Suboxone Withdrawal: What to Expect and Solutions for Managing It

Suboxone withdrawal is a fairly common occurrence. Suboxone is a medication commonly used to help individuals recover from opioid addiction. It is a combination of two active ingredients: buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Together, these medications work to virtually eliminate cravings and withdrawal symptoms, helping individuals transition away from opioids like heroin or prescription painkillers in a safer and more controlled manner.

However, while Suboxone can be an effective treatment for opioid dependence, it is not without its challenges. One of the most common concerns for people undergoing Suboxone treatment is the possibility of withdrawal when the medication is stopped or tapered too quickly. In this article, we’ll look closely at Suboxone withdrawal, its symptoms, the factors influencing the experience, and the strategies for managing and possibly eliminating it.

What Is Suboxone Withdrawal?

Suboxone withdrawal occurs when someone who has been using Suboxone as part of a medication-assisted treatment (MAT) or telemedicine medication-assisted treatment (TeleMAT) program suddenly stops or reduces their dose. 

Unlike full agonist opioids (such as heroin or oxycodone), which produce strong euphoric effects and intense withdrawal symptoms, Suboxone has a “ceiling effect” due to the buprenorphine component. This means that while Suboxone can still produce withdrawal symptoms, they are typically less severe and more gradual than those associated with full opioids.

However, the withdrawal symptoms from Suboxone can still be uncomfortable and challenging to manage. The severity and duration of withdrawal depend on several factors, including the length of time someone has been using Suboxone, the dose they were taking, and their overall health and history of addiction.

“Suboxone withdrawal symptoms are typically less severe and more gradual than those associated with full opioids.”

Common Symptoms of Suboxone Withdrawal

Suboxone withdrawal symptoms can vary from mild to moderate and generally peak within the first 48-72 hours after discontinuation or dose reduction. While the symptoms are typically less intense than those from other opioids, they can still be disruptive and difficult to endure.

Some of the most common symptoms of Suboxone withdrawal include:

  1. Fatigue and Lethargy: One of the most common signs of Suboxone withdrawal is extreme tiredness. People may feel physically drained and mentally foggy, which can make it hard to concentrate or carry out daily tasks.
  2. Irritability and Anxiety: As the brain adjusts to the absence of Suboxone, people may experience mood swings, irritability, and heightened anxiety. These emotional symptoms can be particularly distressing, especially for those with a history of mental health issues.
  3. Body Aches and Muscle Pain: Muscle cramps, joint pain, and overall body aches are common during opioid withdrawal. Since Suboxone is a partial opioid agonist, it can still contribute to some of these physical symptoms.
  4. Insomnia: Difficulty sleeping is another frequent withdrawal symptom. Many individuals report trouble falling or staying asleep, which can exacerbate other symptoms like irritability or fatigue.
  5. Nausea and Digestive Issues: Nausea, vomiting, and diarrhea are common during opioid withdrawal, and Suboxone withdrawal is no exception. These symptoms can be especially unpleasant and contribute to dehydration and fatigue.
  6. Sweating and Chills: During withdrawal, the body may experience fluctuations in temperature. Sweating, chills, and goosebumps are common, and these symptoms can make it hard to feel comfortable.
  7. Cravings for Opioids: Even though Suboxone helps reduce cravings for other opioids, the psychological drive to use opioids can resurface when the medication is discontinued, especially in individuals with a long history of opioid use.

Factors That Influence Suboxone Withdrawal

Several factors influence how an individual will experience Suboxone withdrawal:

  • Duration and Dosage of Suboxone Use: People who have been using Suboxone for a long time or at higher doses may experience more intense withdrawal symptoms than those who have been on lower doses for a shorter period.
  • Tapering Process: Gradually tapering the dose of Suboxone rather than stopping abruptly can help minimize withdrawal symptoms. Healthcare providers often recommend a slow and steady reduction to allow the body to adjust without triggering severe discomfort.
    NOTE: Recovery Care uses the “10% Rule” for tapering off Suboxone. This proven, calculated Suboxone taper can greatly reduce or even eliminate the impact and length of time withdrawals are experienced. See “The 10% Rule for Tapering Off Suboxone” below.
  • History of Opioid Use: Individuals with a long history of opioid addiction may experience more intense psychological cravings and withdrawal symptoms. In contrast, people who are newer to MAT may have a smoother transition off Suboxone.
  • Physical Health: A person’s overall health, including their liver and kidney function, can affect how their body metabolizes Suboxone and how they experience withdrawal. Those with existing health conditions may need closer monitoring.

The 10% Rule for Tapering Off Suboxone

Since 2017, the owners and physicians at Recovery Care have tested multiple theories and suggestions concerning Suboxone tapering. The taper method using the 10% rule has thus far been the most effective at reducing withdrawal symptoms to a minimum. 

Two critical factors for the 10% rule::

  • The person’s dose is never reduced by more than 10%:
    A 10% reduction is small enough that the body generally does not recognize a change. Most people claim there is no discomfort whatsoever in making this dosage change.
  • Dosage changes occur every seven days but never sooner.
    Seven days between dosage changes allows the body adequate time to acclimate to the new dosage.

Use the 10% Rule Until Reaching 1mg Daily

Regardless of where the person begins their taper, the 10% rule is used over the course of weeks or months to help them reach the first major goal of taking 1mg of Suboxone daily. 

