Suboxone Withdrawal Symptoms, Timeline, and Treatment

Updated On: June 15, 2024
7 min read
Written by:

Amanda Stevens, B.S.

Suboxone, a medication used to treat opioid addiction, can be highly effective—but its abrupt discontinuation can also lead to the resumption of withdrawal symptoms.[1] Understanding the symptoms, timeline, and available treatments for Suboxone withdrawal is crucial for individuals seeking to manage this process effectively.

Suboxone Withdrawal
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    How Does Suboxone Work?

    Suboxone is a medication commonly used in the treatment of opioid dependence. It contains two active ingredients: buprenorphine and naloxone.[2] Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors in the brain but to a lesser extent than full opioid agonists like heroin or oxycodone. This activation helps to alleviate withdrawal symptoms and reduce cravings for opioids without producing the same intense euphoria. Naloxone, on the other hand, is an opioid antagonist that blocks the effects of opioids and serves to deter misuse of Suboxone by injection (though Suboxone can still be misused).

    Together, these components work together to support individuals in their recovery from opioid addiction by reducing opioid withdrawal symptoms and cravings while minimizing the risk of misuse and overdose.

    What is Suboxone Withdrawal Like?

    Experiencing Suboxone withdrawal can be a challenging process, often necessitating medical support to manage symptoms safely and effectively.[3] The severity and duration of Suboxone withdrawal can vary depending on factors such as the dosage of Suboxone used, duration of use, individual physiology, and the presence of co-occurring mental health disorders.

    Typically, withdrawal symptoms begin within a day or two after the last dose and may include physical discomfort, psychological distress, and cravings for opioids. In more severe cases, individuals may experience symptoms such as nausea, vomiting, diarrhea, muscle aches, anxiety, insomnia, and irritability, which can significantly impact daily functioning and overall well-being. Severe withdrawal symptoms such as seizures or delirium are extremely rare and typically associated with other co-occurring medical conditions.

    Suboxone Withdrawal Symptoms

    Suboxone withdrawal symptoms can vary in intensity and duration, encompassing a range of physical and psychological effects:[4]

    • Flu-like symptoms: Individuals may experience symptoms resembling a severe cold or flu, including body aches, chills, and fever.
    • Gastrointestinal distress: Nausea, vomiting, diarrhea, and abdominal cramping are common gastrointestinal symptoms of Suboxone withdrawal.
    • Anxiety and irritability: Feelings of anxiety, restlessness, irritability, and agitation are prevalent during Suboxone withdrawal.
    • Insomnia: Difficulty falling or staying asleep may occur, leading to disrupted sleep patterns and fatigue.
    • Muscle aches: Generalized muscle aches and pains are frequently reported, contributing to overall discomfort.
    • Sweating and hot flashes: Profuse sweating, accompanied by hot flashes or cold sweats, can occur as the body attempts to regulate temperature.
    • Dilated pupils: Pupil dilation is a common physiological response during Suboxone withdrawal.
    • Cravings: Intense cravings for opioids, including Suboxone, may arise as the body craves the substance it has become dependent on.
    • Mood swings: Mood swings, ranging from depression and sadness to irritability and agitation, are common during withdrawal.
    • Fatigue: Feelings of exhaustion, lethargy, and decreased energy levels are prevalent throughout Suboxone withdrawal.

    Seeking medical assistance is crucial for individuals experiencing severe Suboxone withdrawal symptoms, as certain complications, such as dehydration, electrolyte imbalances, and severe psychological distress, can arise.

    A suboxone treatment program with trained medical professionals can provide the necessary support and interventions, including medications and therapeutic techniques, to help manage withdrawal symptoms and facilitate a safe and comfortable transition toward recovery.

    Suboxone Withdrawal Timeline

    The withdrawal timeline for Suboxone can vary depending on factors such as dosage, duration of use, and individual physiology. The withdrawal timeline for Suboxone can differ from other opioids due to its longer half-life:

    • Early withdrawal (6-12 hours): Symptoms of Suboxone withdrawal typically begin within 6 to 12 hours after the last dose. Early withdrawal symptoms may include mild anxiety, muscle aches, sweating, yawning, and cravings for opioids.
    • Peak withdrawal (1-3 days): The peak of Suboxone withdrawal symptoms usually occurs within the first one to three days. During this time, individuals may experience intensified symptoms such as nausea, vomiting, diarrhea, abdominal cramps, dilated pupils, insomnia, restlessness, irritability, and heightened cravings for opioids.
    • Subacute withdrawal (1 week): After the initial peak, withdrawal symptoms gradually subside over the first week. However, some individuals may continue to experience lingering symptoms such as fatigue, mood swings, anxiety, and depression.
    • Post-acute withdrawal (Beyond 1 week): In some cases, individuals may experience a protracted withdrawal syndrome characterized by persistent symptoms lasting beyond the first week. These symptoms may include insomnia, anxiety, depression, irritability, fatigue, and cravings for opioids. Post-acute withdrawal syndrome (PAWS) can persist for weeks, months, or even longer in some cases.

