Sublocade for Opioid Addiction: Benefits, Risks and Side Effects

Sublocade is an innovative treatment for opioid use disorder. The drug is given as an injection once a month to prevent relapse for people who are dependent on opioids. It was the first treatment of its kind to be approved by the FDA. So far, it has shown promising results as a maintenance therapy for opioid dependence.

What Is Sublocade?

Sublocade is a monthly injection of buprenorphine. It is used for treating opioid use disorder (OUD). On November 30, 2017, Sublocade obtained FDA approval. People with OUD who have already begun treatment with other forms of buprenorphine can use it. These other forms include Suboxone, Subutex or Zubsolv. They must have completed treatment for seven days and have tapered their dosage to manage their symptoms.

How Does Sublocade Work?

Sublocade works by slowly releasing buprenorphine over time. The concentration of buprenorphine stays stable in the blood. It causes a constant partial stimulation of opioid receptors. This eases withdrawal symptoms that surface after stopping opioid use. Sublocade is available only by prescription from a physician.

Sublocade for Opioid Addiction

The main ingredient in Sublocade is buprenorphine, a partial opioid receptor agonist. This means it binds to the same receptors as opioids and activates them. In turn, buprenorphine causes a euphoric effect similar to opioid drugs. Buprenorphine is longer lasting than most illicit opioid drugs. However, its euphoric sensation is less intense and has less severe side effects. It works to relieve the withdrawal symptoms of opioid dependence and prevent cravings without providing a high.

Some oral medications used for opioid addiction that contain buprenorphine also have naloxone. However, Sublocade does not. Naloxone is an opioid receptor inhibitor that was added to some oral forms of buprenorphine. It increases the safety of the medication while helping to prevent abuse.

Sublocade as Part of Medication-Assisted Treatment (MAT)

Sublocade can be used as part of medication-assisted treatment (MAT) for opioid withdrawal. During MAT, a person undergoes supervised administration of medications. These medications are designed to ease cravings and reduce the severity of withdrawal symptoms. 

Before starting Sublocade, a person should already have received at least 7 days of treatment with another buprenorphine-containing product. While on Sublocade, they will get periodic check-ups. These check-ups monitor for complications and assess how well the injections are working. Sublocade MAT can be used long-term. The person may keep getting treatment for as long as their healthcare provider thinks it’s needed.

Benefits and Effectiveness of Sublocade for Opioid Addiction

The major benefit of Sublocade is that it only has to be injected once a month. Other forms of buprenorphine need to be taken daily. This delivery method ensures the individual will not miss one of the daily doses. Doing so could put them at risk for relapse. In fact, it has been shown that people can go up to two weeks past the intended dose date and still have effective levels of buprenorphine in their system.

Research has shown that the injectable form of buprenorphine is quite effective. Its use has increased the number of people who were opioid-free after 2–6 months of treatment.

Does Sublocade Help with Withdrawal Symptoms?

Sublocade can help mitigate withdrawal symptoms over its extended-release period. The buprenorphine in Sublocade works as an opioid partial agonist. This means it diminishes opioid dependence and eases cravings and withdrawal symptoms. Unlike oral buprenorphine dosing, Sublocade allows people to experience fewer ups and downs. This is because the release is consistent and controlled over a month. 

How Long Is Opioid Addiction Treatment with Sublocade?

Sublocade is a maintenance therapy meant to be used for as long as the person needs. As long they remain stable and do not relapse, they can continue Sublocade treatment. Since opioid dependence is often a chronic problem, a person may need to use Sublocade indefinitely. Right now, there is no maximum duration of treatment.

The person needs regular check-ups to ensure they’re not using opioids or experiencing severe side effects. If they want to stop the treatment, they should discuss it with their doctor. A medical professional can guide them on possible withdrawal symptoms. Doctors can also determine how long it will take for their body to be entirely free of buprenorphine.

Is Sublocade a Cure for Opioid Addiction?

