In this article, I’m going to teach you everything you need to know about the use of Suboxone for opiate withdrawal. Over the past several years, many people have asked me the question:
“Does Suboxone work for opiate withdrawal?”
The answer is “yes” – but only if the Suboxone is used correctly.
If you use Suboxone too soon after taking your last opiate, you will experience a phenomenon called “precipitated withdrawal,” which is a HORRIFIC experience.
I’ll discuss precipitated withdrawal and how to avoid it in detail later. But before I cover this, I’m going to explain how Suboxone is able to help you get rid of opiate withdrawal symptoms.
Once I’ve taught you the basics, then we’ll move right along to the section on how to use Suboxone for opiate withdrawal in a way that is safe and effective.
Why Does Suboxone Work For Opiate Withdrawal?
So we already know that Suboxone helps with opiate withdrawal. So the question then becomes: “how does Suboxone help with opiate withdrawal?” It’s actually a pretty simple process, and one that I find fascinating.
Here are the basics on Suboxone:
Suboxone is a prescription medication containing buprenorphine and naloxone. Buprenorphine is a controlled substance and semisynthetic opioid derivative of thebaine.
Buprenorphine attaches and binds to the same opioid receptors in the brain and other parts of the body that drugs like heroin, oxycodone, hydrocodone, morphine, and other opioids bind to. Once it attaches to these receptors, it mimics the effects that opioid drugs produce (though it’s not as powerful).
For this reason, buprenorphine is known as a “partial opioid agonist.”
The other opiate drugs I just mentioned are known as “full opioid agonists,” because they activate the receptors in a stronger and more complete way than buprenorphine. See the illustration below.
Naloxone is the other compound present in Suboxone.
Naloxone is a pure opioid antagonist. It’s the drug given to people that overdose because an injection of naloxone puts the opioid-user into instant withdrawal, thus saving them from health issues and death.
Naloxone was put into the Suboxone formulation to deter people from injecting it, which would lead to precipitated withdrawal. Taken orally, naloxone isn’t bioavailable. A common misconception (one even I had until my Suboxone Expert Mary informed me) is that naloxone blocks the opiates.
This is false.
The truth is that buprenorphine binds so strongly to the opioid receptors that it’s actually the bupe which blocks opioids. Do yourself a favor and don’t try to get high with opioids on Suboxone or Subutex, it’s just not worth it and it will be a sad experiment, which could end in overdosing.
Opiate Withdrawal 101
To further illustrate why Suboxone works so well for opiate withdrawal, I’d like to give you the basics on the opioid withdrawal syndrome. If an individual continues using opioids after a tolerance has been established, they will eventually develop a physiological dependence.
Dependence develops when the neurons adapt to the repeated drug exposure and only function normally in the presence of the drug.
When a dependent individual abruptly stops taking opioids (leading opioid-blood concentration to fall below the required level), the now opioid-tolerant central nervous system (CNS) goes haywire.
With no inhibitive stimulation to satisfy receptors, the pathways of the CNS fire signals strenuously, performing at a level much higher than pre-dependence levels.
Now the locus coeruleus responds by triggering the autonomic fight or flight response.
What results is known as the opioid withdrawal syndrome, and it’s one of the most agonizing experiences an individual could ever go through.
Some of the most common symptoms of opioid withdrawal include:
- Anhedonia (inability to feel pleasure)
- Achy muscles and limbs
- Teary eyes
- Runny nose
- Gastrointestinal distress
- Hot and cold sweats and chills
- Goose bumps
- Restless Leg Syndrome (RLS)
Using Suboxone For Opiate Withdrawal
A quick fix for stopping this syndrome is to use Suboxone for opiate withdrawal. After an individual takes a dose of Suboxone, the buprenorphine quickly binds to the opioid receptors, and if enough is taken, withdrawal symptoms and opiate cravings are eliminated or drastically reduced.
This is something I am familiar with on a very personal level.
Years ago I was a cook at a fast-paced restaurant in New York. I was addicted to OxyContin and Percocet, and I needed to purchase them illegally and take them daily to avoid getting sick and missing work.
I also had a newborn baby to take care of after work, so between those two main responsibilities, going through acute withdrawal and then being exhausted and depressed for weeks to months was simply not an option. I needed to work to pay bills, but more importantly, my addiction was a secret, so I continued to use to avoid getting sick and bringing attention to myself.
Several months into my addiction, my life was getting more and more out of control.
Then something truly saved me.
One day I woke up without opiates and was in the first stages of withdrawal. I started texting every dealer I knew to see if anyone could deliver prescription opiates to my work, as I had to be there at 8 am, and without the pills it would be very difficult to function.
At 9 am, one of my dealers met me out back by the dumpster and pulled out an orange tablet of Suboxone (this was before they came out with the film). He sold it to me for $20. I went in the bathroom at work and administered a fourth of the pill, which was approximately 2 mg of buprenorphine and 0.5 mg naloxone.
Within minutes I was feeling better!
No more opiate withdrawal, no more cravings, I had energy, I was happy, work was fun, and I quickly decided that taking Suboxone was much better for me than snorting oxy’s.
It seemed like a miracle medication until my dealer ran out of Suboxone a few months later.