    Post Acute Withdrawal Syndrome for Suboxone

    PAWS can occur after the acute phase of Suboxone withdrawal has subsided and refers to a lingering set of symptoms that may persist for months or years.[6] While the acute withdrawal symptoms of Suboxone typically peak within the first few days after discontinuation, PAWS can present as a continuation or recurrence of certain symptoms, albeit to a milder degree. PAWS is believed to stem from neurochemical imbalances and alterations in brain function resulting from prolonged opioid use. The duration and severity of PAWS can vary among individuals, impacting their daily functioning and overall well-being.

    Managing post-acute withdrawal syndrome often requires a multifaceted approach involving medical intervention, therapy, lifestyle adjustments, and ongoing support from healthcare providers and support networks. Incorporating healthy habits such as regular exercise, balanced nutrition, stress management techniques, and participation in support groups or counseling sessions can assist individuals in coping with the challenges of PAWS and sustaining their recovery from Suboxone dependence.

    Types of Drug Withdrawal Treatment

    If you or someone you care about is grappling with opioid addiction—or another substance use disorder—seeking treatment is a vital step in the healing process. Alpas is dedicated to delivering holistic care throughout the journey to recovery, offering a diverse array of services customized to meet your individual needs.

    • Medical Detox: Medically managed detoxification, also referred to as medically supervised withdrawal, is a vital aspect of opioid withdrawal treatment, particularly for individuals with moderate to severe opioid dependence. This level of care involves a supervised process aimed at safely eliminating opioids from the body while simultaneously managing withdrawal symptoms and addressing any potential complications that may arise.
    • Medically Managed Care: Medically managed care, commonly known as medically supervised care, is a crucial component of suboxone withdrawal treatment, especially for individuals with moderate to severe dependence on the medication. This level of care encompasses comprehensive medical oversight and intervention to guarantee the safety and well-being of the individual during the withdrawal process.
    • Inpatient Treatment: Inpatient treatment, alternatively referred to as residential treatment, offers a comprehensive level of care for individuals battling opioid dependence, particularly those with severe addiction or co-occurring mental health disorders. Within a specialized facility, individuals reside and receive round-the-clock medical and therapeutic support in a structured environment.

    How Suboxone Withdrawal Treatment Works

    Suboxone withdrawal treatment typically employs a multifaceted approach designed to manage withdrawal symptoms, address underlying factors contributing to opioid dependence, and establish a foundation for sustained recovery.[7] The process typically commences with a thorough assessment conducted by healthcare professionals to determine the optimal level of care based on the individual’s medical history, the severity of their opioid dependence, and potential withdrawal symptoms.

    Following the initial assessment, individuals in need of medical supervision to safely navigate withdrawal symptoms may undergo medical detoxification. This phase may involve the administration of medications to mitigate symptoms and ensure a secure transition from opioid dependence. Subsequently, individuals may advance to more intensive levels of care, such as residential or inpatient treatment programs, which provide comprehensive therapy, counseling, and support to address the psychological, social, and behavioral dimensions of opioid dependence.

    As you achieve stability and advance in your recovery journey, you may transition to lower levels of care, such as outpatient treatment or participation in support groups. In these settings, individuals continue to receive ongoing support and guidance, enabling them to sustain sobriety in their daily lives. This stepwise approach enables individuals to access appropriate care at each stage of their recovery, fostering long-term success in overcoming opioid dependence.

    Medications Used for Suboxone Withdrawal

    Various medications are commonly utilized to manage withdrawal symptoms associated with Suboxone dependence and facilitate a smoother detoxification process:[8]

    • Buprenorphine: Buprenorphine, the primary active ingredient in Suboxone, is often employed in tapering protocols to reduce dependence and mitigate withdrawal symptoms gradually. By binding to opioid receptors in the brain, buprenorphine helps alleviate cravings and withdrawal discomfort, facilitating a more manageable transition to sobriety.
    • Clonidine: Clonidine, an alpha-2 adrenergic agonist, may be prescribed to alleviate symptoms such as elevated blood pressure, rapid heartbeat, and agitation during Suboxone withdrawal. By modulating the sympathetic nervous system, clonidine helps mitigate autonomic hyperactivity commonly experienced during withdrawal.
    • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs like ibuprofen or acetaminophen may be used to address physical discomfort, including muscle aches, joint pain, and headaches, often associated with Suboxone withdrawal.
    • Antiemetics: Antiemetic medications such as ondansetron (Zofran) may be administered to manage nausea and vomiting, common symptoms during Suboxone withdrawal. Antiemetics help alleviate gastrointestinal distress and improve overall comfort by targeting serotonin receptors in the brain.
    • Sleep aids: Certain medications, including sedative-hypnotics like zolpidem (Ambien) or trazodone (Desyrel), may be prescribed to promote sleep and alleviate insomnia, a prevalent symptom during Suboxone withdrawal. These medications improve sleep quality and duration, restoring normal sleep patterns.

