Suboxone vs Subutex vs Sublocade: One Medication, Three Containers

What is the actual difference?

Suboxone, Subutex, and Sublocade are all buprenorphine. They differ in three ways only: whether naloxone is added, how the drug gets into the body, and how long one dose lasts.

That is the whole comparison.

Everything else is detail about those three things.

A fourth product, Brixadi, is also an injected buprenorphine depot, approved in 2023, given weekly or monthly. It is compared with Sublocade in its own section below. Zubsolv is a buprenorphine and naloxone tablet that behaves like Suboxone.

Why is naloxone in Suboxone at all?

Not to help you. To stop you from injecting it.

Naloxone barely absorbs under the tongue, so when Suboxone is taken as directed the naloxone does close to nothing. Dissolve the film and inject it, or snort it, and the naloxone becomes active, blocks the receptor, and throws an opioid-dependent person into sudden withdrawal. It is a deterrent built into the tablet. That is the entire reason Suboxone exists as a separate product from plain buprenorphine.

Buprenorphine without naloxone: who gets it

Plain buprenorphine, what people still call Subutex, is prescribed when there is a documented reason to skip the naloxone: an allergy or bad reaction to it, and historically pregnancy, where the older guidance preferred the single-ingredient product. ASAM notes that studies of the combination product in pregnancy have found no adverse effects and similar outcomes, and that its use is likely to expand, and ACOG’s 2025 clinical practice update (free abstract on PubMed) says clinicians can prescribe buprenorphine alone or in combination with naloxone. So that reason is weaker than it was. Some prescribers still choose it. Ask why, and expect an answer.

Suboxone film vs tablets

Same drug, same ratio of buprenorphine to naloxone. The film dissolves faster, usually in a few minutes, comes in individually sealed pouches, and is harder for a child to get into. The generic tablets are cheaper and take a little longer to dissolve. Absorption is close but not identical between the two, and some people notice a difference when they switch, so a switch is worth a conversation with the prescriber rather than a silent swap at the pharmacy counter.

How to take Suboxone film

Under the tongue or against the inside of the cheek, and then nothing. No talking, no swallowing, no drinking until it is gone. Buprenorphine absorbs through the lining of the mouth. Swallowed, most of it is destroyed by the liver before it does anything. A film that gets chewed or swallowed early is a wasted dose, and a wasted dose is a withdrawal afternoon.

The “spit trick”

The claim online is that spitting out the saliva after the film dissolves either reduces side effects or that swallowing it adds a little extra effect. Pharmacology says neither is worth much. Buprenorphine that reaches the stomach is mostly inactivated, and the naloxone swallowed is inactive too. What the FDA actually recommends, after its 2022 warning about tooth decay with these products, is the opposite of spitting: once the film is fully dissolved, take a large sip of water, swish it gently around the teeth and gums, and swallow. Then wait at least an hour before brushing. Spit before the film dissolves and you lose the dose. Spit after, and you have changed nothing except your dental exposure, slightly, for the better.

Can you snort Suboxone?

People do, and it is both dangerous and pointless. Through the nose the naloxone becomes active, and in a dependent person that means precipitated withdrawal. The film was also designed for the mouth; it does not become more effective by being ground up. Snorting a film is the one way to make Suboxone work worse.

How long does Suboxone or Subutex stay in your system?

Buprenorphine has a long half-life, roughly 24 to 42 hours after a sublingual dose, and it holds the receptor longer than the blood level suggests. One dose a day is enough for most people. Detection is longer than the felt effect.

• Urine: buprenorphine and its metabolite norbuprenorphine can be found for about four to seven days after the last dose, depending on the test and its cutoff
• Saliva: about five days, in one review
• Hair: hair tests in general can look back up to about 90 days

One detail matters for anyone tested at work or by a court: standard opiate panels do not detect buprenorphine. It needs its own test. A person on Suboxone who screens negative for opiates is not cheating; the panel simply was not looking. A lab that runs a test made for buprenorphine can find it. Detection windows here are general ranges, not guarantees. Our guide to how long drugs stay in your system compares other drugs and what standard panels miss.

How long does Sublocade stay in your system?

