Suboxone

Gold-standard medication-assisted treatment for opioid use disorder

Medication-Assisted Treatment Buprenorphine / Naloxone

Overview

Suboxone (buprenorphine/naloxone) is the most widely prescribed medication for opioid use disorder and has the strongest evidence base of any MAT option. Buprenorphine is a partial opioid agonist — it binds to opioid receptors strongly enough to prevent withdrawal and cravings, but weakly enough that it has a "ceiling effect" that prevents the euphoria and respiratory depression of full opioids. The naloxone component discourages misuse.

How It Works

Buprenorphine's partial agonist properties mean that once it occupies opioid receptors, additional opioids produce little effect — effectively "blocking" full opioids. This eliminates cravings, prevents withdrawal, and blocks the effects of illicit opioids. Most patients on a stable Suboxone dose function completely normally, with no impairment to work, relationships, or daily activities.

Induction & Dosing

Must be in mild-to-moderate opioid withdrawal before first dose (COWS score ≥8–12)
First dose administered at home or in office — 2–4mg initial dose with monitoring
Titrated over 2–3 days to the stabilization dose (typically 12–16mg/day)
Home induction is now the standard — no need for supervised induction in all cases

Available Formulations

Suboxone film (most common): 2mg/0.5mg, 4mg/1mg, 8mg/2mg, 12mg/3mg
Suboxone tablets (generic available)
Zubsolv (different buccal formulation, generic available)
Brixdi (buprenorphine mono — for pregnant patients)
Generic buprenorphine/naloxone films and tablets

MAT With Direct Physician Access

Recovery requires support between appointments. With Dr. Agresti's concierge model, you have his direct cell number — text him about cravings, side effects, or concerns without waiting weeks for the next scheduled appointment. This level of access is especially critical in early MAT when induction and dose adjustment require close monitoring.

Schedule a MAT Consultation

Common Questions

Will I be on Suboxone forever?

Guidelines recommend treating opioid use disorder as a chronic condition. Long-term maintenance is associated with the best outcomes. Some patients eventually taper off successfully with appropriate supports in place. This decision is made collaboratively based on stability and readiness.

Can I work/drive on Suboxone?

Yes — patients on a stable, correct dose of Suboxone function normally and have no impairment to driving, working, or other activities. Suboxone at a therapeutic dose does not cause sedation or cognitive impairment in patients who are opioid-tolerant.

What if I use opioids while on Suboxone?

The buprenorphine occupying opioid receptors significantly blunts or blocks the effects of other opioids. Most patients on stable Suboxone find that using additional opioids produces minimal effect. This is one of the protective mechanisms of Suboxone treatment.