Bupe Jumping off suboxone from 12mg daily?

[AminoAcid]

Firstly I apologize if this may seem a bit long-winded. I have to talk to someone about this, even if it's just on the internet.

I've been on suboxone now for about 4 years (I'm ashamed to say) after having a codeine/dihydrocodeine habit. It has pretty much put my life completely on hold and I seem incapable of doing anything productive while on it. Four times now I have started a semester of university but then postponed due to studying being out of the question, and today I just postponed again after not being able to keep up with the work (memory like an old man, *constant* lethargy and sleepiness, etc). I can't even describe how much of a failure I feel like right now.

I was so upset at screwing another semester that I can honestly say today was the first time in my life I genuinelly wanted to kill myself, I was/am just so ridiculously fed up and would like to just... sleep forever and not wake. The thought of continuing like this seems far too great a task. I haven't even had a social life or a friend in many years, as I just walk around in this convenient somewhat comfortable coccoon created by the Suboxone. Life seems to just pass by and time goes ridiculously quickly, like it just falls from your grasp.

Anyway I've gotten to the point where it's all or nothing. I desperately have to get off this shit, life really isn't worth living in such a state. Problem is that my doctor who presribes it refuses to decrease the dose because he knows of my depression; but he's too stupid to realize that what is making me miserable is the Suboxone itself! In fact he often tries to make me INCREASE the dose!

So what I am planning on just stopping taking the 12mg/day dose altogether, cold turkey. Here are my questions:

- Has anyone ever heard of this being done before (withdrawing from such a high dose)? I did a search but the highest I saw was 8mg.

- Is it dangerous to withdraw from this dose?

- Does anyone have any tips or advice on how to successfully accomplish this?

Thankyou.

 

[Princess_Poppy]

without another opiate, i don't think this sounds very reasonable. you can cut your doses a lot faster than you think. i came off of 70mg of methadone about 2 months ago, maybe a lil longer, and am today taking only .125 of suboxone each day (almost done!!!). i could have cut my doses faster too had i have wanted too, and if i hadn't made, er, mistakes. until you get down around 1-2 mg, i have found you can make pretty big jumps. 8 down to 6, 6 to 4, etc.

good luck

 

[outoftown]

Hi AminoAcid - I am currently on suboxone myself...only about 6 weeks...starting at 8mg per day and i'm down to 2mg. I havent fully tapered yet...but in all the research I have done and knowledge I have gained on suboxone...stopping cold turkey after being 12mg for 4 years would be pretty difficult. Withdrawals from that might be pretty bad and last several weeks (and beyond). i deal with depression myself, suboxone has made it easier for me to get off the medication I was taking (oxycodone). I would do what Princess suggested and try and taper down slowly...you might be able to decrease from 12 to 10, 10 to 8, 8 to 6 and 6 to 4 fairly easily within a few months.

As I said, I have no experience from quitting suboxone cold turkey from any dosage...but everything I have read and been told has discouraged me from quitting it cold turkey at 3mg after only 6 weeks. I don't think it would be life-threatening to do that (the withdrawal itself)...but for someone suffering from depression especially...that could be a really rough way to stop the medication. If this would be dangerous, please someone else chime in here...I've never read anything that said withdrawals from suboxone/opiates is life threatening...miserable yes, but not life threatening.

Good luck in whichever way you go!

 

[Cloudy]

You need to taper or your in a month of hurt.

 

[beengerman]

yeah that dose is too high to jump off. its not a good idea. like cloudy said , you going to be in a world of hurt. even a super quick taper would be better then nothing. 12mg for 4 years, don't try just to jump off that cold turkey man.

 

[tricomb]

Jumping of at 12mg is insane.

It's actually pretty easy to get your dose down to 2mg, It takes no time at all to go:
12mg --> 6mg --> 3mg --> 2mg --> 1.5mg --> 1mg --> 0.75mg --> 0.5 mg--> 0.25mg --> Done!

note: (I highly recommend you split dosing, AM/PM doses usually) Once you start to get lower (2mg and under) towards the sub-milligram doses, that will be much more difficult, but I assure you it will not be anywhere near as bad as jumping off at 12mg.

