Suboxone is a high-dose formulation of buprenorphine in 2mg up to 8mg doses containing 0.5mg and 2mg naloxone, respectively. This opioid agonist-antagonist formulation is designed for the medication assisted treatment of opioid dependence as an alternative to methadone. The other, less common use of suboxone is to provide analgesia. Prior to introducing suboxone on the market, opioid dependence could only be treated at licensed methadone clinics. The introduction of this schedule 3 medication allows private doctors to prescribe treatment to patients dependent on heroin and other illicit opioid drugs, making the treatment for
opioid dependence available to more patients by removing the stigma associated with attending
methadone clinics.
Administration of Suboxone Treatment
Suboxone is available in sublingual film or sublingual tablet form with different strengths. This form of administration allows the active ingredients to be absorbed through the oral mucosa into the bloodstream, where it is taken up to the brain opioid receptors. The film or the tablet is put under the tongue to dissolve naturally with saliva and should not be swallowed or chewed.
So what happens when you accidentally swallow the tablet before it dissolves under the tongue? If the suboxone pills are swallowed or chewed, the active ingredient buprenorphine will not be absorbed into the bloodstream. Without absorption, the effects of the medication will be suppressed, and you will not experience relief from the opioid withdrawal symptoms. So, can you swallow suboxone pills? Yes, but it will negate the action of the medication.
You may want to swallow suboxone rather than allow it to dissolve in the mouth because of the chalky residue that remains after the medication has dissolved. Once the tablet or film has completely
dissolved, you may either swallow or spit out the chalky residue and rinse out your mouth with water.
The neat trick when taking suboxone is to drink some water before placing the tablet under the tongue. This will provide more moisture and allow faster dissolution of the medication. It would be best if you also refrained from speaking during the five to ten-minute period the tablet takes to dissolve and completely absorb the active ingredients. If the medication is not absorbed, the efficacy will be reduced, and you will not feel the desired effects or reduced withdrawal symptoms. Especially if the dose is swallowed, no further replacement dose will be available until the next scheduled dose can be taken.
Mechanism of Action of Suboxone
The buprenorphine component of suboxone works by exerting an agonistic effect on the mu and delta opioid receptors in the brain while at the same time having an antagonistic effect on the kappa opioid receptors. The naloxone component is a potent opioid antagonist and produces opioid withdrawal symptoms in individuals dependent on injectable opioids. If you crush the tablet and inject it instead of putting it under your tongue, the naloxone component will worsen your withdrawal symptoms.
These opposing actions of the medication components dictate that the treatment with suboxone is started once you exhibit mild to moderate withdrawal symptoms. The treatment should not be initiated while you are still using because you may experience severe withdrawals. When you are already
experiencing withdrawal symptoms, taking suboxone will make you feel better.
The medication usually takes a few days for the effects to stabilize. If you continue to use opioids while taking suboxone, the time it takes for the medication levels to become stable is extended.
How to take suboxone?
Rinse your mouth out with water before you place the tablet under your tongue or inside your cheek. Let it dissolve naturally. Do not chew, talk or take anything else into your mouth while the tablet is
dissolving to achieve the best effects. As the medication is absorbed into your system, you will feel relief from withdrawal symptoms within 30 to 60 minutes. The tablet is placed under the tongue because it has two large veins running on the underside that will absorb the medication and, via the bloodstream, take it to the brain to bind the opiate receptors.
If you wonder what happens when you swallow suboxone and whether can you swallow suboxone pills instead of placing them under your tongue? The answer to both questions is yes, but you should not do it. The only thing that will happen is that the medication will not work properly.
It is important to take this medication as prescribed by your doctor to help you relieve the severe effects of opioid abuse.
Caution About Using Suboxone
This medication can increase the potency of other drugs that cause drowsiness. Like alcohol,
antihistamines (allergy medication), and antidepressants. Make sure that you tell your health care provider that you are using suboxone to ensure that you receive proper monitoring if you need to use any of these medications for other problems. Also, remember not to take any other medications without telling your doctor because these drug combinations can turn out to be lethal.
The new drug suboxone was introduced to offer an alternative to methadone as the only treatment for drug addiction. The medication should be taken sublingually. It helps to reduce withdrawal symptoms and reduces cravings for other opiates. Being available through your general practitioner makes it much easier to obtain and fight your opioid drug addiction.
Sources
- https://www.albertahealthservices.ca/assets/programs/ps-1000286-odp-suboxone.pdf
- https://reference.medscape.com/drug/suboxone-zubsolv-buprenorphine-naloxone-343334
- https://emedicine.medscape.com/article/1641147-treatment
