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What is Precipitated Withdrawal?

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The Signs, Risks, Treatments & Timeline of Suboxone Withdrawal

The national opioid crisis is slowly entering its second decade in the United States of America, and the prescribed medication Suboxone is becoming increasingly present among the individuals struggling with substance abuse. It’s transformed from a rarely-used addiction treatment medication only found in hospitals and ambulances to a widespread occurrence in pharmacies and people’s backpacks and purses alike.1

There’s a medically-connected reason for this prevalence of Suboxone among the population trying to cope with substance abuse. It represents a specially-formulated combination of naloxone that blocks the effects of various opioids, including codeine, heroin, and morphine and buprenorphine that creates the effects of normal opioids to reduce withdrawal symptoms but at a lesser effect. This is why Suboxone makes dealing with substance abuse problems easier.2

However, Suboxone can also cause a degree of addiction and instate different precipitated withdrawal symptoms when stopping the use of opioids or drugs abruptly. What’s more, abusing this drug can lead to accidental overdoses. According to the information provided by SAMHSA, there’s been a tenfold increase in emergency department visits related to buprenorphine abuse, one of the drugs that composes Suboxone.3

What Are the Characteristics of Suboxone Withdrawal?

Suboxone is a highly effective drug when it comes to aiding individuals struggling with substance abuse during their process of recovery and treatment. Individuals often take it over prolonged periods of time to offset their opioid or drug withdrawal symptoms after they stop taking illicit substances. It’s after long-term use of Suboxone or other medical antagonists to treat your addiction that you can start experiencing symptoms that characterize Suboxone withdrawal if you choose to stop using Suboxone too.2

These symptoms can appear extremely suddenly, even if you’ve using prescription medication according to exact instructions.. This is why it’s important to first consult your healthcare practitioner before even starting to use this medication to combat your addiction and why you need to fully understand the characteristics of Suboxone and its use. Also, make sure to implement the advised safety precautions which may include:3

  • Not taking other medication alongside Suboxone before consulting with your doctor.
  • Not taking any illegal drugs, tranquilizers, sedatives, or drinking alcohol while taking this drug because it can lead to overdose and ultimately death.
  • Ensuring you continue monitoring your health.

What Constitutes Precipitated Withdrawal?

Precipitated withdrawal occurs when an individual with a drug or opioid addiction starts using antagonists to help alleviate the symptoms of substance abuse withdrawal. The introduction of these antagonists into the system through intake of Suboxone or other antagonist drugs, patients are prone to developing different symptoms resulting from stopping the use of illicit substances and starting use of medical antagonists that fall under the category of precipitated withdrawal.4

It’s worth noting that all medication used to treat substance abuse withdrawal symptoms is effective and safe. Professional treatment programs and facilities offer a comfortable way to recover from your addiction. However, improper use of such medication can lead to the development of precipitated withdrawal symptoms. Some of the medications that most commonly cause precipitated withdrawal syndrome include:4

  • Buprenorphine.
  • Naltrexone (Vivitrol).
  • Naloxone (Narcan).
  • Buprenorphine/naloxone (Suboxone).

Why Can Precipitated Withdrawal Occur After Using Suboxone?

Precipitated withdrawal can occur when using certain types of medication and is a distinct phenomenon when compared to withdrawal caused by stopping or slowing your opioid use. When opioids are present within your system, they will attach to your opioid receptors and activate them. When you stop using those opioids or drugs or by administering partial or complete opioid receptor antagonist medication, you risk experiencing an acute opioid withdrawal syndrome.4, 5, 6

A similar thing can happen when using prescribed medications which serves to block off your opioid preceptors and help you when trying to resolve your substance abuse issues, which is called precipitated withdrawal. When it comes to pharmaceutically precipitated withdrawal symptoms, they arrive more suddenly when compared to substance abuse withdrawal and can peak in their severity extremely quickly. This mostly occurs if you don’t administer prescribed medication adequately and continue its use even after the advised period of time.1, 2

What Are the Symptoms of Suboxone Withdrawal?