If you get down to 250 micrograms (0.25mg) then it should be tolerable, whereas if you were jumping off at 12mg, you'd probably have to call in sick to work for the forseeable future, and the next month or two, or even three months later you'd still be suffering from horrible PAWS.

 

[cire113]

what people don't understand is even when tapering it takes the body a long time to adjust to a lowered dose on Sub...WHen taking daily the stacking effect makes you have enormous amounts in your system.It takes about 11 days for this stacking effect to be complete give or take..

I think the more slow taper and lowest dosage you come off of is best..

Regular withdrawal from Subs even when stopping any dose lasts about 20-30 days(intensity varies from dose).. paws coming off any dose last atleast 15 months ..

This is all my experience.. Ofcourse I'm back on Sub again...

Sub maintenance is a big price to pay for stability it gives versus the alternative of death its worth it?

 

[beengerman]

you saying 15 months just killed me. I 100 percent believe you though. Thats why I've never been successfull.

 

[Tommyboy]

It will be too hard to go cold turkey off that dose. I went from 16mg daily for 18 months and completely stopped after just 10-14 days of tapering down to nothing, and the withdrawal was pretty horrible. It actually didn't take me that long to recover like most people say, but I was out of commission for over a week, but was a lot better by the 2 week mark. Day 3,4, and 5 were the worst due to insomnia, and I lost about 30lbs that month since it was nearly impossible to eat.

I don't know why tapering isn't an option for you. Even if your doctor doesn't aid you in it you can use the amount he prescribes you to taper on your own, and it will be a lot easier to come off after that. I felt very similar to you while on it which is why I wouldn't go back on it for maintenance, but there is no reason to put yourself through worse withdrawals than necessary.

what people don't understand is even when tapering it takes the body a long time to adjust to a lowered dose on Sub..

Most people seem to be fine with lowering their dose at first. It's tapering below 2mg that gets difficult, then jumping off completely which is the most difficult. A slower taper is usually only necessary at lower doses, but you can get to the lower doses pretty quickly with little discomfort.

 

[ErgicMergic]

You own your body, not your doctor; do whatever you feel is right. Like Tommyboy said, having more than you need is not necessarily a bad thing. Just remember, slow and steady wins the race with tapers! Good luck

Most people seem to be fine with lowering their dose at first. It's tapering below 2mg that gets difficult, then jumping off completely which is the most difficult. A slower taper is usually only necessary at lower doses, but you can get to the lower doses pretty quickly with little discomfort.

Yup, and it's usually the last 0.5mg that's painfully hard to walk away from, which is why some use a bit of Kratom to do so.

 

[AminoAcid]

Thanks for all the friendly advice, I'm on my second day without the Sub and I can already feel my dopamine receptors asking (politely for now) for some more, but I've decided to ignore them.

The problem with tapering is that since my doctor won't lower the script, every time I go into the clinic they will only ever give me 12mg (3 x 4mg strips), nothing less. If I'm given those 3 x 4mg strips, it would probably be tempting to just take them all. With the clinic I go to, you're strictly not allowed to take any of the drug home, you've got to take them then and there in front of the person. So to do a personal taper I would have to just take 1 x 4mg and throw the others in the bin (I'm not even sure if they'll let me do that!), and consistently doing that would be unlikely. (I hope that makes sense).

For now I'm going to continue through the withdrawal, and I've told myself that if it gets ridiculously bad (like bordering on hospitalization) I will go and let myself have 4mg. 4mg in the midst of a epic withdrawal will probably seem like heaven, so at least if I do do that it's not a total failure as I sliced off 8mg quickly.

I'm not working at the moment as I'm getting money from parents as they think I'm studying, so I can take at least the next 3 weeks off to withdraw if need be.

