Suboxone is a medication used to treat opioid use disorder and contains a combination of buprenorphine and naloxone. If someone stops using Suboxone, they may experience withdrawal symptoms, particularly if they stop abruptly. Gradual dose reductions and professional support can help manage Suboxone withdrawal.
- Suboxone is a prescribed medication used to treat opioid addiction.
- Coming off Suboxone can cause withdrawal symptoms and should be done with professional support and gradual dose reductions.
- Therapeutic support, over-the-counter medications, and self-care techniques can help manage Suboxone withdrawal.
Understanding Suboxone withdrawal
Suboxone is a medication used to treat opioid use disorder. It is a combination of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. The effects of Suboxone help reduce withdrawal symptoms from other opioids and can be beneficial for maintenance treatment during recovery. [1]
If the prescribing doctor advises that it is safe and appropriate to discontinue Suboxone treatment, a gradual taper is recommended to help prevent withdrawal symptoms. Suboxone withdrawal may cause unpleasant symptoms and should be managed with professional advice. [2]
Symptoms of Suboxone withdrawal
Common physical symptoms of Suboxone withdrawal include: [3][4][5]
- Aches and pains in the muscles and joints
- Weakness
- Tiredness
- Nausea
- Vomiting
- Headaches
- Shaking
- Stomach pain or cramps
- Diarrhea
- Fever
- Chills
- Sweating
- Yawning
Common psychological symptoms of Suboxone withdrawal include: [3][4][5]
- Anxiety
- Depression
- Agitation
- Irritability
- Restlessness
- Cravings
- Trouble concentrating
Suboxone is a long-acting medication with a half-life of up to 42 hours, which means that withdrawal symptoms can take some time to emerge.
Often, the most severe withdrawal symptoms occur within the first three days, and after this time, physical symptoms begin to alleviate. Psychological symptoms, such as insomnia and mood swings, might continue for several weeks, while cravings can continue for several months. [3]
Suboxone withdrawal timeline
Withdrawal symptoms can vary, although they may follow a timeline such as: [3][5]
- Day 3/4: Physical withdrawal symptoms at their most severe
- 7-10 days: Trouble sleeping, mood changes, aches and pains
- 2 weeks: Low mood
- 1 month: Low mood and cravings
If the individual stops taking Suboxone abruptly, known as ‘cold turkey, ’ withdrawal symptoms can emerge within two days and may be more severe. A gradual dose reduction can reduce the severity of withdrawal symptoms and they may emerge more slowly. [2]
The most severe withdrawal symptoms are likely to be alleviated within the first week of stopping, although some can continue for many weeks or months. Often, cravings and mood-related symptoms will continue for some time, which can be managed with additional support such as therapies or medications. [3][6]
The severity of Suboxone withdrawal symptoms can vary significantly from person to person and can depend on several factors, including the amount and duration of Suboxone use, other substance or medication use, physical and mental health conditions, and lifestyle or environmental factors. [5]
Developing a tapering plan
When coming off Suboxone, it is important to follow the prescribing doctor’s advice, as they will guide the individual with safe tapering and dose reductions to help prevent withdrawal symptoms.
Safe tapering schedules can vary depending on individual needs and the severity of withdrawal symptoms, although it is often recommended to make dose reductions of no more than 5-10% every two to three weeks. [4]
If withdrawal symptoms emerge during this time, they should be reported to the prescribing doctor, who can advise and treat the individual as necessary. Tapers can also be slowed or paused to help reduce the severity of withdrawal symptoms.
Managing Suboxone withdrawal
When coming off Suboxone, the individual should be guided by their prescribing doctor, who will gradually reduce the dosage and provide monitoring and treatment as required. [2]
People who require more intensive support may benefit from an inpatient detox program. These services provide round-the-clock professional care with psychological and physiological treatments to help manage the withdrawal process safely.
People requiring Suboxone medication may already be involved with substance use disorder services and can utilize these services to continue managing addictive behaviors, mental health symptoms, and any associated physical health issues.
Suboxone withdrawal should be managed on a case-by-case basis, as the severity of withdrawal symptoms and underlying conditions will vary from person to person. Professionals should be closely involved with case management and ensure the safety of the individual along with providing relapse prevention strategies. [5]
Self-care
Individuals can also try the following tips to help ease their withdrawal process: [7][8]
- Diet: Maintaining a healthy diet can help reduce the impact of some withdrawal symptoms and may improve general health and well-being.
- Exercise: Exercise can also benefit overall well-being and ease the withdrawal process. It also can be beneficial for mental health, improving mood and insomnia.
- Hydration: Drinking plenty of water can be crucial during withdrawal, as this can help reduce the severity of withdrawal symptoms and prevent dehydration that may be caused by vomiting or diarrhea.
- Therapy or counseling: It can be important to begin or continue with psychological therapies during Suboxone withdrawal, as this can be a high-risk time for potential relapse and a worsening of mental health symptoms.
- Support groups: People in recovery can benefit from support groups and 12-step programs, as these groups can provide a sense of community and accountability.
- Hobbies and relaxation: Engaging in enjoyable activities, relaxation techniques, or social events can help improve psychological withdrawal symptoms and social support networks.
- Holistic therapies: Holistic approaches, such as mindfulness, meditation, art therapy, or acupuncture, can be beneficial in recovery.
Managing severe withdrawal and relapse risks
In the event of severe or prolonged withdrawal symptoms, it may be necessary to utilize professional treatment to help reduce their impact.
Additionally, the risk of opioid relapse can be high when coming off Suboxone. As such, it may be necessary to seek professional support to manage cravings or thoughts of using substances. [4]
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