Suboxone Withdrawal: Symptoms, Complications, and Management

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Despite being used to treat opioid addiction and dependencies, Suboxone is a medication that can cause additional dependency and addiction for its users.

If a user quits the medication “cold turkey” after using it for a significant amount of time, withdrawal symptoms similar to those of opioids can occur.

These symptoms differ from person to person and vary in severity; however, they are usually uncomfortable and unpleasant.

This article will discuss the following:

  • What is Suboxone and what do its withdrawal symptoms look like
  • Why do these withdrawal symptoms occur
  • The length and severity of withdrawal symptoms
  • How to manage symptoms
  • The risks of unmanaged withdrawal symptoms.

Let’s get into it.

Understanding Suboxone

Suboxone is the generic brand name for a medication that contains buprenorphine and naloxone.

It is often prescribed for opioid dependency, as results have shown that it can be an effective treatment tool to help those suffering transition back into an addiction-free life.

Buprenorphine, a key ingredient in Suboxone, is a partial opioid that works by occupying receptors in the brain that opiate drugs such as morphine and heroin bind to, lessening the intoxication of the other opiates and preventing further cravings.

However, because it binds to opioid receptors in the brain, Suboxone can produce withdrawal effects similar to those experienced with other opioid drugs.

Why Does Suboxone Withdrawal Occur?

If Suboxone is used for a long period and the body develops a physical dependence on the medication, withdrawal symptoms may occur when the use of the medication is eventually halted.

Withdrawal from Suboxone occurs because the medication binds to opioid receptors in the brain, thereby causing withdrawal effects similar to the ones experienced by opioid users if it is quit “cold turkey.”

It is important to note that physical dependence is not the same as addiction.

Addiction is characterized by prolonged substance abuse that causes biochemical and behavioral changes.

Alternatively, physical dependence is the term used when someone’s body is so used to a drug or medication that they will experience withdrawal if they cease to use it, or if they have developed a tolerance that renders its effects useless on their body.

If a drug or medication dependence has been developed, the body is used to functioning with the substance in its system.

This means that if there is a sudden absence of the substance, the body will not know how to function without it — causing you to develop withdrawal symptoms or become very ill.

Symptoms of Suboxone Withdrawal

The symptoms of Suboxone withdrawal vary between each person and can present as both psychological symptoms and physical symptoms. Here are some of the most commonly experienced:

  • Body aches
  • Lethargy
  • Cravings
  • Nausea
  • Irritability
  • Depression
  • Anxiety
  • Difficulty concentrating
  • Insomnia
  • Headaches
  • Sweating
  • Fever or chills
  • Vomiting
  • Runny Nose.

How Long Do Suboxone Withdrawal Symptoms Last?

It is generally thought that Suboxone withdrawal will last for about a month, with the worst of the physical symptoms experienced in the first 72 hours.

The withdrawal timeline following this includes symptoms such as general aches and mood swings for a week, followed by depression in the week after that. After a month, cravings and depression may still be experienced.

The factors influencing Suboxone withdrawal severity and duration

One of the key factors that can influence the duration and severity of Suboxone withdrawal symptoms is the dosage and length of time spent on Suboxone.

The higher dosage and longer duration of taking Suboxone gives the body more of an opportunity to develop a dependency and tolerance to the medication, which can make adjusting to life without it much more difficult for the system to adapt to.

Additionally, the metabolic rate of the individual can affect the severity of the withdrawal as it controls how the body processes the medication and adapts to functioning without it.

Using other substances or medications may also lessen or worsen withdrawal symptoms, depending on how they interact with Suboxone and what effects they aim to provide.

Finally, your overall health and general lifestyle can have an impact on Suboxone withdrawal. If you are fit and healthy, you may find it easier to cope with withdrawal symptoms — lessening their effects.

How To Manage and Treat Suboxone Withdrawal

Taper off gradually

One of the best steps you can take to manage Suboxone withdrawal symptoms is to taper off the medication gradually. This involves slowly reducing your intake of the medication until you eventually stop taking it altogether.

Gradually tapering off the medication gives your body the time to slowly adjust to functioning without the medication.

This in turn can reduce the number of withdrawal symptoms it produces as your system will not be met with the sudden shock of no longer receiving the substance.

Medical supervision

Another key step to help you manage and treat Suboxone withdrawal is to ensure you are medically supervised while coming off the drug.

Medical supervision means that a trained medical professional will oversee your journey and monitor your symptoms, allowing them to assess the severity of the withdrawal symptoms and step in with extra medical care if needed.

