Medication-Assisted Treatment · Updated April 2026

Sublocade Monthly Injection

Once-monthly extended-release buprenorphine — a proven alternative to daily Suboxone for patients ready to simplify their opioid use disorder treatment. Administered at our four CARF-accredited outpatient clinics across Tennessee and Georgia.

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Same-day appointments available in most cases · TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.

At a glance

Who Sublocade is best for

Sublocade is the long-acting buprenorphine injection most often chosen by patients on fentanyl, severe opioid use disorder, and those who have struggled with daily adherence to Suboxone film or tablets. A single monthly injection delivers steady buprenorphine levels for 28-30 days, eliminating the need for daily dosing. Ling et al., EXPO 2023 showed Sublocade patients had 19 more opioid-free days over 24 weeks compared to daily sublingual buprenorphine — largely an adherence effect. Sublocade injections are administered in clinic by trained providers at Restoration Recovery, an outpatient MAT specialty clinic with four CARF-accredited locations across Tennessee and Georgia.

Most Sublocade patients start on Suboxone for at least 7 days to confirm tolerability, then transition. Same-week first appointments at our Chattanooga and Cleveland clinics; Soddy-Daisy does not offer injection services and our Ringgold clinic is preparing to begin scheduling. TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted. Sublocade is covered under the TennCare medical benefit with prior authorization (separate from BESMART, which speeds buprenorphine pharmacy coverage).

What Is Sublocade?

Sublocade is an FDA-approved, extended-release formulation of buprenorphine delivered as a once-monthly injection. It is prescribed specifically for the treatment of opioid use disorder in patients who have already begun treatment with a buprenorphine-containing medication and are on a stable dose. Rather than taking a daily film or tablet, patients receiving Sublocade visit their provider once a month for a single injection that delivers a steady, controlled dose of buprenorphine over the following 30 days.

For many patients in medication-assisted treatment, Sublocade represents a meaningful step forward in how opioid use disorder is managed. It removes the daily routine of taking medication at home and replaces it with a simple monthly clinic visit, allowing patients to focus more fully on the other parts of their recovery.

How Sublocade Differs from Daily Suboxone

If you are currently taking daily Suboxone (buprenorphine/naloxone sublingual film or tablet), you are already familiar with the benefits of buprenorphine-based treatment. Suboxone is a highly effective medication that reduces cravings and prevents withdrawal, but it does require a daily commitment. The film or tablet must be dissolved under the tongue each day, and patients must plan around their dosing schedule. For patients who want the benefits of extended-release buprenorphine but prefer a shorter interval than monthly, we also offer Brixadi as a weekly or bi-weekly injection.

Sublocade eliminates that daily requirement. Key differences include:

Dosing frequency: Sublocade is administered once per month at the clinic, compared to Suboxone which is taken every day at home.
Medication delivery: Sublocade is a subcutaneous injection that forms a small, solid deposit under the skin. This depot slowly releases buprenorphine into the bloodstream over the course of 30 days, maintaining consistent medication levels.
No daily decisions: With Sublocade, there is no film to remember each morning, no risk of a missed dose, and no need to carry medication when traveling.
Steady blood levels: Because the medication releases continuously from the injection site, patients experience fewer peaks and valleys in buprenorphine levels throughout the month compared to once-daily oral dosing.

Both medications contain buprenorphine and both are effective treatments for opioid use disorder. The choice between them depends on the patient's treatment history, stability, and personal preferences. Your provider can help you determine which option is the best fit for where you are in your recovery.

Who Is a Candidate for Sublocade?

Sublocade is typically recommended for patients who have already been stabilized on a transmucosal buprenorphine-containing product, such as Suboxone, and are doing well in their treatment. Ideal candidates generally meet the following criteria:

Currently stable on a daily buprenorphine dose of 8 mg or higher for at least seven days
Consistent with clinic appointments and counseling participation
Looking to reduce the burden of daily medication management
Motivated to continue their recovery with fewer day-to-day treatment tasks

Sublocade is not typically the first medication prescribed for a patient new to treatment. New patients at Restoration Recovery generally begin with daily Suboxone, which allows their provider to find the right dose and monitor early response to treatment. Once a patient is stable and has demonstrated consistent progress, transitioning to Sublocade becomes an option worth discussing with the care team.

Patients still weighing MAT options often find our Is Suboxone Right For Me? page helpful — it walks through how daily Suboxone, monthly injections, and other pathways compare for different clinical situations. For a direct head-to-head on this specific choice, see our Sublocade vs. Daily Suboxone comparison: what the EXPO and PROBE clinical trials show, how each fits day-to-day life, and insurance coverage in Tennessee. For all five MAT medications side by side in two scannable tables (clinical profile + practical considerations), see our MAT Medications Compared tracker.

