What Is Sublocade?

Sublocade is an FDA-approved, once-monthly injectable form of buprenorphine used in the treatment of moderate to severe opioid use disorder (OUD). Unlike Suboxone (the daily sublingual film), Sublocade is administered as a subcutaneous injection—a small shot under the skin of the abdomen—delivered in a clinical setting once per month. After injection, the medication forms a small, solid depot under the skin that slowly releases a sustained, consistent level of buprenorphine throughout the month.

Sublocade contains only buprenorphine (no naloxone), because the injection format inherently eliminates the diversion and misuse concerns that make naloxone necessary in the oral formulation. It is manufactured by Indivior and delivered through a prefilled, single-dose syringe that must be administered by a healthcare provider.

How Sublocade Differs from Daily Suboxone

Both Suboxone and Sublocade use buprenorphine as their active ingredient and are equally effective at treating opioid use disorder when used as prescribed. The critical differences are in delivery, adherence, and lifestyle impact:

• No daily dosing: Suboxone must be taken once or twice per day, every day. Missing doses can trigger cravings or withdrawal. Sublocade eliminates this daily burden entirely—one injection per month provides continuous medication coverage.
• Consistent blood levels: Daily oral buprenorphine produces peaks (shortly after dosing) and troughs (before the next dose). Sublocade’s depot formulation delivers remarkably stable buprenorphine plasma levels around the clock, which many patients find reduces the subtle cravings that can emerge in the trough period.
• Eliminated diversion risk: Because Sublocade is only administered in a clinical setting, there is no medication supply at home that could be diverted, shared, or sold. This can be meaningful for patients living in environments where drug use is ongoing, or for those who have struggled with misusing their own medication.
• No “did I take it?” uncertainty: Patients and their support networks have complete certainty about medication adherence. This can reduce anxiety and family conflict around treatment compliance.
• Reduced stigma at home: Some patients feel self-conscious about keeping sublingual strips at home or taking medication in front of family members. Once-monthly injections remove medication from the home environment entirely.

Transitioning from Suboxone to Sublocade

Sublocade is not a standalone induction medication—it is designed for patients who have already been stabilized on transmucosal buprenorphine (such as Suboxone sublingual film or Subutex). The transition process is straightforward:

1. Stabilization on Suboxone: Before transitioning, patients must be on a stable dose of Suboxone (or other buprenorphine formulations) for a minimum of 7 days, with no signs of opioid withdrawal and no illicit opioid use. Most patients are stable for several weeks or longer before switching.
2. Last oral dose: On the day of the first Sublocade injection, you take your last dose of Suboxone. Some protocols recommend a short period (2–4 hours) between the last sublingual dose and the injection.
3. First injection: Dr. Agresti or his clinical staff administers the Sublocade injection subcutaneously in the abdominal area. The injection takes only a few minutes. A small lump may be felt at the injection site for several weeks as the depot gradually absorbs—this is normal.
4. Monthly visits: Subsequent injections are given once per month. These appointments also serve as check-ins for Dr. Agresti to monitor your progress, address any mental health concerns, and adjust your overall treatment plan as needed.

The Injection Procedure

Sublocade is administered as a subcutaneous injection in the abdominal region. The procedure is quick, typically causing only mild, brief discomfort at the injection site. Here is what to expect:

• The injection site is cleaned and a small-gauge needle delivers the medication just below the skin
• A firm, pea-sized nodule may form under the skin at the injection site—this is the buprenorphine depot and is expected
• The nodule should not be rubbed, massaged, or manipulated after injection
• Mild redness, itching, or tenderness at the injection site is common in the first few days and resolves on its own
• The depot gradually shrinks and disappears over the month as buprenorphine is released into the bloodstream

Sublocade must not be given intravenously or intramuscularly—subcutaneous delivery is essential for the controlled-release mechanism to work correctly.

Long-Acting, Sustained Release

The scientific advance behind Sublocade is its ATRIGEL delivery system—a biodegradable polymer that, when injected, solidifies into a depot at body temperature. This depot slowly biodegrades over 28 days, releasing buprenorphine at a controlled rate. The result is a pharmacokinetic profile that differs significantly from daily oral dosing:

• Therapeutic buprenorphine levels are achieved within hours of the first injection
• Peak-to-trough fluctuations are minimal compared to daily sublingual dosing
• Plasma levels remain in the therapeutic range for the full 28–32 day interval between injections
• After multiple monthly injections, steady-state buprenorphine levels are maintained consistently

This stable pharmacology translates to a steadier subjective experience for many patients—less awareness of the medication, fewer “wearing off” sensations, and more neurological calm.

Is Sublocade Right for You?

Sublocade may be an excellent choice if you:

• Are already stable on Suboxone and want to simplify your treatment
• Struggle with daily medication adherence or find daily dosing burdensome
• Want to completely remove opioid medication from your home environment
• Have concerns about diversion or are in an environment where that risk is elevated
• Prefer the certainty of confirmed monthly dosing over self-administered daily films

Contact Dr. Agresti’s Office

If you are interested in Sublocade or would like to discuss whether transitioning from Suboxone makes sense for your recovery, Dr. Agresti’s Palm Beach office is here to help.

Office: 44 Cocoanut Row, Suite M-202, Palm Beach, FL 33480
Phone: 561-760-4107
After-hours emergency: 561-386-7743

Learn more about related services:

• Medication-Assisted Treatment Overview
• Outpatient Detox & Addiction Treatment
• Telehealth Psychiatric Treatment in Florida