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How Do Suboxone Programs Work?

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

January 17, 2019

Suboxone is a medication used to reduce or alleviate withdrawal symptoms from heroin or other strong opioids. It can also be used as a maintenance medication for individuals recovering from an addiction to opiates.

Suboxone’s primary ingredient, buprenorphine, is one of the most common, evidenced-based medications used to treat opioid addictions. When used as part of medication-assisted treatment (MAT), within a comprehensive inpatient drug rehab program, Suboxone can be a critical component of recovery from opioids.

Suboxone is prescribed to individuals in both an in an inpatient rehab setting and through outpatient clinics where a doctor prescribes a maintenance dose of the drug.

What Is Suboxone?

Suboxone is a combination medication used to treat opioid dependence and addiction. Delivered as a sublingual film, it contains two drugs, buprenorphine, and naloxone.

Buprenorphine is a partial opioid agonist, which means that it elicits a milder opioid effect than full agonists like heroin and methadone. Because of these characteristics, and the fact that it’s a long-acting medicine, buprenorphine is a first-class medicine for treating opioid dependence and addiction.

When used as prescribed, naloxone creates no noticeable effect. However, Naloxone is added as an abuse-deterrent to discourage people from diverting and misusing the drug.

Medication-Assisted Therapy

Medication-Assisted Therapy (or Treatment) is defined as “the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders” such as opioid addiction.

Methadone Maintenance

Up until the early 2000s, Methadone was the only approved medication used to treat opioid addiction on an ongoing basis. Individuals wanting to be a part of a program at a Methadone Clinic would have to go almost every day to get their daily dose.

Many people choose to partake in a Methadone program to this day as it helps them stay clean from other opioids. One of the downsides is these types of programs is that it is often time-consuming to go to a clinic every day and wait in line to get medicine. It also prevents individuals from traveling to places without a methadone clinic.


When buprenorphine was approved as a treatment for opioid addiction, it offered individuals struggling with an alternative to visiting a methadone clinic on a daily basis. Instead, they could go to a certified doctor and get up to a month’s supply of the medication. The ultimate goal of the program would be weaned off the medication at some point down the road. The average length someone is on a medication like Suboxone is approximately two years.

While medications are a huge part of treating opioid addiction, they aren’t the only tool necessary for effective and long-lasting results. Research shows that combining medications with behavioral therapies and counseling, the foundation behind medication-assisted treatment or therapy offers people a higher chance at a solid recovery.

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Why Does Suboxone Work To Treat Opioid Dependence And Addiction?

Our bodies and brains have naturally-occurring opioid receptors. These sites accept external (exogenous) opioids like heroin and prescription painkillers, which creates these drug’s hallmark euphoria and pain relief. During chronic use, our bodies stop producing our own versions of opioids and instead become reliant on these exogenous drugs. This is termed a physical dependence.

Due to buprenorphine’s properties as a partial opioid agonist, Suboxone can fill these receptor sites. But it does so without the intense euphoria and respiratory depression associated with the drug of abuse. While Suboxone does have a potential for abuse, it’s made significantly less by buprenorphine’s attributes and the addition of naloxone. You are also offered greater protection from the risk of misuse and diversion by choosing the support and care of a good treatment program.

Buprenorphine-based drugs offer the following benefit when used as medication-assisted treatments for opioid dependence and addiction:

  • Limited euphoria and respiratory depression
  • Lower potential for misuse
  • Low risk of overdose and greater safety should it occur
  • Reduces the impact of physical dependence (decreases withdrawal symptoms and cravings)

Additionally, “Buprenorphine’s opioid effects increase with each dose until at moderate doses they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects,” as detailed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Further, “because of buprenorphine’s long-acting agent, many patients may not have to take it every day.”

How Is Suboxone Used To Treat Opioid Use Disorders?

Suboxone is a pharmacotherapy. Pharmacotherapies are used for three purposes within treatment for opioid use disorders:


Withdrawal from opioids can become severe and painful. Used within a medical detox, Suboxone can reduce or alleviate symptoms of withdrawal. A gradual taper of the drug works to decrease these symptoms while your body cleanses the drug of abuse from its system.

Relapse Prevention

During withdrawal, you can experience overwhelming urges (cravings) to use the drug. Suboxone can reduce the severity of these feelings so that you can focus on progressing to the next step of treatment. When used illicitly, the naloxone can precipitate, or bring on withdrawals. The addition of this in Suboxone encourage users not to relapse.

Choosing to be on Suboxone doesn’t mean you’re trading one addiction for another, or that you’re not truly sober because you’re using it. It means that you’re committed to your recovery and giving yourself the best chance at a drug-free life.

We Can Help You Find A Suboxone Program

If you’d like to learn more about opioid dependence and addiction, and the ways that a Suboxone program could work to help you overcome these things, contact us now. can walk you through a confidential assessment so that we can begin building a treatment plan today.

Substance Abuse and Mental Health Services Administration - Medication and Counseling Treatment

US National Library of Medicine - A Guide to Substance Abuse Services for Primary Care Clinicians.: Appendix A—Pharmacotherapy

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