Updated on: September 2, 2026 by John Ingham
Making an informed choice between buprenorphine and Suboxone is a critical step in opioid dependence recovery, as these medication-assisted treatment options can be a vital part of the healing process. While both medications contain buprenorphine as their primary component, they have distinct features that can significantly impact your overall treatment success. Understanding these key differences will help you and your healthcare provider determine the most effective option for your long-term recovery.
Key Points
- Buprenorphine is the active opioid-treatment medication; Suboxone is a brand formulation containing buprenorphine and naloxone.
- Both buprenorphine-only and buprenorphine/naloxone products can be effective medications for opioid use disorder.
- Naloxone has limited bioavailability when Suboxone is taken as directed and is included primarily to discourage certain forms of misuse.
- Brooks Healing Center provides medication-assisted treatment as part of individualized opioid addiction care when clinically appropriate.
What is Medication-Assisted Treatment (MAT)?
Medication-assisted treatment (MAT) uses FDA-approved medications like methadone, buprenorphine, and naltrexone to treat opioid use disorder.[1] Medications for opioid use disorder work in different ways. Buprenorphine is a partial opioid agonist that can reduce withdrawal and cravings, methadone is a full opioid agonist used in regulated treatment settings, and naltrexone is an opioid antagonist that blocks opioid receptors.
These medications can reduce overdose risk and support recovery when used appropriately as part of an individualized treatment plan.
MAT medications are prescribed alongside counseling and behavioral therapy, as addiction requires both physical and psychological treatment.
Research consistently shows MAT’s effectiveness, with studies demonstrating higher recovery rates than abstinence-only approaches.[2] Through taking prescribed MAT medications under medical supervision, patients can focus on recovery without the disruption of withdrawal symptoms and cravings. This medical stability creates a foundation for engaging in therapy and developing coping skills essential for long-term recovery.
What is Buprenorphine?
Buprenorphine is a partial opioid agonist medication used to treat opioid use disorder.[3] As a partial agonist, it partially activates opioid receptors in the brain, helping to reduce withdrawal symptoms and cravings without producing the intense high of full opioids. Buprenorphine also has a ceiling effect – taking more won’t increase its effects beyond a certain point, which reduces abuse potential.[4]
The medication has several forms, including injectable forms like Brixadi, sublingual tablets and films that dissolve under the tongue. The choice of a buprenorphine-only or buprenorphine/naloxone product is individualized, including during pregnancy, based on clinical factors and shared decision-making. Buprenorphine requires careful medical supervision and dose adjustment to manage withdrawal symptoms while effectively preventing misuse.
What is Suboxone?
Suboxone is a prescription medication that combines two drugs: buprenorphine and naloxone.[5] Buprenorphine helps manage opioid withdrawal symptoms and cravings.
Naloxone is included in Suboxone primarily to discourage misuse by injection. Very little naloxone reaches systemic circulation when the medication is taken as directed under the tongue or inside the cheek.
If Suboxone is manipulated and injected, naloxone exposure is greater and may contribute to precipitated withdrawal in someone who is physically dependent on opioids. The reaction is not identical in every person or circumstance.
Like plain buprenorphine, Suboxone comes in sublingual films and tablets.
Buprenorphine/naloxone is commonly prescribed for opioid use disorder because it provides effective buprenorphine treatment while the naloxone component helps discourage certain forms of misuse. It does not eliminate misuse or overdose risk. This allows qualified physicians to prescribe take-home doses, giving patients more flexibility in their treatment while maintaining safety.
A Detailed Comparison: Buprenorphine vs. Suboxone
While both medications contain buprenorphine for treating opioid dependence, several important distinctions between standalone buprenorphine and Suboxone can affect treatment choices:[6, 7]
- Active ingredients: Buprenorphine contains only buprenorphine, while Suboxone combines buprenorphine with naloxone as an abuse-deterrent
- Safety features: Naloxone helps discourage misuse by injection but does not eliminate misuse or overdose risk; withdrawal effects vary by person and circumstance.
