Does Suboxone Help With Pain? What it Can and Can't Do, and Why it's Different with Opioid Use Disorder

Suboxone is an FDA-approved medication for the treatment of opioid use disorder (MOUD), not pain specifically. While it’s true that Suboxone’s main ingredient, buprenorphine, has some pain-relieving effects, the main actions of this medication are to ease withdrawal symptoms, reduce cravings, and prevent return to use. 

“Some people taking Suboxone notice that their pain improves,”  says Dr. Patricia Pechter, DABFM, a clinical quality improvement physician at Boulder Care. “This is because Suboxone activates the same opioid receptors as medications like oxycodone or hydrocodone. But Suboxone is not FDA-approved specifically for pain, so using it this way is considered ‘off-label.’” 

In this article, we’ll unpack how Suboxone helps with pain, and whether or not taking suboxone for pain management is an option.

So, can you use Suboxone for pain relief? First, it’s worth understanding how the ingredients in Suboxone work.

‍Buprenorphine is the active ingredient in Suboxone and has several formulations that are FDA-approved for pain relief. That means that providers can prescribe buprenorphine for pain relief. Suboxone, on the other hand, is only approved for treating opioid use disorder. Within Suboxone, buprenorphine works to reduce withdrawal, cravings, and overdose risk. 

“Buprenorphine is FDA-approved for pain, typically as a patch or buccal film. The distinction is confusing because Suboxone contains buprenorphine as the active ingredient,” says Dr. Pechter. 

Suboxone’s other ingredient is naloxone, which is the active ingredient in Narcan. Naloxone is included in Suboxone as a safety feature, ensuring the medication is used as intended. It will only activate and be felt when Suboxone is injected, which is discouraged. 

Again, Suboxone is not a pain medication and is not typically prescribed as one like buprenorphine. “While both contain the same active medication, they’re designed with different goals in mind,” explains Dr. Pechter. Yet, it’s the effect of buprenorphine, activating opioid receptors, that might help with pain. Suboxone might still be a relevant option for people with opioid use disorder seeking pain management. 

It also comes with another benefit, compared to opioids: a “ceiling effect.” “Suboxone has a ‘ceiling effect’ on breathing suppression,” adds Dr. Pechter. “That means even at higher doses, it’s much less likely to slow breathing dangerously compared to traditional opioids. This is one reason it’s safer in people with opioid use disorder.”

Like any medication, the potential benefits of taking Suboxone can vary person to person. The answer might differ based on factors like why you’re taking Suboxone and what type of pain you’re experiencing.

However, there are some circumstances which Suboxone might be especially helpful—a determination you and your provider can officially make.

If you have opioid use disorder and pain

Suboxone is a medication for helping you cope with opioid use disorder, but it might also help you with pain. “For someone with chronic pain who also has opioid use disorder, Suboxone can provide some pain relief in addition to other non-opioid pain management strategies,” says Dr. Pechter. 

While Suboxone cannot be used specifically as a pain medication, it can act as an added benefit. Taking Suboxone for opioid use disorder while experiencing pain might be a way to manage both issues together. 

Such was the case, to an extent, for Danielle Bellosi, a peer recovery supervisor at Boulder Care. “Personally, I have sciatica, and when I started Suboxone, I noticed a clear reduction in the pain associated with that condition. I wasn’t prescribed Suboxone specifically for pain management — it was part of my recovery — but the impact on my physical discomfort was noticeable,” says Bellosi. “The pain didn’t completely go away, but it became much more manageable and less disruptive to my day-to-day functioning.” 

Of course, treatment decisions are completely based on conversations with your provider, your specific pain, and your tailored care plan. 

It’s critical to remember that Suboxone has a risk of precipitated withdrawal. “Starting Suboxone too soon after using other opioids can trigger precipitated withdrawal, a rapid and very uncomfortable withdrawal response,” cautions Dr. Pechter. “This happens because Suboxone displaces other opioids from receptors but doesn’t activate them to the same degree.”

