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Suboxone Withdrawal: Symptoms, Treatment & Detox Timelines

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Sep 26, 2023 • 4 cited sources

Suboxone is an important Medication for Addiction Treatment (MAT) that helps people overcome opioid use disorder. The medication eases opioid cravings and withdrawal symptoms. 

You can use Suboxone for months or even years. When you decide to stop it, talk with your doctor first. 

Buprenorphine, the main ingredient in Suboxone, is a partial opioid agonist. Since it binds to opioid receptors in the brain, quitting suddenly can cause withdrawal.

Suboxone: A Safe Medication for MAT 

Suboxone includes buprenorphine and naloxone. This MAT option eases withdrawal symptoms and cravings to help people with OUD live their best life in sobriety. 

The buprenorphine in Suboxone binds to opioid receptors and lasts most of the day. It doesn’t cause intoxication for two reasons:[1]

  1. A partial agonist binds weakly to receptors.  
  2. Buprenorphine has a ceiling effect, which means that after a certain point, at higher doses, it doesn’t become more powerful. It’s safer than full opioids for this reason. 

The naloxone added to the buprenorphine in the Suboxone stops the medication from working if Suboxone is tampered with or taken inappropriately. If someone uses the Suboxone in a way other than as prescribed, naloxone will render the opioid agonist effect inert and can even trigger withdrawal symptoms.

Suboxone Withdrawal Symptoms

It’s possible to develop a physical dependence on buprenorphine. When you stop it suddenly, you will likely experience withdrawal symptoms.[1]

Common withdrawal symptoms include the following:[2] 

  • Nausea, stomach upset or vomiting
  • Headaches
  • Anxiety or restlessness
  • Irritability or low mood
  • Insomnia
  • Muscle aches and cramps
  • Sweating
  • Diarrhea
  • Cravings for opioids
  • Potential relapse into opioid misuse

Timeline for Suboxone Withdrawal 

Here is an approximate timeline of what you can expect if you abruptly cease Suboxone:[3]

  • 1–3 days: The beginning of withdrawal is often physically and psychologically painful. You may experience discomfort, pain, nausea, exhaustion, anxiety, cravings and other symptoms.  
  • 4–7 days: By the end of the first week, symptom intensity will peak. It’s uncomfortable, like a serious flu. You are also likely to crave buprenorphine or other opioids.  
  • 2–4 weeks: After 14 days to a month, the worst physical symptoms like sweating, nausea and muscle or joint pain have likely dissipated, although you may still feel occasional discomfort. Anxiety, depression, fatigue, insomnia and similar psychological symptoms are likely still present. Drug cravings could be significant.
  • After a month: You could still struggle with poor mental health, exhaustion, bad sleep quality and other psychological problems. Cravings may still be present as well. 

Factors That Impact Withdrawal Timeline 

A withdrawal timeline is personal. Your journey could be longer or shorter than the one we’re outlining here. Sometimes, that length is dependent on things you can change. Sometimes, it’s due to things outside of our control.

Your withdrawal timeline can vary due to these factors:[3]

  • Biology: Your genes can influence how you respond to drug withdrawal. Some people are simply programmed to move through this phase faster. 
  • Mental health: Your impulsive tendencies, anxiety and phobias can influence how strong drug cravings are and how long they last. 
  • Environment: Chronic exposure to drug-related cues could extend your cravings and withdrawal symptoms. 
  • Behavior: If you’ve ritualized your Suboxone, your withdrawal could last longer. For example, if you always listen to a favorite song while the drug dissolves or treat yourself with a chocolate snack, these steps could reinforce your cravings when you’re exposed to them again. 

Your treatment team can help you spot and address some of these factors before you quit. The more you prepare, the quicker the process is likely to go. 

How to Manage Suboxone Withdrawal Symptoms

Many people who take buprenorphine or other opioid-based medications need help withdrawing. Work with your provider to find the best way to quit use of the medication safely and comfortably. 

A taper is often the safest choice.[3,4] You reduce your dose on a schedule set by your doctor. 

If you experience withdrawal symptoms, inform your physician. They may adjust your amount, hold you at the current quantity or offer recommendations to manage symptoms.

Mild withdrawal symptoms like minor pain or a headache can be managed with solutions such as these:

  • Over-the-counter painkillers like acetaminophen
  • A hot shower
  • Yoga
  • Relaxation techniques

Your doctor may prescribe medications targeting symptoms like body aches, sweating or insomnia. Stay in communication with your doctor throughout the process, so they can best manage any issues that arise and ensure you successfully complete the taper.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Suboxone prescribing information. U.S. Food and Drug Administration. Published February 2018. Accessed August 4, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020733s022lbl.pdf 
  2. Understanding buprenorphine. Queensland Government. Accessed August 4, 2023. https://adis.health.qld.gov.au/sites/default/files/resource/file/Understanding%20Buprenorphine_Fact_Sheet_v1.6_lc_3.pdf 
  3. Piper ME. Withdrawal: Expanding a Key Addiction Construct. Nicotine Tob Res. 2015;17(12):1405-1415. doi:10.1093/ntr/ntv048
  4. McNicholas L. Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction. U.S. Department of Health and Human Services. Published 2004. Accessed August 4, 2023. https://www.naabt.org/documents/TIP40.pdf 

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