Bunavail is a bucally-formatted medication comprised of buprenorphine and naloxone that was approved by the FDA in 2017 for the treatment of opioid dependence. The buprenorphine component of Bunavail functions as a partial mu-opioid receptor agonist whereby it stimulates mu-opioid receptors in the brain to prevent opioid cravings and/or attenuate harsh withdrawal symptoms upon cessation of more potent illicit opioids (e.g. heroin). Essentially, this allows individuals to discontinue or transition off of more addictive opioids – while minimizing likelihood of opioid use relapse.
While many individuals plan on using Bunavail for a long-term to prevent relapse of an opioid use disorder, others may desire to eventually taper off of Bunavail and return to a state of complete sobriety. Unfortunately, when Bunavail is discontinued, most persons are unprepared for the [potentially-harsh] withdrawal symptoms that might emerge. If you plan on discontinuing treatment, it is important to be informed of prospective Bunavail withdrawal symptoms that may ensue.
Bunavail Withdrawal Symptoms (List)
Included below is a comprehensive list of Bunavail withdrawal symptoms. Understand that the specific withdrawal symptoms, the severities of those symptoms, and the total duration over which those symptoms persist – will be subject to substantial individual variation among former Bunavail users. In other words, the withdrawal symptoms that you experience might be different than those documented by another individual undergoing Bunavail withdrawal.
That said, because the buprenorphine component of Bunavail acts upon mu-opioid receptors as a partial agonist, symptoms of Bunavail withdrawal are generally akin to a milder opiate withdrawal. Common symptoms of Bunavail withdrawal include: body aches, diarrhea, dizziness, headaches, heart rhythm changes, nausea, restlessness, sweating, and vomiting. If you ever have questions about particular symptoms of Bunavail withdrawal that you’re experiencing, ask a medical doctor.
- Allergy-like symptoms: Withdrawal from Bunavail can trigger allergy-like symptoms such as: nonstop sneezing, watery eyes, runny nose, itchiness, or scratchy throat. It’s unclear as to why these symptoms occur, however, some speculate that they could be related to a sudden upsurge in histamine production after Bunavail is discontinued. Though these symptoms generally fade within the first month of withdrawal, you may want to ask a doctor for a medication to help manage these symptoms.
- Appetite loss: Appetite may diminish significantly after Bunavail is discontinued such that it becomes difficult to consume a healthy quantity of calories. Appetite loss in withdrawal is primarily related to gastrointestinal distress and nausea – but could be exacerbated by psychological symptoms such as anxiety or depression. If you experience appetite loss in withdrawal, it is recommended to focus on eating nutritious foods that won’t irritate your gastrointestinal tract.
- Anxiety: Anxiety levels can spike after Bunavail is discontinued for many reasons. Intense anxiety in withdrawal is most likely related to a sudden downregulation of inhibitory neurotransmission coupled with an upregulation of excitatory neurotransmission. As a result, stimulatory neurotransmitters and hormones activate the body’s “freeze-fight-flight” response and cause individuals to feel extremely anxious or nervous in withdrawal.
- Body aches, joint pain, muscle pain: Cessation of Bunavail may cause aches and pains throughout the body (e.g. joints, muscles, etc.). Body aches in withdrawal can be triggered by several things including: high stress; inflammation; inadequate sleep; electrolyte depletion; dehydration; and circulation changes. If your body aches are unbearable, it may be helpful to soak in a warm bath or receive a gentle massage.
- Chills: It is relatively common to experience “chills” coupled with goosebumps across the skin after discontinuing Bunavail. The chills could be caused by changes in circulation during withdrawal due to an overactive sympathetic nervous system. Release of stress hormones and stimulatory neurotransmitters can activate the sympathetic nervous system, which in turn, constricts blood vessels and reduces blood flow to various parts of the body – causing chills or coldness throughout withdrawal.
- Cramping: Cramps can occur as a Bunavail withdrawal symptom for a variety of reasons. Some individuals may become cramped due to electrolyte imbalances, dehydration, and/or inadequate nutrition. Others may experience cramps as a result of high stress or poor circulation throughout withdrawal. Receiving a massage, soaking in a warm bath, or supplementing with electrolytes may help combat the cramping.
