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Sublocade Treatment for Opioid Use Disorder (OUD)

Sublocade is an FDA-approved injectable medication for the treatment of opioid use disorder (OUD). It can be taken once per month to support ongoing recovery and sobriety.  

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Key Facts About Sublocade

Sublocade, a buprenorphine injection, is a type of medication-assisted treatment (MAT) for people with OUD. Approved by the Food and Drug Administration (FDA) in 2017, it is a safe long-term treatment option.[1]

Key Facts

  • Sublocade is only taken once per month, making it a safe long-term medication.[1] 
  • Sublocade may better support recovery than other MAT options, as it does not need to be taken daily to be effective.[1] 
  • As a form of MAT, Sublocade is meant to be used simultaneously with participation in counseling or psychosocial therapies.[1]
  • Sublocade works by reducing cravings and withdrawal symptoms without producing the addictive highs associated with opioid abuse.[2]

Understanding Sublocade

Sublocade plays an important role in many people’s ongoing recovery from an opioid use disorder. The chart below outlines some of the specifics of Sublocade, including how it is taken and its risk of abuse.[1-4]

General UseTo help manage moderate to severe opioid use disorder in adults
Forms An injectable solution
DosageOne 100 mg or 300 mg dose per month
How It’s AdministeredOnly meant to be injected by a trained healthcare provider
Side EffectsNausea, vomiting, headaches, and pain or itching at the injection site 
When It Was FDA ApprovedNovember 2017 
Brand & Generic NamesSublocade is the brand name for generic buprenorphine extended-release injections
Drug classOpioid partial agonist-antagonist 
Potential for AbusePotential for dependence, withdrawal, and overdose 
Insurance coverageMay be covered by insurance as part of addiction treatment services that include counseling and psychosocial support

How Does Sublocade Work?

Sublocade works by being injected into the abdominal area of the body. When the solution comes into contact with bodily fluids it forms a solid mass, which allows for an extended release of the medication over time. 

It’s recommended to begin with a monthly dose of 300 mg for approximately two months, followed by a maintenance dose of 100 mg per month. Long-term use of Sublocade is considered to be safe. There is not yet a suggested treatment duration for the medication.[2] Generally, it’s believed that as long as it continues to support your recovery, there is no reason to stop using it or any other form of MAT.

Side Effects of Sublocade

As with any medication, side effects of Sublocade can be expected. Both common and serious side effects of taking Sublocade can occur and include the following:[3]

  • Constipation
  • Nausea
  • Vomiting 
  • Headache
  • Dizziness
  • Drowsiness and fatigue
  • Pain and itching where Sublocade was injected
  • Muscle aches and pain
  • Fever
  • Dilated pupils or blurry vision 
  • Tremors 
  • Heart palpitations 
  • Difficulty paying attention 
  • Breathing issues
  • Abnormal liver function
  • Skin irritation (necrosis)

Taking Sublocade under the care of a medical professional ensures proper treatment and monitoring of any negative side effects that arise. The safety of Sublocade has been established for adults, but it is not yet known for individuals under the age of 17. [1] Should you experience any negative side effects, consult with your healthcare professional, so doses can be adjusted. 

Things to Consider Before Taking Sublocade 

Before taking Sublocade, have an honest consultation with your healthcare provider about your history of drug use and any health issues you may have. Buprenorphine can have negative interactions with other substances and medications, so your doctor must be aware of all substances you are using. 

Additional tips to consider before taking Sublocade include the following:[3]

  • Report all current medications you are taking to your healthcare provider.
  • Do not mix Sublocade with alcohol, sedatives, or other drugs that can impede breathing.
  • If you are pregnant or plan to become pregnant, inform your doctor.
  • Negative side effects can occur and should be monitored and reported to your doctor. 
  • If you wish to stop taking Sublocade, speak with your doctor first, as suddenly stopping use may result in unintended withdrawal symptoms and increase the risk of relapse or overdose. [4]

It is important to remember that Sublocade is designed to be part of a greater treatment program. Sublocade alone will not cure OUD, as there is no cure for the chronic condition of addiction. However, when Sublocade is used in conjunction with participation in a comprehensive treatment program, the risk of opioid abuse and overdose is significantly reduced. The use of MAT can smooth the path to sustained recovery, often putting it within reach. 