Months. Sublocade is buprenorphine suspended in a liquid that turns into a solid depot under the skin and releases the drug slowly. Levels build over the first few monthly injections and, after the last one, decline over months rather than days. The label reports the drug can be detectable for roughly a year after the final dose.

That is the feature, not the bug. It is also why Sublocade is not a good match for someone who expects to be off buprenorphine next month.

Does Sublocade have naloxone in it?

No. Sublocade is buprenorphine only. It does not need the deterrent, because it is given by a clinician and never handed to the patient; the FDA requires that through a restricted distribution program. The reason is not abuse by the patient. Injected into a vein rather than under the skin, the depot could cause occlusion, tissue damage, and potentially fatal pulmonary emboli, a risk the label carries as a boxed warning, which is why it is only ever given by a trained provider.

Starting Sublocade

You do not start on Sublocade. You start on daily buprenorphine, confirm you tolerate it, and then transition. The original label required at least seven days on the sublingual form first; a February 2025 label update allows a start after a single 4 mg dose of the sublingual form and an hour of observation. Either way, the first monthly injection follows a period on the daily form, not a cold induction.

Sublocade withdrawal

Because the depot drains slowly, stopping Sublocade works like a built-in taper. The Sublocade label says no withdrawal was seen in the month after the last injection in its data, that any withdrawal would be expected to come later, and that model simulations show buprenorphine staying at therapeutic levels for 2 to 5 months on average, depending on the dose. It tells prescribers to watch for withdrawal for several months and to consider sublingual or buccal buprenorphine if it is needed. Late is not none: symptoms that show up weeks or months after the last shot are easy to stop connecting to the medication. Tell the prescriber before the last injection, not after, so the plan accounts for it. Our Suboxone withdrawal guide covers tapering and the months after the last shot.

Sublocade cost and copay assistance

As of October 2026, the manufacturer lists Sublocade at $2,202.03 a month for either strength and says most people do not pay that amount. NJ FamilyCare covers it, and under New Jersey law P.L.2017, c.28, fully insured New Jersey plans and the State Health Benefits and School Employees’ plans cannot require prior authorization for in-network opioid use disorder treatment, the injection included, that your own physician, psychologist or psychiatrist finds medically necessary during the first 180 days of each plan year; self-funded employer plans and Medicare are not covered by that rule. For commercially insured patients with a copay, the manufacturer runs a copay assistance program that you can enroll in on its website. The program excludes Medicare, Medicaid and other government insurance. Those plans cover the drug under their own rules, so ask the plan what you will owe.

Brixadi vs Sublocade

Both are buprenorphine injected under the skin, where it forms a depot that releases the drug slowly. Both are given only by a clinician, and both carry the same boxed warning. The differences are in the schedule, how treatment starts, and the logistics. Everything in this section comes from the FDA labels for Brixadi and Sublocade.

Weekly vs monthly dosing

This is the real choice. Of the two, only Brixadi has a weekly option, and the weekly form is where a new patient starts: a test dose, then the first injection, with the dose adjusted at weekly visits up to 32 mg. Once a person is stable, they can move to the monthly form, or back again, using the label’s conversion table. Weekly doses may be given up to two days early or late, monthly doses up to a week either way. Weekly visits suit someone early in treatment, or someone whose dose is still moving. Monthly suits someone stable who would rather think about the medication once a month.

Sublocade is monthly only. It starts with two 300 mg doses, the second as early as a week after the first, and then usually settles at 100 mg a month. The label allows 300 mg monthly when the benefit outweighs the risk.

Where and how it is given: the REMS

Neither drug can be picked up and taken home. Both labels carry a boxed warning that injecting the product into a vein can cause blockage, tissue damage, and life-threatening clots in the lungs, and for that reason both are sold only through a Risk Evaluation and Mitigation Strategy. Health care settings and pharmacies that order and dispense them must be certified, and a clinician gives every injection. In practice the shot is given at a doctor’s office, clinic, or treatment program. Ask whether the office stocks the product or orders it per patient from a specialty pharmacy, because that can decide whether the first injection happens the same day or after a wait.

Which one stays in your system longer?

