Suboxone works by buprenorphine’s very strong tendency to occupy the opiate receptors in the brain. The efficacy of Suboxone is directly related to the percentage of opiate receptors that are occupied by buprenorphine AND the state of neuroadaptation (the changes that occurred in the brain due to ongoing opiate intake) of the brain.
Neuroadaptation is important because as long as there is some degree of neuroadaptation, there will be withdrawal symptoms if opiates or buprenorphine is not present. Only when neuroadaptation has totally reversed itself through healing is withdrawal over. This can easily take more than a year if an individual took large amounts of opiates for a long period of time.
By occupying the opiate receptors, Suboxone works to fool the brain into thinking that that the neuroadaptation has reversed itself and thus withdrawal is over.