How long does Suboxone block opiates? The narcotic component of Suboxone is called buprenorphine and is capable of blocking other opioids and opiates for as long as several full days, although an average figure is probably closer to 36 hours. The drug’s long duration of action is due to its very long half-life of up to 42 hours. A half-life is a measurement of how long it takes the body to break down one-half of a given drug. So, it’s not surprising that a longer half-life would also produce a longer effect. Most opioids are short-acting, with half-lives averaging just a few hours. Heroin’s half-life is amazingly short, just a few minutes! After that it breaks down to morphine and other metabolites, but since morphine is an active metabolite, it certainly produces effects with a longer duration than just a few minutes.
Why does Suboxone Block Other Opioids?
Suboxone blocks other opioids and opiates through a process called affinity. All opioids work in the brain by attaching to one or more of the opioid receptors located there. There are three of these receptors, called the mu, the delta and the kappa, with the mu being most associated with euphoria, sedation and overdose. Different opioids have different affinity values. Affinity refers to how readily and completely an opioid can attach to a receptor. Only one opioid molecule can occupy a receptor site at a time, so those opioids with a higher affinity can sit on the receptor and block other opioids from attaching to it.
Although it’s only a partial agonist, buprenorphine still has a higher affinity than other opioids, so as long it’s on the receptor, any effects from other opioids present will be blocked.
Opioids are either partial agonist or full agonist. Partial means it can only activate the receptor partially, limiting or even eliminating its ability to cause a high. This is one reason why buprenorphine is so useful for opioid maintenance. It relieves withdrawal symptoms and drug cravings but typically doesn’t cause euphoria in someone with a high opioid tolerance. The other opioid used in opioid maintenance treatment called methadone is a full agonist, but it tends to cause little euphoria largely because it’s so slow-acting. It can take two to three hours for a dose of methadone to become fully effective, and its half-life can approach 60 hours!
What is Naloxone and why is it in Suboxone?
The other ingredient in Suboxone is called naloxone or by its brand name Narcan. It’s an opioid overdose rescue drug. It works by the affinity principle and reverses overdose by kicking the other opioid off the receptors. Since naloxone has no narcotic activity of its own, it acts as a place-holder, sitting on the receptor while the overdosed opioid just circulates around. Opioids kill by occupying so many brain stem opioid receptors that the breathing reflex is suppressed to the point of death. As long as the naloxone is on the receptor, the person will be able to breathe. The body will eventually break down the other opioid and eliminate it.
It should be noted, however, that naloxone can fail in certain circumstances involving large amounts of very powerful opioids, especially fentanyl and its chemical cousins. Opioid overdose is always an emergency, whether the person initially responds to naloxone or not. The victim should receive medical attention immediately because only medical professionals will know when the emergency is over and it’s safe to discharge the patient.
Naloxone Prevents Abuse
Naloxone is included in Suboxone to discourage intravenous abuse of the buprenorphine. Since intravenous use is the only way buprenorphine might possibly induce euphoria in someone with a high opioid tolerance, addicts might try to dissolve the film or tablet and inject it. That’s when the naloxone would kick in and prevent any kind of high. When taken by mouth as directed, the naloxone in Suboxone has no effect. However, if injected, it will not only block any high from the buprenorphine, but it will cause an instant opioid withdrawal reaction. Opioid addicts know this and none of them in their right mind would ever inject Suboxone. Naloxone also works by affinity. It has even a higher affinity than buprenorphine does, but it isn’t effective by mouth. It must be given by injection or by nasal spray.
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