Blog

January 18, 2019

How Long Does Suboxone Withdrawal Last?

Quitting Suboxone may be something you, ideally in concert with your treatment team, decide is the right approach at this time. After all, you likely have been on Suboxone as part of medication-assisted treatment (MAT) to transition away from illicit opiates such as heroin or synthetic opiates including fentanyl, as well as prescription painkillers. Indeed, Suboxone is very effective in overcoming opiate addiction and dependence. However, Suboxone is also highly addictive and can produce dependence when used for long-term maintenance. When you want to discontinue taking the medication, but worry how long Suboxone withdrawal will last, you want answers that can ease your mind.

THE FIRST STEP IS SUBOXONE DETOX

Discontinuing Suboxone is not as simple as one day deciding not to take it and completely stopping further use. Going cold turkey is not only asking for a lot of unnecessary and quite painful withdrawal symptoms that come on rapidly, it isn’t safe and may be dangerous— even life-threatening. Abruptly discontinuing Suboxone on your own when you’ve become dependent on it can result in physical withdrawal symptoms lasting from two weeks to a month. Psychological withdrawal symptoms can go on for months or years. And, as a 2018 study in Drug and Alcohol Dependence reported, even among those undergoing buprenorphine taper in an office-based addiction treatment program, more than half did so without clinic supervision and a majority returned to buprenorphine treatment in less than two years. Thus, the safest and most effective way to detox from Suboxone is through MAT, provided at an accredited addiction treatment rehab facility that specializes in detox from opiates and Suboxone.

What happens during Suboxone detox using MAT? Your detox is medically supervised from start to finish to ensure your comfort and to minimize withdrawal symptoms. Should complications arise, or if you have a co-occurring mental health disorder such as depression or anxiety, or are also dependent on or addicted to alcohol, your treatment professionals are by your side to provide medical attention. Learn more about MAT.

Since the most severe symptoms of Suboxone detox appear within the first 72 hours of taking the last regular dose, during MAT you’ll be put on tapered dosing to gradually reduce your Suboxone dosages before you’re taken off Suboxone altogether. One of the MAT medications to treat opiate withdrawal is  clonidine (similar to lofexidine, recently approved by the Food and Drug Administration). Research in the American Journal of Psychiatry found that clonidine is useful not only in reduction of withdrawal symptoms from opioid dependence, but also as an adjunctive maintenance treatment to increase abstinence duration and potentially stave off relapse.

Most of the physical symptoms of Suboxone withdrawal (nausea, vomiting, sweating, fever, body aches, confusion, and lethargy, among others) will subside over the course of a month, although some physical and psychological symptoms, such as cravings for the drug, may persist for months afterward. Once you go through medically supervised Suboxone detox, you’ve passed a big hurdle as the drug has been eliminated from your system. Yet you’re still in Suboxone withdrawal. As such, your journey isn’t over. In fact, to help prevent relapse, it’s imperative that you take part in a personalized treatment plan so that you can better cope with stressors and triggers that may otherwise derail your sobriety.

Learn more about Suboxone withdrawal symptoms and timeline.

WHAT HAPPENS DURING PERSONALIZED TREATMENT?

Depression is one of the most commonly experienced Suboxone withdrawal symptoms. In someone who’s already been diagnosed and/or treated for clinical depression, this can be a serious predictor for relapse if left untreated. Even if you don’t have a full-blown major depressive disorder, however, the depression you may experience during Suboxone withdrawal should be addressed because it can cause you to relapse.

According to the Journal of Current Psychiatry Reports, “more than two-thirds of individuals relapse within weeks to months of initiating [addiction] treatment.”

Other things that a personalized treatment plan entails include individual counseling and group therapy, learning coping strategies, developing a relapse prevention plan, interacting with others who are also beginning their recovery journey from Suboxone, participating in 12-step group meetings and other peer support groups, and engaging in holistic and other alternative treatment approaches.

The best way to receive personalized treatment is through inpatient or residential treatment. This will likely be at the same accredited drug and alcohol treatment center where you choose to undergo medically supervised Suboxone detox. Your length of stay will be determined, in part, by how long you’ve been addicted to Suboxone, any co-occurring substance abuse and mental health disorders, your medical condition, prior treatment and relapse, and other factors. Treatment duration on an inpatient basis may be 35 or 65 days, or longer in some cases. As a 2016 study in Addiction found, for opiate-dependent youth, a longer (56-day) buprenorphine taper produces better abstinence from opiates and retention outcomes than shorter (28-day) buprenorphine taper.

Learn more about inpatient drug and alcohol rehab.

INTENSIVE OUTPATIENT PROGRAM

Once you’ve completed your medically managed detox and inpatient treatment program, the next stage of Suboxone withdrawal could well include participation in an intensive outpatient program (IOP). An IOP combines the best aspects of residential treatment and outpatient care and may be the preferred route for someone who needs ongoing care on a somewhat stepped-down basis. Some IOPs last for 65 days.

The advantages of IOP include gaining added confidence from having ongoing counseling and group therapy support, access to MAT to help manage cravings, life-skills and vocational prep, continuing 12-step group participation, interacting with a strong peer support community.

Learn more about intensive outpatient programs.

AFTERCARE FOR SUBOXONE WITHDRAWAL

Be sure to take advantage of continuing care or aftercare, if available through your drug and alcohol treatment facility. Considered the final stage of treatment, following Suboxone withdrawal and formal treatment program, aftercare is the best way to ensure you have ongoing access to maintenance therapy (such as cognitive-behavioral therapy), medication management, and more.

Learn more about Suboxone aftercare.

