Dangers of Snorting, Smoking, or Injecting Suboxone

Suboxone is a prescription medication, designed as an alternative to methadone. Its purpose is to help alleviate withdrawal symptoms and cravings in those who are recovering from opioid addiction. It may be prescribed as part of a comprehensive treatment program to people recovering from dependance to opioid drugs or narcotic painkillers such as heroin, morphine, oxycodone, codeine, fentanyl, methadone and various others. It is meant to help patients go through the withdrawal process with as little discomfort as possible and reduce the likelihood of relapse.¹

The two active substances found in Suboxone are Naloxone and Buprenorphine. Naloxone belongs to a group of drugs called “opioid antagonists” and its role is to reverse the effects of opioid drugs. Buprenorphine belongs to a group of drugs called “partial agonist opioids”, meaning that it acts similarly to opioids such as heroin or methadone, but it produces a less intense feeling of being “high”.²

As is the case with any other prescription drug, Suboxone is intended to be taken strictly under medical supervision. Even though it is developed to treat addiction to other drugs, and despite the fact that its abuse potential is considered fairly low, in cases of improper use, patients may still develop a dependency to Suboxone itself.¹

Why Do People Snort Suboxone?

As a prescription drug, Suboxone is available in various forms, including tablets, strips or films designed to be dissolved sublingually (under the tongue) or buccally (under the cheek). This means that the drug’s preferred and safest route of administration is through oral ingestion. Suboxone abuse through alternative routes of administration may have dangerous side-effects on the user’s health and may lead to overdose.1,5

There are multiple reasons why people may find themselves tempted to try out an illicit method of Suboxone administration, such as crushing and snorting the drug. One of the reasons may be a desire to get high, due to the fact that Suboxone contains a less potent opioid variant, buprenorphine.1,5

However, the likelihood of getting high on Suboxone decreases significantly if the user has a history of substance abuse and has already developed any type of tolerance to opiates. This stems from the fact that Buprenorphine is only a partial opioid agonist, and will activate the opioid receptors in the brain to a much lesser degree than full opioid agonists.1,5

Additionally, when snorting Suboxone, the user is not only snorting Buprenorphine, they are also snorting Naloxone, which is an opioid antagonist, meaning that it acts as a “safeguard” against opioid misuse by counteracting the effects of the opioid. When administered through the nose, Naloxone’s effects become stronger than when administered orally, which may cause the user to experience immediate opioid withdrawal symptoms.1,5

Even though these withdrawal symptoms in most cases aren’t life-threatening, the sheer discomfort of experiencing them may be one of the reasons why studies report that the combination of Buprenorphine and Naloxone (Suboxone) is less likely to be snorted than buprenorphine alone.1,5

Snorting Suboxone – Side Effects

Administering drugs intranasally (through the nose) has proven to be an effective delivery system for many therapeutic drugs. This is because the mucous membranes on the inside of our nostrils contain cells that are suitable for drug absorption. By ingesting drugs through the nose, we are enabling them to bypass the digestive processes which would normally slow down drug absorption.4

By doing so, we are letting the active components get into the bloodstream more quickly. The final result is a rapid onset of effects. Similarly, those who use recreational drugs may choose snorting them in an attempt to amplify and speed up the drug’s desired effects. However, if the drug is not designed to be administered intranasally, it may have adverse and even potentially fatal consequences to the user’s health.4

Symptoms of using Suboxone in ways other than prescribed may become prominent after prolonged usage, but even a single occasion of administering Suboxone intranasally can have negative effects. Some of the most common side effects of suboxone abuse related to snorting are as follows:2,5

• Difficulty swallowing
• Face and ear pain
• Facial swelling
• Oral ulcers
• Sinus infections
• Nosebleeds
• Damage to the vocal cords

Symptoms Of Snorting Suboxone

Apart from the damage snorting Suboxone can make to the respiratory system, Suboxone abuse may have any of the following side effects:2,5

• Headaches
• Stomach and back pain
• Constipation
• Blurred vision
• Trouble breathing and swallowing
• Nausea/ loss of appetite
• Vomiting
• Weakness
• Dizziness
• Low energy/fatigue
• Sleep apnea
• Increased dependency on the drug
• Behavioral changes
• Withdrawals
• Lack of impulse control
• Cravings

Can You Shoot Suboxone?

Injecting, or the more colloquially used term “shooting”, is the practice of administering a prescribed or recreational drug, using a needle and syringe, directly into the bloodstream through a vein.3,4,6

As with snorting Suboxone, the desired effect of injecting it may be to increase its potency and reach the feeling of being high faster than when taking it orally. But can Suboxone be injected and what effects will injecting it produce? In theory, it can, as Suboxone films contain a gelatine substance that can be scraped off and dissolved in water to be prepared for shooting. But along with the desired effects, the negative side effects of injecting Suboxone are likely to be amplified as well. People who experience a high by injecting Suboxone tend to be those who have no previous history of using opioids and have not developed a tolerance to them.5,6

Naloxone’s opioid antagonizing properties become more bioavailable when the drug is administered freely into the bloodstream. Thus the risk of experiencing severe and immediate opioid withdrawal symptoms though injecting Suboxone becomes even higher than when snorting it. Suboxone injection may carry a greater risk of overdose than other ways of administering the drug.5.6

Injecting Suboxone Side Effects

Some of the unwanted side effects related to intravenous administration of suboxone may include:2,5,6

