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How to withdraw from buprenorphine

Buprenorphine is used to ease withdrawal symptoms from opioids, and is an opioid partial agonist. Because it is a partial agonist, buprenorphine can cause the same or similar side effects as other opioids, including euphoria and respiratory depression. So how can you withdraw from buprenorphine in your system in a way that is safe and reduces the intensity of symptoms?  And what is buprenorphine withdrawal like?  We review here and invite your questions about buprenorphine withdrawal at the end.

When do you withdraw from buprenorphine?

You withdraw from buprenorphine when you stop or abruptly lower doses of buprenorphine after becoming physically dependent on buprenorphine. In fact, withdrawal is characterized by drug dependence, which means that your body needs the drug in order to function normally. If you have been using buprenorphine daily and are ready to live without it, you might consider withdrawal. Or if you have become psychologically dependent on buprenorphine use, and cannot function normally without taking the drug, you may also want to consider withdrawal. While it may seem difficult to face the symptoms of buprenorphine withdrawal, withdrawal from buprenorphine takes a predictable course. While uncomfortable, withdrawal from buprenorphine is routine and treatable.

How long to withdraw from buprenorphine?

The time is takes to withdraw from buprenorphine varies in length depending on the severity of your body’s dependence. You generally start feeling the symptoms of withdrawal as early as a couple of hours after your next expected dose. The physical withdrawal symptoms will peak, or reach the height of their severity, about 48-72 hours after your final use. However, some buprenorphine withdrawal symptoms may be present for weeks, or even months following the final dosage.

Withdraw from buprenorphine symptoms

The symptoms of buprenorphine withdrawal are similar to those of other opioids, like heroin, although they are typically milder. When withdrawing from buprenorphine, symptoms that may occur include:

  • body aches
  • changes in appetite
  • changes in sleeping habits
  • cold sweats
  • flu-like symptoms
  • headaches
  • mood swings
  • nausea

These symptoms can vary depending on the severity of chemical dependence on buprenorphine and the length of use for each person. Some people may face severe withdrawal symptoms, which can peak 2-5 days after the last dose, while others may only see mild withdrawal symptoms. It is always important to consult a doctor when withdrawing from buprenorphine in order to assess your personal needs during withdrawal and to make sure you are withdrawing safely from the drug.

How to ease withdrawal symptoms from buprenorphine

When you decide to discontinue buprenorphine treatment, the daily dose should be decreased gradually over a predetermined period or at a rate you agree upon with your prescribing doctor. This process is called tapering and is the best way to ease withdrawal symptoms from buprenorphine. Withdrawal symptoms may emerge as the buprenorphine dose is decreased. In this event, the taper may be temporarily suspended. Discontinuation of buprenorphine over a period of 3+ weeks is the preferred manner.

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Because buprenorphine is the drug that is typically subscribed to ease symptoms of opioid withdrawal, there may be no easy way to withdraw from use. Easing symptoms of buprenorphine withdrawal can be achieved through home remedies, or by seeking treatment from a doctor or detox clinic. Home remedies such as the use of heating pads, gels, massage creams, hot baths and showers can address physical symptoms of withdrawal, and seeking support groups such as Narcotics Anonymous or SMART recovery can assist with psychological withdrawal symptoms.

How to withdraw from buprenorphine safely

Withdrawing from buprenorphine can be achieved safely under the supervision of a doctor or medical staff in a detox clinic. Because buprenorphine is a partial opioid-agonist, and the effects of the drug resemble those of other opioids, it is important to withdrawal under the supervision of a doctor or counselor, so your withdrawal symptoms can be managed. Doctors will be able to assess the severity of your symptoms and decide on the proper method of withdrawal, which may include tapering you off of buprenorphine or prescribing clonidine or anti-diarrhea medications.

Can I withdraw from buprenorphine at home?

