I do, however, have some concerns about how suboxone is presented in the recent article, “Forced to Fight, Addicts long for the life beyond Heroin.” A recent Smoky Mountain News article details an addict “shooting up” Suboxone. 

Suboxone is a sublingual (meaning taken under the tongue) medication and should never be injected intravenously. This would be a serious misuse of the drug and would certainly get a patient discharged from any prudent medical practice. It could also send a patient into immediate withdrawal. 

Suboxone is made up of two medications: buprenorphine and naloxone. Buprenorphine is a synthetic partial opioid agonist that prevents patients from experiencing withdrawal symptoms and cravings for opioids. Naloxone, better known as narcan, is the opioid reversal drug that is used in opioid overdose. When taken correctly under the tongue, the naloxone in suboxone is very poorly absorbed.

However, when injected, the naloxone has a much higher bioavailability. For this reason injecting suboxone could send a patient into immediate withdrawal as the better-absorbed naloxone reverses the effects of the buprenorphine that is keeping the patient out of withdrawal. I don’t want my patients, or anyone who takes suboxone from another provider or from “the street,” to think that this is an acceptable way to administer their medication. It could be very dangerous for someone to inject suboxone intravenously. 

When taken correctly, suboxone is a life-saving medication that is evidence-based and the “gold standard” of care for opioid addiction. If you are prescribed suboxone and have any questions about how to administer your medication, please talk to your health care provider. If you or a loved one is battling opioid addiction, please talk to your health care provider or visit www.samsha.gov to find a Suboxone prescriber near you.

Sarah Lipham, MS(N), APRN, FNP-C

Waynesville