Sublocade vs. Suboxone: To Inject, or Not to Inject?

Which is better for my recovery: Sublocade or Suboxone?

The opioid epidemic has devastated communities across Tennessee and the southeast, prompting the need for effective and accessible treatment options. Medication-assisted treatment (MAT) has emerged as the gold standard in treating opioid use disorder (OUD). Among the leading medication choices for MAT are Sublocade and Suboxone. While both medications serve the same purpose—to help individuals overcome opioid addiction—they have significant differences that can influence treatment decisions.

In this article, we’ll examine the key differences between Sublocade and Suboxone, their benefits and drawbacks, and how to determine which might be the right choice for someone battling OUD.

What Are Sublocade and Suboxone?

Both Sublocade and Suboxone contain buprenorphine, a partial opioid agonist that helps reduce withdrawal symptoms and cravings while minimizing the risk of misuse. However, their formulations, delivery methods, and dosing schedules differ significantly.

Sublocade

Sublocade is an extended-release injectable form of buprenorphine. Administered once a month by a healthcare professional, Sublocade delivers a steady dose of buprenorphine over 30 days, ensuring consistent levels in the bloodstream.

• Administration: Subcutaneous injection in the abdominal area.
• Frequency: Once a month.
• FDA Approval: Approved in 2017 for moderate to severe OUD in individuals who have been stabilized on oral buprenorphine.

Suboxone

Suboxone is a combination of buprenorphine and naloxone, available as a sublingual film or tablet. It is taken daily and can be prescribed for use at home, making it a more flexible option for many patients.

• Administration: Dissolved under the tongue or on the inside of the cheek.
• Frequency: Daily.
• FDA Approval: Approved in 2002 for OUD treatment.

Key Differences: Sublocade vs. Suboxone

1. Method of Administration
   • Sublocade: Given via injection by a healthcare provider, reducing the risk of misuse or diversion.
   • Suboxone: Self-administered, which allows for greater flexibility but also requires patient responsibility.
2. Dosing Schedule
   • Sublocade: Monthly injections provide steady medication levels, eliminating the need for daily dosing.
   • Suboxone: Requires daily use.
3. Risk of Misuse
   • Sublocade: Minimal risk, as it is administered by a professional and cannot be tampered with.
   • Suboxone: Naloxone greatly reduces the potential for misuse.
4. Cost and Insurance Coverage
   • Sublocade: More expensive due to its specialized delivery method, but is covered by some insurance plans.
   • Suboxone: Generally more affordable and widely available, covered by most insurance plans.
5. Accessibility
   • Sublocade: Requires visits to a healthcare provider for administration, which may be challenging in rural or underserved areas.
   • Suboxone: Can be prescribed for at-home use up to 30-days (generally 28 days), is available at most pharmacies, which greatly increases accessibility for most patients.

Benefits of Sublocade

1. Consistency: Monthly injections eliminate the need for daily dosing, reducing the chances of missed doses or inconsistent treatment.
2. Lower Risk of Diversion: Because Sublocade is administered in a clinical setting, there is virtually no risk of it being sold or misused.
3. Convenience: Ideal for individuals who struggle with adhering to a daily medication schedule.

Benefits of Suboxone

1. Flexibility: Can be taken at home, making it more convenient for patients with busy schedules or limited access to clinics.
2. Widely Available: Suboxone is the most commonly prescribed MAT medication, making it accessible in most areas.
3. Affordable: Generally less expensive than Sublocade, especially in generic forms.
4. Dual Action: The combination of buprenorphine and naloxone reduces the risk of misuse while effectively managing withdrawal symptoms.

Drawbacks of Sublocade

1. Higher Cost: Sublocade can be more expensive, even with insurance coverage. According to Sublocade.com, the list price for Sublocade is $2,016.52 per month for both the 100 mg and 300 mg doses.
2. Limited Accessibility: Requires monthly visits to a healthcare provider for the injection, which may not be feasible for everyone.
3. Invasiveness: Some patients may dislike or fear injections.
4. Comfort & Aesthetics: Sublocade’s subcutaneous injection method creates a noticeable lump under the skin. This area is often red or pink and may be uncomfortable for some patients. Each month, a new injection site is needed to avoid bruising and/or infection.
5. Tapered Dosage: Sublocade’s dosage delivery gradually decreases over a one month period, requiring some patients to supplement their treatment with Suboxone, somewhat defeating the purpose of the injection.

Drawbacks of Suboxone

1. Risk of Non-Compliance: Daily dosing requires patient discipline, and missed doses can lead to withdrawal symptoms.
2. Potential for Misuse: While the naloxone component reduces misuse risk, the medication can still be diverted or abused.
3. Variable Absorption: Sublingual administration can lead to inconsistent absorption if not taken correctly.

Who Might Benefit More from Sublocade?

Sublocade may be a better option for:

• Individuals who struggle with daily medication adherence.
• Those at high risk of diversion or misuse.
• Patients who prefer a set-it-and-forget-it approach to treatment.

Who Might Benefit More from Suboxone?

Suboxone might be ideal for:

• Patients seeking a more flexible treatment option.
• Those with limited access to healthcare providers for monthly injections.
• Individuals who are stable in their recovery and capable of managing daily dosing.

Sublocade vs. Suboxone: Choosing the Right MAT Option

Selecting between Sublocade and Suboxone depends on a variety of factors, including:

• Lifestyle and Preferences: Does the patient prefer the convenience of home administration, or do they benefit from regular clinical visits?
• Risk Factors: Are there concerns about medication misuse or diversion?
• Cost and Coverage: What does the patient’s insurance plan cover, and what are the out-of-pocket costs?
• Clinical Needs: Is the patient stabilized on buprenorphine, and how well do they respond to their current treatment?

Conclusion

Sublocade vs. Suboxone is a decision patients should make after many months of consistent stability taking Suboxone. Both Sublocade and Suboxone are effective tools in the fight against opioid addiction, but they cater to different patient needs and circumstances. Sublocade’s monthly injection offers consistency and reduces the risk of misuse, making it ideal for patients who struggle with daily adherence. On the other hand, Suboxone’s flexibility and accessibility make it a practical choice for many individuals managing OUD.

If you would like to learn the difference between Subutex and Suboxone, read our article titled, “Subutex vs. Suboxone: Understanding the Differences.”

Ultimately, the decision between Sublocade vs. Suboxone should be made collaboratively between the patient and their healthcare provider, taking into account personal preferences, lifestyle, and clinical factors. With the right treatment plan, recovery from opioid addiction is not only possible but achievable.