Suboxone plays a vital role in opioid addiction recovery, but it’s not meant to be a forever medication. Whether due to side effects, long-term goals, or readiness to be medication-free, many people eventually choose to taper off.
Understanding the risks of Suboxone withdrawals and how the drug works is the first step in making a safe and informed plan to stop.
What is Suboxone?
Suboxone is the brand name for buprenorphine, which is a medication used in treating opioid addiction and opioid use disorder (OUD) [1]. First developed in the late 1960s, buprenorphine was one of the first medications ever to be used in treating opioid use disorder. However, Suboxone hit the market in 2002 following FDA approval, after more than 30 years of research and development. Suboxone is made of an alkaloid compound from poppies and is categorized as a Schedule III drug. Along with the treatment of OUD, it is also used for pain management [2] and to relieve withdrawal symptoms. Buprenorphine, or Suboxone, is also known as a partial agonist. In drug treatment, agonists are drugs that block opioids by attaching to opioid receptors without activating them. A partial agonist, like buprenorphine, carries out this function, but to a lesser degree than a full agonist. There are also antagonists that cause no opioid effect but still block opioids and attach to the brain’s opioid receptors; naloxone is an example of an antagonist [3]. Suboxone is a film or tablet that you place inside your cheek or under your tongue. It can be administered in a clinical setting or prescribed for use at home. Because it is a Schedule III drug, there is a lower chance of abuse and overdose. Suboxone is typically used once withdrawal symptoms have started or drug abstinence has begun. Although Suboxone has many benefits in a person’s recovery journey, it could increase the risk of dental complications, like tooth decay, cavities, or oral infections.Buprenorphine and Naloxone are Combined to Fight Addiction and Dependence
Suboxone is unique in that it isn’t only buprenorphine. It also contains naloxone. These two substances are typically combined in order to fight drug addiction and dependence. When used together, they can yield successful results in detoxification from opioids. The dual use of these drugs is also associated with greater retention in drug treatment programs and rehab, a lowered relapse rate, and fewer overdoses than placebos [4]. Suboxone is used to treat many kinds of addictions, including addiction to fentanyl, heroin, hydrocodone, morphine, or oxycodone.What Is the Ceiling Effect?
In drug treatment and addiction recovery, the ceiling effect refers to the occurrence where a drug’s impact on the body plateaus. This means that although higher doses can be taken, it does not increase its effect. Full agonists have no drug ceiling effect, while partial agonists do have a drug ceiling effect. As a result, some addiction medications, like buprenorphine/naloxone (Suboxone), have a drug ceiling effect because they are partial agonists. Because partial agonists do have a limit to how they affect the body, they are commonly used in patients who do not have a strong tolerance to opioids and can be administered either by a medical staff or by the patient themself at home. On the contrary, full agonists completely activate opioid receptors and do not have a drug ceiling effect. While successful in the treatment of addiction, full agonists are more potent and, therefore, must be administered carefully by medical staff. Full agonists are commonly used for patients who have been using substances for a long time and have become dependent on higher doses of opioids [5].Abuse Potential
Suboxone is a Schedule III drug, which means the abuse potential for it is low. Although they aren’t the drug with the lowest abuse potential, like Schedule V, they still are not at high-risk of causing physical or psychological dependence. Other examples of Schedule III drugs include Tylenol with codeine, anabolic steroids, or testosterone [6].Can You Get Addicted to Suboxone?