If you already take Suboxone and are dealing with pain (or will be soon)

Similarly, if you’re already taking Suboxone, it might help with new or upcoming pain, such as an injury, dental work, a surgery, and other related developments. However, this should be coordinated with all relevant medical professionals and should not involve changing your Suboxone dose on your own. 

After a procedure, you will typically also receive another approved pain relief medication. “Someone undergoing surgery who is already on Suboxone for OUD is generally managed with non-opioid options for acute pain, such as Tylenol, ibuprofen, ketamine, lidocaine injections, and nerve blocks,” says Dr. Pechter. 

Suboxone is not FDA-approved for pain medication and is typically not a first choice for pain relief. This positioning is especially true if you aren’t living with opioid use disorder and taking Suboxone for that. Suboxone may not be the right choice for pain management in situations such as:

• Short-term pain if you don’t live with opioid use disorder
• Severe acute pain after surgery
• You need standard pain medication 
• Acute pain without a diagnosis

Suboxone is not designed or approved for pain management. Its risk of side effects can also be increased by some types of pain, such as head injury, tooth problems, and liver issues. 

Critically, if you’re experiencing severe or complex pain, you will likely need a thorough pain-management plan, not just one off-label medication. 

Overall, opioid use disorder can make pain more complicated. Withdrawal symptoms can bring additional pain, your tolerance levels might change how you respond to pain relief, and things such as stress and poor sleep can amplify pain. 

You shouldn’t have to live with pain and deserve the best, well-rounded management available. Instead of Suboxone, you might find benefit from other pain relief approaches, such as:

• Non-opioid medications, like ibuprofen and paracetamol.
• Physical therapy can be a great form of pain management, targeting specific areas of distress.
• Exercise to strengthen certain areas of the body. 
• Psychological and mindfulness-based therapies to work through distress. 

Each person’s pain is unique and will respond positively to different methods. These alternatives can be great, safe options for anyone who has experienced opioid use disorder in the past. 

A medical provider can offer you the best insight into whether taking Suboxone is right for you and what other pain relief options might be beneficial. Unsure whether speaking with a medical professional is the right decision? We recommend talking to a provider if you are: 

• Already taking Suboxone and have new or worsening pain
• Getting surgery, dental work, or any sort of procedure done
• Considering Suboxone and want to know whether it makes sense with your pain history
• Thinking about changing your medication on your own
• Feeling unsure about what type of treatment fits your situation

You can ask your provider questions such as: 

• What are the risks of different medications? 
• What do I need to know about managing my pain as someone living with opioid use disorder? 
• Could buprenorphine be a good pain relief option for me?
• What should I tell my doctors before a procedure? 

Suboxone might offer you pain relief while undergoing treatment for opioid use disorder. ”Overall, I would describe it as not eliminating pain, but creating enough stability — physically and mentally — to make pain more tolerable and life more manageable,” says Bellosi. 

However, it’s typically not a first option for pain relief and unlikely to be used as such unless you’re coping with opioid use disorder or already taking Suboxone. Your provider can give you tailored insight into whether Suboxone might help you with pain. 

Why are doctors prescribing Suboxone for pain? (People also ask SERP module)

Suboxone might help alleviate some pain. However, it is not FDA-approved for pain management and is usually only prescribed if you live with an opioid use disorder. 

Does Suboxone help with chronic pain?

Suboxone might help with chronic pain, but it’s not FDA-approved to do so. Consult your provider about whether Suboxone can help with pain and what alternative options they recommend. If you are not living with opioid use disorder—and taking Suboxone for that—then it’s unlikely you will be given it for pain management. 

What if I’m taking Suboxone and need surgery?

Alert your surgical team to the fact that you are taking Suboxone and if you have opioid use disorder. They will be able to provide tailored information about how Suboxone might affect pain management and offer other pain medications, likely non-opioids.