Zubsolv is a drug formulated with both buprenorphine and naloxone. It is primarily used to treat opioid dependency and addiction, but is also sometimes used for moderate chronic pain management. Most users of Zubsolv are taking it for opioid replacement therapy in attempt to transition off of a more potent opioid. Zubsolv is considered helpful for these individuals in that contains a “partial opioid agonist” (buprenorphine) and “pure opioid antagonist” (naloxone).
These contents give the user some degree of opioid stimulation to mitigate a full-blown opiate withdrawal, but not enough to get the user “high” – making it an ideal replacement drug. Generally when beginning Zubsolv, the goal is to stabilize on the drug, and then gradually reduce the dosage and become opioid-free. The problem is that many people neglect making an effort to reduce the dosage because they actually get addicted to it as an opioid-replacement drug.
When attempting to finally withdraw from Zubsolv, many people realize that it’s much tougher than initially expected. Although Zubsolv is certainly less potent than opioids like heroin and morphine, discontinuation (especially after long-term usage) will still pack a debilitating punch. Many people have come to realize that withdrawal from Zubsolv is so difficult, that they don’t know how to cope.
Factors that influence Zubsolv withdrawal include
If you’re withdrawing from Zubsolv, it is important to be aware of certain factors that will influence your withdrawal. These factors include things like: the time span you’ve been taking it, your current dosage, how quickly you discontinued, as well as your individual physiology.
1. Time Span
In general, the longer you’ve used Zubsolv, the more difficult it will be to discontinue. While you may not have increased the dosage over the long-term due to the fact that there’s a “ceiling effect” (in regards to dosage), your nervous system may be habituated to receive Zubsolv each day. The longer you continue any habit, whether it’s taking this drug or impulse buying junk food each time you’re at the store, the tougher it will be to stop.
Not only does your brain come to expect to receive Zubsolv on a daily basis, but your physiology expects the same production of opioids or pain-relief. Long-term users actually become dependent on the Zubsolv, making it tougher to quit. If you only used the Zubsolv for a short-term (e.g. months), it will likely be easier than someone who’s used it for years.
Zubsolv comes in different dosing formulations of buprenorphine to naloxone ratios. The standard Zubsolv sublingual tablets are dosed as 5.7 mg (buprenorphine) with 1.4 mg (naloxone). It is thought that a doctor may adjust doses by increments of 1.4 mg (for the buprenorphine) and 0.36 mg of the naloxone. Eventually a patient will stabilize on a certain dose with adjustments from the doctor.
Just know that the higher the dosage you’ve taken, the more your body has come to expect the effects of the drug. Although there certainly is a built-in mechanism of a “ceiling effect” to prevent people from abusing the drug and/or overdose, this doesn’t mean that a higher dose is equally as easy as a lower one for withdrawal. Generally the more you increase, the tougher it is when you decrease and/or discontinue.
3. Cold Turkey vs. Tapering
Some have argued that it makes no difference whether you quit cold turkey or taper. While cold turkey may sound like an appealing idea, if you couldn’t handle the effects of discontinuing an opioid and needed to take Zubsolv in the first place, you may want to consider tapering. Feeling good on Zubsolv can make it seem like quitting cold turkey will be easy, when in actuality it shocks the entire nervous system.
Cold turkey is associated with more severe earlier stages of withdrawals and greater likelihood of protracted symptoms due to the fact that the nervous system may go into shock. By conducting a gradual taper prior to completely discontinuing, you’re allowing your body and brain to adjust to the slow changes in dose. This theoretically should make withdrawal symptoms much easier than discontinuing from a high dose. The slower the taper, the less severe the withdrawal symptoms should be.
No two people are identical when completing a withdrawal. Withdrawal for one person may take 2 months and for another may take 4 months before they feel noticeably better. Avoid comparing your withdrawal duration and symptoms to other people. While you may share some commonalities with another person, the length and severity of your withdrawal will likely be subject to individual variation.
It is important to consider things like: your individual physiology, whether you take other drugs or drink alcohol, your genetics, social support, and lifestyle when thinking about withdrawal. One person may have extremely low stress, great social support, be drug and alcohol free, and stay busy during withdrawal to help take their mind off of symptoms. Another person may have a lot of free time, be a smoker, and have high stress – which could compound the withdrawal.
