Patients who have stopped using Suboxone can be safely and quickly restarted. If you are used to high doses of Suboxone, you can likely start again on your own, especially if you have only missed a few doses.
However, if you’ve been off Suboxone for weeks or months, you may want to start at a slightly lower dose to avoid side effects, such as nausea or dizziness. You can then quickly go up to an amount that prevents opioid cravings.
Since this is an individualized decision, talk with a doctor before you get started. They can guide you on the best way to restart Suboxone—at the right dose—for your situation.
Suboxone is considered the gold standard in treatment for opioid use disorder (OUD). It is a combination of buprenorphine and naloxone.[4]
Buprenorphine works to manage opioid withdrawal symptoms and cravings, enabling recovery from opioid misuse.[3] Naloxone serves as a deterrent for misuse of the medication since it will push a user into withdrawal (negating any misuse potential) if it is misused.[5]
Sometimes, individuals forget to take a few doses of their medication for varied reasons. Other times, people may intentionally discontinue Suboxone, either because of side effects or because they want to see if their opioid cravings return.
While some people may be able to discontinue Suboxone without side effects or cravings, others may experience a return of cravings or withdrawal symptoms that put them at risk of relapse to other drug use.
There’s no shame in restarting your prescription. Some people take Suboxone indefinitely to stay on track.[3] If you need help to stay sober, use your prescription. That’s what it’s there for.
These are common reasons to restart Suboxone:
People who discontinue their Suboxone before they are ready are at increased risk of relapse to drug use.[1] If you experience a return of your cravings, it is smart to start Suboxone again as soon as possible. This ensures you can continue to manage your OUD.
A new job, a failed romance, or a loved one’s death could increase feelings of stress. When you’re under pressure, you’re more likely to revert to drug misuse. Returning to Suboxone could help you handle these pressures without relapsing.
Sometimes, an acute injury requiring opioid pain medication can be a trigger that brings cravings back. In these cases, it might be good to restart Suboxone.[2]
Some patients notice that they have cravings for opioids months or even years after discontinuing use of opioids. For these patients, long-term use of Suboxone may be appropriate or even life-saving.
Do not simply begin taking Suboxone again on your own. You need a doctor’s guidance to do this safely. Taking this medication without a doctor’s prescription and supervision can be dangerous due to the potential for side effects and risks, particularly if it is mixed with certain other substances.[6]
If you have not been taking Suboxone for a while, your body may again be in an opioid-naïve state, and this can greatly change the appropriate dosage for you.[6] You may wish to restart Suboxone because you are feeling strong opioid cravings, but you aren’t experiencing withdrawal symptoms. You need a doctor to prescribe the appropriate dose and dosing schedule.
Before you restart Suboxone, your doctor will perform an assessment that includes a physical, learning your history of opioid misuse and use of Medication for Addiction Treatment (MAT), and lab tests. They’ll determine when you last took opioids and use all of this gathered information to determine the appropriate dose at which you should restart Suboxone.
As you restart the medication, you’ll stay in communication with your doctor about any symptoms you experience. As with initial induction of Suboxone therapy, it takes some trial and error to find the right dose for you.[7]
Follow these steps to safely restart Suboxone:[7,8]
No! In fact, it’s best to restart Suboxone prior to actually relapsing to drug use. Reach out to your doctor the moment you notice your cravings are increasing. They can get you a prescription right away and prevent relapse.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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