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What Does Suboxone Feel Like After Opioid Withdrawal?

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After opioid withdrawal, Suboxone simply helps you to feel normal, reducing lingering withdrawal symptoms and reducing craving.

Opioid withdrawal is an intense and uncomfortable process. For many people trying to overcome opioid use disorder (OUD), suddenly quitting opioid drugs can cause a withdrawal syndrome that is both physically and psychologically uncomfortable, putting the individual at greater risk of resuming use, which can lead to overdose and death.

Suboxone is a vital medication to help people overcoming OUD focus on behavioral therapy. You may take this medication for months, years, or even indefinitely, and you will likely  feel mostly normal and stable on it. It does not cause people to feel high or oversedated.

Opioid Withdrawal Syndrome

Opioid use disorder (OUD) is one of the most serious epidemics in the United States, with thousands suffering  negative outcomes every day including overdose and death.

Many people struggling with OUD may try to quit taking these drugs “cold turkey” or without supervision or medication. Unfortunately, without the help of a rehabilitation program and Medication for Addiction Treatment (MAT), quitting can lead to intense, uncomfortable, and debilitating withdrawal symptoms that can make it hard to stay abstinent.

These are symptoms of opioid withdrawal:[1]

  • Agitation, restlessness, and anxiety
  • Muscle aches and pains
  • Increased watering of the eyes
  • Runny nose
  • Sweating 
  • Excessive yawning
  • Insomnia
  • Abdominal cramping, nausea, diarrhea, and vomiting
  • Goosebumps
  • Dilated pupils

Opioid withdrawal is a clinically diagnosable syndrome associated with distressing physical and psychological symptoms. They start after abruptly stopping opioids.[2] This can happen after long-term prescription opioid use overseen by a doctor with no appropriate tapering method or due to an opioid use disorder involving use of illicit opioids.

Acute withdrawal symptoms begin five days or less after the last opioid dose. They can continue for weeks, especially the psychological symptoms, which are in some ways more difficult to overcome than the typical two weeks of physical lethargy and discomfort.

How Suboxone Eases or Prevents Opioid Withdrawal Syndrome

To diagnose the severity of opioid withdrawal syndrome, your physician will monitor you during an abstinence period of one to three days, as the last dose of opioids metabolizes out of your body. They will then measure your withdrawal symptoms using a scale like the Clinical Opiate Withdrawal Scale (COWS) and determine an appropriate dose of buprenorphine to ease these symptoms.[3]

Buprenorphine-based medication is typically started 6 to 12 hours after short-acting opioids like heroin have metabolized out of the body.[4] For long-acting opioids like methadone, it generally starts 24 to 72 hours after they have metabolized out. If it’s taken too soon, while opioids are still in your system, it can actually trigger an opioid withdrawal. Working out the timing of your first dose with your provider is important.

Administration of Suboxone

Sublingual administration of buprenorphine, usually with a film like Suboxone or a related generic, is preferred since the strips dissolve quickly and enter the bloodstream through the mucous membranes of the mouth. Pills or tablets with buprenorphine may also be used.
Suboxone and other formulas of buprenorphine are usually taken once per day, requiring about 15 minutes to dissolve under the tongue or against the cheek. The concentration in the bloodstream peaks after about 3 hours, but you should feel some effects immediately.

The medication’s half-life in the body is between 25 and 70 hours, depending on the size of the dose you have been prescribed.

You should start to feel some relief immediately after your first dose. As  your brain and body break the habit of taking opioids, your cravings will diminish and it will become easier and easier to not relapse over time.

With Suboxone, you will not feel intoxicated, euphoric, sleepy, or “high” as people report they feel when they abuse opioid drugs. You should not feel intense withdrawal symptoms either. Instead, you should feel mostly normal and physically stable. This helps you focus on rehabilitation.

You May Take Suboxone for Years

Suboxone relief should last about 24 hours, which is why doctors prescribe your dose for daily use.

If you feel like you no longer need this daily medication, you and your physician will work together to taper you off the dose you currently take. This may mean you spend a few weeks reducing your dose until you find a new, lower, daily amount that works for you. At some point you may take Suboxone every other day instead of every day; or over months, you may eventually stop taking Suboxone completely.

The goal of a Suboxone prescription is not to taper off the medication, but to stabilize you so you can maintain behavioral counseling and a healthy daily routine. Using Suboxone offers you the ability to change problematic, compulsive behaviors around drugs.

This means you may take Suboxone for months or years. In fact, many people take Suboxone indefinitely as it continues to support their sustained recovery.

SOURCES

  1. Opiate and Opioid Withdrawal. MedlinePlus. https://medlineplus.gov/ency/article/000949.htm. January 2022. Accessed January 2022. 
  2. Opioid Withdrawal. Elsevier. https://www.elsevier.com/__data/assets/pdf_file/0019/537031/opioid-withdrawal-ClinicalKey.pdf. 2017. Accessed January 2022. 
  3. Clinical Opiate Withdrawal Scale. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/sites/default/files/ClinicalOpiateWithdrawalScale.pdf. 2003. Accessed January 2022.
  4. Buprenorphine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459126/. August 2021. Accessed January 2022.

Medically Reviewed By Claire Wilcox, MD

Claire Wilcox, MD, is a general and addiction psychiatrist in private practice and an associate professor of translational neuroscience at the Mind Research Network in New Mexico; and has completed an addictions fellowship, psychiatry residency, and internal medicine residency. Having done extensive research in the area, she is an expert in the neuroscience of substance use disorders. Although she is interested in several topics in medicine and psychiatry, with a particular focus on substance use disorders, obesity, eating disorders, and chronic pain, her primary career goal is to help promote recovery and wellbeing for people with a range of mental health challenges.

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