First week on subs...

[jhll]

Hi All, I'm new to the site, just came off a 1.5 year h/opiate?? binge (Who really knows what's in it - fentanyl, w-18, morphine, if you're lucky some heroin lol??

Started suboxone almost a week ago, waited over 48 from last use before induction with 8 mg and even waiting way longer than every website says, but I still had a few hours of relatively "mild" PW (if there is such a thing as mild precipitated withdrawal).

I think I'm good on the 16 mg per day I don't think I have any withdrawals but I have bouts of nausea, no appetite and literally no sleep since in last 5 days.

Anyone experience this with subs?? Dr thinks I need dose increase but I don't know. I don't feel dope sick, I know what that is. Yes I have no energy and nausea and insomnia which I realize are classic symptoms of opiate withdrawal but this doesn't feel like withdrawal, it's something else.

Regarding dose, it's CRAZY how diverse the opinions are regarding how much bupe you really need. I talked to my pharmacist and he told me that NO ONE is on less than 16 mg and most are 24-32 and they have over 1000 customers. But what you read online is that you can be induced at levels of 2-8. I saw a YouTube video which I think was the main researcher for Suboxone and he was saying that you never need more than 8 mg of bupe because anything more is pointless - however he may have been literally meaning 8 mg in your system so if you dose 16 maybe 50% actually gets absorbed? I'm not actually sure about the bioavailability.

Any insights, advice, would be great!

Thanks.

 

[Ignio]

I did not benefit in anyway from going above 16 mg of burp, it only made my side effects worse. Like you I suffered from nausea and extreme tiredness caused by suboxone. I tried to change from suboxone to pure buprenorphine, this helped a little but not much. In the end, I had to switch to methadone to get rid of the nausea and tiredness. Normally, you will read that methadone will influence cognition, memory and energy level negatively to a much higher degree that buprenorphine making buprenorphine preferable from methadone in many cases. You will also see people claiming that the withdrawals caused by methadone are a lot worse that what buprenorphine cause. Thus, there are many reason for you to STAY on buprenorphine.

But in my case, I had to give up and change to methadone. I attempted for several months to stay on buprenorphine to avoid methadone, but even though I quickly lowered my dosage from 24 mg a day to 8 mg buprenorphine, the side effects never disappeared. Even on 2 mg a day I suffered from nausea and tiredness plus a hell of a lot of withdrawal symptoms due to the low dose, but it was an experiment to see if an extremely low dose would remove the side effects. For me, methadone was a much better solution that buprenorphine as it is causing much less side effects plus it almost removed my cravings for other drugs. But as I said, most people agree that buprenorphine is to prefer from methadone as buprenorphine normally causes less side effects and by many accounts it is easier to quit buprenorphine than it is to quit methadone.

My first advice is to ask your doctor if your can get buprenorphine without naloxone in as this for some reason helped me and to not go above 16 mg buprenorphine. Increasing your dose will just make things worse. However, I might have experienced placebo effects as most say naloxone doesn't have any effect in suboxone. My next advice would be to lower the dose of buprenorphine, you might not need 16 mg and lowering it might cause the side effects to disappear. My last advise would be to consider methadone after you have tried everything else I describe; No matter what methadone is better than relapsing to heroin.

Congrats with starting on substitutions. It is a big step in the right direction.