How to Successfully Taper off Suboxone (+ Timeline)

Medically Reviewed by: Charley Allen

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How to Taper off Suboxone 

Opioid addiction is notoriously difficult to treat. This is due to the intensity of the withdrawal symptoms. However, certain medications are available that blunt the effects of withdrawing from opioids. One of these medications is suboxone. This article explains how to successfully taper off Suboxone and the timeline for the same.

Suboxone is a combination of buprenorphine and naloxone. Both substances have different effects on opioid receptors in the brain. Buprenorphine is a “partial opioid agonist,” meaning, like drugs of abuse, it partially activates opioid receptors in the brain. However, its effect is very limited, so it is difficult for addicts to use buprenorphine to get high.

Nonetheless, injecting buprenorphine alone can result in a high, which is why naloxone is added. Naloxone is an opioid antagonist, meaning it blocks the effects of opioids. According to the Substance Abuse and Mental Health Services Administration, if suboxone is injected, the naloxone aspect will cause an addict to enter withdrawal immediately rather than experiencing any possible high from the buprenorphine. This makes suboxone a relatively safe substance.

Ceiling Effect of Buprenorphine

One reason suboxone is so successful in treating opioid addiction is that it has a “ceiling effect.” This means that, as the dose increases, there is less and less of an effect on the body. So, even if an addict takes multiple doses of suboxone, they will not experience any more relief than what they do with the smallest dose. This makes it very difficult to abuse suboxone and reduces the chances of relapse.

How to Taper off Suboxone?

Even though Suboxone is an effective medication for addiction treatment, it can create physical and psychological dependence. Addiction to Suboxone can cause serious problems if not taken seriously. Withdrawing from suboxone requires a methodical plan and treatment program.

It is best not to quit it cold turkey, or extreme withdrawal symptoms can occur. Like many drug and alcohol addictions, suboxone addiction is best treated with a tapering program to limit the intensity of the withdrawal symptoms.

Like substance abuse treatment for other drug addictions, quitting suboxone can be supported by enrolling in a detox program or other treatment center. That way, addicts can follow a tapering schedule under the guidance of a treatment professional and medical supervision.

It is also important for withdrawing addicts to have access to counseling and the social support system that residential treatment programs provide. This is because the most dangerous side effect of withdrawing from suboxone is the high possibility of relapse on more serious opioids.

Suboxone Withdrawal Timeline

Suboxone withdrawal has many symptoms, such as mood swings, depression, insomnia, and difficulty concentrating. The intensity and length of the withdrawal period depend on how long it has been taken and in what doses. Most people will experience the most intense withdrawal symptoms after 24-72 hours without the drug.

It is important to get professional help when tapering off Suboxone. A doctor or treatment professional can help create a timeline for the taper, so the addict knows how much to take and when to reduce the dose. Generally, the taper should start with 10-20 percent reductions in dosage every four to seven days; however, this is completely dependent on individual tolerance levels.

Suboxone is generally withdrawn over the course of 7 to 28 days. Studies on the efficacy of short-term vs. long-term tapering schedules conflict. However, whether an addict follows a 7-day or a 28-day taper, the withdrawal will generally progress along similar lines.

After Approximately 3 Days

Suboxone withdrawal symptoms begin. These symptoms include muscle aches and pains, sweating, and chills. During withdrawal, digestive issues are common. Addicts can experience stomach cramps, diarrhea, nausea, or vomiting. They might also experience tremors, twitching, teary eyes, runny nose, and gooseflesh. Psychological symptoms include restlessness and anxiety.

Between Days 3 and 5

Physical symptoms peak. At this point, most of the drug has left the body. As a result, the body and brain go into full-blown withdrawal. The physical symptoms will peak. Don’t worry! After this, things will begin to improve every day!

After 1 Week

After 7 days, most of the physical symptoms have begun to disappear. Certain minor physical symptoms, such as body aches and pains, may linger past this point. However, many psychological symptoms and cravings associated with withdrawal will remain.

1 Week to 1 Month

After the physical withdrawal has ended, addicts are generally beset by psychological symptoms. This can manifest as anxiety, depression, insomnia, and dramatic mood swings. Cravings for opioids can continue to plague the addict, though, after one month, the frequency and intensity of the cravings usually begin to subside. Even after one month, however, it is common for addicts to experience mild anhedonia, which is a condition where pleasure and happiness feel out of reach.

After 1 Month

After 1 month, withdrawal symptoms continue to disappear. However, at this point, the chances of relapse are at their highest. Ultimately, relapse is the most dangerous symptom of suboxone withdrawal, as suddenly returning to a drug of choice, such as heroin or oxycodone, can lead to overdose and/or death. This is why proper buprenorphine treatment is essential for a successful suboxone taper.

