Suboxone overdoses are considered rare, but that doesn’t mean they don’t happen. The medication has been designed to be as safe as possible, but a person can still overdose on it, as its manufacturer Indivior notes in its guide on the drug. It is common knowledge that medications should be taken as prescribed, but in many cases, they aren’t. And this is what often leads to an overdose. Suboxone, is a sublingual tablet medication made up of two drugs—buprenorphine and naloxone. It is commonly used to treat opioid dependence in people who need to reduce or quit their opioid use.
This is especially true of those who participate in a medication-assisted treatment (MAT) program that combines the use of medication along with behavioral therapy.
A Closer Look at What’s in Suboxone
Buprenorphine is in a class of medications called opioid partial agonist-antagonists. It is similar to weaker opioids in that it produces euphoria and depressed breathing as opioids do. However, its effects are not as strong as certain opioids, such as heroin and methadone, which means there’s less chance that a person will misuse it or abuse it.
The opioid effects of Suboxone increase with each dose, as the Substance Abuse and Mental Health Services Administration (SAMHSA), explains. However, at moderate doses, the effects do level off, even as more doses are taken. This “ceiling effect,” as this property is called, means a person will feel fewer effects with each dose, a feature that helps protect against misuse or abuse of the drug, and ultimately, overdose.
The other ingredient, naloxone, temporarily reverses the effects of stronger opioids, including buprenorphine. On its own, however, the medication can help people survive an opioid overdose. It does this by blocking opioid receptor sites, and this is what reverses the toxic effects of the overdose.
As SAMHSA explains, “Naloxone is also added to buprenorphine to decrease the likelihood of diversion and misuse of the combination drug product.”
Medication is Still Abused
Even with safeguards in place, some Suboxone users abuse the drug, and this is a dangerous practice. Abuse includes crushing the medication into a powder that is then snorted or injected via a needle (intravenously).
If the drug is taken excessively or ingested in amounts larger than prescribed, one can experience strong effects similar to those of more potent opioids, such as heroin, morphine, or oxycodone (OxyContin). Doing this repeatedly over time can lead to developing a physical and/or psychological dependence on Suboxone and becoming addicted to it. Changing the drug’s form or taking more than recommended isn’t where the abuse stops.
Some people also abuse Suboxone by mixing it with other substances, such as benzodiazepines, sedatives, tranquilizers, antidepressants, or alcohol. This is strongly not recommended. It is a dangerous, slippery slope that can lead to overdose and possibly death.
Some opioid overdoses happen for other reasons, as SAMHSA notes. These reasons include being unclear on how to use the medication properly, taking an extra dose, or someone taking medication that’s prescribed to another person.
If an overdose happens, things can be done to try to save a person’s life. Read on to learn how to recognize and treat Suboxone overdose
Signs of Suboxone Overdose
The signs and symptoms of a Suboxone overdose can look similar to those that happen during an overdose on other opioids, such as the illicit opiate heroin and prescription pain reliever drugs, such as codeine and fentanyl.
If you or someone you know has taken too much Suboxone, you can expect symptoms such as:
- Extreme drowsiness
- Slowed reflexes
- Nausea, vomiting
- Low blood pressure
- Pinpoint pupils
- Blurred vision
- Unclear thinking
- Coordination problems
- Slowed or stopped breathing
- Slowed heartbeat
- Anxiety, mood swings
A Suboxone overdose is serious business. It requires emergency attention as this event can leave someone permanently injured or dead. Call 911 immediately to receive aid from trained first responders. If needed, provide emergency aid until the paramedics arrive.
Keep in mind that some states have Good Samaritan laws, which protect you and the person who has overdosed from being legally penalized while being treated for an overdose, even if the drug used is legally or used illegally.
Treating Suboxone Overdose
Dial 911 for emergency help. Share your location with the operator and be clear when expressing that you are calling for help for a person who has overdosed.
Tell the operator essential information, such as the person’s age, sex, weight, and other drugs the person may have taken. If the person is conscious, ask for vital information that can be helpful in getting the person the emergency aid they need as quickly as possible.
Give naloxone to the person if the medication is available. Naloxone, which is separate from the naloxone present in Suboxone, treats opioid overdose. A coherent person in overdose may be able to help you to locate the medication so that you can help. Brand names for naloxone include EVZIO and Narcan. According to GetNaloxoneNow.org, it can be administered in the form of a nasal spray, an injection via a needle, or an auto-injector with a prefilled, ready-to-use dose of medication.
You can also call out to people who may be nearby and ask if anyone has naloxone on hand. Relatives, caregivers, or users can legally acquire naloxone-based drugs that can be used in emergencies such as these.
