Most people can take Suboxone 12 to 24 hours after short-acting opioids like heroin or oxycodone. Fentanyl and methadone usually mean a longer wait, anywhere from 24 to 72 hours. What matters most is that withdrawal has reached the moderate stage, and your provider will check that before your first dose.
Before you start Suboxone as part of a medication-assisted treatment (MAT) program, there are some things you should know. Starting buprenorphine too early can trigger precipitated withdrawal, so timing matters, especially after long-acting opioids like methadone.
Always be honest with your medical provider about which drugs you have been using to prevent complications during treatment. They will give you the best guidance regarding when to take Suboxone after opioid use.
What Is Suboxone?
Suboxone is an FDA-approved medication used to help those with opioid use disorder (OUD). It is a dissolvable film medication comprised of a combination of two drugs: buprenorphine and naloxone. Over time, patients can earn take-home doses as they show stability.
Buprenorphine is a partial opioid agonist, and naloxone is an opioid antagonist. Buprenorphine occupies the brain’s opioid receptors to relieve or eliminate debilitating opioid withdrawal symptoms. Naloxone, the opioid antagonist, is added to deter misuse of buprenorphine and the medication itself.
Together, these two active ingredients make Suboxone treatment a safe and effective method for those in recovery from opioid use disorder. Many opioid recovery centers offer both Suboxone and methadone for those looking for help. Providers will collaborate with patients to personalize their MAT treatment based on their body’s response to medication.
Some Suboxone side effects include:
- Headache
- Nausea
- Anxiety
- Insomnia
- Sweating
- Constipation
- Fatigue
- Burning sensation in the mouth
Most of these side effects only last several days or weeks after starting the medication. Patients regularly check in with their medical providers to monitor severe or pressing symptoms.
Why Do I Have to Wait to Take Suboxone After Long-Acting Opioids?
How long you wait depends on whether you used a short-acting or long-acting opioid. Short-acting opioids usually mean a shorter wait.
Typical wait times, which your provider will confirm:
| Opioid Type | Typical Wait Time |
| Heroin or short-acting oxycodone | About 12 to 24 hours |
| Fentanyl | About 24 to 48 hours, sometimes longer with regular use |
| Methadone | About 48 to 72 hours, sometimes longer |
Waiting a period of time before taking Suboxone is crucial. If you begin using the medication before experiencing opioid withdrawal symptoms, you may experience precipitated withdrawal. This occurs when there are too many active opioids in your body while ingesting buprenorphine.
Avoiding Precipitated Withdrawal When Taking Suboxone After Long-Acting Opioids
Precipitated withdrawal occurs when specific medications lead to sudden and severe physical or psychological reactions. Whereas spontaneous withdrawal is gradual, precipitated withdrawal happens quickly.
Symptoms of precipitated withdrawal can last for hours or a day, and they can include:
- Nausea
- Diarrhea
- Vomiting
- Chills
- Headaches
The length of precipitated withdrawal symptoms may depend on several factors. Usually, a patient’s history of opioid use and general health are the most significant factors. Although precipitated withdrawal is uncomfortable, it is not typically dangerous and can be treated.
Signs You’re Ready: Moderate Withdrawal
Providers wait until you’re in moderate withdrawal, which usually means several symptoms at once, such as sweating, restlessness, yawning, a runny nose, and aches in your muscles and joints.
To keep things objective, staff use the Clinical Opiate Withdrawal Scale (COWS), a checklist that scores each symptom. A score in the moderate range (13 to 24) means you’re ready for your first dose, and your provider decides the exact point. If your score is still low, waiting a few more hours is usually the safer call.
Can You Take Suboxone After Narcan?
You can take Suboxone after Narcan, but it shouldn’t be a solo decision. Narcan reverses an overdose by pushing opioids off your receptors, which can bring on sudden, intense withdrawal. It wears off in about 30 to 90 minutes, and the opioids you took may still be in your system, so emergency care comes first.
Once you’re stable, your provider will decide when to start buprenorphine. Some hospitals and clinics can begin treatment right away, so it’s worth asking about. Just don’t take a dose on your own in the hours after an overdose.