Zubsolv Withdrawal Symptoms: List of Possibilities
Below is a list of symptoms that you may experience when discontinuing Zubsolv. Keep in mind that you may not experience every single symptom on the list. This is a collective list of symptoms people have reported when they’ve discontinued.
- Agitation: Many people feel extremely agitated when they quit Zubsolv. The agitation may result in you to pace back and forth or move around excessively. You may feel as if you cannot sit still because internally you are wired with nervousness and discomfort.
- Anger: While the first few days of withdrawal may result in a person feeling extremely tired and debilitated with fatigue, a person may start to get some energy back. When a little energy returns, they may not like how they feel and every little thing may make them angry. If you notice you’re feeling intense anger, realize it’s normal. Try to channel it productively rather than using it as an excuse to lash out on others.
- Anxiety: The Zubsolv may actually have helped with anxiety while taking it. When you discontinue, your brain is no longer getting the partial-opioid stimulation from the Zubsolv, and you feel depressed. It may take awhile for your anxiety to lessen due to the fact that your brain will need to elevate its endogenous opioid levels, which will take time.
- Body aches: Your body may become extremely achy and you may develop cramps when you withdraw. Realize that these aches are likely a result of abnormal endogenous endorphin production. Your endorphin levels are likely low due to using Zubsolv for an extended period, which leads to aches. As they return to a baseline, the aches should improve.
- Brain fog: It is very common for people to experience brain fog riddled with concentration problems and memory issues. This is largely due to the fact that in the early stages of withdrawal, you are hit hard with an array of physical and psychological symptoms. It becomes nearly impossible for you to think about anything other than the unpleasant symptoms.
- Cravings: Perhaps one of the most troubling symptoms to experience is that of cravings for Zubsolv or other opioids. It may be tempting to take another Zubsolv and your animal brain is probably trying to entice you to avoid the current pain that you’re enduring and get back the “pleasure feeling.” Realize that these cravings are likely going to be more intense during early stages of withdrawal. Each consecutive day you go without opioids, the easier withdrawal becomes.
- Depression: Your brain is no longer getting the opioid stimulation that it had gotten from the Zubsolv. When you withdraw, your opioid production may be lower than average. Neural activity as well as neurotransmitter levels will be temporarily out of balance, especially in the early stages of withdrawal. The combination of lack of opioids and neurotransmitter level imbalances can lead to severe depression.
- Depersonalization: You may feel as if you aren’t your true “authentic” self anymore. It may seem like an alien has hijacked your body and you are still living in it, but you just feel “weird.” Depersonalization is common when going through any drug withdrawal and means that your brain and physiology is nowhere close to being fully healed. Accept that you don’t feel like yourself, and know that you eventually will.
- Diarrhea: Some people experience intense diarrhea when they initially discontinue any opioid drug. This is because when taking an opioid, it is common for people to become constipated. When the effects of the drug leave the system, you may find yourself on the toilet more than usual.
- Dizziness: Feeling dizzy is something that nearly every person will experience when quitting Zubsolv. The dizziness may be mild, moderate, or severe depending on how quickly you discontinued. It may feel as if the room is spinning in the early stages of withdrawal, but it’ll eventually improve.
- Fatigue: It is common to feel extremely fatigued when you quit Zubsolv. This may be among the most debilitating withdrawal symptoms of all. You try to get some work done around the house, but you can’t because you’re too tired. Even simple tasks may make you feel totally exhausted. While it is important to take extra time to “rest” so that your body recovers, don’t overdo the resting. Sometimes it’s necessary to push through the fatigue a little bit and dig deep to get something done.
- Headaches: Another symptom that nearly everyone experiences is that of headaches. It is important to stay hydrated and consider taking supplements to help reduce the intensity of strong headaches. Get plenty of rest and accept that headaches are an inevitable part of the process.
- Heart rate changes: You may notice that your heart rate changes significantly compared to when you were taking Zubsolv. This is a common reaction that people experience as a result of physical dependence. Engage in some sort of relaxation exercise to help lower your heart rate if it shot up.
