How Long is Suboxone Withdrawal?Anna Ciulla
Suboxone is a prescription medication used to treat opiate addiction. It belongs to a family of drugs called opioid partial agonists, which work to remedy the symptoms brought on by withdrawal. Sadly, the popularity of this “opiate withdrawal cure” has waned, seeing as it carries addictive properties itself.
If you or someone you know is currently dealing with an addiction and want to learn how to get off of Suboxone, then read on to learn everything you need to know about the withdrawal timeline and drug detox process.
What is Suboxone Used For?
You may know that this drug helps with opiate withdrawal, but how does Suboxone work? Suboxone is recommended for long-term use; it is heralded for its ability to increase a person’s chances for recovery from opiate addiction. It effectively lessens the severity of the withdrawal symptoms and dampens future cravings. Recovering addicts may incorporate Suboxone into their lives for years after they quit their previous addiction. Others are eager to clear their body of all opiates for good, prescribed or not. Unfortunately, in some cases, recovering addicts become re-addicted to a new substance and require a Suboxone detox.
Components of Suboxone
Suboxone is a prescription painkiller that contains two ingredients, buprenorphine, and naloxone. It was developed to combat the frequent abuse of buprenorphine, a narcotic under the category of a partial opiate agonist that in the past was prescribed alone to relieve extreme pain.
Naloxone works as an opiate antagonist to fight against the addictive properties of buprenorphine by blocking the opiate receptors in the brain. It is designed to be extremely long-acting and prevents the Suboxone user from experiencing the full euphoric high of its opiate counterpart.
How is Suboxone Ingested?
Suboxone is generally prescribed as an oral medication in the form of dissolving strips or sublingual (under the tongue) tablets. Because of its unique composition, crushing or injecting the painkiller is highly discouraged. Some opiates are snorted or injected into the bloodstream to cause a more immediate high.
The brain receives a more concentrated dose of naloxone if Suboxone is injected. The opiate antagonist (naloxone) will work against the opiate agonist (buprenorphine) and trigger immediate, acute withdrawal symptoms in the body.
How Long is Suboxone Withdrawal?
Suboxone side effects and withdrawal symptoms tend to appear within 36 hours of an individual’s last dose and will continue to intensify until up to 72 hours after. The prolonged withdrawal timeline is a result of buprenorphine’s long-lasting effect on the body, a vastly unique trait from most other opiates.
The blocking effect of naloxone wears off one to two hours after ingesting Suboxone. The numbing effect of the opiate buprenorphine may last as long as 24 hours. This makes Suboxone one of the longest-lasting prescribed painkillers. The withdrawal symptoms associated with Suboxone are often delayed and prolonged in comparison to heroin or pain pills because the drug stays active in the body longer.
Mild but Lengthy Withdrawal
Many people think Suboxone detox is even more severe than detox from stronger opiates, though studies have shown that symptoms were objectively less severe and subjectively milder than morphine detox and withdrawal; this means that doctors saw fewer physical symptoms, and patients reported that those symptoms, while unpleasant, were tolerable.
The reason Suboxone detox is notoriously difficult is that the comparatively mild withdrawal symptoms are drawn out over the span of a week rather than an intense detox that lasts for a day or two.
Factors that Impact Duration of Detox
Some factors impact how long Suboxone takes to fully leave the body. The following characteristics may alter the duration of an individual’s withdrawal symptoms:
- How much Suboxone an individual took
- How long the individual has been addicted
- If Suboxone has been taken with other drugs
- Age and body fat composition
- Liver function
- Urinary pH
If a person takes more than the recommended dose of Suboxone, has been addicted for a long time, and routinely takes it with other drugs like alcohol or cocaine, they may experience longer, more severe symptoms while withdrawing from Suboxone. Older, heavier people have more trouble passing the drug through their system than younger, skinnier people-
Suboxone is not recommended for those who have reduced liver function due to prior drug use. An individual with high urinary pH can help ease detox symptoms by drinking more fluids to reduce the acidity in their urine.
