Suboxone Tolerance: Can You Build Tolerance To Buprenorphine?

Suboxone is a medication that combines buprenorphine and naloxone to help people recover from opioid addiction, including dependencies on fentanyl, oxycodone, heroin, and other prescription painkillers. The Food and Drug Administration (FDA) has approved Suboxone as part of medication-assisted treatment (MAT), which helps people manage withdrawal symptoms and cravings during recovery. This treatment approach has become an important tool in fighting the opioid crisis.

Suboxone works by attaching to the same brain receptors that opioids target, but it provides relief from withdrawal symptoms without creating the dangerous high or overdose risk associated with other opioids. This allows people to function normally while their bodies adjust to being drug-free. However, like other medications, it’s possible to develop a tolerance to Suboxone over time, meaning someone might need higher doses to get the same therapeutic effects they once experienced with smaller amounts.

Factors That Lead To Suboxone Tolerance

Tolerance to buprenorphine can happen for a number of reasons. Some factors may make you more likely to develop a tolerance.

Opioid Receptor Signals

Suboxone works by partially binding to the same receptors in your brain that opioids do. If you continue to use Suboxone, your brain and body may start to build an opioid tolerance.

Large Doses

Taking large doses of buprenorphine can also lead to developing a tolerance. This is because your body may get used to high doses quickly, needing more to feel the drug’s effects later on. It is recommended to start with low doses of buprenorphine to avoid building a tolerance too quickly.

Chronic Pain

In some cases, buprenorphine is used to help treat chronic pain. This is because it is an analgesic, which is the class of drugs that relieve pain. It can also have a sedative effect. Like other medications used to treat pain, you may need more over time to decrease the pain.

Ceiling Effect

Lastly, buprenorphine has what is called a “ceiling effect.” This means that at a certain dosage, 24 mg to be exact, the effects of buprenorphine stop increasing. In other words, if you take more than that dose, you won’t feel increased effects like analgesia. The ceiling effect is also helpful in preventing people from overdosing. However, if your withdrawal symptoms cannot be managed with the particular dosage, you won’t be able to take more to feel better.

Does Suboxone Use Lead To Lowered Opioid Tolerance?

Using Suboxone or other forms of buprenorphine has not been shown to lower your tolerance to opioids. This is because Suboxone is a partial agonist rather than a full agonist like methadone. However, buprenorphine can decrease opioid dependence, making it successful in addiction treatment.

Side Effects Of Buprenorphine Tolerance

As with any other drug and tolerance to that drug, the use of buprenorphine is associated with various side effects.

Constipation

One common side effect associated with using buprenorphine is constipation. If you experience constipation caused by Suboxone, try drinking more fluids, eating more fiber, and exercising.

Respiratory Depression

Building a tolerance to buprenorphine can also lead to partial respiratory depression. Respiratory depression is a condition in which you breathe too slowly or ineffectively, which can be fatal. However, when combined with naloxone to create Suboxone, this side effect is much less likely.

Physical Dependence

As you develop a tolerance to buprenorphine, you may also develop a physical dependence on the substance. This is a serious issue and may require additional treatment as well as help from a medical professional to help you achieve discontinuation of buprenorphine.

How Tolerance To Suboxone Can Affect Opioid Withdrawal

When someone develops tolerance to Suboxone, it can create challenges for their medication-assisted treatment during opioid recovery. Suboxone has what’s called a “ceiling effect,” which means that after a certain dose, taking more of the medication won’t provide additional benefits. If someone becomes tolerant to the highest effective dose, their doctor can’t simply increase the amount to restore the medication’s effectiveness.

This tolerance can make opioid withdrawal more difficult to manage because the Suboxone may no longer adequately control withdrawal symptoms like pain, nausea, anxiety, and intense cravings. When the medication becomes less effective due to tolerance, people in recovery might experience breakthrough withdrawal symptoms even while taking their prescribed dose, which can make staying in treatment and avoiding relapse more challenging.

Treatment Programs For Opioid Use Disorder

Opioid addiction is a serious medical condition that requires professional care and monitoring from healthcare experts. Effective treatment typically combines multiple approaches to address both the physical dependence and psychological aspects of addiction.

Treatment options for opioid use disorder include:

• medication-assisted treatment (MAT) with drugs like Suboxone, methadone, or naltrexone
• medical detox programs to safely manage withdrawal symptoms
• inpatient rehabilitation programs for intensive, round-the-clock care
• outpatient treatment programs for flexible scheduling
• behavioral therapy and counseling
• support groups and peer recovery programs
• family therapy and education
• aftercare and relapse prevention services

The most successful treatment plans often combine medication with counseling and behavioral support to give people the best chance at long-term recovery. Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction treatment.

Written by the Addiction Resource Editorial Staff