Buprenorphine-naloxone sublingual film is a medication for opioid use disorder (MOUD) sold under the brand name Suboxone. Its main uses are preventing cravings and withdrawal symptoms. It has a lower risk of fatal overdose compared to other forms of MOUD, like methadone. Taking high doses doesn’t increase the euphoric effects or the likelihood of overdose. Suboxone also contains an ingredient that helps prevent people from using again. If a person snorts or injects Suboxone, the naloxone kicks in and causes intense withdrawal symptoms.
Most people see the best health outcomes when they keep taking Suboxone indefinitely. It reduces rates of opioid use and overdose long after the initial phases of recovery. It’s one of the most effective long-term treatment approaches for opioid use disorder (OUD).
In this blog post, we’ll talk about how buprenorphine-naloxone sublingual film works and the kinds of experiences most people have with this medication.
What is buprenorphine-naloxone sublingual film?
Suboxone has certain properties that help people stay on track with their recovery goals. It minimizes cravings and withdrawal symptoms. Instead of causing a significant high, it helps people feel more like their “normal” — improving their overall well-being. Suboxone is unique among opioids because there’s no benefit to taking it at a higher dose, at least for those who have an opioid dependence. It’s also less likely than methadone or other opioids to cause overdose.
The medication comes in a strip that dissolves under your tongue. Other brands come in different dosages or forms, such as a buccal film or sublingual tablet.
Other brand names for buprenorphine-naloxone include:
- Bunavail
- Cassipa
- Zubsolv
How buprenorphine-naloxone works in your body
In combination, buprenorphine and naloxone help prevent opioid use and overdose. Buprenorphine helps reduce opioid cravings and withdrawal symptoms. It’s a partial opioid agonist. This means it binds to opioid receptors and only partially activates them. It causes a much milder euphoria compared to methadone, and the high doesn’t get more intense, no matter how much you take. This “ceiling effect” also applies to respiratory depression, which is the cause of most opioid overdose deaths.
Naloxone, in this case, discourages people from using opioids outside of their prescription. It’s an opioid antagonist, which means it binds to opioid receptors and doesn’t activate them. It stays dormant unless you snort or inject your Suboxone. When activated, it causes precipitated withdrawal. This means you’ll experience sudden and intense withdrawal symptoms. On its own, naloxone (also known as Narcan) is used to reverse opioid overdose. However, in Suboxone, it’s the buprenorphine that helps reduce the risk of overdose.
What to expect when starting treatment:
The first step is a consultation with a qualified Suboxone prescriber. They’ll talk with you about your medical history, your opioid use, and any other medications you’re taking. Your provider should understand your goals for recovery before writing you a prescription.
You can’t start taking Suboxone until you’re experiencing significant withdrawal symptoms. If you take it too soon, there’s a risk of triggering precipitated withdrawal. Your prescriber may start you with a low dose and gradually increase it until your symptoms are gone. On your first day of taking Suboxone, you may need to take partial doses to let your body acclimate to the medication. You’d take one partial dose and then wait a couple of hours to take a second or third partial dose.
Suboxone works quickly, although people absorb it and feel its effects at different rates. You should feel some relief within an hour of taking your first dose, and the effects peak at three to four hours. It’s a long-acting opioid, so you’ll feel its effects for up to a few days. The effects of Suboxone can last more than 24 hours, and may stay in your system for up to a week, or longer.
The most common side effects of Suboxone include:
- Anxiety
- Diarrhea
- Fever
- Sneezing
- Runny nose
- Skin that feels different
- Fast heartbeat
- Tremors
- Shivering
- Sweating
- Sleep issues
How to use buprenorphine and naloxone sublingual film
Most people take Suboxone every day. However, in some cases, your provider may tell you to take it every other day. Your dosage may need to be adjusted as your body gets used to this medication and your levels of other opioids decrease. You should work closely with a qualified prescriber, especially during the first few weeks of taking Suboxone.
Take the following steps to take Suboxone sublingual film:
- Before taking buprenorphine-naloxone sublingual film, drink water to moisten your mouth. This helps the film dissolve more easily.
- Unwrap the film and hold it between two fingers by the outside edges.
- Place the film under your tongue, close to the base either to the left or right of the center.
- If your health care provider tells you to take two films at a time, place the second film under your tongue on the opposite side. Try not to let the films touch. Keep them in place until they have completely dissolved. If your health care provider tells you to take a third film, place it under your tongue on either side after the first two films have dissolved.
- While your Suboxone is dissolving, do not chew or swallow it because the medicine won’t work as well. Talking while the film is dissolving can also affect how well the medicine is absorbed.
- After it’s completely dissolved, rinse your mouth with water and swallow. Wait for at least one hour before brushing your teeth.
If you miss a dose, take your medicine when you remember. If it’s almost time for your next dose, skip the missed dose and take the next dose at your regular time. Don’t take two doses at the same time unless your care provider tells you to. If you’re not sure about your dosing, talk to your care provider.
Don’t stop taking Suboxone suddenly since this is likely to cause withdrawal symptoms. This doesn’t mean you are addicted to Suboxone. Your body becomes used to having certain levels of the medicine to maintain your “normal.” Suboxone is safe to take for the long term. Taking a maintenance dose increases your chances of staying on track with your recovery goals and lowers your risk of using again or overdosing.
Daily life on buprenorphine and naloxone sublingual film
Members at Groups have said that taking Suboxone helps them feel “normal.” Without cravings or withdrawal symptoms, they’re able to focus on the things that make their lives worthwhile. You can check out some of their stories on our Resources page.
Suboxone can make a big difference in your recovery journey, but social support through counseling is also critical. Recovery is about more than stopping opioid use. It’s also about creating healthy habits and working on your relationships with yourself and others. You’ll spend time setting new life goals and building up new skills and resources to help you achieve them.
Groups provides access to buprenorphine-naloxone and support for your recovery
It is possible to make a successful recovery from OUD, and for many people, this includes lifelong Suboxone treatment. You get to decide what success means to you. The role of your care providers and your community in this next phase of your life is to support you in becoming the person you want to be.
Learning about your treatment options and what’s possible in life after opioid use will help you determine what kinds of support you need. When you’re searching for care providers, keep in mind that trust is one of the most important factors to look for. At Groups, we believe in educating our members well so they can take an active role in their decision-making process.
Treatment at Groups includes access to Suboxone and meetings with a prescriber who can help you decide if it’s right for you. It also includes counseling in a group setting.
Are you ready to take the next step toward life after OUD? Contact us or give our Recovery Support Specialists a call today. We provide treatment across the country—and we’re always expanding. See if we offer care in your state, either online or at one of our 130+ local offices. If Groups does not offer treatment in your area, you can locate other treatment options here.
