Tuesday September 2nd 2014

How long does buprenorphine withdrawal last?

Buprenorphine can be a useful drug prescribed to treat opiate addiction. Because it is a partial agonist, buprenorphine (used in brand name medications such as Suboxone and Subutex) results in a milder degree of physical dependence and is associated with milder withdrawal syndrome following cessation.  But what kind of timeline can you expect during buprenorphine withdrawal? And do people taking buprenorphine for opioid dependence experience less severe withdrawal than those who abuse buprenorphine to get high?

More here on how long it takes to withdraw from buprenorphine and what symptoms you can expect in the course of the first month after you stop taking it. Then, we invite your questions about buprenorphine withdrawal at the end.

How long until buprenorphine withdrawal starts?

What does buprenorphine withdrawal feel like?  Basically, it feels like a really bad flu.  Buprenorphine withdrawal can start in the hours or days after you take your last dose.

Generally, it is recommended that you gradually reduce your doses of buprenorphine over the period of 2-3 weeks before complete cessation so that the withdrawal symptoms are not as severe. Although the physical withdrawal symptoms resolve after a period of 7-10 days, the psychological withdrawal symptoms can last for months or longer. Symptoms of benprenorphine withdrawal include leg restlessness, nausea, and sweating, yawning, pain, anxiety, irritability, insomnia and cold or flu-like symptoms.

Buprenorphine withdrawal timeline

24 – 72 hours: Buprenorphine withdrawal will usually peak in severity and intensity 72 hours after your last dose and gradually become less intense. During this period, it is common to experience diarrhea, sweating, nausea, dilated pupils, watery eyes and restlessness.

Week 1: In the first week after stopping buprenorphine, week you will probably continue to to feel aches and cramps within the stomach area and in your joints. You may be uncomfortable during this time period and have difficulty sleeping. Mood swings are also common, with bouts of anxiety or depression.

Week 2: After two weeks of buprenoprhine withdrawal, the pain and discomfort of acute withdrawal may not be as severe but you still experience aches. Depression can starts to set in, as well, and you may notice an extreme loss of motivation.

Week 3-4: After three to four week mark, most of the physical withdrawal symptoms will be gone, however you will intense drug cravings may be present for those addicted to buprenorphine. Depression is also common. This time is very important, as you will be very vulnerable to relapse.

How long do buprenorphine withdrawal symptoms last?

Buprenorphine withdrawal symptoms last longer for those who use buprenorphine for longer periods of time or at higher doses. Additionally, those who use buprenorphine other than prescribed (snort, inject, chew) may experience more severe symptoms than someone taking buprenorphine as prescribed. In these cases, physical buprenorphine withdrawal symptoms can last weeks after stopping.

However, psychological withdrawal symptoms can last for many months after cessation. It is recommended that you join a support group or see a psychologist who can help see you through the protracted or post acute withdrawal symptoms (PAWS). Many heavy buprenorphine users experience PAWS. With continued use of buprenorphine, there comes a point where the brain produces in an inadequate amount of neurotransmitters in the body. People going through buprenorphine PAWS manifest long lasting changes in the brain as a result of long term use. These changes are slower to reverse and can persist for many months, depending on the frequency and amount of past dosing.

Buprenorphine withdrawal: How long?

How long buprenorphine withdrawal lasts varies depending on how frequently you used the drug and how large the doses were. If you were a heavy user, burprenorphine withdrawal may be more intense and last longer than someone using buprenorphine for a few months. It is also crucial that your family understands your situation so that they know why you are acting the way you do and can better handle it.

Buprenorphine withdrawal duration questions

If you have further questions about how long burprenorphine withdrawal lasts, please ask them in the comments section below. We will try to respond to you personally and promptly.

Reference Sources: NCBI: Buprenorphine withdrawal
FDA: Suboxone medication guide
NIDA: Methadone Research Web Guide: Part B
National Drug Intelligence Center: Buprenorphine: Potential for Abuse

Photo credit: Dave Stokes

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23 Responses to “How long does buprenorphine withdrawal last?
Tyler
7:03 pm April 26th, 2014

I have been clean from buprenorphine for a little over a week. I have been using 2mg a day for the past 6-8 months. how long can I expect to feel “panicked” throughout the day due to my sobriety? and when can I expect my motivation to start coming back? I dont seem to have any right now.

simon
4:24 pm April 27th, 2014

Im 4 weeks off subutex now and am still hurting, sneezing watery eyes, i can cope with this but i have no strength or energy, i have tried my detox worker who has said its all in my mind, can anyone give me some realistic advise please
thanx

1:06 pm April 30th, 2014

Hello Simon. There is a condition called PAWS, or post-acute withdrawal symptoms. However, I’m not sure that the symptoms you describe may be related to protracted buprenorphine withdrawal. I’d suggest that you consult with a physician for a general exam and assessment.

