Suboxone is an important and medically valuable drug used to reduce dependence on opiates by reducing cravings and blocking opioid action in the brain. Today, tens of thousands of people receive suboxone as part of long-term Medication-Assisted Treatment and as part of maintenance therapy to assist in staying off opioids. To an extent, this treatment is valuable and often necessary. Suboxone is a valuable treatment that can and does save lives, improves outcomes for opioid addiction treatment, and allows thousands of individuals to get their lives back.
At the same time, suboxone maintenance treatment is not a permanent thing. Most people eventually have to taper off the drug and get completely clean. It’s crucial that you discuss this with your doctor and possibly with your counselor before doing so. However, if the time is right, this article will guide you through the process so that you can do so safely.
When is It Time to Get Off Suboxone?
Suboxone is a prescription medication, handed out by a doctor for a medical purpose. Stopping Suboxone without explicitly consulting with your doctor could be a mistake. You may be ready to get off Suboxone if:
- You’ve successfully completed a rehab program and have received aftercare for 6-12 months
- You’re consistently attending self-help group meetings
- You’re enjoying life, finding new and better ways to cope, and have a healthy life balance
- You attend therapy or behavioral therapy and have or are working on solutions to behaviors and root-problems behind addiction
- You’ve successfully completed the term you were asked to stay on Suboxone
- You’ve completed every step of your original recovery plan intended to be paired with Suboxone
- You’re experiencing problems with Suboxone and want to try something else
- You show signs of continued substance abuse
Consult with your doctor about quitting Suboxone. Explain your reasoning and your symptoms. Do not attempt to quit without medical approval and a tapering program.
At the same time, it’s important to understand when not to quit Suboxone. For example, if you’re facing misconceptions, like the idea that using Suboxone is just another dependence, you might want to stay on the drug. Suboxone is physically dependence inducing, but its goal is to function as a crutch while you learn new behaviors and new coping mechanisms that will help you remain in recovery after you quit it. There will always be a right time and place to quit Suboxone, but it’s important to make sure you are ready. There is no more shame in using Suboxone to recover from a substance use disorder than there is to using painkillers after a surgery. It is quite simply a recognized medical treatment for a very common health disorder.
Suboxone induces chemical dependence, typically after a few weeks of regular use. This means you will experience a withdrawal period, during which you will experience the same withdrawal symptoms as for any other opioid. In most cases, withdrawal will last up to one month, but symptoms can be mitigated by tapering.
- 12-72 hours: Physical symptoms begin, typically introducing nausea, vomiting, headaches, muscle aches, and general cold and flu symptoms. Most patients will experience cravings alongside fever and chills, which will increase over the first three days.
- 1 week: Physical symptoms begin to reduce and taper off. Most individuals will still experience considerable muscle aches and pains, some nausea, insomnia, and mood swings.
- 2 weeks: Mental symptoms peak, typically including depression, anxiety, and cravings.
- 1 month: Cravings and depression can last for a month or more after the final dose
Suboxone withdrawal is very similar to opioid withdrawal. Most individuals are most at risk for relapse during the last phase of withdrawal, when cravings and depression are the only real symptoms.
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Most doctors and addiction counselors will insist on patients following a tapering schedule to get off Suboxone. This takes longer than quitting cold turkey because it means cutting the dose in half every few days to few weeks depending on the individual but does mean that you can get off Suboxone with fewer withdrawal symptoms.
Your schedule should also include additional visits to a behavioral therapist, additional visits to your self-help group, and potentially time in a detox center to ensure you receive the care you need to prevent relapse. Individuals who have been clean for some time but who are concerned they may relapse can also enter a halfway or sober house to ensure they have continued support throughout the process.
Making the Right Decisions
Suboxone is a medication used to help individuals get off opioids. However, it is a temporary medication, and everyone will eventually have to quit the drug and learn to live without the crutch. At the same time, it’s important to do so when you’re ready, when your doctor says you’re ready, and when you’ve completed the therapy and training to allow you to do so safely, and without relapse.
You should also have a plan in place to ensure continued sobriety after detoxing from Suboxone. For example, you should:
- Seek out additional therapy and counseling to ensure you stay on track
- Seek out peer support or a sober buddy to talk to about cravings
- Reinforce healthy choices like eating well and regular exercise to keep your mood up
- Take time out to destress and relax
- Be honest with yourself and ask for help if and when you need it
Suboxone can help you get clean, it can give you a clean slate with which to tackle the behavioral and emotional problems contributing to opioid addiction, and it can give you time and space to develop new and healthier coping mechanisms. Once you have those foundations in place, you may be able to quit suboxone and move on with your life, drug free.
Consult with your doctor before making any medical decisions, cutting drugs such as Suboxone, or starting a tapering schedule. The right actions for your needs heavily depend on you, your mental health, your behavioral state, and your physical state. Quitting any prescription medication can be dangerous and may require medical supervision.