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What Happens if You Use While on Sublocade?

If you use while on Sublocade, you could face respiratory depression, extreme sedation, digestive distress, overdose, or a relapse. 

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In other words, if you use while on Sublocade, you could face many of the same risks associated with your opioid use disorder (OUD), including death from opioid overdose

If you’re tempted to layer opioids on your Sublocade, talk to your doctor. You may need a different OUD medication, perhaps at a higher dose, to keep your addiction under control. 

Dangers of Using While on Sublocade 

Sublocade is a prescription medication that is FDA-approved for OUD treatment.[2] It contains buprenorphine, a partial opioid agonist, that can ease cravings for drugs like heroin and oxycodone. Combining it with other drugs can lead to serious health problems, such as the following: 

Respiratory Depression 

Buprenorphine in Sublocade is a central nervous system (CNS) depressant. At high doses, it can slow your breathing rate. In one study of people who were exposed to buprenorphine products, 11.3% experienced respiratory depression while taking buprenorphine alone, and 11.9% experienced this symptom when combining buprenorphine with another drug.[1] 

Taking two CNS depressant drugs is much more dangerous than taking just one. While you might feel just drowsy or sleepy on Sublocade, you could be unconscious when you combine it with another drug. 

Extreme Sedation 

The FDA says sedation is a common Sublocade side effect.[2] Even people who are taking the drug as prescribed can feel a little sleepy and slow as their bodies adjust to the drug. 

Combining Sublocade with another drug can worsen this side effect. You may fall asleep and stay that way, even when you’re shaken or slapped. If you experience this side effect while doing something dangerous (like driving), you could seriously hurt (or even kill) yourself or someone else. 

Digestive Distress

Opioid drugs, including buprenorphine, can cause changes in your digestive system. Many people who take these drugs have symptoms like the following:[3]

  • Constipation 
  • Anorexia 
  • Nausea
  • Vomiting 
  • Abdominal pain 
  • Flatulence
  • Bloating
  • Hard stool 
  • Retained stool 

Combining Sublocade with another opioid (like heroin or oxycodone) could worsen these side effects. Some people feel just uncomfortable due to their digestive changes, but symptoms like retained stool can require medical help. Without it, you could experience severe health problems that don’t get better without treatment. 

Overdose Death 

Buprenorphine has a ceiling effect, meaning that it doesn’t cause more respiratory depression at higher and higher doses. However, it is possible to take too much of the drug. Combining it with another CNS depressant drug is even more dangerous. 

In one study of more than 74,000 opioid-involved overdose deaths, buprenorphine was found in 2.6%. Among those deaths, 92.7% involved at least one other drug.[4]

Studies like this suggest that combining medications with Sublocade with another drug can dramatically increase your risk of dying from an overdose. 

Relapse to OUD 

If you’re using drugs with Sublocade, you’re not addressing your OUD per your doctor’s instructions. 

In one study of Sublocade’s efficacy, 75.3% of people with moderate to severe OUD were abstinent from illicit opioid drugs for a year after they completed 12 Sublocade injections.[5] Studies like this suggest that the medication works, but only if you follow the treatment plan. 

Taking Sublocade with other drugs just once can lead to repeating the act again and again. In time, your OUD could be back in full strength. 

Talk to Your Doctor 

If you’re wondering what happens if you use it while on Sublocade, talk with your doctor. Talk about the thoughts and feelings you’re experiencing. You may need an adjustment to your treatment plan to support your long-term health and avoid relapse. A conversation can help you to stay on track. 

Updated March 18, 2024
Resources
  1. Darracq M, Thornton S. Respiratory depression following medications for opioid use disorder (MOUD)-approved buprenorphine product oral exposures. Clinical Toxicology. 2021;59(4):303-312.
  2. Sublocade prescribing information. U.S. Food and Drug Administration. Published June 2021. Accessed February 27, 2024.
  3. Leppert W. The impact of opioid analgesics on the gastrointestinal tract function and the current management possibilities. Contemporary Oncology. 2012;16(2):125-131.
  4. Tanz L, Jones C, Davis N. Trends and characteristics of buprenorphine-involved overdose deaths prior to and during the COVID-19 pandemic. JAMA. 2023;6(1):e2251856.
  5. Gingerich C. Long-term success for extended-release buprenorphine injection. HCP Live. Published June 7, 2019. Accessed February 27, 2024.
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