The “Suboxone shot” is a monthly injection called Sublocade that delivers buprenorphine, the same active ingredient in Suboxone, through a small deposit under the skin. Instead of taking a daily film or tablet, the injection slowly releases medication over the course of a month, keeping steady levels of buprenorphine in your bloodstream to prevent opioid cravings and withdrawal symptoms.
How the Injection Forms a Depot Under Your Skin
Sublocade uses a specialized delivery system that starts as a liquid inside a prefilled syringe. The liquid contains buprenorphine suspended in a biodegradable polymer. Once it’s injected under the skin, something interesting happens: the polymer comes into contact with your body’s natural fluids and solidifies into a small, firm deposit called a depot. Think of it like a tiny time-release capsule that forms in place.
That solid depot then does two things simultaneously. It releases buprenorphine through gradual diffusion into surrounding tissue, and the polymer itself slowly breaks down over time. As the polymer biodegrades, more medication is freed up. This dual process keeps buprenorphine flowing into your bloodstream at a consistent rate for roughly 28 to 30 days, eliminating the peaks and valleys that come with daily dosing.
What Steady Blood Levels Look Like
One of the biggest advantages of the shot over daily sublingual strips or tablets is how stable the medication levels stay. With the standard dosing schedule (two months at the higher dose, then the lower maintenance dose), average blood concentrations of buprenorphine hold around 3.2 nanograms per milliliter at steady state. The lowest point in the month is about 2.5 ng/mL and the peak is around 4.9 ng/mL. That’s a relatively narrow range, meaning you’re not experiencing a noticeable rise and fall each day.
For comparison, sublingual buprenorphine can swing more dramatically between doses, especially if you miss one or take it at inconsistent times. The shot removes that variability entirely, which is part of why it works well for people who struggle with adherence or who simply want one less daily reminder of their treatment.
The Dosing Schedule
Before starting the injection, you need to be stabilized on sublingual buprenorphine (the daily film or tablet) at a dose between 8 and 24 mg per day for at least several days. This lead-in period confirms you tolerate the medication and are at a stable dose before switching to the monthly format.
Once you transition, the standard schedule is straightforward: 300 mg injections once a month for the first two months, followed by a maintenance dose of 100 mg monthly. If the 100 mg dose isn’t providing enough coverage, your prescriber can bump the maintenance dose back up to 300 mg. The injection is administered subcutaneously, most commonly in the abdomen, though the thigh, buttock, or back of the upper arm are also options. Providers rotate the injection site each month to avoid irritation.
How Well It Works
In a six-month placebo-controlled trial, 42.7% of participants receiving Sublocade achieved sustained abstinence from opioids over the 24-week study period, compared to just 5% of those receiving placebo injections. That’s a significant gap, and it reflects the advantage of consistent medication delivery. When buprenorphine levels stay therapeutic around the clock, the brain’s opioid receptors remain occupied, which blocks the euphoric effects of other opioids and suppresses cravings.
The shot also eliminates a common treatment barrier: diversion risk. Because the medication is locked inside a solid depot under the skin, it can’t be misused or shared. For some treatment programs, this makes it easier to offer patients more flexibility and fewer clinic visits.
How Long It Stays in Your System
Buprenorphine from the injection has a remarkably long tail. The depot formulation has a half-life of up to 60 days, meaning it takes roughly five half-lives (about 10 months) for the drug to fully clear after your last shot. Some studies have detected buprenorphine in the body 22 to 38 months after the final injection.
This extended presence is actually useful for many people. If you miss a monthly appointment or decide to stop treatment, you don’t immediately lose all protection against withdrawal and cravings. The gradual taper built into the depot’s design provides a long, slow off-ramp rather than an abrupt stop. That said, this also means the medication’s effects linger for months after discontinuation, which is worth knowing if you’re planning a transition to a different treatment or to no medication at all.
What the Injection Feels Like
The injection itself is subcutaneous, meaning it goes into the fatty tissue just under the skin rather than into muscle. Your provider pinches the skin at the injection site and inserts the needle at an angle to ensure it stays in the right layer. The whole process takes a few minutes, including preparation.
The most common side effect is discomfort at the injection site: pain, redness, or a firm lump where the depot formed. This is normal and expected because there is literally a small solid mass sitting under your skin. The lump is usually palpable (you can feel it with your fingers) and gradually shrinks as the polymer breaks down over the month. Some people experience mild itching around the site. These reactions are typically manageable and tend to be less bothersome after the first couple of injections as you know what to expect.
More serious reactions, like significant swelling, spreading redness, or signs of an allergic response (hives, facial swelling, difficulty breathing), are uncommon but should prompt immediate medical attention. The injection must be given by a healthcare provider in a clinical setting, partly because proper subcutaneous placement matters. Accidental injection into muscle or skin layers can increase the risk of injection site complications.
Who the Shot Is Designed For
Sublocade isn’t a first-line treatment for someone just starting opioid use disorder medication. It’s designed for people already doing well on sublingual buprenorphine who want to simplify their routine, reduce daily reminders of treatment, or remove the need to keep medication at home. The required lead-in on sublingual dosing ensures you’re already responding to buprenorphine before committing to a monthly injection.
For people who have been on daily Suboxone for months or years and find the routine burdensome, or for those who travel frequently and struggle with pharmacy refills, the shot can be a practical upgrade. It delivers the same active medication through a different, more hands-off route, letting you focus on recovery without the daily ritual of dissolving a film under your tongue.