Suboxone Withdrawal: Timeline, Symptoms & Treatment
Last Updated: November 1, 2023
Suboxone can help with opioid dependency, but stopping it can lead to withdrawal. Seeking professional support can ensure a safe recovery.
Opioids have become an important topic of discussion in recent years. If you manage opioid dependency, you are like many others. The term opioid epidemic, or crisis, has been used to describe the troubling trends of increasing overdoses. For example, from 2019–2021, opioid overdoses increased by 62%. Increased use of potent synthetic opioids like fentanyl has likely contributed to this. Many individuals struggling with dependency began using opioids as prescribed, frustrating healthcare providers and patients.
Suboxone sublingual film was developed to help manage the symptoms of opioid withdrawal and is an important tool for recovery. The medication is generally safer than many opioid counterparts but carries risks, particularly when misused. If you or a loved one need additional support, it is important to know that stopping Suboxone can cause withdrawal symptoms. Awareness of these symptoms and the support available is crucial.
What Is Suboxone?
Suboxone is a combination of two medications called buprenorphine and naloxone. This combination was originally approved for managing opioid dependency in 2002 and is primarily dispensed as a film placed under the tongue. Some clinicians have also begun using buprenorphine for chronic pain management over time.
Buprenorphine is considered a partial opioid agonist (although some debate surrounds its true activity level). The medication binds to opioid receptors strongly and for an extended period. This can be helpful for the prevention of overdoses; buprenorphine can block other opioids by continuing to occupy these receptors and is generally safer. This is particularly helpful during withdrawal, but the potential for dependency and withdrawal from buprenorphine exists.
Buprenorphine is considered the only active ingredient when Suboxone is taken by mouth, as naloxone is not absorbed from the digestive tract. This formulation was developed to discourage misuse of the product. If it is prepared for other routes of administration, like intravenous or intramuscular injections, naloxone will act freely in the bloodstream and block the effects of buprenorphine.
Suboxone Withdrawal Symptoms
Because it acts on opioid receptors, Suboxone produces similar withdrawal symptoms to other opioids. Some of these symptoms include:
- Nausea or vomiting
- Elevated body temperature
- Elevated heart rate
- Stomach upset or abdominal pain
- Joint or muscle pain
- Dilated pupils
- Precipitation of underlying mental health concerns
A primary reason buprenorphine has established widespread use for managing opioid dependence is its relative safety, but the potential for these symptoms to occur still exists.
Symptoms can vary depending on several factors, including the dose used, the length of time an individual has been using opioids like Suboxone and the presence of other substances like alcohol and cocaine. The time since the last dose influences the symptoms that are likely to be experienced at any given time.
Suboxone Withdrawal Timeline
The withdrawal timeline heavily depends on buprenorphine’s half-life, a measure of how long the medication stays active in your system. The average half-life ranges from 24–42 hours, which is significantly longer than morphine or heroin but similar to methadone. Because of this, some symptoms of withdrawal may be delayed. The overall timeline for withdrawal symptoms from longer-acting opioids is:
- Symptoms begin within two to three days.
- Symptoms peak within a week.
- Symptoms resolve within two to three weeks.
The physical symptoms of withdrawal are more prominent during this time. Elevated heart rate, body temperature, pain, nausea and other symptoms can be experienced during initial withdrawal. This early phase can be scary and uncomfortable, but supportive care can make this process much easier and safer. Medications like clonidine (a non-opioid) and NSAIDs are available to improve symptoms.
As the physical symptoms subside, many individuals experience cravings, anxiety, depression and worsening underlying mental health conditions. The psychological symptoms of withdrawal are more prominent after the initial phase and have the potential to last months or years.
Entering treatment and getting help with these conditions to provide comprehensive care and ensure you receive all the help you need drives longer-term success. Establishing care with a therapist, support groups and other forms of social support can also be extremely helpful.
Can You Quit Suboxone Cold Turkey?
It is crucial to include the support of a healthcare professional and develop an individualized plan when considering stopping Suboxone, particularly when it is not being used as prescribed. Especially at higher doses, when Suboxone is stopped suddenly, symptoms requiring supportive care are often present in the short term. These symptoms can potentially be dangerous or even life-threatening in some cases. Higher death rates have been reported among patients during the first month after stopping Suboxone, even when used as prescribed.
In the longer term, ongoing support is important because of the risks of relapse. Unfortunately, some studies suggest that regardless of whether Suboxone is stopped all at once or slowly tapered down, the risk of relapse remains. Triggers and cravings can be experienced years after the last use, but learning to live with and manage them is within reach.
Managing mental health conditions and addiction go hand in hand, and your doctor can help you find the best approach. If you are considering managing opioid addiction over time without medications, working with a therapist for continued support could provide more opportunities for success. In addition to cravings, many individuals also experience depression or other mood changes, making navigating recovery more difficult.
Get Treatment for Suboxone Misuse in the Southeastern U.S.
Navigating recovery from problematic Suboxone use can be intimidating, but help is available. The Recovery Village Atlanta provides separate medical detox programs if desired, and residential rehab with individual personal space is also available. Care is provided by professional, caring staff who take the time to understand you and your unique goals, ensuring your path to recovery starts on solid ground. Contact our Recovery Advocates today to get started.
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