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Overview of Suboxone detox

If you or a loved one has struggled with opioid addiction, then you probably have heard of suboxone. It is a prescription drug used to assist with the detox of opioid drugs. Methadone clinics were the most common treatment for opioid addiction, but in recent years Suboxone has replaced Methadone almost all together. Suboxone is even used as a maintenance drug, with some patients going on the drug for weeks, months, or years at time. This rise in Suboxone use has called for a need of specialized suboxone detox programs.

The active ingredients in Suboxone are buprenorphine (an opioid receptor partial agonist), and naloxone (an opioid blocker). The buprenorphine works by attaching to opioid receptors in the brain so that your body “thinks” it is getting the drugs it needs to function. This prevents painful withdrawal symptoms and can significantly curb cravings. In opioid dependent individuals it rarely makes the user high, but in opioid naive people buprenorphine can have intense effects, making it occasionally a drug of abuse and recreation.

The other ingredient, naloxone, blocks other opioids from the brain. This prevents patients from being able to relapse while on Suboxone. The naloxone also works as an abuse defense. Many people who use opioids inject the drugs, and injections alone can be addicting. Naloxone is fast acting, and when injected will block the buprenorphine from entering the brain and giving the user a rush.

Another defense for abuse is its sublingual design. Suboxone comes in strips, similar to Listerine® breath strips, that dissolve under the tongue. It also comes in a pill form that also dissolves under the tongue. The drug is always orange flavored to help prevent the foul taste of the chemical ingredients.

Buprenorphine was first synthesized in 1969. It was the result of chemists looking to create a painkiller that acted as an opioid but did not have severe negative side effects like morphine. When it showed lower rates of dependence in test animals, it began trials on humans in 1971. By 1978 it launched in the UK as an injectable painkiller, and in 1982 was first made for sublingual use. In recent years it has become more popular as a treatment for opioid addiction rather than a pain killer.

Buprenorphine, though not a full opioid agonist, is still addicting both psychologically and physically. The drug has a long half life making detoxing from the drug a long drawn out process that are tapered down in increments. Because of its long half life, withdrawal can be long and painful, making staying clean sometimes very hard. In the past people were put on Suboxone long term, but many of these people are now attending rehabs and detoxes to come off of the drug.

Click below for detailed Opiate detox guides

How Detoxing From Suboxone works

Suboxone is typically used to taper off of other opioid drugs, but many users get addicted to or physically dependent on buprenorphine. When dependence occurs a user may need to attend an inpatient medical detox center. Detoxing works by slowly tapering the patient off of buprenorphine. This is done by lowering the doses of Suboxone or Subutex (which contains buprenorphine but no naloxone) day by day. This helps curb the effects of opioid withdrawal and it makes it more bearable.

Other medications are also used in a detox center to help with unpleasant symptoms of coming off of Suboxone. Anti anxiety medications are used as well as sleep aids. Sometimes anti-depressants are also prescribed, because depression is very common when coming off of opioids. Drugs for abdominal trouble is also common, typically promethazine. All of these medications together can make for a much more comfortable withdrawal, and will keep the patient on the right track.

On one’s own Suboxone detox can be very painful and long lasting; in medical detox doctors can monitor the process and decide what is appropriate to mitigate symptoms. When medical detox is complete the patient can either attend IOP (intensive outpatient) groups or attend a rehabilitation center. Typically a game plan should be made prior to detoxing from Suboxone, because it can take up to a month for the body to feel normal.

WHAT DOES THE Suboxone DETOX PROCESS LOOK LIKE?

The Suboxone detox process will look similar to any other opioid detox, but it will be longer lasting. The patient will take buprenorphine to taper down off of suboxone. As symptoms arise, drugs like barbiturates or benzodiazepines will be used to help with anxiety, restlessness and sleep. Antihistamines or non-benzodiazepine sleeping aids may also be used, because sleep is often very difficult while detoxing from Suboxone. Blood pressure meds are also common, like clonidine. This helps significantly with restless legs and anxiety.

In detox the patient will be given a room and a bed. They will be monitored 24/7 to ensure a safe and comfortable detox. Vital signs are often checked every couple of hours or as needed. Doctors in addition to nurses and other trained medical staff are always present.

Often in medical detox centers people in recovery from addiction will come in to talk to patients, hold groups, and share their experience. Therapists are also very common in detox centers. They can provide support for patients and also make sure they do not have underlying mental health issues that need to be treated. It is very common for addicts to have some major mental health problem like chronic depression, bipolar disorder or borderline personality.

Buprenorphine withdrawal can be very painful. Over time, the body needs buprenorphine to function, and when the drug is no longer present in the body extreme effects are felt. Buprenorphine withdrawal is not dangerous, but can be unbearable. The point of detox is to mitigate these symptoms and make the detox process safe and comfortable.

