Suboxone contains two medicines, buprenorphine and naloxone. Buprenorphine is the therapeutic opiate that is given for opiate dependence. Naloxone is a narcotic blocker that is added to reduce the likelihood of abuse of Suboxone. However, only buprenorphine is absorbed in the body. Naloxone gets into the bloodstream if someone tries to crush Suboxone and injects it into a vein to try to get high from the buprenorphine. The naloxone will block the buprenorphine from the opiate receptors in the brain and will knock off any other narcotics that are in the brain. This will cause the person to go into immediate withdrawal. As they say “people only inject Suboxone one time”. Naloxone is normally used in the ER if a person is brought to the emergency room unconscious and about to stop breathing. IV naloxone causes the person who has taken a narcotic overdose to start breathing better and wake up. It throws them into severe withdrawal so that they wake up very angry and usually not grateful that they have just been spared death by overdose.
Buprenorphine in the Suboxone is only absorbed in the mouth. That’s why we tell patient’s to hold the Suboxone under their tongue until it dissolves. This usually takes 5 to 10 minutes and the person knows it’s all absorbed when they feel no more granules. If the tablet or the saliva with the Suboxone granules in it is swallowed, it just passes through the body and there’s no benefit.