Key Points

  • Suboxone contains buprenorphine and naloxone.
  • This medication is the gold standard in an opioid use disorder treatment program.
  • It is possible to overdose on Suboxone, and the effects can be fatal.
  • To avoid a Suboxone overdose, take the medication only as prescribed by your doctor.
  • Suboxone toxicity requires emergency intervention to prevent and reverse life-threatening complications such as suppressed breathing or coma.

Suboxone is the gold-standard treatment for individuals with an opioid use disorder (OUD). This medication, when used as directed, is safe and effective. However, using abusive doses or combining it with opiates increases the risk of overdose. Suboxone overdoses can be fatal in some cases. In this blog, you’ll discover the side effects of Suboxone, administration and dosing advice, and the symptoms of a Suboxone overdose.

What Kind of Drug is Suboxone?

Suboxone is an FDA-approved prescription medication used to treat opioid use disorder (OUD). It contains two active ingredients: Naloxone and buprenorphine.[1] The former blocks the euphoric effects of opioids, including heroin and codeine. It also binds to and blocks opioid receptors to reduce a person’s craving for opioids. The latter, buprenorphine, is an opioid partial antagonist that can produce euphoria at a low to moderate dose.[2] This is a desirable effect for individuals experiencing withdrawal or cravings for street opioids. It is also significantly less addictive than traditional opioids and safer to use. Individuals with an opioid use disorder are 50% less likely to experience a fatal overdose when taking this combination prescription.[3] They also have a reduced risk of non-fatal overdoses. Currently, over 100,000 people who use opioids take toxic doses and overdose.[3]

How Much is a Typical Dose of Suboxone?

A standard two-day treatment cycle of Suboxone for individuals dependent on heroin or short-acting opioids begins when signs of moderate opioid withdrawal become evident.
  • Day One: On the first day, the patient starts with an initial dose of 2 mg/0.5 mg of Suboxone administered sublingually via a film.[4] This dose is gradually titrated upward in 2 to 4 mg increments of buprenorphine every 2 hours, with a maximum dose of 8 mg/2 mg.[4]
  • Day Two: By the second day, the patient takes a single sublingual film of 16 mg/4 mg.[4]
After completing this two-day Suboxone cycle, the person will begin maintenance treatment.[4] This consists of taking an adjusted Suboxone dose that addresses the patient’s opioid withdrawal symptoms. A standard schedule is as follows:[4]
  • An adjusted dose in increments or decrements of 2 mg/0.5 mg or 4 mg/1 mg until the patient is free from withdrawal symptoms.
  • A targeted dose of 16 mg/ 4mg sublingual (film or tablet) or buccal film once per day.
Doses may range from 4 mg/1 mg to 24 mg /6 mg. However, the maximum maintenance dose should not exceed 24 mg / 6 mg per day to maintain safe usage.[4]

What Happens if You Take Too Much Suboxone?

Taking more than your prescribed Suboxone dose can lead to an overdose. This risk is higher in individuals who have never used Suboxone before, older adults, and those who combine it with central nervous system (CNS) depressants such as alcohol.[5] The signs of a Suboxone overdose include, but are not limited to:[5]
  • Severe drowsiness
  • Abdominal pain
  • Anxiety or irritability
  • Mood swings
  • Poor memory
  • Difficulty concentrating
  • Loss of coordination
  • Sleepiness
  • Slowed heartbeat (bradycardia)
  • Pinpoint pupils
  • Nausea and vomiting
  • Difficulty breathing
  • Slowed breathing
  • No breathing
  • Coma
  • Death
If you have taken too much Suboxone, call your healthcare provider or the Poison Control helpline at 1-800-222-1222.[6] However, if you begin experiencing symptoms, contact emergency services to obtain life-saving medical attention. An overdose on any opioid can be fatal without treatment from a medical professional. Happens if You Take Too Much Suboxone

Is it Possible to overdose on an Opioid While on Suboxone?

Yes, overdosing on opioids or experiencing opioid poisoning is possible while taking Suboxone.[7] To prevent this risk, individuals on Suboxone should avoid consuming any opioids. If they still have cravings for opioids despite using Suboxone, their doctor can modify the dosage to help reduce those cravings.

What is the Treatment for Suboxone Overdose?

It is important to provide as much detail as possible about how much Suboxone you or your loved one has taken to give the best chance for recovery. This includes:[8]
  • The number of films taken
  • The dosage
  • The last date the prescription was filled
The physician will assess the patient’s blood glucose levels to confirm they are normal and may give a high dose of naloxone if the patient shows signs of respiratory depression or altered mental status.[8] However, naloxone is less effective in adults who overdosed on Suboxone and are experiencing respiratory depression or sedation, unlike its effectiveness in children exposed to Suboxone with similar symptoms. Nevertheless, naloxone is effective when administered multiple times to individuals who have overdosed on Suboxone. Additional treatment measures include:[8]
  • Decontamination using activated charcoal.
  • Life support measures such as intravenous fluids, respiratory support, and medications to stabilize vital signs.

How to Prevent a Suboxone Overdose

The best way to prevent a Suboxone overdose is to take the medication as directed and in the manner prescribed. Misusing Suboxone in any way (including taking doses too close together) can result in an overdose. If you are having difficulty sticking to your current dosing schedule and feel it is ineffective, speak to your physician about titrating your dose. So long as you haven’t reached the maximum dose, there is still room to increase it. It’s important to remember that Suboxone alone isn’t an effective treatment for addressing opioid use disorder. While some people feel the medication is enough, they may find themselves relapsing and trying to find ways to experience a high while taking it. This is why it’s so important to attend therapy sessions as part of a comprehensive OUD treatment plan. According to the American Society of Addiction Medicine (ASAM), withdrawal management during detox is just one approach to overcoming opioid addiction.[9] Joining a support group of others in recovery, attending behavioral therapy, and identifying the people, places, or events that contribute to drug use are all helpful. However, this is just a start.

Finding Support for Opioid Use Disorder

The best approach to overcoming opioid use disorder and maintaining sobriety is to work closely with an addiction center like Southeast Addiction Center TN. Here, you will work with a team of professionals whose main goal is to help you recover your health, social functions, and mental clarity.[10] The programs offered in our residential, inpatient, and outpatient treatment centers are designed to help individuals with OUD get their lives back on track by:
  • Helping them identify triggers for use, such as undiagnosed mental health conditions or trauma
  • Providing a safe and effective method for overcoming cravings and withdrawal through our medication-assisted treatment (MAT) program
  • Helping them to understand their disorder and the reason they began abusing opioids
  • Offering a supportive environment where they can recover without temptations
  • Providing activities to help them rebuild their interpersonal skills, boost their self-esteem and regain their independence
  • Developing a long-term plan to avoid relapsing.
To begin your road to recovery or to learn more about Suboxone treatment, contact us today. We are available 24/7 to answer any questions you have about this and many other evidence-based treatment options we provide. It’s not too late to make a change. Call us today.