Contact BAART Programs for Safe Treatment of Opioid Withdrawal Symptoms
If you are experiencing precipitated opioid withdrawal, reach out to your doctor immediately to discuss treatment options. Even if Suboxone or buprenorphine caused your precipitated withdrawal symptoms, it might also be able to reverse them.
You are never alone on your journey to recovery from opioid use disorder (OUD). Our team at BAART Programs helps people find their own path to recovery through medication-assisted treatment, counseling, and personalized support. All BAART locations are CARF-accredited, reflecting our commitment to safe, ethical, evidence-based care.
Whether you have questions about withdrawal symptoms or are ready to begin the road to recovery, contact us. Start by finding one of our nearest medication-assisted treatment clinics and call or message us today.
If you or your loved one needs support, call us for a confidential, zero-obligation chat
FAQs About Taking Suboxone After Long-Acting Opioids
If you are considering Suboxone treatment programs for OUD, rest assured that we can answer nearly any question you have. The specialized medical providers and healthcare staff at BAART Programs will walk you through everything you need to know.
Here are some of the most common questions asked about taking Suboxone after long-acting opioids.
When Can I Start Taking Suboxone?
You cannot begin taking the medication until you are experiencing acute signs of opioid withdrawal. Otherwise, you will experience precipitated withdrawal, which can cause sudden, intense withdrawal symptoms.
How Is Withdrawal Measured?
Your provider uses the Clinical Opiate Withdrawal Scale (COWS) to score your symptoms. You should be at a score between 13 and 24 before taking your first dose of Suboxone, and the call is made by your provider.
Where Will I Take My First Dose of Suboxone?
Your first dose happens at your first appointment, after a medical assessment and intake. Your provider will explain what to expect and answer your questions.
What Determines My Suboxone Dose?
Your medical provider will determine which dose is best for you, depending on your previous opioid use. After your first induction, you can gauge whether the dose needs to be tweaked.
How Often Should I See My Doctor?
Early in treatment, you’ll visit the clinic daily. As you build stability and meet program guidelines, you can earn take-home doses and visit less often.
Do not hesitate to call the nearest BAART Program treatment center to ask additional questions you may have about Suboxone. Our non-judgmental and knowledgeable staff are ready to help you make an informed decision.
Sources and Citations
- UAMS Psychiatric Research Institute (n.d.) What is Buprenorphine? Available at: https://psychiatry.uams.edu/clinical-care/outpatient-care/cast/buprenorphine/ (Accessed October 13, 2026).
- Centers for Disease Control and Prevention (2024) 5 Things to Know About Naloxone. Available at: https://www.cdc.gov/overdose-prevention/reversing-overdose/about-naloxone.html (Accessed October 13, 2026).
- MNT Medical Network and Brewer, A. (2022) Suboxone (buprenorphine and naloxone). Medical News Today. Available at: https://www.medicalnewstoday.com/articles/drugs-suboxone#side-effects (Accessed October 13, 2026).
- Soares, W.E. III, Schoenfeld, E. and Friedmann, P.D. (2024) Precipitated Withdrawal in the Era of Street Fentanyl—The Important Thing Is to Not Stop Questioning. JAMA Network Open, 7(9), e2435857. Available at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824175 (Accessed October 13, 2026).
- National Institute on Drug Abuse (NIDA) (n.d.) Clinical Opiate Withdrawal Scale. Available at: https://nida.nih.gov/sites/default/files/ClinicalOpiateWithdrawalScale.pdf (Accessed October 13, 2026).
- Substance Abuse and Mental Health Services Administration (2021) TIP 63: Medications for Opioid Use Disorder. Publication No. PEP21-02-01-002. Available at: https://library.samhsa.gov/product/tip-63-medications-opioid-use-disorder/pep21-02-01-002 (Accessed October 13, 2026).
- American Society of Addiction Medicine (2020) ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update. Available at: https://www.samhsa.gov/resource/ebp/asam-national-practice-guideline-treatment-opioid-use-disorder (Accessed October 13, 2026).
