How is Suboxone Abused?

The opioid and heroin crisis has killed more people in the U.S. than the Vietnam War. Opioid addiction and abuse have reached epidemic proportions and are devastating entire communities across the country. Unfortunately, opiate derivatives and heroin are so addictive that it is one of the most difficult drugs to quit, and it is also incredibly dangerous.

Prescription drugs like Suboxone have helped thousands of people abstain from using opiates and heroin. But although these drugs have saved many lives, they do have a dark side. Is it possible to abuse Suboxone, and who is most at-risk of abuse? Let’s find out!

What is Suboxone?

Suboxone is a prescription medication that combines opioid-blocking drugs buprenorphine and naloxone. These two substances are opioid agonists and antagonists. It is used to treat opioid and heroin addiction, helping people avoid relapse and overdose. The medication can be prescribed in either a pill form or a film strip that is placed under the tongue and dissolved. When people take Suboxone as prescribed under the care of a doctor, it can reduce opioid cravings and alleviate withdrawal side effects, but the drug does have a potential for abuse and addiction.

How does Suboxone work to treat opioid addiction?

Humans have naturally-occurring opioid receptors in the brain. When a person takes an opiate derivative or abuses heroin, these receptors are activated. Activation produces a euphoric high and an analgesic effect. It’s incredibly easy to become addicted to the feelings and sensations that opioid drugs produce. On top of that, the human body quickly develops a tolerance to opioid medications, and they will need more and more to get the desired effect.

Unfortunately, this short window where tolerance forms makes a person physically and psychologically addicted to the drug. Withdrawal symptoms for opioids are incredibly painful and distressing. Opioid addicts also experience some of the most intense cravings to use the drug. An opioid relapse is also incredibly dangerous and puts the user at high-risk of overdosing and dying. What medications like Suboxone do is they interact with the body’s opiate receptors in four distinct ways.

1. Suboxone binds to the opioid receptors in the brain, which cuts down on a user’s cravings for the drug and withdrawal symptoms during detox.

2. Suboxone is considered a partial “agonist,” meaning it does excite the opioid receptors in the brain, although this activation is minimal. However, the brain is tricked into being satisfied with the amount of opioid activation that Suboxone induces. Users won’t feel the physical withdrawal and dependence symptoms associated with their addiction.

3. The medication also adheres to the brain’s opioid receptors, so if a person does relapse and takes an opioid, Suboxone will block the high associated with the drug. Suboxone binds to and blocks the receptors for several days after taking the medicine.

4. Suboxone also prevents overdose deaths. As a partial agonist, it has a ceiling for how much it interferes with a person’s breathing.

How is Suboxone abused?

Although Suboxone is used to overcome opioid addiction, it can still be abused. People who are prescribed Suboxone may take far more of the drug than prescribed to get an opiate high. Sometimes, people will abuse Suboxone recreationally if they get it from a friend or a dealer. Places in the U.S. that already experience high-rates of opioid and heroin abuse also report Suboxone abuse and addiction.

Suboxone is abused when the pills are snorted, or the film strips are dissolved and then injected. When someone injects Suboxone, they risk sharing dirty needles and contracting HIV or another bloodborne illness. Injecting Suboxone also causes a much more intense high than snorting the pills. Also, Suboxone film strips are easier for people to smuggle or hide, increasing rates of abuse for the film strips. Investigators have also found that doctors who were sanctioned for prescribing more opioid painkillers than is legal where also prescribing too many Suboxone film strips. These doctors were fined, but unfortunately, the damage was already done in their communities.

Who is most likely to abuse and become addicted to Suboxone?

The high a person gets when they snort or inject Suboxone is not as intense as injecting heroin. What researchers have found is that people who are recovering from a heavy dependence on heroin are the least likely to abuse Suboxone. However, people who are in recovery for a less intense or short-lived addiction to painkillers are the most likely to abuse Suboxone. It’s possible that since the high a person gets abusing Suboxone isn’t early as severe as heroin high, and past heroin users are not as likely to become addicted to Suboxone.

