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Bupe Can a taper be performed painlessly

Bucklecroft Rudy

Bucklecroft Rudy

Bluelighter
Joined
Aug 6, 2011
Messages
467
As the title implies im trying to taper of bupe painlessly. The quick taper was an out and out failure but im considering stepping down by like .2 every week and stepping down into the microgram range. My question is if a taper is performed for a long enough period of time can it be done without any discomfort whatsoever. Say an individual dropped by say 50 micrograms a week.
My assumption was that at the lower doses pain would become apparent however logic dictates that a small enough drop wont manifest itself physically.
 
I think it greatly varies depending on the person, how long they have been taking it, how high their highest dose was, and their unique metabolism and sensitivity to withdrawal symptoms. How gradual the taper is is not the only determining factor in the severity of withdrawals. You are going to have mental symptoms even if you don't have any major physical symptoms. I think the keys to being able to get off any opioid are getting to the point where you can mentally bear some withdrawal symptoms and cravings without automatically running out and using (or increasing your dose back up), and working on your mental addiction and mental health.

My doctor is of the opinion that a faster taper is actually better than a slow taper. He says the ideal situation as far as withdrawal symptoms are concerned is to be on bupe only long enough to cover the withdrawal symptoms from whatever opioid you are using the bupe to replace (such as a week for heroin, a month for methadone, etc) and then tapering off it over a period of 2 weeks. He says the taper should be gradual but quick. He says that once you get down to a low enough dose you are going to have some withdrawal symptoms regardless of how long you wait in between each dose decrease, and each dose decrease will be more noticeable (meaning a dose decrease of 1mg when you are taking 10mg is going to be much less noticeable than a dose decrease of 1mg when you are only taking 2mg). This is just what my doctor says, I'm not sure what he is basing it off, it could just be the experiences of his patients or what he has read on the subject, I dunno. This has definitely been my experience with methadone, once I got down to a low enough dose I had withdrawal symptoms even if I stabilized at that dose for a month. I don't have any personal experience with tapering off bupe, only what I have heard and read.

Personally I think the mental issues are really much more of a concern than the physical issues. People mainly go back to using or increase their bupe or methadone doses because they can't deal with the depression and cravings. Physical withdrawal symptoms really suck, but IMO they are not the primary cause of relapse.
 
Cheers thats a really helpful answer! When you stabilised on the methadone how much had you reduced by? Tapering is basically the act of lowering your tolerance over time. Stabilising on a hugely reduced dose would presumably take far longer than stabilising on a smaller reduction with the difference ranging from days to months. its hard to know conclusively without enlisting someone who has trialled this on themselves!
 
i find it fucked up detox in hospitals taper u off suboxone in 3 days, same as benz0os, so unethical, takes time. ugh
 
The amount that you decrease your dose by affects the severity of the withdrawal symptoms but not their duration.

It varies from person to person, but personally I started getting near-constant WDs after I got below about 25mg of methadone a day. If I go from, say, 20mg a day to 18mg and stabilize at 18mg for a month, the withdrawals seem to get a bit better after about a month, but they don't seem to go away completely (although I haven't bothered waiting much more than a couple months, perhaps they might improve eventually?). Apparently this is partly because at lower doses methadone has a shorter duration of effects, especially in people who have been taking higher doses long-term. For me, 60mg of methadone lasted around 20 hrs, but once I got down to 5mg it lasted only about 5 hours. I currently take 10mg a day and I split it into 2 or 3 times a day, and I still am a bit sick almost all the time and get much more sick when it's getting past about 6 or 7 hrs after I took my last dose. I am putting up with the WDs because I really want to get off it. The other reason is that it takes about a week for the level of methadone in your system to completely adjust after a dose reduction, (meaning to go down and stabilize at the level of the new reduced dose), and then about a month for the acute withdrawals from the decrease to end. So that means it takes around 5 weeks for your body to fully adjust to the new dose (it can take your brain even longer), plus you have the problem of the methadone not lasting long enough so the levels in your body don't stay within the stable range. I'm not sure if that could be helped by taking the methadone more frequently, for me that isn't really an option because I metabolize methadone so fast I would have to be waking up in the middle of the night to take it more frequently. For a person in whom the effects lasted, say 14 hrs at this dose, then taking it every 12 hrs might help. Even if this did, you would have to lower your dose by an extremely small amount each time and wait at least 6 weeks in between each decrease, and likely feel some withdrawals from about the 1st wk to the 5th wk after each decrease. But then there are still PAWS-like symptoms that last even longer.

