Suboxone (buprenorphine) creates a physical dependence in the brain. Stopping cold turkey usually leads to withdrawal symptoms. By slowly taking less and less of the medication, patients can come off Suboxone (or Subutex) within weeks or months without unpleasant symptoms.
Suboxone Withdrawal Symptoms
Suboxone and Subutex are partial opioids, so withdrawal symptoms are similar but milder than withdrawal from opioids like prescription pain medications or heroin.
- Low energy
- Loss of appetite
- Irritability
- Muscle weakness
- Withdrawal insomnia / Restlessness
Physical Symptoms of Suboxone Withdrawal
A tapering schedule reduces or eliminates these symptoms. No reduction in medication should be attempted until all physical withdrawal has subsided from the last dosage reduction.
Mental Symptoms of Suboxone Withdrawal
The most common mental symptoms of withdrawal are anxiety and depression.
That is why it’s so important to keep up with MAT individual and group therapy sessions. Treating all the behaviors and emotions that are unique to you will make a lasting and successful recovery possible. It is also helpful to maintain a healthy diet and a good daily routine or work schedule; exercise can be very beneficial as well.
Suboxone Taper & Relapse
Another side effect of a Suboxone taper is relapse. Suboxone was used to stop opioid receptors in the brain from sending craving signals for opioids. If cravings become intense after tapping from Suboxone, Vivitrol may offer a safety net.
While you may want to move off Suboxone quickly, being so uncomfortable in a taper that relapse occurs is the opposite of the goal.
How Long Does Suboxone Withdrawal Last?
Symptoms of Suboxone withdrawal can last from a few days to several weeks. Generally, symptoms start within 48 hours after the last dose and peak around day three.
Some patients experience mental health symptoms like anxiety, fatigue, sleep issues, mood swings and drug cravings for weeks or months after opioid/Suboxone use, which is known as Post-Acute Withdrawal Syndrome (PAWS).
A slow taper off of Suboxone helps prevent PAWS and minimizes the length and severity of all withdrawal symptoms. Patients here can attest that little to no discomfort is possible coming off Suboxone.
The Standard Suboxone Taper Schedule
It is best to work with your doctor to create a tapering schedule that is most effective for your total recovery and based on the Suboxone clinic requirements.
Everyone is different, but in general, a gradual reduction in the total daily dose (e.g., no more than 10% to 20% every one to two weeks) can be successful.
Generally Safe Suboxone Taper Chart (Aggressive)
- NOTE: These guidelines represent a timeline that helps keep the taper medically safe, but are likely quite a bit faster (more aggressive) than what is ideal.
How to Taper Off Suboxone: According to Patients
"The best advice I can give is to start with a plan, listen to your body and take your time. I found after reducing 2 mg to 1mg to 0.5mg, it became more difficult. But, keep taking your time. You’ll get there."
"I was a heroin user back in the day. Then, I was on 8mg of Suboxone for 5 years. I tapered very slowly and paid attention to what my body was telling me. I had to go back to my original does a few times. Like others say exercise and lots of water helps."
"I recommend tapering down very slowly. You will eventually get off, and you will be able to avoid feeling so sick."
Medications to Get Off Suboxone
Most patients tapering off Suboxone want to get off addiction-related medications, but withdrawals lead some to look for alternatives.
Suboxone to Sublocade
If the biggest frustration with Suboxone is the daily dosing, transitioning to Sublocade could be a good option. Sublocade is a long-acting injection of buprenorphine that is given only monthly.
Some patients cite side effects improve on Sublocade, and it helps with the daily cycles that can come with daily dosing. Sublocade should be continued for a few months but seems to give minimal withdrawal symptoms when stopped.
I was on Suboxone for 10 years and stated the switch to Sublocade at 300 mg. Then, I dropped to 100 mg of Sublocade for two more months. It’s been 12 weeks since my last shot, I haven’t any withdrawals yet, hoping to never get any!
Suboxone to Kratom (Don't Do It)
Kratom is often cited by the non-medial community as a “natural” treatment to detox off of opioids or Suboxone.
In reality, kratom activates opiate (mu-opioid) receptors in a similar way as opioids like heroin. It causes similar withdrawal symptoms and cravings as opioid use.
Research shows:
Kratom is more dangerous and addictive than Suboxone and is illegal in many other countries. Using Kratom to counteract Suboxone withdrawals is likely to cause a setback rather than stopping medication use.
"I got addicted to Kratom after being clean off heroin for 2 years. The next thing I know I’m back on heroin."
Suboxone to Vivitrol
While Vivitrol can’t be used during the Suboxone taper, it can offer a level of security to know there is a non-addictive option to help with cravings after getting off Suboxone.
