How do you reverse or counteract the effects of soboxone if you take it?

Unfortunately, Unless you could go to the emergency room and they are familiar with suboxone, he may have to just wait it out. Have him lie down and make sure you have someone bring him some gatorade and tell him to just lie down and he is going to have to wait it out. That being said, if you think he should go to the ER, then take him, use your judgement on that. Sounds like he went into precipitated withdrawal, i.e. really really bad withdrawal. Did he take it before it had been a full 24 hours since last short acting opiate (lortab, percocet, oxycodone) or was he on methadone, as that can easily cause precip even after 72 hours opiate free. You could Google the COWS sheet, and this is the quiz they give you to rate withdrawal symptoms, google Clincal opiate withdrawal scale if you can't find it under COWS sheet. He is going to feel pretty bad though it will wear off. Suboxone will fight any other opiate for the sites in the brain where they sit, it will rip the previous opiate off the sites, or try to and then neither can site there for a while, so really bad withdrawal sets in. If you think he needs the ER, take him, but I am pretty sure there isn't a whole lot they will do, if they are familiar with suboxone, they might.