Buprenorphine is the backbone of medication-assisted treatment for opioid use disorder, and in Charleston patients can take it two ways: as a daily Suboxone film or tablet, or as a monthly Sublocade injection. Both contain the same medication. The difference is how it gets into your body, how often you think about it, and what each one asks of you week to week.
How each one works
Suboxone is buprenorphine combined with naloxone, dissolved under the tongue once a day. It starts working within an hour and gives you control over timing. It also means a daily decision, a daily supply to keep safe, and pharmacy refills on a schedule.
Sublocade is buprenorphine alone, injected under the skin of the abdomen once a month in our office. The medication forms a small deposit that releases steadily for about 30 days. There is nothing to take home, nothing to lose or share, and no daily routine to keep up.
Who tends to do well on Suboxone
- Patients just starting treatment, since the dose is easy to adjust day by day.
- Patients who want to manage their own medication and have a stable place to keep it.
- Patients whose insurance covers films more readily than injections.
Who tends to do well on Sublocade
- Patients who have been stable on daily buprenorphine for at least a week and want to stop thinking about it every day.
- Patients in court-ordered or monitored treatment, where a monthly office injection answers questions about compliance and diversion.
- Patients in recovery housing or shared living, where keeping medication secure is a daily worry.
- Patients who travel for work or have schedules that make daily dosing unreliable.
What switching looks like
Sublocade is not a first-day medication. Your provider starts you on daily buprenorphine, confirms the dose that keeps cravings and withdrawal quiet, and then gives the first injection, usually after seven days of stability. The first two monthly doses are higher to build the deposit; after that the maintenance dose is set with you. Most patients feel no change at the switch because the medication is the same.
Side effects and safety
Both forms share buprenorphine's common effects: constipation, headache, nausea early on, and sweating. Sublocade adds mild soreness or a small lump at the injection site for a few days. Neither should be combined with alcohol or sedatives without your provider's knowledge. Sublocade must only be injected by a clinician, which is why it is given in our office and never dispensed.
Cost and insurance in South Carolina
South Carolina Medicaid covers both Suboxone and Sublocade, and most commercial plans cover both with prior authorization for the injection. Indivior, which makes Sublocade, runs a patient assistance program for uninsured patients. Our front desk verifies coverage before you commit to either option.
Deciding with your provider
The honest answer is that the best medication is the one you will still be taking in six months. At Hope Addiction Medicine in West Ashley, that conversation happens at your first visit and again whenever your life changes. New patients are often able to be scheduled within a week of requesting an appointment.
This article is general health information and does not replace advice from your own provider.