- Pregnancy and individual clinical factors: The choice between buprenorphine-only and buprenorphine/naloxone formulations should be individualized. Pregnancy, medication access, treatment history, misuse risk, patient preference, and clinician judgment may all influence which formulation is selected.
- Cost considerations: Plain buprenorphine generally costs less than Suboxone, though insurance coverage varies between medications
- Treatment effectiveness: Both medications demonstrate equal effectiveness in treating opioid dependence when taken as prescribed under proper medical supervision
Can These Medications Be Abused?
Buprenorphine is a Schedule III controlled substance and can be misused. At the same time, appropriately prescribed buprenorphine is evidence-based treatment for opioid use disorder and has been shown to reduce opioid-related mortality.
Treatment should distinguish appropriate physical dependence on a prescribed medication from compulsive misuse or opioid use disorder behaviors.
While these medications are designed to treat opioid dependence, both can be misused despite their built-in safeguards.[8] Buprenorphine can be crushed and injected or snorted, which may produce euphoric effects by bypassing its intended sublingual delivery method. Even Suboxone, despite containing naloxone, can be misused by taking higher doses than prescribed or combining it with other substances like benzodiazepines. This dangerous practice can lead to severe respiratory depression.
Some people attempt to sell or trade these medications illegally or try to manipulate drug screenings to obtain extra doses. Withdrawal can still occur if either medication is stopped abruptly, and some individuals may attempt to self-adjust their dosage. These behaviors can lead to overdose, dangerous drug interactions, or legal consequences. This potential for misuse underscores why these medications require strict medical supervision, regular monitoring, prescription drug tracking, and clear treatment agreements between patients and healthcare providers.
What Are the Side Effects of Buprenorphine and Suboxone?
Since buprenorphine is the primary active ingredient in both medications, they share similar side effects, which can include:[9]
- Headache and dizziness, which typically improve as your body adjusts to the medication
- Constipation that may require lifestyle changes or additional treatment to manage
- Nausea and vomiting, especially during the initial adjustment period
- Sleep disturbances, including insomnia or excessive drowsiness
- Oral numbness and taste changes from the sublingual delivery method
More serious but less common side effects may include:[10]
- Liver problems requiring regular monitoring through blood tests
- Respiratory depression, particularly if combined with alcohol or sedatives
- Severe allergic reactions, though these are rare
- Tooth decay from the sublingual tablets or films makes oral hygiene crucial
It’s important to note that for most patients, the benefits of these medications far outweigh their potential side effects. Your healthcare provider will monitor you closely and can help manage any side effects that occur. Never adjust your dose or stop taking these medications without medical supervision, as this can lead to withdrawal symptoms.
Which Medication is Right For Me?
The decision between buprenorphine and Suboxone should be made carefully with your healthcare provider, who will evaluate your specific situation and needs. They’ll consider factors like your treatment history, living situation, and insurance coverage to help determine the most appropriate medication. Your provider will also assess whether you need the additional safety features of Suboxone or if plain buprenorphine would be more suitable.
During your evaluation, be open with your healthcare team about your concerns, past experiences with treatment, and current circumstances. This information helps them create a treatment plan that fits your lifestyle and gives you the best chance of success. Remember that what works well for one person may not be ideal for another, and your provider’s goal is to find the right medication and approach for your recovery journey.
What Can I Do if I’m Struggling With Opioids?
If you’re struggling with opioid use, taking the first step toward recovery can feel overwhelming, but there are many paths to healing and professionals ready to help. Start by contacting your doctor, calling SAMHSA’s 24/7 helpline (1-800-662-4357), or contacting an addiction treatment center. These professionals can assess your situation and help you understand your treatment options, including medical detox, medication-assisted treatment (MAT), counseling, and support groups.
Many people begin their recovery journey with medically supervised detox, which helps manage withdrawal symptoms safely and comfortably. From there, your healthcare team can help you transition into a comprehensive treatment program that includes MAT, individual therapy, group counseling, and other support services. Treatment can be designed specifically to your needs, whether that means intensive outpatient programs that allow you to maintain work and family responsibilities or residential treatment for more structured support.