Buprenorphine withdrawal at home is possible. The main goal is to address physical withdrawal symptoms. For body aches and other pain, use mild pain relievers such as Tylenol or ibuprofen. You can also take warm baths and use heating pads when you experience physical pain. Gastrointestinal stress may also present itself, and will need to be treated by drinking fluids and sometimes taking Imodium. Psychological withdrawal symptoms, such as craving and mood swings will need to be addressed, and it is important to seek help from a sober friend or family member, or to attend support groups such as Narcotics Anonymous or SMART recovery.

The best way to withdraw from buprenorphine

The best way to withdrawal from buprenorphine is under the supervision of a doctor or drug abuse counselor. This can be achieved in either an inpatient or outpatient facility, depending on what is best for you. Both inpatient and outpatient facilities provide evaluation and supervision by doctors and counselors. They also begin psychological and behavioral treatment therapies in order to deal with psychological withdrawal symptoms.

How to deal with withdrawal from buprenorphine questions

Do you have more questions about how to withdrawal from buprenorphine? Are you considering withdrawal and would like to find out more about treatment and symptoms? Comment below with your questions, comments or concerns and we will respond personally and promptly.

Reference Sources: Indian Journal of Psychiatry: BUPRENORPHINE WITHDRAWAL SYNDROME
CSAT: About buprenorphine therapy
SAMHSA: Buprenorphine Facts
University of Indiana: DSM IV Drug Dependence Criteria
SAMHSA: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, Treatment Improvement Protocol (TIP) Series, No. 40.

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18 Responses to “How to withdraw from buprenorphine
Nikki
9:59 am March 23rd, 2014

Hi. Thanks for your reply. Am now down to 0.8mg of subtext, and am afraid that I may have messed up by snorting some heroin last night. I don’t even know why. Am attending smart recovery, and have done so well. Have I messed up, and how to make it better! Please?

andrew
5:17 pm April 11th, 2015

ive been on subutex for a month. before i was on suboxone.for years. i have now down to 0.4 and plan to take for say 4 days than cut that 0-4 in half which will be 0-2. and take that for 4 days maybe 5 days every day. than i will try and add an extra 1 or 2 hours on top of my 24 hours of last dose. the aim is to add an hour or 2 every day or second day to stabalize the dose and than keeping on adding 1 or 2 hours so far very little pain as i hold a full time job. could take me 1 month to get 3 days before i need to take 0-2 of the subutex tablet. i than am thinking of taking panidine or panadol tablets if needed and again over weeks reduce them. so far its working. while droppind down i have had no more than 1 zanax tablet to help with sleep no more than two to 3 days in a row and only at the start of me dropping weather 1ml or half a ml. so far so good. its a long process but its working. if you have any other suggestions as im getting down to a very lose dose. like i said im now on 0-4 and ready to half that.by taking codeine phosphate 30 mg when needed or mercondol for pain when needed can that small dose set me back. also any other tips if you think may help i would love to hear them. i have a girlfriend who is drug free and always has been. work mates are drug free and they know what im doing..the only thing i can think of is putting in the naltraxone implant for a year but dsont know who does thae. hope all this makes sense and any advice i would appriecate.thanks for your time and hope you can add to my plan and any solutions you can suggest than im all ears. love andrew. life is beautiful straight but you must want it and happy for any help. thankyou

Mark
8:57 am May 17th, 2015

I was taking 10/325 Norco at a rate of 10 to 20 a day for a year or more. On 5-5 I had taken 11. I decided enough was enough so on 5-6 I took 1 and 1/2 8mg/2mg suboxone. On 5-7 I took 1/2 of a sub. Then on 5-8 I took nothing and haven’t since. I am just wondering how long I am going to be feeling off. I have 3 crushed discs in my back and a torn rotator cuff. I want to stay off pills or subs. Any suggestions would be nice. Thanks Mark

2:34 pm May 22nd, 2015

Hi Mark. I would have suggested a more slow and gradual taper, yours was pretty abrupt. Please seek your doctor’s help and help him create a tapering schedule that will work for you (if your doc decides you need to go back on the medications for a little while longer). A slow taper and a proper medical help can make detox much more comfortable. Of course, you will also need some counseling sessions or therapy to help you with psychological issues and cravings.