I keep on picturing myself as a little person with only a small pocket knife, and I KNOW there's a massive scary monster coming towards me to rip my soul out at any moment. It's going to be one hell of a brawl.

Feel free to post any more advice, personal stories or thoughts, as it really does help.

 

[ErgicMergic]

^ Ah, in the US methadone clinics do that. We didn't know you had to take them like that.

That's a tricky situation... is there any way you can talk some sense in to your doctor and tell him that 12mg of sub isn't working for you? It is affecting your quality of life, you want off, and 12mg of sub is a maassive amount to jump off cold turkey; he should understand if he had any shred of humanity. If he doesn't, bring a bunch of peer-reviewed articles (check Google scholar) on proper tapering off of suboxone, etc and educate him.

You're in for a hell of a withdrawal, man, you need to take this in to your own hands and take some action or else you will lose your mind in a couple of days or go out and relapse, or both.

 

[DooMMooD]

Input from me: I am currently at 2.5mg

I lower my dose by .25 every couple of weeks (3-6 weeks). I allow my body that much time to adjust to my new dose. Gives almost 0 discomfort aside from that first day or two.

Few tricks:

Day before you lower your dose, take your dose later (instead of 9am take it at 11am). then the day you DO lower your dose, take it a bit earlier (8am instead of 9am). that creates a dose overlap that minimizes discomfort.

Take as much time as you can to adjust to a new dose. As someone else said it takes quite a few days before your suboxone blood levels balance off. It takes minimum 3-5 days for my body to FULLY ADJUST to a drop of .25mg.

I have a excel spreadsheet that helps you calculate your blood level of suboxone. You plug in the amount you've taken every day for X amount of days, and then the new dose. As you put in the new dose you can compare your old blood levels with new ones, and keep going to see just how many days it would take for your blood levels to balance off (first day drops below your eventual rounding off). If anyone wants this lemme know, although credit goes to opiophile.

Although being 100% honest man I dont think this plan is going to work. You still seem to be exhibiting textbook addict behaviors (desire to do it 'your way', lying to your parents to get $, etc etc etc). My parents are supporting me but i actually am finally going back to school next week, no longer lie, and basically do EVERYTHING MY SOCIAL WORKER requests of me.

Your docs may not lower your script but that doesn't mean YOU cant. Although you MUST TELL THEM! Wtf is the doc gonna say if you tell them you took 1mg less this week? Maybe they dont feel your ready to get off of it for X reasons? You really MUST talk to them about this if you want even the slightest shot in the dark. What if you relapse and they dont know because they assume youre still taking the suboxone? Do they drug test? what if they test you , see theres no suboxone in your urine, and kick you out, and then you cannot even taper in the slightest or go back if you relapse? You should address these concerns before you make a VERY LARGE JUMP from 12mg suboxone (the most I ever have taken was 3mg, so even me to drop down to 2.5 and below is a big accomplishment, all relative; if youre used to 12mg suboxone for years....)

Good luck man I hope it works out. Just remember though its no longer about rushing to the finish line, but rather finishing the marathon. Sobriety isn't a dead ass sprint like using is, its miles and miles and miles and miles of work, basically forever; jogging the rest of your life. Don't tire yourself out.



P.S. More about suboxone dosing and the overlap; wrote it in another thread but felt it'd be useful hear. not NECESSARY but hopefully will help clarify and help you understand the 'big picture' of suboxone dosing, EXTREMELY VITAL IMO:

Example: you add 4mg to 2.5mg, you get 6.5mg, cut that in half you get 3.25, but! If you haven't even made it to the hl yet (36 hours lets say for you), you really are at like 4mg when you redose ANOTHER 4mg, meaning now youre at 8, and once again you DONT make it to the HL, meaning its 4-5mg when you redose with 4, giving you effectively 9mg suboxone in you, and again and again....get the idea? you could have a HIGHER BLOOD LEVEL OF SUBOXONE THAN YOUR DAILY DOSE!

