Can you get high on Suboxone? Well, yes, because the narcotic ingredient in the combination drug Suboxone, buprenorphine, is an opioid. It’s always possible to get high with any opioid. However, several factors about Suboxone make this unlikely:
- Buprenorphine is only a partial agonist
- Suboxone contains naloxone
- The high tolerance of the average person using Suboxone makes euphoria uncommon
A naive opioid user, which means someone who has never used opioids before or who rarely does, will generally have a very low tolerance level. This means that it will take only a small dose for this person to feel the opioid’s effects. It also means that this person is at a higher risk for overdose death, since tolerance raises the body’s opioid response and protects against overdose to some degree, often a very high one. Someone with a high tolerance level may take opioid doses over the normally lethal amount without overdosing. This phenomenon is seen with many drugs of abuse, but tolerance levels with some of them will be limited regardless of how slowly the dose in increased over time. This is one reason barbiturates are so dangerous. Even chronic users will develop only a rather small tolerance compared to those seen in opioid users.
Getting high on oral Suboxone is possible for someone with a low opioid tolerance, but when the drug is used for opioid use disorder, called OUD, it’s rarely possible for this user to get high on it. That’s because their tolerance level is simply too high. When used for OUD, Suboxone invariably relieves withdrawal symptoms and keeps drug cravings at bay, but that’s all. The person simply feels normal.
There’s another reason why buprenorphine doesn’t typically cause much euphoria. That’s because it’s a partial agonist, not a full one like methadone, oxycodone, fentanyl or hydrocodone. This means that it only has partial action on the brain’s opioid receptor called the MOR or mu receptor. This limits the euphoric effect even if someone has no tolerance at all.
How Can Suboxone be Abused?
Buprenorphine does act differently when injected as compared to when it’s taken orally. Users have been known to dissolve the drug in water and inject it. This can cause a rather strong high in some people. That’s why Suboxone is a combination drug. It also contains naloxone, which is an opioid overdose rescue drug. It works to reverse an overdose by competing with opioid molecules for a place on the brain’s mu receptors. Because it has a higher affinity for these receptors than the opioids do, it pushes the opioid off the receptor and chemically tells it to take a powder and go away. As long as the naloxone molecule is occupying the receptor, nothing else can. The dispatched opioids are still there, but because they can’t get to the mu receptors, they can’t do much damage. They will circulate around and eventually be metabolized and disappear. The person may require a day or two of observation and repeat naloxone doses because the naloxone is often of shorter duration than that of the ingested opioid, but as soon as opioid levels decline far enough, the person will be fine.
The naloxone in Suboxone is 2 milligrams; the buprenorphine is 8 milligrams. As long as the drug is taken orally, under the tongue as directed, this amount of oral naloxone is not typically enough to counteract the effects of the buprenorphine. However, should the person try to dissolve the drug in water and inject it, the 2 milligrams of naloxone will have a profound effect. Not only will it stop the effects of the buprenorphine, it will cause an instant withdrawal reaction in an opioid-dependent person. This reaction is most unpleasant and will continue until the naloxone wears off. Nothing can be done in the interim. Anyone who has experienced this kind of instant, full-blown withdrawal reaction is unlikely to ever repeat it. People who abuse opioids know better than to try to inject Suboxone.
These are the reasons why Suboxone is used for opioid withdrawal and maintenance. It’s relatively unlikely to be abused, is almost never injected and it can be dosed just once a day because it’s very long-acting.
If you Need Help
If you have questions about Suboxone or would like to enter Suboxone therapy, we can help. Only specially licensed doctors can prescribe this drug, but we can help you find one near you. Just call us at 833-610-1174 anytime. Our experienced counselors will be happy to assist you.