Supportive therapy

Suboxone withdrawal causes physical symptoms, but it can cause mental ones too. This is why those coming off the medication benefit from attending some type of supportive therapy, whether that be behavioural therapy, exposure therapy, or talk therapy.

Not only can these trained professionals help you to work through and lessen symptoms such as anxiety and depression, but they can help you address the psychological factors that created the medication dependency in the first place — ultimately helping you to stay off the medication in the long term.

The Risks and Complications of Unmanaged Suboxone Withdrawal

Severe discomfort

A common withdrawal symptom includes flu-like symptoms such as muscle aches, fever, chills, vomiting, and headaches.

If these symptoms are left unmanaged, you run the risk of them worsening — which can cause severe discomfort and make the withdrawal process a lot more difficult.

Intense drug cravings and relapse

Intense drug cravings, including opioid cravings, are another common symptom of Suboxone withdrawal. If left unmanaged, these cravings can grow to a level where they are distracting and difficult to ignore.

This creates a significant risk of relapse, as often these cravings are too intense for the patient to handle — especially in their vulnerable withdrawal state.

Studies have shown that 40-60% of people who suffer from substance abuse or dependency will relapse again. Your chances of becoming part of this statistic are significantly increased if you do not manage your symptoms and seek help for the intense cravings that may occur.

Mental distress

Withdrawal can cause significant psychological complications, as often the mind has also become dependent on the use of the substance.

Mental health disorders such as anxiety and depression are common during this time, and if you do not seek help to manage these symptoms, they may worsen and result in severe mental distress. This can be harmful to you and the people around you.

Health complications

While uncommon, Suboxone withdrawal can cause serious health complications if left untreated.

If symptoms such as vomiting and diarrhea are experienced and left unmanaged, they can result in severe dehydration.

If this is further left unmanaged, there is a risk of heart failure and death — which is why it is essential that symptoms are managed throughout the withdrawal period.

The Bottom Line

While Subuxone is an effective medication to help those suffering from a dependence on opioids or addiction to transition into a drug-free life, there is a risk that users may develop a dependency.

If this occurs, there is a likelihood that users may experience withdrawal symptoms.  However, there are ways in which the symptoms can be managed.

Ultimately, you must take steps to manage your symptoms when going through withdrawal, as if they are left unmanaged they can have severe physical and mental effects that can have significant long-term impacts on your health and wellbeing.

FAQs about Suboxone

 How does Suboxone work for withdrawal symptoms?

Suboxone is given to those who suffer from opioid dependency.

Instead of quitting the use of an opioid and experiencing severe opioid withdrawal symptoms, Suboxone is taken instead to help the body adjust to life without the use of drugs.

The aim of this is to reduce withdrawal symptoms altogether.

How much Suboxone is needed for withdrawal?

The generally recommended maintenance dosage of Suboxone is 24 mg/6 mg.

However, there is no specific amount of Suboxone that will guarantee withdrawal symptoms when a user stops taking it.

Whether or not you experience withdrawal largely depends on the amount of time you’ve spent on the medication and if your body is dependent on it.

What are the negative side effects of Suboxone?

Most medications come with the risk of side effects, and Suboxone is no exception.

Possible side effects from the use of the medication include numbness or tingling, insomnia, vomiting, nausea, drowsiness, dizziness or blurred vision, increased sweating, and constipation

What is the 3-day rule for Suboxone?

The “three-day rule” is a rule that allows a practitioner who is not registered as a separate narcotic treatment program to administer narcotic drugs to a patient in order to relieve severe withdrawal symptoms.

This is provided that they arrange for a referral for treatment and do not administer more that one day’s medication at once for a maximum of 72 hours (or three days). This applies to Suboxone.

Sources

  1. https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf
  2. https://classic.clinicaltrials.gov/ct2/show/NCT00604188
  3. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496
  4. https://www.addictioncenter.com/addiction/addiction-vs-dependence/
  5. https://delphihealthgroup.com/addiction/dependence/
  6. https://www.americasrehabcampuses.com/addiction/withdrawal/what-happens-to-your-body-during-drug-withdrawal/
  7. https://americanaddictioncenters.org/suboxone/withdrawal
  8. https://lagunatreatment.com/drug-abuse/suboxone/withdrawal-symptoms/
  9. https://www.drugs.com/medical-answers/long-suboxone-withdrawal-3536165/
  10. https://windwardway.com/withdrawal/
  11. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  12. https://lagunatreatment.com/addiction-research/drug-withdrawal/psychological-withdrawal/
  13. https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal
  14. https://americanaddictioncenters.org/suboxone/side-effects
  15. https://www.naabt.org/documents/Three-day-rule.pdf

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