What supportive counseling phrases can I use for a patient with opioid use disorder (OUD) who is being treated with Suboxone (buprenorphine/naloxone)?

Supportive Counseling Smart Phrases for Patients on Suboxone Treatment

Core Therapeutic Messages

"Your treatment with Suboxone is working to keep you safe and stable—this medication reduces your risk of overdose death by more than 50%, and staying on it long-term gives you the best chance at recovery." 1, 2, 3

Commitment to Long-Term Treatment

• "There is no maximum duration for Suboxone treatment—many patients need to stay on this medication indefinitely, just like someone with diabetes needs insulin. This is not a weakness; it's evidence-based medicine that saves lives." 1, 4

• "We will not force you to taper off Suboxone. Stopping this medication dramatically increases your risk of relapse and overdose death because your tolerance drops while you're off opioids." 5, 1, 4, 2

• "If you're feeling pressure to 'get off' medication, remember that Suboxone IS recovery. You are in recovery right now, today, while taking this medication." 1, 6, 3

Addressing Relapse and Setbacks

• "If you use other opioids while on Suboxone, that doesn't mean treatment has failed. Occasional use is common in the first few months, and we'll work through it together by increasing visit frequency and behavioral support—not by punishing you or stopping your medication." 6

• "Relapse is not a moral failure; it's a symptom of a chronic brain disease. This office is a safe, blame-free place where you can be honest about any drug use without fear of judgment or abandonment." 7, 6

• "If you relapse, come back immediately. Don't wait. The longer you stay away, the higher your overdose risk becomes." 5, 1

Medication Safety and Adherence

• "Take your Suboxone at the same time every day. If you miss a dose, take it as soon as you remember—but if it's almost time for the next dose, skip the missed one and get back on schedule." 8

• "Never share your Suboxone with anyone, even if they have the same problem. It can cause severe withdrawal or death in someone who isn't already dependent on opioids, and sharing is illegal." 8

• "Keep your medication in a locked, secure place away from children. Accidental ingestion by a child can cause fatal respiratory depression." 8

Managing Concurrent Substance Use

• "If you're also using benzodiazepines like Xanax, Valium, or Ativan, we need to talk about tapering them. The FDA has a black-box warning that combining benzodiazepines with Suboxone dramatically increases your risk of respiratory depression and death." 1, 8

• "Drinking alcohol while on Suboxone is dangerous and can cause fatal respiratory depression. If you're struggling with alcohol, let's address that as part of your treatment plan." 1, 8

Harm Reduction and Safety Planning

• "I'm giving you a naloxone (Narcan) kit today. Keep it with you at all times. If you or someone around you overdoses, this can reverse it and save a life. I'll show you exactly how to use it." 5, 1, 4, 2

• "Let's get you tested for hepatitis C and HIV today. These infections are common in people who have used drugs, and both are treatable." 5, 1, 4

• "If you ever need emergency care, make sure the doctors and nurses know you're on Suboxone. This information can be lifesaving." 8

Pain Management While on Suboxone

• "If you have surgery or severe pain, we will NOT stop your Suboxone. We'll continue your regular dose and add short-acting pain medications on top of it. You may need higher doses of pain medication because Suboxone blocks some of the effects, but we will manage your pain." 1, 4

Addressing Withdrawal Concerns

• "If you're having withdrawal symptoms between doses—sweating, anxiety, body aches, diarrhea—tell me right away. We can adjust your dose or split it into twice-daily dosing to keep you comfortable." 5, 1, 4

• "Withdrawal symptoms can be safely managed. If they occur during a taper or dose adjustment, we have medications like clonidine for sweating and rapid heart rate, anti-nausea medications, and treatments for diarrhea and insomnia." 7, 5, 4

Behavioral Health Integration

• "Medication alone isn't enough for most people. Combining Suboxone with counseling, support groups, or behavioral therapy gives you the best chance at long-term success." 1, 8, 6

• "Let's screen for depression, anxiety, PTSD, and sleep problems today. These conditions are common in people with opioid use disorder, and treating them improves your overall recovery." 7, 1

• "How is your support system? Do you have safe housing, employment, and people who support your recovery? These social factors matter as much as the medication." 1

Monitoring and Accountability

• "I'll be asking for urine drug screens regularly—not to catch you doing something wrong, but to help us both understand what's working and what needs adjustment in your treatment plan." 1, 8, 6

• "In the first month, I want to see you weekly. Once you're stable, we can space visits out to monthly. Frequent contact early on helps us catch problems before they become crises." 8, 6

• "Bring your medication bottle or blister packs to every visit so we can count what's left. This helps me make sure you're taking the right dose and that no one is pressuring you to share or sell your medication." 6

Empowerment and Collaboration

• "You are the expert on your own body and recovery. I need you to tell me honestly how you're feeling, what's working, and what's not. We're a team, and your input drives the treatment plan." 7

• "Recovery is not a straight line. Some days will be harder than others, and that's normal. What matters is that you keep showing up and working toward your goals." 7

• "You are not defined by your addiction. You are a whole person with strengths, goals, and a future. This medication is a tool to help you reclaim your life." 7, 6

Addressing Stigma

• "Taking Suboxone is not 'trading one addiction for another.' It's treating a chronic disease with evidence-based medicine, just like treating high blood pressure or diabetes." 1, 6, 3

• "If anyone—family, friends, or other doctors—tells you that you should stop Suboxone to be 'truly sober,' they are wrong. The medical evidence is clear: staying on medication saves lives." 1, 2, 3

Emergency Situations

• "If you accidentally take too much Suboxone, or if you feel extremely drowsy, confused, or have trouble breathing, call 911 immediately or have someone take you to the emergency room." 8

• "If you're thinking about hurting yourself or someone else, tell me right now or call the National Suicide Prevention Lifeline at 988. Your safety is the top priority." 1

Practical Medication Instructions

• "Place the tablet under your tongue and let it dissolve completely—don't chew or swallow it. This takes about 5-10 minutes. Don't eat, drink, or smoke until it's fully dissolved." 8

• "Suboxone can make you dizzy or drowsy, especially when you first start or when we adjust your dose. Don't drive or operate machinery until you know how it affects you." 8

• "If you get pregnant while on Suboxone, do NOT stop taking it. Stopping suddenly can harm you and the baby. We'll work together to manage your pregnancy safely, and yes, the baby may have mild withdrawal symptoms at birth, but those are treatable." 8