Quitting opiates is no small feat.  Nausea, diarrhea, sweats, chills, cravings, irritability, runny nose, sleepless nights, mood swings, headaches, cramps, and restless legs are a terrifying prospect for someone who decides to get clean.  However, thanks to science, things can be a bit easier.

In the past, methadone was the go-to drug when trying to get clean from opiates.  Methadone is a full opioid agonist, meaning it binds fully to opioid receptors in the brain and produces the same effects as an opiate. Methadone maintenance has been an option for those who are not ready to get fully clean.  It is a harm reduction medication maintenance form of treatment.  One that involves showing up daily for a dose, that generally increases over time.  The drawbacks are high potential for abuse, having to show up for doses daily, and a VERY difficult detox.

More recently, Suboxone has come onto the scene. Approved by the FDA in 2002 as a way to prevent continued opioid overdose fatality, Suboxone is a cobination of buprenorphine, an opioid, and naloxone, an opioid antagonist otherwise known as Narcan. Unlike other medication-assisted treatments, Suboxone can be taken at home under the supervision of the prescribing doctor. the medication can be taken buccally or sublingually and instructions for use must be followed.

 It is a partial agonist, meaning it only reacts on the opioid receptors partially.  Suboxone is a mix of buprenorphine and naloxone.  Naloxone is the same medication used in Narcan, the anti-overdose drug. It was designed originally as a fast taper method for those wishing to come off opiates such as heroin, fentanyl, or oxycodone.

A fast taper meaning a gradually decreasing amount from 3-7 days. However, many doctors have begun prescribing patients Suboxone to take for long-term medication-assisted treatment.  Sublingual strips or pills are most common.  The feeling is similar to opiates but without the same euphoria.  Similar to methadone, the dosage is gradually increased over time.  Some addicts find themselves taking Suboxone for months or even years.

So what happens when you have been on Suboxone for months or years, and become ready to be totally clean? When will you be able to discontinue use? What is Suboxone detox like?

Suboxone has a much longer half-life than opiates, and stays in the body much longer.  The first three days of Suboxone detox can be similar, or more intense, than withdrawals from heroin.  Sweats, chills, nausea, vomiting, disorientation, diarrhea, cramps, headaches, cramps, aches, along with intense cravings.

Throughout the remainder of the first week, the psychological effects are most apparent.  Insomnia, depression, anxiety, irritability, anxiety, and agitation are to be expected.  Luckily, at this point medications such as Lucemyra and antidepressants may begin to be introduced to help ease the symptoms. But, can suboxone withdrawal cause death?

In the weeks and months following, the psychological effects may be present, but hopefully managed through therapy and medication.  The cravings will still be there, and can seem overwhelming.  The drug is out of your system, but Post Acute Withdrawal Symptoms (PAWS) may still remain.  Naltrexone or Vivitrol, anti-craving drugs, may be used at this time.

A detox facility, followed by treatment, is the most common and safe way to detox from Suboxone.  You will be medically supervised, given a Suboxone taper, and provided with therapy and medications to treat your symptoms.  It makes this process MUCH easier.  However, it is still no easy task.  The most important thing is learning the skills and techniques from trained professionals that will prevent future relapse.

Are you seeking a life totally abstinent from drugs and alcohol, but afraid to take that final step?  Have you experienced Suboxone withdrawal? Please comment below.

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