Suboxone Withdrawal

Are Withdrawals from Suboxone Possible?

During discussions about detox and recovery, Suboxone withdrawal usually isn’t one of the usual suspects included in these conversations. Typically, things like heroin, fentanyl, and various pain killers that require the likes of Suboxone and other maintenance options are in the hot seat.

Individuals who have the goal of recovery in mind participate in various forms of medication-assisted treatment to overcome opiate use disorder. These treatments make it possible to live everyday life and focus on recovery without the never ending chase for heroin or other opioids to stave off the feelings of withdrawal.

Medication Assisted Treatment and Suboxone

However, these medication-assisted treatment regimens, otherwise known as maintenance plans, aren’t meant to be a lifetime solution. The medications used during maintenance are short-term alternatives to an individual’s substance of choice, allowing them to focus on recovery and deal with the underlying mental challenges that drive addiction.

One of the most critical elements of a maintenance plan is that these medications should never be used as replacement drugs. From the first moments of participation in medication-assisted treatment, clients should constantly prepare themselves to reach a point in which they can comfortably begin to ween off these medications as well.

The challenge of many of these maintenance options is that they require detoxification, including a withdrawal period. One of these medications, Suboxone, causes withdrawal symptoms that are equally as severe as heroin and other opioids.

To establish enough background regarding Suboxone withdrawal to cope or help others cope with this process effectively, it helps to have a clear understanding of what Suboxone is. The next section outlines Suboxone and how it’s used during an opioid taper or maintenance program.

What Is Suboxone?

Suboxone is a combination of two drugs: buprenorphine and naloxone. A doctor can prescribe Suboxone, Subutex, and Zubsolv to help treat substance abuse.

The buprenorphine in Suboxone attaches itself to opioid receptors inside the brain, decreasing cravings for opioids while preventing withdrawal symptoms. Naloxone is added to Suboxone/buprenorphine combos as an abuse-deterrent because it blocks opioid receptors from receiving the drug if a user slips into relapse.

Subutex contains only buprenorphine, while Suboxone also includes naloxone. Zubsolv is an alternative to Suboxone with an identical formulation.

Normally clients have two options when it comes to using Suboxone to combat opiate use disorder. Physicians and clients can work together in developing a moderate timeline for using Suboxone in medication-assisted treatment.

Timelines differ depending on the individual and severity of the opiate use disorder. However, ranges are typically between three months and one year, giving clients enough time to take advantage of resources for substance abuse treatment and mental health challenges.

Alternatively, clients may use Suboxone as a short-term assistant to help drive a successful detox process, using what is known as a Suboxone taper for opioids.

Suboxone as an Opioid Taper

Using Suboxone during a short-term opioid taper is an option for clients who don’t want to remain shackled to any medication for a long period. During an opioid taper, the detox process is much faster than participating in a maintenance program.

Over the course of about six weeks, clients will detox from opioids using a schedule that’s deemed appropriate by a physician. There are several strategies for an opioid taper using Suboxone, depending on how a client’s body responds to the medication.

Clients must abstain from any opiates before starting Suboxone. The recommended period is anywhere between 12 and 36 hours; otherwise, clients risk experiencing precipitated withdrawal.

In some cases, clients will begin Suboxone immediately after the period of abstinence, gradually working toward a dose that allows them to remain comfortable during detoxification. After stabilizing, clients will maintain this dose for two to three days, then begin decreasing until the tapering schedule ends, allowing them to avoid dosing altogether.

Alternatively, clients will alternate between Suboxone and their opiate of choice, slowly increasing Suboxone with subsequent doses while decreasing the opiate. Once the point is reached when opiates are eliminated from the regimen completely, individuals may finish the taper using the same method mentioned above.

Individuals may experience different results and doses, and specific strategies may need adjustments. Suboxone is a complex substance, and its effects vary from person to person.

Generally, what are the effects of Suboxone overall and in terms of withdrawal prevention?

The Effects of Suboxone

Suboxone is effective in offering patients a reduced sense of euphoria from opiates. Suboxone can also reduce cravings for opioids and eliminate or decrease any withdrawal symptoms that might occur during detoxification. Suboxone accomplishes this by acting on opioid receptors in the brain, which cause pleasurable feelings when opiates or opioids are misused

The Naloxone ingredient in Suboxone is added as an abuse-deterrent because it causes unpleasant side effects such as nausea if it’s ingested before all traces of opiates are expelled from the body. Naloxone is the active ingredient in Narcan, the popular overdose reversal medication.

Naloxone binds the opiate receptors in the brain, immediately reversing the effects of these drugs. This can send individuals directly into precipitated withdrawal, which is what happens when users segue directly from opiates to Suboxone without waiting until the recommended period of abstinence.

In addition, buprenorphine increases dopamine levels, impacting motivation and satisfaction from everyday activities. This can help with the subsequent depression and mood issues associated with detox.

Some of the side-effects of Suboxone include the following:

• Constipation
• Dizziness
• Headache
• Mild euphoria
• Fatigue

The side effects of Suboxone withdrawal are similar to other opioids and opiate drugs. However, the severity of these side effects depends heavily on a person’s tolerance, duration of use, and frequency of use.

Withdrawal from Suboxone Itself

It seems ironic that a medication intended to eliminate withdrawal symptoms includes a withdrawal period of its own. However, this medication does have its own specific withdrawal period highlighted by identifiable side effects. Some of the symptoms of Suboxone withdrawal include:

Suboxone Withdrawal Symptoms

• Abdominal pain
• Agitation
• Anxiety
• Muscle cramps and aches
• Nausea and vomiting
• Cold or flu-like symptoms
• Racing heart rate
• Mood swings and irritability
• Trouble sleeping/insomnia

Suboxone withdrawal is not a pleasant experience, and its potential for abuse requires a careful approach to dosing during medication-assisted treatment. The withdrawal period is managed easier when you’re aware of the timeline and what to expect during each stage of the process.

