Sublocade is a new medication for the treatment of opioid use disorder. Sublocade is given as an injection once a month to prevent relapse for people who are dependent on opioids. It was the first treatment of its kind to be approved by the FDA and has shown promising results as a maintenance therapy for opioid dependence.
What Is Sublocade?
Sublocade is a monthly injection of buprenorphine that is used for treating opioid use disorder. Sublocade obtained FDA approval on November 30, 2017 for use by people with opioid use disorder who have already begun treatment with a form of buprenorphine like Suboxone, Subutex or Zubsolv that is absorbed through the tissue in the mouth. They must have completed treatment for seven days and have tapered their dosage to manage their symptoms.
Sublocade for Opioid Addiction
The main ingredient in Sublocade is buprenorphine. Buprenorphine is a partial opioid receptor agonist, meaning that it binds to the same receptors as opioids and activates them to give a euphoric effect similar to opioid drugs. Buprenorphine is longer lasting than most illicit opioid drugs, but does not give as intense of a euphoric sensation and has less severe side effects. It works to relieve the withdrawal symptoms of opioid dependence and help to prevent cravings without providing a high.
Unlike some of the medications that contain buprenorphine which are used to treat opioid addiction and orally administered, Sublocade does not have naloxone. Naloxone is an opioid receptor inhibitor that was added to buprenorphine to increase the safety of the medication and help prevent abuse.
Sublocade vs. Vivitrol
Sublocade and Vivitrol are both used as maintenance therapies for opioid use disorders, but they vary in their mechanism of action. Vivitrol is an injectable form of naloxone, which is an opioid receptor inhibitor. It works by preventing opioids from binding to the receptors, which blocks any high or sense of euphoria. Therefore, a person taking Vivitrol will not get the high that they normally would when using opioids. This makes opioid use undesirable and helps individuals with opioid dependence to avoid relapse once they have stopped using opioids.
Sublocade is an injectable form of buprenorphine that also acts by binding to opioid receptors, but it stimulates the receptors instead of inhibiting them. It also will block the additional effect of opioids, but it also has a slight euphoric effect itself. Sublocade helps to lessen the withdrawal symptoms and prevent cravings for opioids. It is also used as a maintenance therapy.
Sublocade Dosage and Administration
Sublocade is an injection containing buprenorphine that must be given by a healthcare provider. Sublocade is injected subcutaneously (under the skin) in the abdomen. The Sublocade shot forms a solid mass under the skin that slowly releases buprenorphine over time. It allows for a constant concentration of buprenorphine in the blood. The injection is given monthly with a minimum of 26 days between treatments. Getting a Sublocade prescription will depend on the status of a person’s treatment.
Sublocade injections are only given once a patient has received another form of buprenorphine treatment as an induction therapy to start their recovery from opioid dependence. This procedure is usually done in an inpatient treatment setting, as the patient needs to be monitored carefully during this process. Only after the patient has received tapering doses of buprenorphine will a Sublocade injection be given.
The first two doses of Sublocade are given at 300 mg, one month apart. Following these treatments, the patient can be placed on a maintenance dose.
Once the patient has stabilized and is no longer using opioids, the Sublocade shot can be used for maintenance therapy. In general, after two monthly doses of 300 mg, the maintenance dose is decreased to 100 mg. However, if the patient is unable to withhold from opioid use on this dosage schedule, the dose can be increased to 300 mg.
If a patient misses a dose, they should seek out and receive the dose as soon as they can. Generally, a delay of up to two weeks will not have an impact on the treatment.
It is not possible to use Sublocade privately or at home, as it must be administered by a healthcare professional. However, when Sublocade is used as a maintenance therapy, the patient is welcome to go home once the shot is given. They do not have to remain under supervision during the course of treatment like some other forms of opioid dependence therapies.
How Does Sublocade Work?
