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A Guide to Suboxone Withdrawal—and How To Get Help

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Clinically Reviewed by:
Lindsey Rae Ackerman, LMFT

Written by:
Alex Salman, MPH on March 6, 2024

Suboxone, sometimes also known by its generic name of buprenorphine (one of the drug’s primary ingredients), is a medication often prescribed to help individuals better manage opioid addiction and prevent withdrawal symptoms. While Suboxone can be an effective tool in medication-assisted treatment (MAT), it’s also crucial to understand the potential challenges associated with opioid-based withdrawal symptoms—and the withdrawal symptoms that are possible either from tapering off the medication or by misusing it. In today’s blog, Clear Behavioral Health will take an in-depth look at Suboxone, its benefits in medication-assisted treatment, and the process of Suboxone withdrawal, including its symptoms, timelines, and the suggested medical detoxification process.

What is Suboxone?

Suboxone is a prescription-based medication that contains both buprenorphine and naloxone, both of which serve different roles. Buprenorphine is a partial opioid agonist, meaning it activates the opioid receptors in the brain—but to a lesser degree than full opioid agonists such as heroin or oxycodone. Naloxone is an opioid antagonist that blocks the effects of opioids and helps prevent misuse when taken as prescribed, blocking the potential high that you would feel by otherwise ingesting opioid-based substances. 

Together, this medication has been shown to reduce the risk of mortality from opioid usage by 50%. Suboxone, which contains both buprenorphine and naloxone, can be administered in either tablet or sublingual film. Subutex, another buprenorphine-based medication (but without the Naloxone), is typically given in pill form. 

Naloxone is often utilized to help reverse the potential symptoms of an opioid overdose and is available as Narcan, a nasal spray that can be obtained over the counter—a potentially life-saving measure.

What is Suboxone primarily used for?

Suboxone is primarily used in the treatment of opioid use disorder (OUD) and opioid abuse to help reduce cravings, minimize potential withdrawal symptoms, and decrease the risk of relapse. Unlike full opioid agonists, Suboxone’s partial-agonist properties can provide relief from withdrawal symptoms without causing the intense euphoric feelings associated with traditional opioid abuse.

The role of Suboxone in medication-assisted treatment

Medication-assisted treatment (MAT) is an evidence-based approach to managing opioid addiction that combines the utilization of medication, such as Suboxone, with counseling and additional treatment support to provide comprehensive care for individuals who are struggling with opioid use. The goal of MAT is to help people achieve and maintain recovery while improving their overall well-being and quality of life, removing potential barriers to recovery (such as the fear of withdrawal and the high potential for opioid overdose) with a combination of interventions and services. 

Suboxone withdrawal

When used as prescribed by a medical professional or as a part of an MAT program, Suboxone and related medications can be an incredibly effective tool in managing opioid addiction, symptoms, and withdrawal. However, that doesn’t mean that Suboxone doesn’t carry several risks in its usage, be they related to withdrawal when taken as prescribed or its potential for misuse and abuse. 

Withdrawal from Suboxone when taken as prescribed

If an individual decides to stop using Suboxone after being on a stable dose, it is possible they may experience withdrawal symptoms as a result. Suboxone withdrawal occurs because buprenorphine, like other opioids, can lead to physical (and psychological) dependence when used regularly, even as prescribed. When the medication is discontinued, the body needs time to adjust, which can then lead to the development of withdrawal symptoms.

While withdrawal symptoms are possible for Suboxone, even when taken as prescribed, your prescriber and treatment team will work with you to gradually reduce your dosage and allow your body the time it needs to adapt in order to best counteract the potential development of any withdrawal-related issues. 

Withdrawal from Suboxone abuse

Unfortunately, some individuals misuse Suboxone by taking higher doses than prescribed, using it without a prescription, or mixing it with other substances. Additionally, it’s possible to crush up the pill form to ingest it nasally or dissolve the sublingual film strips to inject the medication in an effort to get high. 

Misusing Suboxone in any way can similarly lead to physical dependence, just like any other opioid, and increase the risk of withdrawal when attempting to stop using it. Furthermore, the risk of overdose in Suboxone/buprenorphine abuse is high when the medication is adulterated, or when Subutex pills are abused (because Subutex does not contain naltrexone to prevent the high nor work against a potential overdose). 

Symptoms of Suboxone Withdrawal

Suboxone withdrawal symptoms can vary in intensity and duration, depending on the individual’s dose, duration of use, and overall health. Common symptoms of Suboxone withdrawal may include:

Physical symptoms:

  • Flu-like symptoms such as body aches, chills, and sweating
  • Gastrointestinal disturbances like nausea, vomiting, diarrhea, and stomach cramps
  • Insomnia

Psychological symptoms:

  • Anxiety
  • Depression
  • Cravings to use other or more opioids (the re-development of dependence)

Suboxone Withdrawal Timeline

Generally, symptoms may start within 12 to 24 hours after the last dose and peak in intensity within the first few days. As the body gradually adjusts, symptoms typically begin to subside after a week or so. Withdrawal in and of itself is typically not fatal, though it can be both incredibly uncomfortable and lead to additional complications, depending on your overall health. 

Detoxing from Suboxone 

No matter if your withdrawal symptoms are a result of tapering appropriate usage or resulting from abuse, detoxification from Suboxone withdrawal should always be approached with caution and under the supervision of a healthcare professional. Abruptly stopping Suboxone without the proper management and guidance can lead to severe withdrawal symptoms and discomfort, in addition to other, unforeseen medical complications. 

Attending a qualified medical detoxification program is highly recommended for those who may be experiencing Suboxone withdrawal. In such a program, healthcare providers can provide medical support to manage your withdrawal symptoms safely and comfortably. In such an environment the tapering of buprenorphine can be carefully managed to reduce the overall severity of withdrawal symptoms and minimize the risk of complications. Most detox programs will also be able to provide linkage with other critical parts of a well-rounded treatment program, including residential services, counseling, and aftercare.

Reach out now for help with Suboxone withdrawal

Suboxone/buprenorphine withdrawal can be an extremely challenging experience, both for individuals who have been using the medication as prescribed or for those who may be misusing it. It’s essential to recognize the physical dependence that can develop with regular use, and to approach discontinuing Suboxone with the guidance of a qualified healthcare provider.

When used as prescribed in a MAT program, Suboxone can be an effective tool in managing opioid addiction and facilitating recovery. However, when the time comes to discontinue its use, medical detoxification and support can help individuals navigate the withdrawal process safely and comfortably.

If you or someone you love is struggling with addiction, withdrawal, or co-occurring issues, Clear Behavioral Health is here to help. Recovery is always possible with the right supports and appropriate treatment in place, and we can help you safely detox and provide comprehensive addiction and dual diagnosis treatment to help you reach your potential and start your recovery journey today—and we proudly in-network with most insurance plans. Contact us to learn more!

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