How Does Suboxone Work?Suboxone contains buprenorphine and naloxone. Buprenorphine is an opioid narcotic medication. It binds to specific types of opioid receptors, called opioid mu receptors, which are located throughout the body. While the main effects of buprenorphine occur in the central nervous system, buprenorphine can produce effects anywhere opioid mu receptors are found.
Interestingly, buprenorphine is a partial (not full) agonist of mu receptors. This means that it binds to the receptors, but only partially activates them. This usually translates into less of a chance of abuse, although this is not always the case.
Compared to full agonists, such as morphine, partial agonists, including Suboxone, usually have a "ceiling effect." This means that there is a certain dosage after which taking more of the drug does not cause any further effects. This might make Suboxone less dangerous than full agonist drugs, particularly in the case of an overdose.
Buprenorphine does not work well when taken by mouth (when swallowed), as only a small amount of the medication is actually absorbed into the bloodstream (mainly because it is destroyed by the liver first). However, Suboxone is dissolved under the tongue and is absorbed directly through the tissues, avoiding this "first-pass effect" of the liver.
Suboxone contains naloxone mostly to help prevent abuse of the medication via injection. When taken as directed (dissolved under the tongue), naloxone usually has no noticeable effects. However, when injected, naloxone can cause severe withdrawal symptoms, as it is essentially an antidote to opioids. This makes Suboxone less likely to be abused by injection and may also limit the dangerous problems in the case of an overdose. However, an overdose on Suboxone can still cause life-threatening complications.