How to Taper off Suboxone

Physicians in drug rehabilitation centers across the country prescribe Suboxone to their patients with substance use disorders. Suboxone is specifically intended to treat dependence on opioid compounds, including oxycodone, hydrocodone, heroin and more. At an ingredient level, Suboxone combines two specific medications to accomplish this task. The first, buprenorphine, is the key ingredient. Buprenorphine functions in a similar fashion to traditional opioids by binding to the same receptors in the central nervous system. Here, the medicine works to suppress opioid cravings, while also offsetting the associated withdrawal symptoms.

Naloxone is the second most important active ingredient found in the prescription. When used under the brand name Narcan, naloxone is deployed as an anti-opioid overdose medicine used by police officers and medical professionals. Essentially, the medicine blocks opioid receptors in the brain to reverse an overdose. While it retains this functionality in Suboxone, the chief duty of naloxone paired with buprenorphine is to trigger withdrawal symptoms if the medicine is being misused. In fact, the naloxone found in Suboxone remains dormant unless tampered with — think of it as a sort of failsafe. Whenever Suboxone is not used as direct, the naloxone kicks in to block a pleasurable opioid high and imitate a withdrawal instead.

Suboxone is one of several drugs designed for opioid detox. These methods can differ by approach at different rehabilitation facilities, but most refer to the general principle as tapering. The term “taper” indicates a gradual reduction of use rather than complete, immediate cessation. Though quitting is certainly the goal, doing so outright leaves people susceptible to unbearable, sometimes life-threatening withdrawals. Tapering tackles this Suboxone withdrawal problem two-fold by lessening or eliminating symptoms and adjusting the body to life beyond the drug’s clutches.

Suboxone Taper Chart | How to Taper Off Suboxone
Suboxone is interesting in that a “Suboxone taper” really has two separate meanings. For anyone attempting to find out how to taper off Suboxone, it is key to understand this distinction going in. The first definition is using a Suboxone taper schedule to gradually wean off stronger opioids such as heroin. This method uses Suboxone as a safer and measurable substitute.

Tapering off Suboxone has a second connotation. It often takes a long time to recover from opioid substance use disorders. This means a patient will be using Suboxone for quite a while as well. Because Suboxone contains buprenorphine, an opioid, it can result in dependence itself. Thus, physicians suggest a Suboxone taper to recover and stop its use as soon as possible. For the sake of this explanation, the focus will be on the later interpretation — tapering off Suboxone as opposed to using it as a taper for other opioids.

Before diving head first into determining how to taper off Suboxone, it is helpful to understand what a taper prevents. An individual on a Suboxone regimen may have never felt what it was like to go through an opioid withdrawal before. These events, especially heroin withdrawals, can be particularly debilitating. Suboxone is meant to be used to avoid such opioid withdrawals in the first place — and a withdrawal of its own can be avoided, too.

As it stands, a Suboxone withdrawal can be extremely uncomfortable in its own right. This is mostly because these withdrawals can last for a month or longer. To put that in perspective, quitting a short-acting opioid — such as heroin —can result in just a seven-day-long withdrawal. Now, these withdrawals are arguably more painful, but some consider Suboxone withdrawals worse given the extended timeframe.

If an individual decides to forgo a Suboxone taper schedule and quit the medicine cold turkey, they can expect withdrawal symptoms to be at their worst approximately 72 hours after the final dose. Physical symptoms continue for up to two weeks and then will often be replaced by cravings or depression. These psychological side effects will carry forward for a month or longer — this is when people are most likely to have a relapse. It is for this reason that a full detox is recommended in a clinical setting where support and structure are abundant.

Luckily, tapering off Suboxone is almost always going to be done in the presence of medical professionals. These rehabilitation experts will develop an appropriate Suboxone taper chart personalized to each patient’s unique needs.

A Suboxone taper chart can take many forms. Below is an example of how the chart’s content may look like over the course of two months:

Initial Dose: 16 mg/day

  • Day 1: An immediate reduction of 25 percent resulting, in 12 mg/day
  • Day 6: Reduce dose from 12 mg/day to 8 mg/day
  • Day 11: 4 mg/day
  • Day 16: 2 mg/day
  • Day 24: 1.50 mg/day
  • Day 31: 1 mg/day
  • Day 39: 0.75 mg/day
  • Day 45: 0.50 mg/day
  • Day 51: 0.25 mg/day
  • Day 56: 0.13 mg/day
  • Day 60: 0 mg/day

Note: This is just one tapering model. Length of time and cutback amounts will vary patient by patient.

Tapering off Suboxone is a lengthy endeavor. However, having overcome a far worse opioid addiction to get to this point, patients certainly have the resolve to take on such a challenge.

Whether you’re tapering off Suboxone or another opioid, this process is always safer under the care of medical professionals. If you’re ready to begin the road to long-term sobriety, The Recovery Village can help. With dedicated and compassionate professionals, we guide patients through every stage of treatment — from detox to discharge. Call 352.771.2700 to speak with an intake coordinator today. 

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.