How to Get Back on Suboxone

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.

What Is Suboxone?

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]

Why Restart Suboxone?

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:

Risk of Relapse

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.

Changing Circumstances

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.

Illness or Injury

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]

Cravings

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.

The Importance of Medical Supervision

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]

How to Restart Suboxone

Follow these steps to safely restart Suboxone:[7,8]

1. Consult your medical provider. Don’t ever attempt to take Suboxone, including restarting it, without a doctor’s guidance and supervision.
2. Tell your doctor your full history of opioid misuse, including the last time you took opioids and prior attempts at MAT.
3. Get a starting dose and clear instructions from your provider. Oftentimes, this will be a Suboxone dosage of 12 mg buprenorphine/3 mg naloxone on the first day of therapy. Follow these instructions carefully. Some providers may begin patients with 8 mg/2 mg doses.
4. Stay in contact with your provider. Tell them about how you feel, including any withdrawal symptoms you experience.
5. Keep monitoring your symptoms. If appropriate, your doctor may increase or decrease your Suboxone dose. A maintenance dose is often considered 16 mg/4 mg.

Do You Have To Relapse To Restart Suboxone?

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.