Subutex Withdrawal: Symptoms, Timeline, & Prevention

What Is Subutex Withdrawal?

Subutex helps reduce opioid cravings and can prevent someone from relapsing from opioid use disorder. However, it is an opioid, so it’s possible to build a physical dependence on it and experience withdrawal symptoms after abstaining. Subutex itself doesn’t cause someone to get high when used as prescribed, which is why it can be used as part of medication-assisted opioid treatment.

Subutex remains controversial even among professionals in addiction treatment. People can and do abuse this substance, and taking it with other drugs can be extremely dangerous. However, many people also find that Subutex provides them with the relief necessary to maintain a sustainable recovery.

Subutex Withdrawal Symptoms

Withdrawal symptoms are on a spectrum and can vary from mild to severe. Some symptoms may emerge immediately, whereas others may come several days or weeks after initiating the withdrawal process. Subutex withdrawal symptoms generally mimic that of other opioid withdrawals, although some people describe the process as more physically and emotionally draining.

Age, chronic use, medical issues, and withdrawal history may exacerbate withdrawal symptoms. In general, the more you use any drug— and the longer you use it— the more likely you will experience a more severe withdrawal process. Although rare, people can die from opioid withdrawal, often due to electrolyte imbalance from severe dehydration.²

Subutex withdrawal symptoms may include:

• Insomnia
• Anxiety
• Nervous breakdown
• Depression
• Gastrointestinal distress
• Mood swings
• Cravings for Subutex or other opioids
• Diarrhea
• Fever
• Sweating
• Goosebumps
• Extreme irritability
• Fever

Subutex Withdrawal Timeline

Subutex is a long-acting partial opioid agonist. The exact withdrawal timeline varies from person to person. How long you used the drug- and the specific dosage- can impact this process. The first symptoms tend to emerge within 24 hours after using Subutex. These symptoms tend to be mild but peak around 48-72 hours. Symptoms then start subsiding after about one week, but psychological symptoms can persist for several weeks after a full detox.³

6 Ways to Cope With Subutex Withdrawal Symptoms

Although withdrawal can feel uncomfortable and scary, the symptoms are temporary, and it’s essential to be mindful of their short-lived nature. Seeking support during this time is one of the best coping strategies you can implement. Unfortunately, heightened cravings coupled with physical distress can increase the chance of relapsing.

Here are six tips to help alleviate Subutex withdrawal symptoms:

• Stay hydrated: Hydration is critical during withdrawal, and even mild dehydration can  worsen nausea and diarrhea.⁴ It’s advised to drink at least 2-3 liters of water per day and consider drinking electrolytes to replenish lost fluids.
• Distract yourself: The peak stage of withdrawal can feel endless, so try to occupy yourself as much as possible with movies, books, talking to friends, or getting outside.
• Keep yourself accountable: Reach out to trusted loved ones during this time if you are struggling.
• Journal about your feelings: Journaling doesn’t necessarily take the discomfort away, but it’s a self-care strategy that can help you better understand your emotions and triggers.
• Practice relaxation strategies: Allow yourself plenty of rest during this time. If your body feels up for it, consider gentle yoga, meditation, or short walks to ease some discomfort.
• Seek medical supervision: Regardless of your specific circumstances, it’s generally safer to taper from opioids under a professional healthcare provider. They can also prescribe medications that ease withdrawal discomfort.⁵

Subutex Withdrawal Treatment

Subutex withdrawal is generally perceived as an integrative health issue that requires multidisciplinary treatment. Detox is the first step for achieving initial stabilization. Long-term treatment may include components of individual therapy, group programs, inpatient/outpatient care, and medication to address withdrawal and addiction symptoms. Many doctors also prescribe a taper regimen to slowly reduce Subutex intake instead of quitting cold turkey to ease the withdrawal process.

Addiction treatment resources that may be helpful for Subutex withdrawal include:

At-Home Care

Although it’s not generally advised, it is possible to detox at home. The environment needs to be physically and emotionally safe. In ideal circumstances, you should have a supportive care person available to you at all times. They should be aware of your drug history, and you should feel comfortable enough disclosing symptoms and/or cravings with them as they arise in real-time.

Some things you can do to prepare for an at-home detox include:

• Have plenty of fluids available: Make sure you are stocked with water bottles and electrolyte sports drinks. Take small sips throughout the day to mitigate nausea.
• Have entertainment available: Stock yourself with books, TV shows, music, and other accessible distractions.
• Focus on nutrients: You may have little appetite but aim to focus on eating nutrient-rich foods like fruits, vegetables, and protein when you do eat.
• Keep your body warm: Hot showers, heating pads, and warm blankets can all help with the shivering and flu-like symptoms associated with withdrawal.

Rehab & Detoxification Centers

Rehabilitation centers offer comprehensive treatment options for people experiencing withdrawal and substance use disorders. There are numerous options available, depending on your specific needs. Medical detox programs last a few days to over a week, and then you may be referred for inpatient or intensive outpatient care.

These treatments can be paid for via health insurance, scholarships, or a full-fee cash rate. There are also several nonprofit and federal programs available in each state. Getting connected with a local social worker or casework program can help you evaluate different options.

Intensive Outpatient Programs

Intensive outpatient treatment (often known as IOP) offers highly-structured substance use treatment. However, unlike inpatient programs, clients live independently and can generally continue with their ordinary life responsibilities. IOP programs vary in length, but programming may be anywhere from 2-4 hours a day (for about 6-10 hours per week) lasting for about 1-3 months.

Therapy & Support Groups

Therapy can provide immediate support during and just after opioid withdrawal. Many people find that connecting with a trusted therapist offers tremendous relief during this vulnerable time. Group therapy and peer-led support groups also reassure and validate that you’re not alone in your struggles.

Some therapies that can address addiction and withdrawal symptoms include:

• Motivational Interviewing: Motivational interviewing is a standard therapeutic orientation used to help people experiencing ambivalence about change. It can be especially helpful in supporting clients who exhibit resistance to engaging in new patterns.
• Cognitive-behavioral therapy (CBT): CBT is often used within addiction treatment to help clients address the negative core beliefs they have about themselves and others.
• Dialectical behavior therapy (DBT): DBT integrates radical acceptance, emotional regulation, and distress tolerance concepts to help people better manage their circumstances.

Final Thoughts

Every withdrawal process is different, and side effects will vary based on the individual. However, proper treatment can certainly ease the discomfort. Therefore, discussing tapering from or discontinuing Subutex with your treatment team and family is essential before taking the first step.