Can You Quit Suboxone Cold Turkey?

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You can quit Suboxone cold turkey, but you may have uncomfortable withdrawal symptoms. As a result, doctors generally recommend tapering off Suboxone  instead of a “cold turkey” approach.

Never stop taking Suboxone without talking to your doctor. You can make a plan together for the best way for you to discontinue Suboxone.

Is It Dangerous to Quit Suboxone Suddenly?

It is not dangerous to quit Suboxone suddenly.[1] The risk with stopping Suboxone quickly is that you may experience withdrawal symptoms. Withdrawal symptoms are not dangerous or life threatening, however they can be extremely uncomfortable and can cause some patients to be motivated to use other opioids to address the symptoms. Therefore, quitting cold turkey can increase risk of relapse to opioid misuse.

Because suddenly stopping use of Suboxone can be very uncomfortable, many people simply return to opioid misuse in order to make the discomfort go away. This often begins the cycle of drug misuse again, pushing someone back into their opioid use disorder (OUD).

What Is Suboxone Withdrawal Like?

If a patient stops using Suboxone suddenly, they may (or may not) experience buprenorphine withdrawal. This depends largely on the dose of Suboxone they were taking, their individual genetics, their length of therapy, as well as other factors.

Suboxone withdrawal symptoms are generally described as flu-like.[2] The patient may experience muscle aches, fever, nausea, vomiting, diarrhea, sweating, chills, and dilated pupils. They may feel agitated, anxious, and restless. It’s common to have trouble sleeping during this time.

The person may be tempted to return to opioid misuse to simply make these uncomfortable symptoms disappear.

These withdrawal symptoms are much more likely to happen if Suboxone use is stopped suddenly versus tapered slowly.

Does It Matter How Long You’ve Used Suboxone?

The longer you have been on suboxone, the more likely you are to experience withdrawal if you quit cold turkey. Suboxone is a Medication for Addiction Treatment (MAT) that is used on a long-term basis. If your body is accustomed to the presence of this medication, you may experience withdrawal symptoms if you quit suddenly.

Will You Relapse to Opioid Use if You Quit Suboxone Cold Turkey?

Relapse is not guaranteed in any circumstance, but you should be aware of the risk potential. If you experience discomfort by quitting Suboxone cold turkey, relapse to opioid misuse is more likely.[3] You know that your discomfort will go away if you misuse opioids, and that can be a serious relapse trigger for some people.

What Is the Best Way to Stop Suboxone Use?

Doctors recommend a tapered approach to stopping Suboxone use. This involves gradually lowering the dose of Suboxone over a period of anywhere from a week to a few months [3,4]

The exact tapering schedule will vary from person to person, so it’s important to work closely with your doctor during this process. If you begin to experience uncomfortable withdrawal symptoms, your doctor can slow your tapering schedule. Conversely, if you are doing well without any symptoms and want to hasten discontinuation of the drug, your doctor can speed up your taper.

The Bottom Line

Doctors don’t recommend quitting Suboxone cold turkey due to the physical discomfort and resulting increased relapse risk. Consult your prescribing doctor for assistance in stopping Suboxone use safely. A tapered approach gives you the best support to maintain your recovery.

Remember that stopping Suboxone use is not necessary in most cases. If it continues to support your recovery efforts, you can remain on Suboxone indefinitely.[5]

SOURCES

  1. Course and Treatment of Buprenorphine/Naloxone Withdrawal: An Analysis of Case Reports. The American Journal on Addictions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723396/. July 2012. Accessed July 2022.
  2. Buprenorphine Therapy for Opioid Use Disorder. American Family Physician. https://pubmed.ncbi.nlm.nih.gov/29671504/. March 2018). Accessed July 2022. 
  3. Buprenorphine Tapering Schedule and Illicit Opioid Use. Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150159/. August 2011. Accessed July 2022.
  4. A Randomized, Double-Blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers. JAMA Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1761270. December 2013. Accessed July 2022.
  5. Primary Care-Based Buprenorphine Taper vs. Maintenance Therapy for Prescription Opioid Dependence. JAMA Internal Medicine. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1916910. December 2014. Accessed July 2022.

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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