The Epiphany Blog

Suboxone: A Two-Pronged Approach to Treating Opioid Addiction

Written By Epiphany - March 22nd, 2017

How Long Suboxone Stays in Your System is due to its Two Active Ingredients

On average, it takes about 8-9 days for a single dose (roughly 4-8mg) of Suboxone to completely exit the body. Measured in half-life—the time it takes for the liver and kidneys to metabolize and eliminate half of the drug—Suboxone is listed anywhere between 24 to 60 hours, which is considerably longer than most drugs.

Drug tests screening for buprenorphine will detect Suboxone use. Typically, Suboxone remains in the bloodstream 24-48 hours, urine 72 hours, saliva for days, (possibly weeks) and hair follicles contain presence of the drug within 3 days of use. However, those are just the averages as drug metabolism varies person to person due to several factors.

To better answer how long Suboxone will stay in [your] system, we must first examine Suboxone itself—what it is, where it came from, and how it works—as well as what it’s comprised of and how those component parts factor into the overall half-life of Suboxone. We can then more accurately predict—as well as better understand—how fast or slow an individual will metabolize Suboxone.

Approved by the Food and Drug Administration in October 2002, Suboxone is a semisynthetic drug prescribed to addiction to opioids, which includes legal prescription pain medication like OxyContin as well as illegal “street” drugs like heroin. Under a doctor’s supervision, Suboxone is usually taken once daily via sublingual tablets, administered under the tongue or inside the cheek.

While onset of Suboxone is slow, withdrawal from the drug doesn’t take effect for days. For this reason, Suboxone is effective in addiction maintenance because it reduces withdrawal symptoms and cravings, similar to methadone.

In fact, Suboxone was developed as an alternative to methadone. Initially, researchers at Reckitt Benckiser (formally Reckitt & Colman) were looking to synthetize an opioid compound similar to—but more complex than—morphine, so that undesirable side effects might be mitigated.

This eventually led to buprenorphine, launched in the United Kingdom in 1978, as an injectable treatment for severe pain and released in sublingual form 4 years later. Suboxone appropriated buprenorphine as one of its two active ingredients, combining it with naloxone in a strategically formulated 4:1 ratio.

While Suboxone blocks opioids (i.e. narcotics), users can still experience the euphoric feelings associated with an opioid “high” when taking Suboxone due to the buprenorphine component. Buprenorphine functions as a mu-opioid (MOR) receptor partial agonist as well as a delta- (DOR) and kappa-opioid (KOR) receptor antagonist.

Put simply, buprenorphine attaches to the same receptor as other opioids, making it a double-edged sword. On the one hand, it helps control withdrawal symptoms that cause cravings and lead to relapse. Yet, it also carries the risk of abuse and/or addiction. Hence making Suboxone a Schedule III drug.

The inclusion of naloxone, however, aims to deter misuse. Naloxone is an opioid antagonist, and so blocks the cell receptors in the brain that produce an opioid high. This makes Suboxone an unattractive choice for users who crave a quick fix because—initially—it will have the opposite effect on the user: that of withdrawal.

This explains the slow onset of Suboxone. When taken as intended, naloxone and buprenorphine separate immediately in the mouth. The fat-soluble buprenorphine molecules enter the bloodstream through the capillaries that line the mouth. Naloxone, unable to pass through these delicate capillary beds, remains behind in the saliva. After being swallowed, naloxone makes its way through the body until eventually being metabolized by the liver.

This gives naloxone a relatively short half-life (between 30-81 minutes). While it’s usually cleared from a user’s system usually within 48-84 hours, naloxone will block opiates (and thus prevent a “high”) for approximately 24 hours.

The half-life of buprenorphine, however, is estimated at 37 hours—considerably longer. Additionally, buprenorphine is metabolized into norbuprenorphine that has a half-life that exceeds 37 hours.

Due to all these variables, as well as the many body systems involved in metabolizing the drug, determining how long Suboxone will stay in a user’s system depends on factors such as:

  • Basal metabolic rate (BMR)
  • Dosage
  • Urinary pH
  • Liver function and health
  • Hydration level
  • Genetics (specifically as it relates to the presence of CYP3A4 enzyme within the liver)
  • Age
  • Body composition (height/weight/fat percentage)
  • Frequency of use
  • Ingestion of other drugs and substances (e.g., alcohol)
  • Frequency/intensity of exercise