The primary active ingredient in Suboxone is buprenorphine, which is a partial opioid agonist.  This means that the buprenorphine’s opioid effects are limited compared a full opioid agonist like Heroin.  Opioids attach to receptors in the brain called mu receptors that cause the release of a neurotransmitter called dopamine.  This release of dopamine produces pleasurable feelings.  When the opioid is taken away these feelings leave and withdrawal symptoms begin.  The buprenorphine in Suboxone will attach to these opioid free receptors suppressing the withdrawal symptoms and reduce cravings.

Suboxone also contains naloxone, an opioid antagonist, which means that it can cause the negative effects of an opioid – namely the withdrawals.  Naloxone is present to discourage people from dissolving the tablet and injecting it. When Suboxone is used as directed by placing under the tongue, very little naloxone reaches the bloodstream, so what the patient feels are the effects of the buprenorphine. However, if naloxone is injected, it can cause a person dependent on a full opioid agonist to quickly go into withdrawal.

Suboxone treatment can be broken down into 5 phases: 

• Intake – The doctor will ask you questions about your medical health history and substance use history.  The goal here is to be as honest as possible so that your doctor has accurate information so that a treatment plan can be created to meet your needs.
  
  • During this visit, you and your doctor will go over the pros and cons of Suboxone therapy and what you can expect from the treatment.  
• Induction – The goal of the induction is to switch you from your current opioid to Suboxone.  You need to arrive in mild-to-moderate opioid withdrawal.  If Suboxne is started before withdrawal, the medication can make you feel worse because it can cause withdrawal symptoms.
  
  • An induction can last anywhere from 2 to 7 days. Urine drug screening at every visit is also fairly standard during induction.
• Stabilization – The Suboxone dose is "fine tuned" about once a week, as needed.  This is to find a dose where your withdrawal symptoms and cravings are suppressed, and you experience minimal to no side effects.
• Maintenance – Maintenance dosing is when the dose becomes more stabilized and treatment begins. During maintenance, your treatment compliance and progress will continue to be monitored.
  
  • Participation in some form of behavioral counseling is strongly recommended to maximize the likelihood of your treatment success.
• Medically Supervised Withdrawal – Length of therapy is up to your doctor, you, and sometimes your therapist or counselor. In this phase of medically supervised withdrawal, your doctor will slowly taper your Suboxone dose, taking care to see that you experience minimal withdrawal symptoms or cravings. Your dose can always be changed if you experience uncomfortable symptoms or cravings at the reduced dose.

For more information:  http://www.suboxone.com