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Sublocade (Buprenorphine HCL) is an injectable formulation of buprenorphine that lasts up to 30 days on a single dose.  Although buprenorphine has been available for over a decade, Sublocade offers patients a once monthly dose that is superior to previous products at maintaining steady levels of the medicine in a patient’s system, eliminating the peaks and valleys that are present with daily dose formulations.  Another benefit of monthly injections is the commitment the patient makes to stay compliant on the medication.  Skipping a day, and/or taking more than prescribed are no longer a concern for prescribing physicians.    

Buprenorphine is a partial opioid agonist, this means it activates opioid receptors much like a full agonist, however it has a “ceiling effect” meaning once the appropriate dosage is reached, taking more will not achieve the euphoria that most opioid abusers are craving.  Compared to older drugs like methadone, buprenorphine has a safety profile that dramatically decreases risk of complications typical with full agonist opioids such as methadone.  Sublocade further reduces risk of misuse by only needing to be administered once every 30 days.  Common protocol is to stabilize patients on oral buprenorphine for at least seven days prior to the Sublocade injection, ensuring the patient tolerates buprenorphine therapy and is a good candidate for the extended release formulation.   

Sublocade is not a cure for opioid addiction.  Those who choose to begin medication assisted treatment for opioid addiction need to be aware that buprenorphine is forty times stronger than morphine and physical dependence will develop over time.  Some professionals believe substituting one opioid for another is only masking the underlying issue.   

We believe buprenorphine, in all it’s different formulations (Buprenex, Suboxone, Subutex, Zubsolv, and Sublocade) has a place in addiction treatment as a bridge to help patients comfortably transition from their opioid of choice, to complete abstinence.  Many former opioid abusers have successfully used buprenorphine to taper off heroin and other dangerous drugs, and ultimately improve quality of life starting with the first dose.   

Below we have outlined the pros and cons of Sublocade. 

 

Pros:

Once monthly dose helps patients stay compliant with treatment. 
Steady blood concentration levels eliminate the possibility experiencing withdrawal symptoms in between daily doses 
Allows patients to focus on recovery, and removes the responsibility of having to take medication at the same time daily.   
Prevents diversion of other shorter acting formulations(suboxone/subutex) to the black market 

Cons: 

Replacing one dependency for another 
Only can be administered by a healthcare professional 
Can be cost prohibitive for patients without health insurance 
Withdrawal from buprenorphine can be very difficult, sometimes requiring a medically assisted detox 

*We always recommend consulting a Healthcare professional prior to making the decision to begin opioid replacement therapy.