- Cravings: Anyone with a history of opioid dependence may experience intense cravings for opioids when withdrawing from Bunavail. The opioid cravings occur because the brain is no longer receiving mu-opioid receptor stimulation from Bunavail to keep them under control. More specifically, the nucleus accumbens region of the brain is no longer receiving the downstream release of dopamine from opioidergic drugs – triggering a craving response.
- Depression: Withdrawal from Bunavail can disrupt neurotransmitter activity in multiple regions of the brain. Neurotransmitter disturbances or irregularities can cause potentially-severe depression in Bunavail withdrawal. If you find yourself feeling more depressed than usual after quitting Bunavail, seek professional medical attention as soon as possible. Untreated depression may exacerbate withdrawal symptoms or make the withdrawal process more difficult.
- Diarrhea: Opioidergic drugs like Bunavail are understood to act both peripherally and centrally on mu-opioid receptors. Action on peripheral mu-opioid receptors can cause opioid-induced constipation. However, when Bunavail is discontinued, peripheral mu-opioid receptors become underactive which can yield diarrhea. If you end up with diarrhea in withdrawal, you may want to consider using over-the-counter Imodium.
- Dizziness or lightheadedness: After discontinuing Bunavail, you may find yourself feeling incredibly dizzy. It may seem as though your head is spinning or you’ve lost your balance. Dizziness occurs for a myriad of reasons, including: heightened stress, blood pressure changes, cerebral blood flow fluctuations, and neurotransmitter irregularities. Be sure that you’re consuming adequate food, staying hydrated, and finding healthy ways to relax in withdrawal – as this may alleviate some of the dizziness.
- Fatigue: Bunavail withdrawal can cause many individuals to experience extreme fatigue. The fatigue may be so debilitating that you find yourself unable to perform basic tasks around the house or get out of bed in the morning. Getting plenty of rest, doing what you can to decrease your stress, and engaging in some light or simple exercise (e.g. going for a walk outside) may help boost your energy level a bit throughout withdrawal.
- Fever: It is possible to develop a fever after discontinuing Bunavail. Fevers in withdrawal may be caused by dysregulation of internal thermoregulation centers after Bunavail is discontinued. Some individuals claim that using over-the-counter fever reducers such as acetaminophen and NSAIDs can help alleviate this withdrawal symptom.
- Flu-like symptoms: After discontinuing Bunavail, it may feel like you’re dealing with symptoms that are similar to those associated with the flu. Flu-like symptoms that could emerge in Bunavail withdrawal include: body aches, chills, diarrhea, dizzy spells, fever, headache, nausea, and vomiting. To get these flu-like symptoms under control, some find acetaminophen or NSAIDs helpful.
- Headaches: Headaches are a very common in Bunavail withdrawal due to increased stress, altered cerebral blood flow, and impaired sleep. Dehydration and electrolyte depletion may also be culpable for headaches in withdrawal. If you end up with headaches after quitting Bunavail, be sure that you’re drinking enough water, eating sufficient calories, and reducing stress as much as possible.
- High blood pressure: High blood pressure is a Bunavail withdrawal symptom that can occur due to sudden increases in stimulatory neurotransmitters and activation of the sympathetic nervous system. Inadequate sleep might also cause blood pressure to spike in withdrawal. It is recommended that all individuals monitor blood pressure closely after quitting Bunavail.
- Insomnia or difficulty sleeping: Insomnia and sleep disturbances in Bunavail withdrawal can be very challenging to manage. It may be necessary to utilize a sleep aid prescribed by a medical doctor in the early stages of withdrawal if you find yourself completely sleepless. Doing things like meditating or taking a warm bath at night might help you relax enough to get some sleep in withdrawal.
- Irritability: You may find yourself feeling extremely irritable after discontinuing Bunavail. The irritability is probably related to increased sympathetic nervous system activation and heightened stress in withdrawal. A combination of therapy with a licensed psychologist, stress reduction, and light exercise may help you deal with irritability or anger in withdrawal.
- Nausea: Withdrawal from Bunavail can cause severe nausea for a subset of individuals. In fact, the nausea could become severe enough to trigger vomiting. If you become extremely nauseous to the point that it’s interfering with your ability to eat and/or causing you to vomit – you may want to utilize an antiemetic medication (or drug that helps treat nausea).
- Palpitations: The heart may flutter, pound rapidly, or beat irregularly after withdrawing from Bunavail. Irregular heartbeats or fluttering sensations are referred to as “palpitations.” Palpitations are generally triggered by excessive sympathetic tone and excitatory neurotransmitters. To minimize the frequency of these palpitations, it may be helpful practice deep breathing, meditation, or find healthy ways to lower stress.
