In October 2002, the Food and Drug Administration (FDA) approved a combination drug that physicians could prescribe to ease and even eliminate some symptoms commonly associated with abrupt opioid cessation. That drug was Suboxone. It comprises two active ingredients: buprenorphine and naloxone, and according to the FDA and multiple licensed rehab facilities across the U.S., it has helped countless people overcome their addiction to OxyContin, oxycodone, fentanyl, heroin, and a plurality of other long-acting opioid drugs. But it’s hardly perfect; some individuals who take Suboxone to overcome their struggles with OxyContin, fentanyl, heroin, and the like become addicted to it, essentially trading one horrible addiction for another.

Buprenorphine / Naloxone

How Does Suboxone Work?

Suboxone is a short-acting opioid (SAO) that delivers a quick onset of action and short-lived analgesic activity. And that makes it different compared to long-acting opioids (LAOs), which provide a much slower onset of action and longer duration of analgesic activity. The buprenorphine in Suboxone works by attaching to opioid receptors in the brain and blocking long-acting opioids that would otherwise also lock onto them. Meanwhile, the naloxone in Suboxone works by counteracting the euphoric effects of long-acting opioid drugs. Available data shows Suboxone has a 40% to 60% success rate in helping individuals get through an addiction recovery program and enabling them to maintain sobriety for at least one year.

Shedding Light on the Symptoms and Dangers of Suboxone Withdrawal

Even when someone takes Suboxone as directed, they can encounter numerous unpleasant side effects. Of course, those side effects can be even more varied and far more intense when someone abuses the powerful opioid drug. Some of these side effects include the following:

  • Constipation
  • Headaches
  • Insomnia
  • Nausea and vomiting
  • Peripheral edema
  • Profuse sweating

Some of the not-so-common and potentially life-threatening side effects associated with abusing or even taking Suboxone as directed include the following:

  • Low blood glucose levels
  • Poor liver function
  • Adrenal changes
  • Sleep apnea
  • Rashes, hives, and other allergic reactions to Suboxone

How Do People Develop an Addiction to Suboxone?

The buprenorphine in Suboxone is a partial opioid agonist, which means it triggers feelings of euphoria just like other opioids. But because it is a partial opioid agonist, the euphoric feelings triggered by buprenorphine are generally much milder. Because of this, some people take higher doses of Suboxone than directed by their physician and eventually build up a tolerance to the drug. When they build up a tolerance, they take even more Suboxone to achieve the desired euphoric effects. The more they engage in this pattern of behavior, the more likely they are to develop an addiction. According to a study published by the National Institute on Drug Abuse, because it contains buprenorphine, Suboxone is one of the most commonly abused prescription medications in America. Although Suboxone triggers a milder euphoric high than other opioids, it does not mean the withdrawal symptoms are any less intense or varied when someone stops taking it.

Withdrawal Symptoms: How the Body Responds To Abrupt Cessation of Suboxone

Overcoming an addiction to Suboxone is not too different from overcoming an addiction to any other opioid. Both will require completing detox, the body’s natural way of purging itself of opioids and related contaminants. The same applies to weathering the storm of withdrawal symptoms that go hand in hand with an opioid detox. Some of these withdrawal symptoms include the following:

  • Nausea and vomiting
  • Diarrhea
  • Muscle pain
  • Insomnia
  • Anxiety and depression
  • Irritability
  • Elevated heart rate, blood pressure, and body temperature
  • Intense drug cravings
  • Tremors
  • Restlessness
  • An inability to focus
  • Hallucinations

It’s important to note that withdrawal symptoms can vary in intensity and duration depending on individual factors, including how long an individual was on Suboxone, the dosage they might have been taking, and their overall physical and mental health.

Suboxone Withdrawal Timeline

The withdrawal symptoms associated with a Suboxone detox seldom come on suddenly or all at once. Instead, they come in stages and get progressively more intense as time goes on. These stages include

The first 24 hours – This initial stage is delineated almost entirely by anxiety, fatigue, and general discomfort. Some liken it to coming down with the flu or experiencing the beginnings of the common cold. Most people can get through the first 24 hours of their Suboxone detox journey without medical intervention.

Days 2 to 3 – Suboxone withdrawal symptoms generally peak 48 to 72 hours after someone has taken their final dose. During this time, they also pick up in intensity, consisting primarily of high fever, body aches, nausea, vomiting, and diarrhea.

Week one – At this stage, most of the physical withdrawal symptoms associated with the abrupt cessation of Suboxone will start to subside. But the same can’t be said for the psychological ones. Even after quitting Suboxone for one week, many people struggle with anxiety, depression, mood disorders, and other psychological symptoms. Thankfully, most rehab facilities offer a mix of psychotherapy and pharmacotherapy to help individuals cope with and eventually overcome these symptoms.

Week two – This stage marks the end of Suboxone withdrawal symptoms for some people. For others, it’s the beginning of post-acute withdrawal syndrome (PAWS), a persistent occurrence of withdrawal symptoms that can sometimes last for months after an individual stops taking Suboxone. According to a study published by the University of California, Los Angeles (UCLA), an estimated 90% of recovering opioid users experience PAWS. Symptoms typical of PAWS are almost exclusively psychological and can include any of the following:

  • Apathy or pessimism
  • Feelings of anxiety, depression, or panic
  • Increased sensitivity to stress
  • Insomnia or hypersomnia
  • Irritability
  • Obsessive-compulsive behaviors

Why It Is Better to Gradually Taper off of Suboxone

Most of the severe and life-threatening symptoms people experience when quitting Suboxone occur after they abruptly stop taking it. Studies show that gradually tapering off of Suboxone helps minimize withdrawal symptoms and can make it considerably easier for someone to end their dependence on the drug. For reference, tapering off of Suboxone involves slowly decreasing the total daily dose of the medication and ultimately discontinuing its use altogether. Most rehab facilities can arrange tapering schedules to help individuals overcome their struggles with Suboxone, and they are pretty effective.

In a study published by UCLA, researchers found that 44% of individuals who went through a 7-day tapering-off period successfully ended their dependence on Suboxone, with most reporting only mild or no withdrawal symptoms. Those who experienced withdrawal symptoms while tapering off of Suboxone were prescribed and advised to take clonidine, an antihypertensive drug. Although such a prescription drug might seem peculiar, it is appropriate since clonidine helps block chemicals in the brain that would otherwise trigger the sympathetic nervous system activity responsible for many Suboxone withdrawal symptoms, such as anxiety, restlessness, and profuse sweating.


In summary, Suboxone is an FDA-approved drug that helps individuals overcome addiction to a wide range of opioids. But it is also a drug that can lead to the development of addiction if someone abuses or fails to take it as directed by a physician. To learn more about Suboxone withdrawal symptoms or overcoming Suboxone addiction, consider speaking with a Long Island Interventions associate today.


  • How does suboxone work?
  • What all is suboxone used for?

Published on: 2023-01-28
Updated on: 2024-05-10