Sublocade & Brixadi

For many people recovering from opioid use disorder, the daily routine of taking Suboxone films or tablets adds friction to an already difficult journey. Missed doses, medication reminders, insurance refills, and the psychological weight of a daily habit can make sustained recovery harder than it needs to be.

Long-acting injectable buprenorphine changes that equation. A single injection — administered weekly, monthly, or every two months depending on the medication — delivers steady, effective treatment without the daily reminder that recovery is ongoing.

Fresh Start Health Centers offers both FDA-approved long-acting buprenorphine injections: Sublocade (monthly) and Brixadi (weekly, monthly, or bimonthly options). Our providers across Kentucky are licensed to prescribe and administer these medications as part of a comprehensive medication-assisted treatment (MAT) program.

What Are Sublocade and Brixadi?

Both Sublocade and Brixadi are extended-release formulations of buprenorphine, the same active medication in Suboxone. Instead of dissolving under the tongue every day, the medication is injected subcutaneously (under the skin) and slowly released into the bloodstream over days or weeks.

Both medications work the same way:

Reduce cravings for opioids
Block the effects of other opioids if used
Prevent withdrawal symptoms
Support long-term recovery when combined with counseling and support services

Both medications require patients to first be stabilized on oral buprenorphine (Suboxone or generic equivalent) for at least seven days before starting injections.

Sublocade vs. Brixadi: Understanding the Difference

Both medications are approved by the FDA for the treatment of moderate to severe opioid use disorder in adults who have initiated treatment with a transmucosal buprenorphine-containing product. The main differences are in dosing frequency and administration.

Sublocade

Dosing: Once monthly injection
Doses available: 100 mg or 300 mg
Injection site: Abdomen only
Storage: Refrigerated until use
FDA approval: 2017
Best for: Patients stable on daily buprenorphine who prefer the least frequent injection schedule

Brixadi

Dosing: Weekly (8 mg, 16 mg, 24 mg, 32 mg) or Monthly (64 mg, 96 mg, 128 mg)
Injection sites: Buttock, thigh, abdomen, or upper arm — more flexibility
Storage: Room temperature (no refrigeration required)
FDA approval: 2023 in the US (available in Europe under name Buvidal since 2018)
Best for: Patients who want more dosing flexibility, need weekly starting doses before transitioning to monthly, or prefer injection site options

Which is right for you?

Your provider at Fresh Start will help determine which medication is right for you based on:

Your current buprenorphine dose and stability
Your insurance coverage
Your personal preference for injection schedule and site
Your recovery goals and stage of treatment

Some patients start on Brixadi weekly injections during early recovery when close support is helpful, then transition to Sublocade monthly injections once stable.

Who Is a Candidate for Long-Acting Buprenorphine?

Long-acting injectable buprenorphine is FDA-approved for adults with moderate to severe opioid use disorder who are:

Currently stabilized on oral buprenorphine for at least seven days
Not allergic to buprenorphine or the injection formulation ingredients
Able to attend regular follow-up appointments
Committed to a comprehensive treatment plan that may include counseling

You may particularly benefit from injectable treatment if you:

Struggle with medication adherence to daily Suboxone
Have concerns about medication diversion or family safety
Travel frequently and find daily medication burdensome
Have completed initial stabilization and want to reduce daily reminders of your recovery
Have experienced treatment interruptions due to missed doses

Long-acting buprenorphine is not appropriate for everyone. Patients who are pregnant, have severe liver disease, or are new to buprenorphine treatment should discuss risks and alternatives with a qualified provider. Learn more about buprenorphine at the SAMHSA buprenorphine resource page.

What to Expect at Fresh Start Health Centers

Our approach to long-acting buprenorphine treatment integrates medical care, coordinated support, and privacy that respects federal 42 CFR Part 2 confidentiality protections for substance use disorder treatment records — which provide stronger confidentiality protections than standard HIPAA rules.

Your first visit

An initial evaluation includes:

Comprehensive assessment of your substance use history and current medications
Physical examination and lab work as clinically appropriate
Discussion of treatment options including Sublocade, Brixadi, oral buprenorphine, and adjunct services
Insurance verification and cost estimation
Treatment plan development with your input

If you’re not currently on buprenorphine, we can initiate oral buprenorphine at your first visit. If you’re already stable, we can plan your first injection at a follow-up appointment approximately one to two weeks later.

Injection appointments

Injection appointments are quick — typically 15 to 20 minutes. The medication is administered subcutaneously by a trained clinician. Most patients experience minor injection site reactions (redness, tenderness, or a small firm area under the skin) that resolve within a few days.

Monthly injections mean you visit us once a month for continued treatment. Weekly Brixadi patients visit weekly initially, often transitioning to monthly dosing once stable.

Ongoing support

Recovery is more than medication. Fresh Start offers or coordinates:

Counseling referrals to licensed behavioral health providers
Peer support connections
Medical management of co-occurring conditions (hepatitis C, mental health, primary care)
Coordination with recovery community resources across eastern Kentucky

Insurance Coverage and Cost

Both Sublocade and Brixadi are covered by most insurance plans that cover opioid use disorder treatment, including:

Kentucky Medicaid

Kentucky Medicaid covers both Sublocade and Brixadi. Prior authorization is typically required. Fresh Start Health Centers handles the prior authorization process on your behalf. Your out-of-pocket cost is generally minimal or zero for Medicaid patients.

