Suboxone Withdrawal

Suboxone can cause opioid withdrawal symptoms when you stop taking the drug. The most intense withdrawal symptoms will occur if you quit the drug abruptly after using it for a long time. Unfortunately, withdrawal is a normal part of using the medication for people who want to become abstinent from opioid use eventually. Suboxone causes withdrawal symptoms that are similar to other opioids, including nausea, fever, vomiting, and sweating. 

Suboxone is a medication that’s used to treat opioid use disorders. It is made up of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, which means it binds to receptors and partially activates them. This helps to satisfy cravings and avoid withdrawal symptoms without causing significant intoxication. 

Naloxone is an opioid antagonist, which means it binds to opioid receptors and blocks opioids from binding. This drug is usually given to reverse opioid overdose and intoxication. In Suboxone, it serves to prevent abuse of the medication. When taken as directed, naloxone doesn’t take effect. When it’s abused, it can block opioid binding and cause withdrawal symptoms.

What Are Suboxone Withdrawal Symptoms?

Suboxone is used to treat addiction to opioid drugs. It binds to the same receptors to stop withdrawal symptoms and cravings. Unfortunately, that also means you will still be opioid-dependent. 

When you stop using the drug, you’ll go through withdrawal symptoms that are consistent with other opioids. These include nausea, vomiting, diarrhea, and sweating. Opioid withdrawal is often compared to the flu, though symptoms may be more severe than a typical case of the flu. Symptoms can include:

• Nausea
• Vomiting
• Diarrhea
• Sweating
• Anxiety
• Irritability
• Insomnia
• Chills
• Fever
• Body aches
• Headaches
• Dehydration

While some drugs can cause deadly withdrawal symptoms, Suboxone typically doesn’t cause dangerous withdrawal symptoms. In rare cases, dehydration as a result of vomiting, sweating, and diarrhea can be life-threatening if you don’t have access to enough fluids. Many fatal cases of opioid withdrawal because of dehydration have occurred where a person was going through withdrawal while incarcerated.

What Is the Timeline for Suboxone Withdrawal?

Your experience with Suboxone withdrawal will depend on a few important factors. One of the most significant is whether or not you taper off slowly or quit cold turkey. Abruptly quitting can cause you to experience more intense symptoms more quickly. The length of time you were dependent, and the size of your dose, can also affect your timeline. However, it could look like the following:

• First 24 hours: The buprenorphine part of Suboxone has around a 28-hour half-life. The term “half-life” means it will be reduced to half of its concentration in the blood around that time. Typically, a drug starts to lose its effectiveness when it reaches the end of its half-life. After a day, withdrawal symptoms will begin, and you may start to have opioid cravings. Early symptoms can include nausea, fatigue, and body aches.
• 3 days: Your withdrawal symptoms will intensify until they reach their peak. Peak symptoms are usually uncomfortable, causing nausea, vomiting, body aches, weakness, and fatigue. After your symptoms peak, they will start to go away.
• 7 days: You’ll slowly start to feel better after your symptoms have hit their peak. Most of your physical symptoms may be gone by the end of the first week. However, cravings and other psychological symptoms may continue.
• 2 weeks: Lingering symptoms may start to dissipate, but some symptoms, such as anxiety and depression, may still affect you. Cravings and these psychological symptoms may need to be addressed in treatment to avoid a relapse. 

Should I Detox?

If you’re taking Suboxone as part of a treatment program, you may go through a detoxification process as a part of your treatment. Detox is a normal part of Suboxone treatment with the goal of abstinence. If you’ve taken the drug illicitly, or if you’re otherwise dependent outside of a treatment program, the need for medical detox will be up to your medical professionals. Detox is a high level of care that’s designated for people who will go through severe withdrawal symptoms or those who have other serious medical conditions. 

When you enter a treatment program, you’ll go through a medical and clinical assessment process to help determine the level of care that is appropriate for you.

Sources

Darke, S., Larney, S., & Farrell, M. (2016, August 11). Yes, people can die from opiate withdrawal. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512

National Institute on Drug Abuse. (2018, January). Opioid Addiction. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies

SAMHSA. (2019, September 27). Naloxone. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/naloxone

SAMHSA. (2019, November 22). Buprenorphine. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine

Welsh, C., & Valadez-Meltzer, A. (2005, December). Buprenorphine: a (relatively) new treatment for opioid dependence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994593/