There may be other factors involved as well, my doctor just said that with methadone and bupe once you taper down to below a certain dose you're going to feel some withdrawals no matter what and you might as well just get it over with by tapering more quickly.

I am not as familiar with buprenorphine, it's supposed to be not quite as bad as methadone for tapering and you can do the taper more quickly than a methadone taper (I'm not sure why), but I assume it still has the same issue of if you've been on it for a long time it will likely cause some WDs no matter how careful/gradual the taper. But this is not a good reason to just keep taking the same dose and not even try to taper. The WDs really are different for everyone and you won't know how it's going to affect you unless you try. But, as I said before, I think it's really important to learn how to bear some level of WDs without running out and using and to work on your mental addiction and the reasons you were using in the first place (depression, anxiety, etc).

Buprenorphine often lasts longer than methadone, so you may not have the same problems with it not lasting a full day as myself and many methadone patients have had at lower doses. You might be able to get to a really low dose of bupe before you find it not lasting you all day. Bupe is also generally thought to have a lower dependence-liability than methadone, perhaps because it is an agonist/antagonist and not a full agonist. I assume this is why you can taper more rapidly, perhaps the acute WDs from each dose decrease won't last quite as long? But the length of the WDs from bupe is usually said to be about the same as methadone, so I find that confusing.

Perhaps some people who successfully tapered off long-term bupe maintenance can give you some more specifics.

My best advice at this point would be to try to taper it fairly quickly, but make each dose decrease a percentage of your current dose, instead of a set number of mgs. Dropping from 10mg to 9mg is much easier than dropping from 2mg to 1mg, because at 10mg a 1mg drop is 10%, whereas at 2mg a 1mg drop is 50%. I would guess each dose decrease should be around 10-20%. Tapering this way can get difficult though, as doses that aren't rounded to the nearest mg can be difficult to measure.

Sorry this is so long! Just trying to be detailed :)
 
Cheers again ^^ top answer!. I want to ask anyone who has had experience with reducing by like 50micrograms per week. At what point did withdrawal symptoms start? Its hard to judge because noone seems to have done this! Im currently on 3mg a day which ive been on for around 2-3 weeks now. My plan is to reduce by a miniscule amount stabilise rinse and repeat. Once the withdrawals manifest im considering switching to a short acting opiate and just riding out the 3-4 days of withdrawals.
To me that seems more logical since ultimately it looks like whatever I do im in for withdrawals. I'd rather just have 4 days of the flu than 2 weeks of it. I thought that even though at say 100mcg your essentially taking a homeopathic dose due to the small gradual decline the body will have become used to that dose. The reality seems to be that the lower the dose the longer it takes to acclimatise.
My doctor promised me that it was possible to do this painlessly!
 
200ug is not even close to a "homeopathic" dose of bupe ;) . Do you really realise just how dilute homeopathic preparations really are? It's insane [that anyone thinks they work].

0.2mg (200ug) of bupe is actually a single unit dose form of bupe, as SL tablets, used in treatment of acute and chronic pain occasionally in some medical settings. 0.2mg is not at all a negligible amount! Remember that this is a drug somewhere between 75 and 125 times as strong as oral morphine, weight for weight. That's really strong!

ps. I think your doctor lied to you, or is misinformed. It's not going to be painless. Even if you mostly miss out on physical withdrawal, there will still be PAWS, unless you're very lucky!
 
Its easy to forget just how strong bupe is - is it worth switching to a short acting opiate for 3 - 4 weeks and then jumping off from that? I wouldnt even bother to taper, just stock up on loperamide and take the fall bareback. I never hear of people doing it so im wary, but it sounds like a far more viable way to quit than forcing myself to go through 2 weeks of painful withdrawals followed by paws. Why not just endure it for 3 days and exercise through the paws?? Besides I have nigella sativa oil that I need to try out but cant since it interferes with the bupe
 
Bucklecroft Rudy said:
Cheers again ^^ top answer!. I want to ask anyone who has had experience with reducing by like 50micrograms per week. At what point did withdrawal symptoms start? Its hard to judge because noone seems to have done this! Im currently on 3mg a day which ive been on for around 2-3 weeks now. My plan is to reduce by a miniscule amount stabilise rinse and repeat. Once the withdrawals manifest im considering switching to a short acting opiate and just riding out the 3-4 days of withdrawals.
To me that seems more logical since ultimately it looks like whatever I do im in for withdrawals. I'd rather just have 4 days of the flu than 2 weeks of it. I thought that even though at say 100mcg your essentially taking a homeopathic dose due to the small gradual decline the body will have become used to that dose. The reality seems to be that the lower the dose the longer it takes to acclimatise.
My doctor promised me that it was possible to do this painlessly!
Click to expand...
Haha, when I got on methadone my doctor at the time promised me the same thing 8) It is not remotely painless. Seems like a lot of doctors either don't know that much about it or are willing to lie just to get you on methadone or buprenorphine.

