Did you take opioids during buprenorphine use? First, check for signs of an overdose. If someone is unresponsive, breathing slowly, or has blue lips, call 911 right now. If naloxone is nearby, apply it and follow the steps.
If you are steady and safe, reach out to your buprenorphine prescriber or treatment team quickly. Speak plainly about the event. Do not quit, restart, or alter your buprenorphine without help. Slipping back is a chance to link up with care again. It does not show that treatment did not work.
Our site is a U.S. treatment directory. We do not treat patients. This guide gives general info to aid your talk with your care team.
Actions to Take After Using Opioids on Suboxone
If a person is hard to wake, breathing slowly or shallowly, or has blue or gray lips or skin, call 911 now.[1] These are signs of a possible opioid overdose.
If you have naloxone, give it as soon as possible when an overdose is suspected.[2] Follow the product instructions for the specific kit you have. Naloxone can reverse an opioid overdose.[2] Even if the person responds to naloxone, they still need emergency help because symptoms can return.[3] Stay with the person until help arrives.
If you are dealing with thoughts of suicide or self-harm, call or text 988.[4] If you are in immediate danger, call 911 or go to the nearest emergency room.
Reach out to your buprenorphine prescriber or treatment team right away if you lack emergency signs. Do not alter your medication dose without their guidance. You can learn more about recognizing an opioid overdose in our guide on recognizing an opioid overdose.
- Check responsiveness and breathing. See if the person wakes up and if their breathing is normal.
- Call 911 if overdose is possible. Look for signs like slow breathing or blue lips.[1]
- Give naloxone if available. Use it according to its product instructions.[2]
- Stay with the person. Wait for emergency responders to arrive.[3]
- Contact your care team. If it is not an emergency, reach out to your prescriber promptly.
- Wait for guidance on meds. Do not adjust your buprenorphine dose on your own.
What Follows a Relapse on Buprenorphine?
If you use opioids while on buprenorphine, you need support. This is not a moral failing. Buprenorphine is a partial opioid agonist that can lessen cravings and ease withdrawal symptoms.[5]
35.2%
of urine samples in the taper group tested negative for opioids[6]
53.2%
of urine samples in the maintenance group tested negative for opioids[6]
Two groups took part in the study. One stopped using buprenorphine slowly. The other continued the treatment. These findings reflect the sample, not the odds of a negative test. They are not a general relapse rate. They cannot forecast your personal outcome.
Illicit drugs on the street are hard to predict. They often contain fentanyl or other strong substances.[7] Mixing buprenorphine with alcohol or sedatives raises the risk of overdose.[5]
Resuming use shows you should get help. It is not a cause for shame. Tell your care team about where you are now. They can help you review your plan and update it if needed. You can read more about managing cravings on medication here. You can also learn more about is MAT just trading addictions here.
Get Back in Touch With Your Buprenorphine Treatment Team
Talk to your prescriber or treatment program now. That is the top choice after using opioids again. Staying quiet makes it tougher to get help. Your care team has seen this before. They want to help you stay safe.
They will look at your specific needs. Buprenorphine treatment is adjusted for each person, per ASAM guidance.[8]
What to Tell Your Treatment Team
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Immediate safety
Address any urgent medical needs first. If you are in danger, call 911 or go to the nearest emergency room.
When stable
Contact your prescriber or treatment team to report what happened.
Follow-up
Review the event with your care team and agree on next steps together.
Not sure how to begin the conversation? Check our guide on requesting medication-assisted treatment. It offers tips for speaking with providers. Going back to opioid use disorder treatment is a sign of strength. Your buprenorphine treatment support team is there to help you move forward.
Buprenorphine: Side Effects, Dependence, and Addiction
Worrying about how buprenorphine impacts your body is normal. Knowing the difference between physical dependence and addiction can help. Our guide to is mat trading addiction helps you understand physical dependence and what to expect from medication-assisted treatment.
| Feature | Physical Dependence | Addiction |
|---|---|---|
| What it means | Your body adapts to the medication over time. | A complex condition involving compulsive use despite harm. |
| Key distinction | It does not, by itself, mean a person has an addiction.[9] | Only a qualified clinician can check an individual situation. |
Starting or changing buprenorphine can cause mild side effects in many people. Headache is one of the most commonly reported side effects, though others like nausea, constipation, and dizziness are also frequent.[9] These often get better as your body adjusts. Let your prescriber know if you notice new, severe, or worrying signs.