Vivitrol is given as a monthly shot after fully weaning off Suboxone. The injection contains naltrexone, which is not an opioid.
Vivitrol doesn’t involve withdrawal symptoms when stopped and comes with limited to no side effects. It is a great option to ease the transition of opioids.
Learn more about the transition from Suboxone to Vivitrol.
Suboxone to Methadone
Since methadone is also habit-forming, taken daily and actually requires more in-person visits, a switch from Suboxone to methadone usually defeats the goal of reducing medications or inconvenience. The switch, however, is straightforward.
See also: Switching From Suboxone To Methadone
Need Help With Your Suboxone Detox?
Our Medication-Assisted Treatment (MAT) doctors actually listen and can help you taper off Suboxone quickly without withdrawals.
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1 2 3 … 14 MORE ›What is the average dosage to begin with for opoid addiction and chronic pain of headaches (migraines)?
The range of Suboxone dosing is between 8 mg and 32 mg daily. The first day, Suboxone is usually dosed up to 8mg, and by the second day it is increased up to 12 or 16 mg. There are many different approaches to Suboxone dosing, with 16 mg being an average. There is limited evidence to support doses above 24mg being helpful for most people, as the risks start to outweigh the benefits for many. This applies to opioid addiction and chronic migraine/headache pain.
Only a doctor could answer that correctly, but seems the average dosage many folks start with for MAT medical-assisted detox is the 8/2 sublingual strips. That was way too much for me, but everyone is different.
I’m currently on half milligram every 30 hrs. The ws seem to start then, cold chills, runny nose, sneezing 5 times always 5! Lmk if I should keep going or find help. My doctor went outta business and I lost my insurance.
Hi I’m going to start tapering down from 8 mg a day… I’m going in for elective surgery local anesthesia with IV sedation at the end of the month has anyone has surgery with a twilight sedation the dr told me to start weening off then stop 3 days before procedure how can I do this in less then a month did anyone have to stop suboxone for surgery … thank you
Hi Pat,
At Symetria, we only recommend lowering your Suboxone (buprenorphine) dose for “big” surgery like a knee replacement, and even then, lowering to 12mg. For a surgery requiring local anesthesia with IV sedation, and being at 8mg a day, you should be able to stay on your regular dose, except the day of surgery. Perhaps ask to speak with the anesthesia team so your entire care team is involved and doing what’s best for you.
Im 19 week pregnant and on suboxone. I started last Christmas on 24 mg and now as of today im down to 2 mg. I slept ruff last night anf was up by 5AM when usually I sleep till 8AM or so. I know its cause im tapering myself off…What do you think?
Hi Kim,
At Symetria, we recommend pregnant women maintain their stable dose but switch to Subutex (buprenorphine without naloxone). We also recommend mothers increase their dose as needed as the fetus grows and increases the mother’s base demand. Tapering off buprenorphine puts the fetus in distress. Rushed tapers also often to lead to relapse, which puts both mother and baby at risk. I strongly suggest you consult with a doctor specialized in buprenorphine before changing your dose further.
I have been off suboxone for a month now and still have withdrawal symptoms like runny nose, severe soul crushing anxiety and diarrhea. Some days are better than others, but when will this finally stop?
It depends on when you started feeling withdrawal after stopping the Suboxone. It’s very rare to be feeling physical withdrawal symptoms (i.e. diarrhea, runny nose) lasting longer than 3 weeks. However, the emotional and psychological withdrawal symptoms (i.e. anxiety, depression, irritability, decreased motivation, decreased focus/foggy thinking) can sometimes persist for months after stopping any long-term opioid use, including Suboxone. This is called Post Acute Withdrawal Syndrome (PAWS). This may explain why you are still having severe anxiety. I’d recommend you contact the medical provider who was managing your Suboxone for further evaluation and guidance.
It’s took me a solid 2 months to not feel any withdrawls
I’ve been taking suboxone for two days after being on hydrocodone for three months, but I want to stop it all. I’m at 8 mg a day how can I stop? I have 2 strips left and won’t have any more after that.
Using Suboxone to detox yourself off of hydrocodone, and then getting off of Suboxone quickly sounds freeing, but patients that continue with the Suboxone for at least several months before deciding to slowly taper off will do better in the long run. They will have more time to address the issue that led them to use hydrocodone in the first place, as well as having less opioid withdrawal and a lower risk of returning to substance use. If you still wish to stop the Suboxone now, having only 2 strips left is not enough for a taper, and you will end up feeling bothersome opioid withdrawal. Either way, I’d suggest following up with your Suboxone provider or clinic to get more medication.