Suboxone dependence is a major concern for substance abuse patients and professionals alike. Not only do patients need to go through the disturbing experience of opioid detox, but they might also develop a dependence on their medication.
Patients can safely take Suboxone for a prolonged time. However, some patients who are susceptible to psychological dependence, or those who don’t require large doses of Suboxone to manage their opioid withdrawal symptoms, can gradually be put off the drug through Suboxone detox programs.
Understanding what Suboxone withdrawal entails and why it’s an important step in recovery for some people is the first element of the detox process. So, keep reading this guide for all the information you need.
Table of Contents
What Is Suboxone?
Suboxone is a combination of two agents, buprenorphine and naloxone, used in medication-assisted treatment (MAT).
This drug can be a lifesaver for patients suffering from opioid addiction. Medical professionals prescribe Suboxone to patients who are dependent on high doses of opioids. It reduces the severity of opioid withdrawal symptoms during recovery.
To explain, the first active agent in Suboxone is buprenorphine, a partial opioid agonist. It activated some opioid receptors, particularly the mu receptor, which is responsible for the physical symptoms of opioids.
However, buprenorphine is a kappa receptor antagonist, blocking the sedative and euphoric effect of opioids binding to this receptor.
As for naloxone, it is an opioid receptor antagonist. It displaces opioids from the receptors, deterring drug abuse patients from relapsing. This agent is also used in opioid overdose cases.
Since Suboxone has some stimulative effect on opioid receptors, it has a potential for dependency as well. While Suboxone misuse is uncommon, patients might have a hard time quitting the drug.
How Suboxone Detox Works
Suboxone detox is a program that aims to help opioid abuse patients quit all medication-assisted treatment.
Patients might continue on Suboxone indefinitely, especially those with severe dependence on opioids. That said, some professionals prefer their patients quit Suboxone a couple of months into recovery, completely cutting their reliance on opioids.
The opioid withdrawal symptoms of Suboxone aren’t as severe. In fact, Suboxone doesn’t produce any psychological symptoms during detox, since it has no action on the kappa opioid receptors.
Still, it’s important to understand that buprenorphine is a long-acting opioid. Unlike morphine or fentanyl, it stays in the patient’s system for longer, with a half-life of 38 hours. So, the withdrawal symptoms might be less harrowing, but they last longer.
Elements of Suboxone Detox
Suboxone detox can take a physical and mental toll on a patient, especially since most patients who are reliant on this medication have already gone through opioid withdrawal.
Accordingly, medical professionals’ main goal for Suboxone detox isn’t just to get rid of the drug in the system and eliminate the physical dependence, but it’s also to make the experience as comfortable as possible. This way, there’s less risk of relapses.
At-Home Detox
Detoxing from Suboxone at home is typically safe. The main concern professionals have is engaging in opioid misuse or relapse due to the withdrawal symptoms of Suboxone.
It’s recommended that patients still consult a doctor before attempting to go through home Suboxone detox.
That’s because Suboxone is a part of opioid detox. It can also be safely consumed indefinitely if there’s a risk of substance abuse relapse. For this reason, only doctors can assess whether the patient is at an appropriate stage in their recovery journey.
Furthermore, patients must adequately prepare their homes for the detox process. Their living area must be free of opioids and triggering substances. They must also follow a carefully designed opioid tapering plan.
Inpatient Detox
Numerous facilities offer inpatient medical care for Suboxone withdrawal. These programs provide an optimal withdrawal environment.
For starters, patients don’t have the added stress of preparing their homes for the detox or engaging in stimulating activities to keep their minds off the intense cravings.
Suboxone detox programs allow the patient to safely get rid of their physical dependence, as well as prepare them psychologically in case of urges.
Additionally, inpatient detox is ideal for patients with underlying medical or mental conditions. Medical professionals can monitor substance abuse patients and adjust their other medications accordingly.
Medical Aid
Typically, opioid addiction patients get prescription medication for the withdrawal symptoms. Well, in the case of Suboxone withdrawal, patients can’t receive any opioid analogs.
That’s because Suboxone itself is a prescription medication used in MAT. The best course of action would be to slowly taper the Suboxone doses, instead of quitting it cold turkey or substituting it for another opioid agonist.
Patients will also receive various over-the-counter medications to alleviate the withdrawal symptoms of Suboxone. These drugs include NSAIDs, vitamins, and antihistamines.
Emotional Support
Addiction recovery requires plenty of emotional support, especially if a patient is attempting to be drug-free.
Not only does the help of the patients’ friends and families ease the psychological symptoms, but it also keeps them motivated in their journey.
Having a support system can also significantly prevent relapse, as well as make the physical withdrawal symptoms more comfortable.
Dual-diagnosis patients are in particular need of emotional support. Their psychological state might worsen during Suboxone detox, and the sudden change in environment and routine can be somewhat intolerable.
Symptoms of Suboxone Detox
Suboxone withdrawal symptoms are similar to those of opioid withdrawal. Yet, the psychological symptoms are more manageable, and patients exhibit minor drug cravings.
Alternatively, the physical symptoms are somewhat identical to patients with opiate dependence.
The severity of the symptoms depends on the extent of Suboxone dependence and the dose the patient is used to. Moreover, patients quitting Suboxone cold turkey will typically experience tougher symptoms, as their bodies won’t have time to adjust.
The symptoms of Suboxone withdrawal include the following:
- Diarrhea
- Vomiting
- Abdominal cramps
- Sweating
- Nausea
- Chills
- Fever
- Muscle aches
- Runny nose
- Anxiety
- Insomnia
- Irritability
Suboxone Detox Timeline
Understanding what to expect during Suboxone detox can make the withdrawal process much more bearable. The reason is that patients will understand when their symptoms should occur, and when they’ll dissipate.