FAQ’s
How long do I need to stay on buprenorphine or Suboxone?
Treatment duration varies significantly for each person and depends on multiple factors, including your recovery progress, stability, and support system. While some people may stay on these medications for months, others might need years of treatment. There’s no “right” length of time – the goal is to maintain stability in your recovery. Your healthcare provider will work with you to determine when and if tapering off medication is appropriate based on your circumstances and progress.
What happens if I miss a dose?
If you miss a dose, take it as soon as you remember unless it’s almost time for your next scheduled dose. Never take a double dose to compensate for a missed one, as this can be dangerous. Contact your healthcare provider for guidance if you need help with what to do. Missing multiple doses can lead to withdrawal symptoms, so it’s important to maintain a consistent dosing schedule and talk to your provider if you’re having trouble staying on track.
Can I take other medications while on buprenorphine or Suboxone?
Some medications can interact dangerously with buprenorphine and Suboxone, particularly benzodiazepines, alcohol, and other sedatives. Always inform your healthcare provider about all your medications, including over-the-counter drugs and supplements. Your provider will need to review any new medications before you start them to ensure they’re safe to use with your treatment.
Will I experience withdrawal symptoms when stopping these medications?
Yes, stopping buprenorphine or Suboxone can cause withdrawal symptoms, which is why you should never stop taking them abruptly. When the time is right to discontinue treatment, your healthcare provider will create a tapering plan to reduce your dose over time gradually. This careful tapering helps minimize withdrawal symptoms and gives you the best chance of maintaining recovery. Depending on your current dose and individual needs, the process may take several weeks or months.
Sources
[1] Center for Drug Evaluation and Research. (2024). Information about Medications for Opioid Use Disorder (MOUD). FDA. https://www.fda.gov/drugs/information-drug-class/information-about-medications-opioid-use-disorder-moud
[2] Brunisholz, K. D., Knighton, A. J., Sharma, A., Nichols, L., Reisig, K., Burton, J., Scovill, D., Tometich, C., Foote, M., Read, S., & Whittle, S. (2020). Trends in Abstinence and Retention Associated with a Medication-Assisted Treatment Program for People with Opioid Use Disorders. Progress in Community Health Partnerships: Research, Education, and Action, 14(1), 43–54. https://pmc.ncbi.nlm.nih.gov/articles/PMC7751497/
[3] Substance Abuse and Mental Health Services Administration. (2024, March 28). Buprenorphine. Www.samhsa.gov. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
[4] What is Buprenorphine? | UAMS Psychiatric Research Institute. (n.d.). Https://Psychiatry.uams.edu/. https://psychiatry.uams.edu/clinical-care/outpatient-care/cast/buprenorphine/
[5] HIGHLIGHTS OF PRESCRIBING INFORMATION. (n.d.). https://www.suboxone.com/pdfs/prescribing-information.pdf
[6] What is Buprenorphine? | UAMS Psychiatric Research Institute. (n.d.). Https://Psychiatry.uams.edu/. https://psychiatry.uams.edu/clinical-care/outpatient-care/cast/buprenorphine/
[7] Buprenorphine/Naloxone (Suboxone) | NAMI. (n.d.). Www.nami.org. https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/buprenorphine-naloxone-suboxone/
[8] A. Yokell, M., D. Zaller, N., C. Green, T., & D. Rich, J. (2011). Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Current Drug Abuse Reviews, 4(1), 28–41. https://pmc.ncbi.nlm.nih.gov/articles/PMC3154701/
[9] Substance Abuse and Mental Health Services Administration. (2024, March 28). Buprenorphine. Www.samhsa.gov. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
[10] Buprenorphine Sublingual and Buccal (opioid dependence): MedlinePlus Drug Information. (2019, October). Medlineplus.gov. https://medlineplus.gov/druginfo/meds/a605002.html
