Did you use opioids while on buprenorphine? First, check for signs of an overdose. If someone is unresponsive, breathing slowly, or has blue lips, call 911 right now. Use naloxone if you have it. Follow the directions.
If you feel okay and are not in urgent danger, call your buprenorphine prescriber or treatment team soon. Tell them the truth about the event. Do not stop, restart, or adjust your buprenorphine yourself. A slip back is a sign to rejoin care, not that treatment did not work.
Our site is a U.S. treatment directory. We do not provide treatment. This guide gives general info to help you plan next steps with your care team.
How to Handle Relapse on Buprenorphine
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.
Call your buprenorphine prescriber or treatment team soon if you do not have emergency signs. Do not change 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.
Relapse on Buprenorphine: Next Steps
Support is due to you if you use opioids while taking buprenorphine. This is not a moral failure. Buprenorphine acts as a partial opioid agonist. It can lower 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]
The research looked at two different groups. In one group, patients tapered off buprenorphine. The second group continued taking the medication. These numbers show sample-level results, not the share of people with negative tests. Do not treat these figures as a universal relapse rate. They do not predict what will happen to you.
Unpredictable nature of street drugs. They often contain fentanyl or other strong substances.[7] Mixing buprenorphine with alcohol or sedatives raises the risk of overdose.[5]
Relapsing is a signal that you need support. It is not something to feel ashamed about. Share your current status with your care team. They can help you review your plan and adjust it if needed. Here, you can read more about handling cravings while on medication. You can also learn more about is MAT just trading addictions here.
Link Up With Your Buprenorphine Treatment Team Again
Speak to your prescriber or treatment program without delay. Using opioids again calls for this next step. Trying to hide it makes getting help tougher. Your care team knows this happens. They want to keep you safe.
Your specific needs are what they will review. Per ASAM guidance, buprenorphine treatment fits each person.[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.
Struggling to start the chat? Read our guide on requesting medication-assisted treatment. It gives tips for speaking with providers. Rejoining opioid use disorder treatment shows strength. Your buprenorphine treatment support team is here to help you go on.
Effects, Body Changes, and Relapse Risk
Feeling anxious about how buprenorphine works in your body is common. Learning to tell physical dependence apart from addiction can help. Our guide to what to expect from medication-assisted treatment offers more context on how these medications support recovery.
| 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. |
Mild side effects are common when you start or change buprenorphine doses. Headache is a top reported issue, but nausea, constipation, and dizziness happen often, too.[9] These signs often fade as your body adapts. Tell your prescriber if you see anything new, severe, or worrying.
Some buprenorphine products dissolve in the mouth. Serious dental issues have been tied to these forms.[10] The FDA issued warnings for patients taking these drugs for opioid use disorder or pain.[10] Speak with your dentist or prescriber if you have tooth or gum worries. They can aid in keeping your mouth healthy during treatment.
Long-term safety depends on the specific product and the person using it. We know about some risks, like dental issues with certain formulations. Other possible long-term effects need ongoing monitoring by a healthcare professional. Bring up your unique concerns and any lasting symptoms with your prescriber to decide the best next steps.
How Long to Stay on Buprenorphine and When to Stop
Buprenorphine has no set time limit. ASAM does not fix a deadline for treatment.[11] Your prescriber helps you pick what is right for you.
People sometimes hesitate to stop for two reasons. One is that withdrawal symptoms can happen. The other is that your body may lose opioid tolerance. Using opioids again after a break means an old dose can be dangerous.[12]
Never stop or shift your dose because of an article. Do not do it after a single slip-up. Check with your prescriber first.
ASAM notes that you should know the risks and benefits of your care. You should help make these decisions.[13] Bring up questions and talk about your worries. Build a plan with your doctor that fits 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.
Dealing with Cravings and Moving Forward Safely
Taking opioids again does not wipe out your progress. It does not show that your treatment failed. It is not a sign you have given up.
If you support someone, listen to them without judging. NIDA recommends using non-stigmatizing language that reflects an accurate, science-based understanding of substance use disorder.[14] Helping a person reconnect with care works best. Threatening or shaming a person does not help. You cannot decide things for them. However, you can offer to help them place the next call.
Safety is why staying in treatment matters. 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 this approach's value, ask your care team for details. Our guide to cravings on mat covers safe steps to take and emergency signs to watch for.
For suicidal thoughts, call or text 988.[4]
Talk to your care team using the questions below as prompts. These do not serve as a diagnosis or a safety assessment.
Prompts for Your Care Team Conversation
These questions are for discussion with your healthcare provider and are not a diagnosis.
Look for Ongoing Care and Help
After you feel safe, set up a regular care plan. You are not on your own. Staff can hook you up with local treatment facilities, support groups, and community-based organizations.[16]
Speak with your prescriber about the event. Ask if you should keep or switch buprenorphine treatment. Find out how to adjust your plan. For extra support, check outpatient opioid treatment options that match 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.
