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What Happens If I Stop Taking Suboxone Cold Turkey?

Individual experiences stopping Suboxone “cold turkey” vary greatly. Some people may be able to stop taking the medication immediately with few or no side effects, while others may have severely unpleasant withdrawal symptoms. The higher the dose of Suboxone you are on, the longer you have been on it, and your personal biology and genetics may play a role in the degree of withdrawal, if any, you experience.

Withdrawal from Suboxone is never life threatening, but it can be extremely unpleasant. One of the risks of stopping Suboxone cold turkey is that the withdrawal symptoms may be so unpleasant that it pushes people to use other opioids to alleviate the symptoms, leading to relapse.

Doctors don't recommend cold-turkey detox from Suboxone. If you're wondering how to get off of Suboxone, talk with your medical team instead. You could develop a taper schedule that helps you get off the medication slowly and safely. 

Side Effects of Suboxone Withdrawal

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”. You can remind yourself that they are a normal and natural part of adjusting to the lack of this medication. 

Why Taper Suboxone Instead of Quitting Cold Turkey?

While discontinuing Suboxone cold turkey isn't medically dangerous, [3] it can still be extremely unpleasant and uncomfortable, and can cause people to relapse into using opioids in an attempt to make the symptoms abate. One solution to this problem is to avoid quitting cold turkey, and instead, tapering slowly off of the medication. 

How to Taper Off Suboxone

Tapering your Suboxone dose means taking a little less every week until you're taking none at all. Some people need 7 days, and others need 28.[4] Some people benefit from even longer taper times.[5] The most common way to taper is to decrease somewhere between 10 - 20% of your dose every week or so.

Your taper schedule depends on the following:

  • Your symptoms: How uncomfortable are you? How strong are your cravings? Are you in pain?
  • Your therapy: Are you keeping your appointments for support groups, group therapy, and individual therapy? 
  • Your support system: Do you have people helping you stick to your commitments? Do you have someone you can check in with for accountability?

Many people remain on Suboxone indefinitely, and it is considered perfectly safe to do so [6]. However, if you decide for whatever reason that you wish to discontinue Suboxone, talk to your doctor about coming up with a safe and effective tapering strategy to meet your specific goals and needs.

References

  1. Opiate Withdrawal Syndrome in Buprenorphine Abusers Admitted to a Rehabilitation Center in Tunisia. African Health Sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398454/. December 2016. Accessed June 2022. 
  1. A Comparative Study of Factors Associated with Relapse in Alcohol Dependence and Opioid Dependence. Indian Journal of Psychological Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688890/. September 2017. Accessed June 2022. 
  1. Course and Treatment of Buprenorphine/Naloxone Withdrawal: An Analysis of Case Reports. American Journal of Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723396/. July 2013. Accessed June 2022. 
  1. Buprenorphine Tapering Schedule and Illicit Opioid Use. Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150159/. August 2011. Accessed June 2022. 
  1. A Randomized, Double-Blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers. JAMA. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1761270. December 2013. Accessed June 2022. 
  1. Buprenorphine for Opioid Use Disorder. New York State Department of Health. https://health.ny.gov/publications/0112.pdf. June 2021. 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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