Getting Sublocade involves a few specific steps: finding a provider who offers the injection, stabilizing on oral buprenorphine first, navigating insurance approval, and then visiting a clinic monthly for the shot. Unlike daily buprenorphine tablets or films, Sublocade is a once-monthly injection that can only be given by a healthcare provider in a clinical setting. You cannot pick it up at a pharmacy or give it to yourself at home.
Step 1: Find a Provider
Not every doctor who prescribes buprenorphine offers Sublocade injections. The medication ships directly from a specialty pharmacy or distributor to the provider’s office, and the clinic must be enrolled in a federal safety program (called REMS) to receive it. This means you need a provider who both prescribes buprenorphine and has the setup to order and administer the injection on-site.
SAMHSA’s Buprenorphine Practitioner Locator lets you search by zip code or state for providers experienced in buprenorphine treatment. Keep in mind that the directory only lists practitioners who opted to share their information, so it’s not exhaustive. Calling addiction treatment centers, opioid treatment programs, or your insurance company’s provider line can also surface clinics that specifically offer Sublocade. When you call, ask directly whether they administer Sublocade injections, since some providers only prescribe the oral forms.
Step 2: Start on Oral Buprenorphine
Sublocade isn’t a first-line starting point. Before your first injection, you need to be on a stable daily dose of oral, sublingual, or buccal buprenorphine (typically 8 to 24 mg per day) for at least seven days. This induction period lets your provider confirm that you tolerate buprenorphine well, find the right dose, and ensure you’re not experiencing significant side effects before committing to a long-acting formulation that stays in your body for weeks.
If you’re already taking a daily buprenorphine product and want to switch to Sublocade, you may be able to transition relatively quickly, since you’ve already demonstrated tolerance. Your provider will confirm your current dose falls within the appropriate range and schedule your first injection.
Step 3: Get Insurance Approval
Most insurance plans, including Medicaid, cover Sublocade but require prior authorization. This means your provider’s office submits paperwork proving you meet the plan’s criteria before the medication is approved. The specific requirements vary by insurer, but common criteria include:
- Age 18 or older
- Diagnosis of opioid use disorder
- Current stability on oral buprenorphine (at least 7 days at 8 to 24 mg daily)
- A recent negative opioid drug screen (within 7 days of the first injection, in some plans)
- Agreement not to use supplemental oral buprenorphine alongside the injection
Your provider’s office typically handles the prior authorization process, but it can take several days to a couple of weeks. If you’re denied, your provider can appeal with additional documentation.
Copay Assistance
If you have commercial insurance, Sublocade’s manufacturer offers a copay card that covers up to $1,920.50 for each of your first two injections per calendar year and up to $800 for each injection after that, with a maximum annual benefit of $13,441. This can significantly reduce out-of-pocket costs. Your provider’s office or the specialty pharmacy coordinating your shipment can usually help you enroll.
Step 4: The First Injection
Once insurance approves the prescription, the specialty pharmacy ships Sublocade directly to your provider’s office (not to you). The medication must be kept refrigerated and can only sit at room temperature for up to seven days before it must be used or discarded, so shipment is coordinated around your appointment.
The injection itself goes into the abdominal area, just under the skin. It forms a small solid deposit that slowly releases buprenorphine over the following weeks. The appointment is quick, but your provider may monitor you briefly afterward, especially for the first dose. You’ll likely feel a small lump at the injection site, which is normal and gradually shrinks as the medication absorbs.
The Ongoing Schedule
The standard dosing pattern is two monthly injections of 300 mg to build up steady levels in your body, followed by 100 mg maintenance injections each month after that. If 100 mg isn’t providing adequate relief, your provider can increase the maintenance dose to 300 mg monthly.
Each injection must be spaced at least 26 days apart, though the second injection can be given as early as one week after the first if needed. In practice, most people settle into a predictable monthly visit. Because the medication releases continuously between appointments, you don’t need to take daily pills or films, which removes the daily routine and the risk of missed doses.
Who Can Prescribe It
Federal prescribing rules changed significantly in 2023. The old “X-waiver” system, which required doctors to get a special license to prescribe buprenorphine for opioid use disorder, was eliminated. Now, any practitioner with a standard DEA registration that includes Schedule III authority can prescribe buprenorphine, including Sublocade, as long as their state law allows it. There are also no longer federal caps on how many patients a provider can treat.
Practitioners who received or renewed their DEA registration after June 2023 must have completed at least eight hours of training on substance use disorders, or hold board certification in addiction medicine or addiction psychiatry, or have graduated within the past five years from a program that included at least eight hours of substance use disorder coursework. State requirements may add additional layers, so availability still varies by location.
What to Expect Practically
The biggest adjustment for most people is shifting from a daily medication routine to a monthly office visit. Many people find this easier to manage, since there’s no film or tablet to remember each morning and no prescription to refill at a retail pharmacy. The tradeoff is that you’re committed to showing up at a clinic each month, and you can’t adjust your dose day to day the way you might with oral buprenorphine.
Some insurance plans require reauthorization every six months. At those checkpoints, your provider may need to submit updated documentation showing that treatment is going well, which can include drug screening results and chart notes. Staying consistent with your appointments and any required lab work makes the reauthorization process smoother.