- Insomnia: The first few weeks of withdrawal may be characterized by sleepiness, but eventually you may transition to a point of intense agitation, anxiety, and insomnia. If you find that you cannot fall asleep, you may want to consider supplementing melatonin and/or engaging in some sort of relaxation exercise like mediation.
- Irritability: Most people feel extremely irritable for awhile after they’ve quit Zubsolv. Even though it may seem like you’re doomed to an eternity of irritability, you can reduce the irritability by engaging in a relaxing or soothing activity when it strikes.
- Joint pain: In addition to body aches, you may specifically notice that your joints are in pain or throbbing. The joint pain may be a physical reaction that your body is having in attempt to function without the drug. It had come to rely on the subtle opioid properties for pain relief, but it’s no longer getting them.
- Mood swings: Don’t be surprised if your mood is all over the map during withdrawal. One day you may feel exhausted, another day mad at the world, and another day hopeful for the future. Realize that your mood will fluctuate as your nervous system and brain recalibrate themselves to homeostatic functioning.
- Nausea: You may become nauseated to the point that you feel like throwing up. Nausea is most likely to occur in the earlier stages of withdrawal, and should lessen after a few weeks.
- Palpitations: It may feel as if your heart is pounding loudly or uncomfortably fluttering in your chest. These are a common physical reaction associated with drug withdrawal and increased anxiety. Do your best to accept them as a withdrawal symptom and realize that they’re not the same thing as a heart problem; these are medically benign.
- Restlessness: Many people complain of restlessness and restless leg syndrome during discontinuation. This involves feeling an uncomfortable sensation of creeping, throbbing, pulling, or energy in the legs that provokes movement. This is an inevitable symptom of withdrawal for many and can be very annoying, but will subside over time.
- Sleep problems: At some stages of withdrawal you may end up sleeping excessively, while during other stages you may end up not getting enough sleep. Sometimes you may sleep for awhile, but wake up feeling like you hadn’t slept at all. Do your best to fight through the sleep issues and realize that your circadian rhythm will eventually reset itself.
- Sweating: A very common symptom associated with Zubsolv withdrawal is that of sweats. You may find that you perspire in excess throughout the night or all day. Some people sweat around the clock as a result of the body detoxifying itself and attempting to function without the opioid.
- Swelling: Some people may notice that their limbs (e.g. arms, legs, etc.) swell up. If you notice that your limbs have become swollen, it’s directly related to withdrawal. Know that in a few days the swelling should gradually begin to subside. It may be alarming to swell up during withdrawal, but it’s a reaction that some people have upon discontinuation.
- Vomiting: Many people feel extremely sick when they stop the drug. This is due to the fact that the body developed a tolerance to its effect and is now in a state of backlash. The combination of many symptoms such as nausea and dizziness can easily provoke vomiting. To reduce the chances of vomiting, make sure to slowly taper.
Note: If you have experienced a symptom that isn’t on this list, feel free to mention it in the comments section below. Also consider reading about Suboxone withdrawal – a relatively similar drug to Zubsolv.
How long does Zubsolv withdrawal last?
There is no definitive timeline that can be stated for Zubsolv withdrawal. In general, most people find that the first couple weeks have the most severe symptoms. After several weeks, things may seem to slightly improve. After a full month, many people finally start seeing some positive signs of improvement. Realize that the length of your withdrawal is highly individual, therefore asking how long it will last is futile.
It is important to keep in mind that it will eventually end, and therefore your focus should be on improving as quickly as possible. To maximize your chances of a quick recovery, you’ll want to make sure you are eating a healthy diet, socializing, staying as busy/productive as possible, getting some light exercise, and not dwelling on your symptoms. I recommend giving it a full 90 days before you reevaluate your symptoms.
This isn’t to say you’ll be 100% better in 90 days, but it’s just to motivate you to get to the 3 month marker after full discontinuation. At this point you’ll realize that the worst stage of many symptoms is completely over. If you’ve been on Zubsolv and are currently going through withdrawal and/or have already made it through withdrawal, feel free to share your experience in the comments section below.