Suboxone is a combination opioid prescription medication used primarily to treat OUD or opioid use disorder. It’s composed of two medications: buprenorphine, a semi-synthetic narcotic, and naloxone, an opioid antagonist used to reverse opioid overdose. Naloxone is present in the Suboxone formula mainly to discourage intravenous abuse of buprenorphine. This article will discuss the following question: what are Suboxone withdrawal symptoms?
Suboxone was approved in 2002 for the treatment of OUD. Prior to that, the only narcotic-based legal medication for OUD was methadone. Although highly effective for both the treatment of pain (no OUD involved) and OUD itself, methadone comes with some serious limitations:
- It can only be dispensed at licensed methadone clinics, which may not be located nearby
- It must be dispensed on a daily basis, taking time away from work and home life
- It’s a full narcotic with a higher overdose potential
- It cannot be prescribed for home use for OUD except under very limited circumstances
In contrast, Suboxone:
- Is in a lower controlled substance class and may be prescribed on a monthly basis for at-home use
- It’s a partial narcotic, rarely causes euphoria and is safer than methadone
But, Suboxone still has limitations, too. It can only be prescribed by a doctor with an X number. This means the doctor has completed a special class to be certified to prescribe the drug. Doctors without an X number may not legally prescribe Suboxone for opioid maintenance purposes. Again, these special Suboxone doctors may not be located near you. It’s also possible the doctor may not be able to accept more Suboxone patients because there’s a quota. This is typically around 100 patients. If the doctor’s quota is full, you will need to either wait for an opening or find another Suboxone doctor. That is, if you can. The system doesn’t make much sense. Why make people who need and want help wait?
Suboxone has another important limitation that doesn’t apply to methadone, too. It can only be started after full withdrawal symptoms are present. This typically means some 24 to 48 hours of waiting in opioid withdrawal misery. Beginning Suboxone too soon can cause even more severe withdrawal symptoms as part of a syndrome known as PW or precipitated withdrawal. PW is the worst kind of opioid withdrawal and has no real treatment other than time.
Suboxone Withdrawal Symptoms
The buprenorphine in Suboxone is a partial narcotic. This means that in contrast to other full narcotics like morphine, fentanyl and oxycodone, buprenorphine can only partially activate the brain’s opioid receptors. These are called the mu, the delta and the kappa. It’s the mu we’re most concerned with here, the receptor most associated with addiction and withdrawal.
Although not a full narcotic, buprenorphine is still addictive and fully capable of producing a set of most unpleasant withdrawal symptoms if suddenly stopped. Withdrawal symptoms may also occur if the dose is suddenly reduced by too much too fast:
- Stomach pain
- Intestinal cramps
- Restless leg syndrome
- Bone and muscle pain
- Depression, anxiety and drug cravings
Once the brain has become dependent on an opioid of any type, physical and chemical changes occur. The brain cannot function normally without the presence of the narcotic. Acute withdrawal symptoms typically subside within seven to 10 days, however, they can persist for up to a month and more.
The best way to avoid severe withdrawal symptoms, other than avoiding opioids altogether, is to reduce the dose very slowly. It’s not a race. You can liken getting off opioids to losing weight in that like the excess weight, the drug dependence did not occur overnight. It will take time for your body to adjust. It’s best to just accept that, and follow your doctor’s recommendations for a drug taper.
Suboxone can be tough to withdraw from. Tapers taking up to a year are possible in some circumstances.
Let us Help
If you still have questions about Suboxone or Suboxone withdrawal, call us anytime at 833-497-3812. We’re a group of trained drug counselors able to answer all your questions about Suboxone and other drugs. We can help you find a Suboxone clinic near you if you decide that Suboxone therapy may be the right choice for you. Help is available 24 hours a day and is just a phone call away.