After Tapering off of Suboxone

Over the long term, there is always the potential for another relapse with an opioid drug. While taking suboxone can enable an addict to withdraw more gently and greatly increases the chances of recovery, it is important for addicts to remain involved in a recovery program. This can mean being active in a 12-step program such as Narcotics Anonymous or living in a sober home.

That way, recovery professionals can monitor you and answer your questions as you work on yourself and build a new sober life from the ground up. Ultimately, withdrawing from suboxone takes a very short period of time, but recovering from opioid addiction and dealing with the psychological effects of opioid withdrawal is a lifelong process.

What is Opioid Use Disorder?

Opioid use disorder is a mental health condition in which an individual has difficulty controlling their use of opioids, such as heroin or prescription painkillers. It is characterized by compulsive drug-seeking and using behaviors despite harmful consequences.

Symptoms of opioid use disorder include tolerance to the substance, withdrawal symptoms when not taking the drug, increased amounts taken over time, and an inability to control the use of opioids. People suffering from opioid use disorder often struggle to meet their obligations at work or school, have problems with relationships, engage in risky behaviors, and experience physical health problems due to drug use. It is important to note that opioid use disorder is treatable and can be managed through medication.

Read Further:

Long-term Side Effects of Suboxone

Frequently Asked Questions

Taper off Suboxone slowly and gradually with a proper suboxone tapering schedule. Starting with 10-20 percent reductions in dosage every four to seven days is a good way to approach the taper. Trying to taper off quickly will cause more intense withdrawal symptoms and increase your risk of relapse.
Tapering off Suboxone at home is possible but not recommended. Tapering off should be done with the help of a medical professional, who can provide support and advice to ensure you are tapering safely. If tapering at home, it’s important to have a plan of action in place and access to doctors or other medical professionals if needed.
The approach to tapering off buprenorphine is the same as for Suboxone. Start with 10-20 percent reductions in dosage every four to seven days, and ensure you have access to medical help if needed. Buprenorphine can be more difficult to taper than other opioids due to its long half-life, so it is important to work with a familiar doctor.
The best way to get off buprenorphine is through a gradual, supervised taper. This should be done with the help of a medical professional who can provide support and advice to ensure you are tapering safely. If using at-home methods for tapering, it’s important to have a plan in place and access to doctors if needed.
Weaning off buprenorphine should be done slowly and gradually, with 10-20 percent reductions in dosage every four to seven days. Do not wean off too fast, as this could lead to more intense withdrawal symptoms and an increased risk of relapse. 

It is important to have access to medical help and work with a doctor familiar with buprenorphine and opioid addiction in general. With the right support, it is possible for addicts to wean off buprenorphine and start the process of recovery successfully.

Opioid withdrawal is difficult for many reasons. First, opioid drugs are very addictive, so the body and brain can become physically dependent on them. This leads to intense physical withdrawal symptoms, such as muscle cramps, nausea, sweating, and insomnia. It also leads to long-term substance abuse after the initial dose.
Suboxone tapering usually falls between mild and moderate on the clinical opiate withdrawal scale. Tapering typically begins with a 10-20 percent reduction in dosage every four to seven days, which can result in some mild withdrawal symptoms.
Suboxone drug abuse can lead to physical opioid dependence. Suboxone is an opioid in and of itself, so people may become dependent on it with continued use. It is important to taper off Suboxone gradually and with the help of a medical professional in order to avoid withdrawal symptoms and reduce the risk of relapse.
A tapering schedule helps with withdrawal symptoms by gradually reducing the body’s dependence on opioids. By tapering off slowly, the body has time to adjust without being overwhelmed by intense withdrawal symptoms. Additionally, a taper schedule allows medical professionals to monitor and intervene if needed, helping people stay on track to complete their taper goals
Medication-assisted treatment (MAT) is available for suboxone addiction, including buprenorphine and naltrexone. Buprenorphine helps to ease withdrawal symptoms, while naltrexone blocks the effects of opioids and reduces cravings. Both medications can be part of a comprehensive treatment plan that includes therapy, counseling, and support groups.  It is important to have a plan and access to doctors or other medical professionals if needed. MAT can help individuals stay on track while they taper off of suboxone and begin the journey toward recovery.
  1. Virk MS, Arttamangkul S, Birdsong WT, Williams JT. Buprenorphine is a weak partial agonist that inhibits opioid receptor desensitization. J Neurosci. 2009 Jun 3;29(22):7341-8. doi: 10.1523/JNEUROSCI.3723-08.2009. PMID: 19494155; PMCID: PMC2752300.
  2. Tripathi BM, Hemaraj P, Dhar NK. Buprenorphine withdrawal syndrome. Indian J Psychiatry. 1995 Jan;37(1):23-5. PMID: 21743710; PMCID: PMC2970944.
  3. Dydyk AM, Jain NK, Gupta M. Opioid Use Disorder. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553166/

Author

Edited by: David Beasley

David Beasley - Design for Recovery

RADT
David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen
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LMFT
Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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