How Much Does Sublocade Cost? 

For individuals with insurance, the cost of Sublocade may be covered as part of addiction treatment services. Medicare, for example, covers the cost of opioid use disorder treatment services, including medications such as buprenorphine.[6] Contact your insurance provider to find out exactly what addiction treatment services are covered under your insurance plan. 

As of 2019, the average cost of one Sublocade injection per month was approximately $550, or $6,600 per year, without insurance. That number is based on receiving a 300 mg dose for two months, followed by 100 mg monthly doses for maintenance. [5]

The Role of Sublocade in Addiction Treatment 

Sublocade can play an important role in helping individuals maintain sobriety from opioid abuse. Its use is indicated for people who have already detoxed and have become stabilized on a medication that contains buprenorphine. [2]

Buprenorphine medications like Sublocade reduce cravings for opioids and thus support recovery.[7] The amount of time an individual remains on buprenorphine depends on their personal situation and response to treatment.[8] Doses can be adjusted for better treatment outcomes, and treatment can last as long as necessary.[3]

Sublocade Therapy at Boca Recovery Center 

Sublocade therapy may be part of your long-term recovery plan. Sublocade can be used for long-term MAT as well as during the initial stages of treatment once a patient has stabilized following detoxification. 

Sublocade is not sufficient to treat OUD on its own, but it can play a vital role in supporting sobriety. When used in combination with psychotherapy and other treatment approaches, Sublocade can effectively support people on their recovery journeys. 

At Boca Recovery Center, we offer comprehensive addiction treatment, helping you to achieve recovery with evidence-based care, including the use of medications and therapy. Reach out today to learn more.

Frequently Asked Questions About Sublocade

These are some of the questions we hear most about Sublocade treatment for OUD:

How long does Sublocade stay in your system?

While the injection is given monthly for maintenance management of OUD, Sublocade may be detected in urine and blood drug tests for 12 months or longer after use.[9] This is the case after maintenance levels have been reached, which means treatment for at least four months. 

Does Sublocade have naloxone in it?

No, Sublocade does not have naloxone in it.

Can Sublocade cause precipitated withdrawal?

Yes, Sublocade can cause precipitated withdrawal since it contains buprenorphine. Before starting Sublocade, you’ll take a transmucosal form of buprenorphine to manage initial withdrawal symptoms.[9] 

What happens if you use Sublocade?

If you misuse opioids while on Sublocade, you may experience a range of negative effects, such as respiratory depression, decreased awareness, confusion, and severe drowsiness. It can lead to overdose, including coma and death.[10] If you are using Sublocade, your prescribing doctor should provide you with naloxone (Narcan) to use in case of overdose. 

Updated May 6, 2024
Resources
  1. FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder. U.S. Food & Drug Administration. Published November 2017. Accessed January 16, 2024.
  2. Clinical review report: Buprenorphine extended-release injection (Sublocade). Canadian Agency for Drugs and Technologies in Health. Published July 2019. Accessed February 20, 2024.
  3. Buprenorphine. Substance Abuse and Mental Health Services Administration. Published January 30, 2024. Accessed February 20, 2024.
  4. Buprenorphine sublingual and buccal (opioid dependence). U.S. National Library of Medicine. Published May 15, 2023. Accessed February 20, 2024.
  5. Pharmacoeconomic Review Report: Buprenorphine extended-release injection (Sublocade). Canadian Agency for Drugs and Technologies in Health. Published July 2019. Accessed February 20, 2024.
  6. Opioid use disorder treatment services. Medicare.gov. Accessed February 20, 2024.
  7. Poliwoda S, Noor N, Jenkins JS, et al. Buprenorphine and its formulations: a comprehensive review. Health Psychology Research. 2022;10(3).
  8. Chambers LC, Hallowell BD, Zullo AR, et al. Buprenorphine dose and time to discontinuation among patients with opioid use disorder in the era of fentanyl. JAMA Network Open. 2023;6(9):e2334540-e2334540.
  9. Sublocade: Highlights of prescribing information. Indivior. Accessed February 20, 2024.
  10. Buprenorphine extended-release injection (Sublocade). San Mateo County Health. Accessed February 20, 2024.
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