The following discussion assumes you have not tapered off of your medication.
One common scenario is a patient misses an appointment or doesn't get to the pharmacy and misses a dose or two of their medication. They notice their withdrawal is not as bad as they had expected after the first 1-2 days. Then they think that perhaps they don't need the medication any more because, after all, they haven't used any opiates or had the urge to use opiates for weeks or months.
Unfortunately there are at least two things that haven't been considered in the decision process.
First, is the fact they have not had the urge to use and have not used in weeks or months is in part because their opiate needs are being met by the medication. They still have an opiate deficit. The medications work so well to fill the opiate deficit that people sometimes forget this – because they feel perfectly normal, not at all like they did when they were using every day.
Second, is that although it is typical when using street opiates to have withdrawal within 24 hours if you don't get another dose of opiates both methadone and Suboxone are much longer lasting medications – maximum withdrawal does not occur for most people until day 5.
Almost inevitably the outcome of stopping methadone or Suboxone is a relapse. Just like stopping illicit opiates usually leads to a relapse. Sometimes it is right away, sometimes it is weeks later.
Relapse should be avoided if possible – sometimes it results in people dramatically increasing their use of opiates. Other times it results in a change in the route of administration – perhaps moving from snorting to intra-venous use. And then sometimes it results in a life changing experience for example a loved one or boss that finally gives up on you or getting arrested. These things follow you for a long time after the relapse has passed.
In any case where you have relapsed please contact BMC as soon as you decide to restart the program. We will do our best to get you in right away.