Buprenorphine Detox, Withdrawal & Treatment
What is Buprenorphine?
Buprenorphine is a medication authorized by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD) as medication-assisted treatment (MAT). As with all medications used in MAT, Buprenorphine should be designated as part of a thorough treatment plan that involves counseling and other behavioral therapies to provide clients with a holistic approach.  Because of Buprenorphine’s opioid effects, people who do not have an opioid dependency are prone to abuse this drug. Therefore, you may be required to get into Buprenorphine detox if you have developed a dependence on the drug.
Due to its partial agonist properties, Buprenorphine offers some potential pharmacologic advantages over methadone in managing opioid addiction, such as decreased respiratory depression; less sedation, more minor withdrawal symptoms, lower risk of toxicity at higher doses, and reduced risk of diversion. There is also the potential for better acceptance by the general public, patients, and healthcare professionals and the ability for physicians to provide more integrated treatment for all medical/psychiatric conditions.
Buprenorphine has three FDA indications: opioid detoxification, opioid maintenance, and pain management. Opioid detoxification outlines the process in which a physically dependent individual is slowly tapered off all opioids. Opioid maintenance, on the other hand, is the long-term substitution with a regulated opioid to decrease the illicit drug use.
Buprenorphine is a DEA Schedule III medication. Under federal law, Buprenorphine (Suboxone and Subutex) can only be prescribed for opioid addiction by “qualified physicians.” 
Buprenex (the parenteral formulation) is not FDA-approved for treating opioid dependence, and its use for that purpose is illegal and may be punishable by law.
Qualifications to Prescribe Buprenorphine
The physician can refer patients for counseling and ancillary services. The physician is licensed under state law and meets at least one of the following requirements:
- Certification in addiction medicine from the American Society of Addiction Medicine (ASAM)
- Board certification in addiction medicine from the American Osteopathic Association (AOA)
- Training or experience deemed sufficient by the Secretary of Health and Human Services
- Training or experience is deemed sufficient by the physician’s state licensing board.
- Completing at least eight hours in the treatment and management provided by the ASAM, AOA, the American Medical Association, the American Academy of Addiction Psychiatry, or the American Psychiatric Association.
- Participation in the clinical trials leading to the approval of Buprenorphine
Additionally, a “qualified physician” must have the capacity to refer patients for appropriate addiction counseling and ancillary services and must certify that they will treat no more than 30 patients at one time with Buprenorphine.
How Should This Medicine Be Used?
Buprenorphine comes as a sublingual tablet. The combination of Buprenorphine and naloxone comes as a sublingual tablet (Zubsolv) and as a sublingual film (Suboxone) to take under the tongue and as a buccal film (Bunavail) to apply between the gum and cheek. After your doctor determines an appropriate dose, these products are usually taken once a day. Furthermore, to help you remember to take or apply Buprenorphine or Buprenorphine and naloxone:
- Take or apply it around the same time every day.
- Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
- Take or apply Buprenorphine or Buprenorphine and naloxone exactly as directed.
Please do not take or apply more or less of it or take or apply it more often than prescribed by your doctor. 
Your doctor may determine to start your treatment with Buprenorphine, which you will take to the doctor’s office. You will begin on a low dose of Buprenorphine, and your doctor will increase your quantity for 1 or 2 days before switching you to buprenorphine and naloxone.
Buprenorphine and Naloxone
Depending on the opioid you were taking, your doctor may choose a different option to start you on treatment with Buprenorphine and naloxone right away. In addition, your doctor may increase or decrease your buprenorphine and naloxone dose depending on your response.
If you are taking the sublingual tablets, place the tablets under your tongue until they completely melt. If you are taking more than two tablets, either place them all under your tongue at the same time or place them under your tongue up to two at a time. Do not chew the tablets or swallow them whole. Do not eat, drink, or talk until the tablet dissolves completely.
If you need to switch from one Buprenorphine or buprenorphine and naloxone product to another, your doctor may need to adjust your dose. To emphasize, each time you receive your medication, check to ensure that you have received the buprenorphine product prescribed for you. Ask your pharmacist if you have are not sure that you received the proper medication.
When To Stop?
Do not stop taking Buprenorphine or Buprenorphine and naloxone without discussing it with your doctor. Quitting Buprenorphine or Buprenorphine and naloxone too suddenly can cause withdrawal symptoms. Your doctor will advise you when and how to discontinue taking Buprenorphine or Buprenorphine and naloxone.
In addition, you may undergo withdrawal symptoms such as hot or cold flashes, restlessness, teary eyes, runny nose, sweating, chills, muscle pain, vomiting, or diarrhea. 