- Restlessness (RLS): It is extremely common to feel restless or end up with RLS (restless leg syndrome) in Bunavail withdrawal. Restlessness is caused by an imbalance between excitatory and inhibitory neurotransmitters throughout withdrawal. Put simply, excessive quantities of excitatory neurotransmitters are being produced such that they overpower the inhibitory response and cause agitation, restlessness, and fidgety feelings.
- Stomach aches: Stomach aches might occur during Bunavail withdrawal as a result of gastrointestinal distress and/or inadequate calorie intake. Ask your doctor what he/she recommends you do to normalize gastrointestinal function in withdrawal. An intervention like Imodium is helpful for many.
- Suicidal thoughts: It is possible to experience suicidal thoughts as an adverse withdrawal reaction. Suicidal thoughts are generally caused by irregular neurotransmitter signaling, excessive stress, and/or psychological depression. If you experience suicidal thoughts after withdrawing from Bunavail, seek emergency medical attention.
- Sweating: Sweats can be intense and seemingly nonstop after discontinuing Bunavail. Some claim that sweats are worse at night than during the day, whereas others find that the sweating remains constant. If you find yourself dripping with sweat and feeling clammy in withdrawal, you may want to carry a towel around to help wipe some of it up.
- Vomiting: Vomiting can occur in Bunavail withdrawal if nausea becomes severe and/or remains untreated. If you experience vomiting as a withdrawal symptom, be sure that you’re replenishing your body with water and electrolytes after vomiting episodes. While vomiting may be inevitable for some individuals in the first few days of Bunavail withdrawal, others might be able to prevent vomiting with strategic use of an antiemetic medication.
- Weight loss: Due to appetite loss, dehydration, diarrhea, vomiting, and restlessness in withdrawal – some individuals may end up losing weight after quitting Bunavail. If you lose weight in Bunavail withdrawal, be sure that you’re staying hydrated, consuming enough calories needed to help your body recover from symptoms, and managing any diarrhea that you experience.
- Yawning: Some individuals claim that they experience incessant yawning after withdrawing from Bunavail. In many cases, the yawning is due to lack of deep sleep and high stress. Taking steps to decrease your stress and improve your sleep quality may help reduce the frequency of yawns after discontinuing Bunavail. Shifts in neurotransmitter levels within the brain may also be culpable for the induction of yawning.
Note: If you know of additional Bunavail withdrawal symptoms that weren’t documented in the above list – be sure to share them in the comments section.
Factors that influence Bunavail withdrawal symptoms
There are several factors that may influence the severity of Bunavail withdrawal. Factors that are believed that influence Bunavail withdrawal severity include: duration of Bunavail treatment; Bunavail dosage used during treatment; use of substances in withdrawal, lifestyle of the former user, and gene expression. It is the combination of these factors that probably accounts for differences in withdrawal experiences.
Bunavail treatment length
The total amount of time over which you use Bunavail may influence withdrawal severity. Someone with a high tolerance to opioids who only uses Bunavail for a short-term may experience withdrawal symptoms that are mostly attributable to previously-used opioids (rather than Bunavail).
On the other hand, someone who uses Bunavail for a long-term may become so adapted to its regular physiologic presence – that harsh withdrawal symptoms occur when the medication is discontinued. In most cases, the longer the term of Bunavail treatment, the greater the severity of withdrawal.
The dosage of Bunavail that was administered throughout treatment might also influence withdrawal severity. In most cases, the higher the dose of Bunavail that is administered throughout treatment, the greater the severity of withdrawal symptoms that will emerge following discontinuation.
High doses of Bunavail alter physiology (neurotransmitter levels, receptor sites, etc.) to a greater extent than lower doses, ultimately making it more difficult for the central nervous system to transition back to homeostasis after the medication is discontinued.
If you used a low dose of Bunavail (e.g. 2.1 mg/0.3 mg – purple strips), your withdrawal may be easier to manage than if you used a high dose (e.g. 6.3 mg/1 mg – orange strips).
Bunavail withdrawal speed (taper vs. cold turkey)
The speed or rate at which you discontinue Bunavail treatment could definitely influence the severity of your withdrawal symptoms. It is understood that persons who gradually taper off of opioid replacement medications like Bunavail tend to experience fewer debilitating withdrawal symptoms, on average, compared to individuals who taper rapidly or quit “cold turkey.”