How the Injection Works

The Sublocade injection is administered by a healthcare provider at the clinic. It cannot be self-administered or taken home. The process is straightforward and takes only a few minutes.

During the injection, the provider delivers the medication subcutaneously into the abdominal area. Once injected, the liquid solution forms a small, solid depot beneath the skin. This depot acts as a slow-release reservoir, gradually delivering buprenorphine into the bloodstream over approximately 30 days. Patients may feel a small lump at the injection site, which is normal and resolves on its own over time.

The first two injections are given at a dose of 300 mg, one month apart. After that, the provider may continue at 300 mg or adjust to a 100 mg maintenance dose depending on the patient's clinical response and treatment goals. Your provider will determine the appropriate long-term dosing plan based on your individual needs.

Benefits of Monthly Sublocade Treatment

Patients who transition from daily Suboxone to Sublocade often report several practical and clinical advantages:

No daily dosing decisions: One injection per month replaces 30 days of daily film administration, removing a common source of treatment friction.
Consistent medication levels: The depot delivery system provides steady buprenorphine levels, which can mean fewer cravings and a more even experience throughout the month.
Reduced diversion risk: Because Sublocade is administered in the clinic and cannot be taken home, it significantly reduces the risk of medication misuse or diversion.
Convenience and freedom: Patients no longer need to plan around daily dosing, store medication at home, or manage refill schedules. Travel and daily routines become simpler.
Continued recovery support: Sublocade works alongside counseling, IOP, and other recovery services. The medication addresses the physical component of opioid dependence while patients continue building the skills and support systems needed for long-term recovery.

The Evidence

What the Research Shows on Sublocade

Sublocade earned its FDA approval on the strength of the PROBE trial — a rigorous 504-patient placebo-controlled study across 36 U.S. sites, published in The Lancet in 2019. The trial compared once-monthly Sublocade injections to placebo injections across six months. The gap between the two groups is one of the clearest demonstrations in all of addiction medicine that a depot buprenorphine injection works.

Sublocade dramatically increases time opioid-free

Percent of weeks opioid-free (urine + self-report)

5% Placebo injection

42% Sublocade injection 8× more opioid-free time

Source: Haight BR et al. Lancet. 2019;393(10173):778–790. PROBE pivotal trial, 504 patients, 36 U.S. sites.

Nearly 1 in 3 patients reach full treatment success

Patients abstinent at least 80% of weeks

2% Placebo injection

28% Sublocade injection 14× more likely to succeed

Source: Haight BR et al. Lancet. 2019;393(10173):778–790.

Patients stay in treatment longer

Completed the full 6-month trial

34% Placebo injection

60% Sublocade injection Nearly 2× retention

Source: Haight BR et al. Lancet. 2019. PROBE completion data.

Why these numbers are remarkable

Patients on Sublocade were opioid-free for nearly half of the treatment period. Patients on the placebo injection were opioid-free about 5% of the time — a figure that reflects just how difficult opioid use disorder is to manage without medication support.

Treatment success — defined as being abstinent at least 80% of weeks — was reached by nearly one in three Sublocade patients. Only 2% of placebo patients cleared that threshold. Retention was dramatically better as well: six in ten Sublocade patients completed the full trial, versus about one in three on placebo.

The depot injection gives patients a built-in reason to stay engaged: the medication is already working in their body for the next 30 days. There is no daily dose to miss, no medication to forget, no refill to run out of. What the research shows is what patients in the clinic report: once the injection is given, the hardest part of the day-to-day maintenance is already done.

A Cochrane systematic review of 31 clinical trials covering 5,430 participants has also confirmed the broader buprenorphine-class effect: patients on buprenorphine-based medications are substantially more likely to remain in treatment than those on placebo, and retention improves with therapeutic dosing. (Full citations in References.)

At Restoration Recovery, Sublocade is prescribed as part of a full treatment plan that includes counseling, peer support, and ongoing check-ins. The medication gets patients stable. The team keeps them there.

Starting Sublocade — Your First Appointment

Sublocade is started after a short stabilization period on transmucosal buprenorphine (the FDA label requires at least 7 days). Your first visit at Restoration Recovery follows the same four-step clinical flow we use for all opioid use disorder intake, scoped toward your Sublocade transition:

Intake. You’ll complete paperwork and a clinical intake. For opioid use disorder, this includes a DSM-5 assessment to confirm the diagnosis and severity, and a COWS (Clinical Opiate Withdrawal Scale) score to measure your current withdrawal state. The COWS score determines whether you’re clinically ready to begin buprenorphine the same day without risking precipitated withdrawal.
Counseling. You’ll meet with a counselor to discuss your substance use history, any prior treatment, and your goals — including why an extended-release injection fits the recovery you’re trying to build.
Doctor evaluation. A medical provider reviews your intake, COWS score, and counselor notes; explains how Sublocade works; walks you through the Suboxone-bridge plan; and answers your questions.
Suboxone bridge + Sublocade order. If clinically appropriate, you leave the same day with a Suboxone prescription as your bridge medication. Your provider orders Sublocade during this visit (we don’t stock injections on-site), and your first injection is scheduled for a follow-up after at least 7 days of stable Suboxone use, per the FDA label.