By my third day without Suboxone, I was so tired and depressed that I just said “screw it” and bought some oxy’s, and the vicious cycle continued.
How To Use Suboxone For Opiate Withdrawal
Alright, so now you know why so many people use Suboxone for opiate withdrawal…because it works! And now we’ve reached the “How-To” portion of this article.
To use Suboxone for opiate withdrawal in a manner that is safe and effective, there are certain guidelines to follow.
The first guideline is to use the appropriate “timing.”
Suboxone should not be taken too soon, because precipitated withdrawal can start if you take Suboxone before the other opioid drug completely leaves your body. The timeline may differ from person to person depending on several factors, including personal physiology and genetics.
Generally speaking, you should wait to take Suboxone the following amounts of time after your last dose of these specific drugs:
- Morphine: 8-12 hours
- Heroin 12-24 hours
- Oxycodone and hydrocodone: 12-24 hours
- Oxymorphone: 24-30 hours
- Methadone: 36 hours to a week
Note: A general rule of thumb is to wait until you’re experiencing moderate opioid withdrawal symptoms. Prior to induction, doctors typically look for their patients to have objective withdrawal symptoms sufficient to produce a score of a 5 to 6 on the Clinical Opiate Withdrawal Scale (COWS).
What Is Precipitated Withdrawal?
Suboxone-precipitated withdrawal can occur when an individual takes Suboxone too soon after taking a full opioid agonist (such as heroin, oxycodone, hydrocodone, etc). Due to buprenorphine’s high affinity but low intrinsic value at the mu opioid receptor, buprenorphine displaces full agonists from these receptors without activating the receptor to an equivalent degree.
This leads to a net decrease in opioid agonist effect, thus precipitating a withdrawal syndrome.
Many people are under the impression that the naloxone in Suboxone initiates precipitated withdrawal.
However, this is simply not true.
The naloxone can only precipitate withdrawal if it’s injected into someone that is dependent upon opioids. It basically has no effect if it’s taken sublingually.
How Much Suboxone Should I Take For Opiate Withdrawal?
The second guideline to follow when using Suboxone for opiate withdrawal has to do with “quantity.”
Even if you have the timing right, that doesn’t necessarily mean you’ll be free of opiate withdrawal symptoms. To effectively reduce symptoms, you’ll want to use the appropriate dosage.
So how much Suboxone does it take to eliminate opiate withdrawal symptoms?
That depends on several things, the most important being:
- How long you’ve been using opiates
- What types of opiate or opiates you’ve been using
- The average amount of opiates you’ve been using on a daily basis
According to the Suboxone official website, on Day 1 of opiate withdrawal, clinicians should start with an initial dose of 2 mg/0.5 mg or 4 mg/1 mg buprenorphine/naloxone and may titrate upwards in 2 or 4 mg increments of buprenorphine, at approximately 2-hour intervals, under supervision, to 8 mg/2 mg buprenorphine/naloxone based on the control of acute withdrawal symptoms. So the maximum Suboxone that should be taken on Day 1 is 8 mg/2 mg, and for Day 2, the maximum amount is increased to 16 mg/4 mg.
How Do I Administer Suboxone?
When Suboxone first came out, and for years after, it came in tablets. Nowadays, they prescribe a Suboxone film that looks similar to a Listerine breath-freshening strip.
According to Suboxone.com, the following guidelines should be adhered to when taking Suboxone film:
- Before taking Suboxone film, drink water to moisten your mouth. This helps the film dissolve more easily.
- Hold the film between two fingers by the outside edges. Place Suboxone film under your tongue, close to the base either to the left or right of the center.
- If your doctor tells you to take 2 films at a time, place the second film under you tongue on the opposite side. Try to avoid having the films touch as much as possible.
- Keep the films in place until they have completely dissolved.
- While Suboxone film is dissolving, do not chew or swallow the film because the medicine will not work as well.
- Talking while the film is dissolving can affect how well the medicine in Suboxone film is absorbed.
- Here is a 7-minute video on Suboxone.com that shows you how to correctly use Suboxone film.
Suboxone For Opiate Withdrawal Conclusion
Many people have used Suboxone for opiate withdrawal symptoms. If used correctly, Suboxone can eliminate withdrawal symptoms and cravings very well. However, if used incorrectly (taking it too soon), the buprenorphine in Suboxone can precipitate withdrawal.
This is a very unpleasant experience.
I’ve never gone through precipitated withdrawal, but I’ve talked to many people that have. It’s a terribly awful experience, and one that can be avoided with the proper knowledge.
Some individuals choose to use Suboxone for opiate withdrawal symptoms for a few days just to get them through the acute withdrawal period. Others find that a few weeks to a few months of Suboxone treatment will increase their chances of success.
Finally, there are individuals that choose to be in Suboxone maintenance treatment for several months or years.
Everyone is different, so different approaches will work for different people. Suboxone may be a good choice for some people, and for others, medication may not be the way to go.
I believe that there are many paths to recovery. Find your path, and don’t let anyone tell you that your path is wrong.
They only do this because it doesn’t obey their rules for recovery.
Follow your heart, and you’ll be guided to the right path. Click here now to view my best home detox program.
If you have any question on using Suboxone for opiate withdrawal, please post them in the comment box below.