Suboxone is a medication for opioid use disorder (MOUD) that helps people recover from opioid addiction). Like with any medicine, getting the dosage right for Suboxone is important. For Suboxone in particular, it can plateau or lose some of its effects at higher doses. It can also have more side effects at higher doses. On the flip side, dosage that’s too low can result in withdrawal.
Suboxone contains two ingredients:
- Buprenorphine is a partial opioid agonist that helps reduce pain and opioid withdrawal symptoms.
- Naloxone is an opioid antagonist that can cause intense withdrawal symptoms if a high dose of Suboxone or another opioid is taken.
Suboxone films and tablets are available in different strengths and doses. Most people who take it for opioid use disorder (OUD) need a maintenance dose between 4 mg buprenorphine/1 mg naloxone and a maximum of 24 mg buprenorphine/6 mg naloxone.
The right dosage for you will depend on several factors. Your prescriber will consider the type of opioid you were using and the amount you were taking. Your biology and health history are also relevant. Be sure to take your Suboxone exactly as instructed and only take the amount prescribed to you. Never take another person’s Suboxone. You should consult with a licensed provider and get your own prescription.
It can take some time for your body and brain to adjust to Suboxone. Your prescriber may start you with a low dose and gradually raise it until your symptoms are under control. You should tell your prescriber about any symptoms you notice while taking Suboxone. It could be a sign of withdrawal or a side effect of the medication.
In this blog post, we’ll share eight symptoms that might tell you your Suboxone dose is too low.
8 signs your Suboxone dose is too low
If your Suboxone dose is too low, your symptoms will feel like opioid withdrawal and cravings.
Opioids affect every system in the body and different parts of the brain. They can change certain hormone levels, affect your digestion, impair your immune system, cause cardiovascular changes, and more. In the transition to recovery, your body needs to adjust to lower levels and different types of opioids. Any rapid changes can cause intense withdrawal symptoms to show up quickly. Suboxone helps slow down these processes. Some people are able to taper their dose down with time. Others need to keep taking Suboxone indefinitely.
The following symptoms could indicate that your Suboxone dose is too low:
- Anxiety — Withdrawal from an opioid creates effects that are the opposite of the euphoric “high” people experience when they take them. If your dose of Suboxone is too low, the opioid receptors in your brain won’t receive enough stimulation. Instead of feeling happy and comfortable, you may feel anxiety, fear, dread, agitation, and other unpleasant emotions. You may have difficulty with social situations or worry about what you’re experiencing and when you’ll be able to get relief.
- Tremors — Shaking and shivering are common symptoms of opioid withdrawal. If you’re trembling or shaking while taking Suboxone, you may need a higher dose.
- Sweating — Sweating may indicate that your Suboxone dose is too low. You may also experience chills, flushing, or fever.
- Nausea and vomiting — Your intestines contain opioid receptors, so a drop in opioid levels can cause gastrointestinal symptoms. Some people experience nausea and vomiting when this happens.
- Abdominal pain — Abdominal pain is another symptom you may notice if your Suboxone dose is too low. It’s also related to opioid receptors in your gut.
- Diarrhea — Diarrhea is another GI-related symptom that can be caused by opioid withdrawal. Taking opioids usually causes the opposite effect: Many people who take opioids have constipation.
- Cravings — If you’re dependent on opioids, going without them causes cravings. During the recovery process, medication plays a critical role in keeping cravings to a minimum. If you’re experiencing cravings while on Suboxone, let your prescriber know. They may need to adjust your dose.
What else could be causing these symptoms?
Sometimes when people experience these symptoms it’s because they’re not taking their Suboxone properly. It bears repeating that you should always take your Suboxone exactly as instructed. Sublingual or buccal strips need to be absorbed under the tongue or between the gum and cheek, respectively. If you swallow them, you may not absorb enough of the medication to prevent withdrawal. If you’ve missed a dose of Suboxone, that could also cause withdrawal symptoms.
How do I know if my Suboxone dose is too low?
Talking to your prescriber is the best way to find out if your dose is too low. Keep track of your symptoms so you can give them a clear picture of your symptoms. Note when they started, the intensity, and the frequency. You might ask if there’s anything else that could be causing your symptoms and what your options are to find some relief.
You can also use the COWS scale to monitor your own symptoms and to communicate with your care providers. This scale measures withdrawal symptoms so clinicians can determine how to treat people experiencing opioid withdrawal and when to give them certain medications. A score of 5 or less means you’re not actively in withdrawal, and 5 to 12 points is considered mild withdrawal. A score of 13 to 24 points indicates moderate withdrawal, 25 to 36 is moderately severe withdrawal, and 37 or higher is severe withdrawal.
Get help with Suboxone medication management at Groups
At Groups, each of our members gets personalized treatment through a provider and a licensed counselor. Your care team can help you explore your options and determine if Suboxone is right for you. You can also give and receive support with peers during group sessions. Suboxone treatment, counseling, and group support make up our approach to OUD recovery.
We prescribe Suboxone for most of our members because it has built-in protection from intoxication and overdose. It also has a low potential to be taken in excess. Suboxone doesn’t make you feel “high” like some other MOUD, and it makes it harder to get high on other opioids.
Treatment at Groups includes the following:
- Care team including a provider and a licensed counselor
- Suboxone prescription (for most)
- Group support meetings
- Custom life-goal assistance
- Access to naloxone
Our goal is to provide treatments that support the life you want to live. We know that deciding what’s best for you is a complex process with many variables. Establishing trust between yourself and your care providers is critical for your success. We don’t punish people or kick them out of our program for using opioids. This helps encourage honesty so we can have deeper, more productive conversations.
Are you looking for a prescriber who has experience treating OUD? We can help. Your provider at Groups will get to know you so they can provide personalized and effective treatment.
If you’re ready to start your recovery, give us a call today. Let’s talk through your goals and your treatment options. If Groups doesn’t offer treatm
