Used opioids while taking buprenorphine? First, check for signs of an overdose. If someone is unresponsive, breathing slowly, or has blue lips, call 911 right now. If naloxone is available, use it and follow its instructions.
If you are stable and not in immediate danger, contact your buprenorphine prescriber or treatment team promptly. Be honest about what happened. Do not stop, restart, or change your buprenorphine on your own. A return to use is a reason to reconnect with care, not proof that treatment has failed.
We are a U.S. treatment directory, not a treatment provider. This guide offers general information to help you navigate next steps with your care team.
What to Do After Opioid Use 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.
If there are no emergency signs, contact your buprenorphine prescriber or treatment team promptly. 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: What Happens Next?
If you use opioids while taking buprenorphine, you deserve support. It is not a moral failure. Buprenorphine is a partial opioid agonist that can reduce opioid withdrawal symptoms and cravings.[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 study compared two groups. One group tapered off buprenorphine. The other stayed on it. These are sample-level results, not percentages of people with negative test results. The figures are not a universal relapse rate. They do not predict what will happen to you.
Street drugs are unpredictable. They often contain fentanyl or other strong substances.[7] Mixing buprenorphine with alcohol or sedatives raises the risk of overdose.[5]
Going back to use is a sign to reach out for help. It is not a reason for shame. Talk to your care team about your current situation. They can help you check your plan and make changes if needed. You can read more about managing cravings on medication here. You can also learn more about is MAT just trading addictions here.
Reconnect With Your Buprenorphine Treatment Team
Call your prescriber or treatment program right away. This is the best next step after using opioids again. Hiding what happened makes it harder to get help. Your care team has seen this before. They want to help you stay safe.
They will look at your specific needs. ASAM guidance says buprenorphine treatment is tailored to 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.
If you are unsure how to start the talk, see our guide on requesting medication-assisted treatment. It has tips for talking with providers. Reconnecting with opioid use disorder treatment shows strength. Your buprenorphine treatment support team is there to help you move forward.
Side Effects, Physical Dependence, and Addiction
It is normal to worry about how buprenorphine affects your body. Knowing the difference between physical dependence and addiction can help. Our guide to medications for opioid use disorder explains how treatment supports recovery without replacing it.
| 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. |
Many people have mild side effects when starting or changing buprenorphine. 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. Tell your prescriber about any new, severe, or worrying signs you see.
Some buprenorphine products dissolve in the mouth. These have been linked to serious dental problems.[10] The FDA has warned about these risks for patients using these medicines for opioid use disorder or pain.[10] If you worry about your teeth or gums, talk to your dentist or prescriber. They can help you care for your mouth while you stay on treatment.
Long-term safety varies by the specific product and the individual person. While some effects, like dental issues with certain formulations, are known risks, other potential long-term impacts require ongoing monitoring by a healthcare professional. Discuss your individual concerns and any persistent symptoms with your prescriber to determine the best course of action for your health.
Treatment Duration and Decisions About Stopping
There is no set time to stay on buprenorphine. ASAM does not set a fixed limit for treatment.[11] Your prescriber helps you decide what is right for you.
Some people worry about stopping for two reasons. First, coming off the medicine can cause withdrawal symptoms. Second, your body may lose tolerance to opioids. If you stop and use opioids again, an old dose can be dangerous.[12]
Do not stop or change your dose because of an article. Do not do it after one slip-up. Talk with your prescriber first.
ASAM says you should know the risks and benefits of your care. You should help make these decisions.[13] Ask questions. Share your worries. Work with your doctor on a plan 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.
Cravings, Support, and a Safer Next Step
Using opioids again does not erase your progress. It does not mean your treatment failed. It is not a sign that you have given up.
If you are supporting someone, listen without judgment. 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. Shaming or threatening them does not help. You cannot make their decisions for them. But you can offer to help them make the next call.
Staying in treatment matters 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 are unsure about the value of this approach, ask your care team for more information. For more on managing those urges, our guide to cravings on mat offers practical support for opioid cravings during treatment.
For suicidal thoughts, call or text 988.[4]
Use the questions below as prompts for a conversation with your care team. They are not 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.
Find Follow-Up Care and Support
Once you feel safe, build a steady plan for care. You do not have to do this alone. Staff can connect you with local treatment facilities, support groups, and community-based organizations.[16]
Talk with your prescriber about what happened and whether to continue or change buprenorphine treatment. Ask how to adjust your plan. If you need more support, look into 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.