Some buprenorphine pills dissolve right in your mouth. Serious dental issues have been tied to these forms.[10] The FDA warns of these risks for people taking the meds for opioid use disorder or pain.[10] Ask your dentist or prescriber if your teeth or gums bother you. They can help you keep your mouth healthy during treatment.
How safe a product is long-term depends on the person and the specific drug. While some effects, like dental issues with certain formulations, are known risks, other potential long-term impacts require ongoing monitoring by a healthcare professional. Talk to your prescriber about your specific worries and any lasting symptoms to find the best path for your health.
Time on Treatment and Ending Care
Buprenorphine use has no fixed end date. ASAM does not set a strict limit for treatment.[11] Your prescriber guides you in choosing what works best.
Some people worry about stopping for two reasons. First, ending the medicine can bring on withdrawal symptoms. Second, your body might lose its tolerance to opioids. If you quit and take opioids again, a past dose can be dangerous.[12]
Do not change or end your dose after reading an article. Do not react to a single slip-up. Check with your prescriber before acting.
ASAM says you should know the pros and cons of your care. You should take part in these choices.[13] Raise questions and share concerns. Make a plan with your doctor that suits your life.
Ongoing care
You take your medicine as prescribed. You see your prescriber for regular check-ups.
Shared talk
If you want a change, you meet with your prescriber. You talk about risks, benefits, and other options together.
Next steps
If you change treatment, you follow a plan from your clinician. You keep getting support to stay safe.
Managing Cravings and Choosing a Safe Move
Taking opioids again does not undo your progress. It is not proof that your treatment failed. Nor does it mean you have quit.
Listen without judgment if you support someone else. NIDA advises using non-stigmatizing language that shows a true, science-based view of substance use disorder.[14] Supporting a return to care works best. Shame or threats do not help. You cannot make choices for them, but you can help with the next phone call.
Remaining in treatment is key for safety. Treatment with medications for opioid use disorder is associated with reduced risk of overdose death compared with being out of treatment.[15] If cravings feel overwhelming, talk to your prescriber about ways to manage them. If you doubt the value of this method, ask your care team for details. For more on navigating those urges, our guide to cravings on mat covers how to talk with your prescriber.
For suicidal thoughts, call or text 988.[4]
Try the questions below to start a chat with your care team. They do not act as a diagnosis or a safety check.
Prompts for Your Care Team Conversation
These questions are for discussion with your healthcare provider and are not a diagnosis.
Set Up Continuing Care and Help
When you feel secure, put together a consistent care plan. You do not have to handle this on your own. Staff can point you to local treatment facilities, support groups, and community-based organizations.[16]
Discuss the events with your prescriber. Ask if you should keep using buprenorphine or change your treatment. Inquire about making adjustments to your plan. For more support, explore outpatient opioid treatment options that fit your daily life.
When You Contact a Program
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Frequently Asked Questions
I used opioids while on Suboxone. What should I do now?
Check for overdose signs first. Look for slow breathing, blue lips, or being hard to wake up. If you see these, call 911 or go to the ER now. If you are safe, call your prescriber or team soon. Do not stop or change your meds without them.
Is it dangerous to use opioids while taking buprenorphine?
Yes, it can be risky. Buprenorphine does not make opioid use safe. Other drugs and unknown supplies add more risk. If you think an overdose is happening, use the emergency steps at the top of this page.
What is the relapse rate for Suboxone?
There is no single number that predicts your outcome. Results vary based on who was studied and for how long. They also depend on how success was measured. Your path will look different from others'.
Should I stop taking buprenorphine after using opioids?
Do not stop or change your meds on your own. Call your prescriber to ask what to do next. Using opioids again is a good time to talk about support. Your care team can help adjust your plan.
What does Suboxone do to someone who is not opioid-dependent?
Effects vary from person to person. It can be misused for its high, especially by people not used to opioids.[17] Never take meds not prescribed to you. Ask a clinician about any questions you have.
Is 8 mg of Suboxone a day a lot?
Is it normal to be on Suboxone for 10 years?
How long does it take to become physically dependent on Suboxone, and why can stopping be hard?
Dependence can happen during normal treatment. This is not the same as addiction. There is no fixed timeline for everyone.[20] Stopping suddenly can cause withdrawal symptoms that range from mild to severe.[20] These symptoms are usually managed by doctors or through a slow taper.[20] Talk with your prescriber before stopping or trying to handle withdrawal alone.