Obviously this was a very very rudimentary example, not taking into account BOA, how you dose (eg 1x a day or 2x smaller doses), whether or not you 'fucked' with your meds (eg. took extra one day to get high). But all of that not withstanding, the fact is you could still have enough buprenorphine left in your body 9 days later to block something as meager as a perc.

This is why I feel it is vital for anyone on suboxone to see a chart/graph of their dosing, when their blood levels level off, and simply be able to view firsthand just what it looks like when they take X amount every day at the same time, of a drug that has a mean half life of 36 hours...the overlap of suboxone dosing can be INSANE! You MUST maintain daily blood levels, by either consistently taking it EVERY SINGLE DAY (not once fucking with it, and it will level off after weeks) or find a dosing plan that will create a stable blood level (figuring out when to dose ecach day and how much of your dose: eg 4mg in the morning 2mg at night).

After all the research i've done, I am a very large proponent of once a day dosing, until you get to the sub 2mg range. and even then if you can manage 1x a day all your dose vs 2x a day half your dose....still better from the #s i've crunched.

 

[AminoAcid]

Can your program calculate how long it would take for a person's suboxone blood concentration to fall to zero if they've been on ~12mg for 4 years (I have varied a bit from that, but only like 2 mg variation)?

I'm just starting on my third day without Sub and surprisingly feel physically fine, which I guess is a testament to it's massively long half-life.

I already feel completely horrible about lying to my parents, and feel like a worthless piece of shit, but I know I need to keep the lie going for a little longer to have the opportunity to withdraw, as if I need to suddenly start work then there's obviously no chance of making any large, quick medication changes. Addiction really does make you do shitty things, that's just another reason I'm stopping it.

I should've mentioned before that about 1.5 years ago I went cold turkey off 10mg. I actually managed to make it to around 6 days, but what got me through was actually computer games. I had the new Call of Duty and just played that constantly. Sadly this time I'm only on my laptop and have no good games, so I'll be relying on YouTube to get me through.

I was stupid then though and went back on codeine and a little after that back on suboxone. What was interesting from that experience though is that it wasn't the physical withdrawal that I couldn't handle, it was the emotional void left. I mean taking physical pain is something I can do, but having to deal with life without my coccoon was too hard, and this probably won't get better for at least a couple of weeks.

Also yea they do urine tests occassionally to make sure you aren't taking other drugs, and I'm not really sure what they would do if I gave a sample with no Suboxone at all in it... I guess they would obviously be concerned as it heightens the potential for overdosing say if I went from nothing back to a high dose.

Tommorrow is probably not going to be fun.

 

[Znegative]

Jumping of at 12mg is insane.

It's actually pretty easy to get your dose down to 2mg, It takes no time at all to go:
12mg --> 6mg --> 3mg --> 2mg --> 1.5mg --> 1mg --> 0.75mg --> 0.5 mg--> 0.25mg --> Done!

note: (I highly recommend you split dosing, AM/PM doses usually) Once you start to get lower (2mg and under) towards the sub-milligram doses, that will be much more difficult, but I assure you it will not be anywhere near as bad as jumping off at 12mg.

If you get down to 250 micrograms (0.25mg) then it should be tolerable, whereas if you were jumping off at 12mg, you'd probably have to call in sick to work for the forseeable future, and the next month or two, or even three months later you'd still be suffering from horrible PAWS.

Dont have time to read through the rest of this thread, but tricomb is spot on here. DONT JUMP OFF AT 12 MG!! It is not hard to quickly taper down to 2 mg, just be a little patient. You will also start to feel less lethargic. Around 4mg, buprnorphine starts to give you a stimulating effect actually, and this increases the lower the dosage. One thing to know is that once you get down to two mg, you should stabalize there for about 2 weeks before going any lower. you could technically decrease your dosage by 25% every four days without too much pain, but you will most likely be more successful if you take your time. It takes 12 days for bupe to be completely elliminated from the system, and I've found it takes about that long to completely stabalize at each lowered dose once you're under 2 mg. I'll add more later.

