How the Suboxone Taper Schedule Works
For patients who are attempting to stop abusing opioid drugs and/or trying to withdraw from their dependence on these substances quickly and safely, Suboxone is a medication that can be given over a certain period of time and tapered off in smaller and smaller doses until the individual no longer needs it. But how does the Suboxone taper schedule work?
What is the Suboxone Taper Schedule?
Suboxone is a brand name medication that contains both the partial opioid agonist buprenorphine and the opioid antagonist naloxone. The medication is given to individuals who want to stop abusing and/or end their dependence on opioids, and it is usually tapered off as the individual needs it less and less. This lessens withdrawal symptoms associated with opioid dependence, simplifies the process of addiction treatment, and minimizes a person’s chances of relapse.
Different Patients; Different Schedules
Much in the same way that methadone is prescribed and tapered in patients who are addicted to opioid drugs, each individual patient who is prescribed Suboxone will likely be given their own tapering schedule. This is because there is no one specific amount of time that every individual needs in order to withdraw from opioid dependence safely and recover from addiction. After consulting with your doctor about your Suboxone taper schedule, you will be able to find out what your specific timeline will look like and how long you may be on the medication before you are able to stop taking it for good.
Consulting with a Doctor
When you first decide that you want to start a Suboxone taper schedule to minimize your opioid withdrawal symptoms and facilitate your addiction treatment, you must consult a doctor. According to the U.S. Food and Drug Administration, “A Federal law, Drug Addiction Treatment Act of 2000… limits office-based use of buprenorphine-containing products to prescribers who have met qualifications to receive a waiver.” This means certain doctors are able to prescribe buprenorphine products, of which Suboxone is one, if they have been certified by the government and met certain requirements. Once you find a doctor who has this necessary certification, you can discuss your treatment plan and decide on a tapering schedule that meets your specific needs.
The Induction Phase
Before you can begin the tapering of the drug, your body must first be introduced to Suboxone. As stated by the Substance Abuse and Mental Health Services Administration, “Buprenorphine for induction therapy is administered when an opioid-addicted individual has abstained from using opioids for 12-24 hours and is in the early stages of opioid withdrawal.” During this phase, you will be placed on a dosage of buprenorphine as decided by you and your doctor, and you will be monitored closely to make sure your withdrawal symptoms are being safely managed.
In most cases, Suboxone is not given during the initial phase of treatment, the induction phase. Another medication, Subutex, is prescribed to patients in this stage in order to introduce the body to buprenorphine and safely begin the withdrawal process. Subutex only contains buprenorphine and not the combination of buprenorphine and naloxone like Suboxone. According to the FDA, “Subutex is given during the first few days of treatment while Suboxone is used during the maintenance phase of treatment.”
The Stabilization Phase
Once your body has been introduced to buprenorphine, usually through Subutex, you will be switched to Suboxone in order to be stabilized on the drug. SAMHSA states, “The stabilization process has begun when a patient has discontinued or greatly reduced the use of his or her drug of abuse, no longer has cravings, and is experiencing few or no side effects.” During this time, the dosage of the drug may be adjusted but will usually not be tapered until you are completely stabilized.
Tapering and Eventual Termination
Tapering begins when the doctor and patient have both agreed that the dosage of the drug can be lowered by a certain amount gradually in order for the individual to experience few, if any, withdrawal symptoms and to feel that the lowering of the dosage is not increasing cravings or contributing to the possibility of relapse. Suboxone comes in 2mg and 8mg strengths as a tablet that is placed under the tongue. As the tapering process continues, you may even be allowed to take the medication home and administer it there, helping you avoid the need to go to your doctor’s office every day.
Eventually, your dosage of Suboxone will become minimal enough that you can be taken off of the drug completely. Remember to discuss any needs you have with your doctor and not to stop taking Suboxone until you feel ready.
Warning Signs During Suboxone Tapering
For the most part, Suboxone tapering has been proven to be safe and effective, even when it is done quickly. According to the National Institute on Drug Abuse, a study of two different types of tapering schedules for Suboxone found that short-term tapering treatment can often be just as effective, if not more so, than long-term treatment. The study meant to “determine the relative ease of using a more rapid v. a gradual taper, should someone need to discontinue [the medication],” and the results were favorable. Other studies have compared Suboxone and buprenorphine in general to methadone and found it to be as effective if not more so than methadone for the purpose of tapering. However, there is a possibility that Suboxone tapering could lead to problems, which you must be cautious of during the process.
If you start to feel that the tapering process is causing you to experience severe withdrawal symptoms or symptoms you cannot cope with, consult your doctor immediately. In most cases, these symptoms are managed, but there is a possibility you could experience them.
In addition, some individuals being treated with Suboxone begin to abuse the drug. If you are doing so, or believe that you may be in danger of doing so, talk to your doctor so you can receive the proper help.
A Suboxone taper schedule is different for each individual, but it allows a person to slowly withdrawal from their dependence on opioid drugs and to do so in a way that minimizes withdrawal symptoms and the chance for relapse. For many individuals, Suboxone tapering works well and can be implemented after the individual has been stabilized, and sometimes even maintained for a specific amount of time, on the medication.