Snorting Suboxone: What Happens When It’s Snorted or Sniffed?

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Suboxone is a medication used to treat people who are addicted to opioids. It contains an opioid medication, but it also contains another substance that’s intended to prevent misuse. However, in the world of addiction treatment, relapse and drug misuse is an ever-present challenge. Snorting is one way a drug like Suboxone might be misused, but the drug’s own safeguards may make snorting an unpleasant experience. Still, snorting is a potentially dangerous way to use drugs recreationally. 

What happens when you snort Suboxone, and can it be dangerous?

What’s in Suboxone?

Suboxone is a combination of buprenorphine and naloxone, two active ingredients that work together to make the drug useful in treating opioid addiction. The medication is taken sublingually, which means you place it under your tongue, and the medication is absorbed into your bloodstream from there. Because of the way the medication is designed, taking it in other ways can cause it to have very different effects on the body. Here’s a closer look at the medication’s ingredients.

Buprenorphine

Buprenorphine is a partial opioid agonist used to treat substance use disorders. As a partial agonist, it can bind to opioid receptors and activate them. However, it only activates them partially, which means it will have milder effects than a typical opioid agonist like heroin. Buprenorphine is also very good at binding to receptors. It can kick other opioids off of opioid receptors, and once it binds, it’s difficult to get it off for a while. 

Buprenorphine can cause some of the effects of a traditional opioid, but it is strong enough to prevent people that are dependent on opioids from experiencing significant withdrawal symptoms. However, it’s said to have a plateau effect, also called an effects ceiling. This refers to the fact that its effects diminish after a certain dose size. In other words, it won’t increase its effects with very large doses. For that reason, buprenorphine is less likely to cause intoxication or overdose. Buprenorphine can be misused in an attempt to achieve a euphoric high. For that reason, it may be administered once per day as it’s being used in MAT. However, Suboxone has another safeguard against misuse.

Naloxone

Naloxone is an opioid antagonist, which means that it can bind to opioid receptors, but it doesn’t activate them. Instead, naloxone blocks the receptors from being activated by other opioids, and it can even kick opioids off their receptors to block them. Naloxone is used by itself, and it’s sold under the brand name Narcan. 

When used on its own, it acts as an opioid overdose antidote. It works by binding to opioid receptors, kicking off any opioids, and stopping the effects of opioids. It not only stops an opioid overdose from progressing, but it also reverses the opioid overdose symptoms. This life-saving use of naloxone may be essential in treating an overdose, but it may seem counterintuitive when it comes to treating opioid withdrawal. 

When Suboxone is taken as directed, the naloxone isn’t very effective. Since the medication is taken sublingually, naloxone has a hard time making it into the bloodstream. However, buprenorphine can be absorbed into the bloodstream with this method of administration. Naloxone is present in Suboxone as a safeguard against misuse. The sublingual use of a dose of buprenorphine isn’t enough to cause a euphoric high. 

Some users may attempt to achieve a high by using the drug in different ways like snorting, injecting, or smoking. These methods may cause a euphoric high, but they will also allow naloxone to take effect. 

Someone who is dependent on opioids would experience immediate withdrawal symptoms when the naloxone starts to affect them. Not only would naloxone prevent buprenorphine from causing any intoxicating or euphoric effects, but it would also cause unpleasant withdrawal symptoms. This may act as a deterrent to Suboxone misuse.

Suboxone and Medication-Assisted Treatment

Suboxone is used in medication-assisted treatment (MAT), which is treated with an opioid medication alongside other addiction treatment methods. The goal of this kind of treatment is to prevent withdrawal symptoms and cravings to help you get out of the cycle of active addiction. It may also allow you to attend treatment after skipping the withdrawal period, so you can learn how to cope with cravings and triggers before going through detox. 

MAT is generally reserved for people that have achieved sobriety and relapsed several times. Chronic relapse is a significant problem in addiction treatment, and it can make it difficult for some people to achieve lasting recovery. MAT may take longer than traditional treatment methods, and it will mean being dependent on opioid medication for months. But it can help give some people the boost they need to make it through recovery. 

snorting-subxone

What Are the Effects of Abusing Suboxone?

If you’re using Suboxone, you’re likely in recovery from opioid addiction. One of the biggest consequences of snorting Suboxone is threatening your recovery. Addiction recovery is a long and challenging process, but it’s one that’s necessary for returning to a meaningful life, free from active addiction. Using Suboxone properly can free you from the endless cycle of needing to find, use, and recover from drugs. 

