It’s common to wonder what the side effects are of any medication, but especially something like Suboxone® (brand name for the generic buprenorphine/naloxone), which is used as an FDA-approved long-term maintenance treatment for opioid use disorder (OUD).
Here are the most common:
- Increased sweating
- Abdominal pain
- Constipation
- Nausea
- Vomiting
- Headaches
- Insomnia
- Low blood pressure
- Chronic pain
- Opioid withdrawal symptoms
As you may notice, constipation is a common side effect of Suboxone and one that should be taken seriously. Here’s what you need to know about why constipation happens and what you can do about it.
Why Suboxone causes constipation
There’s a whole lot of science-y terms that we could throw out here, but the most important thing to understand is this: our intestines contain opioid receptors which, when stimulated by something like Suboxone, slow down the contractions of the muscular walls of the intestines. As a result, the food and other waste do not move along nearly as fast as usual.
Also, opioids increase the absorption of fluids in the gastrointestinal tract — and without fluids, the intestines become dry making bowel movements more difficult.
Symptoms of opioid-induced constipation
We don’t need to tell you that the feeling isn’t so comfortable, with symptoms that can range from abdominal pain, bloating, painful bowel movements, and nausea (on the milder end) to torn or protruded anus and hemorrhoids (on the more serious end).
Is all opioid-induced constipation the same?
While all opioids cause constipation to a certain degree, there are differences between the effects of short-acting and long-acting opioid medications.
- Short-acting opioids (e.g., heroin, oxycodone, hydrocodone, codeine) cause short-term, temporary symptoms of constipation
- Long-acting opioids (e.g., Suboxone, fentanyl, methadone) remain in your system for a longer period of time and thus cause more prolonged symptoms of constipation
How to manage + relieve symptoms of constipation
When you’re on a treatment plan through Ophelia, your dedicated healthcare team will be there to support you throughout the entire process with mental health/pain management support and personalized medical advice to deal with any unpleasant side effects. Depending on your specific circumstances, your care team may recommend one of the following treatment options:
- Over-the-counter supplements
Such as aloe vera, senna, milk of magnesia, or Miralax . - Lifestyle changes
Including exercising more regularly, preferably daily, and changing routines around bowel movements . - Dietary changes
Including drinking more fluids and adding in more fiber-rich foods or fiber supplements (such as Metamucil of FiberCon) to your diet.
- Laxatives/stool softeners
Including Colace, lubricant laxatives (such as mineral oil) or glycerin suppositories
- Prescription medications
Such as Movantik (naloxegol), Relistor (methylnaltrexone), or Amitiza (lubiprostone) — although Ophelia doesn't typically prescribe these.
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