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
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148 Comments
Is anything beneficial to taper off completely without suffering? I’ve gone from 16mg down to under 4mg, and I still can’t seem to lower it without constant twitching of my legs and arms, especially when trying to sleep at night.
Best advice I can say is when you start have a plan. Know your history, listen to your body and take your time. Set goals and take your time. You’ll get there. Good luck!
Constant twitching of your arms and legs is called Restless Leg Syndrome, I have had it since I was 17. I am 67 and I was on Oxyicodeine for a herniated disc, I am now on 2mg of Suboxene. I take Pramipexole for Restless Legs and also Restless Arms. But be careful, I took to much and did not wake up for 5 days, I almost died, but I was lucky. Taken properly it is a godsend. Talk to your Doctor. Good Luck.
I’ve been taking suboxone for about a year and a half but have never exceeded over 4mg per day. How difficult do you think it would be to stop cold turkey?
I I’ve been taking 8 mg / 2 many grams since 2009 my doctor took me off of them for having an extra benzo in my system abruptly I have a few left over how can I detox safely
I only been on subs for 4 months and at my clinic they didnt help with tapering down so i did it in my own way to the point i was taking an 8th piece of 8mg for the last week and Its been 4 days since my last dose and so far my withdrawal symptoms are sweats and random anxiety . Feeling much better than the first 3 days. Since I have been on them for 4 months straight will it be easier for me rather than someone that’s been dependent on it for a year ??
I have been taking subutex for about 2, maybe 3 years now almost. I do half of an 8mg tablet a day. I don’t want to be on them but am scared to death to come off cold turkey due to work and everything else I still have to do in life. So I want to taper off but I’m not sure how to even start. Can anyone help? I also snort them since I don’t like taking pills and so I do about 2mg in the am and other 2mg at night. Someone please help..!