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Telltale Signs Your Suboxone Dose Is Too Low 

When you start treatment with Suboxone (buprenorphine/naloxone), your doctor will work hard to find the dose that keeps you both comfortable and focused. Your honesty makes this possible. Your doctor needs to know how you’re feeling to ensure you’re getting the right amount.

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Sometimes, even though your doctor tries very hard, the dose isn’t quite right. Here’s what you need to know about the signs your Suboxone dose is too low. 

What Are the Signs Your Dose of Suboxone Is Too Low?

While every person is different, people with a too-low dose of Suboxone often share the same signs and symptoms. These are among the problems you might notice: 

You Develop Withdrawal Symptoms 

The buprenorphine in Suboxone loosely latches to opioid receptors in your brain and body, triggering chemical reactions that can reduce symptoms of opioid use disorder (OUD), including withdrawal

If the dose is too low, you could develop subtle physical withdrawal symptoms, such as the following:[1]

  • Overly watery eyes 
  • Aching muscles 
  • Runny nose 
  • Sweating
  • Yawning

The signs may come and go throughout the day. For example, they might be strongest when you’re about to take your next dose and weakest when you take it. 

Your Mood Changes

Some withdrawal symptoms are mental. For example, you might experience agitation and anxiety that can’t be explained by anything else.[1] 

If your dose is far too low, you might develop signs of emotional relapse. A part of your brain is thinking about returning to drug use. As a result, you might become withdrawn and less likely to share your feelings with others. You might also start focusing on other people’s problems rather than your own.[2]

You Experience Drug Cravings 

When buprenorphine molecules latch to opioid receptors, you feel a decrease in drug cravings. If your dose is too low, they might reappear or persist.[3] 

Cravings can feel different in different people. Some feel these cravings as a physical ache, while others are preoccupied with drugs. Either one could be dangerous. 

You Start Planning for Relapse 

Medical providers say that relapse is a process, not an event. A planning phase is part of the relapse process.[2] 

You might start thinking about where you could buy drugs or when you might use them without anyone noticing. You might also start bargaining with yourself and saying that you could use it just one time with no consequences. 

You Experience a Relapse 

If your dose is too low for too long, you might return to opioid use. A physical relapse like this can be incredibly dangerous. 

In the early 2000s, researchers discovered that people released from prison on drug charges often overdosed and died when they were released. They discovered that people lost their tolerance for drugs in prison, and when they returned to their former dose on release, it was too strong and led to an overdose.[4]

Not all relapses lead to an overdose. However, you can relapse to drugs and feel very sick or guilty about it. In addition, one relapse can lead to another. 

What Does a Normal Suboxone Dose Look Like? 

Suboxone comes in several strengths. Your doctor can help you find which one is right for you. 

The following doses of Suboxone are available:[5]

  • Buprenorphine 2 mg/naloxone 0.5 mg
  • Buprenorphine 4 mg/naloxone 1 mg
  • Buprenorphine 8 mg/naloxone 2 mg
  • Buprenorphine 12 mg/naloxone 3 mg

In the maintenance phase of treatment, most people take 16 mg of buprenorphine and 4 mg of naloxone in a single dose.[5]

The Importance of Getting the Correct Dose of Suboxone for You 

Talk to your doctor about your symptoms, and work together to find the right Suboxone dose for you. 

During the stabilization of your treatment, it’s common for doses to rise and fall until you find the perfect fit.[6] Adjusting the amount you take doesn’t mean your treatment isn’t working or that you’ve failed. It just means that you haven’t found the right solution quite yet. Your doctor can help, as long as you’re honest about how you’re feeling and what you need.

Updated March 16, 2024
Resources
  1. Opiate and opioid withdrawal. U.S. National Library of Medicine. Published April 30, 2022. Accessed February 29, 2024.
  2. Guenzel N, McChargue D. Addiction relapse prevention. StatPearls. Published July 21, 2023. Accessed February 29, 2024.
  3. Kakko J, Alho H, Baldaccino A, et al. Craving in opioid use disorder: From neurobiology to clinical practice. Frontiers in Psychiatry. 2019;10:592.
  4. Strang J, McCambridge J, Best D, et al. Loss of tolerance and overdose mortality after inpatient opiate detoxification: Follow up study. BMJ. 2003;326(7396):959-960.
  5. Suboxone prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed February 29, 2024.
  6. Medication assisted treatment program. It Matters. Accessed February 29, 2024.
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