Common Side Effects of Suboxone (Buprenorphine/Naloxone)

Suboxone is a brand name medication that can be prescribed to treat opioid use disorder (MOUD. It contains both buprenorphine and naloxone.

This page covers the side effects of Suboxone, alternative medications, and adjunctive therapies to improve treatment outcomes.

What Are the Side Effects of Suboxone?

Suboxone side effects may include:¹

• Headache.
• Body aches and pain.
• Excessive perspiration.
• Insomnia.
• Swelling, usually in the legs, feet, and ankles.
• Nausea or vomiting.
• Constipation.

Some side effects are specific to the sublingual or buccal formulation of Suboxone—the form that is a film placed beneath the tongue or between the cheek and gums. These include:¹

• Numbness of the mouth, tongue, or lips.
• Burning sensation affecting the mouth or lips.
• Redness or inflammation of the mouth lining.

In rare cases, some patients experience dental caries or tooth loss from Suboxone (sublingual or buccal formulations).²

If these side effects are a significant problem for someone, they may benefit from other formulations of buprenorphine and naloxone.

Are There Behavioral and Mental Side Effects of Suboxone?

In addition to physical side effects, some mental and behavioral effects of Suboxone may include:¹

• Slowed reaction time.
• Sleepiness.
• Dizziness.
• Coordination problems.
• Misuse. Buprenorphine is a partial opioid agonist meaning it activates opioid receptors (thus relieving withdrawal and cravings) without yielding the same level of euphoria or dopamine response, and overdose risk.³ However, it still carries some risk of misuse and people may develop a physiological dependency.

Alternatives to Suboxone in Medication-Assisted Treatment

There are several other MOUDs used in evidence-based addiction treatment. Other common medications to treat opioid addiction include:

• Methadone. Methadone is a long-acting opioid and can help with cravings, withdrawal symptoms, and prevent other short-acting opioids like heroin from binding to the opioid receptors.⁴ However, unlike the partial opioid agonist buprenorphine in Suboxone, methadone is a full (slow-acting) opioid agonist.⁴
• Naltrexone. Unlike methadone and Suboxone, naltrexone is an opioid antagonist, meaning it blocks the effects of opioids, discouraging their misuse.⁴ Naltrexone does not treat withdrawal; however, it may reduce cravings in some patients.⁴
• Buprenorphine. There are several other formulations of buprenorphine that include implants and extended-release injections.⁴

The decision to start treatment with MOUDs and which medication to take should be made after an assessment and consultation with a clinician. Medications, when combined with therapy, tend to yield improved treatment outcomes.^5,6

Therapies and Treatments Used with Suboxone

Suboxone is more effective when used in conjunction with other treatment interventions, often provided in inpatient or outpatient settings. Suboxone improves treatment retention, allowing patients to get the full benefit of other approaches like behavioral therapy and peer support.^5,6

A few different therapies are used in addiction rehab, including:⁷

• Cognitive-behavioral therapy (CBT). CBT is a commonly used, evidence-based treatment for various conditions, including addiction. It involves helping people develop coping strategies and recognize and avoid their triggers for opioid use.
• Motivational enhancement therapy (MET) is also a therapeutic strategy commonly used in addiction treatment. OUD often involves experiencing conflicted feelings about use; the person may know the negative impacts of use on their life, but may have a hard time giving it up if they have used it to cope with emotional pain. In such a case, MET is a process that helps the person weigh the costs and benefits of opioid use and helps them to get closer to the point of making healthy changes.
• Contingency management (CM) is also commonly used in addiction treatment and is found to be very effective. It involves providing tangible rewards (e.g., vouchers, movie tickets), when treatment goals have been met. Examples of goals include a certain number of days of abstinence or consistent attendance at therapy sessions.

Peer support groups are also an important part of recovery from OUD. These include groups like SMART Recovery or Narcotics Anonymous. Participation in these groups alongside professional treatment helps to bolster the skills learned in therapy and sustain recovery by building a support network.⁷

Other mental health conditions (e.g., depression, generalized anxiety, posttraumatic stress disorder) often occur alongside OUD. Treating addiction and co-occurring mental health disorders concurrently instead of one at a time often leads to greater treatment success.⁸

At American Addiction Centers (AAC), our rehab facilities provide these evidence-based therapies along with holistic, alternative approaches like yoga, meditation, and art and music activities.

AAC is also proud to offer addiction treatment programs tailored for specific populations like veterans and first responders, LGBTQI+, professionals, young adults, and trauma survivors.

Start Your Recovery Today

If you are concerned about your opioid use or that of a loved one, you can reach out to us at . Admissions navigators can answer questions, verify your health insurance coverage for rehab, discuss other payment options, and guide you through the rehab admissions process.