Long-term Suboxone® use for OUD treatment

Make an informed decision on your recovery journey by exploring the benefits, side effects, and considerations of long-term Suboxone use for OUD treatment.

Ophelia team
Suboxone medication package
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Fact checked by
Arthur Robin Williams, MD

Suboxone® is a medication that is commonly used to help people living with an opioid use disorder (OUD) through recovery (important safety information). This buprenorphine-naloxone medication and others like it have helped millions of Americans maintain long-term results. Research and anecdotal evidence both show that the medication works and helps people lead the lives they want to lead.

However, long-term Suboxone use isn't for everyone—the decision to stop is highly personal and can vary based on medical guidance and individual factors. The most important thing is to be sure you and your clinician are confident in your readiness to quit and have the tools to navigate life’s challenges without the medication. Discontinuing Suboxone without the proper support and taper can needlessly prolong withdrawal.

Learn more about Suboxone and the advantages and disadvantages of long-term use to treat OUDs below.

What is Suboxone?

Suboxone is a combination of two medicines: buprenorphine and naloxone. The former activates opioid receptors in the brain to combat cravings and withdrawal symptoms. The latter blocks the action of opioids at the brain's opioid receptors.

This unique combination allows Suboxone to reduce cravings and the risk of overdose, helping people with OUD on their recovery journey. The medication is safe, trusted, and accessible. It's been promoted as the first-line OUD treatment by the United States Department of Health and Human Services.

How does long-term Suboxone use for OUD work?

Suboxone is often prescribed as part of a medication for addiction treatment (MAT) plan for patients with OUD. In MAT, patients are prescribed a medication, like Suboxone, to help manage the mental and physical toll of withdrawal symptoms and cravings. Alongside this, they receive therapy.

The patient's doctor may reduce Suboxone dosage over time, as withdrawal symptoms and cravings are brought under control. However, it's normal for patients to take Suboxone for anywhere from six months to a year, or even longer. Every person's case and needs are different.

Benefits of long-term Suboxone use

Long-term Suboxone use can support lasting sobriety. The medication helps suppress symptoms of OUD, including uncomfortable withdrawal symptoms like nausea, vomiting, diarrhea, chills, and headaches. Living without those symptoms and having access to a care team can also make it easier to address psychological and social factors that contributed to opioid misuse in the first place. Being able to understand and cope with life’s challenges without those substances leads to a higher quality of life.

For many people, staying on medication is the most effective way to maintain their recovery. According to the Centers for Disease Control and Prevention (CDC), MAT is a comprehensive and effective means of treating OUD. The recommended dosage will depend on an individual patient’s needs and can be adjusted as those needs shift from immediate intervention to maintenance over time.

This is especially important when considering the relatively high rate of relapse for those trying to recover from OUD. While some people may manage to achieve initial sobriety in the short term, maintaining that sobriety over time can prove challenging. Suboxone use reduces the risk of relapse, especially within the first few years, which can be an especially vulnerable period. This medication also helps patients sustain their results over time. Since it’s an opioid agonist, it binds to the same receptors in the brain as the drugs that have had negative consequences, cutting down on cravings and the potential for misuse or overdose.

Side effects of long-term Suboxone use

Although long-term Suboxone use helps patients with OUD in their recovery, it does come with side effects that can influence a patient’s decision to taper off. Possible long-term side effects of Suboxone include:

  • Constipation: The intestines contain opioid receptors that slow down when stimulated by Suboxone. This also slows the contractions of the intestinal walls, so waste moves through more slowly.
  • Other gastrointestinal issues: Common complaints include Suboxone-related stomach pain, cramps, and discomfort. There have also been reports of stomach ulcers developing in people using Suboxone, as well as nausea and vomiting.
  • Changes in blood pressure: While Suboxone is rarely thought to cause high blood pressure, it may be linked to a temporary spike in blood pressure. This is usually just because patients are at the peak of withdrawal when they get their first dose.
  • Dental problems: The U.S. Food and Drug Administration (FDA) has warned that patients using Suboxone and similar sublingual medicines with buprenorphine have reported oral health issues. These include cavities, and tooth decay and loss.
  • Anxiety and depression: This side effect may be exacerbated by the fact that Suboxone shouldn't be mixed with many common antidepressants and anti-anxiety medications, including SSRIs, tricyclic antidepressants (TCAs), and SNRIs.
  • Sexual side effects: Sexual side effects may range from a lower sex drive to erectile dysfunction issues and difficulties achieving orgasm.

Suboxone's long-term effects may further include heightened pain sensitivity, drowsiness, confusion, profuse sweating, sleep disruptions, and swelling in the arms or legs. Less common but more severe side effects include allergic reactions, breathing disorders while sleeping, liver failure, low blood pressure when standing up, and overdose.

Finally, it's important to note that Suboxone isn't appropriate for all patients. For example, it can interact with other medications, and cause serious, or even fatal, health issues such as a coma. Medications that can't be taken with Suboxone include sedating antihistamines, Benzodiazepines, and opioids, among others.

Additionally, Suboxone may not be safe for patients who are pregnant or breastfeeding, or who have thyroid disorders or kidney problems. Alternatives may be possible. For example, historically, Subutex®, which is buprenorphine minus the naloxone, has been given to pregnant women as an alternative.

Safe access to Suboxone with Ophelia

While the long-term side effects of Suboxone shouldn't be ignored, the medication can still be a valuable part of a MAT program, helping people with OUDs on the road to recovery. Ophelia provides accessible MAT to people in select states.

Interested in Ophelia? The first step is to meet your dedicated clinical care team over the phone. If you're eligible, you'll be given a Suboxone prescription that you can pick up at a local pharmacy. You'll then receive ongoing medical support and maintenance for the duration of your treatment.


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