Suboxone®, a combination of buprenorphine and naloxone, is a US Food and Drug Administration-approved opioid replacement therapy that works to curb cravings and prevent withdrawal symptoms during opioid abuse recovery. It is the most commonly known among the buprenorphine-based medications to address substance use disorder as part of Medication Assisted Treatment (MAT).
Suboxone® treatment can lead those seeking to overcome addiction toward desirable and sustainable outcomes.
Can You Swallow Suboxone®?
Swallowing Suboxone® is not recommended as it will reduce the effectiveness of the medication. Suboxone® is designed to be taken sublingually, meaning under the tongue, for maximal absorption into the bloodstream.
Why Can't You Swallow Suboxone®?
Swallowing Suboxone® is not recommended due to its unique formulation for sublingual administration. The active ingredient, buprenorphine, is best absorbed by the veins under the tongue. When swallowed, the medication is subject to different metabolic processes, reducing its effectiveness in managing opioid cravings and withdrawal symptoms.
Will Suboxone® Still Work if Swallowed?
If Suboxone® is swallowed instead of taken sublingually, its efficacy will be compromised. Swallowing it will diminish its therapeutic benefits and potentially lead to withdrawal symptoms or cravings resurfacing. When ingested, the medication will not provide the intended results in managing opioid cravings and withdrawal symptoms.
How Sublingual Suboxone® Works
Suboxone® is presented as a sublingual film that's administered as a single dose. Over the course of treatment, a MAT provider may adjust the dosage in decrements or increments to a level that suppresses opioid withdrawal symptoms and is comfortable for the patient with OUD.
To take the medication, place your Suboxone® under your tongue and allow the film to dissolve fully for 15 minutes, without swallowing. If more than one Suboxone® film is prescribed, then the second one is still placed sublingually but on the opposite side from the first, carefully positioning them to minimize overlapping.
How Long Does Suboxone Take to Dissolve?
Suboxone® film takes at least 5 to 10 minutes (sometimes more) to dissolve completely. After it dissolves, hold the taste in your mouth for at least 20 minutes for it to be most effective.
During this time, it is essential not to chew, swallow, or talk to ensure optimal absorption of the medication. This sublingual absorption allows the active ingredients in Suboxone® to enter the bloodstream directly, providing effective relief from opioid cravings and withdrawal symptoms. Suboxone® should stay under the tongue until the entire film fully dissolves.
Chewing, moving, and swallowing Suboxone® is not advised because less medication will be absorbed into the bloodstream — meaning it won’t work as well and could result in withdrawal symptoms.
How to Successfully Start Suboxone®
In order to start Suboxone® therapy, patients must be in moderate opiate withdrawal. MATClinics uses COWS (clinical opiate withdrawal scale) to determine if patients are in moderate withdrawal and able to start their medication. A patient will need to score between 13 and 24 on the COWS to start Suboxone® treatment of opioid use disorder.
When a patient is taking Suboxone® for the first time, the prescribing clinician will review how to take the medication successfully. The patient will then take their medication as prescribed in the morning, in the evening, or sometimes both.
Once the patient is in moderate withdrawal, they cut or break off a 2 mg piece and place it under their tongue then let it dissolve. Since Suboxone® is only absorbed sublingually, patients are advised not to talk, swallow, or smoke during this process.
After 45 minutes, patients' withdrawal symptoms will likely have improved or worsened. If the withdrawal symptoms have improved, patients may take another 2 mg film. If symptoms become worse, patients should contact their prescribing clinician, as they may have precipitated withdrawal.
Later that day, patients should take another 4 mg (or the rest of the film they previously cut into pieces).
The next day, patients can start taking their prescribed dose.
Starting Suboxone can be a challenging process, and methods may vary from person to person depending on individual circumstances. It is crucial to work closely with your treatment provider to ensure you start on your medication successfully.
Tips for While Taking and After Taking Suboxone®
Below is more detailed information for prospective patients on how to take sublingual films:
- Always take your Suboxone® film exactly as prescribed by your doctor.
- Fold along the dotted line and tear downward at the slit to open the film package. You can also use scissors to cut along the arrow if you prefer.
- Ensure that your hands are dry, and hold the Suboxone® film between two fingers by the outside edges.
- Place one film at a time under your tongue, close to the base. Lean your head slightly forward, and let the film dissolve completely. Suboxone® is absorbed into the bloodstream through the veins under the tongue.
- Develop a daily routine so that it's easier to remember when to take Suboxone®.
- Talking can also interfere with how well Suboxone® is absorbed. Do not eat, drink, talk or smoke while taking the film.
- You may want to do something else that doesn't require talking while you wait, such as watching TV or reading. Also, let family and friends know you won't be able to talk or answer the phone during this time.
Get Safe Suboxone® Treatment
MATClinics' science-based approach to dealing with opioid use disorder involves a well-balanced combination of Suboxone® treatment, counseling, and case management. Every patient is assigned a dedicated case manager who will consistently follow up to ensure that patients are following procedures correctly and are aware of counseling alternatives.
MATClinics has several Suboxone® clinics in Maryland. If you or a loved one is struggling with addiction, we encourage you to begin the healing and recovery process by getting in touch with MATClinics now.