Suboxone is a highly effective drug for treating substance abuse symptoms and for aiding the recovery of individuals struggling with opioid dependence. However, if taken over prolonged periods of time, it can develop a physical addiction that can produce a number of withdrawal symptoms similar to the ones that occur if abruptly stopping the use of illegal substances, including:6, 7

  • Concentration difficulties.
  • Headaches.
  • Sweating.
  • Chills.
  • Fever.
  • Drug cravings.
  • Irritability.
  • Depression.
  • Anxiety.
  • Indigestion.
  • Digestive distress.
  • Lethargy.
  • Insomnia.
  • Body and muscle aches.
  • Vomiting.
  • Nausea.
  • Restlessness.

What Are the Symptoms of Precipitated Withdrawal?

On the other hand, beginning to take prescription medication designed to prevent the appearance of drug or opioid withdrawal symptoms can also lead to the development of slightly different precipitated withdrawal symptoms, including:7

  • Runny nose.
  • Sweating.
  • Goosebumps and chills.
  • Excessive sweating.
  • Diarrhea.
  • Vomiting and nausea.
  • Stomach cramps.
  • Physical pain.
  • Anxiety and restlessness.
  • Cravings.

What Is the Timeline for Suboxone Withdrawal?

For the vast majority of individuals, Suboxone withdrawal symptoms will begin during the first 2 to 4 days. The symptoms as well as the timeline of their appearance can vary from one individual to another. However, the following remains a general timeline of all the symptoms associated with Suboxone withdrawal over a certain period of time:8, 9

  • Initial 24 to 72 hours: Suboxone withdrawal is most intense during this initial period and tends to peak approximately three days after your final dose. Some of the most common symptoms during this period are:8, 9
    • Dilated pupils.
    • Watery eyes.
    • Yawning.
    • Sweating.
    • Increased body temperature.
    • Diarrhea.
    • Nausea.
  • First two weeks: As the withdrawal process continues, you might experience the following symptoms:8, 9
    • Agitation.
    • General feeling of restlessness and discomfort.
    • Pain in bones and muscles.
    • Weakness.
    • Goosebumps.
    • Diarrhea.
    • Nausea and vomiting.
    • Weight loss and poor appetite.
    • Increased heart rate and blood pressure.
  • Weeks three and four: At the end of the fourth week most individuals experience little to no physical Suboxone withdrawal symptoms. However, various psychological symptoms can persist, such as:10
    • Cravings.
    • Lack of motivation.
    • General malaise.
    • Depression.
    • Dysphoric mood.
    • Anxiety.
    • Insomnia.

How Long Can Precipitated Suboxone Withdrawal Last?

In general, the majority of physical precipitated Suboxone withdrawal symptoms will subside after a period of approximately one month. However, it’s worth emphasizing that psychological dependence can remain even after physical manifestations of withdrawal disappear. Finally, it’s worth noting that the duration of the symptoms will also depend on each individual and their physical as well as mental state, with the one-month mark remaining in most cases.

What Risks Does Precipitated Withdrawal from Suboxone Carry?

Precipitated Suboxone withdrawal can cause a wide range of physical and psychological issues. When it comes to short-term risks, they’re mainly physical and range from mild discomfort, nausea, and body aches to more severe issues of dehydration, diarrhea, vomiting, and heightened blood pressure. As for long-term effects, after the passing of physical withdrawal manifestations, patients can continue experiencing different mental health issues, from lack of motivation and drug cravings to severe forms of anxiety, insomnia, and depression.11

Keeping in mind these symptoms, precipitated withdrawal usually isn’t life threatening, although it can be in severe circumstances and if there’s alcohol and drug mixing with prescription medication. Hospitalization can occur, during which patients usually receive all the necessary care and attention combined with close monitoring of their potentially worsening condition. What’s more, the doctors may continue administering microdoses of Suboxone to keep the unwanted symptoms at bay.11

It’s worth noting that aging patients and individuals with pre-existing medical conditions are under greater risk of developing potentially life-threatening symptoms of precipitated Suboxone withdrawal. Finally, there are patients experiencing extreme agitation and serious anxiety, making it necessary to apply adequate sedation or even general anesthesia until their immediate condition passes.11

How Can You Put a Stop to Suboxone Withdrawal?

