Key Takeaways:
- Sublocade is an injection, not an implant. It goes under the skin of your abdomen once a month. The buprenorphine implant was a different product called Probuphine, and it was discontinued in 2020.
- Staying on it is what drives the results. In the RECOVER follow-up study, 75.3 percent of people who completed 12 monthly injections were still off illicit opioids a year later.
- Stopping early changes everything. Among those who received two or fewer injections, only 24.1 percent hit that same one-year mark.
- The trial data beat the placebo clearly. Across weeks 5 to 24, abstinence ran at 24 percent on the 300 mg dose and 21 percent on 100 mg, against 2 percent on placebo.
- You cannot inject it yourself. A healthcare provider has to give it, and injecting it into a vein can cause serious harm or death because the medicine forms a solid mass.
If you have been taking buprenorphine films or tablets daily, you are familiar with the routine: the trips to the pharmacy, the doses that you don’t want to miss, the pill bottle that you need to store somewhere safe. This is where Sublocade helps; it eliminates many of those by switching from daily doses to monthly dosing.
We’ll discuss what Sublocade is, how it works, and review the clinical trial numbers candidly, as well as examine its differences from the other buprenorphine products and who it’s appropriate for and who it’s not.
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What Is Sublocade and How Does It Work for Opioid Addiction Treatment
Sublocade is a buprenorphine extended-release injection, and, as Indivior, its manufacturer, says, it is the first monthly injectable buprenorphine treatment approved by the U.S. Food and Drug Administration (FDA) for opioid use disorder (OUD). It is indicated for the treatment of moderate-to-severe opioid use disorder in adults who have initiated treatment with a transmucosal buprenorphine product and have had such treatment for at least 7 days prior to initiating treatment with buprenorphine transdermal.
The last part is important. The medication you begin with is not Sublocade; it’s films or tablets, with stabilization on these and then switching. If someone is giving you the injection on day one, they’ve taken a wrong step.
The Science Behind Long Acting Buprenorphine Injections
The shot is injected into the fat of the abdomen, and the fluid forms a small solid gel lump under your skin. The deposit then slowly releases buprenorphine for the next month.
The medication carries a boxed warning against intravenous use: injected into a vein, it can form a solid mass that may be harmful or even fatal. That’s why a provider always administers it, and no take-home version exists.
Clinical Outcomes: Success Rates in Medication Assisted Therapy
The pivotal trial lasted for 24 weeks and included two dosing regimens of Sublocade versus placebo as secondary endpoints; both met these goals.
The numbers were:
- Abstinence, weeks 5-24 – 24 percent on 300 mg, 21 percent on 100 mg, 2 percent on placebo.
- People who dropped out – 36 percent on 300 mg and 38 percent on 100 mg, compared with 66 percent on placebo
- The most common side effects are headache, constipation, nausea and itching at the place where the injection was given.
- Injection site reactions (these are mostly mild and rarely are severe enough to prevent treatment)
Patient Retention and Treatment Adherence Data
This is where this drug shines the best. Two thirds who received the placebo quit the study, while about a third of those who received Sublocade continued, and retention is strongly associated with better outcomes in opioid treatment.
It’s not a complicated reason. It’s not a missed dose if you’ve had an injection that lasts for a month.
Reduction in Illicit Opioid Use
The trial also monitored craving and withdrawal symptoms; craving and withdrawal were also better controlled on Sublocade than on placebo. The results reflect the injection alone; no additional buprenorphine was permitted during the study, which means the outcomes weren’t propped up by supplemental dosing.
Sublocade Versus Other Buprenorphine Formulations
This should be straightened out as the products are mixed up all the time, and one of them no longer exists.
- Daily films or tablets (Suboxone or Subutex) that can be adjusted as needed, are taken under the tongue and are easy to miss.
- A monthly shot into the belly under the skin by a provider (Sublocade).
- Brixadi is another extended-release buprenorphine injection (weekly or monthly).
- Probuphine is the buprenorphine implant inserted into the arm that was phased out of the market in October 2020 and is no longer available.
The Role of Injection Therapy in Managing Opioid Use Disorder
Easily, patients will come up with the practical benefits of injections first. No meds to take each day, no line at the pharmacy each week and no pills in the house that someone else might take.
It also takes away a certain type of strain. Once you have the medicine in your system and it has been working for a month, there is no daily choice to be made about taking it – a real relief for anyone who has struggled with the decision each day.
Why Monthly Injections Improve Patient Compliance
With daily medication, you need to make the right choice 30 times a month. Long-acting buprenorphine has a question once.
