Long-Term Suboxone Use: What You Should Know

August 31, 2022

Table of Contents

Long-term Suboxone use is common, with most patients remaining on Suboxone for months or years.

Some patients remain on Suboxone indefinitely, as it supports sustained recovery with limited potential for negative effects. Studies show that people who remain on Medication for Addiction Treatment (MAT) for longer periods of time are more likely to sustain recovery from opioid use disorder (OUD).

What Are the Long-Term Effects of Suboxone Use?

Suboxone (buprenorphine/naloxone) is recommended as a long-term maintenance medication for OUD.[1] People who remain on MAT on a long-term basis are much more likely to experience sustained recovery from OUD, resulting in fewer instances of opioid misuse and fatal overdose due to such misuse.[2]

With OUD, the potential for relapse remains high in some individuals, even after months or years of abstinence from opioids.[3] As a result, continuing MAT can be crucial during the first few years of recovery. Remaining on Suboxone greatly reduces the likelihood of relapse.

Long-term Suboxone use is not associated with any significant health effects as far as we know. The side effects tend to be the same long term as they do short term, and are listed below. In addition, these initial side effects tend to wane over time as the body becomes used to the medication.

If you have been taking Suboxone for a long time, you may experience withdrawal when you stop taking the medication. This can be managed with a tapered approach[4] to stopping use. If you and your doctor decide you can safely stop taking Suboxone, your doctor will design a tapering schedule to minimize withdrawal symptoms during the transition period.

Are There Any Potential Suboxone Side Effects?

Side effects of Suboxone can occur with both short-term and long-term use. Some stomach discomfort may occur when you first start taking Suboxone, but this should generally dissipate within a few days.

Other potential side effects include the following:[5]

  • Blurry vision
  • Constipation
  • Diarrhea
  • Nausea
  • Headache
  • Insomnia
  • Tongue pain
  • Mouth numbness
  • Backaches

These side effects are rare, so talk to your doctor if you experience any of them. They are not more common with long-term use, so if you didn’t experience side effects initially, it’s unlikely you will experience them down the road.

Should You Stay on Suboxone on a Long-Term Basis?

If Suboxone is helping your recovery, doctors usually recommend staying on it long-term, and even for life if necessary. Suboxone and other forms of MAT reduce the likelihood of relapse [6]

If you stop taking MAT and relapse to opioid misuse, you have a high potential for overdose since you haven’t been misusing opioids in a while and your body may have decreased tolerance to the doses of opioids you were previously taking. If you take the same dose you took before MAT, it’s likely that dose will lead to overdose since your tolerance has declined. Opioid overdose can be fatal.

Issues are more commonly seen with short-term use of Suboxone or MAT.[7] When people stop using MAT too soon, they are more likely to relapse back to opioid misuse and experience overdose. Because of this, it’s generally recommended that patients remain on Suboxone as long as needed, even indefinitely, to support their recovery from opioid use disorder.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

Sources

  1. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction: A Treatment Improvement Protocol. U.S. Department of Health & Human Services. https://www.naabt.org/documents/TIP40.pdf. 2004. Accessed July 2022.
  2. Medication-Assisted Treatment of Opioid Use Disorder. Harvard Review of Psychiatry. https://journals.lww.com/hrpjournal/FullText/2015/03000/Medication_Assisted_Treatment_of_Opioid_Use.2.aspx?casa_token=EpvYkcA4kRQAAAAA:qQLteHzO2f6joZKS9HdlJpSWz_G2BRdGoIG1zKeVnyPLFW_EsDaHqVWb_ZM0Qwa-2RKy6dideGZkv6gt5t8uFp2vl6Y. March–April 2015. Accessed July 2022.
  3. Comparative Effectiveness of Extended-Release Naltrexone Versus Buprenorphine-Naloxone for Opioid Relapse Prevention (X:BOT): A Multicentre, Open-Label Randomised Clinical Trial. The Lancet. https://www.sciencedirect.com/science/article/abs/pii/S014067361732812X. January–February 2018. Accessed July 2022. 
  4. Discontinuation of Buprenorphine Maintenance: Perspectives and Outcomes. Journal of Substance Abuse Treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382404/. December 2014. Accessed July 2022.
  5. Practical Considerations for the Clinical Use of Buprenorphine. Addiction Science & Clinical Practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851017/. August 2004. Accessed July 2022. 
  6. Discontinuing Buprenorphine Treatment of Opioid Use Disorder: What Do We (Not) Know? The American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19121245. February 2020. Accessed July 2022.  
  7. Impact of Long-Term Buprenorphine Treatment on Adverse Health Care Outcomes in Medicaid. HealthAffairs. https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01085. May 2020. Accessed July 2022.

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