 

[cj]

good luck man. Btw your doctors an idiot 12mg suboxone for a codeine habit is insane.

 

[akaijunkie]

Jumping off at 12mg is freaking nuts. Definitely taper down before you do that. I personally can taper down from 8mg to 2mg in about 2 weeks....it's getting lower than that i have lots and lots of problems with, and usually i either end up back on my DOC or back at 2mg of bupe...


I haven't had and bupe in over 2 weeks, and only slipped up one night, so maybe this time it'll stick...
I wish you luck!

 

[Znegative]

Like I said earlier, if you take it slow, you shouldn't have too many problems, and like Tricomb said, when you get down to those lower doses, split it in half. I actually found transitioning from 3mg to 2mg to be more difficult than going down from 2mg to 1. I GAURANTEE though, that after four days you will feel adjusted to the lower dosage, considering you taper at a reasonable rate (don't expect to feel to hot going from 4mg to 1mg after four days).

 

[tricomb]

good luck man. Btw your doctors an idiot 12mg suboxone for a codeine habit is insane.

I thought I was the only one shocked by that part. Crazy....

 

[jaguraguguru]

Yeah this is far too high of a dose to jump off from... It greatly increases the risk that you will turn back to codeine or worse, a different, stronger opioid to manage your withdrawal symptoms. I think I have a really good way for you to be able to go to your doctor and take closer to the dose that you want (such as 4 or 8 mg instead of 12). When they give you the 3x4mg strips, put all three in your mouth, but be careful that they do not touch eachother in your mouth. If you can do it without getting caught/in trouble and without swallowing the third, swallow two of the strips, but keep one in your mouth for sublingual intake. The two that you swallow will only be absorbed about 10% (about 1/3 the amount absorbed sublingually), so your total dose will seem like 6.7 mg rather than 12. In the meantime, do your best to convince your doctor you're ready to taper down; this dose was too high to begin with and needs to be reduced. Tell him you're ready, you don't have withdrawal symptoms at this dose and maybe tell him you feel opiate effects from it and so your tolerance has decreased. Tell him that you have no cravings at all and don't even consider opiates anymore.

Be careful man, that's an awfully high dose to drop from. But to give you a little comfort, I want you to know that not everyone has even close to the same reactions to things like withdrawal from suboxone. I was on it for about 2 years straight (with a couple 2 week periods of tapering and abstinence) and I tapered down to about .125 mg/day and when I stopped taking it, I had very minor, mostly annoying withdrawal symptoms for about 5-7 days and felt completely fine for the next 2 months with no real cravings or PAWS or anything. Not everyone has 15 months of withdrawal or PAWS, or even 6 months, or even 3 months. And the lower the dose one drops off from, the less long PAWS lasts, unlike the previous poster suggested.

In addition, buprenorphine blood levels drop by 1/2 about every 1.5 days, and it is well-accepted (and provable, if you need me to prove it) that blood levels adjust to a dose change in ANY drug that has normal pharmacokinetics, like buprenorphine does, in a length of time equal to 4 half-lives, which means that it will take about 5-7 days for your body to level out to the next steady state concentration after a dose change in buprenorphine (suboxone), no matter how much you change the dose. In addition, it means that if you stop taking suboxone completely, your blood levels will be close to zero after 6-7 days. The important thing is that withdrawal (and especially PAWS) symptoms may not follow the path of your blood levels directly. You can probably drop to 30-70% of your steady state concentration before being in strong withdrawal, but after levels reach zero, you may even see an escalation in withdrawal symptoms as other systems of your body adjust to the change.

It might be worth looking for a new doctor if that is feasible to you. Are there places where you can get your medication and take it home with you to dose yourself? Even if not, it's very important that you find a way to get your treatment in a way that is responsive to your needs. You're clearly taking too much and need to take less, so if you can find a doctor to help, please try to do this! Good luck, let us know how things go.

Jaguraguguru