If you’ve decided to start medication-assisted treatment (MAT) for opioid use disorder, one of the first decisions you’ll make with your provider is which medication is right for you. At Fresh Start Health, the three options we hear about most are Suboxone, Sublocade, and Brixadi. All three use the same core medication—buprenorphine—but they’re delivered very differently, and the right choice depends on your lifestyle, your goals, and how much you value convenience versus control. Here’s a clear, side-by-side look at how they compare.
What they all have in common
Suboxone, Sublocade, and Brixadi are all forms of buprenorphine, a partial opioid agonist that reduces cravings and withdrawal symptoms without producing the same high as full opioids. Buprenorphine has a “ceiling effect,” which makes it safer in overdose than medications like methadone. All three are FDA-approved, evidence-based treatments for opioid use disorder, and all three are available through Fresh Start Health’s clinics in Eastern Kentucky and through telehealth where appropriate. The difference comes down to how and how often you take them.
Suboxone: the daily film or tablet
Suboxone combines buprenorphine with naloxone and is taken daily as a film or tablet that dissolves under the tongue. It’s the most widely used option and the one most people start with.
- How often: Once a day, at home.
- Best for: People who want flexibility, who are just starting treatment, or who want the ability to adjust their dose easily with their provider.
- Things to consider: Because it’s taken daily, it requires consistency. You’ll need to keep the medication on hand and remember to take it each day. Some people prefer this level of involvement; others find it harder to stick with over time.
Sublocade: the once-monthly injection
Sublocade is a long-acting buprenorphine injection given once a month by a healthcare provider. After the injection, the medication forms a small deposit under the skin that releases buprenorphine steadily over the following weeks.
- How often: Once a month, in the clinic.
- Best for: People who are stable on treatment and want to stop thinking about a daily dose, who travel, or who find daily medication hard to maintain.
- Things to consider: Most providers want you stabilized on oral buprenorphine (like Suboxone) for about a week before starting Sublocade. Because it’s monthly, there’s no daily routine—but it does require a monthly clinic visit for the injection.
Brixadi: weekly or monthly injection, more flexible dosing
Brixadi is also a long-acting buprenorphine injection, but it comes in both weekly and monthly formulations and a wider range of dose strengths. This added flexibility means treatment can be started sooner and tailored more precisely.
- How often: Weekly or monthly, depending on your treatment plan.
- Best for: People who want the convenience of an injection but need more dosing flexibility, or who want to begin an injectable earlier in treatment.
- Things to consider: Brixadi can be started with less lead time than Sublocade, which can be helpful for people who want to move to an injectable quickly. Like Sublocade, it’s administered by a provider.
Which one is right for you?
There’s no single “best” medication—there’s only the best fit for your situation. As a general guide:
- If you value flexibility and the ability to fine-tune your dose, Suboxone is often the starting point.
- If daily dosing is a struggle and you want maximum convenience, a monthly injection like Sublocade may be a better fit once you’re stable.
- If you want an injectable but need flexible dosing or a faster start, Brixadi offers a middle path.
What matters most is starting some form of treatment. Studies consistently show that any of these buprenorphine-based options dramatically reduces the risk of overdose and supports long-term recovery. The decision is one you’ll make together with a Fresh Start Health provider based on your medical history, your daily life, and your goals.
Cost and insurance
Fresh Start Health accepts Medicaid and many insurance plans, and these medications are covered under most plans for opioid use disorder treatment. As a 340B covered entity serving Eastern Kentucky, we work hard to keep treatment affordable regardless of your coverage. If cost is a concern, talk to us—we’ll help you understand your options before you start.
Frequently Asked Questions
What is the difference between Suboxone, Sublocade, and Brixadi?
All three contain buprenorphine, the same core medication that reduces opioid cravings and withdrawal. The difference is how they are delivered. Suboxone is a daily film or tablet you take at home. Sublocade is a once-monthly injection given in the clinic. Brixadi is an injection available in both weekly and monthly forms with more dose options. The best choice depends on how much daily involvement you want and how quickly you want to start an injectable.
Is Brixadi or Sublocade better?
Neither injection is universally better—they suit different needs. Sublocade is monthly only and usually requires about a week of stabilization on oral buprenorphine first, so it fits people who are already stable and want maximum convenience. Brixadi comes in weekly or monthly strengths and can be started with less lead time, so it fits people who want an injectable sooner or need more flexible dosing. A Fresh Start Health provider can help you decide based on your treatment plan.
Can I switch from daily Suboxone to a monthly injection?
Yes. Many people start on daily Suboxone and later switch to a long-acting injection like Sublocade or Brixadi once they are stable. For Sublocade, most providers want you stabilized on oral buprenorphine for about a week before the first injection; Brixadi can often be started with less lead time. Your Fresh Start Health provider will time the switch to keep you comfortable and avoid withdrawal.
Does insurance or Medicaid cover Suboxone, Sublocade, and Brixadi in Kentucky?
Fresh Start Health accepts Medicaid and many commercial insurance plans, and these buprenorphine medications are covered under most plans for opioid use disorder treatment. As a 340B covered entity serving Eastern Kentucky, we work to keep treatment affordable regardless of your coverage. If cost is a concern, call us or use our chat function and we will help you understand your options before you start.
Ready to talk through your options?
Choosing between Suboxone, Sublocade, and Brixadi is a conversation, not a test. Our team at Fresh Start Health will walk you through each option and help you decide what fits your life. To get started, call us or use our chat function on the website—we’re here to make the first step easy. Learn more about our addiction treatment services.