October 18, 2018

Do I Need Detox for Suboxone?

Suboxone (buprenorphine) has been a life-saving medication for many people addicted to opiate prescription drugs, as well as illicit opiates such as heroin and synthetic opiates including fentanyl. Yet, in spite of its effectiveness in helping addicts overcome opiate addiction, Suboxone is a highly addictive opiate that can produce significant dependence on its own when used for longer than the recommended short-term treatment for opiate use disorder (OUD).

What Is Suboxone?

Suboxone is a medication that combines buprenorphine and naloxone. It is used in the treatment of opiate addiction and dependence. It is a partial opiate agonist that produces some of the same withdrawal effects as other opiates when discontinued “cold turkey.” Suboxone is classified as a Schedule III narcotic under the Controlled Substances Act. As such, the drug is also a target for diversion, misuse and illicit use by opiate users seeking a less expensive alternative to heroin (in some geographic regions), or to get high. A study in European Addiction Research found that heroin and amphetamine users in Sweden used illicitly obtained buprenorphine to get high.

How Do You Know You Need Detox?

If you’ve tried to quit using Suboxone on your own and felt the onset of withdrawal symptoms, you know the road ahead isn’t particularly easy or quick. If you’re a polydrug user, complications during Suboxone withdrawal can be dangerous, even life-threatening. None of this bodes well for self-detox from Suboxone. You need help. The question is: what kind of help and where do you get it?

Need Help Quitting Suboxone?

If you have overcome opiate addiction through medication-assisted treatment (MAT) using Suboxone, and now find yourself dependent on the treatment drug, it may seem like a catch-22. On the one hand, the opiate addiction was wreaking havoc on your life and Suboxone may very well have proven a life-saver— particularly if you experienced one or more opiate overdoses.

Now that you’re clear of the original opiate dangers, however, and you’re experiencing some of the negative effects of long-term Suboxone use, you may be upset, even angry, that you now have an addiction to Suboxone. Furthermore, you may be confused about how to go about quitting Suboxone safely and effectively.

If you’ve been abusing, misusing or illicitly obtaining Suboxone and are now dependent or addicted to the drug and decide it’s time to stop using it, it’s not as simple as no longer taking it.

The only way you’ll be successful quitting Suboxone starts with effective detox at an accredited medical or addiction treatment facility that specializes in opiate and Suboxone detox. Withdrawal symptoms can be severe and lead to complications that create or exacerbate health conditions. This is particularly true if you have other existing substance use disorders (SUDs) such as alcohol use disorder (AUD), and/or a mental health disorder, including anxiety and depression.

In fact, severe depression is one of the possible Suboxone withdrawal symptoms that requires professional medical attention to safely address.

Suboxone Withdrawal Symptoms

Withdrawal symptoms associated with Suboxone discontinuation include:

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Anxiety
Convulsions
Dehydration
Depression
Diarrhea
Fatigue
Fever
Goose-bump skin
Headache
Indigestion

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Insomnia
Involuntary leg kicking
Irritability
Muscle cramps
Nausea
Pain in the abdomen
Sweating
Thoughts of suicide
Vomiting

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Some undergoing Suboxone withdrawal may experience symptoms lasting from two weeks to more than a month, or longer, particularly symptoms of depression.

Learn more about Suboxone withdrawal symptoms and timeline.

How Long Will Suboxone Detox Take?

The length of time it will take for Suboxone detox (buprenorphine detoxification) depends on how long the drug has been used, pattern of typical use, and other individual differences. Since the most severe withdrawal symptoms appear within the first 72 hours of quitting the drug, it’s important to seek immediate professional Suboxone detox instead of trying to quit on your own.

Supervised medical detox will involve gradual buprenorphine tapering to a very low dose before cessation. Clonidine (and generic form), a blood-pressure medication used to treat opiate withdrawal is one of the MAT medications used. It is similar to lofexidine, only recently approved by the Food and Drug Administration, yet significantly less expensive. Learn more about MAT.

Most physical withdrawal symptoms during detox from Suboxone will subside within the first month, although some of the psychological ones, including drug craving, may persist for several months. As a matter of fact, relapse potential is very high at the one-month mark following detox. Most of the physical withdrawal symptoms have ceased, yet stressors and triggers can still precipitate a return to drug use.

Learn more about Suboxone detox.

What Happens After Suboxone Detox?

After successful detox from Suboxone, effective recovery entails undergoing a personalized treatment plan. That’s because detox alone is not enough to help you manage your recovery and maintain your sobriety. Coping strategies and development of a relapse prevention plan are two crucial components of successful recovery from Suboxone dependence or addiction.

With a formal treatment plan at an accredited drug and alcohol rehab center, you can be assured you’re getting the most effective and latest evidence-based treatment approaches. You’ll also benefit from interaction with peers who are also learning to be proactive in their recovery from Suboxone addiction. Such peer support can prove invaluable as you transition from treatment to living in recovery and maintaining your sobriety.

Depending on whether you choose inpatient or residential detox followed by treatment, or detox at a medical facility and outpatient treatment afterward, elements of your treatment program may include:

Individual counseling
Group therapy
12-step group meetings and other peer support groups
Alternative or holistic treatment approaches
Continuing care, aftercare and potentially alumni programs

Learn more about inpatient drug and alcohol rehab.

Learn more about continuing care.

While the decision to detox from Suboxone is yours alone to make, choosing medically-supervised Suboxone detox is the safest and most effective approach. A successful detox, immediately followed by treatment, will give you the best chances of a successful, long-term recovery.

For related information, see these articles:

Sources:

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

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 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

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-us