Rapid tapering or “cold turkey” Bunavail discontinuation leaves the user’s physiology in a Bunavail-adapted state, yet no Bunavail is administered. As a result, physiology is still expecting the Bunavail medication and scrambles to function without it. A severe physiologic backlash may occur evidenced by gross imbalances in neurotransmitters, hormones, and electrolytes if Bunavail is discontinued too rapidly.
On the other hand, if Bunavail is discontinued gradually over a reasonable duration, physiology slowly begins adapting to lower quantities of the medication. When Bunavail is finally discontinued after a long taper, physiology will be closer to homeostasis (or pre-Bunavail functioning) – compared to “cold turkey.” Gradually tapering off of Bunavail essentially guides physiology closer to normal so that withdrawal symptoms aren’t as severe.
Use of substances in Bunavail withdrawal
Use of substances throughout Bunavail withdrawal such as: prescription medications, over-the-counter medications, and supplements – may influence withdrawal severity. In most cases, withdrawal ends up being much tougher to manage without physiologic support from prescriptions, over-the-counter medications, or supplements.
For this reason, persons who are using medications or supplements after discontinuing Bunavail should find it easier to cope with symptoms. Oppositely, anyone who transitions from using Bunavail to nothing (zero supplements, zero medications, etc.) – may experience harsher withdrawal symptoms due to lack of physiologic support.
Lifestyle & genetics
A person’s lifestyle and genetics might play a role in determining how severe withdrawal symptoms end up, as well as how quickly they subside. Individuals who make a conscious effort to live as healthy as possible during Bunavail withdrawal may have an easier time dealing with discontinuation symptoms – and might even experience fewer total symptoms than those who make unhealthy choices.
Staying physically active, socializing with supportive friends/family, eating a nutritious diet (and avoiding junk food), and managing stress are all healthy lifestyle choices that could alleviate withdrawal symptoms. On the other hand, remaining sedentary, socially isolated, taking no steps to manage stress, and consuming junk food – might make withdrawal more difficult than it needs to be.
Additionally, a person’s gene expression or epigenetics might affect the severity of withdrawal. Perhaps expressing (or lacking) certain genes could yield a quicker recovery in Bunavail withdrawal – than average. That said, expressing or lacking certain genes might also yield a prolonged recovery in Bunavail withdrawal than average.
How long does Bunavail withdrawal last? (Duration & Timeline)
Because duration of Bunavail withdrawal is subject to individual variation, there’s no exact timeline that documents how long Bunavail withdrawal is likely to last. General medical literature suggests that acute withdrawal from Bunavail is usually most severe within the first 72 hours and can remain relatively debilitating for up to 14 days after the final dose. That said, most of the harshest acute symptoms tend to clear up within 2 weeks of Bunavail cessation.
While the acute phase of withdrawal may seem unbearable, many individuals will also experience “post-acute withdrawal syndrome” – referred to under the acronym PAWS. Post-acute withdrawal syndrome is characterized by longstanding symptoms of opioid withdrawal that persist for months after opioid cessation. For some individuals, the PAWS phase will last for 3 to 6 months, whereas for others it may take even more time.
The amount of time that’s needed to overcome PAWS will be contingent upon the severity of the opioid dependence being treated with Bunavail. Those with extremely high tolerance to opioids may have longer-term post-acute withdrawal phases than persons with lower tolerance levels. In any regard, it is recommended to work with medical professionals to ensure that you recover at the fastest possible pace.
How to minimize the severity of Bunavail withdrawal symptoms
If your aim is to minimize the severity of Bunavail withdrawal symptoms, recover as quickly as possible, and prevent adverse reactions – it is recommended that you read over what’s listed below. Strategies for minimizing the severity of Bunavail withdrawal should include: receiving guidance from a medical doctor; discontinuing Bunavail gradually; using medications that your doctor thinks will help during withdrawal; meeting with a psychologist; and living a healthy lifestyle.
- Medical doctor guidance: A medical doctor is trained to recognize adverse reactions in Bunavail withdrawal and knows how to help treat debilitating withdrawal symptoms. To overcome your withdrawal symptoms as fast as possible, schedule regular checkups with a medical doctor.