Immediate Withdrawal Symptoms to Know About
Physical withdrawal symptoms from Suboxone may include:
- Muscle cramps
- Restless legs
- Loss of appetite
- Profuse sweating, cold sweats
- Discomfort in the mouth
- Numbness or swelling of the tongue
Psychological withdrawal symptoms from Suboxone may include:
- Mood swings
Lasting Withdrawal Symptoms
After one week, withdrawal symptoms will have reduced significantly. At this point, a person may feel fit to carry on with normal day-to-day activities without feeling the intense craving for Suboxone. However, some psychological symptoms persist long after the physical symptoms disappear.
After two weeks, most if not all symptoms will have abated, except for one: depression. Prolonged use of Suboxone may change the chemical composition of the brain and increase an individual’s risk for depression even after finishing the prescription or stopping their addiction. Many people continue to experience cravings and depression for up to a month after the last time they take Suboxone.
Another prolonged withdrawal symptom of Suboxone addiction is a condition called PAWS, or post-acute withdrawal syndrome. Mild psychological symptoms related to PAWS, such as depression and anxiety, can last for up to one year after recovering from an addiction to Suboxone.
Often, PAWS is misdiagnosed as a mental health disorder unrelated to the withdrawal. It is difficult to detect unless doctors are aware of a patient’s previous OUD and therefore is exceptionally difficult to treat especially in those who used Suboxone without a prior prescription.
Getting Through Suboxone Withdrawal
Detox is uncomfortable for everyone. If you are going to make it through the Suboxone withdrawal timeline, you are going to need the help of a professional. Support yourself through this phase of recovery by drinking plenty of water to help flush out the drug, resting well so your body has the chance to repair itself and surrounding yourself with emotional support from family, friends, and/or a someone you trust who has been through this before.
This is best carried out in a long term residential treatment facility, where the patient will have medical supervision if anything is to arise during their Suboxone detox.
How Long Does Suboxone Stay in the Body?
We can break down the half-life of Suboxone’s ingredients to see why the drug remains active in the body for so much longer than other opiates.
The half-life of a drug is the amount of time it takes for half of it to pass through the body. The half-life of buprenorphine ranges from 24 to 60 hours, depending on the amount taken and the physical characteristics of the individual such as height, weight, metabolism, and age. The half-life of naloxone ranges between one hour to 90 minutes, a significantly shorter presence in the system in comparison to buprenorphine.
Danger of Addiction
Suboxone is addictive because it contains buprenorphine, a narcotic. While naloxone works to inhibit the opiate receptors in the brain, it only results in a partial chemical bond rather than a full chemical bond, so the user still experiences the painkilling properties of the narcotic. Therefore, it is very important that the user is made aware of the dangers of long-term Suboxone treatment before the choose that path for their recovery.
While on their own some of these characteristics seem applicable to a healthy, stable person, together they evoke a cry for help. Be conscious of the signs of Suboxone drug addiction:
- Considerable weight loss
- Trouble managing finances; difficulty holding down jobs; chronic unemployment
- Loss of interest in hobbies, activities
- Sudden urge to sleep while engaged in ordinary activities
- Severe GI side effects
- Active tear ducts; constricted pupils
- Secretive behavior
- Used needles in the living space; injection marks on arms, thighs, between toes
The painkiller has been found to cause mild euphoria in some users, though not nearly as much as a pure opiate or even other narcotic painkillers that do not incorporate some sort of opiate antagonist. Nevertheless, Suboxone can cause psychological addiction, which greatly increases the risk of future physical addiction and relapse after recovery.
Suboxone is used outside the direction of a doctor by individuals who are addicted to other opiates. The milder opiate prevents withdrawal during periods of time in which they do not have access to their drug of choice. Some people continue to self-medicate with Suboxone to ward off physical withdrawal symptoms. This propagates the cycle of abuse.
Short-term, erratic use of suboxone in this way can result in addiction to Suboxone along with the original drug and long-term depression even after full OUD recovery.
