Suboxone Program

Suboxone is a combination pill, composed of both buprenorphine and naloxone. It is available in two strengths, 2 mg (buprenorphine) / 0.5 mg (naloxone) as well as 8 mg (buprenorphine / 2 mg naloxone).

How is Suboxone taken?

Unlike methadone, Suboxone comes in a pill form and is taken “sublingually”, meaning it is placed under the tongue to dissolve. The buprenorphine component is absorbed quite quickly by the generous bloodstream under the tongue. The naloxone portion, however, is not absorbed and remains in the mouth, either to be swallowed or spit out.

There are many reasons why Suboxone may be the preferred form of therapy.

  • Less stigmatizing than methadone.
  • Can often get to a stabilized or maintenance dose within the first or second day.
  • Has a better safety profile (less likely to cause overdose, little to have no effect on heart rhythms).
  • May be easier to come off of than methadone.
  • Longer acting than methadone so may not require daily dosing.
  • Fewer side effects, such as constipation, than methadone.

What are the disadvantages of Suboxone over that of methadone?

  • May not fully satisfy cravings or block withdrawal symptoms for those with high tolerances.
  • May be more costly if not covered by Ontario Drug Benefit Program.
  • Dose adjustments may be more difficult.
  • May cause a “PRECIPITATED WITHDRAWAL”. If you are planning on going onto Suboxone, it is very important that you present for the first dose in a state of mild to moderate withdrawal. If you get the first dose while actively using other opiates, it was cause a severe withdrawal that is difficult to reverse for hours.

Recommended waiting period before starting Suboxone.

How long should I wait after my last dose before starting Suboxone? In general, most short acting opioids (like heroin, morphine, oxycodone) result in withdrawal symptoms starting about 6 hours after consumption. Long acting opioids (like methadone, oxycontin, etc) take much longer to leave the system. The question really comes down to how soon the individual feels mild to moderate symptoms kick in. These symptoms include yawning, sneezing, slight nausea, slight muscle cramping. They should not be severe symptoms such as vomiting and diarrhea. Once a person has established how soon withdrawal symptoms kick in for their last use, adding on a few more hours usually does the trick. In general, for short acting opioids, most people should present in the morning, not having used anything else, including codeine, from at least the night before. For long acting opioids, the person may need to miss one or two full days.

Withdrawal is uncomfortable and often causes a lot of anxiety along with physical symptoms. It is important to note that even mild symptoms can often trigger much anxiety as it reminds the dependant of a time when withdrawal became severe. Be aware of this and remember that the mild to moderate symptoms you are experiencing will soon be alleviated.

Suboxone can not be used during pregnancy.

If you are pregnant, methadone would be a better choice. If you become pregnant while on Suboxone, you would need to immediately notify your physician.

Source: Supporting content for this website has been sourced from Canadian Addiction Treatment Centres

How do I access the program?

Please visit Monday through Friday (8:00 a.m. – 5:00 p.m., EST) and identify yourself as a patient who is interested in our Suboxone program. Your family physician, psychiatrist, clinical psychologist, addiction counselor, other allied health professional, or employer may also call on your behalf for further information.

You are the one making the changes. Northwood Recovery is here to support you improve the quality of your life.

We have a reputation for running a caring and non-judgemental atmosphere. Our goal is to help you lead a life without substance use. You may want to restart school and work, reconnect your family, and bring back hope. Northwood Recovery understands each person has a unique and personal goals. That means working hard to get you free of substances and safely off methadone or suboxone.