Suboxone Program



Addiction Treatment

Scarborough       647-350-6662

richmond hill

alcohol abuse


drug abuse




addiction counselling



Richmond Hill     905-787-8999


addiction treatment Clinic

Hamilton             905-544-5255

  • If a patient decides to start on the suboxone program they have to abstain from opiate use for 24 hours before starting. The patient must be in moderate withdrawal before Suboxone is administered

  • The reason for this is due to the high affinity of buprenorphine (Active component of Suboxone) to the opiate receptor. It binds very tightly to the receptor such that if there are any other opiates in a patients system the buprenorphine will displace them off the opiate receptor. The partial agonist properites of buprenorphine only partially stimulates the receptor. This leads to the rapid development of withdrawal symptoms – a complication known as precipitated withdrawal

  • It is important to be in moderate withdrawal before starting Suboxone. If so, the Suboxone will start working right away and you will soon feel better. If you are not in at least moderate withdrawal, you may feel worse

  • Starting Suboxone is termed an Induction and should only be attempted by a physician trained in the procedure

  • Before induction, your physician will ensure you are in moderate opiate withdrawal. He/She will then administer a test dose of Suboxone and have you wait in the clinic for at least one hour. After which, the physician will reassess you to make sure you haven’t gone into the precipitated withdrawal discussed above. If you are fine then the remainder of the starting dose of suboxone will be administered

  • The administration of Suboxone is sublingual. The buprenorphine component is not effective if the pill is swallowed, only if it is allowed to dissolve and absorbed under the tongue

  • NOTE: The naloxone component of Suboxone is only active if the pill is liquefied and injected – taken in this way naloxone blocks any effect buprenorphine (or any opiate) would have. This is a safety feature and prevents abuse

  • A patient will reach a stable dose of Suboxone within 24 hours to a few days (compared to a few weeks with methadone)

  • Similar to the Methadone Program, patients must initially go to a pharmacy every day to get their dose. The pharmacist will witness the doses being taken

  • As they progress in the treatment program patients will be allowed to have take home doses (carries) to take on their own. This will be based on stability, abstinence from drug use, and in consultation with their physician

  • The Suboxone program follows similar rules with respect to clinic visits, urine testing and granting of carry home doses as the Methadone program, however, the Suboxone program is probably easier than the methadone program with respect to how quickly take home doses are granted and travel allowances