Suboxone strips are thin, dissolvable films placed under the tongue or inside the cheek to treat opioid use disorder. Each strip contains two active ingredients: buprenorphine, which reduces cravings and withdrawal symptoms, and naloxone, which discourages misuse. They are one of the most widely prescribed medications for opioid addiction treatment in the United States.
How Suboxone Strips Work
Buprenorphine, the primary ingredient, binds tightly to the same receptors in the brain that opioids like heroin, fentanyl, and oxycodone target. But unlike those drugs, buprenorphine only partially activates those receptors. This partial activation is enough to ease withdrawal symptoms and quiet cravings without producing the intense high of a full opioid. It also has a ceiling effect: after a certain dose, taking more doesn’t increase the effects, which makes it significantly harder to overdose on compared to full opioids.
Because buprenorphine binds so strongly, it essentially blocks other opioids from attaching to those same receptors. If someone takes heroin or another opioid while on Suboxone, the effects are significantly blunted. This blocking action serves as a built-in safety net against relapse.
Naloxone, the second ingredient, is an opioid blocker included specifically to deter misuse. When you take a Suboxone strip under the tongue as directed, naloxone is barely absorbed into the bloodstream and has little effect. But if someone dissolves the strip and injects it, the naloxone becomes fully active, blocks the opioid receptors, and can trigger immediate withdrawal symptoms. It’s a deliberate design choice to make the medication difficult to abuse.
Available Strengths
Suboxone film comes in four dosage combinations, listed as buprenorphine/naloxone:
- 2 mg / 0.5 mg
- 4 mg / 1 mg
- 8 mg / 2 mg
- 12 mg / 3 mg
The ratio is always 4:1, buprenorphine to naloxone. Doses are individualized and often start low, then adjusted based on how well symptoms are controlled. A common maintenance dose is 16 mg of buprenorphine per day, though some people need more or less.
How to Take a Suboxone Strip
The film dissolves through the moist lining of your mouth, so placement matters. Before applying, wet the inside of your cheek with your tongue or rinse with water. Place the strip under your tongue (sublingual) or against the inside of your cheek (buccal), then press and hold it for about five seconds. Leave it in place without touching, chewing, or swallowing it until it fully dissolves.
If you need more than one strip at a time, place the second one on the opposite side of your mouth. Don’t eat or drink anything until the film has completely dissolved. Afterward, take a sip of water, gently swish it around your teeth and gums, and swallow. That last step matters for dental health, which we’ll get to below.
What Suboxone Treatment Looks Like
Timing the first dose is critical. Buprenorphine’s strong binding can actually knock other opioids off the receptors and trigger withdrawal if taken too soon after using. Most prescribers require you to wait at least 12 hours after your last short-acting opioid (like heroin or oxycodone) and at least 36 hours after a long-acting opioid (like methadone). You should already be experiencing mild withdrawal symptoms before your first dose. Once taken at the right time, the medication typically relieves those symptoms rather than worsening them.
Treatment can be short-term (tapering over days or weeks to get through detox) or long-term maintenance lasting months or years. Neither approach is curative, but maintenance treatment significantly reduces cravings, prevents withdrawal, and blocks the effects of opioid relapse. Many people stay on Suboxone for an extended period, and that’s considered effective, evidence-based care rather than simply trading one drug for another.
Common Side Effects
In a four-week clinical trial of patients taking 16 mg daily, the most frequently reported side effects were headache (36% of patients), nausea (15%), and insomnia (14%). These tend to be most noticeable in the first few weeks and often improve as your body adjusts. Constipation, sweating, and mild drowsiness are also possible, consistent with other opioid-type medications.
The Dental Health Warning
In January 2022, the FDA issued a safety warning about dental problems in people using buprenorphine films and tablets. Reports included tooth decay, cavities, oral infections, and tooth loss, including in patients who had no prior dental issues. The acidic nature of the dissolving film and its effect on saliva production likely contribute to the problem.
This doesn’t mean you should stop treatment. The recommended approach is to maintain consistent oral hygiene, get regular dental checkups, and rinse your mouth with water after each dose dissolves. Prescribers, dentists, and pharmacists are encouraged to coordinate so dental problems are caught early without interrupting opioid treatment.
Prescribing Access in the U.S.
Getting a Suboxone prescription used to be complicated. Doctors needed a special waiver (called an X-waiver) and were limited in how many patients they could treat. That changed in 2023. The Consolidated Appropriations Act removed the waiver requirement entirely, and there are no longer any patient caps. Any practitioner with a standard DEA registration that covers Schedule III medications can now prescribe buprenorphine for opioid use disorder, as long as their state law permits it.
New or renewing DEA registrants do need at least eight hours of training on substance use disorders, or board certification in addiction medicine, or recent graduation from a program that included substance use disorder coursework. But for patients, the practical effect is that far more doctors, nurse practitioners, and physician assistants can now prescribe Suboxone than before.
Storage and Disposal
Suboxone strips should be stored at room temperature, ideally around 77°F (25°C), with a safe range of 59 to 86°F. Keep them in their sealed foil pouches until you’re ready to use them, and store them somewhere children and pets cannot access. Buprenorphine is dangerous and potentially fatal to anyone not tolerant to opioids, especially small children.
If you have unused or expired strips, the FDA recommends removing each film from its pouch and flushing it down the toilet. This is one of the few medications where flushing is the recommended disposal method, specifically because the risk of accidental exposure to others outweighs environmental concerns. Don’t flush the foil pouches or packaging.