Also remember, as I said, that the dose reductions shouldn't be a set amount like 50mcg, they should be a percentage of the total current dose. You can start off dropping by much higher than 50mcg at a time, you just need to make the decreases smaller and smaller the lower your dose gets. How are you planning on measuring such small quantities though? That is one of the reasons few people do this.

Bucklecroft Rudy said:
Its easy to forget just how strong bupe is - is it worth switching to a short acting opiate for 3 - 4 weeks and then jumping off from that? I wouldnt even bother to taper, just stock up on loperamide and take the fall bareback. I never hear of people doing it so im wary, but it sounds like a far more viable way to quit than forcing myself to go through 2 weeks of painful withdrawals followed by paws. Why not just endure it for 3 days and exercise through the paws?? Besides I have nigella sativa oil that I need to try out but cant since it interferes with the bupe
Click to expand...

The reason most people don't do this is because most doctors aren't willing to prescribe them shorter-acting opioids and when obtained illicitly most people have trouble forcing themselves to taper on a shorter-acting opioid or may start using it to get high. But yes it should definitely help with the withdrawals if you have the ability to do it correctly. You are correct that the best plan would be to use it for 3-4 weeks (so that the bupe withdrawals it is masking will be gone) and then taper off.
 
Im in Britain where Dihydrocodeine is fairly readily available. It costs around a fiver a day to dose totalling about 100 quid for the entire enterprise. I then have all summer to recover hah - I was planning on going travelling ffs so I may have to put the on hold. Worse things have happened I suppose.
Im not going to bother to do the whole microgram thing in fact. Im going to stock up on dihydrocodeine and jump in about 3 weeks. How long do you recommend staying on the SOA to ensure that im withdrawing from that and not the bupe?
 
Apologies for double posting - edit wont work.

I consider this method to be equally effective as a short taper (at least in my particular case) if only because the levels of pain are virtually identical. A short taper is far from painless in my experience as is a SAO detox. On the other hand a SAOD can be fairly painless with the right comfort meds - weed loperamide and nigella sativa in my case!
 
I would say around a month, then quickly taper off the SAO with the help of some other meds (like the ones you mentioned). You might as well try to get your bupe dose down as much as you can in the meantime though.
 
I've never tapered ff bupe painlessly so I cant say for sure, but I have tapered down to relatively low dosages and found ways that seemed to work to make it as painless and comfortable as possible. For one, it is very easy (at least IME) to taper down from high dosages such as 16mg to 8mg. This can be done in about four days with little to no discomfort, and then jump down to 6mg in another four days, then again down to four.

It's when you get to dosages around 4-6mg that tapering becomes harder, as you are reaching a dosage where there is a more dramatic drop in buprenorphine blood levels every 24 hours, since you are near the ceiling dosage. When I got down to four mg, I went down to 3mg and stayed n that dosage for 2 weeks to completely stabalize on it, I then repeated this process when I dropped down to 2, and then 1mg. I suffered some mild WD symptoms during the first few days of decreasing the dose, but I was also probably dropping my intake by too much. From what I hear, the most painless way to go about it is to decrease your dosae by 25. It is important though that when you get under the four milligram range, that you give yourself around 2 weeks to stabalize on that dosage, as it takes buprenorphine roughly 12 days to be completely eliminated from your system. Therefore, it makes sense that it would take around the same ammount of time to shed the stacked up previous half lifes. IME though, after four days, you feel pretty well adjusted to the new lower dosage.

In the end, you will not be able to completely avoid bupe withdrawals, but you CAN lessen the severity. With a proper taper, the worst symptoms you will likely experience would be insomnia, anxiety, depression and lethargy. These symptoms will come and go and probably linger for a few months due to Post Acute Withdrawal Symptoms. However, if you stick with it, you will eventually stabalize. I wish you the best of luck!
 
