When will Suboxone be out of my system and out of my urine?
There are a few reasons why you may be asking this question.
- You are out of Suboxone and wondering how long it will be before you get withdrawal symptoms.
- You are going to have an employment drug test and you are worried about it showing Suboxone.
- Your support network of recovering friends and your own family wanted you to quit Suboxone and they say that you seem intoxicated, even though you stopped taking it days or even weeks ago.
- You want to transition from Suboxone to naltrexone, and you want to know when you can get started with naltrexone.
So, let’s address these concerns. If you have other reasons why you are interested in knowing how long Suboxone stays in your system, please use the comment section below.
I ran out of Suboxone. When will I start feeling sick?
Suboxone is a buprenorphine-containing medication used to treat opioid use disorder with medication-assisted therapy. Buprenorphine is both an opioid agonist and an opioid receptor blocker. After taking your last suboxone tablet or film, you may feel fine for a while. Many patients have described going into the next day and not feeling sick at all. The main active ingredient in Suboxone is buprenorphine. Buprenorphine has a long half-life. It is between 21 and 42 hours. This means that at about a day and a half, you may start to feel withdrawal symptoms. Some people may feel it sooner than this. It depends on your metabolism and your Suboxone dosage.
I have to take a drug test. Will Suboxone show up in my urine test?
If you stop taking Suboxone to pass a drug test for work, it could take more than just a few days for your urine to not show buprenorphine or the metabolite, norbuprenorphine. This is because, with the passing of each half-life period, only half of the buprenorphine leaves your system. Generally, it takes five half-lives for the drug to be considered to be out of your system. This could be a week or more. Many employment drug tests will not show buprenorphine at all, even while you are still taking it. This is because most drug testing kits do not test for buprenorphine or any metabolite of buprenorphine. It will not show on a drug test that only checks for opiates and opioids of abuse.
Is it a good idea to stop Suboxone to pass a drug test?
A more important consideration is if you should stop your buprenorphine treatment at all to pass the employment drug test. Buprenorphine protects you against relapsing on opioids. It helps you to function at your best and stay clean from drugs. If you stop taking your Suboxone, you may get very sick with withdrawal symptoms unless you taper very gradually over a long period of time. You may also risk a dangerous relapse. Your addiction treatment program is important to your continued success in staying clean and living a fulfilling life.
You were pressured to quit Suboxone and you did it. Now, they don’t believe that you are clean.
Unfortunately, our society has mixed messages about treating opioid-dependent patients. There are many so-called experts who are against the treatment of opioid addiction with medications such as methadone and buprenorphine. Because treatment with these drugs is essentially using an opioid to treat opioid addiction, they say that you are trading one addiction for another. This is simply not true. If you have quit heroin and now take methadone or buprenorphine, you know that you are not living in an addictive state anymore. But, what if you do give in to the pressure and quit your buprenorphine? Within a few days, you will likely feel withdrawal symptoms. Some people may mistake these symptoms for continued drug use. I recommend that you speak with your doctor before considering stopping the prescribed medication.
You are interested in switching to naltrexone for continued opiate addiction treatment.
Naltrexone is an opioid blocker. It is known to have a good success rate at preventing opioid relapse. The difficulty, however, in transitioning from buprenorphine to naltrexone is that you must wait at least two weeks after quitting buprenorphine to get started. This is because if there is even a little buprenorphine left in your system, the naltrexone may cause you to have precipitated withdrawal symptoms. This transition should be undertaken carefully and under the care of a doctor. You may even want to consider a residential detox or rehab program to help you make the switch so your risk of opiate relapse is minimized.
How long does buprenorphine stay on the opioid receptors?
Some experts believe that buprenorphine binds to the mu-opioid receptor and does not ever come off of the receptor. You may wonder how this can be true. How can the effects of buprenorphine ever wear off if it stays on the receptor permanently? Opioid receptors do not last forever. In fact, they degrade in about three days. There is a continuous turnover of receptors where they are being replaced by new receptors.
What about naloxone, the other ingredient in Suboxone.
Naloxone is present in Suboxone as an abuse-deterrent. When you take your Suboxone sublingual tablet or sublingual film as directed, very little naloxone is absorbed into your system. This means that it rarely has any effect on patients. The purpose of naloxone being used in Suboxone is to prevent drug abusers from shooting up or snorting their Suboxone. If they do, the naloxone will be effective and it will cause precipitated withdrawal symptoms. While this form of substance abuse is not common, doctors are encouraged to only prescribe the buprenorphine/naloxone combination unless the patient is pregnant or has had an adverse reaction to naloxone in the past. The brand of buprenorphine that does not contain naloxone is Subutex.
What is the half-life of naloxone?
Naloxone has a very short half-life that averages around an hour. It is a short-acting drug with a half-life that can be as short as 30 minutes. because of the short half-life of naloxone, it is actually not a very effective abuse-deterrent. Because of this, experts are now recommending a switch to subcutaneous buprenorphine and implants. These include Sublocade, Brixadi, and Probuphine.
Isn’t naloxone the same as Narcan?
Yes. Naloxone is the ingredient in Narcan, the drug that is used to reverse opioid overdoses. This is a much better and more effective use of naloxone. This is a cornerstone of harm reduction. The FDA is fast-tracking approval for naloxone to be available over-the-counter. Even now, anyone can get Narcan with a prescription or, in many states, without a prescription at the pharmacy. Ideally, we should all carry Narcan, just like many of us now carry hand-sanitizer. The more Narcan that is available in the world, the more likely that opioid overdoses can be reversed and lives saved.
If Narcan has such a short half-life, what if it is given to someone overdosing and it wears off?
This is a serious concern. In emergency situations where you have given someone Narcan for an opioid overdose, you should always call 911 as soon as possible. The dosage delivered by the nasal spray is effective in most cases but very short-acting. Also, be prepared to give them Narcan again. It can wear off and the patient can go into a dangerous overdose again with respiratory depression. The slowed breathing caused by heroin, fentanyl, oxycodone, morphine, or other opioids can lead to an overdose death.