Key Points

  • Belbuca and Suboxone are both drugs that contain buprenorphine.
  • Belbuca is typically used for pain relief, whereas Suboxone is often prescribed for opioid use disorder (OUD).
  • The FDA has not approved the use of Belbuca in OUD.
  • Both Belbuca and Suboxone can be addictive and can cause withdrawal symptoms.
  • Suboxone contains Naloxone, which helps reduce the addictive potential of the drug, whereas Belbuca only contains the active ingredient buprenorphine.
  • Belbuca has significantly lower levels of buprenorphine than Suboxone per dose.

Belbuca and Suboxone are both prescription medications that contain the opioid buprenorphine — a substance typically used to help treat opioid use disorder (OUD). As an opiate, it’s also a potent pain relief medicine for those suffering from long-term chronic illnesses, where other painkillers aren’t effective. But is every drug containing buprenorphine suitable for both functions?

In this article, we’re exploring the key differences between Suboxone and Belbuca to determine how they can be used so you can understand which one is the right fit for you.

What’s the Difference Between Belbuca and Suboxone?

The main difference between Belbuca and Suboxone is their composition. Belbuca is a buprenorphine-only medication approved by the FDA for use in pain relief.[1] Suboxone is a combination of buprenorphine and naloxone used to treat opioid addiction. [2]

To fully understand why these two drugs differ greatly in their use and effect on the body, we need to understand the roles of buprenorphine and naloxone on the body, as well as the potential side effects and withdrawal symptoms each drug can provoke.

What is Buprenorphine?

Buprenorphine is a partial opioid agonist that works by attaching to the opioid receptors in the brain, acting similarly to other opiates like heroin.[3]

As a partial agonist, it activates opioid receptors to a lesser degree than full agonist opiates such as morphine and heroin. The level of receptor activation that can be achieved with buprenorphine levels off, making it a viable option for the treatment of opioid use disorder as taking more won’t produce a bigger “high,” therefore reducing the risks of a potential overdose. It also lasts longer in the body, helping to reduce opioid cravings and withdrawal symptoms.

Buprenorphine is sold under many names, including Belbuca, and depending on the brand, it can be taken sublingually, transdermally, or injected.[4]

It can also be sold as a combination drug, such as Suboxone, which is a mixture of buprenorphine and naloxone.

Comparing Belbuca vs. Suboxone

The main difference between Belbuca and Suboxone is their chemical composition. While both contain buprenorphine, Belbuca is a buprenorphine-only medication, and Suboxone is a buprenorphine and naloxone combination drug.[1][2]

Because of this difference, key considerations, including the way each drug works, their side effects, and withdrawal symptoms vary.

How They Work

Belbuca is a buprenorphine-only medication that has been approved by the FDA for pain relief use. It uses a buccal delivery system, absorbing into the bloodstream via the inside of the cheek. As a buprenorphine-only drug, it partially activates opiate receptors, which provides analgesic reactions without overstimulating the euphoric “high” sensation of other full-agonist opiates.[5]

Suboxone, however, is a combination of buprenorphine and naloxone created specifically as a treatment for opioid use disorder. Naloxone works as an antagonist, attaching to opioid receptors, effectively “kicking out” any opioids that are currently attached.[6] When combined with buprenorphine, it helps prevent people from overdosing by creating painful withdrawal symptoms if misused, as it blocks opioid receptors from binding with the buprenorphine.[7]

Side effects

Belbuca vs. Suboxone Side Effects

Both Belbuca and Suboxone have similar side effects that can cause discomfort. Understanding potential side effects can help you manage your symptoms and reduce the risk of abuse.

Common side effects of Belbuca include:[1]

  • Nausea
  • Headaches
  • Dizziness
  • Tiredness or drowsiness
  • Constipation

Common side effects of Suboxone include:[2]

  • Vomiting
  • Nausea
  • Increased sweating
  • Insomnia
  • Headaches

With both medications, they can produce serious side effects that require medical attention, such as:

  • Feeling faint or dizzy
  • Chest pain
  • Elevated heart rate
  • Allergic reactions
  • Liver problems
  • Shortness of breath
  • Swelling

There are many medications that can interact negatively with Belbuca and Suboxone, so it’s important to ask your doctor before taking any other drugs, as you may experience serious side effects like the ones listed above.

While these drugs share mostly the same side effects, there is one side effect of Suboxone that users of Belbuca will not experience. Suboxone causes pain and discomfort if taking too much of the drug as a direct result of the naloxone blocking the opioid receptors and causing intense withdrawal symptoms.[7] However, in both instances, taking too much of the drug will cause severe medical issues and can even lead to death.

How long they stay in your body

When understanding how long a substance stays in your body, most medical professionals focus on a drug’s half-life. The half-life of a drug represents how long it takes for 50% of the substance to leave the body.[8] After this, approximately five-half-lives of the remaining substance are removed from the body.

The reason why understanding the half-life of Belbuca and Suboxone is so important is that the longer the half-life, the less likely you are to suffer withdrawal symptoms.

Belbuca has a half-life of 48 hours, and Suboxone has a half-life of 37 hours.[9] This means there is a slightly lower chance of experiencing withdrawal symptoms with Belbuca. However, every person is different, and many other factors impact whether a substance becomes addictive and, therefore, if you suffer withdrawal symptoms. These include dosage, addiction potential, and how long you’ve been taking the medication.

Withdrawal symptoms

As we’ve discussed, the addition of naloxone in Suboxone can create more intense withdrawal symptoms if the medication is abused by trying to take too much. While the mechanism helps mitigate potential overdosing, it does mean there is a moderate chance of withdrawal symptoms, especially if not taken exactly as directed.

However, Belbuca also has the potential to create withdrawal symptoms, especially if not taken specifically as directed by a medical professional. This is why, before being prescribed as a pain relief medication, your physician will ask if you have any previous or current addictions, as well as discuss your mental health.

Typically, healthcare providers will not prescribe Belbuca unless absolutely necessary and without the confidence that there is a low risk of addiction based on your mental health and addiction history.

In both cases, withdrawal symptoms will include muscle aches, shaking, cravings, hot and cold sweats, and vomiting.[1][2] By following your physician’s advice and being open about how your medication is making you feel, you can reduce the risk of experiencing withdrawal symptoms.

Which is Better for Opioid Dependency — Belbuca or Suboxone?

While buprenorphine is a widely recognized treatment for opioid dependency, not all variations of the drug are suitable for opioid addiction treatment.

Belbuca, though typically prescribed in low doses, can still become addictive and without the protective properties of naloxone, can be misused. Therefore, it is not approved by the FDA for use as an OUD treatment.[10] It is, however, an approved medication for chronic pain management.

Suboxone, on the other hand, is only FDA-approved for opioid addiction treatment and should not be prescribed as pain relief.[11]

As such, Suboxone is the only medication of the two that should be used when treating opioid dependency.

You Don’t Have to Face Your Opioid Addiction Alone

Dealing with an opioid addiction can be isolating and confusing. It’s hard to know what to do or who to talk to. Taking the first steps to recovery is often the most challenging — but we’re here to help.

At Southeast Addiction Center, we help people through their OUD treatment, including creating personalized treatment plans and finding the right medication to relieve their pain. Our knowledgeable team will guide you through every step of the way.

To take your first step on the road to recovery, get in touch with our team today so we can start your treatment journey. Opioid addiction might feel lonely, but you’re not alone. We’re here for you every step of the way.