Table of ContentsView AllTable of ContentsHow Medication-Assisted Treatment (MAT) WorksSymptomsIdentifyingCausesTreatmentCoping

Table of ContentsView All

View All

Table of Contents

How Medication-Assisted Treatment (MAT) Works

Symptoms

Identifying

Causes

Treatment

Coping

Another key difference between precipitated withdrawal and typical withdrawal is that the latter occurs gradually while the former can occur suddenly. The sudden onset of symptoms can be a frightening experience.

Precipitated withdrawal occurs when a person who is dependent on opiates develops sudden and severe withdrawal symptoms due to the effect of buprenorphine. Understanding how medically-assisted treatment with buprenorphine works is crucial to grasp how precipitated withdrawal can occur.

While MAT is usually thought of as treatment for opioid use disorder, it also includes treatment for addiction to other substances such as alcohol. Some of the most commonly used MAT medications include:

Treatment for Opioid Addiction

Symptoms of Precipitated Withdrawal

While medication-assisted treatment has proven to be effective and life-saving for people living with substance use disorders, it’s not without its downsides. The most prevalent being precipitated withdrawal.

When trying torecover from substance use disorder, the first step is to recognize your need to stop abusing the substance you’ve grown dependent on. During this process, medication-assisted treatment may be used to help you cope with withdrawal symptoms and block the urges to use the illicit substance.

In short, medication-assisted treatment with naltrexone or buprenorphine forces your body to stop depending on opiates. However, if you have are not in withdrawal or have not completely stopped using opiates, when you take naltrexone or buprenorphine your body can not adjust to this sudden deprivation, causing precipitated withdrawal symptoms. These symptoms include:

Precipitated withdrawal symptoms may begin within one to two hours after the first dose of buprenorphine has been administered. It will often start to subsidize within 6 to 24 hours.

Identifying Precipitated Withdrawal

One study from Australia found that precipitated withdrawal occurred in about 9% of cases where buprenorphine is used to treat substance use disorder. When someone who is addicted to opiates wants to begin treatment with buprenorphine, one tool often used to measure withdrawal symptoms is the Clinical Opiate Withdrawal Scale (COWS).COWS provides a rating for 11 common signs ofopioid withdrawal, which doctors can use to assess a person’s level of withdrawal from opioids.

If your doctor determines that you are in the midst of withdrawal from opiates and then administers an appropriate dose of buprenorphine, your symptoms will rapidly diminish. If, however, the buprenorphine is administered too soon after your last dose of opioids, before you are in withdrawal, the buprenorphine will act as an opioid antagonist and cause precipitated withdrawal.

Naltrexone can also cause precipitated withdrawal in someone dependent on opioids who still has them in their system. Once naltrexone has been started, it acts to block the effect of opioids and prevents people from getting high off of opiates. It also helps prevent overdose.

Causes of Precipitated Withdrawal

The use of drugs which can act as opioid antagonists triggers precipitated withdrawal. Buprenorphine is a partialopioid antagonistwhich is used to treat opiate use disorder. It is the most common medication used in MAT plans. To understand how this opioid antagonist triggers precipitated withdrawal, you need to understand how buprenorphine works.

The manner in which MAT medications are administered can help prevent precipitated withdrawal from occurring. This is why it’s important to use them with with the guidance of a healthcare professional.

Taking MAT medications too early in your recovery can trigger precipitated withdrawal, especially when you haven’t been sufficiently weaned off the opioids you depend on.

Treatment for Precipitated Withdrawal

Coping With Precipitated Withdrawal

Precipitated withdrawal can be an incredibly uncomfortable experience lasting anytime between a couple of hours and a few days. A few tips to help you cope with the troubling symptoms include:

How to Deal With Withdrawal Symptoms

A Word From Verywell

Buprenorphine remains a key fighter in the fight against opioid dependence and other substance use disorders despite its side effects. However, it’s important only to use buprenorphine when under medical supervision. A single dose can bring on symptoms of precipitated withdrawal.

How MAT medications are administered determines how effective the treatment will be and prevents side effects from occurring.

Seek HelpIf you or a loved one going through precipitated withdrawal also begins to experience symptoms such as difficulty breathing, loss of consciousness, chest pain, uncontrollable movements, confusion, and heart palpitations, call 911 or your nearest medical emergency services immediately.911

Seek Help

If you or a loved one going through precipitated withdrawal also begins to experience symptoms such as difficulty breathing, loss of consciousness, chest pain, uncontrollable movements, confusion, and heart palpitations, call 911 or your nearest medical emergency services immediately.

911

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Mason BJ, Heyser CJ.Alcohol Use Disorder: The Role of Medication in Recovery. Alcohol Res. 2021 Jun 3;41(1):07. doi: 10.35946/arcr.v41.1.07

SAMSHA.MAT medications, counseling, and related conditions.

Theriot J, Sabir S, Azadfard M.Opioid antagonists. In:StatPearls. StatPearls Publishing; 2022.

Quattlebaum THN, Kiyokawa M, Murata KA.A case of buprenorphine-precipitated withdrawal managed with high-dose buprenorphine.Family Practice. 2022;39(2):292-294.

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