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Does Suboxone Make You Tired?

Some people have reported feeling tired while on Suboxone, especially those who are just beginning to use the medication. 

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This is primarily due to the drug’s impact on the central nervous system, which can slow down brain activity. This causes a user to feel less stress but also drowsy, lethargic, or generally fatigued.[1] This may be more likely at higher doses of Suboxone. 

In most cases, it is an effect that hits people who are new to the medication or after a dosage increase. It usually passes as their body adjusts to the medication or the higher dose. 

As people switch from active opioid abuse to Suboxone, they may experience fluctuations in energy levels and periods of fatigue.[1] Again, these sensations will generally pass once the person gets used to the medication.

If you are taking Suboxone and believe that it is negatively impacting your ability to function, speak to your prescribing physician. They can assess the situation and determine if a change in dose is needed or if a different medication may work better for you. 

Starting Suboxone & The Potential for Fatigue

Most people who experience fatigue when taking Suboxone do so in the first few days or weeks of starting the medication.[2] It can take time for your doctor to dial in the right dose for your needs, so if your dose is too high, you may continue to feel tired beyond the adjustment period. If the dose is right for you, however, the sense of fatigue you feel will usually pass on its own. 

If fatigue persists after a few weeks or if you feel that it’s too powerful for you to feel comfortable functioning as you need to at work and at home, reach out to your doctor and ask about different dosing options. A slight dose adjustment can sometimes alleviate this side effect. 

Factors That Impact Fatigue While on Suboxone

There are a number of factors that will have an impact on whether or not someone will feel overly tired while taking Suboxone and if that feeling will pass or remain over time. In many cases, these factors can be addressed and changed, so fatigue is no longer much of an issue. 

Dosage 

The primary factor may be the amount of Suboxone you are taking. Higher doses of the medication tend to make people feel a greater sense of fatigue than lower doses due to the more intense impact on the central nervous system.[3]

Additionally, it could just take your body a while to adjust to the dose, even if it is the correct dose for your needs. All medications usually come with an adjustment period, and Suboxone is no different. 

Administration 

The time of day that Suboxone is taken may impact the levels of fatigue felt as well. The dose may be strongest in the hours after it is taken and cause more fatigue at that time. If you can take the dose at night before bed rather than first thing in the morning, you may be able to lessen the amount of fatigue you feel.

Consistency is also important.[4] If you are not taking your dose at the same time every day and maintaining a steady blood level of the medication, it can negatively impact energy levels. 

Underlying Medical Conditions 

Underlying medical conditions (other than addiction) may also impact how the medication impacts you. For example, Suboxone is metabolized by the liver, so anyone who is living with liver dysfunction or liver disease may metabolize Suboxone more slowly, allowing higher levels of the medication to build up in the system, thus creating higher levels of fatigue.[5]

Similarly, other medical conditions that cause the person to feel tired can make the fatigue caused by Suboxone feel more overwhelming.[6] Thyroid disorders, anemia, sleep apnea, and other disorders that are characterized by fatigue may be worsened when taking Suboxone.  

Use of Other Substances 

Mixing illicit substances that also depress the central nervous system can contribute to the level of fatigue experienced while taking Suboxone.[7] Alcohol and sedatives can cause fatigue on their own. When they are combined with Suboxone, the effect can be synergistic, meaning it can multiply the effect rather than layering the effect of one on top of the other. 

On the other end of the spectrum, use of stimulant drugs or products containing caffeine can mask the fatigue effect of Suboxone. Caffeine can also negatively impact sleep quality and contribute to fluctuations in energy levels as it wears off. 

Lifestyle Factors

Difficulty sleeping or struggles with insomnia or sleep apnea can increase feelings of tiredness during the day.[8] In some cases, Suboxone can contribute to issues falling asleep or staying asleep, and this can certainly increase levels of fatigue the following day. 

Similarly, diet and hydration levels can have an impact on fatigue.[9] Nutritional deficiencies or dehydration can cause fatigue, and both can worsen feelings of fatigue caused by Suboxone.

Though exercise can be tiring, it can also help to improve energy levels over time, whereas low levels of physical activity can contribute to feelings of lethargy.[10] Lethargy due to lack of exercise in combination with Suboxone can make the user feel even more tired while on the medication. 

Psychological Factors

Stress levels and emotional well-being can contribute to levels of fatigue, as can anxiety and depression.[11] When someone is struggling with any of these issues, whether acutely or due to a chronic diagnosis, it can impact their energy levels, and Suboxone may exacerbate the issue. 

Especially for people in early recovery, life can feel stressful. The adjustment period during the transition from active addiction to active recovery can feel emotionally overwhelming. This can cause people to feel tired, and Suboxone can amplify that feeling in some cases. 

