Suboxone can be an important part of treatment for opioid use disorder (OUD), but stopping the medication—especially suddenly—can cause withdrawal symptoms.
Suboxone withdrawal may include symptoms such as nausea, diarrhea, sweating, muscle aches, restlessness, anxiety, insomnia, and drug cravings. Because buprenorphine, one of the active ingredients in Suboxone, is long-acting, withdrawal may develop more gradually than withdrawal from some shorter-acting opioids.
If you take Suboxone and are considering stopping treatment, talk with your healthcare provider first. Your provider can help determine whether discontinuing the medication is appropriate and develop an individualized plan that considers your symptoms, recovery progress, and risk of returning to opioid use.
What Is Suboxone?
Suboxone is a prescription medication containing two active ingredients: buprenorphine and naloxone.
Buprenorphine is a partial opioid agonist. It attaches to opioid receptors in the brain but produces different effects than full opioid agonists such as heroin, fentanyl, or oxycodone. When used as prescribed, buprenorphine can reduce opioid withdrawal symptoms and cravings. How Suboxone is taken can affect how well the medication is absorbed. Learn more about how to take Suboxone properly and factors that can affect its absorption.
Naloxone is an opioid antagonist included in Suboxone to discourage misuse of the medication by injection.
Buprenorphine is one of the medications approved by the U.S. Food and Drug Administration (FDA) for treating opioid use disorder. Medication treatment can be combined with counseling, behavioral therapies, and other recovery support depending on an individual’s needs.
Can Suboxone Cause Withdrawal?
Yes. Physical dependence can develop when someone takes buprenorphine regularly, even when Suboxone is being taken exactly as prescribed.
Physical dependence isn’t necessarily the same thing as addiction.
With physical dependence, the body adapts to the presence of a medication. If the medication is stopped suddenly or its dosage is reduced, withdrawal symptoms can occur.
This is one reason people taking Suboxone shouldn’t abruptly stop or change their medication without talking to the healthcare professional managing their treatment.
What Are the Symptoms of Suboxone Withdrawal?
Suboxone withdrawal symptoms can vary from person to person.
Possible opioid withdrawal symptoms associated with stopping buprenorphine can include:
- Muscle aches
- Restlessness
- Anxiety or irritability
- Insomnia or difficulty sleeping
- Sweating
- Runny nose
- Watery eyes
- Abdominal cramping
- Nausea
- Vomiting
- Diarrhea
- Dilated pupils
- Chills or goosebumps
- Increased heart rate
- Drug cravings
Some people may experience relatively mild symptoms, while others may find withdrawal more difficult.
How someone experiences withdrawal can depend on several factors, including how long they have taken the medication, their dosage, other substances or medications they use, their overall health, and how the medication is discontinued.
What Is the Suboxone Withdrawal Timeline?
There isn’t one exact Suboxone withdrawal timeline that applies to everyone.
Buprenorphine has a relatively long half-life, meaning it remains in the body longer than many short-acting opioids. Because of this, withdrawal symptoms may not begin immediately after the last dose and may develop more gradually.
A person’s experience can also differ depending on their dose, duration of treatment, metabolism, health, and whether Suboxone was stopped suddenly or reduced under medical supervision.
Early Suboxone Withdrawal
During the early phase of withdrawal, someone may begin experiencing symptoms such as:
- Anxiety
- Restlessness
- Muscle aches
- Sweating
- Runny nose
- Difficulty sleeping
- Cravings
Because buprenorphine is long-acting, these symptoms may emerge later than they would after stopping a shorter-acting opioid.
Acute Withdrawal
As withdrawal progresses, symptoms can become more noticeable.
This period may include gastrointestinal symptoms such as nausea, vomiting, abdominal discomfort, or diarrhea in addition to insomnia, sweating, aches, restlessness, and cravings.
The intensity and duration of this phase vary significantly between individuals.
