What does the treatment with Suboxone involve?

There are two phases in treatment with buprenorphine, called induction and maintenance.  The induction phase is the beginning of treatment, the transition from other opioids.  This must be done with care, because of the particular characteristics of buprenorphine.  Of course one goal is to avoid withdrawal, but that is not possible to do completely.  In order to start buprenorphine, you must have stopped other opioids long enough that you are in mild to moderate withdrawal; only then can buprenorphine treatment start, otherwise it is likely that you will suffer a very unpleasant effect called precipitated withdrawal.  What happens is that the buprenorphine displaces the heroin, or fentanyl or other opioid from the mu receptors, but at the same time only partially activates them.  What happens then is immediate, severe withdrawal.  This is avoided by ensuring that when you take your first dose of Suboxone you are already off other opioids long enough to be in moderate withdrawal.  That can be gauged by several means, including evaluation by your doctor.  The other important aspect of treatment initiation is that you will want to be careful to minimize the dose of Suboxone, both for lowering your costs and for minimizing side effects.  This again requires careful consultation with your doctor to get right.  The maintenance phase starts when you have reached the right dose of Suboxone that can be continued long-term.  A common consideration for that phase is how to taper the dose of Suboxone, which many people hope to do.  This also requires careful consultation with your doctor to be done safely and effectively.