Suboxone has two components: buprenorphine and naloxone. While buprenorphine is a partial opioid agonist, it is not generally a drug of abuse. Naloxone is designed specifically to deter users from abusing the drug by snorting or injecting it.[2,3]
Suboxone should only be taken as prescribed and in the dose recommended by the doctor.
If you are concerned about your ability to stick to your medication-assisted treatment (MAT) regimen or if you would like to start taking Suboxone as a way out of active opioid addiction, contact your doctor. If you have snorted Suboxone and are experiencing adverse effects, seek emergency medical help.
Will Snorting Suboxone Get Someone High?
No, snorting Suboxone will not get you high. There are multiple mechanisms in place within the chemical makeup of the medication to ensure that anyone who attempts to abuse the drug in this manner will not get high and will be pushed into full-blown opioid withdrawal, characterized by extreme withdrawal symptoms.[4]
What Happens to the Body When You Snort Suboxone?
Both components in Suboxone work together to stop anyone from abusing the medication. Each one has its own unique mechanism, and each one can be differently disruptive to the body if someone tries to snort it.
Buprenorphine
The buprenorphine in Suboxone is a partial opioid agonist.[5] This means that it binds to the opioid receptors similarly to how full opioid agonists like morphine and heroin do, but without the same level of affinity. Buprenorphine will never have as strong of an effect on the system as these full opioid agonists because it is a partial opioid agonist and it has a ceiling effect.
The ceiling effect means that no matter how much buprenorphine you ingest, it will only have a certain level of impact on the system.[6] For those who are not used to taking opioids, it may induce a small high, but for most people in recovery from an opioid addiction, it will have no impact.
Naloxone
When you crush a Suboxone tablet and snort it, you are attempting to subvert the intended chemical process that occurs when it is dissolved under the tongue. It puts too much of the medication into the system at one time (instantly, through the mucous membrane), which activates the naloxone.[7]
Naloxone is an opioid antagonist, which means it essentially throws all opioids off the opioids receptors, including buprenorphine. This leaves the person with no opioids in their system, immediately triggering what is known as precipitated withdrawal. This means the onset of severe and abrupt opioid withdrawal symptoms. For some, this can cause health issues that require medical treatment.[8] If this occurs, seek medical attention immediately.
Dangers of Snorting Suboxone
Snorting Suboxone poses several risks and can lead to complications beyond the immediate health risks that come with precipitated withdrawal.
Here are just a few of the dangers associated with snorting Suboxone:
Precipitated Withdrawal
This is often what occurs first when Suboxone is snorted.
Mechanism
When naloxone is activated, it blocks opioid receptors and stops any opioids from binding to them. Snorting the drug increases the bioavailability of the naloxone in Suboxone and potentially increase its activation, which can trigger the sudden and severe withdrawal symptoms that the person is trying to avoid by being on the medication in the first place.[9]
Symptoms
The symptoms of precipitated withdrawal can include the following:[4,11]
- Nausea and vomiting
- Diarrhea
- Muscle cramps
- Agitation and anxiety
- Yawning
- Runny nose
Tissue Damage
Suboxone tablets have been known to cause irritation to the tissue in the mouth when used as directed. Snorting the drug through the thin nasal membranes can cause serious inflammation that can lead to damage of the nasal passage, septum, and cartilage walls over time, especially if the act is repeated.
Nasal Bleeding
Irritation to the tissues in the nose can make them more delicate than they already are and lead to frequent nosebleeds.
Increased Risk of Infection
Respiratory infections and general nasal infections can result when the nasal passages are damaged, especially if there are rips and tears in the tissue that allow for the introduction of bacteria or other pathogens that ultimately can lead to infections.
No Medication Efficacy
Snorting Suboxone side steps the intended sublingual absorption, which means that it is not able to chemically respond the way it was designed to. This alteration means that the medication will not be delivered into the bloodstream the way that it should, which will negate the medication’s purpose and stop it from being effective.
Potential for Addiction
Misusing Suboxone by snorting it is indicative of the behaviors that characterize an active opioid use disorder. Ongoing issues with drug abuse and addiction demonstrate that a change needs to be made in the treatment program that address underlying compulsive behaviors. If those changes are not made, it may be a sign that the person is on the road to returning to active addiction with an increased risk of overdose and death.[10]
Social & Legal Consequences
Abusing Suboxone during recovery can be traumatizing to the relationships that the person is attempting to rebuild after active addiction. The trust-building process will be broken down, which can make it more difficult to return to active recovery. In some cases, if sobriety was a requirement for employment, it can mean losing a job.
Additionally, if there are legal contingencies placed on maintaining the rules of a treatment program or remaining sober, the attempt to abuse Suboxone can potentially have repercussions that are costly in terms of freedom and/or finances.
Get Help if Snorting Suboxone
If you are taking Suboxone as a part of a medication regimen and you are having a hard time staying the course, reach out to your prescribing physician and ask for help. Relapse isn’t a failure; it’s often part of recovery, but it’s a clear sign that you need assistance.[12,13]
By reaching out for help, you’re taking the first step to a return to sustained recovery. With the right tools, you can get back on track.
- Poliwoda S, Noor N, Jenkins JS, et al. Buprenorphine and its formulations: a comprehensive review. Health Psychology Research. 2022;10(3).
- Buprenorphine quick start guide. Substance Abuse and Mental Health Services Administration. Accessed March 29, 2024.
- Naloxone. Substance Abuse and Mental Health Services Administration. Published September 18, 2023. Accessed March 29, 2024.
- Dunn KE, H. Elizabeth Bird, Bergeria CL, Ware OD, Strain EC, Huhn AS. Operational definition of precipitated opioid withdrawal. Frontiers in Psychiatry. 2023;14.
- Virk MS, Arttamangkul S, Birdsong WT, Williams JT. Buprenorphine is a weak partial agonist that inhibits opioid receptor desensitization. Journal of Neuroscience. 2009;29(22):7341-7348.
- Walsh SL, Preston KL, Stitzer ML, Cone EJ, Bigelow GE. Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clinical Pharmacology and Therapeutics. 1994;55(5):569-580.
- Yokell M, D. Zaller N, C. Green T, D. Rich J. Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: An international review. Current Drug Abuse Reviews. 2011;4(1):28-41.
- FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. US Food and Drug Administration. Published December 20, 2019. Accessed March 26, 2023.
- Middleton LS, Nuzzo PA, Lofwall MR, Moody DE, Walsh SL. The pharmacodynamic and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/ naloxone tablets in opioid abusers. Addiction. 2011;106(8):1460-1473.
- De Sousa A, Kadam M, Sinha A, Nimkar S, Matcheswalla Y. A comparative study of factors associated with relapse in alcohol dependence and opioid dependence. Indian Journal of Psychological Medicine. 2017;39(5):627.
- Oakley B, Wilson H, Hayes V, Lintzeris N. Managing opioid withdrawal precipitated by buprenorphine with buprenorphine. Drug and Alcohol Review. Published January 21, 2021.
- DiClemente CC, Crisafulli MA. Relapse on the road to recovery: Learning the lessons of failure on the way to successful behavior change. Journal of Health Service Psychology. 2022;48(2):59-68.
- Compton WM, Volkow ND. Extended-release buprenorphine and its evaluation with patient-reported outcomes. JAMA Network Open. 2021;4(5):e219708.
