Table of Contents
What is Suboxone?
Before getting into how long does Suboxone stay in your system, it it is important to understand what Suboxone actually is. Suboxone is a partial agonist made of naloxone and buprenorphine used to treat opioid addiction and withdrawal. Physicians prescribe Suboxone as a tablet or film strip that dissolves under the tongue or between the cheeks and gums.
Because Suboxone contains the opioid partial agonist buprenorphine, it has the potential for abuse and addiction, leading to its classification as a Schedule III narcotic. 1
While helpful in relieving opioid withdrawal symptoms, Suboxone often comes with a few side effects.
Common Suboxone Side Effects
- Feeling hot
- Flushed skin and sweating
- Pain in lower back or side
- Painful or difficult urination
Suboxone, Buprenorphine, and Naloxone.
Although often referred to interchangeably, Suboxone and buprenorphine are not the same.
Buprenorphine is a partial opioid agonist prescribed to treat withdrawal and cravings. Buprenorphine binds to opioid receptors to reduce cravings without delivering the euphoric high that accompanies full opioids agonists like heroin, methadone, oxycontin, or morphine. Because buprenorphine is a partial rather than full opioid agonist, it activates the opioid receptors less strongly, reducing its potential for abuse compared to methadone. 2
Suboxone refers to medications with mixtures of partial opioid agonist buprenorphine and full opioid antagonist naloxone. As an opioid antagonist, naloxone reverses the effects of opioids by binding to opioid receptors and blocking the “high,” making it undesirable. Doctors commonly use naloxone as a primary measure to reverse opioid overdoses and to curb cravings and symptoms of withdrawal. 3
The partial opioid agonist properties of buprenorphine combine with opioid antagonist qualities of naloxone to create a powerful medication that’s helped thousands recover from opioid addictions.
Methadone vs. Suboxone
When comparing methadone vs. Suboxone, it is easy to see why the two are confused. Both drugs are commonly prescribed to ease the physical and mental symptoms when going through opioid withdrawal. However, while both drugs may lead to similar experiences, they differ in how they achieve their results.
Physicians typically prescribe methadone to people going through opioid withdrawal or to relieve chronic pain. Methadone is a Schedule II narcotic, reflecting its commonplace medical use and increased risk for abuse and addiction. Methadone works by binding to opioid receptors and preventing the debilitating experience of opioid withdrawal.
When comparing methadone and Suboxone, methadone is cheaper and more widely available. In addition, some research suggests it may lead to longer-term recovery-adherence by more closely mimicking the “head-nodding” effects of opioids. 4 However, it is this exact argument that’s led many, including the New York Times, 5to label Suboxone as a safer alternative to opioid withdrawal than methadone. Suboxone also works more quickly than methadone, reducing physical withdrawal symptoms in weeks rather than the possible months it can take to wean off opiates using methadone. 6
When discussing methadone’s drawbacks, most professionals mention the necessity of having a doctor present to administer and regulate doses alongside the higher potential for abuse. Methadone abuse has increased astronomically in past years, with the CDC reporting methadone-related poisoning deaths increased sevenfold from 790 in 1999 to nearly 5,420 in 2006. 7
Is Suboxone Addictive?
The short answer is yes because Suboxone is a partial opioid, it carries the potential for addiction.
The issue with Suboxone is that it acts as a replacement for more destructive opioids. The brain remains dependent on Suboxone to prevent withdrawal and curb cravings without solving the root problem of opioid addiction.
Suboxone’s potential for abuse and addiction is limited by naloxone and the partial agonist qualities of buprenorphine, which diminish the potential “high” from buprenorphine and other opioids. However, people looking for a high find that dissolving multiple Suboxone strips or crushed tablets in a glass of water and injecting it directly into the bloodstream bypasses the effects of naloxone, which are activated by the digestive system.
Statistics on Suboxone Abuse
Since 2005, buprenorphine-related emergency department visits rose from 3,161 to a staggering 30,135 in 2010. Conducted by the Substance Abuse and Mental Health Services Administration, the study found the majority of the buprenorphine-related emergency room visits – 52% – involved non-medical or recreational use of pharmaceuticals. While Suboxone may provide life-saving help for many struggling with opioid addiction, it also carries the potential for abuse and addiction. 8
When abused for non-medical uses or outside the direction of a medical professional, Suboxone use may lead to dependence which can then escalate to addiction. Suboxone withdrawal begins within twenty-four hours from when the last dose of the substance is taken. Moreover, the withdrawal symptoms can last roughly a month, depending on the amount of Suboxone that was used.
Suboxone withdrawal mirrors withdrawal symptoms from other opioids. The first seventy-two hours of Suboxone withdrawal can include symptoms such as: 9
- Nausea and vomiting
- Muscle aches
- Digestive issues
- Difficulty concentrating
- Dilated pupils
After the first week, most people continue experiencing certain withdrawal symptoms such as mood swings, insomnia, and muscle aches.
After the second week of withdrawal, many people find themselves experiencing depression. This depression is often followed for another few weeks by the addition of drug cravings.
How is Suboxone Metabolized?
The half-life of a drug refers to the time it takes to remove half the drug’s original amount from the body. It typically takes about four to five half-lives to completely remove a drug from the body. The long-lasting nature of buprenorphine lengthens the Suboxone half-life, typically taking users five to eight days to eliminate all traces of Suboxone. 10
For most healthy individuals taking Suboxone as prescribed, the drug will fully clear their system within eight days. However, several other variables can impact how long Suboxone stays in the body.
Both buprenorphine and naloxone are processed through the liver before being excreted as urine, so poor liver function can slow down the excretion of Suboxone. As a result, people with poor liver health find it can take much longer to eliminate the substance from their systems, requiring anywhere from seven to fourteen days.
In addition to liver health, other factors that impact how long this drug remains in the body include:
- Body fat content
- Weight and height
- Size of the last dose taken
- Length of time abuse has persisted
As the liver metabolizes Suboxone, it creates metabolites that can remain detectable in the body even after this substance is eliminated from the body’s system. The presence of these metabolites means buprenorphine can be traceable in detection kits for longer than eight days. Common Suboxone detection tests include:
- Urine test: Urine tests can trace buprenorphine within forty minutes of ingestion and up to two weeks since their last dose for heavy users.
- Hair test: Hair tests can also detect buprenorphine for one to three months after last use, although they are not as reliable as alternate tests.
- Saliva test: Saliva tests can typically trace buprenorphine use from within the last few days to over a week from the last dose.
- Blood test: Blood tests can detect buprenorphine the quickest at just over two hours but have a much shorter testing window. Because of its invasive nature, the saliva test is often preferred.
Treatment for Suboxone Addiction
If you find yourself struggling with Suboxone abuse and looking for addiction treatment, you are not alone. The first step towards recovery is speaking to your physician, who can share the addiction treatments available to you.
Clearing the drug from your system is always the first step in recovery. Detox from Suboxone abuse usually begins with tapering the substance. A Suboxone taper involves gradually reducing a person’s dose to limit withdrawal symptoms and help the individual detox safely.
Therapies typically act as the second stage in recovery programs, tackling the psychological nature of addiction. Popular therapies in Suboxone recovery include cognitive behavioral therapy, which helps individuals challenge patterns of thought to create more helpful patterns of behavior. Other therapies may include individual or group therapy, stress management, and relapse-prevention planning.