Bring a valid photo ID, your insurance card (if applicable), and a list of any medications you currently take. The first visit typically lasts 60 to 120 minutes.

What monthly Sublocade visits look like

Once your monthly cadence begins, each visit also serves as an opportunity to check in with the care team, discuss progress, and address any concerns. Monthly visits typically include:

A brief clinical assessment and vitals check
Administration of the Sublocade injection
A short observation period following the injection
Discussion of any side effects, changes in health, or adjustments to the treatment plan

Counseling continues alongside medication. Restoration Recovery provides individual and group counseling as part of a comprehensive treatment approach. Medication alone is not a complete treatment for opioid use disorder, and patients are encouraged to engage fully in all recommended components of their care plan.

Common side effects of Sublocade may include mild pain, redness, or itching at the injection site. These reactions are generally temporary and resolve within a few days. Your provider will review all potential side effects with you before your first injection.

Anything you share during intake, counseling, or your monthly Sublocade visits is protected by HIPAA and 42 CFR Part 2 — the federal rule that specifically shields addiction-treatment records from disclosure without your written consent.

Why Patients Choose Restoration Recovery for Sublocade

Sublocade is effective — the research is clear. But the difference between an injection that launches a strong recovery and one that fades has everything to do with the clinic behind the prescription. Here is what patients find at Restoration Recovery:

Four physical clinics across Tennessee and Georgia. Chattanooga, Cleveland, Soddy-Daisy, and Ringgold. Sublocade is administered in-clinic, so your monthly injection is also a built-in check-in with a provider who knows you.
MAT-certified providers and a CARF-accredited program. CARF (Commission on Accreditation of Rehabilitation Facilities) is the gold standard in addiction-treatment accreditation — a level of clinical scrutiny most outpatient clinics do not pursue.
One of Chattanooga’s longest-running outpatient clinics. Some of our patients have been with us for more than five years. Continuity matters in recovery, especially on a long-term injection.
4.5 stars across more than 40 verified Google reviews. Real patients, real experiences. Read a few before you call.
Integrated counseling and behavioral health in-house. Medication without counseling is only part of a treatment plan. We provide both under one roof so nothing falls between the cracks.
Most major insurance plans accepted. TennCare, Medicaid, Medicare, and commercial carriers. For most patients, out-of-pocket cost is minimal to none.
Confidential by federal law. Your treatment is protected under HIPAA and 42 CFR Part 2, a federal rule that specifically shields addiction-treatment records from most forms of disclosure. What you share with us stays with us.

Insurance and Access

Restoration Recovery accepts most major insurance plans for Sublocade treatment, including TennCare, Medicaid, and many commercial insurance plans. Our patient services team can verify your coverage and explain any out-of-pocket costs before treatment begins. Visit our insurance page for more information about accepted plans, or contact us directly to have our team check your benefits.

For TennCare members specifically, Restoration Recovery is enrolled in TennCare’s BESMART program, which speeds preferred buprenorphine pharmacy coverage (Suboxone film and tablet, generic buprenorphine/naloxone). Sublocade is administered in the clinic rather than filled at a pharmacy, so it is covered under the TennCare medical benefit with its own prior authorization process — separate from BESMART. Our team coordinates both pathways when clinically appropriate.

If you have questions about cost or coverage, we encourage you to call before your appointment. Our goal is to make sure that financial concerns do not stand in the way of effective treatment.

Our Clinic Locations

Sublocade injections are available at all four Restoration Recovery clinic locations across Tennessee and Georgia:

Chattanooga, TN — Main clinic at 6141 Shallowford Rd, Suite 100
Cleveland, TN
Soddy-Daisy, TN
Ringgold, GA

Each location is staffed by providers experienced in medication-assisted treatment for opioid use disorder. Same-week appointments are often available for new patients looking to begin treatment, and existing patients on daily Suboxone can discuss the transition to Sublocade at their next scheduled visit.

Frequently Asked Questions

How is Sublocade different from daily Suboxone?

Sublocade delivers the same active medication (buprenorphine) but through a once-monthly subcutaneous injection instead of a daily sublingual film or tablet. The steady blood level over a full month means you don’t experience the small peaks and troughs that can come with daily dosing, and you don’t have to remember the medication each morning. Both are effective for opioid use disorder; the choice usually comes down to lifestyle preference, insurance coverage, and clinical history. FDA labeling requires a period of stabilization on daily transmucosal Suboxone before the first Sublocade injection.