Side Effects Of This Medication
Buprenorphine or Buprenorphine, and naloxone may produce side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- Stomach Pain
- Difficulty falling asleep or staying asleep
- Mouth Numbness or Redness
- Tongue Pain
- Blurred Vision
- Back Pain
Some side effects can be critical. Therefore, if you experience any of these symptoms or those listed in the IMPORTANT WARNINGS or SPECIAL PRECAUTIONS sections, call your doctor immediately:
- Difficulty breathing or swallowing
- Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- Hallucinations (seeing things or hearing voices that do not exist)
- Fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching
- Loss of coordination
- Nausea, vomiting, loss of appetite, weakness, or dizziness
- Dark-colored urine
- Light-colored stools
- Inability to get or keep an erection
- Irregular menstruation
- Decreased sexual desire
- Slowed breathing
- Upset stomach
- Extreme tiredness
- Blurred vision
- Slurred speech
- Unusual bleeding or bruising
- Lack of energy
- Pain in the upper right part of the stomach
- Yellowing of the skin or eyes
What Should I Do If I Forget A Dose?
Take or apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take or apply a double amount to make up for a missed one.
In case of overdose, there’s a high chance you will collapse, have a seizure, have trouble breathing, or cannot awake.
Symptoms of Overdose May include the following:
- Pinpoint Pupils
- Sleepiness or Extreme Drowsiness
- Unable to Respond or Wake Up
- Blurred Vision
- Slow or Shallow Breathing
- Difficulty Breathing
Buprenorphine Detox Withdrawal
Day 1: Withdrawal symptoms may begin within 6-12 hours since the last Buprenorphine dose. Early symptoms include anxiety, fatigue, and general discomfort.
Day 2: Day two of Buprenorphine detox withdrawal may cause further anxiety and depression to occur. Day two can also have increased nausea and vomiting in some people. The body aches that were experienced on day one may increase in intensity.
Day 3: Day three of Buprenorphine withdrawal: Withdrawal symptoms may begin to diminish in intensity, but you should still be experiencing some level of discomfort and lethargy. Some people will find their energy returning; however, this is usually accompanied by increased anxiety and insomnia.
Day 4: Though most of the withdrawal symptoms will be subsiding, some people may experience residual anxiety and insomnia.
Day 5: The worst of the withdrawal is over on day five of Buprenorphine cessation. Individuals begin to find their mood improves and their energy levels increase. However, many people continue to experience prolonged periods of depression and fatigue, and these symptoms can last for weeks.
Day 6: By day six of Buprenorphine withdrawal most of the initial symptoms have subsided and some individuals begin to feel significantly better. However, many people continue to experience depression and lethargy. Symptoms such as muscle aches also tend to linger for a few weeks after quitting Buprenorphine.
Day 7: Most of the withdrawal symptoms have subsided by now, although some people may experience a lack of concentration and attention. Some people also experience mood swings or changes in appetite due to lasting psychological symptoms.
Day 8-21: Symptoms should begin to reduce further over this period as residual effects from Buprenorphine withdrawal decline. However, some people may continue to experience depression and lethargy for another few weeks. Day 21 is the median time period for withdrawal symptoms to resolve completely.
Day 22-50: After day 25 of Buprenorphine Detox withdrawal, most of the acute symptoms have subsided, although some individuals still feel tired or depressed. Most people feel completely recovered by day 50 of Buprenorphine cessation.
Buprenorphine Detox & Addiction
Frequent use of Buprenorphine raises the risk of dependence. Buprenorphine is not as promptly addictive as certain other medications. In addition, Buprenorphine doesn’t eliminate discomfort when given as pain relief, but it alters how the patient senses pain. In time, anyone will grow tolerance and need a greater dosage to experience the management of pain.
On the other hand, if you use this medicine for therapeutic purposes, you may grow buprenorphine dependence even faster. Buprenorphine is taken orally, snorted, or injected at times. Basically, recreational users of Buprenorphine also often administer Buprenorphine to improve its effectiveness. Unfortunately, this approach will provide rapid, intense yet high levels of risk for increased overdose and an increased incidence of dependency. In short, addiction to Buprenorphine warrants a systematic and high-dose use of this medicine.
If you are medicinally using Buprenorphine or prescribing it by a doctor doesn’t matter; because anybody is subject to produce buprenorphine dependence. Dependence is dangerous for life because even the most fundamental relationships, jobs, and hopes can be wrecked.
It is necessary to remember that many more effective treatments are available even if you have ventured into therapy before. Above all, if you get quality care, you have a better chance of healing. Reach out to us here at We Level Up Addiction Treatment Center in New Jersey.
We Level Up New Jersey Comfortable Buprenorphine Detox
For anyone who suffers from addiction, just the thought of having to stop using can cause severe mental distress. But, with the help of a medical detox center, the medical detox process is managed. A comprehensive team prescribing medications can alleviate your withdrawal pains while monitoring your health 24 hours. We are assuring both your safety and comfort.
At We Level Up NJ, our thorough approach to rehabilitation supports several levels of care because we ensure the best possible outcome for every patient who enters our doors. From an intensive and more supportive atmosphere for those in the early days of recovery to a comfortable residential-style living dynamic upon completion of detox, we are here to help guide you down the safe and results-based path to your sobriety.
To start reclaiming your life from addiction and undergo a buprenorphine detox, you may contact us, and we will guide you to recovery.
 Buprenorphine – Substance Abuse and Mental Health Service Administration
 Buprenorphine – National Center for Biotechnology Information, U.S. National Library of Medicine