Suboxone Abuse Statistics

Given that some people may abuse Suboxone strips, researchers have conducted studies to determine the nature of Suboxone abuse. A recent review of the research revealed that most people who misuse Suboxone do so to try to stop using other opioid drugs, like heroin, or alleviate opioid withdrawal symptoms. Only a small portion of people who abuse Suboxone do so to get high, which suggests that many people need Suboxone treatment, provided under the care of a doctor, but a significant portion cannot receive this type of treatment. Ultimately, they resort to misusing Suboxone on the streets.

One study in the review revealed the following Suboxone abuse statistics:

  • 4 percent of people in the study indicated that Suboxone was their primary drug of abuse.
  • 15 percent of study participants said that Suboxone was cheaper compared to other drugs.
  • 63 percent of those in the study said that they used Suboxone illegally to help them remain abstinent from other drugs.
  • Half of the study sample indicated that their motive for Suboxone abuse was pain relief.
  • A third of people in the study used Suboxone to cope with psychological issues.

Given these findings, what can be inferred is that only a small portion of people who use Suboxone not prescribed by a doctor do so to get high or to abuse the drug legitimately. Most people are either attempting to stop using stronger drugs or treat physical or psychological pain. This means that Suboxone abuse can largely be attributed to lack of access to legitimate medical or psychiatric care.

What are the signs of Suboxone abuse and withdrawal?

People who abuse and are addicted to Suboxone will exhibit similar symptoms to heroin or opioid addiction. Some of the most common Suboxone addiction symptoms include:

  • Secretiveness
  • Shopping around for additional prescriptions
  • Stealing prescriptions from friends or family
  • “Losing” prescriptions to get more drugs
  • Taking more than is prescribed
  • Mixing the medication with other drugs or alcohol to get a more intense effect
  • Appearing sedated or drowsy
  • Nausea and vomiting
  • Feeling physically or emotionally numb
  • Experiencing constipation
  • Slowed breathing
  • Impaired cognition
  • Looking high or otherwise intoxicated

What are the Suboxone withdrawal symptoms?

  • Sweating and shaking
  • Moodiness and depression
  • Irritability
  • Fatigue
  • Problems sleeping
  • Rapid heart rate
  • Flu-like symptoms
  • Intense cravings to use Suboxone
  • Aches and pains
  • Stomach upset

How long do Suboxone strips stay in your system?

Another important consideration when assessing the impact of Suboxone abuse and withdrawal is how long Suboxone stays in the system. The answer depends on how much Suboxone a person has taken and individual factors like age, overall health, and metabolism. That being said, drug testing laboratories report that buprenorphine, the main chemical in Suboxone, can be detected in the urine for up to a week, whereas metabolic byproducts of the drug can remain for as long as two weeks. If you have been consistently taking Suboxone, it may be detected on a urine drug screen for two weeks after you stop using.

It is also useful to consider the half-life of Suboxone, which has been found to range from about 28 to 37 hours, equal to a day or a day and a half. This means that it takes several days for Suboxone to clear out of the system, leading to a longer urine detection window. While this may not be the best of news for those looking to pass a drug screen, it does mean that Suboxone withdrawal is less severe than withdrawal from stronger opioids like heroin. In fact, a series of case studies of individuals who abruptly stopped taking Suboxone showed that they experienced only mild withdrawal. This is promising for those misusing Suboxone to get high or alleviate physical pain or psychological distress. 

How is Suboxone addiction treated?

Suboxone addiction is treated in the same way as other drug addiction issues. The most effective treatment options include integrated plans that utilize the expertise of a medical team consisting of doctors, therapists, drug abuse counselors, mental health advocates, and social workers. People who abuse drugs need intense and well-managed follow-up care, and maintenance plans to help them avoid a relapse. They will also need support and encouragement from family and loved ones to maintain sobriety. Ongoing therapy sessions also enable those in recovery to avoid relapse triggers and stay healthy.

Are you or a loved one struggling with Suboxone addiction? It’s never too late to get help. Please contact the experienced drug addiction counselors at Mission Harbor today to explore your treatment options.


Updated 5/30/21

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