Anesthesia Implications

Use – Suboxone is a combination of buprenorphine and Narcan. This is designed to give the patient the effects of buprenorphine, but to disallow patient abuse SPECIFICALLY by IV or IM injection. The Narcan component has extensive first-pass hepatic metabolism with only 0-2% bioavailability orally, and less than 10% bioavailability sublingual. In other words, if suboxone is taken as prescribed (sublingual), it will give the therapeutic affects of buprenorphine and omit the therapeutic effects of Narcan. If the patient attempts to abuse this drug by injecting it, the Narcan component will reverse the buprenorphine effects. Therefore, Suboxone has a lower abuse rate than buprenorphine alone.

Buprenorphine – The implications, if taken as prescribed, are the same as buprenorphine. Refer to the post on Buprenorphine for those implications.