What’s the first month of Sublocade like — will I still need daily Suboxone?

Your first Sublocade injection is typically given after at least a 7-day stabilization period on daily transmucosal Suboxone (film or tablet). Most patients feel steady within a few days of the injection as the blood level reaches maintenance range. You stop taking daily Suboxone once you receive the injection; the long-acting medication takes over. Some patients notice mild adjustment in the first few weeks — usually tiredness or emotional variability — which typically resolves by the second month. Your provider will schedule a follow-up call to check in and make adjustments if needed.

Will I feel withdrawal between injections?

No. Sublocade’s extended-release formulation maintains therapeutic buprenorphine blood levels for at least 28 days — that’s why it’s dosed once a month. The PROBE trial (Haight 2019, Lancet) showed 6-month retention rates of 60% on monthly Sublocade versus 34% on placebo, partly because patients don’t experience the daily-dose cliff. If you feel early signs of withdrawal before your next injection appointment, call us — we can adjust timing or bridge with short-acting buprenorphine if clinically needed.

Does my insurance cover Sublocade, or will I have a copay?

Most insurance plans cover Sublocade, including TennCare (BlueCare, Wellpoint, UHC Community Plan), traditional Medicare, Medicare Advantage, and most commercial plans. Prior authorization is usually required. TennCare members typically have $0 out-of-pocket for both the office visit and the medication. Commercial copays vary: some plans classify Sublocade under the medical benefit (office-administered) and others under pharmacy benefit. Our intake team verifies your specific coverage before your first injection, and we don’t stock Sublocade on-site — the injection is scheduled as a follow-up appointment once the medication is ordered and approved. See our insurance page for carrier details.

What happens if I miss an injection appointment?

Call us as soon as possible. A short delay (a few days to a week past your 28-day mark) is typically not a clinical emergency — buprenorphine’s long half-life means some therapeutic effect persists. Beyond two weeks past the due date, you may start experiencing withdrawal, and we may recommend a brief transition back to daily Suboxone until your next injection. Missing multiple doses is a significant clinical concern and worth discussing with your provider. The goal is continuity — we’d rather see you back on schedule promptly than have you struggle between doses.

Can I switch from Sublocade back to daily Suboxone if I want to?

Yes. Sublocade-to-Suboxone transition is clinically routine. Because Sublocade’s buprenorphine is released slowly for weeks after the last injection, you simply stop getting injections and, as blood levels decline naturally (typically over 4 to 12 weeks), your provider transitions you to daily Suboxone at an appropriate dose. Some patients switch for lifestyle reasons (travel, insurance change, or preference), others because they’re approaching the end of their structured treatment plan. Whatever the reason, the transition doesn’t require a medical “taper” — just coordinated care with your provider.

Taking the Next Step

If you are currently on daily Suboxone and interested in whether Sublocade could simplify your treatment, bring it up with your provider at your next appointment. If you are new to treatment and want to learn about all of your medication options, our team is ready to help you understand the path forward.

Restoration Recovery offers a full range of outpatient treatment services for opioid use disorder, including medication management, individual counseling, IOP, and peer support. Every treatment plan is built around the individual patient, and our providers will work with you to find the approach that best fits your life and your goals.

References

The statistics and clinical findings on this page come from peer-reviewed medical research and authoritative public-health sources. Patients, family members, and providers are welcome to verify any claim against the original source.

Haight BR, Learned SM, Laffont CM, et al. Efficacy and safety of a monthly buprenorphine depot injection for opioid use disorder: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2019;393(10173):778–790. [PubMed]
Lofwall MR, Walsh SL, Nunes EV, et al. Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs Daily Sublingual Buprenorphine With Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial. JAMA Internal Medicine. 2018;178(6):764–773. [PubMed]
Greenwald MK et al. Examining the benefit of a higher maintenance dose of extended-release buprenorphine in opioid-injecting participants treated for opioid use disorder. Harm Reduction Journal. 2023;20:173. [PubMed]
Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550. [PubMed]
Mattick RP, Breen C, Kimber J, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database of Systematic Reviews. 2014;(2):CD002207. [Cochrane]
American Society of Addiction Medicine (ASAM). National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update. [ASAM]
National Institute on Drug Abuse (NIDA). Medications for Opioid Use Disorder. Accessed 2026. [NIDA]
SUBLOCADE (buprenorphine extended-release) for injection, sublingual tablet. Prescribing Information. Indivior Inc. Accessed via DailyMed, U.S. National Library of Medicine. [DailyMed]

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