Sublocade, by a wide margin. Its label says that after steady state, which takes four to six months, buprenorphine can be detectable in blood and urine for twelve months or longer after the last injection. Brixadi’s label puts detectable blood levels at about one month after stopping the weekly form and about four months after the monthly form; it notes the link to urine levels is not known. Both labels tell prescribers to watch for withdrawal for several months after the last injection. That long tail is a cushion for some people and a drawback for anyone planning surgery, a pregnancy, or a switch to naltrexone, so raise it before starting.

Is one better?

No head-to-head trial of Brixadi against Sublocade has been published that we could find. Each was tested against something else. Brixadi’s 24-week phase 3 trial of 428 adults compared it with daily buprenorphine-naloxone under the tongue and found it no worse on the main measures, and better on one secondary measure of opioid-free urine tests. The decision usually comes down to whether you want a weekly option, how soon you need to start, which one your insurer and prescriber’s office handle, and how you feel about a drug that lingers for a year. Both are buprenorphine.

Where methadone fits

Methadone is the other half of the “Suboxone vs methadone” question and it is not on the table above because it is a different drug. Methadone is a full opioid agonist. Buprenorphine is a partial one with a ceiling, which is why buprenorphine alone rarely causes overdose and methadone can. Methadone for opioid use disorder can only be dispensed through a licensed opioid treatment program. Many programs start with daily visits, though since SAMHSA’s 2024 rule a program can allow up to 7 days of take-home doses during the first 14 days of treatment. Buprenorphine can be prescribed from any medical office. In head-to-head comparisons, more people stay in treatment on methadone than on buprenorphine, and a large Canadian study found the same after fentanyl entered the drug supply. Buprenorphine is easier to get. Which one fits is a decision to make with a prescriber. Our medication guide compares all three medications, naltrexone included.

Kratom and Suboxone

Kratom’s active compounds act on the same opioid receptors, weakly. Two things follow. A person dependent on kratom can be started on buprenorphine, and most clinicians who treat kratom dependence with a medication choose it, although no controlled trial has tested it yet. And a person already on buprenorphine who takes kratom gets very little from it, because the receptors are occupied. The risky order is the reverse: heavy kratom use, then a first dose of buprenorphine before withdrawal has started, which may bring on sudden withdrawal, the same risk the buprenorphine label describes after other opioids. Tell the prescriber about the kratom. It counts.

The one rule for all three

Buprenorphine must be started in withdrawal, and it must not be combined with sedatives without a prescriber knowing.

Started too early, while a full opioid is still on the receptor, buprenorphine knocks that opioid off and replaces it with a weaker signal. The result is sudden, severe withdrawal. Fentanyl has made the timing harder to judge, and some programs now use low-dose starts to avoid it; a 2026 systematic review found the early evidence for those starts encouraging but mostly low in quality. Our opioid detox guide explains the timing. Combined with alcohol or a benzodiazepine such as Klonopin, buprenorphine loses its safety ceiling, because the other drug is doing the breathing suppression. Nearly all buprenorphine-involved deaths involve at least one other drug (93 percent in a 2023 CDC analysis), most often another opioid, and frequently a benzodiazepine or alcohol.

In New Jersey

Since the 2023 removal of the federal X-waiver, any New Jersey prescriber whose DEA registration covers Schedule III can start buprenorphine, in any form, subject to the federal training attestation and their scope of practice. Under New Jersey law P.L.2017, c.28, fully insured New Jersey plans and the State Health Benefits and School Employees’ plans cannot require prior authorization during the first 180 days of each plan year for in-network treatment, or for outpatient prescription drugs that treat substance use disorder, buprenorphine included, when your own physician, psychologist or psychiatrist finds them medically necessary. Self-funded employer plans, Medicare and Medicaid are not covered by that rule, so verify with the plan. NJ FamilyCare covers the film, the tablets, and the monthly injection. Our insurance guides go plan by plan.

Periscope Behavioral Health, which publishes this site, is opening a medical detox in Hammonton, Atlantic County, expected Summer 2027. For help independent of us, the state’s IME Addictions Access Center at 1-844-276-2777 screens NJ FamilyCare and uninsured residents and refers them to treatment. Until the Hammonton detox opens, the admissions line of our publisher, Periscope Behavioral Health, at (888) 313-3583, can talk through options in New Jersey and Florida, including facilities Periscope operates. What a plan covers depends on the plan and the facility’s network status. Many emergency departments in the state can start buprenorphine the same day.