The Golden Rule: Wait for Withdrawal
The most critical part of induction is timing. If you take Suboxone too early, it will kick the existing opioids off your receptors and cause precipitated withdrawal, which is intense and immediate.
- Short-acting opioids (Heroin, Percocet, Vicodin): Wait at least 12–24 hours after your last dose of 7-OH
- The Goal: You should feel “mild to moderately sick” (nausea, aches, chills, dilated pupils) before your first dose of suboxone.
The Induction Schedule Day 1
Most clinical protocols follow a “start low and go slow” approach over the first 24–48 hours.
Day 1: Finding the Threshold
| Time | Action | Note |
| Hour 0 | Take 2mg to 4mg: | Place under the tongue; let it dissolve completely. Do not swallow. |
| Hour 2 | Re-evaluate: | If withdrawal symptoms persist, take another 2mg to 4mg. |
| Hour 4+ | Incremental Dosing: | Continue small doses every 2-4 hours until symptoms stabilize. |
| Daily Cap | Total: 8mg to 12mg. | Most people feel stable within this range on Day 1. |
Stabilization Day 2
- Take the total amount of suboxone you used the last 24 hours and start Day 2 as a single morning dose or 1/2 dose 12 hours apart.
- If you still feel “cravings” or mild withdrawal, increase the dose by 2mg to 4mg.
- The goal is to reach a “ceiling” where you feel normal—not high, but not sick.
Best Practices for Success
- The “No Talk, No Spit” Rule: While the film or tablet is dissolving (5–10 minutes), do not eat, drink, or talk. This ensures maximum absorption into the bloodstream.
- Hydration: Withdrawal is dehydrating. Drink water, Gatorade, or Pedialyte.
- Comfort Meds: Zofran (for nausea) Seroquel for sleep to help get you through the waiting period before the first Suboxone dose.
When to Call our office Immediately
Suboxone is generally safe, but seek help if you experience:
- Extreme drowsiness or “nodding out.”
- Difficulty breathing or a slow heart rate.
- Signs of an allergic reaction (swelling of the lips, tongue, or throat).