Suboxone Precipitated Withdrawal – Be Careful

What is Suboxone Precipitated Withdrawal?

In short, precipitated withdrawal is a very quick and intense onset of opiate withdrawal symptoms.  It’s like quitting opiates but jumping from day one withdrawal to day four withdrawal, really bad.  It is relatively uncommon but bad enough that it should be avoided.  The precipitated withdrawal with Buprenorphine happens because of it’s high binding strength to opiate receptors, so basically the Buprenorphine pushes out the opiates in your brain and fills the opiate receptors with Buprenorphine (in Suboxone) so it’s almost like jumping from no withdrawal to day four withdrawal intensity— and can even be dangerous.  Buprenorphine is strong stuff– it beats the crap out of opiates and displaces the opiates from your opiate receptors taking you to hell in a hurry.

What happens if you get Suboxone Precipitated Withdrawal?

Well to be honest, if you are affected by precipitated withdrawal, you are going to feel rapid onset of opiate withdrawal symptoms, much faster than cold turkey, and no this will not reduce the “detox” time.  Common sense would say, take some opiates, the Suboxone isn’t working, but taking opiates once precipitated withdrawal has occurred would not be helpful because your receptors are blocked by the Buprenorpine which has a much stronger “hold” on the receptors than opiates rendering the opiates nearly useless.  The best advice I can give if this happens is go to the hospital and explain what happened, they can give you medicine to reverse the situation and make you feel better.

Avoiding Suboxone Precipitated Withdrawal

You need to restrict intake of opiates for a period of time before taking Suboxone, basically you should be in some form of withdrawal.  If you are not in some pain you are risking precipitated withdrawals.  If you need to taper, use the taper charting tool on this site, you can plot your own taper charts.

Suboxone TaperAvoid Short Acting Opiates for 24 hours to minimize chances of precipitated withdrawal.

Crushed OxyContin®

Please verify all information with your doctor every situation is different and drug interactions change things.

VERY IMPORTANT — Avoid Long Acting Opiates for 24 hours to minimize chances of precipitated withdrawal.

OxyContin® (Orally)
Methadone * really long lasting get medical attention first!

* It is recommended that patients transitioning from methadone to Buprenorphine slowly taper down on the methadone, for at
least one week. Last dose must be no less than 36 hours prior to induction, and better if be 96 hours or more.  Expect discomfort
for a few days coming from Methadone.

Does Suboxone Work?  Is it worth the risk?

I think that Suboxone is a wonderful medication that probably saved many lives including one of my friends.  So yes, it works and works well.  My recommendation is to find a doctor that believes in a shorter duration of treatment with Suboxone.  Longer periods of time on Suboxone will end up being difficult to wean down below 1mg so you’ll need to go below 1mg in slow, very slow micro amounts.  You can cut an 8mg strip into at least 24 tiny squares giving you around .3mg dose which believe it or not is enough to remove morning withdrawal or mild withdrawal discomfort, but it takes an hour or two.   Recognizing Suboxone’s strength is important, don’t go from one addiction to another.

Good luck and stay clear of Suboxone Precipitated Withdrawal!

Another article about Precipitated Withdrawal
Sources of information:
Center for Substance Abuse Treatment.
FDA & Suboxone®/Subutex®


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