Suboxone Dosage and Administration: Balance for Each Patient

Did you know last year more than 109,000 Americans died due to drug overdose? And according to Disease Control and Prevention (CDC) reports, the majority of these deaths were because of a potent synthetic opioid called fentanyl. This drug has become more available to American people since the increase in the flow of fentanyl from China after the latter added it to the list of controlled substances in 2019. This drug has increased the problem of opioid addiction in America, at large, due to its easy availability in the form of a pill, indistinguishable from pain killers. To address this problem, in general, is a task we should better leave to authorities. However, on an individual level, we can address it through addiction treatment with the help of Suboxone to end dependence on drugs.

Fighting the Menace of Fentanyl and Other Opioids

Suboxone is the second most effective drug for the treatment of opioid addiction. It contains Buprenorphine, an opioid agonist that reduces the urge to take opioids. In addition to buprenorphine, it also contains naloxone which acts as an antagonist. 

While buprenorphine helps in getting rid of cravings more safely than most of the other medicines, Naloxone in Suboxone prevents a patient from getting addicted to buprenorphine. Both substances as part of Suboxone, therefore, work in tandem to help you in becoming less dependent on other harmful drugs such as heroin, morphine, fentanyl, etc, and in finally overcome addiction completely.

How do we use Suboxone: Administrative Routes

Suboxone comes mainly in two forms, a tablet or film.

Sublingual Administration: You need to administer it through the mouth but only by letting it dissolve. So, the best way to let it dissolve is to place the tablet under the tongue for 15 to 30 minutes. This is known as sublingual administration. 

Buccal Administration: The other way of administering it is by placing it between the gums and cheeks and letting it dissolve. This comes in the form of a film and this route is known as buccal administration. Before placing it in your mouth, you can drink water to moisten your mouth to help the tablet dissolve easily. In accordance with the prescription and your comfort, you can place two tablets/films at the same time when required. 

Another way is to place them one after the other. The thing you need to notice here is that it should only be administered sublingually. Swallowing or chewing it won’t be effective. The other thing which you should keep in mind is that you should not eat or drink until the drug has dissolved completely. Thus, waiting for at least 30 minutes before you eat or drink is ideally advisable. 

Suboxone Dosages Available

The target dosage of suboxone sublingual tablet to be achieved is 16 mg/4 mg. The strength of buprenorphine and naloxone may be varied in ratio as shown in these two commonly recommended forms:

• Buprenorphine 2 mg/ naloxone 0.5 mg and 
• Buprenorphine 8 mg/ naloxone 2 mg.

On day 1, an induction dosage of 8 mg/2 mg is recommended. You, under the supervision of a clinician, need to begin with an initial dose of 2 mg/0.5 mg or 4 mg/1 mg buprenorphine/naloxone. Then the dosage titration can be increased from 2 or 4 mg of buprenorphine, with an interval of 2 hours, to 8 mg/2 mg buprenorphine/naloxone according to the control of acute withdrawal symptoms. 

On day 2, a single daily dose of 16 mg/4 mg is used. The maintenance dose should be kept in the range of 4 mg/1 mg buprenorphine/naloxone to 24 mg/6 mg buprenorphine/naloxone per day based on the opioid withdrawal signs and clinical responses to the condition of individual patients. This treatment, as evident from the complexities in dosage variance, should strictly be initiated under the supervision of clinicians and, with the stability of the patient, be transferred to unsupervised administration. However, you should be mindful of the fact that suboxone usage is subject to diversion and abuse. So clinical supervision is necessary.

The other thing you need to be careful of is greater exposure to naloxone as it can increase the risk of precipitated withdrawal. Therefore, sublingual administration, in whicah exposure to naloxone is somewhat low, is more suitable than buccal administration in which exposure to naloxone is higher but it is better to ask your healthcare provider and adhere to their instructions instead of taking decisions on your own. You can get the 

Suboxone Treatment in a Nutshell

As charted out in detail above, suboxone treatment is a well known and commonly used treatment method for opioid addiction. It is ideally administered as a tablet through the mouth in varying dosages, with the right balance to be achieved for each patient. The ease of administering it and its effectiveness in limiting withdrawal symptoms makes it one of the most opted-for treatment methods. Therefore, a greater awareness of suboxone dosage and effectiveness can help in limiting the menace of drug abuse.