Sublocade™

Long term treatment of opioid addiction can be managed through a new medication called Sublocade. Learn more about this new medication and why it’s used.

Sublocade™ is a medication that can be used to help those who are addicted to opioid-based pain medications recover from their addiction. This medication replaces the effects of other opioids and helps reduce the cravings and symptoms experienced during withdrawal.

Many people wonder, “What is Sublocade™?” Sublocade™ is a brand name for the medication buprenorphine and it is given as an injection once every month. The Sublocade™ injection absorbs slowly into the body throughout the month and should not be taken more than once per month.

Sublocade™ features unique properties that cause it to weakly mimic opioids like morphine or heroin while inhibiting the effects of other opioids. This ability means that someone who uses Sublocade™ will not experience the withdrawal symptoms and drug cravings as someone withdrawing from an opioid normally would. Sublocade™ also makes it harder to misuse opioids, as Sublocade™ negates the effects of opioids.

Background & History

Before the invention of Sublocade™, its active ingredient, buprenorphine, was typically given as a daily medication absorbed through the lining of the mouth. Buprenorphine treatment would typically involve starting with a high dose in the initial stages of withdrawal, then reduce as the opioid clears from the system.

The FDA approved Sublocade™ in 2017. Sublocade™ ingredients consist exclusively of buprenorphine. However, unlike the other buprenorphine medications, it was made to be a long-lasting injection.

Many people considering using Sublocade™ might wonder, “How does Sublocade™ work?” The Sublocade™ manufacturer, Idivior, created this injection to form a pellet underneath the skin following the injection that would gradually release into the body at a steady rate. This function allows the drug to be present in the body for a month without needing additional doses or injections of Sublocade™ during that time.

As Sublocade™ is a newer drug, it can be expensive. The initial wholesale price for Sublocade™ was $1580 per injection, and this wholesale price does not include the costs that are added by the pharmacy that obtains the medication and the costs incurred by the doctor or provider acquiring the Sublocade™.

Drug Class and Abuse Potential

Sublocade™ belongs to a class of drugs called mixed opioid agonists-antagonists. Sublocade™ acts on the same opioid receptors that opioid drugs such as morphine and heroin do, but only works on these receptors weakly and keeps the other opioids from acting on the opioid receptors.

Sublocade™ can be abused — just like any other drug that stimulates opioid receptors — and given this potential for abuse, it is tightly controlled by legal restrictions. One key difference between Sublocade™ and other drugs that act on opioid receptors is that Sublocade™ stops having an increased effect beyond a certain dosage. This difference makes it very unlikely that an overdose on Sublocade™ can occur and decreases the potential that it could be abused.

Generic Version

There is no generic version of Sublocade™. While the active drug, buprenorphine, is the generic name for Sublocade™, it is not currently available as a long-lasting injection outside of the brand name Sublocade™. This limitation is because the company that invented Sublocade™ currently owns the exclusive rights to make buprenorphine as a long-lasting injection medication.

There is another form of injectable buprenorphine that is much shorter lasting and is designed to be used to treat pain, not to treat opioid addiction. Because of how short the effects of this type of buprenorphine injection are, it is not used for opioid addiction treatment.

In addition to Sublocade™, there is another type of extended-release buprenorphine that is a device that is implanted in the body — typically in the arm — and releases buprenorphine slowly over six months.

Using Sublocade™ in the Treatment of Opioid Use Disorder

Sublocade™ can be used as opioid replacement therapy to reduce the cravings for opioids and decrease, or eliminate, withdrawal symptoms that may otherwise be experienced. Sublocade™ also inhibits other opioids and makes it harder to get high from opioids such as heroin or fentanyl.

Sublocade™ use is strictly controlled and it can only be given by a health care professional. Unlike other types of treatment, such as methadone treatment, Sublocade™ can be given in a physician’s office without requiring a high level of monitoring. Typically, Sublocade™ is started after a week of an oral form of buprenorphine for those whose physician believes it will benefit.

During Treatment

During Sublocade™ treatment, the injection is provided in a physician’s office or a clinic. The injection goes into the abdomen and a small, hardened area may later be felt under the skin at the injection site. The deposit that forms under the skin will slowly absorb into the body and will last for one month.

There will likely be follow-up after this medication has been given to evaluate its effectiveness and if it generated the desired effects.

Maintenance

Sublocade™ maintenance injections will be needed every month for as long treatment continues. Sublocade™ injections may be given until the person seeking treatment wishes to stop and to try continuing without the drug. Some people may benefit from an indefinite period of treatment if it continues to help them.

Side Effects

As with any medication, there are side effects that may be caused by Sublocade™. The most common Sublocade™ side effects include:

• Constipation
• Headache
• Nausea
• Itchiness or pain at the injection site
• Vomiting
• Fatigue
• Changes in the levels of liver enzymes

Sublocade™ can cause some other, serious side effects such as decreased or complete cessation of breathing, coma and death. Typically these side effects are only experienced when Sublocade™ combines with other substances or medications, or when Sublocade™ is misused. Consultation with a physician is necessary to fully understand all the risks and side effects that may occur with Sublocade™ use.

Sublocade™ and Pregnancy

There is not much information available regarding the relationship between Sublocade™ and pregnancy. The active ingredient of Sublocade™, buprenorphine, is rated a Category C medication. This classification means that animal tests showed adverse results but no adequate information is available regarding testing the drug on humans. With Category C drugs, their benefits may sometimes outweigh the risks during pregnancy.

There is research that suggests a baby may experience withdrawal symptoms after birth if buprenorphine medications are used during pregnancy and also that buprenorphine medications may cause less of an effect on the developing baby than methadone.

Ultimately, the use of Sublocade™ during pregnancy depends upon the unique situation of each mother seeking treatment. Pregnant women should always consult with their physician before taking a new medication or adjusting an existing medication regimen.

How is Sublocade™ Different From Other Opioid Addiction Medications?

Sublocade™ vs. Suboxone 

Suboxone is an oral form of buprenorphine, the active drug in Sublocade™. Suboxone is administered as a dissolvable pill and contains naloxone, which further reduces the effects of opioids. Suboxone may work as an initial treatment for opioid withdrawal, but it is also easier to give in to the temptation to stop using Suboxone or to use too much, as it is a daily medication that may be stopped or overused easily. Comparatively, Sublocade™ is better managed because it is given only by healthcare professionals and is long-lasting.

Sublocade™ vs. Vivitrol

Vivitrol contains a medication called naltrexone that can be taken as a pill or as an injection. Vivitrol is designed to reverse the effects of opioids so that opioid drugs will not work. Vivitrol can only be used once opioids are no longer present in the body after detox. Vivitrol will not help with opioid cravings and withdrawal symptoms as Sublocade™ will.

Success Rate

As Sublocade™ is a newer drug, there is not much information available about the drug’s success rate. Some physicians believe that Sublocade™ may result in a sobriety rate as high as 80 percent for those who use it as their method of opioid treatment.

Online Sublocade™ reviews — which are not meaningful scientifically — tend to indicate that most people who use Sublocade™ have positive results from using it.

How The Recovery Village Uses Sublocade™

The Recovery Village may use Sublocade™ as part of a broader treatment plan for patients who have an opioid addiction. Sublocade™ is used to reduce drug cravings and withdrawal symptoms in combination with behavioral therapies and other treatments.

Contact one of the caring, professional representatives at the Recovery Village to learn more about how the Recovery Village uses Sublocade™ to promote opioid addiction recovery. Call today to find out how treatment can address your addiction and any co-occurring mental health disorders.

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Benjamin Caleb Williams, RN

Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more