- Gradual Bunavail discontinuation: Persons wanting to withdraw from Bunavail should do so using a slow taper to minimize severe withdrawal symptoms. Rapid Bunavail discontinuation without tapering (i.e. “cold turkey”) can provoke very harsh symptoms. Tapering at a rate of 10% per month is often recommended, however, talk to your doctor for a customized tapering protocol.
- Medications & supplements: A medical doctor may prescribe medications or recommend that you try certain supplements to help ease Bunavail withdrawal symptoms. Use these medications and supplements as instructed by your doctor to recover at a fast rate.
- Psychologist support: If you have a history of opioid dependence, it is recommended to receive support from a trained psychologist in withdrawal. Psychotherapy may help prevent relapse and enhance your ability to cope with symptoms in withdrawal.
- Living a healthy lifestyle: To recover at the fastest possible rate from withdrawal symptoms, you’ll want to live a healthy lifestyle. Unhealthy habits may exacerbate your withdrawal symptoms or sabotage your withdrawal efforts.
Best supplements to manage Bunavail withdrawal symptoms
Included below is a list of supplements (and over-the-counter meds) that might be helpful in managing or attenuating Bunavail withdrawal symptoms. Understand that not everyone will benefit from using the substances listed below in withdrawal. Moreover, prior to using any supplement in withdrawal, it is recommended that you verify the safety of that supplement with a medical doctor.
Affiliate link disclosure: The supplements listed above contain affiliate links which help MentalHealthDaily.com earn money. If you want to support the site, buying products through affiliate links is appreciated. I did my best to select products that I thought were reasonably priced and potentially therapeutic for persons experiencing Bunavail withdrawal.
- Electrolyte formula: Electrolyte levels in the brain and body can become imbalanced after quitting opioids. To ensure that you don’t end up with suboptimal electrolyte levels in withdrawal, supplementing with a formula could be of benefit.
- Imodium: Imodium is one of the better over-the-counter medications available for treating withdrawal-related diarrhea.
- Magnesium citrate: Magnesium citrate is a supplement that may help the muscles relax in withdrawal. Many people find it useful for managing other symptoms like anxiety, insomnia, restless leg, and headaches.
- Epsom salts: Epsom salts may be among the best supplements for managing body aches and cramps in Bunavail withdrawal. Adding these to a warm bath may be just what you need to reduce the body pain of withdrawal.
- Glutathione: Glutathione or GSH is an important antioxidant that aids in detoxification. To help the body detoxify itself, you may want to consider supplementing with glutathione.
- Krill oil: Krill oil is a supplement with many potential therapeutic properties. Some believe that it may help enhance brain function and counteract inflammatory responses within the body during withdrawal.
- Low-dose melatonin: Melatonin might help enhance sleep while quitting Bunavail.
- Multivitamin: The body may not absorb nutrients from food as well as it could during withdrawal. Vomiting, diarrhea, etc. can interfere with nutrient absorption. To minimize odds of a vitamin deficit in withdrawal – you may want to supplement.
- Probiotic: Taking a probiotic supplement in the later stages (non-acute) of withdrawal may help repair the gut and/or restore normal GI function.
- B complex: Supplementing with a vitamin B complex isn’t necessary, but could help if your withdrawal is severe. B vitamins often help reduce activation of the sympathetic nervous system – which might decrease symptoms like stress, anxiety, and insomnia.
- Curcumin: Curcumin is a supplement that might alleviate joint pain and inflammation upon Bunavail cessation.
Have you experienced Bunavail withdrawal symptoms?
If you’ve recently discontinued Bunavail or are dealing with discontinuation symptoms, share a comment below about your Bunavail withdrawal experience. By sharing a comment about your Bunavail withdrawal, you may help someone else who is struggling or feels completely alone in the withdrawal process.
To help others better understand your withdrawal experience, provide additional details such as: how long you used Bunavail; the dosage that you used throughout treatment; and the severity of your opioid use disorder. Also note things like: whether you tapered off of Bunavail or quit cold turkey, how long you’ve been off of it; and whether you’re using other medications or supplements throughout withdrawal.
Are there any tactics or strategies that you found particularly helpful in managing Bunavail withdrawal symptoms? Did you work with a medical doctor while discontinuing Bunavail – or did you quit Bunavail without any medical support? What were the worst or most challenging symptoms of Bunavail withdrawal that you endured?