Finding yourself in a situation where Suboxone becomes the source of withdrawal symptoms instead of the cure to them means you need to look for different types of treatment capable of accommodating your unique requirements. Depending on your current physical and mental state, you might need to chart a course toward recovery without including opioid medication to avoid precipitated withdrawal symptoms. This is when you need to resort to finding guidance from professionals with the following characteristics who can help you find alternative treatment:12

  • Experience and education in substance abuse rehab and treatment.
  • Awareness of all the issues you’re struggling with contributing to your current physical and mental state.
  • Dedication to providing a comprehensive precipitated withdrawal reatment solution tailored to your specific needs.
  • Availability to provide expert long-term support.

However, you also need to know that there are available methods for preventing precipitated Suboxone withdrawal symptoms. Even though this can be triggered by the medication you’re taking to overcome your substance abuse issues, you can still use the prescribed medications without fear of precipitated withdrawal under close professional observation and according to the exact doctor’s recommendations. What’s more, there are several other things you can do to avoid experiencing precipitated withdrawal:13

  • Letting your treatment professional know which drugs you last used and when.
  • Taking OUD medication as your doctor advises it.
  • Not taking less or more medication than prescribed.

Finally, even if the symptoms of Suboxone withdrawal appear, there’s a wide range of available coping strategies that will greatly assist you in dealing with the physical and mental strain. Instead of engaging in different types of maladaptive behavior, you can engage in a range of positive coping strategies, including:12, 13

  • Social activity: Spending time with friends and family can help alleviate some psychological withdrawal symptoms even if you choose not to share your struggles with them.
  • Hobbies and relaxation time: Finding the time to relax and unwind with your preferred pastime activities can help you maintain a positive recovery atmosphere and assist you in dealing with the rough patches.
  • Adaptation: Understanding that withdrawal represents a part of the recovery process can help you deal with it more easily and effectively as an inseparable part of you getting better.

What Are the Available Options for Treating Precipitated Suboxone Withdrawal?

There are different types of treatment designed to help stop precipitated Suboxone withdrawal, including:14, 15

  • Medical detox: The process of medical detoxification is extremely important for treating precipitated and Suboxone withdrawal as it serves to eliminate any harmful toxins still present in your body and alleviate the often unpleasant and harmful symptoms.14
  • Inpatient treatment: Inpatient facilities for treating precipitated withdrawal offer a safe, caring, and nurturing environment that helps you eliminate all real-word distractions and difficulties and allows you to fully dedicate yourself to recovery.14
  • Outpatient treatment: Outpatient treatment facilities for precipitated withdrawal don’t require you to stay at the facility at all times. You can come to your scheduled sessions and participate in counseling and behavioral therapy.14
  • Medication: Finally, there are certain types of medications that can help offset the negative effects of Suboxone withdrawal, inducing Ondansetron (Zofran), Clonidine, and Lofexidine (Lucemyara).15

How Can I Find Help for Precipitated Withdrawal?

If you or a person you love require assistance and treatment for precipitated Suboxone withdrawal, you can always contact American Addiction Centers (AAC). They provide a wide selection of effective treatment solutions fostered by their network of nationwide Suboxone withdrawal rehab facilities. They have the mission to provide adequate treatment to every individual looking for help and maximize their chances of a full recovery.

Feel free to contact one of their Suboxone withdrawal hotlines and inquire about the available treatment methods and verify the amount of insurance coverage you have for this type of treatment. They’ll help you find the most suitable treatment facility according to your specific requirements and allow you to quickly find assistance for your precipitated withdrawal syndrome. What’s more, they offer a variety of payment options to choose from to ensure you find your fit.

AAC ensures maximum privacy and confidentiality during every single interaction you have with their admissions navigators who are dedicated to helping you find the facility that suits you best. All you need to do is contact their helpline, present the unique circumstances of your physical and psychological state, give them your unique requirements and they’ll handle all the other aspects of finding treatment.

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The editorial staff of Projectknow.com is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands of pages for accuracy and relevance. Our reviewers consistently monitor the latest research from SAMHSA, NIDA, and other reputable sources to provide our readers the most accurate content on the web.
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