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Suboxone Withdrawal

Suboxone is a medication used to treat opioid addiction. It first hit the market in the United States in 2002 to help people addicted to drugs like morphine, heroin, OxyContin, and codeine get clean without enduring the intense cravings and withdrawal symptoms that occur when addicted individuals try to quit without help. Suboxone contains the semisynthetic opioid buprenorphine and a dormant opioid antagonist called naloxone that activates if anyone tries to abuse the drug by dissolving the strips to inject the drug into the body.

The opioid content lessens cravings and withdrawal, but as an opioid, Suboxone itself still has abuse and addiction potential. If a person becomes addicted to it, that person will experience withdrawal symptoms similar to those from any other opioid if they go without the drug.

People being treated for opioid addiction are unlikely to experience much withdrawal as they will be gradually weaned from this medication after being switched onto it from a stronger drug. However, they may experience some mild symptoms. Those who really need to be concerned are those who take Suboxone recreationally before becoming addicted to another opioid.

Unlike methadone, which has been used to treat heroin addiction under highly controlled programs for decades, Suboxone and similar drugs containing buprenorphine can be dispensed at a pharmacy so clients can self-administer the medication at home. Although this is more convenient than having to make a daily trip to a methadone clinic, it opens up the possibility of obtaining the drug illegally.

Because of this, the medication has emerged on the black market, and people are starting to take it without a prescription and become addicted to it. This problem has been made worse by the fact that Suboxone has become so popular, reaching the title of “blockbuster drug” by raking in a total of $1.55 billion in 2013. People without a tolerance to opioids can experience an intense, euphoric high from taking Suboxone, even if it’s not as powerful as drugs like heroin.

The Withdrawal Process

Opioid withdrawal can be very intense to the point that it serves as a deterrent to even trying to quit. Suboxone is no exception. However, going through at least mild withdrawal symptoms is often necessary for an addicted person to get on the road to recovery.

Because Suboxone comes in premeasured doses made for tapering off the drug, it’s easy to take the weaning option with this drug rather than stopping intake all at once. This does lessen the withdrawal period, but the process can last for a few weeks to several months, depending on the severity of the addiction. Withdrawal symptoms may appear every time the dose is lowered, which typically happens every one or two weeks.
More mild Suboxone withdrawal symptoms can include:

  • Nausea or stomach upset
  • Headache
  • Restlessness
  • Sleepiness
  • Runny nose
  • Irritability
  • Anxiety or depression
  • Sweating
  • Discomfort
  • Difficulty concentrating
  • Muscle tension
  • Body aches

In some cases, it may be necessary for an addicted person to stop intake of Suboxone all at once, commonly called “quitting cold turkey.” This causes withdrawal symptoms to be much more intense, and more severe symptoms may appear, including:

  • Vomiting
  • Fever
  • Chills
  • Insomnia
  • Lethargy
  • Depersonalization
  • Diarrhea
  • Dizziness
  • Pain

Withdrawal symptoms can start within just a few hours of taking the last dose of the drug. After that, the physical symptoms tend to peak at around 72 hours. After this point, the aches, nausea, and agitation will begin to taper off and typically become manageable or disappear entirely at the one-week mark. After this, emotional symptoms, such as anxiety and/or depression, irritability, and mood swings, can continue for two weeks to a month. Cravings can also continue during this time. In rare and severe cases, emotional symptoms and cravings can last for several months.

Professional Detox Treatment

Even if a traditional detoxification process via a cold-turkey approach is necessary, withdrawal symptoms don’t have to be devastating. There are medical options for those facing detox including what is called medically assisted detox. This treatment can be found at many of the more than 14,500 addiction treatment centers across the US.

This kind of treatment starts with the client checking into a hospital room or a specialized addiction treatment center where they will stay during the worst of the withdrawal symptoms – typically about a week, though the stay can be extended if the severe symptoms continue. This way, clients can be monitored at all times, including their vitals, to ensure that any dangerous symptoms are treated immediately. Not only this, but any discomfort can be treated. In fact, the goal of medically assisted detox is to make the withdrawal period as easy as possible. Any uncomfortable symptoms are taken as a sign that the treatment is not ideal and needs to be adjusted.

Unfortunately, because Suboxone is a drug meant to treat addiction, there is no medication that can directly treat addiction to Suboxone.

There are, however, plenty of medications that can treat specific withdrawal symptoms. With opioid withdrawal, anxiety, depression, and other psychological symptoms can be treated with nonaddictive medications like selective serotonin reuptake inhibitors (SSRIs). Since these can take time to start working properly (4-6 weeks on average), clients may be put on these medications before medically assisted detox begins in order to optimize the experience.

During withdrawal, pain can be treated with acetaminophen or similar painkillers, nausea can be eliminated with anti-nausea medication, and insomnia can be treated with nonaddictive sleep aids. Pretty much any symptom can be treated as it arises, making the withdrawal process much easier.

Unfortunately, staying in a hospital for this long can be very expensive, and insurance may not cover this type of addiction treatment. However, doctors can prescribe or recommend any number of medications that can help addicted people to detox at home. Alternative treatments can also be recommended, including physical exercise, a nutritious diet, relaxation activities and techniques, massage for aching muscles, and plenty of social support. The important thing is to consult a medical professional before attempting to detox, as they can provide advice and solutions based on training and education.

After Detox

Getting through withdrawal is not the end of addiction treatment, but the beginning. Addicted individuals who end their treatment at detox are very likely to relapse. In one 2006 study, it was found that 62.4 percent of people with alcohol use disorders who completed full addiction treatment beyond just stopping use of the drug remained in remission, while only 43 percent of people who did not receive treatment were able to avoid falling back into disordered alcohol use.

The typical next step of addiction treatment is rehab in which clients either stay in an inpatient facility for a few weeks or months, or opt for an outpatient program that allows them to come into a treatment center a few times per week for a couple months. Rehab commonly involves therapy, 12-Step programs or general support group meetings, and educational workshops designed to teach addicted persons about their illness and how to avoid relapse.

Once this is completed, aftercare is just as important as the more active treatment of inpatient or outpatient rehab. Aftercare refers to the steps people take to directly keep themselves on the path to recovery, including continuing therapy, regular attendance of support group meetings, physical activities meant to keep one feeling good so intoxicants aren’t needed, etc. It’s important to remember that avoiding relapse is all about taking care of oneself and increasing general life satisfaction.

About The Contributor
Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Oxford Treatment Center is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed... Read More