I know next to nothing about bupe except it has a horrifically long half-life. If you do get to where you can't function, and need to get something done in a bad way, have you thought of getting some kratom? It's helped me tremendously in being as close as possible to painless in my mega-pod taper.
 
Found this on another site. Its referred to as the oxy method. Feedbac was overhwhelmingly positive with users reporting zero discomfort. Methinks its too good to be true - but the logic seems sound. I attempted this but didnt measure doses out accurately. I'll attempt it again and if I have no luck i'll switch to dihydrocodeine and just deal with the PAWS.


Hello O'philes. This should be of great help to any of you who have been sick (all of us at one point or another, LOL) because of a "not so good" self-detox, or what have you...or even those who are interested in quitting (or drastically reducing their opiate intake and tolerance).

Okay here it is. And please take comfort in the fact that this is *the* method trusted and used within the medical community to help patients taper off their medicine *regardless* of the dosage. One could be using 20 milligrams of methadone (just one example) or 200 milligrams, and the method is the same for both. Also, this works for ALL opiates...and for ALL routes of administration.

Basically what we are going to do is reduce the intake, in milligrams, by a factor of "one-third" every fourth day.

Here's an example. John Doe uses OxyContin daily. He has a habit and is up to 240 milligrams per day, but he wants to quit for hatever reason. One problem, he is scared to death of getting "sick."

Here's what he would do:

Days 1 through 3: Take the 240 mg as you would normally
On Day 4, reduce this amount by one-third, so 240 divided by 3 is 80 (meaning starting on Day 4, John takes 160 milligrams)

Days 4 through 6: take 160 milligrams.
On Day 7, reduce this amount (160mg) by one-third, so that's 53 milligrams less. So starting Day 7 take 107 milligrams.

Days 7 through 9: take 107 milligrams.
On Day 10, reduce this (107mg) by one-third, so that gives you 36mg less which is 71 milligrams

Days 10 through 12: take 71 milligrams.
On Day 13, reduce this (71mg) once again, by a factor of one-third, so that's 24mg less, which is 47 milligrams.

Days 13 through 15: take the 47 milligrams, then on Day 16, reduce again by a factor of one-third.

And so on and so forth until you reach zero, or darn close to it. i realize that a couple of calculations above involved decimals, but it's impractical to take "37.66 mg" of something, so rounding up to the nearest milligram won't hurt you.

The key in this method is to gradually reduce your intake every 3 days by one-third. So bascally take your dose for 3 days, then on the 4th, 5th, and 6th, you'll be taking the one-third less dose. Days 7,8,and 9 are a further reduction, and so on. It is important, folks that you keep it every three days (not two, and not four) for the method to work. And also, the "one-third" aspect is very important: cutting dosage by 33 percent is crucial. 25 percent, 40 percent, etc. is not acceptable, and you may be uncomfortable.

You have a guarantee that if you follow this method strictly (to the nearest milligram--> round up if u have to if you end up with a decimal number) you will be free of the physical dependence, effectively and most importantly *painlessly* with NO WITHDRAWAL ;-);)

I am glad to help and always around to answer questions (Feel free to PM anytime):D

Take care folks
Much respect
peace out

Anthony / (OxyContinuously)
 
Sounds like a good method to me. I doubt that you will get NO withdrawal symptoms, but they may be limited to the mental ones as opposed to the physical. You are still going to get PAWs afterwards too, I don't think that's avoidable. But I think it should be much less painful than tapering on methadone or buprenorphine. The key is being able to actually stick to your tapering schedule.

The other thing is that when using a method like this to get off a long-acting opioid such as bupe, you will likely need to stabilize on the short acting opioid for about a month before you start the taper. The reason is that it takes around a month for the acute withdrawals of the bupe (or methadone) to be gone, so if you start lowering the dose of the SAO before that point you will still be feeling the WDs from the LAO.

I would love to try this method, unfortunately it seems impossible to find a doctor willing to prescribe.

If you decide to do this, keep us updated on how it goes :)
 
I have mysElf stuck on this suboxone merry go round, and I am deathly afraid of going through withdrawal problems just to get off of this stuff.

I want to scream but that wouldn't do me any good either.
 
mareseatoats said:
I have mysElf stuck on this suboxone merry go round, and I am deathly afraid of going through withdrawal problems just to get off of this stuff.

I want to scream but that wouldn't do me any good either.
Click to expand...

Scream. Then hit the gym, and most importantly the sauna, as often as possible. Drink tons of gatorade. Scream again and see. It may do you good. ;-)
 
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