Mark
11:34 pm May 22nd, 2015

I seem to be past the worst of it. I did not even miss a day of work. I did experience some cravings but the decision was either quit or possibly lose my wife who I will have been with 40 years on the 24th. I still think about the pain. I don’t know how much is real and how much is from withdrawal. She is so happy that she has helped with whatever I am going thru. I thank you for this blog and your concern. It means a lot to me to know there is a place to converse and get advice. I have not hidden it from anyone now ( Employer, friends family ) Two people have told me today they both quit 7 days ago because of me. I hope I’m not preaching but my son said so many of the people he went to school with ( he is 26) are either on pills or moved onto heroin and at least 6 have od’d. I wish all the best to all who read this and I know if you want to you can do it. Thanks again Mark

2:53 pm June 4th, 2015

Hello Mark. Thank you for your feedback and kind words. Your comment tells such an inspiring and positive story, that I’m sure others will be encouraged as well. I’m glad you are spreading the support and that others are following into your footsteps. Keep going brave!

Mark
6:35 am October 17th, 2015

Hi Ivana
Just checking in to let you know all is well. It is so nice to be able to wake up everyday! No more worries about how I am going to make it thru the day. I found out I’m going to be a Grandpa again soon. So nice to have a feeling of purpose and hope again. Thanks again for being there for support. Hope all is well with you and everyone who are going thru trials. If you want it you can do it.

vicki
7:05 pm October 17th, 2015

my dr gave me butrans patches 20 I was on them for 2,1/2 years. they worked well for a while, then I fell down the a lot of steps hurt my self pretty badly. knowing my dr wouldn’t give me anything I went to another dr. well needless to say he cut me off the patches cold turkey. Its been 7days, I have been using the loratob 7.5 to help. a friend gave me a suboxone said it would help. seems to me if im trying to get off that is just putting it back in my system.. any suggestions?

2:45 pm October 19th, 2015

Thank you for writing again Mark. It’s nice to hear that things are looking up for you. Enjoy life!

5:43 pm November 6th, 2015

Hi Vicki. Ask the pharmacist in your pharmacy about the amount you can take to slowly taper doses down and prevent your organism from going through an abrupt and unpleasant withdrawal.

Mark
8:40 am February 20th, 2016

Hi Ivana
Just checking back in to let you and all out there know that I now have a second grandson. Life is good and the will is strong. Here in the Detroit area they have started allowing naloxone to be sold over the counter to help reverse opioid overdoses. I have been trying to organize meetings to teach how this can save some ones life. The abuse is so bad and since I have been there myself in the past I am trying to keep others from going through what I had to, without them having to worry about the stigma attached. Every day when I get up I am thankful for the support of this blog and you for being here to listen and guide us. I have rambled on long enough. If we all pull together and support each other we can beat this as a family of people who value life and the rewards we cannot see while we are addicted. May inner peace and a strong support system be with you all. Mark

5:51 pm February 22nd, 2016

Mark, it’s so good to hear from you again. Congratulations on becoming a grandpa for the second time! I’m very pleased that things are going for the better. And, yes, we know that city by city naloxone is starting to be available OTC, mostly at Duane Reades and Walgreens. It is really good news and I hope it reduces opioid drug overdoses drastically. Thank you for writing back and praising us like this. It’s comments like yours that can make our day and motivate us to work even more committedly on our mission to help people. Kind regards, Ivana

Jeremy
12:08 am April 20th, 2016

I have been on buprenophine for 6 years. The first 4 years I was on suboxone, the last 2 I’ve been on straight bupe. I’m prescribed 3 8 mg for chronic pain. Before that I was on full opiods both by prescription and illegal from the street.Anyways my doctor and I both agree that with my pain which I’m stuck with for life, and the amount of time I’ve been opiates, I’ll need to be on bupe forever. If I come off,o would be unable to work, and would be constantly battling pain and temptation of illegal opioids to relieve it. I often wonder what my withdrawal would be like and how long would it last and how intense would they be after 6 yrs and at 24mgs/day. I’ve considered giving it a try and seeing how much worse the pain can be without the subutex. Anyone quit after that long and that much? If so, how bad was it?

