and legs
- When using sublingual films, numbness or burning sensations in the mouth
Less common but more severe side effects may include:
- Low blood pressure when standing up (orthostatic hypotension )
- Liver issues and even liver failure
- Breathing disorders during sleep
- Allergic reactions to some ingredients
How To Use Suboxone Safely In The Long Term?
The ultimate goal of MAT programs is long-term sobriety. MAT helps build positive habits that help patients gradually stop using both their drugs of abuse and maintenance medications such as suboxone.
The exact period of suboxone use varies individually, but it may be used for several months to a year or even more. Suboxone is a safe long-term medication when used appropriately.
These are some recommendations for safe suboxone use:
- Reduce or even eliminate the intake of central nervous system depressants such as alcohol, benzodiazepines, and other opioids.
- Take suboxone in the prescribed form, method, and dosage. Chewing, swallowing, or modifying intake in any other way may lead to incomplete absorption.
- Drink some water before taking the sublingual film. It’ll help dissolve it better. But don’t drink or eat anything until it’s dissolved completely. The same goes for tablets.
- Do not smoke, snort, or inject suboxone.
- Make sure you are not allergic to buprenorphine or naloxone.
- If you forget a dose, take it as soon as you remember. If it’s almost time for the next dose, simply wait and take that one. Do not take double doses to make up for a missed dose.
- Don’t take extra doses if you feel withdrawal effects coming back. Discuss with your doctor.
When appropriately taken with no underlying health issues, suboxone is a safe medication that will help overcome opioid abuse, combined with behavioral therapy and psychosocial support. If you or someone you know is looking at suboxone, please discuss with your doctor the long-term effects it can have.