Suboxone was once heavily prescribed as a short-term detox medication. It is no longer the recommended course of action for rapid treatment as it has been found to increase the risk of severe withdrawal symptoms, relapse, and overdose. Discontinuation of the drug should only be considered after long-term use when the body has had enough time to adjust to life outside of opiate addiction.
If you haven’t relapsed and your cravings are under control, it may be safe for you to continue your recovery from opiate addiction without the help of medication. Talk to your doctor about your desire to quit Suboxone before taking action on your own. The initial period after stopping Suboxone is notoriously difficult; it takes about this long for the regions of your brain in charge of opiate cravings to ditch the addiction and return to a somewhat normal state.
That being said, most health professionals will recommend that you continue your long-term Suboxone treatment. Recovery is never over, and every treatment strategy that allows you to maintain a stable, healthy lifestyle helps.
Inpatient Rehab Treatment Facility
Suboxone is intended to be used as part of a long-term comprehensive opiate addiction treatment program. The prescription alone is not enough to safely recover from an opiate use disorder (OUD) and protect against relapse. Inpatient rehab or residential treatments combine medication-assisted treatment (MAT) with holistic therapy and a structured, isolated environment to facilitate a successful recovery from an opiate use disorder. By combining these elements, inpatient programs have become the most successful treatment for opiate addiction.
MAT is available for those who need extra support after quitting Suboxone. Prescriptions like clonidine or Zofran reduce withdrawal symptoms such as nausea, while Tylenol or aspirin reduces pain during the detox without the use of an opiate analgesic.
If you are worried about your chronic pain returning after you stop taking Suboxone, schedule a visit with a pain management specialist to figure out a non-opiate treatment plan that works best for you.
Your best course of action for OUD recovery is to seek help from a professional Suboxone detox center where the staff is trained to know the appropriate taper dose to use, what to do in the case of side effects, and how to handle adverse reactions.
There are a few serious medical complications associated with Suboxone detox:
- Vomiting and breathing in vomit (may lead to choking or future lung disease like pneumonia)
- Dehydration due to diarrhea or vomiting
- Seizure resulting from low blood sugar
- Mood swings, depression, anxiety, aggression, suicidal thoughts
- Intense opiate cravings
Outpatient Treatment Facility
Outpatient treatment is another option for breaking an addiction to Suboxone. It is more cost-effective, probably more convenient, and still gives the patient access to support systems and treatment services within the rehab facility. However, the patient must commit to traveling back and forth from the treatment facility following detox; the detox stage must be performed in the treatment facility under the supervision of a doctor.
The large disparity in half-life between naloxone and buprenorphine contributes to Suboxone’s addictive properties as a partial opiate. The exceedingly long half-life of buprenorphine retards physical withdrawal symptoms. Individuals who are addicted to Suboxone may choose to manage the addiction on their own, only to be caught off-guard with intense withdrawal symptoms days after they decide to quit.
At-home Suboxone detox is highly discouraged. Since withdrawal symptoms include intense opiate cravings, the risk of relapse jumps dramatically. It is easy to go back to using Suboxone to stop the withdrawal symptoms or worse, relapse to the previous OUD that Suboxone was prescribed to treat. Self-detox is not worth the risk.
A Closing Thought
While Suboxone was once a primary medication used to help patients detox from opiates, its addictive nature destroyed its popularity among healthcare professionals. If you or someone you love is struggling with a Suboxone addiction, then it’s best to reach out to Beach House Rehab Center as soon as possible. Through medically-supervised detox and an educated support team, the addiction can be kicked, and the patient can live a perfectly healthy and prosperous life.
The Lancet. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicenter, open-label, randomized controlled trial. January, 2018. Volume. 391, Issue 10118
A Randomized Acceptability and Safety Study of Suboxone Induction in Heroin Users
Create Consultancy. Evaluation of Suboxone Feasibility Study in Ireland. April, 2011.