What Are Suboxone Withdrawal Symptoms?

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Suboxone is a mild opioid, and so the withdrawal symptoms from Suboxone are similar, although usually less severe than withdrawal from other opioids like oxycodone or heroin. Common symptoms include chills, aching muscles, nausea, vomiting, GI upset, stomach cramping, and anxiety.

People describe these symptoms as "flu-like," and you can remind yourself that they are a normal and natural part of adjusting to the lack of this medication. The withdrawal from opioids is thankfully never life threatening, but can be extremely uncomfortable and can put you at risk for a drug relapse in an attempt to make the symptoms abate.

If you decide to discontinue Suboxone, talk with your doctor first. Don’t attempt to stop taking the medication suddenly on your own. Together with your doctor, you can create a plan that keeps you safe. 

A Typical Timeline for Suboxone Withdrawal

In studies of a “cold-turkey” approach in which people stop taking the Suboxone suddenly, people felt the first withdrawal symptoms within one day of the last dose, and they felt the worst within about three days. After 10 days, they felt better. Symptoms were described as "moderate," and not severe.[1] The timeline of withdrawal varies for each individual, but overall patients can expect symptoms to start as soon as the day after discontinuing Suboxone and last anywhere from one day to a week or two. 

How to Manage Suboxone Withdrawal Symptoms

It's never wise to quit Suboxone abruptly. Remember that you're using this medication to address addiction, which is a chronic and relapsing condition. Pushing your body through withdrawal might put you at risk of relapse.

Instead, talk with your doctor about tapering your Suboxone dose slowly. Typically, you'll make a tiny adjustment to your medications until you're not taking any more at all.[2] This helps to minimize withdrawal symptoms and prevent relapse.

While you're moving through the taper, make sure you:

  • Hydrate. Clear, cool fluids can soothe your symptoms and ease discomfort. 
  • Manage temperature changes. Use layers to ride out chills and hot flashes. 
  • Move. Stretch, walk, or just breathe fresh air. Sore muscles appreciate the exercise, and gentle movement can help you to feel better.
  • Rest. Sleep when you feel tired and move when you're awake. Your body repairs itself while it sleeps, and that restorative process is vital during withdrawal.
  • Use over the counter medications as needed for symptoms. Some medications include Imodium (helps prevent diarrhea associated with withdrawal), Pepto Bismol helps with GI upset from withdrawal, Acetaminophen or Ibuprofen (can help with headaches and muscle cramps that can be associated with withdrawal), among others. 

Talk With Your Doctor

There's no shame in staying on Suboxone for long periods of time. Many people keep taking the medication for years or even indefinitely. If it supports your recovery, it makes sense to stay on it. However, if you think it's time to quit, talk with your doctor and create a strategy together. Involve your treatment team, such as your therapist and support network, in the conversation. They can all help you decide if stopping Suboxone use is a good choice for your recovery.

If it is, your doctor will guide withdrawal, helping you to stay safe and supported throughout the entire process. Don’t attempt to do it alone.

References

  1. Buprenorphine Withdrawal Syndrome. Indian Journal of Psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970944/. January 1995. Accessed June 2022. 
  1. A Patient's Guide to Starting Buprenorphine. American Society of Addiction Medicine. https://www.asam.org/docs/default-source/education-docs/unobserved-home-induction-patient-guide.pdf?sfvrsn=16224bc2_0. Accessed June 2022. 
  1. COWS Score for Opiate Withdrawal. MD Calc. https://www.mdcalc.com/cows-score-opiate-withdrawal. Accessed June 2022. 

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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