Buprenorphine Withdrawal and Detox

Buprenorphine is an opioid medication that is prescribed to treat opioid use disorder (OUD) and alleviate moderate to severe pain. Common brand names for buprenorphine include Subutex, Suboxone, and Butrans, and well-known slang terms include “buse”, “sobos”, “strips”, and “oranges”.

Buprenorphine Withdrawal and Detox

Since buprenorphine is a partial opioid agonist, it only activates some opioid receptors in the brain while blocking others. This means that a euphoric effect is still present, but is weaker than it is with other opioids such as heroin, methadone, and morphine. When buprenorphine is abused or used incorrectly, the addiction potential increases and a physical dependence can form, which may lead to drug addiction. Once a user is dependent on buprenorphine, they may experience several physical and psychological manifestations of withdrawal upon trying to quit this drug.

This article will help you learn about the duration of withdrawal and what symptoms to expect during a buprenorphine abstinence crisis. Different treatment options will also be covered to help you make an informed decision about your detoxification and withdrawal process.

Possible side effects of buprenorphine

A buprenorphine user experiencing adverse side effects after taking a dose.

Buprenorphine can cause adverse and uncomfortable side effects even to those that are using it as directed, though they may differ slightly depending on the method of consumption. Possible side effects of buprenorphine include but are not limited to:

  • Constipation and abdominal pain
  • Nausea and vomiting
  • Changes in appetite
  • Drowsiness, dizziness, or unusual fatigue
  • Headaches
  • Excessive sweating
  • Rashes and itching (especially with the transdermal patch and injection)
  • Numbness or irritation in your mouth (from sublingual tablets)

Most of the time, these side effects are mild and fade on their own as buprenorphine leaves your system. If the medication is misused, you are more likely to experience adverse reactions.

In cases of severe allergic responses or otherwise dangerous reactions, some serious side effects may be experienced such as reduced respiratory function, low blood pressure, issues with adrenal function, and liver problems.

If you are concerned about your response to buprenorphine or experience an extreme reaction as stated above, contact a medical professional as soon as possible.

Buprenorphine withdrawal symptoms

A buprenorphine abstinence crisis is often compared to that of heroin, though the experience may be more mild. Withdrawal from other opioids such as methadone is usually more intense or includes a greater number of symptoms, but buprenorphine withdrawal can still be very uncomfortable and may lead to relapse if attempted alone. Generally, symptoms are flu-like in nature and consist of:

  • Nausea and vomiting
  • Abdominal cramps and muscle aches
  • Watery eyes and runny nose
  • Headaches
  • Excessive sweating
  • Insomnia
  • Changes in appetite
  • Intense drug cravings
  • Mental turmoil including anxiety, irritability, and depression

The intensity of these symptoms depends on several factors, including the duration of a person’s addiction, the size of their doses, their general health, and more. As the severity of the addiction worsens, so do the withdrawal symptoms.

How long does buprenorphine withdrawal last?

Depending on the method of consumption, the half-life of buprenorphine usually ranges from 3 hours for injections to over a day for sublingual administration. This means that you may begin feeling withdrawal symptoms at very different times depending on your method of use.

Acute withdrawal will likely appear within a day or two, peak within 3 to 5 days, and then fade after one to two weeks. This does not mean that withdrawal is completely over, and physical withdrawal symptoms can last for weeks after the last dose. Drug cravings and psychological withdrawal symptoms will likely last the longest and can take several weeks or months to fade, which contributes to the high possibility of relapse.

It is necessary to note that this timeline may make withdrawal sound easy, but full drug detoxification does not only consist of a week of flu symptoms. The intensity of the drug cravings and the lingering physical and psychological symptoms can be unbearable and often lead to relapse weeks or months down the line.

What is buprenorphine detox and withdrawal treatment?

There are two main options for the treatment of buprenorphine addiction and withdrawal. With the guidance and advice of a doctor, it is technically possible to slowly detox at home, but this is not a viable choice for many who wish to get off of buprenorphine for good. This process involves gradually lowering the dose of the drug in order to avoid the worst of the abstinence crisis as your body gets used to having a lower concentration of buprenorphine. This is a time consuming and often uncomfortable detox method that often leads to relapse due to lack of support.

An addiction treatment expert recommending different therapies after a drug detox procedure.

Another option for drug detoxification and addiction treatment involves the ultra-rapid opioid detoxification (UROD) procedure. During the procedure, the patient is under anesthesia for 6-8 hours as they are given medications such as naloxone and naltrexone, which cleanse opiates from the body. This method may be repeated several times and is only ever practiced in a qualified and prepared medical facility in order to ensure the patient’s health.

UROD is meant to help patients get through acute withdrawal without having to experience the most painful symptoms, but this is only one part of the treatment as a whole. After the detox procedure, a combination of pharmacotherapy, physiotherapy, or behavioral therapy will likely be recommended to help the patient on their path to full recovery.

If you or someone you know needs help getting through buprenorphine withdrawal, get in contact with us to learn about the best treatment option for you.

Frequently asked questions

01. What are the symptoms of buprenorphine withdrawal?
You may experience flu-like symptoms of varying intensities over the course of one to two weeks. The physical manifestations of withdrawal may include nausea and vomiting, abdominal pain, runny nose, headaches, sleep troubles, reduced or increased appetite, and intense drug cravings. Drug cravings and psychological symptoms such as irritability, anxiety, depression, and brain fog can persist long after acute withdrawal has faded.
02. What is the buprenorphine withdrawal timeline?
Acute withdrawal will likely appear within a day or two, peak within 3 to 5 days, and then fade after one to two weeks, though some more mild physical symptoms can last for even longer. Drug cravings and psychological withdrawal symptoms will last the longest and can take several weeks to several months to fade, which contributes to the high possibility of relapse. Both the severity of the abstinence crisis and the duration of withdrawal will depend on a variety of factors including your method of use and the intensity of your addiction.
03. How do I get off of buprenorphine?
Though it is technically possible to self-detox, this can be a very painful process that frequently results in relapse. A more comfortable way of getting off of buprenorphine is in a medical facility that specializes in drug detoxification. Ultra-rapid opioid detoxification (UROD) is a drug detoxification procedure that can be paired with other treatment methods such as pharmacotherapy, physiotherapy, and behavioral therapy in order to help you recover in the most safe and effective way possible.