Is There a Suboxone Shot? A Detailed Guide

Suboxone is a popular medication used to treat opioid addiction and dependence. It comes in tablet and film forms that dissolve under the tongue. But is there a Suboxone shot available?

The short answer is no – there is currently no injectable form of Suboxone on the market. However, there is a similar monthly injection called Sublocade that contains the active ingredient buprenorphine. Sublocade lasts longer than Suboxone and helps manage opioid cravings and withdrawal symptoms.

Below is a comprehensive guide to Suboxone, Sublocade, and other key information on medication-assisted treatment options for opioid addiction.

Overview of Suboxone

Suboxone is the brand name for a medication that contains two active ingredients – buprenorphine and naloxone. It comes as a sublingual film or tablet that dissolves under the tongue.

Buprenorphine is a partial opioid agonist that binds to opioid receptors and reduces cravings and withdrawal symptoms. The naloxone component deters misuse if the medication is injected.

When taken properly, the buprenorphine is absorbed sublingually while the naloxone has low bioavailability and systemic effects. Suboxone has become a popular treatment option for opioid dependence because it:

• Reduces opioid cravings and withdrawal symptoms
• Provides less opportunity to get high compared to full agonists like methadone
• Allows for take-home dosing rather than requiring daily clinic visits
• Has lower risk of overdose and safer side effect profile

Suboxone is intended to be one part of a comprehensive treatment plan that includes counseling and behavioral therapies. It can be an effective intervention but does have potential for misuse and diversion if not closely monitored.

Is There an Injectable Form of Suboxone?

No, there is currently no injectable preparation of Suboxone available. Suboxone is specifically designed to be taken sublingually as a film or tablet.

Injecting Suboxone would defeat the purpose of the medication and could potentially override the safety mechanism of the naloxone component. It would also increase risks like infection at the injection site, blood vessel damage, and transmission of blood-borne illness from sharing needles.

Additionally, injecting any medication meant for sublingual use can be dangerous due to differing pharmacokinetics and bioavailability. Overall, an injectable form of Suboxone has not been developed and would not be recommended for treatment of opioid use disorders.

What About Sublocade for Injection?

While there is no Suboxone shot, there is a monthly injectable buprenorphine product called Sublocade that is FDA-approved to treat opioid dependence.

Sublocade provides sustained release delivery of buprenorphine over a 30 day period. It‘s given as a subcutaneous injection in the abdominal region by a healthcare provider.

After the first two monthly doses, Sublocade can be administered once monthly. It provides consistent levels of buprenorphine to reduce opioid cravings and withdrawal symptoms without the need for daily dosing.

Some key facts about Sublocade:

• Active ingredient is buprenorphine (without naloxone)
• Given as subcutaneous injection into fat under skin
• Steady buprenorphine levels for 30 days
• Requires less frequent dosing than sublingual Suboxone
• Helps manage opioid withdrawal and cravings
• Lower potential for misuse or diversion

Sublocade may be an option for patients who have been stabilized on low to moderate doses of Suboxone. It provides a long-acting monthly alternative to daily sublingual dosing.

How Long Does the Sublocade Shot Last?

The effects of the Sublocade injection are designed to last for one month or 30 days on average. However, the exact duration can vary based on the dosage administered as well as individual factors.

After the first month‘s injection, most patients receive a second 300 mg dose of Sublocade at the start of the next month. At this point, steady state buprenorphine levels have been reached and a once monthly maintenance dose of 100 mg can provide therapeutic effects for the full 30 days.

Some patients may be transitioned to the longer dosing interval sooner than one month if they quickly reach therapeutic levels. Others may need more time at closer dosing intervals before moving to once monthly injections.

So while 30 days is the intended duration, the prescribing doctor will determine the right dosing schedule based on clinical evaluation of each patient. Sublocade provides sustained buprenorphine levels for around a month, but ongoing assessment helps optimize the timing.

How Often Do You Get the Suboxone Shot?

The frequency of Suboxone shot administration depends on the product used and the unique needs of each patient.

As mentioned, there is no approved Suboxone injection at this time. However, the related product Sublocade can be injected on a monthly basis for sustained buprenorphine delivery.

After two initial doses given about a week apart, Sublocade is then administered once per month. So the standard dosing schedule would be:

• Initial dose
• Second dose at 1 week
• Third dose at 1 month
• Ongoing once monthly injections

This monthly schedule is the recommended maintenance regimen. However, some patients may receive the injections more frequently than once per month during the initial stabilization period under medical guidance.

The prescriber will determine the appropriate injection schedule based on the patient‘s individual opioid tolerance, level of physical dependence, time on previous buprenorphine treatment, and other factors.

More or less frequent dosing may be required initially to achieve steady buprenorphine levels. But the goal is to get to a once monthly injection protocol tailored specifically to the patient‘s needs. Ongoing communication with the healthcare provider is key to determining optimal injection frequency.

Who Qualifies for Sublocade?

