Can Suboxone be injected?
Yes. But the effects of injecting depend on the opioid tolerance of the person injecting buprenorphine. We review injecting Suboxone here, and invite your questions, comments, or feedback about treatments for Suboxone addiction at the end. In fact, we try to respond to all questions about signs or symptoms of Suboxone addiction with a personal and prompt response.
Why inject Suboxone?
One common reason for injecting buprenorphine relates to the low oral bioavailability of the drug. Only 25-30% of sublingual buprenorphine reaches the blood circulation, compared to 100% of injected buprenorphine.
Some people who inject buprenorphine claim that they are trying to stretch the action of illicit buprenorphine 4-fold, so that 8 mg prevents cravings and withdrawal for 4 days rather than one. Because of the shortage of buprenorphine-certified physicians in many areas, many addicts ‘treat’ themselves with buprenorphine purchased on the street at inflated prices.
Suboxone injection and buprenorphine tolerance
The brain does not distinguish between buprenorphine that has been injected and buprenorphine taken sublingually. The brain is subject to a more rapid rise in blood level of buprenorphine when the drug is injected. But the effects of injected buprenorphine vary with tolerance.
Buprenorphine has a long half-life (i.e. stays in the body longer than most medications). If a person injects usual clinical doses of buprenorphine daily, tolerance will develop to the medication after a week or two. At that point, injecting buprenorphine will not result in any significant subjective effects, just as sublingual doses do not have significant effects in patients tolerant to buprenorphine.
However, a person who is used to taking large amounts of illicit opioids (greater than 80 mg of oxycodone, for example) will usually experience sudden and severe withdrawal symptoms after injecting buprenorphine. The effects are similar, but more rapid, than the effects of sublingual buprenorphine in the same person.
Little incentive to inject Suboxone
The pharmacology of buprenorphine removes much of the incentive to inject the medication. For regular opioid users, injection of buprenorphine precipitates withdrawal. People who inject buprenorphine regularly are essentially ‘on buprenorphine’, and have little subjective effect from the medication. People who get ‘high’ from injecting buprenorphine are those who have a low opioid tolerance, who use buprenorphine infrequently (i.e. every few days or less often).
Photo credit: Jefferson County Wisconsin Immunization Office