Later Withdrawal and Recovery
Physical symptoms generally improve over time, but some people may continue experiencing symptoms such as sleep difficulties, mood changes, anxiety, or cravings after the most noticeable physical symptoms have improved.
These symptoms are another reason continued medical care and recovery support can be important after changing or discontinuing medication for opioid use disorder.
Rather than relying on a universal day-by-day timeline, talk with your healthcare provider about what you may expect based on your individual treatment history.
How Long Does Suboxone Withdrawal Last?
There isn’t a single answer to how long Suboxone withdrawal lasts.
The medication’s long duration of action means withdrawal can have a different onset and course than withdrawal from short-acting opioids. Some symptoms may resolve sooner than others, while cravings, sleep problems, or mood-related symptoms may persist beyond the initial physical withdrawal period.
Factors that can influence withdrawal duration include:
- How long Suboxone has been used
- The prescribed dose
- How the medication is discontinued
- Individual metabolism
- Physical and mental health
- Use of other medications or substances
- Previous opioid use
- Individual response to withdrawal
A healthcare professional familiar with your medical history is best positioned to discuss what you might expect.
Why Shouldn’t You Stop Suboxone Suddenly?
Stopping Suboxone suddenly can cause opioid withdrawal symptoms and may destabilize someone’s recovery.
There is also another important concern: returning to opioid use after stopping treatment can increase overdose risk.
After a period without opioids, opioid tolerance can decrease. If someone returns to using opioids at an amount they previously tolerated, the risk of overdose may be higher.
The FDA cautions that medication for opioid use disorder shouldn’t be withheld simply because someone may need treatment for an extended period. Decisions about continuing, adjusting, or discontinuing buprenorphine should be made with a qualified healthcare professional based on the individual’s needs.
Do You Have to Stop Taking Suboxone?
Not necessarily.
There is no universal point at which everyone taking buprenorphine for opioid use disorder must discontinue treatment.
The appropriate length of treatment varies from person to person. Some people may use medication for shorter periods, while others benefit from longer-term maintenance.
The Substance Abuse and Mental Health Services Administration (SAMHSA) notes that the length of time a person receives buprenorphine treatment should be individualized and that, in some cases, treatment can continue indefinitely.
Taking medication for opioid use disorder for an extended period doesn’t mean treatment has failed.
The goal is to support recovery and reduce the risks associated with opioid use disorder.
Can Suboxone Be Tapered?
Healthcare providers may gradually reduce buprenorphine when a patient and provider decide that discontinuation is appropriate.
This process is commonly referred to as tapering.
There isn’t one tapering schedule that’s appropriate for everyone. How quickly a medication is reduced depends on individual circumstances and should be determined by the healthcare professional managing the prescription.
Attempting to create your own tapering schedule or abruptly changing your dosage can lead to withdrawal symptoms and other risks.
If you’re experiencing side effects, worried about dependence, or simply don’t want to continue taking Suboxone, talk with your prescriber rather than changing the dose on your own.
Is Suboxone Withdrawal Dangerous?
Opioid withdrawal is often extremely uncomfortable and can sometimes result in complications, particularly when vomiting or diarrhea leads to dehydration or when other medical conditions are present.
However, one of the most significant concerns surrounding discontinuation of medication for opioid use disorder is the potential return to opioid use and resulting overdose risk.
This is particularly important in an illicit drug supply where fentanyl and other potent synthetic opioids may be present.
Seek immediate medical attention if you or someone else experiences severe symptoms, signs of dehydration, loss of consciousness, difficulty breathing, chest pain, confusion, or another medical emergency.
If an opioid overdose is suspected, administer naloxone if available and call 911.
Is Suboxone Withdrawal the Same as Precipitated Withdrawal?
No.
These terms describe two different situations.
Suboxone withdrawal can occur when someone who has developed physical dependence on buprenorphine stops taking it or significantly reduces the amount.