That single shift is the cause of most of the retention difference, and is most significant when cravings are at their peak and motivation is at its lowest on any given day, early in the recovery process. It’s also a reason that doctors recommend the injection for anyone who has previously experienced a miss of doses and then relapsed.
Patient Success Rates: Real-World Evidence From Clinical Trials
The long-term picture was from the RECOVER study and gave the most dramatic figure in this whole area. According to the results of the study, 75.3 percent of patients with moderate to severe opioid use disorder were not using illicit opioids a year after getting 12 monthly doses of Sublocade (buprenorphine) – compared with 24.1 percent of the patients who got two or fewer doses.
That’s roughly three in four, compared with about one in four. That “gap” is the reason why it’s worth completing the course instead of just giving up once things get easy.
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Long-Term Outcomes for Opioid Dependence Management
Long-term use of the same product revealed a similar safety profile to transmucosal buprenorphine, except for reactions at the injection site. So in this type of MAT, it isn’t the safety question; it’s a monthly appointment and then a sore belly for a few days. It’s a fair trade for most people who are battling opioid dependence for years instead of months.
Choosing the Right Medication Assisted Therapy Approach
Sublocade isn’t necessarily the most suitable option, and any clinic that claims otherwise is not measuring but selling. It usually works well for individuals who have not taken it every day, those who prefer the medication to be outside of the home, or those who have missed doses in the past and have relapsed.
If you don’t enjoy getting a shot as much and don’t want to go to a clinic monthly, if your dose still needs to be adjusted often, or if it would take too long to get to your clinic each day, you might prefer to take a film every day. But, for others, methadone is still the appropriate treatment, especially when buprenorphine hasn’t held them.
Begin Your Recovery Journey at Silicon Valley Recovery
As a form of treatment, buprenorphine decreases the likelihood of death from opioid use disorder – it is not about the percentage of abstinence. When someone says it’s replacing one addiction with another, it’s not based on evidence; it’s based on stigma.
To determine if Sublocade may be right for you, please contact Silicon Valley Recovery for an evaluation. They can start you on sublingual buprenorphine, switch you to monthly buprenorphine injections when you’re prepared, and address all the anxiety and depression that frequently accompany opioid dependence.
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FAQs
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How does Sublocade injection frequency compare to daily buprenorphine dosing for opioid addiction?
Sublocade is one injection a month given by a provider, while films and tablets are taken every single day. That difference removes thirty chances a month to miss a dose, which is the main reason retention rates look better.
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Can medication assisted therapy with long-acting buprenorphine prevent relapse during early recovery?
It reduces the risk considerably, and the RECOVER data showed 75.3 percent of people who completed 12 injections were still abstinent a year later. It is not a guarantee, though, and counseling alongside the medication is still part of the standard approach.
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What are the side effects of Sublocade treatment versus other buprenorphine formulations?
The most common are headache, constipation, nausea, and itching where the injection site, with injection site reactions being the main difference from films or tablets. Long-term studies found the wider safety profile stayed consistent with transmucosal buprenorphine.
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How quickly does opioid dependence management improve with monthly injection therapy?
The trial allowed a four-week grace period before measuring outcomes, so the first month is about reaching steady levels in your body. Most people notice cravings settling within the first few weeks, and the clearer results showed up from week five onward.
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Is Sublocade suitable for patients with severe opioid use disorder and multiple previous treatments?
Yes, and it is specifically approved for moderate to severe opioid use disorder, so a difficult history does not rule you out. You do need to be stabilized on transmucosal buprenorphine for at least seven days first, which is a sequencing requirement rather than a barrier.
References
- Indivior PLC. (2019). The Lancet publishes phase 3 results demonstrating efficacy, safety and tolerability of SUBLOCADE (buprenorphine extended-release) injection for subcutaneous use. https://www.indivior.com/latest/category/insights/2019/the-lancet-publishes-phase-3-results-for-sublocade
- Gingerich, C. P. (n.d.). Long-term success for extended-release buprenorphine injection. HCPLive. https://www.hcplive.com/view/longterm-success-extended-release-buprenorphine-injection
[a]“Sublocade implant” is wrong. Sublocade is an injection. It goes under the skin of the abdomen once a month and forms a gel deposit that slowly releases the medication. There is no Sublocade implant and never has been.
The implant was a different product, Probuphine, inserted in the upper arm, and Titan Pharmaceuticals discontinued it in October 2020. It’s no longer available in the US.
The brief carries this error in a secondary keyword and in one FAQ heading. I corrected it throughout, kept “Sublocade” as the keyword.
