Suboxone is a brand-name prescription medication that pairs the long-acting partial opioid agonist buprenorphine with the opioid antagonist/antidote naloxone.
This combination medication has been approved by the Food and Drug Administration (FDA) as a treatment for opioid addiction and is considered to be safe and effective when used for this purpose.
However, as with any medication, misuse of Suboxone does occur and can result in a variety of potential consequences, including drug overdose.
Risk Factors For Suboxone Overdose
Suboxone’s unique combination of drugs gives this medication a great deal of resistance to tampering and reduces the risk of severe overdose effects.
However, there are a number of different factors that can increase a person’s risk of overdose if Suboxone is misused, whether intentionally or unintentionally.
These factors include:
Level Of Opioid Tolerance & Dependence
Suboxone use by individuals who are not opioid dependent can increase the risk of overdose.
Those prescribing Suboxone do so under the assumption that those who will use this drug already have a degree of tolerance against the potentially dangerous effects of opioid drugs like fentanyl, oxycodone, heroin, and others.
Overdose risk may increase for those who have stopped using opioid drugs for a period of time, resulting in a loss of this assumed drug tolerance.
Using Suboxone To Get High
Buprenorphine possesses a ceiling effect that limits its euphoria at a certain dose, regardless of how much more is taken. Taking more and more to get high can increase the risk of overdose if the person is unaware of the ceiling effect and continues to take higher doses.
Use In Children & The Eldery
Suboxone use by children or the elderly can also increase the risk of overdose. These individuals will likely have more difficulty processing the medication and may experience the effects of Suboxone more intensely.
Suboxone Use Without A Prescription
Any non-approved use of Suboxone by those who do not have a proper prescription from a medical professional, or who are not strictly following the requirements of their Suboxone treatment program, can increase the risk of overdose.
Polydrug Use & Adverse Interactions
Concurrent use of Suboxone with certain other drugs, particularly sedatives, central nervous system depressants, and potent opioids including fentanyl, increase the risk of a suboxone overdose.
A number of other drugs are known to interact with Suboxone with more or less serious outcomes.
Drugs that are known to have negative effects when taken with Suboxone, potentially including an increased risk or severity of overdose, include:
- drinking alcohol (ethanol)
- benzodiazepines, including alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and others
- St. John’s wort
- certain antibiotics, including clarithromycin, and erythromycin
- certain antifungal medications, including fluconazole, ketoconazole, and itraconazole
- certain antidepressants, including fluoxetine (Prozac) and phenelzine (Nardil)
- protease inhibitors, including indinavir, ritonavir, saquinavir, lopinavir
Symptoms Of A Suboxone Overdose
A suboxone overdose will likely generate the same symptoms as other opioid overdoses, and may include:
- blurred vision
- nausea and vomiting
- pinpoint pupils
- blue colored lips and fingertips
- loss of physical coordination and muscle control
- abdominal pain
- depressed breathing
- slowed heartbeat
- impaired cognition, concentration, and memory
If you suspect that you or someone around you has overdosed on any opiate/opioid medication or drug, including Suboxone, you should immediately call 911.
Respiratory depression caused by an opioid overdose can rapidly cause oxygen starvation and brain damage or death without prompt medical attention.
If you have naloxone, which is sold under the brand-name Narcan and carried by first responders, you should administer it.
This is the same medication included in Suboxone to discourage tampering and abuse, but naloxone has a much shorter half-life than buprenorphine and may wear off long before the effects of the overdose.
Suboxone & Medication-Assisted Treatment
Both methadone and buprenorphine are approved for the treatment of opioid dependence in a treatment approach known as medication-assisted treatment (MAT). Both can alleviate withdrawal symptoms and cravings, while blunting the effects of other opioids.
But unlike methadone, which is generally only administered on-site at specialized methadone clinics due to its considerable potential for abuse, Suboxone is considered to be safe enough that it can be prescribed and distributed at outpatient medical offices.
Suboxone is produced as sublingual films or tablets, which means that the medication is placed under the tongue and allowed to dissolve. It is typically taken once per day at the same time each day.
While some do misuse Suboxone in large doses for the pleasurable effects of the buprenorphine, research suggests that illicit Suboxone is more often obtained with the intention of self-treating opioid dependence.
While Suboxone is an important and valuable drug for the treatment of opioid use disorder, it has its risks, including certain side effects, the risk of Suboxone addiction, potential for abuse, and unpleasant Suboxone withdrawal symptoms that will occur if a person stops using the drug.
If you or your loved one need support from qualified addiction treatment experts, please contact Northeast Addictions Treatment Center today.
- Food and Drug Administration (FDA) — SUBOXONE® (buprenorphine and naloxone) sublingual film
- Journal of Addiction Medicine — Illicit Use of Buprenorphine/Naloxone Among Injecting and Non Injecting Opioid Users
- Substance Abuse and Mental Health Services Administration (SAMHSA) — Buprenorphine
- Substance Abuse and Mental Health Services Administration (SAMHSA) — Opioid Overdose Prevention TOOLKIT, Five Essential Steps for First Responders
Northeast Addition Editorial Team
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This page does not provide medical advice.