Suboxone has a relatively long half-life, which means it stays in the body for longer. In turn, patients will begin to experience withdrawal symptoms 72 hours into the detox.
However, patients who are on high doses of Suboxone might get headaches, nausea, and vomiting after only 24 hours.
By 72 hours, the withdrawal symptoms are at their worst, with patients experiencing mood swings as well as dehydration due to excessive vomiting and diarrhea. That’s why hydration and electrolyte balance are crucial starting with the third day of detox.
The physical symptoms should last for about ten days, decreasing in severity over time. On the other hand, the psychological dependence symptoms will begin to appear.
These include insomnia and irritability. While the emotional symptoms aren’t as severe as with other opioid detoxes, they may last for up to two months.
Why Suboxone Detox Is Important
It’s important to understand that continuous use of Suboxone is safe. There’s also no shame in relying on this medication to curb opioid use.
Stopping Suboxone is a decision that patients must make on their own terms, and after consulting with their therapist.
Usually, patients prefer to go through Suboxone detox for the following reasons:
Becoming Drug-Free
Many individuals dislike the idea of taking synthetic medications. Relying on these drugs can make patients feel like they’re not in control.
Some patients might not be in need of prolonged use of Suboxone, as their opioid dependence wasn’t that severe. Additionally, patients can also achieve a lot of progress in recovery, making MAT obsolete. So, they can start their drug-free life by tapering the medication.
What’s more, holistic approaches are increasing in popularity every day. Accordingly, patients might prefer to use natural methods rather than continue taking prescription medication.
Developing Suboxone Dependence
Suboxone doesn’t provoke dependence or tolerance like other opioids, especially short-acting ones. Still, patients, particularly those suffering from underlying mental conditions, might become reliant on Suboxone.
These patients might find themselves experiencing intense drug cravings if they accidentally miss a Suboxone dose.
In this case, Suboxone detox might be recommended, as well as dealing with the patient’s triggers.
Risk of Relapse
The main purpose of Suboxone is to keep opioid use at bay. However, having opioids on hand can be a contributing factor to relapse.
That’s because substance abuse patients might misuse the drug by increasing the dose. After a while, the Suboxone dose might not be satisfying enough, prompting the patient to turn to opioid use.
Factors Affecting Suboxone Detox
Each patient has a different experience during detox. This depends on their outside environment, their mental state, and other factors that include the following:
Treatment Plan
Symptoms of Suboxone withdrawal last for a long time as is. For this reason, professionals might prefer their patients to go through withdrawal at once, instead of tapering the medication.
Then, patients should expect the withdrawal symptoms to be severe, as their bodies will have to adjust to having no opioids overnight.
In contrast, gradually decreasing the dose of Suboxone until the patient no longer needs it will ease the withdrawal symptoms. However, the detox will go on for months.
Severity of Suboxone Dependence
Patients who receive a low dose of Suboxone will naturally be less dependent on the drug.
Alternatively, the length of MAT using Suboxone inversely correlates to the severity of the withdrawal symptoms.
While patients won’t have developed dependence or tolerance to naloxone and buprenorphine, they might be experiencing post-acute withdrawal syndrome from their opiate detox.
Accordingly, the quicker the patient is put off Suboxone, the higher the probability of psychological symptoms and, thus, opioid relapse.
Underlying Mental Conditions
The psychological symptoms of Suboxone detox are tolerable, compared to other opioids. Yet, if a patient has a dual diagnosis, they might find the detox process rather triggering. Not only will the withdrawal symptoms be more difficult, but their mental health condition might worsen.
What to Expect After Suboxone Detox
After successfully undergoing Suboxone detox, patients will have substantially progressed in their recovery.
Still, addiction treatment is everlasting. Substance abuse patients need to constantly take the necessary measures to prevent relapses and continue their journey.
Here are all the steps that patients can go through after becoming drug-free:
Recovery
The chronic nature of addiction means that patients must always be on the recovery path. Recovery doesn’t just include detoxification and hospitalization, though.
Instead, patients can advance through their recovery journey by always keeping in touch with the community. They can attend group meetings, volunteer in addiction centers, or even sponsor other patients who are on the recovery path.
Therapy
Therapy is a crucial element of recovery. It helps patients get in touch with their emotions, understand their triggers, and manage their urges and cravings.
Moreover, therapy is one of the ways patients can get through the traumatic experience of addiction and detox. They’ll process their emotions in a healthy manner, and learn to accept their past and mistakes.
Lifestyle Changes
Lastly, substance abuse patients must undergo drastic life changes at every step of the recovery process. After Suboxone detox, it’s crucial to keep away from opioid agonists and other euphoric substances.
Many patients can take becoming drug-free a step further, completely quitting over-the-counter medication, alcohol, and even coffee! This way, they can restore their sense of control.
Wrapping Up
While many patients can use Suboxone on a long-term basis without any medical issues or emotional dependence, others prefer to go through recovery completely drug-free. Therapists might also recommend that their patients be put off this medication if they no longer have the need for it.
Suboxone detox is typically longer than opioid detox. Since the long-acting medication doesn’t have any psychological effect, the psychological withdrawal symptoms are minimal.
Accordingly, patients might quit this drug cold turkey, or taper it. Some patients might also go through a home detox safely. The most important part, though, is having the knowledge and emotional support needed to go through this difficult experience.
Published on: 2023-11-24
Updated on: 2024-06-10