Suboxone is the brand name for a combination medication used to treat opioid use disorders (OUD). It is composed of buprenorphine, an opioid, and naloxone, an opioid reversal agent. Since Suboxone was approved in 2002 for the treatment of OUD, the number of prescribers has increased substantially. A 2011 review found that 76% of surveyed Americans who use opioids had obtained Suboxone without a prescription.
If you are taking Suboxone for an opioid addiction and working, it is important to know how long it stays in the body and how it’s detected on drug tests.
Suboxone (buprenorphine and naloxone) is classified as a partial opioid agonist. This means that it acts on the same receptors in the brain as other opiate medications but only partially turns them on. Buprenorphine binds tighter to these receptors than other opioids do and can help reduce cravings and prevent withdrawal.
The naloxone component reduces the potential for abuse because it helps reverse the effects of opioids. If Suboxone is taken differently than prescribed, snorted or injected for example, naloxone reverses the medication’s effects in the body. When taken as prescribed, the naloxone component is inactive in the stomach. As a result, Suboxone is helpful to treat OUD and is available as a sublingual film or sublingual tablet.
Suboxone is available as a film that dissolves in the mouth or as a tablet. It begins to work quickly — usually in about 30 to 60 minutes. After being ingested, it works its way into the bloodstream and eventually into the brain, where it reaches opioid receptors.
The peak effect of Suboxone can vary depending on the dose you take — the higher the dose, the longer it takes for the peak effect to be felt. In general, this peak can range from one to over four hours. The time it takes for Suboxone to be metabolized varies depending on which formulation you take.
The half-life of a medication is the time it takes the body to metabolize and eliminate half of one dose. Buprenorphine, the opioid component in Suboxone, has a very long half-life of 24–42 hours. This is much longer than most other opiates. Naloxone, the reversal agent, has a much shorter half-life of 30–60 minutes.
Suboxone contains an opioid called buprenorphine, but it is chemically distinct from other morphine-like opioids and would not show up on a drug test the way these medications do. Most drug tests detect morphine, codeine and heroin. Extended opioid panels are becoming increasingly common and test for hydrocodone, hydromorphone, oxymorphone and sometimes oxycodone. A specific test would be needed to detect the presence of buprenorphine.
Buprenorphine is metabolized to norbuprenorphine in the body and excreted primarily in feces (69%) and approximately 30% in the urine. Due to the long half-life of buprenorphine and its metabolite, they are detected in urine for much longer than some other opioids. The urine detection window of buprenorphine is one to seven days and 1–14 days for norbuprenorphine.
Factors such as liver function can impact the amount of time Suboxone is detected in urine. Suboxone is metabolized in the liver, so each dose of Suboxone may last longer in the body for people with liver problems.
Buprenorphine is detected in blood for 26–42 hours. If your drug test detects the metabolite norbuprenorphine, this can be detected for much longer — between 15–150 hours.
Buprenorphine in Suboxone can be detected in hair for up to 90 days. However, this is not often measured due to cost and how inconsistently results are interpreted.
The buprenorphine in Suboxone can be detected in saliva for up to three days after taking a dose. Saliva levels do not correspond with doses of Suboxone, so its use may be limited in this way.
For most people, Suboxone remains in the system for many days. There are many factors that can affect this, including:
Similar to other opioids, Suboxone can also cause dependence. As a result, the safest way to stop taking this medication is to speak with your healthcare provider or attend rehab treatment. Most often, you will slowly taper your doses down until you no longer need this medication. If you abruptly stop taking Suboxone or reduce your dose too quickly, you may experience withdrawal.
Withdrawing from Suboxone is very similar to withdrawing from other opioids. If stopped too quickly, physical symptoms of withdrawal can manifest. These symptoms are likely to be worse within the first 72 hours but can persist for over one month. Suboxone withdrawal symptoms can include:
Suboxone detox can be similar to detoxing from other opioids but is usually milder. The opioid component of Suboxone, buprenorphine, can result in dependence with withdrawal symptoms similar to other medications like heroin or oxycodone. Because of the drug’s long half-life, these symptoms can last for days to weeks, depending on the individual.
Treatment for Suboxone withdrawal can help ease this process. Symptoms of withdrawal can often be treated and support can be given to avoid relapse. It is important to treat the whole person — from withdrawal symptoms to psychological support. By doing this, the likelihood of relapse is far reduced and the chance for success is much higher.
Suboxone is classified as a Schedule III medication under the Controlled Substances Act. This means that this medication poses the risk of abuse but has a recognized medical use. Due to this, a prescription for Suboxone for opioid use disorder must be written by a prescriber who is enrolled in a restricted program.
Those taking Suboxone for OUD are also at an increased risk for addiction. When initially marketed, Suboxone was thought to have a relatively low risk for addiction. Unfortunately, Suboxone is increasingly purchased “on the street” — sometimes to avoid withdrawal symptoms of drugs like heroin and other times by people who have not normally taken opioids. As a result, we have come to find that there is a risk for Suboxone addiction.
If you or a loved one is struggling with Suboxone or other opioid addiction, contact us today. Our caring medical professionals are here to support you through your journey. At The Recovery Village at Palmer Lake, we offer a full continuum of care to best suit your needs. We offer levels of treatment ranging from medical detox and inpatient care to outpatient services and family services. Get started on your path to a drug-free life today.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.