How Long Should You Stay on Suboxone?

Some people may want to only use Suboxone during acute withdrawal (usually for at least a few months). But many people may need the medication indefinitely.

Suboxone helps to prevent relapse.[1] As long as you're tempted to return to opioid drugs, Suboxone could help you. For some people, that strong pull never really goes away. 

Taking Suboxone for life is a safe option for those who feel they need it to prevent relapse.

What Is Suboxone?

Suboxone is a medication designed to help people dealing with opioid use disorder (OUD).

There are two active ingredients in Suboxone: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist approved by the United States Food and Drug Administration (FDA) in various formulations as a maintenance medication.[2,3]

‍The goal of Suboxone treatment is to stabilize someone who has struggled with opioid use disorder and prevent the harms that come with it, including fatal overdoses.[4]

You might take Suboxone, with a prescription, for months, years, or indefinitely, depending on what is right for you. It is safe to take Suboxone on a long-term (months or years) basis if necessary.

Occasionally, people experience some nausea or dizziness, particularly when first starting Suboxone. However, these symptoms usually subside quickly as your body gets used to the new medication. If you do experience these issues, you should talk with your doctor about whether your dosage is right for you.

Factors That Impact Your Suboxone Treatment 

Substance use can fundamentally alter brain structures. Using medications like Suboxone allows people overcoming OUD the time they need to heal these structures.

The dose you need and the length of your treatment can vary due to these factors:

• OUD severity: If you took opioids for long periods or used very high doses, your brain cells have gone through many changes. You may need higher Suboxone doses, and you may need to stay on the medication for long periods as you heal.
  
• Underlying conditions: Mental health issues like depression or anxiety can raise your relapse risks. If you have these issues, you may need to stay on Suboxone longer.
  
• Support systems: It's easier to maintain sobriety with the help of friends and family. If you're connected, you could reach out to your network when you feel your resolve slipping. If you don't have this network, you may need to stay on medications longer.
  
• Personal preference: For many people, Suboxone allows them to return to work or school, take care of their family, and develop a life away from substance misuse. You may not want to risk these benefits and quit the medication.

Your doctor can help you find the dose that’s right for you. And together, you can determine how long your treatment should last. 

What Does Suboxone Treatment Entail?

When you start Suboxone treatment, you must abstain from opioids for 12 to 24 hours, depending on the size of your last dose, to ensure that there are no more active opioids in your bloodstream. You might experience early withdrawal symptoms, but you should begin Suboxone treatment before more intense symptoms emerge.

The lowest starting dose for buprenorphine/naloxone medicines is 2 mg/0.5 mg once a day, but many people find the optimal daily maintenance dose is higher than that (anywhere from 2 to 24 mg of Suboxone). On average, it takes two to four days for doctors to find the right dose.[5]

Once that dose has been reached, you will use Suboxone film strips, which dissolve under the tongue or the cheek, usually once per day.

Buprenorphine remains bound to your brain’s opioid receptors throughout the day, which dramatically lowers cravings and withdrawal symptoms. If you develop withdrawal symptoms like anxiety or cravings or feel too sedated, your doctor can adjust your dose.

As you become physically stable while you take Suboxone, you may find that you no longer experience cravings for opioids, and you can more easily do your daily activities and focus on recovery.

Why Do Doctors Recommend Long-Term Suboxone Use?

Studies show that people who take buprenorphine-based medications like Suboxone are more likely to relapse if they stop taking their prescription within six months of starting it.[6]

Taking a medication like buprenorphine that binds to opioid receptors in the brain helps to prevent negative effects from withdrawal symptoms that could trigger a relapse. By stopping these sensations, you can focus on changing addictive behaviors and create a plan to avoid relapse.

How to Stop Suboxone 

You should never stop taking Suboxone without talking to your doctor first. Buprenorphine inside Suboxone is an opioid, and if you quit cold turkey, you might develop withdrawal symptoms. 

Your doctor can help you explore what life might be like without Suboxone. If you both feel it's time to quit, you can develop a tapering schedule to help you stop taking your medication safely. 

Suboxone Use Duration FAQs

How long is it safe to take Suboxone?

It is safe to take Suboxone for as long as needed. Many people take it indefinitely.

How long do you take buprenorphine?

Buprenorphine is the active ingredient in Suboxone. It's a partial opioid agonist that can reduce withdrawal symptoms from OUD. It is safe to take at prescribed doses for as long as needed.

What does Suboxone do to the brain?

Suboxone binds to the opioid receptors in the brain to reduce withdrawal symptoms and cravings in people who are overcoming dependence on opioids.

Sources

1. 5 Myths About Using Suboxone to Treat Opiate Addiction. Harvard Medical School. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496. October 2021. Accessed January 2023.
2. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. September 2022. Accessed January 2023.
3. What Are Misconceptions About Maintenance Treatment? National Institute on Drug Abuse. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. December 2021. Accessed January 2023.
4. Buprenorphine/Naloxone (Suboxone). National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). January 2021. Accessed January 2023.
5. Buprenorphine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459126/. May 2022. Accessed January 2023. 
6. Guide for Families: Medications for Opioid Use Disorder. Providers Clinical Support System. https://pcssnow.org/resource/guide-for-families-medications-for-opioid-use-disorder/. June 2021. Accessed January 2023.