Timelines of Suboxone Withdrawal

Most of the physical symptoms of withdrawal will subside after one month, but psychological challenges may persist. Normally, the most intense period during withdrawal begins somewhere between 48 and 72 hours. The section below outlines an example of the Suboxone withdrawal timeline.

24 Hours-Day 2

This period is highlighted by extreme fatigue, irritability, headache, frequent yawning, and anxiety. Symptoms will steadily intensify until some time around the 72-hour mark.

Day 3-Day 5

Normally this is considered the most intense stage of Suboxone withdrawal. Users will experience stomach cramps, muscle aches, insomnia, irritability, sweating, cold chills, restless legs, increased heart rate, and high blood pressure.

Day 6-Day 12

The first portion of this period may include muscle aches, irritability, insomnia, and stomach issues. However, after about 10 days, most of the physical symptoms will subside. Depression is the most significant challenge during this period.

One Month

Depression and cravings continue to pose the biggest challenges at this point. It’s important to remain proactive and maintain a strong aftercare plan after you complete treatment. This is normally the period when clients have the highest risk of relapse.

There are several options, including medications, exercises, and natural remedies, to help you manage Suboxone withdrawal. Many of these options already exist for clients who are in medically-assisted detox and can make withdrawal much easier to complete.

Managing Suboxone Withdrawal

Managing Suboxone withdrawal is much easier with the right combination of medication and other therapeutic options. Use the following section as a guide to help you avoid the most intense side effects of Suboxone withdrawal.

Medications

Medications can help to reduce symptoms of withdrawal during detoxification. Participating in medically-assisted detox provides clients with more options in terms of prescription medication.

Options include:

• Diphenhydramine for insomnia
• Buspirone Hydrochloride (Buspar): Anti-Anxiety Medication
• Benzodiazepines for severe anxiety
• Lucemyra (Lofexidine Hydrochloride): This is almost identical to the blood pressure medicine clonidine but marketed as a non-addictive alternative to maintenance options. Manufacturers claimed this was the first drug to provide direct relief for withdrawal symptoms. Basically, this medication lowers blood pressure and stabilizes the heart rate while promoting a calming effect. Prescriptions for this drug can cost upward of $700, while clonidine is priced as low as $5. Many physicians will prescribe clonidine off-label to save clients hundreds of dollars.
• Promethazine for stomach issues
• Muscle relaxers for restless legs and muscle aches
• Mood stabilizers and anti-depressants for mood swings and depression
• Ibuprofen for soreness
• Alternative Options

Clients may also experience relief from some of the following:

• Yoga
• Sauna/steam treatment
• Massage
• Exercise
• Swimming

Any activity that increases metabolism has potential benefits. Additionally, efforts to maintain a healthy diet and important vitamins and minerals intake go a long way during recovery. You should also remain focused on staying hydrated to prevent more severe medical side effects.

During medically-assisted detox, staff provides access to all of the above benefits. Constant monitoring ensures you remain stable throughout the entire process, increasing the chances of a successful recovery.

Medically-assisted detox is always recommended because of the controlled environment and the increased chances for relapse when you remain on your own. Many times, clients feel capable of completing detox at home without assistance.

Understanding the need for medically-assisted detox is critical for accomplishing long-term recovery and avoiding relapse.

Do I Need Detox for Suboxone?

You need to be aware of the importance of medically-assisted detox in terms of your specific situation. Analyzing your history of opiate and Suboxone abuse and the potential severity of withdrawal symptoms can help you determine the need for medically-assisted detox. The presence of a strong support system will always play a role in your decision. How else can you determine whether you need medically-assisted detox for Suboxone?

• Suboxone abuse can quickly turn into an addiction with physical dependence. If you’ve been physically dependent on Suboxone for a significant amount of time, you probably need medically-assisted detox
• The dangers in terms of Suboxone withdrawal center around how easily you can relapse during detoxification if you do not receive assistance with managing the process. When you complete medically-assisted detox at a facility like Pathfinders Recovery Center, you can easily transition into an inpatient treatment program and increase your chances of a successful recovery.
• If you’ve attempted at-home detox more than once and failed, you are a good candidate for medically-assisted detox.

Medically-assisted detox is a great way to begin your journey toward recovery by transitioning into an inpatient treatment program with resources for aftercare planning upon graduation.

Inpatient Treatment for Opioids

Once you’ve completed the detox process, entering the appropriate treatment program is the next logical step. When it comes to opioids, inpatient treatment is the most appropriate level of care.

Because of the significant impact that opioids have on the mind and body, intense therapy is often required to remedy the most damaged areas of a client’s life. It takes a full-time effort from multiple members of a recovery team working in conjunction with a client to ensure the following goals are reached:

• The treatment of potential underlying mental health disorders through participation in dual-diagnosis treatment
• Effectively learning how to communicate emotions, avoid impulsive behavior, and understand how our behaviors relate to our disorders.
• Identify what causes us to relapse by learning about triggers and potentially high-risk environments and situations.
• Learn new and effective coping mechanisms and increase healthy productivity
• Create an effective aftercare plan with mental health services and primary care options —information regarding the location of 12-step group recovery meetings and similar programs.
• Learn about the importance of a sober support system and the role friends, and loved ones play in your continued recovery.

At Pathfinders Recovery Center, we provide all our clients with the tools and resources they need to rebuild their lives and break free from the chains of substance abuse. Contact one of our admissions specialists to take the first step toward one of the best decisions you will ever make.