How to Stop Suboxone Without Withdrawal or Anxiety, by Bruce Semon, M.D., Ph.D.

This blog post is about how to stop suboxone without withdrawal or anxiety.  This is based on my professional experience. I have been seeing patients for opiate problems and prescribing Suboxone for more than 10 years. I am a board certified psychiatrist and a DEA Authorized Suboxone prescriber.

Suboxone is a lifesaver for so many people. It allows them to get off heroin or pills. Once on Suboxone, they have no more concern about going into withdrawal. They are not anxious about whether they will be able to find opiates on the street.

But eventually, many of my patients tell me they want to stop Suboxone. They tell me that family pressure, insurance and costs or just the wanting to be off pills, makes them want to stop.

You Can Stop Suboxone Without Withdrawal

When patients want to stop Suboxone, they tell me that the internet is full of horror stories about how difficult this is. In my experience, however, Suboxone can be stopped safely without the kind of withdrawal that is often described. This post is about my recommendations to my patients on how to get off of Suboxone. I have been using this method for years.

How to Wean Off of Suboxone-The First 6 Weeks

As a representative example, many patients with opiate problems start on 8 mg of Suboxone twice a day. I tell them first that by 9 months, the opiate receptors are healing and they can start cutting down on Suboxone if they want to. Some patients could start earlier.

When the patient is ready to start weaning off of Suboxone, I tell them to pick an easy day, say a Sunday. Instead of taking 2 Suboxone that day, take only one and a half. But on Monday, go back up to 2 Suboxone. Continue to take 2 per day on Tuesday and Wednesday. By Wednesday, the person can say “Oh, I did that,” meaning that they successfully cut the dose for one day and did not have a problem. Then on Thursday, they can go down to 1 and 1/2 Suboxone again, but on Friday and Saturday, go back up to two Suboxones. Then on Saturday, the patient can say again “oh, I did that.” They cut the dose again without problem. I show this schedule in a chart below.

Starting with the second week, I recommend that on Sunday, the patient takes one and a half Suboxone. On Monday, the patient should go back up to 2 Suboxone. This time however, the patient should go down to 1 and 1/2 Suboxone on Tuesday. On Wednesday they should take the regular dose of 2 doses. On Thursday they would take 1-1/2 doses. On Friday and Saturday, they would take 2 doses. By the end of the second week, the patient has been able to reduce the dose by a half dose on three different days.

During the third week, the patient would use this schedule: Sunday, the patient takes one and a half Suboxone. On Monday, the patient should go back up to 2 Suboxone. Tuesday-one and a half doses. On Wednesday they should take the regular dose of 2 doses. On Thursday they would take 1-1/2 doses. On Friday, 1-1/2 doses, and Saturday, they would take 2 doses.

The fourth week, the patient would use this schedule: Sunday, the patient takes one and a half Suboxone. On Monday, the patient should go back up to 2 Suboxone. Tuesday-one and a half pills. On Wednesday they should take the regular dose of 2 doses. On Thursday they would take 1-1/2 doses. On Friday, 1-1/2 doses, and Saturday, they would take 1-1/2 doses.

The fifth week looks like this: Sunday, the patient takes one and a half Suboxone. On Monday, the patient should go back up to 2 Suboxone. Tuesday- 1-1/2 doses. On Wednesday , 1-1/2 doses. On Thursday they would take 1-1/2 doses. On Friday, 1-1/2 doses, and Saturday, they would take 1-1/2 doses.

The sixth week they should take 1-1/2 doses every day.

The patient has now reduced their dose in 6 weeks.

How to Wean Off Suboxone-The Next 6 Weeks

For the next stage, they again pick an easy day, say a Sunday, decrease to either 1 Suboxone or 1 and 1/4 Suboxone but again on Monday, Tuesday and Wednesday, go back up to 1 and 1/2. Then again by Thursday, the patient should again say “oh I did that” and decrease the dose to 1 or 1 and 1/4 Suboxone but again go back up to 1 and 1/2 on Friday and Saturday. Then again the patient says “oh, I did that”. The following week, the patient should again add Tuesday for three days total. Then the following week add Friday and each week add another day until you the patient are at the lower dose.

The patient gradually decreases the amount of Suboxone and does not suffer bad side effects, such as withdrawal or anxiety. This is a sample schedule to get from 2 doses per day to 1 dose per day.

How To Wean Off Suboxone-The Third Six Week Cycle

During each cycle of six weeks, the patient decreases their dose of Suboxone by one half film or tab on Sunday and Thursday but continues the regular doses on the other days. Then add Tuesday, as in the above tables. The next week, add Friday. The next week, add Wednesday, then the next week add Saturday, then finally the next week add Monday. Then when that dose is stable, start another 6 week cycle following a similar pattern. Just cut the current dose by ½ or ¼ dose. Once you get to 8 mg per day, you may want to decrease by 1/4 film or tab per cycle.

This is a sample of the 3rd 6 week cycle

The Final Steps to Get off Suboxone

When the patient gets to 1/4 of an 8 mg tab or film, they may want to switch to the 2 mg size of Suboxone, so that they can cut this in half. When the patient is down to 1 mg per day, then they can continue cutting the film or tab or start lengthening out the time between doses to 30 hours for at least several days, then 36 hours for at least a few days, then up to 48 hours and 60 hours between doses. By the time the patient gets to 72 hours between doses, they probably are ready to stop Suboxone.

Why This Method Works

This method is gradual, consistent and progressive. It does not cause anxiety or withdrawal or discomfort. The patient is only decreasing the dose one day per week at a time. The patient is not decreasing the dose all at once or going cold turkey. Suboxone actually leaves the body slowly, so the patient’s body will hardly notice the decrease in Suboxone when it is only one day at a time. Following this method, the patient can succeed.

This is just the way I have been successful helping patients get off of Suboxone. Be sure to do this only with the guidance of your Suboxone prescriber. Do not go cold turkey or do this without medical guidance by someone who knows your particular medical situation.

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