Some worry that using Suboxone is just “swapping one addiction for another.” However, this is not the case. Although Suboxone is used in place of opioids to help drug addiction patients taper off and get clean, it is not a substance that is addictive. The FDA classifies it as a Schedule III drug, which means it has a moderate to low risk for abuse and addiction. However, there may still be risks in taking it.Suboxone Dependence
Although it is possible to develop a dependence on Suboxone, addiction is extremely unlikely because of the drug’s ceiling effect. This means that after a certain amount, you won’t feel any effects. Drugs without a ceiling effect are more likely to cause dependence or addiction because their effects can keep getting more intense the more you increase the dosage [7].Suboxone Withdrawal Timeline
Although it is not usually considered addictive, Suboxone can still have withdrawal effects if it is stopped suddenly. These Suboxone withdrawals symptoms can include:- Vomiting and nausea
- Headaches and other body aches
- Insomnia or lethargy
- Digestive distress and indigestion
- Anxiety
- Depression
- Irritability
- Drug cravings
- Fever
- Chils
- Sweating
- Difficulty concentrating
- Within the first 72 hours, withdrawals begin, and the physical symptoms are the most intense during this time.
- After one week, a person might experience bodily aches and pains, insomnia, or mood swings
- At two weeks, a person may experience depression or other psychological side effects.
- After one month, cravings and depression can occur but typically dissipate.
How to Stop Taking Suboxone
The best way to stop taking Suboxone is to wean off it using a taper method. This is because stopping it cold turkey could lead to an onslaught of uncomfortable withdrawal symptoms. Although Suboxone is supposed to help patients, there could be a time where you feel like it is not right for you. If you are trying to determine whether or not you should stop taking Subozone, consider the following. Stop taking Suboxone if you are:- Showing signs of an allergic reaction
- Having difficulty breathing or swallowing
- Exhibiting overdose signs
- Having surgery
- Pregnant or nursing
- Experiencing side effects that are too difficult to manage
- Continuing use of substances or other drugs
Suboxone FAQs
What happens if you run out of Suboxone?
If you run out of Suboxone, you may begin to experience withdrawal symptoms from opioid dependence, such as anxiety, muscle aches, irritability, and cravings. It’s important to contact your healthcare provider to discuss a plan for managing your treatment and to avoid sudden discontinuation, which can worsen symptoms.Is Suboxone hard to get off of?
Getting off Suboxone can be challenging for some individuals, as it involves tapering off the medication to avoid withdrawal symptoms. Suboxone is designed to help manage opioid dependence, but the process of discontinuing it requires careful guidance from a healthcare provider. Gradually reducing the dose can help ease Suboxone withdrawals symptoms and make the transition smoother.What happens when you stop Suboxone suddenly?
Stopping Suboxone suddenly can lead to withdrawal symptoms, which may include body aches, anxiety, nausea, insomnia, and intense cravings. Sudden cessation can also increase the risk of relapse. It’s highly recommended to work with a healthcare provider to taper off the medication gradually rather than stopping abruptly.What is the timeline for Suboxone withdrawal?
Suboxone withdrawals typically begins within 24-48 hours after the last dose and may peak around 2-3 days. Symptoms can last for a week or longer, depending on factors like the dosage and length of use. Some people may experience lingering psychological symptoms, such as cravings and mood changes, for weeks after the physical symptoms subside.Get Compassionate, Evidence-Based Addiction Treatment at California Detox
When it comes to helping treat opioid use disorder, one of the best ways to do so is through medication-assisted treatment (MAT). That’s where medications like Suboxone come into play. If you or someone you care about is struggling with opioid use disorder, find compassionate, evidence-based MAT at California Detox. Our treatment centers are recognized as some of the best in Southern California, thanks to our dedicated team, proven therapies, and luxurious amenities. At California Detox, we prioritize each patient’s individual needs, recognizing that there’s no single approach to overcoming addiction and achieving lasting recovery. That’s why we tailor every treatment plan to fit the person’s unique needs, using proven methods such as:- Medication-Assisted Treatment (MAT)
- Motivational Interviewing
- Dialectical Behavior Therapy (DBT)
- Cognitive Behavioral Therapy (CBT)
- Adventure Therapy
- Close proximity to the beach
- Gourmet, catered meals
- 24/7 compassionate care
- Yoga and breathwork sessions
- Beach views from every room
- Pet-friendly accommodations
- On-site gym access
