What Are The Long-Term Side Effects of Suboxone?

Suboxone is a prescription medication that is approved by the FDA to treat opioid dependence. It comes in the form of a sublingual film that dissolves under the tongue and is taken on a daily basis. Suboxone contains two active ingredients: buprenorphine and naloxone. Buprenorphine helps stop drug cravings and reduce withdrawal symptoms, while naloxone prevents misuse of the medication. When taken as prescribed and combined with a comprehensive addiction treatment program, Suboxone can reduce the risk of relapse in people who were addicted to opioids.

Unfortunately, no medication is 100% risk-free, especially when taken in the long term. Suboxone can be used on a short and long-term basis, however, there are a few significant long-term risks of Suboxone. Learning about these risks can help you decide whether or not Suboxone treatment is right for you.

Short-Term Side Effects of Suboxone

Suboxone may cause mild to severe side effects. Most of the more common side effects are relatively mild and include:[1]

• Headache
• Body aches
• Abdominal cramps
• Anxiety
• Increased heart rate
• Insomnia
• Sweating
• Depression
• Nausea
• Constipation
• Weakness
• Fatigue
• Back pain
• Burning tongue
• Redness in the mouth

These side effects usually go away within a couple of days or weeks. If you end up taking Suboxone and these side effects persist,  your doctor or pharmacist may change your treatment regimen.

Other serious side effects are very rare. These include:

• Allergic reaction
• Breathing problems
• Coma
• Hormone problems
• Abuse and dependence
• Withdrawal symptoms

If you take Suboxone and experience any of these side effects, you should call your doctor immediately or dial 911 if you think you are having an emergency.

Consequences of Taking Suboxone Long-Term

Suboxone is commonly prescribed as part of medication assisted treatment for opioid use disorder and is often intended for short term or transitional use. Many individuals are gradually tapered off the medication once they achieve stability in recovery. In some cases, however, long term Suboxone maintenance may be recommended to help manage opioid dependence and reduce the risk of relapse.

While long term use can be clinically appropriate for certain individuals, it is not without risks. Prolonged Suboxone use may lead to physical dependence, meaning the body adapts to the medication and withdrawal symptoms can occur if it is stopped abruptly. Hormonal changes have also been observed, which may affect energy levels, mood, or sexual function over time. In addition, Suboxone is processed by the liver, and extended use may contribute to liver strain or damage, particularly in individuals with preexisting liver conditions. For these reasons, ongoing medical monitoring is an important part of long term Suboxone treatment.

Physical Dependence

Buprenorphine is one of the two medications in Suboxone. It is a partial opioid agonist that reduces physical withdrawal symptoms and psychological cravings. However, the medication has opioid properties that can be physically addictive. Anyone who takes Suboxone for a long time will develop a physical dependence on the medication. Similarly, stopping the medication cold turkey will result in opioid withdrawal symptoms.[2]

If you participate in a Suboxone treatment program, you should never stop taking the medication without first speaking with your doctor. Your doctor can give you a tapering schedule and dose to follow that slowly and safely weans your body off of buprenorphine.

Hormone Problems

Some people who take opioid medications long-term, including buprenorphine, develop reduced cortisol levels. Cortisol is a steroid hormone that regulates several bodily functions ranging from metabolism to immune response. Chronically reduced cortisol levels lead to a condition called adrenal insufficiency.[3]

Symptoms of adrenal insufficiency include:

• Depression
• Nausea
• Vomiting
• Diarrhea
• Loss of appetite
• Fatigue
• Weakness
• Low blood pressure
• Dizziness

Some researchers believe secondary adrenal insufficiency caused by opioid replacement therapy is more common than we currently realize.[3]

Liver Damage

Some studies have suggested that long-term Suboxone use can lead to increased liver enzymes. Increased liver enzymes can cause inflammation or damage to the liver. However, it’s important to note that liver damage was more likely in patients who were living with Hepatitis C (HCV.) HCV causes increased liver enzymes, which is thought to be the sole cause of liver damage in most affected patients. Liver damage is also more likely in patients who misuse and inject Suboxone.[4]

Although extremely rare, your doctor may conduct tests to check and monitor your liver function and enzyme levels if you are at high risk for liver disease. Symptoms of liver damage may include:

• Stomach pain
• Fatigue
• Jaundice (yellowing of the skin or whites of the eyes)

Your doctor will ask you to stop taking Suboxone if you show signs of liver damage.

How to Know When it is Time to Stop Taking Suboxone

Once you start having more stable moods and your cravings are under control, your doctor may speak with you about getting off Suboxone. You should never stop taking Suboxone unless you have approval from your physician and feel confident in your sobriety. Your substance abuse counselor may also be able to help you decide when to stop. When the time comes to stop taking your medication, your doctor will slowly begin lowering your dose. This allows you to gradually get used to not having Suboxone in your system. A Suboxone taper will also prevent withdrawal symptoms. Suboxone, like all other aspects of addiction treatment, is highly individualized, so no two individuals are exactly the same. Some people need to stay on the medication for a year or more while others only take it for a few months. It’s vital that you stick to your treatment plan and take the suggestions of your treatment provider.

• Anxiety or depression
• Cardiovascular symptoms
• Changes in physical coordination
• Excessive sweating
• Hallucinations or disorientation
• Intense cravings
• Lack of motivation or energy
• Poor mental health
• Severe headaches
• Seizures, blackouts, or tremors
• Severe muscle aches or pains
• Severe irritability
• Significant changes in sleep patterns
• Suicidal ideations
• Uncontrollable shaking or tremors
• Vomiting or diarrhea

If any of these symptoms are present, it is essential to seek professional help immediately. The team at our New England recovery center will provide safe and effective treatment that will help you achieve sobriety and long-term recovery.

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