Sublocade works by slowly releasing buprenorphine over time. The concentration of buprenorphine stays stable in the blood and causes a constant partial stimulation of opioid receptors that eases the withdrawal symptoms that surface after stopping opioid use. Sublocade is available only by prescription from a physician.
Sublocade Side Effects
There are side effects that can occur with Sublocade injection. Sublocade side effects include:
- Increase in liver enzymes
- Pain at the injection site
- Itching at the injection site
Risks and Contraindications
Sublocade should not be administered to people who are hypersensitive or allergic to buprenorphine. It should also not be used in combination with many other types of drugs. It is best to speak with a physician before using it in combination with any other drug.
Sublocade should never be injected intravenously. It is a liquid when it is injected, but forms a solid when it enters the body. If this drug were to get in the blood, it could cause major clotting issues and even death. It should also not be administered into the muscle, only subcutaneously.
As with any buprenorphine-containing medicine, Sublocade has a risk of causing slow and ineffective breathing or slowing of neurological functions that can be life-threatening. Sublocade should be discontinued if a person has symptoms of either condition.
How Long Is Opioid Addiction Treatment with Sublocade?
Sublocade is a maintenance therapy that is meant to be used for as long as the patient needs. As long as a patient remains stable and does not relapse, they can continue Sublocade treatment. Since opioid dependence is often a chronic problem, a person may need to use Sublocade indefinitely. Right now, there is not a maximum duration of treatment.
The patient should be monitored periodically to make sure they are maintaining abstinence from opioid use and are not suffering from any severe side effects. If the patient is considering stopping the treatment, they should talk with their doctor about withdrawal symptoms that may occur and the length of time it will take to be completely free of buprenorphine in their system, given the extended-release nature of the Sublocade shot.
Benefits and Effectiveness
The major benefit of Sublocade is that it only has to be injected once a month versus the other forms of buprenorphine that need to be taken daily. This delivery method ensures that there is no worry that the patient will miss one of the daily doses and put themselves at risk for relapse. In fact, it has been shown that patients can go up to two weeks past the intended dose date and still have effective levels of buprenorphine in their system.
Research has shown that the injectable form of buprenorphine is quite effective, significantly improving the number of patients who were opioid-free after 2–6 months of treatment.
The Recovery Village Palm Beach Offers Sublocade Treatment to Help You Recover
The Recovery Village Palm Beach offers comprehensive treatment plans for individuals who are dealing with substance use disorders. If you or a loved one have an opioid use disorder and are interested in using Sublocade as a treatment, The Recovery Village Palm Beach can help. We offer Sublocade injection along with the counseling and psychological support to overcome opioid addiction. Contact The Recovery Village today to speak with a representative and learn more about our comprehensive treatment plans.
Key Points: Understanding Sublocade Treatment and Recovery
Some key points to remember about Sublocade are:
- The Sublocade injection contains buprenorphine and is used for the treatment of opioid use disorders.
- Sublocade is used as maintenance therapy for people who have already started the opioid dependence recovery process with another form of buprenorphine treatment.
- When used in combination with counseling and psychological support, Sublocade can be a highly effective treatment for opioid use disorders.
If you or a loved one struggle with a substance use disorder, The Recovery Village Palm Beach can help. Call to speak with a representative to find out what treatment options may work best for you. Take the first step toward a healthier future, call today.
Substance Use and Mental Health Disorder Services Administration. “Buprenorphine.” May 7, 2019. Accessed July 19, 2019.
Food and Drug Administration. “Sublocade prescribing information.” November, 2017. Accessed July 19, 2019.
Food and Drug Administration. “Vivitrol medication guide.” July, 2013. Accessed July 19, 2019.
Substance Use and Mental Health Disorder Services Administration. “Naloxone.” April 11, 2019. Accessed July 19, 2019.
Rosenthal R.N., and Vgoradia V. 2017. “Advances in the Delivery of Buprenorphine for Opioid Dependence.” Drug Design, Development and Therapy, 11:, August 28, 2017. Accessed July 19, 2019.