Begin CPR immediately on a person who is not breathing or a person whose heart has stopped. The 911 emergency dispatcher may be able to walk you through and give you instructions on how to do this. Follow the instructions carefully.
Of course, overdose symptoms vary by the person. Someone who has overdosed on Suboxone may have symptoms that differ from those listed above. If so, it doesn’t mean the person is safe; the individual still needs help.
One reason the symptoms may look different is a person may have taken Suboxone along with other substances, which can change how symptoms present themselves.
This is why first responders need as much information as possible. Helpful information, such as how the overdose occurred and what substances were involved, can help ensure the person gets the right treatment. As mentioned earlier, calling 911 is the right thing to do, but consult with a medical professional about any other symptoms that raise concern as soon as possible.
If you or someone you know is taking Suboxone on prescription, it’s best to avoid taking other drugs with it, both prescription and nonprescription. If you are taking Suboxone on prescription, tell your physician and pharmacist about all the medications you are taking. Also tell them about any vitamins, nutritional supplements, and herbal products, MedlinePlus.gov advises.
Time to Get Help
Taking too much Suboxone is a sure sign that it’s time to see a doctor, whether the user is on a prescription for the medication or is using it recreationally.
If you are on a treatment plan, but you’re misusing the medication, then your doctor can adjust the treatment plan you’re following. Your plan may also need to be changed to address the issue of misuse or abuse, and there are effective alternative treatment plans that can help you with this.
Recreational Suboxone users are advised to seek professional treatment immediately. Misusing this drug can harm the body.
If the medication is used along with other drugs or alcohol, the compounded effects of all the substances together can combine and harm the body, making overdose even more complicated and harder to reverse than if just Suboxone were used alone.
Suboxone Overdose Treatment
Many people wonder, “Can you overdose on Suboxone?” Suboxone overdose is less common because of its application and use to safeguard your sobriety. Unfortunately, however, it can happen. As mentioned above, Suboxone overdose symptoms present themselves similar to other opioid overdoses. If you or someone you know is prescribed Suboxone, you must know the symptoms of taking too much Suboxone. Knowing this can potentially save your life. As you might expect, Suboxone overdose can be fatal despite it being less common. If you reach a point where you’re using more than you should be, Suboxone overdose treatment is imminent.
If you’re using Suboxone, it likely means you’ve been through the continuum of care, and you’re enrolled in a medication-assisted treatment (MAT) program. Although it’s highly successful in treating opioid addiction, some individuals slip and start abusing Suboxone. Even though its abuse potential is much lower, it still can be abused. If you reach this point, you must check yourself back into treatment to undergo medical detox and begin the process of removing all traces of the drug from your system. As you know, the process can last anywhere from three to seven days, depending on how much you are taking.
If you were enrolled in an outpatient program, you’d likely be considered for inpatient care at this point. Inpatient treatment is ideal for those with a history of relapse and a severe substance use disorder. If you started snorting or using Suboxone as a way to achieve intoxicating effects, this would also be the best option for you. When taken this way, you likely experience euphoria, sedation, and other side effects that shouldn’t occur with Suboxone use. For that reason, living on-site will be the best option for you as you start over and understand what made you abuse the drug in the first place.
Suboxone withdrawal symptoms can be severe as well, more so than other opioids, which is another reason treatment should be sought out. These symptoms include:
- Increased body temperature
- Body aches
Due to its severity, you’ll be better served in a treatment facility that can treat your withdrawal symptoms and pressing needs once you complete detox. Once you reach an inpatient treatment facility, the staff will pull up your treatment plan and look for ways to revise it, and see what went wrong in your previous plan. It could mean tweaking how often you visit therapy, adding more intensive therapy sessions, or keeping you longer than before. In many cases, people will leave sooner than they should, which is a significant problem. You must stay on-site for 30 to 90 days to start a new regimen and embrace your new life away from drugs and Suboxone.
Cognitive behavioral therapy (CBT) is a source of inspiration when you’re looking to move away from drug use. It can help you examine your thoughts and change how you respond to negative stimuli. Other therapy options like dialectical behavior therapy (DBT) can also help you adjust to a new life of sobriety. Once you complete treatment, you can’t assume you’re cured. Unfortunately, there is no cure for addiction, meaning you must manage it for the rest of your life. You can do this by attending aftercare programs. Our staff can put you in touch with fellow alumni and 12-step programs that change your environment once you leave treatment.
Once you leave treatment, you shouldn’t associate yourself with friends you used drugs around. One way to do this is by choosing a treatment center far from home and starting a new life elsewhere. Our staff can connect to sober individuals on the same path toward sobriety as you while you try to lead a life away from drug use. Even if medication-assisted treatment didn’t work for you, don’t lose hope. Many options exist to help you.