Alan Burton
2:27 am May 30th, 2014

How long and how server will symptoms last from been on subutex 12months but 4mg for last month could u please help as important thinking of just stopping and doing my own detox over using nothing thank

8:01 am May 30th, 2014

Hello Alan. Onset of withdrawal from buprenorphine usually occurs 48 hours after the last dose, peaks around the third day and lasts for up to ten days. Cases of withdrawal from buprenorphine are similar to morpliine type drugs and generally moderate in intensity. You can check out a few case studies to glean what you can here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970944/

But you can also benefit from seeking counsel with your prescribing physician and/or asking about best practices in buprenorphine withdrawal from detox clinics around you, or at a local pharmacy. The more information, the better!

Drew
5:18 pm July 4th, 2014

I have been off subutex for about 3 months now.I have had little to no energy since I stopped taking it. What is the normal ranges when I should get my energy back?

Ivana @ Addiction Blog
7:37 am July 7th, 2014

Hello Drew. Low energy levels and fatigue are common subutex withdrawal symptoms. The longer you have been using subutex, the more your body and mind are used to the drug. The duration of the withdrawal also depends on the quantities of the drug you were taking. And, of course, there are the individual characteristics like body mass, metabolism, age, hydration etc. that influence how long the symptoms will last.

Craig
6:18 pm July 18th, 2014

I’ve taken 16mg of subitex over the space of ten days.. I do a hard labour job as a Hodd carrier and need to stop taking this stuff ASAP. It’s Friday so have the weekend to hopefully recover.. Is this enough??

Sara
3:21 am July 21st, 2014

I am at day 23 off of buprenorphine starting at 16 mg, reduced to 4mg for the last 24 months. I don’t ever remember having this much aches and pains, slowly not as severe but definitely still enough that I can’t ignore it. How long does the lack of energy and body aches usually last?? I am 34, good health, BMI 16%. Female.

kat
2:30 pm July 26th, 2014

The answer to my prayers to subutex withdrawal is GABAPENTIN it is a non habit forming(non benzo) anxiety medication that is also used for nerve pain(which is why it helped my restless leg syndrome) as well as seizures. It really helped with ALL symptoms including energy! Ask your physician about this medication, it has been a miracle for me. I am day 6 off buprenorphine, 4mg for two freaking years.

lydia t
3:07 pm July 27th, 2014

I’ve been on methodone for three years. I usrd fourteen strips of suboxen in a 3 week period and taperd off. Its been 4 fays since my last1/5 piece of suboxen and I feel like I’m dying. I really think the suboxen just prologed my methodone withdrawal. Any info would be greatly appreciated.

Ivana @ Addiction Blog
8:39 am July 29th, 2014

Hello Craig. Quitting Subutex cold turkey isn’t recommenden by doctors. Ideally, you’d want to taper off gradually. Withdrawal symptoms from Subutex are not pleasant at all and they’ll probably persist for longer than a weekend. The severity and duration depend on hoe long you were using Subutex, the dosage you are comming off of, your metabolism, bodily mass, health status etc. It’s safest to see a doctor and come up with a tapering schedule.

Ivana @ Addiction Blog
10:42 am July 29th, 2014

Hi Sara. The bodily aches and pains should gradually lessen as you make it further through withdrawal. It’s one of the most common withdrawal symptoms which occcur as your body is working towards returning to physical and mental homeostasis. The fatigue you’re experiencing is a result of your body relying on the drug to give you energy throughout the day. Eventually the fatigue will subside and your energy levels will return to normal. Keep in mind that this may take an extended period of time.

Christi
2:52 pm July 30th, 2014

Hello all okay i was on oxy 80s n Roxie 30s for 6 yrs and then myself i switched to suboxone myself then when i couldn’t find those i would get the subutex! Now when i took suboxone i could make 1 8mg strip last me ten days and pretty much the same with the subutex tab! Now i have clonidine .1mg but i went through 2 days of the stomach issues that seems to have subsided now i have the restlessness n crawling skin i need some advice on how long this crawling skin crap last i was on a small dose but for almost a year plz help thanks xoxo

6:46 pm July 31st, 2014

Hello Christi. Symptoms of restlessness and crawling skin tend to peak about 72 hours into a detox and resolve within 7-10 days after last dose. Have you consulted with a supervising physician?

Cassie
5:27 pm August 3rd, 2014

Please help me! :-( I have to come off of them I’ve been taking suboxone 24 MG a day for 5 years! How long will the intense physical withdrawals last and am I just starting it over by taking lortab. It’s not taking the withdrawals away completely. Will it eventually??? I have to have back surgery next week and don’t wanna have pain from surgery AND withdrawals. I need help and have NO support

Ivana @ Addiction Blog
10:07 am August 4th, 2014

Hi Cassie. Unfortunately, when withdrawing from a substance after taking it long-term, the symptoms are an inevitable part of the process. Taking other medications can help make the withdrawal symptoms less intense and more manageable. However, it cannot take them away completely. Talk to a doctor or a pharmacist to see what you can do about it.

