Suboxone is a combination of a synthetic opioid called buprenorphine and naloxone, a synthetic opioid overdose rescue drug. Naloxone’s close chemical cousin naltrexone is also used in some MAT opioid maintenance programs, often in long-acting injectable form under the brand name Vivitrol. How long does Suboxone last after the first dose? You may be wondering about this, and you probably also have some other questions. This article will serve as a complete guide about both the benefits and the drawbacks of Suboxone.
Suboxone and Subutex: What’s the Difference?
Buprenorphine is also available under the brand name Subutex, which contains only buprenorphine as an active ingredient. Subutex is a sublingual pill, which means it’s placed under the tongue and allowed to dissolve there. Combination product Suboxone is supplied as a small orange strip intended to dissolve in the mouth. Both Subutex and Suboxone must be taken sublingually because buprenorphine is poorly absorbed when swallowed due to its low BA profile. BA stands for bioavailability, which is a measurement of how much of a particular drug’s dose is absorbed by the body by various ROAs or routes of administration. Suboxone contains naloxone; Subutex does not.
MAT: Medication-Assisted Treatment
Buprenorphine is an ideal medication for opioid MAT for several reasons:
- It’s a partial agonist, not a full one
- It has a very wide therapeutic margin
- It causes little to no euphoria, especially in people with existing high opioid tolerance levels
- It’s strong enough to relieve withdrawal symptoms most of the time
- Buprenorphine has a very long half-life and needs to be taken only once every 24 hours
Although any opioid will relieve opioid withdrawal symptoms, only two are legally approved for this purpose in the United States, buprenorphine and methadone. Both have very long half-lives, which means the drug’s effects last much longer than usual. A drug’s half-life refers to how long it takes for the body to fully metabolize half of the amount taken. For example, most opioids have half-lives of approximately a few hours. This means that after that period of time, only half the dose taken is still available, so to maintain the effect, more of the drug will be needed.
The Half-Life of Buprenorphine
Buprenorphine has a half-life of about 24 to 36 hours. This time period can vary from person to person, but at least some of the drug’s effects will definitely persist for at least 24 hours because the body cannot eliminate even half the dose any faster than that. This long half-life makes buprenorphine and methadone, too, excellent choices for MAT. Both Suboxone and Subutex will relieve opioid withdrawal symptoms and keep drug cravings at bay for at least 24 hours, so they need be taken only once a day. Neither buprenorphine nor methadone produce much of other opioids’ typical subjective effects. This means they don’t make the user feel high. Instead, they just feel normal and can safely go about their day, performing a job, going to school or caring for children and family.
Suboxone and Subutex vary only by Suboxone’s added ingredient, naloxone. The naloxone is present to discourage intravenous abuse of the buprenorphine. Although oral buprenorphine is highly unlikely to produce any kind of high, buzz or euphoria, especially in someone already tolerant to opioids, the same may not be true for intravenous use. To prevent possible buprenorphine abuse, naloxone is included. The small amount present will not have much effect when the medication is taken by mouth as directed. However, if it’s dissolved in water and injected intravenously, the naloxone will compete with the buprenorphine in the brain, preventing any kind of high and probably causing profound opioid withdrawal symptoms to boot.
Beginning Suboxone: the Limitations
Your first dose of Suboxone will last as long as any other dose: It will be somewhere between 24 to 48 hours on average. However, Suboxone can remain active on the brain’s opioid receptor sites for as long as 72 and even 96 hours. Before beginning Suboxone therapy, you must not have taken any kind of opioid for at least the previous 24 hours. This 24 hours is a minimum figure; it could be longer. If you take buprenorphine any sooner than that, it can conversely produce severe withdrawal symptoms. This reaction is known as precipitated withdrawal syndrome or PWS.
If you’d like more information about Suboxone treatment, we can help. You will need to find a specially licensed doctor to prescribe this medication for you, although you can fill it at any pharmacy. Just call us anytime at 833-497-3812, and a member of our professional drug counseling staff will help you find a Suboxone program near you.