• Painful abscesses and permanent damage to the veins³.
• Sharing paraphernalia for intravenous drug administration may increase the risk of contracting bloodborne infections such as HIV or Hepatitis C.
• Vessel occlusion, meaning the veins may become blocked by harmful pieces of gelatin entering the bloodstream.
• Endocarditis, an inflammation of the inner lining of the heart.
• Suboxone overdose with potential fatal consequences.
• Opioid withdrawal symptoms such as muscle aches, agitation, abdominal cramping, nausea, diarrhea, excessive sweating etc.
• Relapse: In patients whose opioid addiction was under control with Suboxone, starting to inject the drug may indicate a return to unwanted addictive behaviors. 
• Euphoria or a complete lack thereof: Although some individuals, especially those without a history of opioid abuse, may experience a feeling of euphoria through Suboxone injection, the combined action of Naloxone and Buprenorphine are expected to inhibit it completely.
• Sluggishness: Using inappropriate doses of Suboxone, as is the case with injecting it, may affect the user’s ability to think, speak and coordinate movement. It may also cause shallow breathing, extreme drowsiness and blurred vision. 
• The effects of injecting suboxone may even be fatal due to an increased risk of overdose.

Symptoms Of Shooting Suboxone

Some of the psychological signs of Suboxone abuse you may notice in someone who is shooting it may include any of the following:2,6

• Impaired memory
• Unpredictable mood swings
• Erratic behavior
• Loss of interest in hobbies and activities
• Apathy
• Depression
• Troubles Sleeping
• Loss of appetite

What Is Smoking Suboxone?

As is the case with other opioids, Suboxone abuse through smoking is possible, although unlikely to produce a strong high. Different forms in which Suboxone is prescribed may make it more or less difficult to smoke. The film form of the drug is difficult to powderize, making this form virtually impossible to smoke. Furthermore, Suboxone strips cannot be smoked directly, since they are unable to catch fire. However, it is possible to crush Suboxone tablets into powder and then use it for smoking.4,5

What is most commonly classified as “smoking Suboxone” is the practice of crushing the pills, placing them on a piece of foil, heating them and then inhaling the vapors through a straw-like instrument. Another way of smoking Suboxone may involve dissolving the strips or sublingual films in water, heating the liquid mixture and inhaling the vapors. In both cases a mild high is possible to be achieved. Nevertheless, achieving a high with this kind of misuse is diminished by the deterring properties of naloxone, which are activated by heating.5

Smoking Suboxone Side Effects

Along with improper use of the drug comes an array of discomforting effects. Some of the side effects that people who smoke Suboxone may experience include:1,2

• Dizziness
• Blurred vision
• Fatigue
• Headache
• Backache 
• Tongue pain
• Mouth numbness
• Coughing
• Pneumonia
• Dental deterioration
• Excessive sweating
• Nausea
• Vomiting

What Are The Other Ways Suboxone Is Used?

Suboxone is a prescription drug available in various forms designed to be taken orally. It can be abused through oral administration if taken in doses different or larger than prescribed. Suboxone may be administered in the form of tablets, films or strips. These are to be kept under the tongue or on the inside of the cheek until they completely dissolve and should by no means be swallowed whole or chewed, as this may increase the risk of negative side-effects.1

Snorting Vs Smoking Vs Injecting

It is a known fact that the route of administration of a drug is directly related to how quickly it will be absorbed into the bloodstream and how strong an effect it will have on the person who uses it. The three most popular illicit ways to use opioid drugs, including prescription drugs such as Suboxone, are snorting, smoking and injecting. Each of these ways of misuse carries its own set of health risks and may end in fatal consequences(source #4).4

Research has shown that out of the three most popular ways to ingest illicit drugs, the fastest way to get psychoactive substances to the brain is by smoking them. The second fastest way to onset the effects of a drug is to inject it directly into a blood vessel. The third and the slowest is through intranasal administration, or snorting.5,6

It is also known that the route of administration correlates to the level of a drug’s addictiveness. The faster the drug is able to find its way to the brain, the higher its potential for addictiveness and also the likelihood of overdose. This can be applied to Suboxone abuse as well.5

However, due to the fact that Suboxone contains a powerful opioid antagonist, by using Suboxone in ways other than prescribed, users are more likely to put themselves at risk of experiencing immediate and intense withdrawal symptoms than reaching the desired high. Additionally, all illicit ways of using Suboxone may have a fatal outcome.2,5

How To Get Help For Suboxone Abuse?

If you or a loved one are showing symptoms of Suboxone abuse or addiction, getting adequate treatment and support is of utmost importance. To obtain information on prescription drug abuse in strict confidentiality, and get advice on where to find help, call American Addiction Centers’ 24-hour helpline at (888) 287-0471. 

Calling a helpline may be the first step toward overcoming a substance use disorder or helping a loved one get back on the right track. Our 24-hour helpline is designed to be at your disposal at any time of night or day, point you in the right direction on where to seek treatment and provide you with the resources to explore treatment options most suited to your needs.

During a conversation with one of our trained dispatchers, you will be able to find out the costs of rehabilitation programs and verify your insurance coverage for addiction treatment. In case your insurance doesn’t cover the expenses and you’re worried about not being able to finance your recovery, calling our helpline may introduce you to other possible payment options and help develop a payment plan best suited for your care. 

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