Learn more about Continuing Care.

WHEN IS SUBOXONE WITHDRAWAL OVER?

Just as every person is unique, the amount of time for Suboxone withdrawal is also different from one individual to another. After detoxing from Suboxone, if you don’t experience continuing withdrawal symptoms such as intense cravings for the drug, or you haven’t been on Suboxone that long and it’s left your system rather quickly, you may not require as long or as much treatment as someone who’s a chronic or long-term Suboxone user.

If you’ve been struggling with another substance use disorder, such as alcohol use disorder (AUD), a pre-existing or recently developed mental health disorder such as anxiety or depression (both symptoms experienced in Suboxone withdrawal), or have other medical conditions requiring ongoing treatment, though, your overall Suboxone withdrawal may last some to many months longer. There is no way to predict how long it will take, although there will be clear indicators on your recovery journey that you are getting stronger and are better able to live a drug-free life.

HOW YOU CAN HELP YOUR SUBOXONE WITHDRAWAL EXPERIENCE

Getting the help you need throughout Suboxone withdrawal is vital, not only to ensure your comfort and safety, but also to assist in preventing relapse and reducing the timeline for the entire withdrawal experience. The following recommendations from recovery experts are things you can do to help:

  • Take all your prescribed medications exactly as directed by your doctor and/or treatment professionals.
  • Keep all appointments with your doctor, therapist, other medical professionals. This is especially important if you require continuing treatment for depression and mood swings following Suboxone detox and treatment program.
  • Recognize that how long it takes for Suboxone withdrawal is partly in your hands. In other words, a lot is up to you in managing your withdrawal experience.
  • Participate in 12-step group meetings so you can continue to interact with others who are on the recovery journey and support each other’s sobriety goals.
  • Engage in therapeutic alternative and holistic therapies. Alternative therapies may include art, exercise, animal-assisted therapies, cooking and others. Holistic therapies to consider include yoga, meditation, acupuncture, hypnotherapy, drumming and more.
  • Practice coping strategies you learned during treatment.
  • Work on eliminating stress from your life. Stress is a huge trigger for relapse.
  • Gradually restore social activities. The emotional support and bonding you have with loved ones, family and close friends is a proven way to boost your self-confidence.
  • Take up or return to a hobby, leisure or other activities you enjoy.
  • Maintain a positive attitude. Recovery is likely to have ups and downs. Being optimistic that you can weather the rough patches—buoyed by your support network—will greatly enhance your confidence and provide the strength you need to live a drug-free life.

Perhaps one of the best indications your Suboxone withdrawal has finally ended is that you no longer find yourself obsessively worrying about whether or not you’ll relapse, you feel strong and firm in your recovery foundation, and are able to successfully cope with any recurring stresses and triggers. It’s still vitally important to connect regularly with your support network, as this helps further reinforce and strengthen your commitment to sobriety.

For more about Suboxone, addiction, detox, withdrawal and rehab, check out these articles:

  1. How Does Suboxone Work?
  2. Will Suboxone Show Up in a Drug Test?
  3. Do I Need Detox for Suboxone?
  4. Dangers of Long-Term Suboxone Treatment
  5. How Long Do Withdrawal Symptoms Last?
  6. Dangers of Drug Detox at Home and Quitting Cold Turkey
  7. How to Know if You Need Rehab Treatment
  8. Prescription Opiate Detox: What to Expect from Withdrawal and Recovery
  9. Choosing Between Inpatient and Outpatient Rehab
  10. The Benefits of Inpatient Rehab
  11. What to Consider Before Trying to Detox at Home
  12. Are All Drug Detox Programs the Same?
  13. What Does a Day in Rehab Look Like?
  14. Top 10 Signs of Addiction

Sources:

Addiction. “A randomized controlled trial of buprenorphine taper duration among opioid-dependent adolescents and young adults.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26918564

Addiction. “Buprenorphine tapering schedule and illicit opioid use.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150159/

American Journal of Psychiatry. “Clonidine Maintenance Prolongs Opioid Abstinence and Decouples Stress From Craving in Daily Life: A Randomized Controlled Trial With Ecological Momentary Assessment.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25783757

Current Drug Abuse Reviews. “Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse and Illicit Use: An International Review.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154701/

Drug and Alcohol Dependence. “Characterizing opioid withdrawal during double-blind buprenorphine detoxification.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447545/

Drug and Alcohol Dependence. “Tapering off and returning to buprenorphine maintenance in a primary care Office Based Addiction Treatment (OBAT) program.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29958128  

Drug Enforcement Administration. “Controlled Substances: Alphabetical Order.” Retrieved from https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

European Addiction Research. “Buprenorphine misuse among heroin and amphetamine users in Malmo, Sweden: purpose of misuse and route of administration.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17851242

JAMA Internal Medicine. “Primary care-based buprenorphine taper vs maintenance therapy for prescription opioid dependence: a randomized clinical trial.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25330017

Journal of Current Psychiatry Reports. “New Findings on Biological Factors Predicting Relapse Vulnerability.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674771/

MedPage Today. “FDA Approves First Non-Opioid Drug to Treat Withdrawal Sx.” Retrieved from https://www.medpagetoday.com/painmanagement/opioids/72938

National Institute on Drug Abuse. “A look at drug craving.” Retrieved from https://www.drugabuse.gov/news-events/latest-science/look-drug-craving

Substance Abuse and Mental Health Services Administration. “Buprenorphine.” Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine

Substance Abuse and Mental Health Services Administration. “Substance Use Disorders.” Retrieved from https://www.samhsa.gov/disorders/substance-use

 

 

close