Key Points

• No, buprenorphine is not the same as Suboxone; however, buprenorphine is one of the ingredients found in Suboxone (buprenorphine and naloxone).
• Suboxone contains two drugs -- buprenorphine and naloxone -- and is approved to treat opioid dependence, also called opioid use disorder (addiction to opioid drugs, including heroin and narcotic pain medicines). It is available as a dissolvable film that is placed under the tongue or in the cheek area and given once a day.
• Buprenorphine is an opioid (or narcotic) medication used to treat opioid dependence or for moderate-to-severe pain. Naloxone is an opioid antagonist added to buprenorphine to block the effects of the opioid medication.
• Suboxone is used to treat opioid dependence only and is not approved for use as a pain medication.

How does Suboxone come?

Suboxone comes as a sublingual (under the tongue) film. The ingredients in Suboxone include buprenorphine and naloxone. The brand name Suboxone sublingual tablets have been discontinued by the manufacturer, but are still available in a generic form.

Buprenorphine is a partial agonist at the mu-opioid receptor, which means it activates this opioid receptor to a lesser extent than full opioid agonists (like oxycodone or morphine, for example). It is also an antagonist at the kappa-opioid receptor, which means it blocks this receptor.

Naloxone is a pure opioid antagonist that competes with and displaces opioids at opioid receptor sites. It is often added to drugs used to treat opioid dependence to help prevent abuse of the product.

Other brand names for drugs used for opioid dependence that contain both naloxone and buprenorphine include:

• Bunavail (buccal film)
• Zubsolv (sublingual tablets)

Brand names examples of single ingredient buprenorphine products approved to treat opioid dependence include:

• Probuphine (subdermal implant)
• Sublocade (subcutaneous, extended-release injection)

Do not switch from Suboxone sublingual film to other medicines that contain buprenorphine without speaking with your doctor. The amount of buprenorphine in a dose of Suboxone sublingual film is different from other medicines that contain buprenorphine. The doses that you need and that your doctor prescribes may be different.

Learn more: Does Suboxone help with pain?

How is Suboxone used in opiate dependence?

Suboxone is commonly used as part of a Medication Assisted Therapy (MAT).

Medication Assisted Therapy is used in patients with Opioid Use Disorder (OUD) for long-term maintenance to help prevent a relapse after a medically-supervised withdrawal (or detoxification). It is used in patients with opiate dependence.

• Medication Assisted Therapy (MAT) combines approved medications with counseling and support. A multi-pronged approach to treatment can be more successful in patients with OUD and help prevent relapses.
• MAT can help patients remain free of drug dependence on opiates (often called narcotics) by blocking the euphoria (the high) that is experienced.
• MAT can improve the safety of treatment, as well: patients who lose their opioid tolerance are at risk of fatal overdoses if they return to opioid use, so medical supervision can be life-saving.
• Methadone, buprenorphine, buprenorphine / naloxone, and naltrexone (Vivitrol) are all medications approved for MAT.

Does naloxone cause a “high”?

Naloxone is a full opioid antagonist that blocks opioid receptors in the brain. It is not a controlled substance and does not cause a “high”.

You may have heard of naloxone as the brand name product Narcan or Evzio. Naloxone is a pure opioid antagonist that competes with and displaces opioids at opioid receptor sites. Narcan is used to reverse slowed or stopped breathing that can occur with an opioid overdose. Naloxone, when added to buprenorphine, blocks the effects of the opioid medication, including pain relief or feelings of euphoria (the “high”) that can lead to opioid abuse.

In fact, naloxone is used in certain buprenorphine products to deter misuse by crushing, dissolving, or injecting the oral formulations. Buprenorphine is itself an opioid, and some people will attempt to get high by tampering with Suboxone and abusing it. Naloxone, if injected or used as a film as part of Suboxone, would cause an opioid withdrawal syndrome in those dependent on opiates before the effects of other opioids have subsided.

Injecting Suboxone film may also cause death, overdose, life‐threatening breathing problems or infections and other serious health problems.

Is Suboxone used for maintenance treatment in OUD?

Yes, maintenance treatment may be started with Suboxone after a medically-supervised opioid withdrawal (also called a detoxification).

Suboxone (buprenorphine and naloxone) is a dissolvable film given as a single daily dose. For maintenance treatment, Suboxone film may be given sublingually (under the tongue) or buccally (between the check and gum).

The recommended target dosage of Suboxone sublingual film during the maintenance phase is 16 mg buprenorphine and 4 mg naloxone per day as a single daily dose.

Bottom Line

• Buprenorphine is not the same as Suboxone; Suboxone is a two-ingredient drug used to treat opioid dependence.
• Buprenorphine is an opioid agonist used to treat opioid dependence OR for treatment of moderate-to-severe pain. However, Suboxone is not used to treat pain.
• Naloxone is a pure opioid antagonist that blocks opioid receptor sites. It is often added to drugs used to treat opioid dependence to help prevent abuse of the product.

This is not all the information you need to know about Suboxone (buprenorphine and naloxone sublingual film) for safe and effective use. Review the full Suboxone information here, and discuss this information with your doctor or other health care provider.