Tips to Combat Fatigue While on Suboxone

Once the sources of fatigue are identified beyond the use of Suboxone, there are a number of potential changes that can be made to lifestyle choices, healthcare management, and the substance abuse treatment plan that can help to reduce levels of fatigue. Here are some steps to take:

Maintain a Regular Sleep Schedule

The average adult needs between seven and nine hours of sleep per night.[12] Sleep too little or too much, and it can cause fatigue the next day. Additionally, it can be helpful to set up a sleep routine, and try to go to bed and wake up at the same time each day, even on weekends. 

If possible, limit the use of screens, excessive activity, and caffeine in the hours before bed. Create a bedroom that is conducive to sleep—dark, cool, and quiet. 

Evaluate Your Diet

Eating a balanced diet with large amounts of fruits and vegetables, and moderate amounts of whole grains and lean proteins, can help you to maintain energy levels throughout the day. Avoid large meals and heavy foods that can increase tiredness, especially before bedtime. Drink lots of water to avoid dehydration, which can also lead to fatigue. 

Exercise Regularly

Regular exercise that increases heart rate and helps to build muscle can help to improve your energy levels as well as your mood and overall sleep quality.[13] If you have historically been lethargic and don’t exercise regularly, start slowly and increase the intensity and length of your workouts over time. Include both cardiovascular exercise and weight-bearing exercises, and remember that a little goes a long way. 

Limit Caffeine & Alcohol

While caffeine may seem like a good way to overcome fatigue, it will ultimately make it  harder for you to fall asleep, creating a cycle of highs and lows in energy levels. Similarly, alcohol can decrease the amount of restorative sleep you experience. “Passing out” does not provide the same value to your body as falling asleep naturally, which can ultimately increase tiredness.[14]

Manage Stress

There are a number of tools you can use to lower the amount of stress you feel during the day and decrease the amount you feel when taxing events occur. For example, you can practice meditation, yoga, gratitude journaling, progressive guided muscle relaxation, or breathing exercises. 

Monitor Other Medications

Review any other medications you are taking with your healthcare provider, as some can contribute to fatigue. There may be alternatives or adjustments that can help.

Stay Mentally Active

Engage in activities that keep your mind stimulated and alert. This can include puzzles, reading, or learning new skills.

Consider Vitamin or Mineral Supplements

In some cases, if you are deficient in certain nutrients, it may be appropriate to take vitamins or mineral supplements to help raise your energy levels. Do not take any vitamins or supplements without first talking to your doctor. Request a blood panel that will let you know if you are deficient in nutrients that can contribute to fatigue, such as iron, vitamin D, or B vitamins.[15]

Prioritize Tasks

Sometimes fatigue comes from overwhelm, and in recovery, it can feel like there are so many things that need to be accomplished all at once.[16] If this describes you, make a list of the big items you need to do and break each one down into a series of manageable steps. Take the most important item from your list and follow this process, so no single task feels overwhelming. 

Seek Support

Seek out support groups where you can share your experiences and strategies with other people who are facing similar challenges. Talk about your fatigue and other experiences in therapy. A good support network can lay the groundwork for coping and avoiding relapse to substance abuse. 

Consult Your Healthcare Provider

Talk about what you are experiencing in terms of fatigue with your prescribing physician. They might choose to adjust your Suboxone dose or recommend other ways to manage your fatigue. Always work closely with your healthcare provider to ensure that any changes to your lifestyle or treatment plan are safe and appropriate for your situation.

Updated April 6, 2024
Resources
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  2. Highlights of prescribing information. U.S. Food and Drug Administration. Published 2010. Accessed March 24, 2024.
  3. Simojoki K, Vorma H, Alho H. A retrospective evaluation of patients switched from buprenorphine (Subutex) to the buprenorphine/naloxone combination (Suboxone). Substance Abuse Treatment, Prevention, and Policy. 2008;3(1):16.
  4. Guide to Taking Suboxone ®. Accessed March 14, 2024. Delaware Department of Health and Social Services. Accessed March 24, 2024.
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  10. Puetz TW. Physical activity and feelings of energy and fatigue. Sports Medicine. 2006;36(9):767-780.
  11. Kocalevent RD, Hinz A, Brähler E, Klapp BF. Determinants of fatigue and stress. BMC Research Notes. 2011;4:238.
  12. Chaput JP, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this? Nature and Science of Sleep. 2018;10(10):421-430.
  13. Regular exercise plays a consistent and significant role in reducing fatigue. ScienceDaily. Published November 8, 2006. Accessed March 24, 2024.
  14. Helaakoski V, Kaprio J, Hublin C, Ollila HM, Latvala A. Alcohol use and poor sleep quality: A longitudinal twin study across 36 years. SLEEP Advances. 2022;3(1).
  15. Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and minerals for energy, fatigue and cognition: A narrative review of the biochemical and clinical evidence. Nutrients. 2020;12(1):228.
  16. Kop WJ, Kupper HM. Fatigue and stress. Stress: Concepts, cognition, emotion, and behavior. 2016;1:345-350.
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