Withdrawal symptoms occur when someone who has taken Suboxone over time suddenly quits using it.
- Lists the main symptoms of Suboxone withdrawal.
- Details a Suboxone withdrawal timeline.
- Explains the causes of withdrawal.
- Outlines treatment for withdrawal.
- Helps you find a detox center.
Signs and Symptoms
The severity of withdrawal symptoms varies by individual. It depends on how much of the drug is taken and for how long.
Suboxone withdrawal signs and symptoms can include the following:
- Dilated pupils
- Tachycardia (increased, rapid heart rate)
- Hypertension (heightened blood pressure)
- Fever, chills, and other flu-like symptoms
- Muscle aches and pains
- Diarrhea and vomiting
- Abdominal cramping
- Loss of appetite
- Goose bumps
- Profuse sweating
- Excessive yawning
- Runny nose4,5
Detoxing off Suboxone is rarely life-threatening. But some of these symptoms can become so severe that emergency medical treatment may be required.
- The most troubling consequence of Suboxone withdrawal symptoms is a relapse, which can lead to overdose. Seeking supervised withdrawal at a detox center can help ensure a safe and successful withdrawal.4
- Vomiting and diarrhea sometimes lead to dehydration. Vomiting can also cause aspiration, a serious medical condition that can cause lung infection and choking.4
- Cardiac arrhythmias and severe depression – potentially leading to suicidal thoughts and behavior – are among the more serious, yet less common, withdrawal symptoms.
Sudden withdrawal from opioid drugs typically follows a predictable timeline. Certain symptoms emerge quickly and subside while others linger. For example, intense cravings for the drug begin within a few short hours and remain throughout the withdrawal process. That said, certain factors, such as the amount of time someone has used and the dose, can affect how long it takes to detox from Suboxone.
The Suboxone withdrawal timeline may include the following stages:
- Within 12 hours: Cravings start, muscles begin aching, and the person may experience anxiety, tearing, insomnia, runny nose, and sweating.
- First 2-3 days: Symptoms intensify. Diarrhea and vomiting may occur. The person may also have goose bumps, abdominal cramps, increased blood pressure and heart rate, and dilated pupils.
- Within a week: The more severe symptoms begin to ease off while the psychological effects may remain. 4,5
Post-Acute Withdrawal Symptoms
Minor physical withdrawal symptoms may continue for several months after quitting Suboxone. These include:
- Mental fogginess.
- Trouble sleeping. 5
Causes of Withdrawal
Like other opioids, regular Suboxone use can lead to dependence. With repeated use or abuse, the body becomes dependent on the drug to maintain optimal functioning. When Suboxone levels begin to decline in the user’s system, the system is thrown off-balance and the brain sends craving sensations until the need is met.
Because of the inclusion of naloxone – an opioid antagonist – in the formulation of Suboxone, misuse of the drug can cause withdrawal symptoms (for example, if it is used excessively and/or when it is used with other opioids).
One reason for its effectiveness as a treatment for opioid dependence is that if it’s used along with other opioids, such as heroin, the naloxone component will precipitate withdrawal symptoms that will not be completely relieved by taking more opioids.
Suboxone Withdrawal Treatment
Even though Suboxone withdrawal is not life-threatening, its symptoms can be very uncomfortable. Suboxone detox centers can ease the acute symptoms of withdrawal and increase the likelihood of long-term recovery.
Slowly tapering off the drug with medical assistance is often the most effective way to quit opioids, including Suboxone. Tapering reduces the withdrawal effects and minimizes how long they last. During the tapering process, the person can begin to undergo additional therapy for substance abuse, if needed.
Suboxone withdrawal treatment programs include:
- Detox centers provide close monitoring and management of acute withdrawal and any associated medical issues. But they will not always offer further treatment for addiction, which will more likely take place as part of a separate substance abuse treatment program.
- Outpatient Suboxone withdrawal treatment can help with both short-term and longer-term recovery efforts, and participants are able to return home when treatment is completed for the day. An outpatient treatment regimen often consists of group and individual addiction therapy on a part-time basis throughout the week.
- Inpatient programs take place at live-in treatment centers where people attend therapy groups, 12-step meetings, and individual counseling, and participate in other recovery activities such as exercise and yoga. Many of these programs offer detox at the start of treatment.
- Day treatment or partial hospitalization programs are outpatient programs that include medical support and therapy. Some may help people detox off Suboxone.
- Dual diagnosis programs treat mental disorders and substance abuse. Mental health conditions sometimes exist in association with opioid use disorders. Suboxone users may also be using alcohol and other drugs, and these additional issues need to be treated.
- 12-step programs such as Narcotics Anonymous are free and offer peer support. To prevent relapse, these programs may continue for months or longer. SMART Recovery is a popular non-12-step program.
- Long-term treatment programs, also known as therapeutic communities, involve a commitment of up to 15 months and include additional services such as education and training.6
Medications for Suboxone Withdrawal
Withdrawing from Suboxone may require some of the same medications used to treat other opioid addictions and withdrawal.
- Naltrexone is a drug used to prevent relapse by blocking the effects of Suboxone. Vivitrol is an injectable form of naltrexone with longer-lasting benefit.4,7
- Clonidine helps reduce withdrawal symptoms such as cramping, sweating, anxiety, and muscle discomfort.4
- Benzodiazepines may help with insomnia and anxiety.
- Nausea and anti-diarrhea medications are also available.
Find a Detox Center
If you or someone you care for suffers from Suboxone addiction, help is available. Whether the solution is inpatient care, a detox center, or outpatient therapy, the suffering does not have to continue.
When you call, have your insurance information on hand. Also make sure you can provide information about how long you’ve abused Suboxone, whether you’re abusing other drugs, whether you want to travel or stay in your hometown for treatment, and whether you have medical or psychiatric concerns that need to be treated.
. U.S. Drug Enforcement Agency. (2013) Buprenorphine.
. U.S. Substance Abuse and Mental Health Services Administration. (2016) Buprenorphine.
. U.S. Department of Justice: National Drug Intelligence Center. (2004) Intelligence Bulletin: Buprenorphine: Potential for Abuse.
. U.S. National Library of Medicine: MedlinePlus. (2016) Opiate and Opioid Withdrawal.
. Merck Manual. (2016) Opioid Toxicity and Withdrawal.
. Merck Manual. (2016) Opioid Use Disorder and Rehabilitation.
. National Institute on Drug Abuse. (2014) Prescription Drug Abuse: Treating Addiction to Prescription Opioids.