Suboxone is a medication that the Food and Drug Administration has approved to treat opioid dependence. The drug contains two components, namely buprenorphine, and naloxone.
Buprenorphine works with the nervous system to deliver analgesia (pain relief). Naloxone blocks or reverses the effects of opioid medication by displacing opioids from the opioid receptors in the brain.
But there has been a lot of confusion about whether you should swallow or spit Suboxone. It is important to note that the buprenorphine in Suboxone does not have a bioavailability of 100% when taken orally.
This means that if you swallow it, much will be lost during digestion, and all the medication will not be absorbed into your body.
So, should you swallow or spit Suboxone? Read this post to the end to find out.
How Does Suboxone Work?
Before we answer that question, we should first understand how Suboxone works. The medication is a combination of two drugs: buprenorphine and naloxone. These two medications work very differently to do the same thing — relieve an individual from his/her opioid dependence.
Buprenorphine has a high affinity for the μ-opioid receptor. In simple terms, it attaches itself to the opioid receptors in your body.
Once attached, buprenorphine activates or stimulates the receptors. This leads to a reaction that brings about certain effects similar to other opioids, such as analgesia and euphoria.
Naloxone is a potent pain medication that produces less euphoric effects compared to other opioid medications. It attaches itself firmly to the μ-opioid receptors and displaces other opioids from those receptors. This causes some nasty withdrawal effects such as anxiety, irritability, sleeplessness, runny nose, nausea, and vomiting, among others.
Do the Manufacturers of Suboxone Tell Patients to Spit or Swallow?
Interestingly, the official prescribing information doesn’t provide directions on whether Suboxone should be swallowed or spit. In other words, the manufacturers of Suboxone just leave it out there for patients and prescribing doctors to figure out on their own.
But why should there be a question about what to do once the Suboxone film has been dissolved and gone? Well, a significant number of patients who take the medication complain so much about the bad-tasting Suboxone saliva that remains in their mouths once the film has dissolved.
Even in cases where the saliva isn’t bad tasting, patients are left wondering whether they should swallow or spit it. In most cases, doctors, pharmaceutical companies, and drug treatment experts don’t address this concern forcing patients to turn to online forums for answers.
So, Should You Swallow or Spit Suboxone?
The answer to this question is not as simple as it may seem. You need to know that Suboxone has two different forms: a pill and a film strip, which can be used for buccal administration (i.e., sticking it under your tongue).
The film strip form of Suboxone comes in 2mg/0.5mg, 4mg/1mg, 8mg/2 mg, and 16 mg/4 mg strengths, while the pill form comes in 2mg tablets only.
The difference between taking a tablet or a film strip is that when you swallow a tablet, it first passes through your stomach before being absorbed into your bloodstream, where the effects could take up to an hour before they are felt.
However, when you take a film strip, the effects are felt almost immediately because it gets absorbed through the buccal mucosa (i.e., under your tongue).
It is essential that you do not let a film strip dissolve in your mouth: You could accidentally swallow it and defeat its purpose. If this happens, please consult your prescribing physician.
Spitting a Suboxone film strip in your mouth can be an effective way to take this drug. You could also sprinkle the powder from a pill in your mouth and swallow it with excess water.
You should know that if you are having difficulty tolerating medication via the sublingual route (i.e., under your tongue), it is still possible for your physician to prescribe a pill.
However, it is recommended that you consult your primary care provider if you do not see the results of treatment, have problems tolerating medication, or have further questions.
Does Swallowing or Spitting Make a Difference?
To answer this question, we have to look at the buprenorphine component of Suboxone. The buprenorphine contained in the medication is not well absorbed when taken orally. This means that a lot of it is lost in digestion, and only a fraction enters the body to provide relief from opioid withdrawal symptoms.
The bioavailability of Suboxone, when taken orally, is between 30% and 87%. The Suboxone film has a bioavailability of about 30%. This is because the buprenorphine used in the film only binds to the u-opioid receptors in the mouth and not those in your stomach.
A study showed that when you swallow, less than 10% of buprenorphine gets into your system. Also, there are other non-opioid medications that have high bioavailability when taken orally.
So, if you spit Suboxone after taking it, up to 87% of the buprenorphine will be lost and won’t provide any relief from your opioid dependence. This is why many doctors believe that you should swallow Suboxone.
However, if you swallow Suboxone, it may take longer to relieve opioid withdrawal symptoms than when you spit it. This is because buprenorphine has a long half-life and remains in your body for a long time, even after the effects have worn off.
When you swallow Suboxone, buprenorphine is attached to the opioid receptors in your digestive tract. However, when you spit it out, buprenorphine is already broken down and doesn’t attach itself to the opioid receptors in your stomach anymore.
So, What Should You Do? The Bottom Line
Based on this information, we can say that Suboxone should be swallowed whole and not crushed and mixed with water before taking. This is because when Suboxone is ground into powder, the buprenorphine active ingredient will attach itself to the opioid receptors in your stomach, and this provides less pain relief than taking the medication without crushing it.
Spitting Suboxone doesn’t provide great benefits compared to swallowing it whole because buprenorphine is poorly absorbed when taken orally.
So, it’s only logical to swallow the entire tablet. However, one thing you can do before taking Suboxone is to chew the film because the bioavailability of the buprenorphine, in this case, is 30%. You can also cut or break up your pill into smaller pieces.
We hope that this information can help you decide whether to swallow or spit Suboxone. If you have a question, feel free to contact our experienced Suboxone doctors for professional assistance.