Mark
8:36 am May 16th, 2016

Hi Ivana
Just a quick note to let you know that is has been over a year now and I don’t think I have looked forward to an anniversary in a long time. The 24th will be 41 years but the first clean and sober one in at least 5. I still always think about how you are always there to talk to when the need arises. I feel that just knowing I have a place to post updates and get a reply back helps to keep me focused. We walked the Sleeping Bear Dunes all the way 20 years ago and promised that we would do it again when I turned 60. Well I think that my wife Katie had lost all hope that that or much else of any good was going to come out of me after the addiction started. I have made plans for this trip now and she is a little concerned that it could cause me to relapse from the pain and soreness. With a strong support system and people like you I know that everything will be fine. Remember you just have to get through today and then get back up and do it again. One day at a time is all it takes. Peace and prayers to all who are struggling, I am 60 and proof if you want it bad enough you too can kick it. Mark

Danny
12:43 am June 4th, 2016

hi, i have been taking buprenorphine since 1993, in the early years a come down/withdrawing wasn’t a problem, it was a 0.2 temgesic tablet i was taking, not all the tablet to start with, maybe a quarter a night for the first 6 months, then a half tablet a night for 3 years, then up to 3/4 of a tablet for a further 7 years, i always had a rest every year for the first ten years of at least 3 months to prove to myself i could go without it and wasn’t a junkie, i was kidding myself on that i wasn’t a junkie but i was and still am, when subutex,, subbies were first available they were cheaper than temgesic as loads more people were prescribed them, £2.50 for a 0.2ml tem, and £3.50 for 8ml of subutex, that was forty tems for £3.50, go figure,,, i am now 56 and think i should call it a day as the effect since stopping smoking cigs and hash is not the same as i had been used to all those years, the come down i had the last time i took tems was terrible, it lasted 7 weeks the reason i had managed to stick to coming of the tems was i love driving motorbikes and round about the 3rd week of pain i went out on my bike, the adrenalin rush i got from driving the bike was enough to kill my pain, if your reading this don’t let my pain put you of your come down you know its going to be hard, at the end of the come down and your all sorted what a feeling it is to be healed, life is great, the things i noticed was some ones white shirt was a glowing white, the smell of flowers at night was amazing, my dinner was very tasty, i have been taking one 8ml tablet a day for the last 5 years, but during march i decided to cut down, at the moment i am taking about 4ml to 8ml a week, i did get a adverse effect as i cut my dosage to 4ml a day at the start, one day of brain damage and sore legs, my legs are still sore but manageable

bob
10:12 am June 17th, 2016

Ive stopped subutex cold turkey, todsy makes my 8th day. The first 5days i was ok, and the last few days seen to feel like there getting worst. I cant sleep my bodys aching and i dont want to get out of bed. I was only snorting a little line of subutex a day

matty
11:47 pm August 14th, 2016

Hi I’ve recently stopped taking 14ml of subutex and I’m in severe withdrawal . My breathing is erratic and I’m in a lot of pain I can’t see a doctor till the morning will I be ok? I thought I could deal with just stopping as I went a few days without taking my script one weekend as I lost it and I felt ok but it’s been roughly 5 days without it now and I used abit of heroin yesterday to kerb the way I’m feeling. I’ve been on a subutex script now for about 2 years through a addiction centre. I know now it’s was really foolish of me to just stop the way I have. i know I won’t be sleeping tonight and I’m gonna feel like this but what can I expect from the doctor to help me in the morning? Thanks for your time.

4:41 pm August 24th, 2016

Hi Matty. Sorry we didn’t get to you on time. Did you see a doctor? How are you feeling now?

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