Ending opioid use can be difficult to manage on your own, partly because withdrawal symptoms make it hard to stay on track with your recovery goals. Medications for opioid use disorder (MOUD) like Suboxone can help reduce cravings and withdrawal symptoms. However, if taken at the wrong time, they can trigger a sudden, intense reaction called precipitated withdrawal.
There are ways you can avoid this on your recovery journey. In this blog post, we’ll talk about what precipitated withdrawal is and share strategies you can use to avoid it.
What is precipitated withdrawal?
Precipitated withdrawal is a sudden, intense onset of opioid withdrawal symptoms after taking a medication containing an opioid “partial agonist” (meaning partial strength) while stronger “full-strength” opioids are still in a person’s system. The most common partial agonist is buprenorphine (i.e., Suboxone). If taken while other, stronger opioids (like heroin, fentanyl, oxycodone, methadone, etc.) are still in a person’s system, buprenorphine blocks the activity of other opioids, causing the symptoms of precipitated withdrawal.
The symptoms of precipitated withdrawal are the same as the symptoms of opioid withdrawal, and include:
- Tremors
- Muscle aches
- Runny nose and tears
- Goosebumps
- Extreme tiredness
- Sweating
- Agitation
- Nausea and vomiting
- Diarrhea
- Light sensitivity
- Racing heart
When transitioning from full-strength opioids to buprenorphine, the timing of the first dose of buprenorphine is critical to prevent precipitated withdrawal.
4 ways to avoid precipitated withdrawal
The process of stopping opioid use suddenly will always cause “spontaneous” withdrawal symptoms. These begin as soon as six hours after taking a fast-acting opioid or up to a couple of days after taking a slower-acting opioid. They’re uncomfortable, and they can last from a few days to a few weeks. Precipitated withdrawal symptoms begin much faster, within a couple of minutes or hours after taking a partial agonist. They may last between six hours and a few days. If you or someone you love is experiencing precipitated withdrawal, you should seek medical care.
There are a few different ways to protect yourself from precipitated withdrawal. Try these strategies:
- Take buprenorphine exactly as prescribed, at the right dose and at the right time — Only take buprenorphine that is prescribed to you and take it exactly as advised by your medical provider. The most important thing to remember is that the first dose of buprenorphine should not be taken until you feel very sick with withdrawal. Symptoms may include anxiety, restlessness, cramps, nausea, diarrhea, shakes, goosebumps, yawning, sweating, and fast heartbeat. This usually occurs 12 to 16 hours after the last dose of a short-acting opioid (heroin, hydrocodone, oxycodone immediate release), 17 to 24 hours after intermediate acting opioids (OxyContin), or 30 to 48 hours after your last methadone dose.
- Be honest with your medical provider — It’s critical that you tell your medical provider exactly what substances you’ve been taking and when you last took them. This is especially true for any full strength opioids you’ve been using. Without this critical information, your medical provider can’t craft the right plan to help you prevent precipitated withdrawal.
- Ask your care provider to prescribe “comfort medications” — While you wait for the proper time to take your first dose of buprenorphine, there are many other medications that can help keep you more comfortable. Some of these medications are over the counter and some need a prescription. Usually you only need these medications for a few hours or days, and once you have successfully transitioned onto buprenorphine you can stop taking them.
- Don’t try to manage withdrawal symptoms on your own — Experiencing withdrawal symptoms without treatment can raise your risk of overdose and risky behavior such as sharing needles. People who aren’t engaged in medical care may also be more likely to have other medical conditions that may be preventable or treatable. Getting support from a counselor, a physician, and your peers can help make the road to recovery much easier. At Groups, we offer comprehensive care that includes Suboxone prescriptions and access to our supportive community. You’ll work with both care providers and others who are also in recovery from opioid use disorders.
Get help ending opioid use without precipitated withdrawal
Typical withdrawal symptoms make recovering from opioid use disorder hard enough. MOUD can help you avoid precipitated withdrawal and intense withdrawal symptoms in general. Working closely with a trusted care provider and leaning on friends and peers who support your recovery goals will help you achieve the best outcomes.
You’re welcome to be a part of our community at Groups. We understand the challenges of ending opioid use, so we don’t kick people out for using. Our support groups are a great place to meet people who are working on similar goals.
Are you looking for help with your recovery process? Give our Recovery Support Specialists a call today for more information. Let’s talk about the life you want to live and how we can help you make it a reality. If Groups doesn’t offer treatment in your state, you can locate other treatment options here.