Sublocade is approved by the FDA for treatment of opioid dependence in adults. To qualify, patients must meet several criteria:

• 18 years or older
• Currently stabilized on low to moderate doses of transmucosal buprenorphine equivalent to 8-24 mg per day of Suboxone for a minimum of 7 days
• Participating in counseling or medication-assisted treatment (MAT) program
• Able to understand risks and benefits of treatment

Sublocade is not recommended for use during pregnancy or breastfeeding. Patients with liver problems may need dose adjustments.

Sublocade is not intended for use in children or adolescents under 18. It has also not been studied in patients over the age of 65.

In summary, Sublocade is approved for adult patients only, who are already stable on low to moderate dose buprenorphine therapy, enrolled in counseling/MAT, and meet other clinical criteria.

It offers an alternative maintenance approach but requires responsible patient selection by the prescribing physician. Ongoing monitoring and psychosocial support are still important parts of the treatment plan.

Does the Sublocade Shot Make You Feel High?

No, the Sublocade injection does not make you feel high or euphoric when taken as prescribed. Because it contains buprenorphine without naloxone, it can produce mild opioid effects that relieve drug cravings and withdrawal sickness. But the sustained levels do not cause euphoria or sedation.

Buprenorphine is a partial opioid agonist, meaning it activates receptors enough to ease addiction symptoms but has a ceiling effect that limits the high caused by full agonists. Sublocade provides steady buprenorphine over a month.

Some patients may feel brief lightheadedness or dizziness following the injection. Nausea and headache are also possible side effects. But these sensations are not the same as getting high and tend to resolve within a few days.

Importantly, Sublocade blocks the effects of illicit opioids while preventing cravings and withdrawal. If misused by injecting or taking large doses, Sublocade could potentially cause overdose symptoms like extreme drowsiness, confusion, or respiratory depression.

Overall, when taken properly under medical supervision, Sublocade does not produce a high feeling but rather helps stabilize patients in recovery from opioid addiction.

Can Any Doctor Prescribe Sublocade?

No, Sublocade can only be prescribed by doctors who have undergone specialized training and certification by the FDA. Because Sublocade contains an opioid drug, it is tightly regulated like other buprenorphine products.

To prescribe Sublocade, physicians must complete an FDA-mandated REMS (Risk Evaluation and Mitigation Strategy) training program. Certified doctors are listed in the Sublocade REMS database.

Additionally, prescribers must have a unique DEA (Drug Enforcement Administration) identification number allowing them to treat opioid dependence with Sublocade. This requires applying for a waiver under the Drug Addiction Treatment Act of 2000.

Only healthcare providers who have met certification criteria under the Substance Abuse and Mental Health Services Administration and registered as a Sublocade prescriber can administer this medication.

Patients should confirm their doctor has completed the proper training and credentials to prescribe Sublocade. Self-injection teaching must also be provided to the patient by a certified prescriber.

Can Pharmacists Inject Sublocade?

No, pharmacists cannot directly administer injections of Sublocade. While pharmacists play a key role in educating and counseling patients about this medication, they do not have legal authority to inject drugs like Sublocade.

Only providers who have undergone specific Sublocade training and certification can administer the injection. The initial doses are given in the prescriber‘s office until the patient receives instruction on self-injection techniques to continue treatment at home.

Additionally, the scheduling of Sublocade as a controlled substance means that only registered, waivered physicians can order and possess the medication for administration. Pharmacists can fill valid prescriptions but do not have independent injection privileges.

Pharmacists must be knowledgeable about Sublocade, including proper storage, handling, dispensing, and disposal. But administration is reserved for medical providers who have met stringent regulatory requirements for injecting this Schedule III controlled medication.

Can a Nurse Give a Sublocade Injection?

Yes, a licensed nurse can legally administer Sublocade as long as they are working under the direction of an authorized prescriber. Sublocade injections are given subcutaneously, which falls within the scope of practice for most nurses.

Typically, a doctor, nurse practitioner or physician assistant who is waivered to prescribe Sublocade will order and store the medication. A licensed nurse on their team can then deliver scheduled injections to patients under approved protocols.

Nurses play a key role in patient education, injection technique training, and ongoing monitoring related to Sublocade therapy. They help ensure proper injection procedures, record-keeping, and follow up within the framework prescribed by the healthcare provider.

It is important that nurses follow all instructions from the delegating provider and have the necessary knowledge and skill to give Sublocade injections safely. With proper oversight, nurses can legally administer Sublocade to patients under a qualified prescriber‘s care.

What Happens If You Don‘t Dissolve Suboxone?

If Suboxone is swallowed instead of dissolved under the tongue, it will not have the intended therapeutic effect. The medication will travel to the stomach rather than being absorbed sublingually into the bloodstream.

Swallowing Suboxone leads to poor bioavailability of the active drug compounds. This means lower concentrations reach the brain‘s opioid receptors, reducing the ability to manage withdrawal and cravings.

Additionally, consuming Suboxone orally may allow more of the naloxone component to take effect, potentially bringing on sudden withdrawal symptoms. This is the opposite of the purpose of taking this medication.

Bypassing the sublingual route also means missing the rapid onset of Suboxone. This can result in continued opioid hunger or relapse. Always allowing Suboxone film or tablet to fully dissolve is critical to achieving the benefits of this medication.