Switch to the 2mg Suboxone Sublingual Films WHen Reaching 2mg Daily

Reducing dosages accurately at or below the 2mg dosage level requires the use of the 2mg Suboxone sublingual films. These lower-dosage films can be cut into smaller, precise amounts, making it easier to taper more accurately. 

After Reaching 1mg Daily, Begin the Final Processes

After the person successfully reduces their dose to 1mg Suboxone daily and has acclimated for at least seven days, they will begin the final stages of tapering:

  • Cut the 2mg films into 4 pieces (0.5mg each)
  • Reduce the dose to 0.5 for seven days or as long as needed to acclimate.
  • Begin the final “flip-flop” stage lasting 14 days:
    • Take .05mg every other day for seven days.
    • Take .05mg every two days for seven days.
    • If minor withdrawals persist on the sixth day;
      • Take .05mg every three days for nine days.

At this time, the person should have little to no discomfort from withdrawals. However, some people claim they felt restless when sleeping for two to three days following their final dose. Most claimed any symptoms of withdrawal had ended after 4 days following their final dose.

“I have performed two Suboxone tapers:

A Four-Day Suboxone Taper – This taper occurred at a prominent inpatient treatment center in Nashville, TN. Three days after my last dose, painful withdrawals set in. They lasted for thirteen hellish days and nights, followed by two months of feeling like absolute garbage. I still can’t believe a reputable inpatient treatment center would do this to a person. It was inhumane at best.

The 10% Rule Taper (Three Months) – This was painless and is what I believe is the only humane method for tapering off of Suboxone. The 10% weekly reduction was unnoticeable. It wasn’t until my very last days of taking 0.5mg every other day that I felt any discomfort. I had restless legs two nights in a row. I then switched to 0.5mg every three days. Again, I had restless legs at nighttime three days after my final dose of 0.5mg. After that, I was finished and felt completely normal.”

Drew Bourke – Co-Owner/President  (Addict in Recovery)
Recovery Care of Columbia

Managing Suboxone Withdrawal

While Suboxone withdrawal can be uncomfortable, there are strategies and tools that can help individuals manage the process safely and with less distress.

  • Tapering Under Medical Supervision: The best way to minimize Suboxone withdrawal symptoms is to taper the medication slowly under the supervision of a healthcare provider. This gradual reduction allows the body to adjust to lower levels of buprenorphine, reducing the likelihood of severe withdrawal.
  • Supportive Care: Staying hydrated, eating nutritious meals, and getting regular exercise can help manage some physical withdrawal symptoms. Drinking plenty of fluids can alleviate nausea and prevent dehydration, while exercise can boost energy levels and help with mood regulation.
  • Therapy and Support Groups: Psychological support plays a key role in managing opioid withdrawal. Participating in individual therapy (such as cognitive-behavioral therapy) and support groups can help individuals deal with cravings, emotional distress, and other psychological aspects of withdrawal.
  • Medications for Symptom Relief: In some cases, doctors may prescribe medications to help manage withdrawal symptoms. For example, over-the-counter pain relievers can help with muscle aches, while anti-nausea medications can reduce gastrointestinal distress.

Ask Yourself; Why Am I Experiencing Subvoxone Withdrawal?

Your experiencing Suboxone withdrawals may be due to reasons not considered below. However, it is always wise to consider your options for finding a solution that eliminates or at least reduces your discomfort, such as a “10% Rule Suboxone Taper.” (see above).

Below are common reasons that people experience Suboxone withdrawals along with suggestions for overcoming them.

  • I Was Discharged from My Current Suboxone Doctor
    If you live in Tennessee and have been discharged from your current Suboxone provider, click here to register for the Telemedicine Suboxone Taper Program at Recovery Care. Recovery Care provides a 100% telemedicine program. All you need is a cell phone with wifi access. Recovery Care accepts all TennCare Medicaid and all major insurance plans.
  • My Pharmacy Will No Longer Dispense My Suboxone Medications
    The owners and Suboxone doctors at Recovery Care understand there are times when a local pharmacy may begin refusing to dispense someone’s Suboxone medications. That’s why Recovery Care has partnered with a special Tennessee pharmacy that will deliver your Suboxone medications to your door for a small overnight delivery fee. (approx. $12) Click here to register for the Telemedicine Suboxone Taper Program at Recovery Care and request your Suboxone medications be delivered to your door.
  • My Doctor Didn’t Provide a Taper Plan / My Current Suboxone Doctor Told Me to Taper At My Own Speed
    As noted above, Suboxone requires a “gradual” taper to reduce or eliminate withdrawal symptoms. If your current Suboxone provider is unwilling to provide you with a concrete tapering plan, we strongly suggest changing providers. Click here to register for the Telemedicine Suboxone Taper Program at Recovery Care to begin a slow, gradual Suboxone taper guided by doctors who genuinely want to help you with your recovery.

Need Help Tapering Off Suboxone Gradually? We Can Help!

Your recovery is precious to you. The last thing you want is to end you successful Suboxone program with painful withdrawals, and nor should you. Painful withdrawals don’t have to be a part of your tapering process. Using the guidance a trained Suboxone doctor and an effective taper can mean the difference between a successful recovery program and relapse. The Suboxone doctors at Recovery Care are interested in your comfort and well-being. Read our hundreds of Google customer reviews below to see for yourself. Your SUboxone taper should be a pleasant experience, not a white-knuckle experience. If your current Suboxone provider is unwilling to provide you with a reasonable plan for tapering off Suboxone, make the change to Recovery Care and get the help you deserve.

Register below to begin a Suboxone program or get assistance with a Suboxone Taper: