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How Do You Taper Off Suboxone?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Jan 16, 2024 • 5 cited sources

Tapering off Suboxone involves gradually using smaller amounts of medication until you’re taking none at all. 

If you’re ready to stop taking your medication for opioid use disorder, consult your doctor. They will create an individualized Suboxone tapering schedule for you and show you how to wean off this medication safely and effectively. 

Remember that plenty of people stay on Suboxone indefinitely, so you don’t have to taper off it if it continues to support your long-term recovery efforts.

Why Consider a Suboxone Taper?

Suboxone is safe for long-term use, and some people take the medication open-endedly to keep their opioid use disorder (OUD) under control.[1]

These are three reasons people cite when requesting a Suboxone taper, including:

  • Your OUD is under control: Your opioid cravings are gone, you’ve been in recovery for many years, and you don’t think you need medication.
  • You’re dealing with side effects: While most people tolerate Suboxone well, some patients will have persistent bothersome side effects, including nausea, GI upset, dizziness, sexual dysfunction, or headaches.
  • Your health or life has changed: Pregnancy, an upcoming surgery, or significant changes in life circumstances are other reasons people sometimes discontinue Suboxone.

Know that you’re not required to quit taking medication that helps you. But if you’re ready to quit, your doctor can help you plan.

Individualized Approach to Buprenorphine and Suboxone Tapering

While research suggests that longer treatment periods are generally beneficial, it is important to remember that everyone is different. 

Some people may be able to taper off buprenorphine or suboxone relatively quickly after stopping their opioid use, while others may need to take it for a longer period of time.

Factors to Consider When Tapering Buprenorphine or Suboxone

If you are considering tapering off buprenorphine or Suboxone, it is important to talk to your doctor. They can help you assess your individual risk factors and make a plan that is right for you. 

Some factors that your doctor may consider include:

  • Your history of opioid use
  • Your severity of OUD
  • Your response to treatment
  • Your goals for recovery
  • Your support system
  • Your mental health

How Long Does it Take to Taper Off Suboxone?

There is no one-size-fits-all Suboxone tapering schedule—everyone’s body, physiology, symptoms, and mental health are different.

Some people are able to taper off their Suboxone in a matter of two weeks, especially if they’re on a low dose to start, while others may take one to two months.

Your Suboxone taper schedule will depend on many things, such as:

  • Your current Suboxone dose
  • How long you’ve been taking Suboxone for OUD
  • Any tapering history you have
  • The emergence of withdrawal symptoms or cravings
  • How you feel on lower doses
  • Your individual physiology
  • Your mental health
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How to Taper Off Suboxone 

You probably started taking Suboxone in a tapering format. You took one dose, watched for symptoms, and took another if you felt sick.[3] As you taper off Suboxone, you follow the same process in reverse.

A Suboxone taper process sounds easy enough. You take a smaller dose every few days until you take none. But a little planning can help you feel much more comfortable and in control. Follow these steps:

1. Determine Your Dose

How much Suboxone are you taking right now? How many milligrams are in each dose, and how often do you take the drug? 

Your prescription should include all the necessary details. If not, ask your doctor or pharmacist.

2. Set Your Schedule

Are you facing a firm deadline, or do you have time to let your body adjust more slowly? In general, the longer the taper, the more comfortable you will feel.

7-Day Suboxone Tapering Schedule

Below is a sample 7-day Suboxone taper schedule:[5]

Stabilization dose8mg16mg24mg
Day
18mg16mg24mg
26mg12mg20mg
36mg10mg16mg
44mg8mg12mg
54mg4mg8mg
62mg2mg4mg
72mg2mg2mg

Generally speaking, a longer Suboxone tapering schedule may be better because it reduces the risk of withdrawal symptoms and cravings returning. However, if you are on a relatively low dose, a 7-day taper may work for you.

