Suboxone Detox Treatment Programs

What Is Suboxone?

Suboxone is brand name prescription treatment medication that combines both buprenorphine and naloxone.¹ It is used to help people recover from opioid addiction by easing withdrawal symptoms and reducing cravings, which may help reduce continued opioid misuse and prevent opioid relapse.³

Suboxone is designed to be used as a part of a comprehensive opioid addiction treatment program that also involves counseling, behavioral therapies, and other psychosocial supports.¹

What Is Suboxone Used For?

Suboxone is administered once daily as a sublingual (under the tongue) or buccal (on the inside of the cheek) film.¹ It reduces cravings and withdrawal symptoms and can prevent the euphoric effects of opioids when used as directed.3 People can take Suboxone on a short- or long-term basis.⁴

There is no maximum length of treatment with Suboxone, so people can continue to receive it for as long as needed.¹ Because many people see a return to opioid misuse when medications for OUD are discontinued, your treatment team may advise you to remain on medications like Suboxone for as long as they provide a benefit.⁴

Suboxone contains 2 different medications to support people recovering from opioid misuse:

• Buprenorphine is an opioid receptor partial agonist. This means that it attaches to and partially activates opioid receptors (the same receptors that are activated by the opioids you may have misused) to diminish withdrawal symptoms and opioid cravings.³ Though it may lead to some opioid effects such as euphoria and respiratory depression at moderate doses, as a partial agonist, such effects are less intense than full opioid agonist drugs, like methadone.² When used at prescription doses and when taken as directed, it can help people safely manage opioid withdrawal and cravings without pronounced reinforcing effects.²
• is an opioid receptor antagonist and is included in Suboxone as a deterrent to misuse. It blocks opioid receptor activation in the brain and blunts the euphoric effects of buprenorphine if misused (such as dissolving the film to inject it). It could also precipitate immediate opioid withdrawal, thereby reducing the likelihood of misuse.^3,4

Suboxone Side Effects

It is possible to experience Suboxone side effects and adverse reactions when taking the substance. If you experience Suboxone side effects that are bothersome or persistent, you should speak to your prescribing physician.²

Some of the common Suboxone side effects, and particularly those associated with buprenorphine, can include:^1,2

• Headache.
• Nausea and vomiting.
• Constipation.
• Dizziness.
• Sleep problems.
• Drowsiness and fatigue.
• Attention problems.
• Sweating.
• Dry mouth and related tooth decay.
• Muscle pain and cramps
• Dilated pupils.

As an orally administered film, Suboxone may also be associated with specific adverse reactions like:¹

• Oral hypoesthesia (loss of sensation).
• Glossodynia (burning sensation in the mouth).
• Oral mucosal redness/swelling.

Suboxone’s safety has been supported by clinical trials and using Suboxone is typically considered safe when used as prescribed.¹ However, Suboxone can present specific risks, especially if you use it in unintended ways.

Effects for Pregnant Women and Newborns

Pregnant or breastfeeding mothers should consult a physician before taking Suboxone. It is unclear how Suboxone affects an unborn baby. However, doctors warn that if Suboxone is taken while a woman is pregnant, is it possible for the baby to be born with a drug dependency, leading to life-threatening consequences.

The drugs that combine to make up Suboxone can also pass into breast milk and may harm a nursing baby. But there is limited research on the effects on the infant.⁸ Pregnant or breastfeeding mothers should consult their physician before taking any medication-assisted therapies such as Suboxone.

Detoxing From Suboxone

Suboxone is a prescription medication used to treat opioid addiction or dependence. This article will discuss the use of Suboxone in the process of opioid withdrawal, as well as the tapering off and withdrawal process associated with the abuse of Suboxone.

Suboxone Detox Symptoms and Timeline

Suboxone was designed to address the withdrawal process that occurs with physical dependence and/or addiction to opioid drugs, including heroin, morphine and oxycodone. Suboxone combines the effects of two drugs (buprenorphine and naloxone) into one medication, giving it an advantage over other similar drugs. It is designed to treat physical dependence, which can be useful in avoiding relapse. However, simply taking Suboxone as part of a medically assisted detox does not treat the underlying addiction.

Additionally, people may become physically dependent on Suboxone or abuse it. If someone were to immediately discontinue using Suboxone, the withdrawal symptoms would most likely not occur immediately. The withdrawal timeline below is based on the time following the last dosage of Suboxone taken. Withdrawal from Suboxone or other opioid drugs is not life-threatening, even though it may feel that way to the person experiencing it.

• 24 to 72 hours: Withdrawal will be most intense within the first 3 days or 72 hours following the last dosage. The symptoms will likely peak between 48 hours and 72 hours for most individuals. Common symptoms in this phase include:
  • Nausea.
  • Sweating.
  • Chills and/or fever.
  • Diarrhea.
  • Dilated pupils.
  • Watery eyes.
  • Restlessness and malaise.
• First week: Users may continue to feel restless after the first week and experience muscle and joint pains, cramps, insomnia and mood swings.
• Second week: Physical aches and pains may subside.
• Third week and beyond: Most of the physical withdrawal symptoms should have subsided. However, some people may continue to experience cravings and psychological or emotional symptoms.

For most people, the acute effects of opioid withdrawal range anywhere from 3 to 5 days and can last as long as 10 days.

Protracted Withdrawal Syndrome or Post-Acute Withdrawal Syndrome (PAWS)

The acute withdrawal effects described above usually peak within a few days and then subside rather quickly, but some people may experience prolonged emotional and/or psychological symptoms, including:

• Anxiety.
• Irritability and agitation.
• Insomnia.
• Mood swings.
• Bouts of depression.
• Drug cravings.