Do You Have to Let Suboxone Dissolve?

Yes, allowing Suboxone to completely dissolve under the tongue is essential to get the full effects of this medication. The film or tablet is formulated to dissolve and provide transmucosal absorption of the active ingredients.

Suboxone contains buprenorphine and naloxone in a specially designed matrix using proprietary technologies. This sublingual delivery system allows direct absorption into the bloodstream as it dissolves.

If you swallow Suboxone before it‘s fully dissolved, the matrix design is bypassed. This reduces the bioavailability and the amount of drug that can reach receptors and exert its effects.

Always allow the minimum specified time – which can depend on the specific product – for complete dissolution. Don‘t eat, drink, talk or swallow during this period. Letting Suboxone dissolve fully helps ensure you get the expected benefits.

Will Suboxone Work If You Just Swallow It?

No, if you simply swallow a Suboxone tablet or film whole, it will not have the desired effect. Suboxone is created specifically to be absorbed under the tongue, not through the GI tract.

Several problems occur when Suboxone is swallowed instead of properly dissolved sublingually:

• Lower buprenorphine levels reach the brain, unable to adequately relieve withdrawal or cravings
• More naloxone is absorbed, potentially throwing you into acute withdrawal
• Slow onset of action leaves you feeling restless, anxious, and at risk of relapse
• Higher variability in absorption provides uneven coverage and effects

Additionally, the Suboxone unit absorbs moisture and gels during dissolution, allowing optimal uptake through the tissues under the tongue. Bypassing this sublingual route leads to poor efficacy.

Always take Suboxone exactly as directed – letting it fully dissolve under the tongue. Swallowing Suboxone whole will result in reduced benefits and unpredictable effects.

Is It OK to Swallow Dissolvable Tablets?

For some medications formulated as orally disintegrating or orodispersible tablets, it is fine to swallow them. These tablets usually disintegrate rapidly to allow the medication to be absorbed in the stomach.

However, Suboxone and certain other drugs are specifically designed for sublingual absorption. While the sublingual tablets do physically dissolve, the pharmacokinetics require direct buccal membrane absorption.

For drugs like Suboxone with sublingual or buccal delivery technologies, allowing complete dissolution in the mouth is critical. Otherwise, swallowing the tablets results in lower efficacy.

Always check the prescribing information and packaging to confirm the proper administration method. Sublingual tablets must go under the tongue. But some other orally disintegrating tablets can be safely swallowed as directed.

What Is the Best Way to Absorb Suboxone?

The best way to take Suboxone to achieve full absorption is sublingually. This means placing the film strip or tablet under your tongue and allowing it to completely dissolve before swallowing.

To optimize sublingual absorption:

• Ensure hands are clean and dry before handling Suboxone
• Place strip or tablet under the tongue near the base on the bottom
• Keep tongue flat and still, avoid talking/drinking/smoking
• Allow saliva to help dissolve, don‘t spit out residual
• Wait 10-15 minutes for full dissolution before swallowing
• Do not eat/drink for 5-10 minutes after administration

Taking Suboxone correctly under the tongue allows direct absorption into the many blood vessels located there. This delivers the medication efficiently so it can relieve withdrawal symptoms and reduce cravings.

Always follow dosage directions and allow time for complete sublingual dissolution for best absorption. Sublingual administration is critical for Suboxone to work properly.

How Long Does It Take for Sublingual Tablets to Dissolve?

On average, sublingual tablets take 15-30 minutes to fully dissolve under the tongue. However, exact dissolution times can vary based on:

• Tablet size – Larger tablets may take longer
• Composition – Some dissolve quicker than others
• Saliva amount – Dry mouth slows dissolution
• Tongue movement – Excess motion breaks tablet down slower
• Temperature – Warmer saliva dissolves medication faster

For Suboxone specifically, the film strips dissolve in around 5-10 minutes while the tablets take 15-30 minutes on average. Always follow directions for the specific product.

Don‘t spit, talk, eat/drink, or otherwise disturb the tablet. Let it completely dissolve, periodically checking to make sure it has broken down fully before swallowing saliva. This ensures proper sublingual absorption.

How Much Suboxone Is Absorbed Sublingually?

When taken correctly under the tongue, Suboxone exhibits high sublingual bioavailability, with about 30-50% of the total dose being absorbed sublingually and bypassing initial metabolism.

Specifically, studies have shown:

• Suboxone film: ~65% absorbed sublingually
• Suboxone tablet: ~30% absorbed sublingually

The remainder is swallowed and absorbed through the GI tract. But sublingual administration allows rapid onset and efficiently delivers a substantial portion of the dosage directly into the systemic circulation.

Suboxone is specifically formulated using film technology or ion-exchange resins to promote dissolution and absorption under the tongue rather than in the GI tract. Skipping this sublingual step drastically reduces total absorption and efficacy.

Always taking Suboxone as directed by allowing complete dissolution maximizes the amount of drug available to act at opioid receptors, relieve cravings, and suppress withdrawal.