Key Takeaways
- Yes, it is possible: You can experience withdrawal-like symptoms while on Suboxone, often due to “precipitated withdrawal” or incorrect dosing.
- Timing matters: Taking Suboxone too soon after using other opioids can trigger immediate and intense detox symptoms.
- Dosing is key: If your dose is too low, it may not fully cover your opioid receptors, leading to breakthrough withdrawal symptoms.
- Medical supervision is crucial: Adjusting your medication should always be done under the guidance of a healthcare provider to minimize discomfort.
Question:
Can you experience withdrawal symptoms while on Suboxone?
Answer:
Suboxone is a lifesaving medication used in Medication-Assisted Treatment (MAT) for opioid use disorder. It combines buprenorphine and naloxone to reduce cravings and stabilize brain chemistry. However, many patients ask: can you experience detox symptoms while on Suboxone? The short answer is yes, though it usually happens under specific circumstances.
This blog explores why this occurs. The most common cause is precipitated withdrawal, which happens when Suboxone is taken before full opioid agonists (like heroin or fentanyl) have left the body. Additionally, if a patient’s maintenance dose is too low, they may experience “breakthrough” withdrawal symptoms as the medication wears off. Understanding the difference between precipitated withdrawal, improper dosing, and unrelated illness is vital for successful recovery. By working closely with addiction specialists at SCBH, patients can find the right dosage to feel stable, comfortable, and ready to focus on their recovery journey.
Understanding How Suboxone Works
To understand why you might feel sick while taking this medication, we first need to look at how it interacts with the brain. Suboxone contains two main ingredients: buprenorphine and naloxone.
Buprenorphine is a partial opioid agonist. This means it binds to the same receptors in your brain as opioids like heroin or oxycodone, but it activates them less intensely. It has a “ceiling effect,” which limits euphoria and reduces the risk of misuse. Its main job is to stop withdrawal symptoms and cut cravings.
Naloxone is an opioid antagonist. Its primary role in Suboxone is to prevent misuse. If someone tries to dissolve and inject the film or tablet, the naloxone activates and blocks the opioid effects immediately. When taken as prescribed (under the tongue), the naloxone is mostly inactive.
Even with this design, some people still feel unwell. Let’s break down the main reasons why this happens.
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Call 866-881-1184What is Precipitated Withdrawal?
The most severe form of detox symptoms while on Suboxone is called precipitated withdrawal. This is often the reason people search for answers regarding feeling sick after taking their dose.
Why It Happens
Buprenorphine has a very high “affinity” for opioid receptors. This means it sticks to them very tightly—tighter than heroin, methadone, or fentanyl. If you take your first dose of Suboxone while you still have other strong opioids in your system, the buprenorphine will aggressively “kick” those other opioids off the receptors.
Because buprenorphine is only a partial agonist, it doesn’t activate the receptor as strongly as the drug it just replaced. The result is a sudden, steep drop in opioid activity in the brain. This sends the body into rapid, intense withdrawal.
Symptoms of Precipitated Withdrawal
Unlike regular withdrawal, which comes on slowly, precipitated withdrawal hits fast and hard. Symptoms include:
- Severe nausea and vomiting
- Intense stomach cramps and diarrhea
- Extreme agitation and anxiety
- Rapid heart rate
- Cold sweats and goosebumps
To avoid this, doctors require patients to be in a state of mild to moderate withdrawal before taking their first induction dose.
Can You Experience Detox Symptoms While on Suboxone Due to Low Dosage?
Once you are past the induction phase and are on a maintenance plan, you should generally feel normal. However, you might still ask: can you experience detox symptoms while on Suboxone if the dose isn’t right?
Yes, this is known as “breakthrough withdrawal.”
Metabolic Differences
Everyone metabolizes medication differently. Some people process buprenorphine very quickly. If you are a “fast metabolizer,” a standard dose might wear off before your next scheduled dose. You might wake up in the morning feeling achy, anxious, or sweaty because the medication levels in your blood have dropped too low.
Tolerance Changes
In the early stages of treatment, finding the “sweet spot” for dosing takes time. If your tolerance was very high before starting treatment (common with fentanyl use), standard starting doses of Suboxone might not be enough to fully saturate your opioid receptors. This leaves some receptors empty, triggering mild detox symptoms like runny nose, yawning, or restlessness.
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Check Your CoverageThe “Ceiling Effect” and Fentanyl
The illicit drug supply has changed drastically with the introduction of fentanyl. Fentanyl is lipophilic, meaning it is stored in fat cells and stays in the body longer than traditional opiates. This complicates the induction process.
Because fentanyl lingers, it is harder to determine exactly when it is safe to take Suboxone. Patients might wait the recommended 24 hours, take their medication, and still experience detox symptoms because fentanyl was slowly released from their fat stores. This challenging landscape makes professional medical supervision at a center like SCBH more important than ever.
Psychological Withdrawal vs. Physical Withdrawal
Sometimes, what feels like detox symptoms is actually psychological distress. The ritual of using drugs is a powerful habit. Even if Suboxone is physically blocking withdrawal, you might feel:
- Anxiety
- Phantom cravings
- Restlessness
- Insomnia
These are often called PAWS (Post-Acute Withdrawal Syndrome). While Suboxone handles the acute physical sickness, it doesn’t instantly cure the brain’s emotional reliance on the ritual of using. Therapy and counseling are essential to address these symptoms.
What To Do If You Feel Sick
If you are asking “can you experience detox symptoms while on Suboxone” because you are currently feeling unwell, here are actionable steps to take.
- Do Not Stop Treatment: Stopping your medication abruptly will only make withdrawal worse.
- Contact Your Provider: Tell your doctor immediately. They can adjust your dose or split your dose (taking it twice a day instead of once) to keep blood levels steady.
- Check Interactions: Ensure you aren’t taking other medications or supplements that interfere with how your body processes buprenorphine.
- Stay Hydrated: Dehydration mimics withdrawal symptoms like headaches and fatigue.
Conclusion
Recovery is a journey, and comfort is key to staying the course. While Suboxone is highly effective, it is not uncommon to experience hurdles with dosing or induction. If you are experiencing detox symptoms while on Suboxone, it does not mean the treatment has failed. It usually means an adjustment is needed.
At SCBH, we specialize in helping you navigate these complexities. We ensure your medication levels are optimized so you can focus on what matters most: rebuilding your life.
REFERENCES:
Velander, J. R. (2018). Suboxone: Rationale, science, misconceptions. Ochsner journal. https://pmc.ncbi.nlm.nih.gov/articles/PMC5855417/
