Can Suboxone Be Given After Naloxone?
Answer:
Yes. In 2019, New Jersey became the first state to allow paramedics to administer Suboxone (buprenorphine) to patients immediately after their opioid overdose was reversed with naloxone. This initiative aims to ease withdrawal symptoms and increase the likelihood that overdose survivors will enter long-term treatment.
Why Combine Naloxone and Suboxone?
The idea behind this strategy is twofold:
1. To relieve acute opioid withdrawal symptoms
- Naloxone (Narcan) reverses the effects of opioids by rapidly displacing them from brain receptors.
- While lifesaving, this can also trigger sudden, intense withdrawal in overdose survivors.
- Administering Suboxone (buprenorphine) afterward reduces these withdrawal symptoms and helps stabilize the patient.
2. To increase the chance of long-term recovery
- Once the opioids are reversed, many patients experience brief clarity.
- Suboxone extends that moment, giving patients a “softer landing” and increasing their willingness to accept treatment.
- This creates a window of opportunity for connecting patients to care.
How Does the New Jersey Model Work?
New Jersey equipped certified paramedics with Suboxone and developed a protocol to administer it in the field:
This process occurs in mobile intensive care units, which are the only EMS teams currently authorized to carry and administer the medication.
Paramedics must get permission from an emergency physician who holds a DEA waiver to prescribe buprenorphine.
Suboxone is administered after naloxone has reversed the overdose and the patient is alert.
Expert Reactions to the Policy
Many addiction specialists see this as a bold and positive step:
“It’s a potentially brilliant idea,” said Dr. Dan Ciccarone, an addiction researcher at UCSF.
“We’re treating the person in as well-meaning and patient-centric a manner as possible.”
“Buprenorphine is a critical medication that doesn’t just bring folks into recovery—it can also dampen the devastating effects of opioid withdrawal,” added Dr. Shereef Elnahal, New Jersey’s Health Commissioner.
Why It Matters for the Future of Addiction Treatment
This policy could pave the way for other states to adopt similar models. By expanding access to buprenorphine immediately after overdose:
- Emergency care becomes more recovery-focused
- Patients experience less suffering in the hours following overdose reversal
- The path to long-term treatment begins earlier, improving outcomes and reducing repeat overdoses
Thinking About Suboxone Treatment?
If you or someone you love is struggling with opioid dependence, Suboxone may be part of the solution, whether after an overdose or as part of a structured outpatient treatment plan.
At SaVida Health, we offer:
- Suboxone-based Medication-Assisted Treatment (MAT)
- In-house counseling and case management
- Flexible outpatient services, including same-day appointments
- Supportive, judgment-free care
Contact us today to learn more or schedule an evaluation.