There is no cure for opioid addiction. However, recovery from opioid use disorder (OUD) is possible. Drugs like Sublocade can form an essential component of a recovery program. Inpatient or outpatient rehab combined with MAT can lead anyone to lifelong recovery from opioid addiction. 

Sublocade vs. Vivitrol

Sublocade and Vivitrol are both used as maintenance therapies for opioid use disorders. Still, they vary in their mechanism of action. Vivitrol is an injectable form of naloxone, which is an opioid receptor inhibitor. It works by preventing opioids from binding to the receptors. If these receptors are blocked, the person will not get feelings of pleasure associated with opioids. This makes opioid use undesirable. It also helps individuals with opioid dependence avoid relapse after quitting opioids.

Sublocade is an injectable form of buprenorphine that also acts by binding to opioid receptors. However, it stimulates the receptors instead of inhibiting them. It also will block the additional effect of opioids. Sublocade helps to lessen the withdrawal symptoms and prevent cravings for opioids. It is also used as a maintenance therapy.

Sublocade Dosage and Administration

Sublocade is an injection containing buprenorphine that must be given by a healthcare provider. Sublocade is injected subcutaneously (under the skin) in the abdomen. The Sublocade shot forms a solid mass under the skin that slowly releases buprenorphine over time. It allows for a constant concentration of buprenorphine in the blood. The injection is given monthly with a minimum of 26 days between treatments. Getting a Sublocade prescription will depend on a person’s treatment status.

During Inpatient Treatment

Sublocade injections are given only after someone has already started opioid dependence recovery with another form of buprenorphine treatment. This procedure is usually done in an inpatient treatment setting. This is because the person needs to be monitored carefully during this process. Only after they have received tapering doses of buprenorphine will a Sublocade injection be given.

The first two doses of Sublocade are given at 300 mg, one month apart. Following these treatments, the person can be placed on a maintenance dose.

As Maintenance Medication

Once someone has stabilized and is no longer using opioids, the Sublocade shot can be used for maintenance therapy. Generally, after two monthly doses of 300 mg, the maintenance dose is decreased to 100 mg. However, the dose can be increased to 300 mg if the person cannot withhold from opioid use on this dosage schedule.

If someone misses a dose, they should seek out and receive it as soon as possible. Generally, a delay of up to two weeks will not impact the treatment.

In Private Outpatient Treatment

It is not possible to use Sublocade privately or at home. This is because it must be administered by a healthcare professional. However, when Sublocade is used as a maintenance therapy, the person is welcome to go home once the shot is given. They do not have to remain under supervision during treatment like some other forms of opioid dependence therapies.

Sublocade Side Effects

There are side effects that can occur with Sublocade injection. Sublocade side effects include:

• Itching at the injection site
• Pain at the injection site
• Headache
• Fatigue
• Constipation
• Vomiting
• Nausea
• Increase in liver enzymes

Risks and Contraindications

Sublocade should not be administered to people who are hypersensitive or allergic to buprenorphine. It should also not be used in combination with many other types of drugs. It is best to speak with a physician before using it in combination with any other drug.

Sublocade should never be injected intravenously. It is a liquid when injected but forms a solid when it enters the body. If this drug were to get into the blood, it could cause major clotting issues and even death. It should also not be administered into the muscle, only subcutaneously.

Sublocade, like other buprenorphine-based products, may cause slowed breathing and nervous system function. These side effects can be life-threatening. Sublocade should be discontinued if a person has symptoms of either condition.

Is Sublocade Right for Me?

The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab offers evidence-based treatment plans for people struggling with substance use disorders. If you or a loved one have an opioid use disorder and are interested in using Sublocade as a treatment, The Recovery Village Palm Beach can help. We offer the Sublocade injection along with counseling and support to overcome opioid addiction. Contact The Recovery Village today to speak with a Recovery Advocate and learn more about our treatment plans.