Can You Overdose on Suboxone?

Is Suboxone an Opioid? 

Suboxone is a semi-synthetic opioid replacement used to treat addiction. It is made up of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that is found in medical settings where it is used in the medication assisted treatment (MAT) of opioid use disorder (OUD). Buprenoprhine acts as an effective opioid supplement for patients undergoing treatment for opioid addiction. 

While the drug does denote recreational effects, these effects are capped at approximately 8mg. This is due to the fact that buprenorphine has a ceiling effect and can obtain full occupancy of the opioid receptor at a low dose. See Can Suboxone Lead to Addiction? for more on Suboxone’s ‘ceiling effect.’ The partial opioid properties of the buprenorphine in Suboxone can alleviate cravings and provide stability but if more of the medication is taken then prescribed or if it is misused there is a risk of respiratory depression, overdose, and death. 

Suboxone Overdose 

It is very important that the patient has begun withdrawal before commencing Suboxone treatment. If Suboxone intercepts with other opioids in the patient’s system, it can cause precipitated withdrawal and overdose. The partial opioid properties of buprenorphine substitute the effect of full opioid agonists (e.g., fentanyl, morphine) in the brain. Buprenorphine can act more effectively to imitate the secretion of endorphins and experience of euphoria catalyzed by full opioid agonists at a more controlled level when the patient is in withdrawal. This is what makes Suboxone a great instrument in the medication assisted treatment of addiction. If the buprenorphine reacts with an opioid already present at the receptor site, it can lead to an overdose caused by extenuating respiratory depression. Respiratory depression is a fatal side effect of opioid use. See When to Take Suboxone; A Complete Guide for more. Suboxone overdose can also occur if the medication is misused, i.e., injected, snorted, and/or incorrectly dosed.  

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Can you OD on Suboxone?

It is extremely difficult to overdose on Suboxone alone. Typically Suboxone overdoses occur if the medication is not taken as directed, if it is misused, or if it is used with other opioids, alcohol, or other drugs. . When opioids bind to the opioid receptors and stimulate the brain’s reward system, they produce a euphoric feeling that desensitizes over time and imprints a desire for more. The way opioids alter our brain chemistry is discussed in Can Suboxone Lead to Addiction? Suboxone provides a smaller quantity of euphoria than that of full opioid agonists and helps diminish opioid withdrawal while the naloxone present in the medication reduces the recreational and misuse potential of the drug further.

Suboxone Overdose Symptoms

Suboxone helps manage addiction by providing mood enhancement, protection against withdrawal, reliable pain-relieving effects, and low dependency. Overdose on Suboxone is rare, there is much lower overdose potential than on other opioids such as heroin or fentanyl, for example, due to the minialized pressure Suboxone places on the lungs and heart. While overdose is possible, the harm potential increases when Suboxone is combined with other drugs like benzodiazepines or morphine, no matter how small the dose may be. Suboxone overdose symptoms include dizziness, abdominal discomfort, and excessive perspiration.

How Many Suboxone Can You Take?

The highest milligram (mg) of a single Suboxone dose retails at 12mg; however, Suboxone can be prescribed up to 32mg and 40mg in rare cases. You can take two, sometimes three, Suboxone films at once, i.e., if you are prescribed a 16 mg dose, you would take two 8mg films or one 4mg film and one 12mg film. See How to Use a Suboxone Strip for more on managing multiple Suboxone films. Overdosing a prescription or using the medication in the company of other substances that act on the nervous system can lead to overdose.

Suboxone lasts approximately 8-12 hours. Sometimes its effects linger over a 24-33-hour period, depending on the dose. It takes about 45 minutes for the medication to kick in. The likelihood of overdosing on Suboxone without combination is very low. Suboxone misuse such as injection or intranasal ingestion is much more likely to cause an overdose. All in all, treating opioid addiction with a partial opioid has been proven to be an effective method of treatment, but there are some negative side effects of Suboxone.

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The Negative Side Effects of Suboxone

The protracted effects of Suboxone are caused by the extensive grip the buprenorphine in the drug applies to the opioid receptors in the brain. Suboxone binds very tightly and at a low dose. 2mg of Suboxone will fill 60-70% of the receptor site. It is much easier to drop from 24mg to 16mg to 8mg and even 4mg doses because the majority of the receptor site fills at a low dose. Most Suboxone withdrawal symptoms occur when the dosage is tapered below 2mg. It is the last 2mg that can create problems. Withdrawal symptoms such as vomiting and dizziness increase the chance of relapse because patients are inclined to turn to opioids to relieve their discomfort. Patients can also become depressed, irritated, and anxious. Undiagnosed medical conditions, unstable relationships, unpredictable mood swings, and unsupportive environments can also increase the likelihood of relapse and consequent overdose. These are some of the risks associated with tapering off Suboxone too soon. However, with a steadfast taper plan in place, coming off Suboxone is both possible and feasible.

If you are experiencing any side effects from taking Suboxone, contact your provider for further assistance.

How Much Suboxone is Too Much?

When used responsibly with the assistance of a licensed practitioner, Suboxone is a widely recognized tool used to successfully treat addiction. It allows the brain to adjust to the absence of full opioid agonists at the receptor site. Suboxone helps retrain the brain to produce endorphins naturally. While physical dependence can occur, if regulated with the oversight of a medical professional, Suboxone attenuates withdrawal symptoms, reduces cravings, and decreases tolerance. Taper over time with a consulting medical professional that can provide the appropriate medications to treat withdrawal symptoms. See the directory of medical professionals on staff at Confidant here and message us today!

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