Precipitated withdrawal can occur when buprenorphine is started too soon after certain opioids. Because buprenorphine binds strongly to opioid receptors, taking it before an appropriate period of opioid withdrawal can rapidly displace other opioids and trigger sudden withdrawal symptoms.
The timing of buprenorphine initiation should therefore be discussed with a qualified healthcare professional.
What Can Help With Suboxone Withdrawal?
The safest starting point is to talk with the healthcare provider prescribing your medication.
Your provider can evaluate why you want to discontinue Suboxone, whether doing so is appropriate at this stage of treatment, and how your health and recovery can be supported throughout the process.
Depending on your circumstances, professional support may include:
- Medical monitoring
- An individualized medication plan
- Management of withdrawal symptoms
- Behavioral healthcare
- Counseling
- Peer recovery support
- Continued opioid use disorder treatment
- Overdose prevention planning
Treatment should be individualized rather than based on a withdrawal schedule found online.
When Should You Talk to Your Suboxone Doctor?
Talk with your healthcare provider if you are thinking about stopping Suboxone, experiencing withdrawal symptoms, struggling with side effects, having difficulty taking the medication as prescribed, or experiencing increased opioid cravings.
You should also tell your provider if you’ve returned to opioid use.
A return to use doesn’t mean you should avoid seeking care. Opioid use disorder is a chronic, treatable condition, and treatment plans can be adjusted as someone’s needs change.
Finding Help for Opioid Use Disorder
If you’re worried about Suboxone withdrawal, you don’t have to navigate medication changes on your own.
A healthcare professional who treats opioid use disorder can evaluate your current treatment, discuss your concerns, and help you understand the potential benefits and risks of continuing or discontinuing buprenorphine.
Addiction Treatment Magazine’s directory can help you find Suboxone doctors near you and explore opioid addiction treatment resources in your area.
Frequently Asked Questions About Suboxone Withdrawal
What does Suboxone withdrawal feel like?
Suboxone withdrawal can cause opioid withdrawal symptoms such as muscle aches, sweating, restlessness, anxiety, insomnia, nausea, diarrhea, abdominal discomfort, and cravings. Symptoms and severity vary between individuals.
When does Suboxone withdrawal start?
Because buprenorphine is long-acting, withdrawal may develop more slowly than withdrawal from shorter-acting opioids. The exact onset varies based on factors including dose, treatment duration, metabolism, and how the medication was discontinued.
How long does Suboxone withdrawal last?
There isn’t a universal timeline. The duration and severity of withdrawal vary between people, and some symptoms may persist longer than others. A healthcare provider can provide guidance based on your treatment history.
Can you stop Suboxone cold turkey?
Abruptly stopping Suboxone can cause withdrawal and may increase other risks associated with opioid use disorder. Don’t discontinue or change a prescribed dose without discussing it with the healthcare professional managing your treatment.
Is it better to taper off Suboxone?
When discontinuation is appropriate, a healthcare professional may gradually reduce buprenorphine rather than stopping it abruptly. There isn’t one tapering schedule that works for everyone, so the process should be individualized and medically supervised.
How long should you stay on Suboxone?
There is no predetermined treatment length that’s appropriate for everyone. The duration of buprenorphine treatment should be individualized, and some people may benefit from long-term treatment.
Can you become physically dependent on Suboxone?
Yes. Regular buprenorphine use can lead to physical dependence, meaning withdrawal can occur when the medication is stopped. Physical dependence isn’t necessarily the same as addiction.
Sources
Substance Abuse and Mental Health Services Administration (SAMHSA). Buprenorphine.
U.S. Food and Drug Administration (FDA). Information about Medication-Assisted Treatment (MAT).
National Institute on Drug Abuse (NIDA). Medications to Treat Opioid Use Disorder Research Report.
Substance Abuse and Mental Health Services Administration (SAMHSA). Medications for Opioid Use Disorder.
U.S. Food and Drug Administration. SUBOXONE (buprenorphine and naloxone) Sublingual Film Prescribing Information.