That is only half accurate about injecting Suboxone. The naloxone certainly is a lot more bioavailable with injection use than sublingual use, but most people I have heard from who inject Suboxone do not have any issues with the naloxone.
In many cases naloxone does not prevent the buprenorphine from doing its thing even when injected as Suboxone (my theory is that the buprenorphine has a higher binding affinity than the naloxone present). For many, many people the naloxone on Suboxone will not send someone into precipitated withdrawal (assuming one doesn’t have full agonists or other opioids in their system, but the precipitated withdrawal if they did would come more from the buprenorphine than the naloxone).
As a general rule, precipitated withdrawal issues with Suboxone are almost entirely related to the buprenorphine. Naloxone is actually a pretty poor antagonist to use in the case of buprenorphine. The buprenorphine is just much, much stronger. Luckily OD and buprenorphine isn’t common among people who use opioids, thanks to its ceiling affect. In he case of a buprenorphine OD, I shudder to think how much naloxone would be necessary to reverse it
Some people definitely seem to experience side effects from naloxone when injecting buprenorphine, but again most people I’ve heard from don’t have any issue with the naloxone. I certainly never had any issues plugging or insulfating it, but even with injection the naloxone seems to be out competed by the buprenorphine, rendering it rather insignificant.
Not suggesting someone should inject Suboxone, just pointing out the naloxone issue being more marketing then lived experience.