Medicare

Medicare Part B typically covers Sublocade and Brixadi when administered in a clinic setting (as we do). Part D coverage varies. Your Medicare coverage will be verified before treatment begins.

Commercial insurance

Most major commercial insurance plans cover Sublocade and Brixadi. Prior authorization requirements vary by insurer. Fresh Start handles verification and authorization.

Manufacturer assistance programs

Both medication manufacturers offer patient assistance programs for those who qualify:

Sublocade (Indivior): the inSupport program offers copay assistance for commercially insured patients
Brixadi (Braeburn): Brixadi patient assistance offers copay support and financial assistance for uninsured patients

Our team will help you enroll in any programs you qualify for.

Self-pay pricing

If you don’t have insurance, we offer transparent self-pay pricing. Contact us for current rates. Coverage varies; contact your plan for specifics.

Our Kentucky Locations

Fresh Start Health Centers offers long-acting buprenorphine treatment at multiple locations across eastern Kentucky:

Ashland — Serving Boyd, Carter, and Greenup counties
Morehead — Serving Rowan, Bath, and Menifee counties
Vanceburg — Serving Lewis and Mason counties
Grayson — Serving Carter and Elliott counties

We also offer telemedicine follow-up appointments for eligible patients — reducing travel burden while maintaining consistent care. Initial evaluations and injection appointments must be conducted in person.

Frequently Asked Questions

Does Kentucky Medicaid cover Sublocade and Brixadi?

Yes. Kentucky Medicaid covers both medications for the treatment of opioid use disorder. Prior authorization is typically required, and Fresh Start handles that process on your behalf. Coverage varies by plan and clinical situation — contact us to verify your specific coverage.

How much does Sublocade cost with insurance?

For Medicaid patients, cost is generally minimal or zero. For commercial insurance patients, out-of-pocket costs vary by plan and typically range from $0 to a few hundred dollars per month after copay assistance. Our team verifies your coverage before treatment begins and helps enroll you in manufacturer copay assistance programs when available.

Is Sublocade or Brixadi addictive?

Both medications contain buprenorphine, which is a controlled substance. Buprenorphine has a much lower potential for misuse than full opioid agonists like heroin, fentanyl, or oxycodone because of its ceiling effect on respiratory depression. When used as prescribed under medical supervision, buprenorphine is a safe and effective treatment for opioid use disorder and outcomes vary based on individual factors and adherence to your treatment plan.

How long will I need to be on injectable buprenorphine?

There is no fixed treatment duration. Some patients remain on medication-assisted treatment for years; others transition off after achieving sustained recovery. Treatment duration is a personal decision made with your provider based on your recovery progress, life circumstances, and preferences. Research supports that longer treatment durations are associated with better outcomes.

Can I switch from Suboxone to Sublocade or Brixadi?

Yes. Most patients starting long-acting injectable buprenorphine transition from oral Suboxone (or generic equivalent). Your provider will help you plan the transition, typically involving at least seven days of stable daily buprenorphine before your first injection.

What if I miss an injection?

Missing an injection appointment can result in withdrawal symptoms and increased risk of relapse. Contact Fresh Start immediately if you’re unable to attend your scheduled injection. We can help you get back on schedule quickly, often within a day or two.

Are these medications available for telemedicine prescribing?

Initial evaluations and injection administration must occur in person under federal DEA regulations. Follow-up appointments and check-ins can be conducted via telemedicine for eligible patients.

Does taking Sublocade or Brixadi appear on my medical records?

Federal 42 CFR Part 2 provides strong confidentiality protections for substance use disorder treatment records — protections that go beyond standard HIPAA privacy rules. Your treatment records at Fresh Start are not shared with your primary care provider, employer, or other parties without your written consent, with narrow exceptions defined by federal law.

How does Sublocade compare to Vivitrol?

Sublocade and Vivitrol are both once-monthly injections, but they work in completely different ways. Sublocade contains buprenorphine — a partial opioid agonist that activates opioid receptors just enough to prevent withdrawal and reduce cravings. Vivitrol contains naltrexone — an opioid antagonist that blocks the receptors entirely. Sublocade requires that you first be stable on oral buprenorphine (Suboxone) for at least seven days. Vivitrol requires that you be completely opioid-free for 7 to 14 days before your first injection. Sublocade is a controlled substance; Vivitrol is not. Both are covered by Kentucky Medicaid. Talk with your provider about which option fits your treatment goals.

Ready to Get Started?

If you or a loved one are considering long-acting buprenorphine treatment, we’re here to help.

Call us: 606-225-8200
Book online: Schedule a consultation
Locations: Ashland, Morehead, Vanceburg, and Grayson, Kentucky

Same-week appointments are often available. All initial consultations are confidential and protected under 42 CFR Part 2.

Medically reviewed by Dr. Jerrel Boyer, D.O. — Medical Director, Fresh Start Health Centers

Sublocade® is a registered trademark of Indivior Inc. Brixadi® is a registered trademark of Braeburn Inc. This content is for informational purposes only and is not a substitute for professional medical advice. Consult a qualified healthcare provider to determine appropriate treatment for your situation. Individual results vary. Fresh Start Health Centers complies with the confidentiality requirements of 42 CFR Part 2 for substance use disorder treatment records.