Although many medications will be used, some symptoms will still be felt. It may be difficult to sleep and one may still feel nauseous. Even if some symptoms are felt, they will not be nearly as severe as if a person was detoxing on their own. On one’s own one will feel anxious, depressed and even hopeless. In detox, therapists and doctors can reassure the patient that what they are going through is natural and will not last forever. This is important because suboxone withdrawal can be so severe that a person may decide it is not worth getting getting clean. Detox can be scary because people may have only experienced withdrawal on their own and felt the full effects of not taking suboxone.

Suboxone Detox Withdrawals

Pill Bottle Icon Suboxone has an opioid blocker Naloxone in attempt to prevent users from injecting the drug
Pill Icon Suboxone is usually orange flavored
Syringe Icon Because Buprenorphine is a partial agonist, it is difficult to abuse the drug to get a greater high if one is already dependant on opiates.

Buprenorphine withdrawal can be very painful. Over time, the body needs buprenorphine to function, and when the drug is no longer present in the body extreme effects are felt. Buprenorphine withdrawal is not dangerous, but can be unbearable. The point of detox is to mitigate these symptoms and make the detox process safe and comfortable.

Although many medications will be used, some symptoms will still be felt. It may be difficult to sleep and one may still feel nauseous. Even if some symptoms are felt, they will not be nearly as severe as if a person was detoxing on their own. On one’s own one will feel anxious, depressed and even hopeless. In detox, therapists and doctors can reassure the patient that what they are going through is natural and will not last forever. This is important because suboxone withdrawal can be so severe that a person may decide it is not worth getting getting clean. Detox can be scary because people may have only experienced withdrawal on their own and felt the full effects of not taking suboxone.

List of Suboxone Withdrawal Symptoms

  • Nausea
  • Vomiting
  • Insomnia
  • Anxiety
  • Depression
  • Lethargy
  • Restlessness
  • Restless legs
  • Chills
  • Sweating
  • Irritability
  • Poor concentration
  • Headaches
  • Extreme cravings
  • Body pain/muscle pain

Can you detox from Suboxone at home?

Because Suboxone withdrawal is not itself dangerous, one could theoretically detox from Suboxone on their own. This is not advised because when coming off of Suboxone, one could become very agitated and desperate. They may put themselves or others in harms way to relieve their symptoms.

Suboxone withdrawal is extremely painful and can be significantly more comfortable in a detox. On one’s own, a person may change their mind because their symptoms are so great. They will feel sick and may not be able to sleep for days. Buprenorphine withdrawal does not cause dangerous seizures like benzodiazepines, but has severe symptoms that can cause more serious health problems. Suboxone withdrawal can lead to dehydration, malnutrition, and sleep deprivation.

At home one cannot be tested for blood borne diseases or liver dysfunction either. These are common problems in opioid addicts, and can be much more effectively treated when caught early. In medical detox blood tests will be ran to test for many different diseases.

In medical detox doctors and therapists can also check for underlying mental health conditions. Mental health problems can also make it very difficult to remain sober and can exacerbate depression and anxiety. At home one cannot have a comprehensive treatment plan to make sure they are effectively treated for their addiction.
If a person does not have their drugs when they are physically dependent, they are more likely to commit crime to get their fix. This is also why medical detox is a good idea. If a person begins to have a panic attack doctors can administer more medication to calm their agitation and cravings.

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How long does it take to detox from Suboxone

Withdrawal length varies person to person. It all depends on age, weight, height, and amount of use. How fast a person’s metabolism works is the biggest factor that determines the length of detox. The next factor is the amount and length of abuse. The longer and more of the drug a person takes, the longer and more intensely the withdrawal will be felt.

Suboxone withdrawal can take anywhere from a week, to months, to years. The most severe of the physical symptoms most commonly last a week or two. After that the most prevalent symptoms are insomnia, anxiety, depression and poor concentration. After about a month it should be much easier to sleep and anxiety will diminish. Depression can last longer, but long term medication can be prescribed for this and talk therapy is also beneficial.

In addition to antidepressants, there are non-narcotic and non-addictive medications for anxiety, sleep and concentration. Clonidine is a common drug prescribed because it significantly helps anxiety yet is fairly harmless and non addictive. Sometimes Clonidine is even prescribed for concentration.

The initial inpatient detox itself usually lasts about a week, but can be anywhere from 3-10 days.

  • According to CVS, 57% of people prescribed suboxone are 20-40 years old
  • There are fewer than 16,000 physicians permitted to prescribe Suboxone in the U.S. as of 2013
  • 3 million prescriptions were written for buprenorphine in 2012. This number includes the combination formulation of Suboxone as well as the buprenorphine-only medication known as Subutex
  • Suboxone was first approved as a treatment for opioid addiction in the U.S. in 2002
  • In 2012 there was a $1.5 billion market for Suboxone, and this number is rising