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Buprenorphine has some advantages over methadone, another medication widely used in the treatment of opioid addiction. While methadone must be dispensed from an opioid treatment program (OTP) specially certified by the Substance Abuse and Mental Health Services Administration (SAMHSA), buprenorphine may be prescribed and dispensed from certain doctors’ offices (from physicians who have qualified for a special waiver). Secondly, unlike methadone which is a full opioid agonist, Suboxone combines a partial opioid agonist (buprenorphine) with an opioid antagonist (naloxone) to deter abuse and decrease the risk of drug diversion. For some practitioners, this makes Suboxone the preferred treatment for those at risk of abusing their treatment medications.3
As a partial opioid agonist, buprenorphine:2.4
There are several factors that will influence both the length of time and the severity of symptoms that occur during the withdrawal process. These factors include:11
Tapering the drug slowly under the care of a physician will help to alleviate the symptoms of withdrawal.
For most people, Suboxone withdrawal symptoms will begin within 2-4 days and last approximately 10-20 days. The following is a typical timeline (individual experiences will vary):12,13
First 24-72 Hours: Withdrawal from buprenorphine (there is no withdrawal from naloxone) will be most intense in this time period and will usually peak in its intensity at around 72 hours since the last dose. The symptoms most common during this phase include:12,13
Weeks 1 and 2: As withdrawal continues, the following symptoms are likely:
Weeks 3 and 4: By this time, the physical symptoms of withdrawal will likely have subsided, but many people still experience feelings of depression, general malaise, restlessness, lack of motivation, and cravings for the drug.
For many, the early withdrawal symptoms are similar to a bad case of the flu. The acute symptoms usually peak within a few days to a week as mentioned above; however, some people experience prolonged psychological symptoms for weeks or months after withdrawal ends, such as:14
Withdrawal from Suboxone and other opioid drugs is not often life-threatening; however, it certainly may feel that way at its peak.11 During medical detox, staff can help to relieve your discomfort through the use of medications and supportive care.
If the individual is addicted to Suboxone, substance abuse treatment should commence after detox is complete and will center around individual and group therapy.