Factors Affecting Suboxone Withdrawal

Several factors affect the withdrawal symptoms that people experience as a result of using any opioid drug:¹

• The method of discontinuation: People who use Suboxone under the supervision of a physician typically taper down the dosage slowly until they can stop using the medication altogether. Quitting Suboxone use in this manner results in mild or no symptoms of withdrawal. Stopping the medication or drug abruptly will produce more intense withdrawal symptoms and a potentially protracted term of unpleasant withdrawal.
• The dosage of the drug typically used: The higher the dosage typically used, the more severe and long-lasting the withdrawal symptoms will be.
• The length of time the drug was used: The longer a person uses the drug, the more complicated the withdrawal process will typically be.
• How the drug was used: Certain methods of drug use, such as injecting or snorting, may cause people to develop higher tolerances to the drug compared to taking it in pill form. Having developed a higher tolerance to a drug often results in exaggerated drug dosing to overcome the effect. This, in turn, will result in longer and more intense withdrawal symptoms.
• Individual variations between people: Individual differences can also dictate the severity and length of withdrawal symptoms. No two people experience the same process when withdrawing from any drug.

Risks of Suboxone Use

Use of opioid drugs over the long term will result in changes in pathways of the brain.² Long-term users have a higher probability of developing a substance abuse disorder to similar drugs.

For example, a heroin addict using Suboxone for heroin detox will more quickly develop a physical dependence on Suboxone than someone who was addicted to another, non-opioid class of drugs and who then started using Suboxone.

Contrary to what many sources on the Internet claim, Suboxone was not designed to replace one addiction with another, but people who use replacement medications such as Suboxone to deal with addiction to opioids should only do so under the supervision of a physician.

Comparing Approaches to Suboxone Detox Treatment

Past research has supported the observation that higher doses of and longer periods on medications such as buprenorphine are associated with lower rates of relapse in those in recovery.³ By this token, the 5-day taper would have advantages over the 3-day taper due to a longer detoxification period. The person also receives more of the drug in this time interval.

Some people may need a longer tapering off period than 5 days. A person’s drug history may also play a role in the effectiveness of the use of maintenance medications, tapering periods and dosages in treatment outcomes. People with more chronic histories of drug abuse appear to respond better to higher doses and longer tapering off periods than people who recently developed substance abuse disorders.⁴

Detoxing From Suboxone at Home

You may be wondering how to detox from Suboxone at home. Using Suboxone to detox from an opioid drug or detoxing from Suboxone itself should only be done under the supervision of a physician. Engaging in your own unsupervised “detox” instead of attending a supervised inpatient or outpatient detox program has several disadvantages:

• People who attempt to “go it alone” often find it easier to give in to temptation and relapse.
• You do not receive assessment or treatment for other emotional or psychological issues that may have contributed to the substance abuse disorder, nor for issues that may arise in conjunction with the withdrawal process itself.
• A medical professional cannot treat unforeseen issues that can occur during the detox process.
• There is no formalized treatment program in place that can help you to develop strategies to deal with relapse triggers.
• You are not exposed to a network of professionals and peers who encourage recovery.
• You do not develop coping strategies for stress, boredom and other factors that often cause relapse.
• You do not receive a long-term aftercare program to help you maintain sobriety.

Tips for Suboxone Detox

Several other factors may assist in the detoxification and addiction recovery process:

• Eat a balanced diet and avoid fatty foods, sugar, starch and alcohol.
• Become educated on the process of withdrawal and detoxification.
• Find things to do to keep busy – boredom can be a trigger for relapse.
• Stay close to family and drug-free friends and build a social support network to help maintain new goals.
• Keep a regular schedule and get plenty of sleep.
• Try to get regular exercise.
• Do not be afraid to ask for help.
• Stay focused and be patient. Recovery takes time.

What Happens After Detoxification?

Detox helps you get clean so that you can begin to work on your addiction and on the issues that may have led you to use drugs or alcohol. Working through the causes of your addiction is an essential step, whether you were using Suboxone to withdraw from another drug such as heroin or you had become dependent on or were abusing Suboxone itself. 

If you choose to attend a Suboxone detox program in an inpatient or outpatient rehab facility, you may be able to transition into the recovery program there. If you complete Suboxone detox in a detox clinic, the staff can make recommendations for another program or directly transfer or refer you to a nearby treatment center.

Common recovery options for opioid addiction include:

• Inpatient or residential rehab. Inpatient drug recovery programs usually last anywhere from 28 or 30 days to 60 days or 90 days. Many offer detox as the first stage of treatment. After you complete detox, you participate in a recovery program that includes individual and group therapy, medical care and relapse prevention planning.
• Outpatient treatment. Outpatient programs may also offer detox as well as individual and group therapy. However, you travel to the treatment center on certain days of the week instead of living there. You may choose an intensive outpatient program.
• 12-Step programs. These programs are based on the 12-Step approach of Alcoholics Anonymous (AA). Narcotics Anonymous is a popular 12-Step program that helps people recovering from opioid addictions.

Aftercare

Many people struggle to stay clean after they leave a treatment program. They return to familiar environments filled with triggers and people they used to take drugs with. Aftercare provides ongoing support to help people stay sober once they leave a formal treatment program. Many programs will help you establish an aftercare program before you discharge.

Suboxone can be an effective tool in recovery from opioid addiction, but it also requires careful medical supervision—especially during detox. The process may feel overwhelming, but with the right support, many people find lasting recovery and relief from cravings. Detox is not just about stopping Suboxone; it’s about creating a strong foundation for long-term healing.