28-Day Suboxone Tapering Schedule

If you’d prefer to take your time weaning off Suboxone, here is a sample 28-day schedule:[5]

Stabilization dose8mg16mg24mg
Day
18mg16mg24mg
28mg16mg24mg
36mg12mg20mg
46mg12mg20mg
56mg12mg20mg
66mg10mg16mg
76mg10mg16mg
86mg10mg16mg
9-116mg8mg12mg
12-144mg8mg10mg
15-164mg6mg8mg
17-194mg4mg6mg
20-222mg4mg4mg
23-252mg2mg2mg
26-282mg2mg2mg

Keep in mind, these are just sample schedules and that your Suboxone tapering plan will be tailored to meet your needs.

3. Share Your Plans

Tell your friends, family members, and support groups that you are tapering off Suboxone. Ask them to help you and encourage you. If the process gets tough, turn to them for support.

4. Work With Your Doctor

Can you set up and pull off your own Suboxone taper? Maybe. But it’s not advised, and can be very dangerous. It’s best to let a doctor guide you through the process. Your doctor can help you understand and anticipate side effects and prepare adequately for this transition.

How Hard Is It to Come Off Suboxone?

It’s manageable to come off Suboxone if you have a physician’s guidance and supervision. Experts say people rarely develop significant withdrawal symptoms when they lower their dose gradually.[2] Your doctor can help you find a schedule that’s right for you.

If you experience withdrawal symptoms or opioid cravings at any step in the tapering process, your doctor will likely raise your dose and slow the taper. 

If you find it hard to come off Suboxone, it’s a sign that you should stay on the medication. You are likely to relapse if you aren’t feeling stable without it. 

What Are the Risks of Quitting Suboxone?

Before you think of quitting, consider whether or not you’re truly ready to do so. Talk to your treatment team and support network to assess whether it’s the best decision for your long-term recovery.

There is no shame in taking Suboxone for long periods or even indefinitely when necessary. Addiction is a chronic, relapsing condition. If your medication helps you stay sober, keep taking it.

These are a few known risks of quitting Suboxone:

Withdrawal Symptoms

Opioid withdrawal symptoms are not usually life-threatening, but they can be extremely uncomfortable. They can cause people to relapse toward repeated drug use to ease the painful symptoms. And if you take too large a dose when you relapse, this could be fatal.

If you quit taking Suboxone too rapidly, you could develop uncomfortable symptoms like nausea and vomiting.

Relapse 

Using Suboxone for longer periods of time is associated with a better chance of recovery.[4] The medication alleviates chemical imbalances in your brain, allowing you to focus on your recovery. Each dose helps you to avoid discomfort and cravings, making you less likely to relapse.

If opioid cravings become overwhelming, some people turn to street drugs like heroin rather than medications like Suboxone. But one slip could lead to a life-threatening overdose. 

How to Decide if a Taper Is Right for You

Your doctor can be especially helpful in discussing why you want to taper off Suboxone. If you want to quit because of difficult side effects, your doctor could suggest a different formulation or dose. You could still get the help you need without abandoning a medication that is helping to keep you from relapse.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Impact of Long-Term Buprenorphine Treatment on Adverse Health Care Outcomes in Medicaid. Health Affairs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531057/. May 2020. Accessed March 2023.
  2. Dosing Guide for Optimal Management of Opioid Dependence. Suboxone. https://www.naabt.org/documents/Suboxone_Dosing_guide.pdf. Accessed March 2023.
  3. OUD Induction Handout. British Columbia Ministry of Health. https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/oud-induction-handout.pdf. Accessed March 2023.
  4. Extended Suboxone Treatment Substantially Improves Outcomes for Opioid-Addicted Young Adults. National Institutes of Health. https://www.nih.gov/news-events/news-releases/extended-suboxone-treatment-substantially-improves-outcomes-opioid-addicted-young-adults. November 2008. Accessed March 2023.
  5. Ling W, Hillhouse M, Domier C, et al. Buprenorphine tapering schedule and illicit opioid use. Addiction. 2009;104(2):256-265. doi:10.1111/j.1360-0443.2008.02455.x

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