Is it normal to feel emotionally flat on Suboxone®?

Some people taking Suboxone® (buprenorphine-naloxone) may feel emotionally flat or numb. This doesn’t necessarily mean the medication is the cause or isn’t working. Talk to your QuickMD doctor about possible causes and ways to help.

It can be frustrating to feel emotionally flat when you expected treatment to help you feel more like yourself. We’ll cover what may be behind it, how to tell it apart from depression, what can help, and when to talk with your QuickMD doctor.

Feeling numb, muted, or just “off”: what patients describe

Some patients on Suboxone (buprenorphine-naloxone) tell us they feel emotionally numb, off, or not like themselves. Some also say they feel like they’re just going through the motions, or that things they used to enjoy don’t excite them as much. Low motivation, tiredness, and trouble concentrating often accompany it. 

These are common experiences in recovery. If you’re feeling the same way, you’re not imagining it. 

Feeling flat isn’t the same as feeling sad, though, and it can be hard to tell the two apart. Sadness is a low mood, while flatness is feeling less of everything, including the good. It also doesn’t mean Suboxone (buprenorphine-naloxone) has stopped working. When you feel this little, it’s natural to wonder, but cravings can be under control while emotions still feel muted. 

Feeling emotionally numb can be frustrating, especially when you’re working hard on your recovery. But it doesn’t mean you’ve lost your progress or that you’ll always feel this way. Talking with your QuickMD doctor can help you understand what’s behind these feelings and what might help you feel better.

Flatness and sadness are two separate feelings, and the sections below go through what can be behind flatness.

If irritability or mood swings are part of what you’re feeling, too, our guide to mood and personality while on Suboxone (buprenorphine-naloxone) explores why these changes may happen during recovery

How common is emotional flatness in recovery?

Feeling emotionally flat isn’t unusual during recovery from opioid use disorder. Researchers call a reduced ability to enjoy things anhedonia. Studies show that some people experience this during recovery, but it doesn’t necessarily mean Suboxone (buprenorphine-naloxone) is causing it or that your treatment isn’t working.

Research offers some helpful perspective:

• Emotional changes can happen during recovery. A review of 11 studies found that people with opioid use disorder were more likely to experience reduced enjoyment. However, most studies looked at patients at only one point in time, so they couldn’t determine how long these feelings lasted.
• Buprenorphine treatment may support emotional well-being. A study supported by the National Institute on Drug Abuse found that patients who started buprenorphine reported fewer depression and anxiety symptoms after 12 weeks than those waiting for treatment.

If you’re feeling emotionally numb, it doesn’t mean your recovery isn’t progressing. Your QuickMD doctor can help you explore possible causes and ways to improve how you’re feeling.

What can cause emotional flatness while you’re on Suboxone

If you’re not sure why you feel this way, it’s understandable. There are several possible causes, and some of them can be treated. 

Your reward system is still recovering

Opioids act on the part of the brain that registers reward. After a long period of opioid use, ordinary things like a good meal or time with friends can feel less rewarding than they used to. 

Lingering effects like this are sometimes called post-acute withdrawal symptoms, meaning symptoms that stay or return after the main withdrawal has passed. 

Low mood that was there before

Feelings of sadness or anxiety can sometimes become more noticeable during recovery. These feelings may have been present before treatment or may be related to other factors worth discussing with your doctor.

Drowsiness and brain fog

Buprenorphine can cause drowsiness in some people. Feeling tired or mentally foggy can sometimes make it harder to feel engaged or motivated, which may resemble emotional flatness. Your QuickMD doctor can help you explore whether your medication dose or timing could be contributing.

Sleep, stress, and daily life

Not getting enough sleep, dealing with stress, feeling disconnected from others, or adjusting to new routines can all affect your energy and emotional well-being.

If you’re unsure what might be contributing to how you feel, your QuickMD doctor can help you explore possible causes and ways to feel better.

Flat or depressed? How to tell the difference

Flatness and depression can feel a lot alike, and it isn’t always easy to tell which one you’re dealing with. Flatness often feels muted as you keep up with daily life. Depression is a low mood or loss of interest that affects your daily life and lasts most of the day, nearly every day, for at least two weeks. 

If any of these sound familiar, tell your QuickMD doctor: 

• Feeling down on most days
• Crying spells
• Little interest in things you’d normally care about
• Sleeping or eating noticeably more or less than usual
• Feeling hopeless, helpless, guilty, or like you’re not worth much
• Struggling to get through work or chores

Depression can show up alongside opioid use disorder, but it can be treated. Our guide to Suboxone (buprenorphine-naloxone) and mental health explains how our doctors look after mood and Suboxone (buprenorphine-naloxone) together.

What can help when you feel flat

These are small things you can start this week, alongside your QuickMD doctor’s care.

• Keep taking Suboxone (buprenorphine-naloxone) as prescribed: If you have concerns about how you’re feeling, talk with your QuickMD doctor before making any changes to your medication.
• Stick to a consistent sleep schedule: Going to bed and getting up at about the same time most days helps, and so does a simple routine you can repeat.
• Get outside for a short walk: Even ten minutes counts.
• Stay connected and make time for things you enjoy: Reach out to a friend or loved one, or try an activity you used to enjoy. Even if it doesn’t feel quite the same right away, it’s worth giving yourself time.
• Ask about counseling: Our guide to therapy for addiction recovery explains how talking with a therapist can support the work you’re already doing. Online therapy might be a good option if you don’t want to go in person.

When to talk to your doctor

If you’re feeling emotionally flat, it’s worth bringing it up with your QuickMD doctor. Your emotional well-being is an important part of recovery, and talking about how you feel can help your doctor better understand your needs and support your progress.

Call or message your QuickMD doctor if:

• You’ve felt flat for more than two weeks
• Your mood is low, or you’ve lost interest in things
• It’s interfering with your job, your relationships, or your daily tasks
• You’re sleepy, foggy, or worn out during the day
• You’re thinking about lowering your dose or stopping Suboxone (buprenorphine-naloxone). Talk first, before changing anything.

At the visit, your QuickMD doctor may:

• Review your Suboxone (buprenorphine-naloxone) dose and what time of day you take it
• Ask how you’re sleeping and whether you’re drinking or taking other medications
• Screen for depression
• Discuss counseling and, if appropriate, potentially consider antidepressants and Suboxone (buprenorphine-naloxone treatment together

If you’re having thoughts of harming yourself, you don’t have to face them alone. Call or text 988 to connect with a trained crisis counselor who can offer free, confidential support 24/7.