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Is Suboxone Addictive? How to Tell if Someone Has a Problem

Few people abuse Suboxone. Many cases of Suboxone “abuse” stem from people who are addicted to heroin using the drug without a prescription to get sober. Suboxone is a prescription medication used to treat opioid use disorders (OUD). Suboxone was made with abuse potential in mind. Pharmacists added an ingredient that kicks in only when someone takes too much at one time.

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How Does Suboxone Work?

A dose of heroin moves from the needle to the user’s brain. When it arrives, it links to receptors and triggers a dopamine release. Suboxone can connect to the same receptors, but it works a little differently. 

Suboxone contains two ingredients:

  • Buprenorphine: This is a weak opioid agonist. It can trigger a low level of dopamine release, but a ceiling effect keeps a high from kicking in. 
  • Naloxone: This is an opioid antagonist. Take too much of any opioid, and this medication can stop an overdose. Particles are removed from their receptors immediately. 

People using Suboxone for an OUD take doses once or twice per day on a schedule set by their doctors. They are told not to skip a dose, as it could lead to a relapse to illicit drugs. 

In 2008, when Suboxone was relatively new, doctors gave it to help people through withdrawal symptoms. They took the drug for just a few days, and when they stopped experiencing cold-like symptoms from heroin or opioid withdrawal, they stopped Suboxone too.

Early studies proved that longer stays on the medication meant better treatment outcomes. Since then, it’s not uncommon for doctors to give this medication to their patients indefinitely. 

Suboxone Abuse Is Rare

Heroin and prescription painkillers are powerful, and they deliver immense changes very quickly. Suboxone, by contrast, is much weaker, and it’s difficult to abuse. 

Buprenorphine offers partial power, so it can’t deliver a big high. Naloxone offers even more protection, as it can block opioid activation for a short period. People accustomed to the big, immediate highs of heroin or painkillers just don’t get the same rush from Suboxone

People with an OUD taking Suboxone tend to feel normal, not high. The medication blocks symptoms of withdrawal while reducing cravings.

This allows people in recovery to focus on therapy and rebuilding their lives rather than looking for another hit of drugs. They aren’t likely to abuse a weak drug that is helping them so much.

Some experts call Suboxone abuse a “myth.” They point out that anyone using this medication without a prescription is technically abusing it.

But some people with OUDs can’t get prescriptions or admission into treatment programs. So they buy Suboxone on the street in a misguided effort to get sober. They’re not trying to get high. They’re trying to get well. 

Signs of Suboxone Abuse

What about people with no history of opioid use disorder? Could they get a high from Suboxone? It’s possible, and it could be a form of drug abuse that your family overlooks. 

While almost three-fourths of people using buprenorphine don’t misuse it, some people do. And some live with other people who steal and abuse their medications. 

Physical Signs of Suboxone Abuse

Taking too much of this medication too often can cause the following:

  • Sedation
  • Narcolepsy
  • Slurred speech
  • Pinpoint pupils 

People using the drug for too long can experience withdrawal when they try to quit suddenly. Suboxone withdrawal can cause these symptoms:

  • Flu-like symptoms
  • Diarrhea 
  • Paranoia 
  • Sweating and goosebumps 

People abusing Suboxone may try to crush the pills to snort them or shoot them. Manipulating the pills in this way can cause the naloxone ingredient to take over, placing the drug user in immediate withdrawal. Someone like this may seem fine one minute and incredibly sick the next. 

Psychological Signs of Suboxone Abuse

People abusing Suboxone may keep their intoxication from you. But you may notice lifestyle or personality changes, including these:

  • Legal difficulties, such as arrests or fines
  • Neglected responsibilities 
  • Changes in friends and hangouts
  • Reduced interest in the things the person once loved 

The person may deny the drug abuse. And if caught, the person may keep using despite the consequences. 

Suboxone Safety: What You Should Know

Doctors say Suboxone is so safe that it can be given to people for months, years, or even throughout their lifespan. If you have an OUD, Suboxone is one of the best tools doctors have to help you focus on therapy and rebuild your life. It is a safe and effective form of treatment for an OUD.

If you don’t have an OUD and are experimenting with Suboxone abuse, you are in danger. You might be tempted to swap out this prescription medication for a stronger opioid, like heroin, and that could be devastating for your health and your life. 

Whether you’re abusing a prescription you have now, or you’re stealing or buying the drug to use it illegally, you need to ask for help. Medication management combined with therapy can help to ease your drug cravings, help your mind to heal, and allow you to build up a better life.

Each person’s therapy program is different, and your team can create one based on your needs and preferences. The first step is to admit that you need help. 

Updated October 13, 2023
Resources
  1. Intelligence Bulletin: Buprenorphine Potential for Abuse. (September 2004). National Drug Intelligence Center.
  2. Buprenorphine/Naloxone (Suboxone). (January 2021). National Alliance on Mental Illness.
  3. Extended Suboxone Treatment Substantially Improves Outcomes for Opioid-Addicted Young Adults. (November 2008). National Institutes of Health.
  4. Managing Opioid Addiction With Buprenorphine. (May 2006). American Family Physician.
  5. The Facts About Buprenorphine for Treatment of Opioid Addiction. (2009). U.S. Department of Health and Human Services.
  6. 5 Myths About Using Suboxone to Treat Opiate Addiction. (October 2021). Harvard Health Publishing.
  7. Trends In and Characteristics of Buprenorphine Misuse Among Adults in the U.S. (October 2021). JAMA.
  8. Buprenorphine. (August 2021). National Library of Medicine.
  9. Warning Signs of Substance and Alcohol Use Disorder. Indian Health Service.
  10. Medication-Assisted Treatment (MAT). (March 2022). Substance Abuse and Mental Health Services Administration.
  11. Suboxone: Rationale, Science, Misconceptions. (Spring 2018). The Ochsner Journal.
  12. Buprenorphine Therapy for Opioid Use Disorder. (May 2018). American Family Physician.
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