Opioids are notoriously addictive, and it can be extremely difficult to overcome an opioid use disorder. Even with tools like MAT and addiction-related therapies, recovery is hard work. If you’re being treated with Suboxone or if it’s somehow available to you through some other means, what would happen if you tried to use the drug to achieve a euphoric high? 

Your first problem is the opioid itself. Buprenorphine isn’t going to cause the same effects that prescription opioids or heroin do. As a partial opioid agonist with an effects ceiling, using buprenorphine recreationally will only produce limited intoxicating effects. You may also encounter some of the drug’s unpleasant side effects like headaches, constipation, stomach aches, sleep problems, blurred vision, and back pain. 

Buprenorphine might be more potent if it’s mixed with other substances. Though it’s able to kick opioids off of their receptors, it may combine with other opioids to create more intense effects. When you start buprenorphine treatment, medical professionals will wait for your withdrawal symptoms to begin to give you your first dose. 

This is done to confirm that you actually are dependent on an opioid and to avoid mixing the medication with drugs that are already in your system. Mixing buprenorphine with other substances like alcohol or benzodiazepines may also cause intoxicating effects. Mixing depressants and opioids can even cause a life-threatening overdose. 

Abusing Suboxone by snorting or smoking it can cause you to go into withdrawal, which may discourage you from misusing the drug in the future. Because it’s so unpleasant to misuse in this way, Suboxone doesn’t have a high misuse liability.

Side Effects of Snorting Suboxone

When buprenorphine is snorted alone, it has been shown to cause symptoms that are similar to opioid agonists. Including a feeling of sedation, euphoria, physical comfort, and a sense of well-being. When Suboxone is snorted, it means you’re also snorting naloxone, which can become active when it enters your body through nasal passages. This can cause an opioid-dependent person to experience withdrawal symptoms, which can include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Sweating
  • Sleep problems
  • Muscle aches
  • Watery eyes
  • Excessive yawning
  • Cramping 
  • Goosebumps
  • Tremors 

Opioid withdrawal symptoms generally aren’t life-threatening unless you aren’t able to access water or keep it down without vomiting. In such cases, opioid withdrawal can cause potentially dangerous dehydration. 

Snorting powdered substances can cause a unique set of symptoms that are caused by this abrasive route of administration. Snorting can cause:

  • Nasal inflammation 
  • Pain in the nostrils
  • Bloody nose
  • Congestion
  • Runny nose
  • Difficulty breathing
  • Infections

Long-term snorting can cause potentially serious issues like necrosis, perforated septums, throat infections, and lung infections. 

Why Would Someone Snort Suboxone?

Snorting may seem like an unpleasant way to introduce anything into your system, but it’s often seen in recreational drug use and even some medications. Today, medications that are insufflated usually come in liquid nasal sprays. Liquids may be less damaging to nasal passages than powders. 

The tendency to see snorting that’s associated with recreational drug use may have to do with several factors. For one, snorting a drug doesn’t require any extra drug paraphernalia. Smoking requires rolling paper, or pipes and injecting requires needles. Snorting only requires you to have access to a powdered form of the drug. Snorting may also be associated with a faster, more intense high. 

When you swallow pills, it takes time for them to be digested and absorbed into your bloodstream through your intestines. If a drug can be snorted and still be effective, it may be a faster route of administration. Cocaine may have a lot to do with the assumption that snorting drugs offers a fast, potent high. Cocaine is more potent and works more quickly when it’s snorted compared to when it’s swallowed. 

Suboxone may be snorted to make the most of a single dose. When taken as a part of an MAT program, you’ll likely get one dose per day. Taking that dose sublingually isn’t enough to cause a high. Snorting buprenorphine would cause you to experience some intoxicating symptoms, but naloxone prevents that.

Sources

National Institute on Drug Abuse. (2018, July). Cocaine. from https://www.drugabuse.gov/publications/drugfacts/cocaine

National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids

RxList. (2019, November 11). Suboxone (Buprenorphine HCl and naloxone HCl): Uses, Dosage, Side Effects, Interactions, Warning. from https://www.rxlist.com/suboxone-drug.htm

SAMHSA. (2019, November 22). Buprenorphine. from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine

SAMHSA. (2021, January 04). Medication-assisted treatment (MAT). from https://www.samhsa.gov/medication-assisted-treatment

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