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    What’s the Best Way to Find Suboxone Withdrawal Treatment?

    Seeking treatment for Suboxone and opioid withdrawal is a crucial step towards reclaiming health and well-being for those grappling with opioid dependence. Begin by consulting healthcare professionals, such as your primary care physician or addiction specialist, who can conduct assessments and advise on suitable treatment options tailored to your needs.

    Seek support from family and friends, as their encouragement and assistance can be invaluable in embarking on recovery. Do your research to identify programs that offer evidence-based treatments and comprehensive care for Suboxone and opioid dependence.

    Look for treatment modalities that integrate medical interventions, behavioral therapies, and holistic approaches to address the multifaceted nature of opioid dependence. Various resources are available to assist in finding treatment referrals, including:

    By taking proactive steps to seek treatment, individuals can embark on a journey toward recovery and a healthier, substance-free lifestyle.

    Cost of Drug Withdrawal Treatment

    The expenses associated with drug withdrawal treatment can fluctuate depending on various factors, including the type of facility and the level of care required. Inpatient programs typically incur higher costs due to the round-the-clock supervision they provide. Moreover, the duration of treatment plays a role in determining expenses; while longer programs may entail higher initial fees, they often offer more extensive and comprehensive support.

    Insurance coverage is a critical consideration, as many plans include provisions for detoxification, rehabilitation, and therapy services. Additionally, financial aid programs or flexible payment options, such as sliding-scale fees, may be available to assist individuals with financial constraints. When assessing costs, it’s crucial to prioritize the quality of care and the potential long-term benefits of treatment. Exploring insurance coverage, financial aid opportunities and alternative funding avenues can enhance the accessibility of treatment options.

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    Frequently Asked Questions about Suboxone Withdrawal Treatment

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    How is Suboxone withdrawal treatment different from other opioid withdrawal treatments?

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    Suboxone withdrawal treatment differs from other opioid withdrawal treatments primarily because Suboxone itself is a partial opioid agonist. This means that it activates opioid receptors in the brain but to a lesser extent than full opioid agonists like heroin or oxycodone. As a result, Suboxone withdrawal treatment often involves a more gradual tapering process to minimize withdrawal symptoms compared to treatments for full opioid agonists.

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    Can I undergo Suboxone withdrawal treatment at home, or do I need medical supervision?

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    Suboxone withdrawal treatment usually requires some medical facility, depending on the individual’s needs and the severity of their withdrawal symptoms. While some people may successfully taper off Suboxone with minimal medical intervention, others may require closer monitoring and support, especially if they experience severe withdrawal symptoms or have underlying medical conditions.

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    Will I need ongoing support after completing Suboxone withdrawal treatment?

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    Ongoing support after completing Suboxone withdrawal treatment is often crucial for maintaining sobriety and preventing relapse. This support may include counseling or therapy, attending support groups such as Narcotics Anonymous or SMART Recovery, and engaging in healthy lifestyle practices. Additionally, regular follow-up appointments with healthcare professionals can provide continued monitoring and assistance in managing any lingering withdrawal symptoms or challenges in early recovery.

    Sources
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    [01]

    [1] Patient Information for SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII). (n.d.). Www.suboxone.com. https://www.suboxone.com/ on April 9, 2024

    [2] Suboxone | European Medicines Agency. (n.d.). Www.ema.europa.eu. https://www.ema.europa.eu/en/medicines/human/EPAR/suboxone#:~:text=Suboxone%20is%20a%20medicine%20to on April 9, 2024

    [3] Oakley, B., Wilson, H., Hayes, V., & Lintzeris, N. (2021). Managing opioid withdrawal precipitated by buprenorphine with buprenorphine. Drug and Alcohol Review. https://doi.org/10.1111/dar.13228 on April 9, 2024

    [4] Suboxone: Side effects, dosage, uses, and more. (n.d.). Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/325827 on April 9, 2024

    [6] Haskell, B. (2022). Identification and Evidence-Based Treatment of Post–Acute Withdrawal Syndrome. The Journal for Nurse Practitioners, 18(3), 272–275. https://doi.org/10.1016/j.nurpra.2021.12.021 on April 9, 2024

    [7] World Health Organization. (2019). Withdrawal Management. Nih.gov; World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/ on April 9, 2024

    [8] Kleber, H. D. (2007). Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience, 9(4), 455–470. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202507/ on April 9, 2024

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