Joel
6:04 pm August 5th, 2014

I am 51 years old active man who has had some severe injuries in his life. Being a lifelong firefighter has not helped as I have been hospitalized twice from my job. Getting to the point, I have seen specialist in Houston and Atlanta about my pain. Multiple MRI’s have shown degenerative lower back disease from compression (falls) and arthritis throughout my joints. I was legally prescribed 10 mg percs. and I finally sought help and started the buprenorphine treatment. The only way to stop is gradual and you need a partner to help you who will not give in. Start eating right and treating your body right by working out and staying active more than ever before. Cut your dosage down over at least 3 months and then to every other day, to every third day. You must remain strict ! Weed and Xanax may help but I get drug tested randomly so that is not an option. Above all, seek The Lord, stay in His word, pray without ceasing. You can do anything when He has your back !

Raffi
3:15 pm August 11th, 2014

I have been using opiates for 21 years. For at least 6 years, probably longer, I started injecting 100MU of Fentanyl/day. I had perfected the cooking method, and could get as many as 16 great shots per 100MU film. Unfortunately it was almost impossible to find that much Fentanyl on the market as the drug became more popular and the prices quadrupled in a very short time. Replacing Fentanyl with Methadone proved to be impossible – I had to get 180mg of methadone/day to get to work – which I have kept throughout my using career. Indeed, I started using at work – in the harm reduction field, which was quite new at the time and its boundaries quite unclear.

Anyway, about two years ago I went through 2 weeks of withdrawal to move to Suboxone. It was pure hell. Every time I would take a 4mg pill, I would go through precipitated withdrawal – and I took one every 4 hours, going through hell until one day I woke up feeling hungry. I needed 48mg/day of Suboxone to do so – half the highest recommended dose in Ontario, where I live. I had bought a huge supply from friends in the US and was getting the rest from my doctor. He wouldn’t prescribe more than 32mg/day on condition that I taper to 24 in a few months.

When my Suboxone pills started to deplete, I decided to go through another full on withdrawal. Fifteen days later I had to give it up – I was good on 4mg/day though.

About a year later, that 4mg rose to 18mg/day – I’ve gone through so many withdrawals, I can tell when I need more suboxone when the wind rubs one of my hair follicles the wrong way.

Today is the 20th day of my withdrawal, and it seems it’s getting worse, not better. I can’t keep food in and I’m always dehydrated, no matter how much I drink. Some of my friends thought I had got a stomach bug because bupe withdrawal is not supposed to last that long. I went to hospital – I have no bugs in me. Does anyone has any idea how much longer this may last? Please no remarks about why I’m doing this way. Even though I recommend tapering to our service users, for me tapering has never worked. Also, I’ve been working towards this in my own way during the past two years.

Joanne
7:17 am August 15th, 2014

I have been off subutex for just over 3months and have last watery mouth with bad taste, RLS has gone thank god. Wondering when back to normal completley. When I detowed from Meth it only took 3weeks intense yeh but nothing as ad as subutex long suffering drug never take anything ever again. Am told 6months before body back to normal can’t wait hurry up.

Jay
7:32 pm August 17th, 2014

Raffi ii came off subutex 2months ago and I am still waking up at 4am or going to Sleep at 4am for 2hours to 4hours my skin is crawling quite badly and have watery mouth this is taking longer than I was told by doctor. Am hoping another week who knows I haven’t a clue how king this last but I pray it’s not much linger maybe someone can help me.

elisha
9:41 am August 22nd, 2014

Iv been sniffing roughly 1ml a day for a couple days then avin a couple days off like that for about 4 month… Wat are my withdrawals gunna be like? iv decided to stop now and not had none for 3 days

Josh
12:42 pm August 23rd, 2014

I was on 3 8mg Subutex for about ten months. Got cut off by my doc because the DEA was up his ass about having like a dozen more patients than the allowed 100. Anyway, I feel fine physically. Took my last quarter (2mg, if that) about 4 days ago. Note that, although I was Prescribed 3 a day, I only ever took anywhere from a half to one and a half per day. My only issues – as of right now – are not being able to fall asleep, Zero motivation, and obsessive thoughts, like my mind is telling me I need tex, even though my body doesn’t. I’ve been up the last two nights, then took some sedating meds (prescribed 2mg Klonipin, Somas – very strong muscle relaxer, and Unisom), and Finally got in about a 5hr nap last evening. I don’t want to be dependent on anything again. I’ve been to rehab over a dozen times, and detox almost 20 times. I always relapsed, so I got on Methadone, and was on 75mg/day for almost 3yrs. Now THAT detox was F*¢king awful. And after a month off Methadone, I got put on Subutex. I just can’t wait to be symptom free, mentally and emotionally. No real physical stuff going on except inability to sleep. Everything else is in my head. I’ve had post-acute withdrawal symptoms several times before and it seems recouping from getting off tex may end up being worse than the PAWS I experienced before. I’m just hoping I’ll be able to sleep again soon, stop being a filthy hobo who doesn’t even have enough motivation to do laundry or shower everyday. I’m being very antisocial and irritable and paranoid. And still mentally craving Something to take (preferably tex) but I know I’m this far into it, I don’t wanna go back to square one. It’s hard, and it sucks, but it’s worth it in the long run, for sure.

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