Two of the most common questions people have about medications are: “How long should I take it?” and “What happens if I stop taking it?”
Buprenorphine/naloxone (Suboxone) is usually most effective when taken long-term.
Research shows that within one month of stopping buprenorphine treatment, more than 50% of patients relapse to illicit opioid use. Since relapse rates for opioid use are much higher after people taper off than for people who take it long-term, we usually recommend that patients take buprenorphine/naloxone (Suboxone) on a long-term basis. This is of course an individual decision and your provider will work with you to determine the best individualized plan for you.
It is important to know what will happen if you stop taking buprenorphine/naloxone (Suboxone).
Buprenorphine/naloxone (Suboxone) usually has less severe withdrawal symptoms than other treatments, such as methadone. Because buprenorphine/naloxone (Suboxone) is a partial opioid agonist, it usually has less severe Suboxone withdrawal symptoms than full opioids (e.g., oxycodone, heroin, fentanyl).
Suboxone withdrawal symptoms can be lessened by tapering off buprenorphine/naloxone (Suboxone) slowly rather than abruptly stopping the medication. Tapering off over at least 4-12 weeks is recommended. With at least a 4-12 week Suboxone taper, there are lower relapse rates and people usually feel mild and steadily decreasing withdrawal symptoms.
Since relapse rates are higher for people who stop taking buprenorphine/naloxone (Suboxone), we usually do not recommend discontinuing it, but every person and every case is different and we encourage you to communicate with your provider while you create your treatment plan together. It is important to remember that buprenorphine/naloxone (Suboxone) cannot get you “high”, and is a very useful medication for most people who want to stop taking opioids. It is also considered a safe long-term treatment option.
For people who choose to taper off buprenorphine/naloxone (Suboxone), there are some methods to help reduce Suboxone withdrawal symptoms. Non-prescription methods include exercise and hot showers. NSAIDs, like ibuprofen or naproxen, can help relieve headaches and muscle aches. Clonidine helps reduce anxiety, irritability, sweating, and runny nose, and hydroxyzine (Atarax) can also help with anxiety and insomnia. Tizanidine (Zanaflex) helps reduce muscle spasms. Ondansetron (Zofran) relieves symptoms of nausea and vomiting. Loperamide (Imodium) helps relieve diarrhea. Bentyl helps relieve gastrointestinal (GI) symptoms, especially abdominal cramping.
Your Bicycle Health provider can assist with withdrawal symptoms throughout the tapering process.
Bicycle Health’s providers generally do not recommend that people stop taking buprenorphine/naloxone (Suboxone). We understand that some people might feel hesitant to take a medication indefinitely, but it’s important to remember that opioid misuse is a chronic medical condition. Similar to other chronic medical conditions, like asthma or high blood pressure, people usually benefit the most when they continue to take their medication. We know that not everybody thinks this way about buprenorphine/naloxone (Suboxone), but the most current and advanced studies indicate that the majority of people benefit most by taking it long-term. You can learn more here about why Suboxone is not “just trading one drug for another.”
The main reason to not taper buprenorphine/naloxone (Suboxone) is not actually the withdrawal symptoms; it is the risk of relapse. Relapsing on opioids can often have devastating consequences for people’s relationships, employment, legal status, and, of course, their health.
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.