Precipitated withdrawal occurs when a medication called buprenorphine is taken while still on opioids. Buprenorphine is designed to treat opioid use disorder by blocking opioid receptors in the brain and spinal cord while also having a weak opioid effect. This stops cravings and helps patients quit using opioids like heroin.
Causes and Symptoms of Precipitated Withdrawal
When buprenorphine is taken too early, before the effects of the opioids have worn off, it can cause precipitated withdrawal.
This happens because the buprenorphine rapidly displaces the opioids still present in the blood and on the opioid receptors without allowing the body to adjust to the lower opioid activity. This leads to severe withdrawal symptoms, including:
- Pain, including headaches
- Anxiety
- Diarrhea
- Nausea and vomiting
- Runny nose
- Goosebumps
- Chills
To avoid precipitated withdrawal, it is essential to wait until detoxification has begun before starting buprenorphine-containing medications like Suboxone. For most opioids, this waiting period should be at least 24 hours.
For fentanyl and methadone, it should be 2-3 days. Microdosing may help reduce the risk of precipitated withdrawals.
Where Can I Get Suboxone?
QuickMD is the largest TeleMOUD service in the US, treating tens of thousands of patients for opioid use disorder and reaching even the most rural areas. Our patients can get prescribed Suboxone via telemedicine and pick up their medications at their local pharmacy or have it mailed to their homes (in many states).
