Opioids Large dose Codeine addiction and Buprenorphine dose...

[monstanoodle]

Hiyer OD
Jeez, it's been time since I've posted in here so do forgive me if this would be better suited elsewhere.

This is one of those genuine SWIMming pool situations! Shock fuckin horror!

Right, a person who wishes to remain anon. has had a large Codeine habit (around 1.6g a day) for a long time and has recently been to see an addiction specialist who will be putting them on Buprenorphine (Subutex). Said doctor wants to put said patient on 8mg a day and moving up to 20mg.

I've remembered many posts here in the past, that must have been hoovered up in the big "Spring Clean", where people have said that when it comes to Buprenorphine - less is more.

When I was on it for a gear habit, even though it wasn't the right replacement for me, 4mg held me physically, and we all know that when you take more that you're not just increasing it's µ-agonist effect, but it's antagonist effect also.

I've said to this person that I thought their doctor was going to put them on too high a dose, that it would be unecessary and harder to come off in the long run.

I'd just like to start this new thread to have those who have been on Buprenorphine for a while and thought they were put on too high a dose to share their tales and give advice.

Oh, and before anyone starts saying "Subs for Codeine?? Madness!", you'd be surprised how physically painful a high dose Codeine habit can be because it is a very physically-acting Opiate (the stomach cramps etc. have been worse for me than some gear WD symptoms) and this person finds the psychological aspect just as difficult - Which I can fully appreciate

Thankyou for those with good info to add!

 

[Mafila]

I have never taken Codeine and don't know much about it, including the dosage. I was addicted to 90-120mg of Oxycodone for nearly two years. I have been on Suboxone for the past year and a half and all I can say is that 8mg a day is too high of a dosage. 4mg a day is my optimal dosage but I try to take less, although I normally just stick to 4mg a day. I don't understand the point of raising someone to 20mg a day of Suboxone, if anything the doctor should begin lowering the dose from 8mg a day. I'm thinking that the doctor is over-prescribing this individual and is more concerned with money than anything else. I know many people around here who are prescribed to take 16mg a day by their doctor and even that is too much for them, most of them just take 2mg-4mg a day and sell the rest. Some doctors here don't over-prescribe and will actually prescribe someone 2mg-4mg of Suboxone a day, which I find to be the optimal dosage for opiate addicts. Someone who actually needs 20mg of Suboxone a day is someone who is taking an extremely high dosage of opiates or is being switched from Methadone to Suboxone, but I honestly don't see the point in actually taking that much Suboxone each day as I've never met anyone who actually needed that much each day, even people I know with 10-year long heroin addictions are fine with no more than 4mg in a day.

I'm not a doctor and I can't tell you for sure, but hopefully my opinion combined with the opinions of others will help you. Just make sure you wait for more opinions from others since I am not a doctor and am only speaking from my own experience and the experience of several friends.

 

[NeighborhoodThreat]

I don't think its madness at all, 1600mg codeine is a LOT, though. I'm wondering how their liver is doing....

I think 8mg would kill their WD however, I'm hesitant to offer a conversion to buprenorphine or another opioid from 1600mg codeine because of the various metabolic issues we have to consider..

 

[monstanoodle]

Mafila - Thanks for yer reply mate
Yea I'm totally with you, many people are scripted far too much when in comes to Bupre.
In America this is most likely to do with money, but this individual is in the UK and prescriptions come at a set price or are available free if you're on certain types on benefit.
Here, in the UK, I think it's more an issue of not knowing how strong it is! I mean 20mg would be ludicrous for many people, even with big habits. But the doc I saw when I went on it was reluctant to give me any more than 4mg and wanted to try get me to taper down fairly swiftly.

NhT - Thankyou to you also man Said individual's liver is fine as they're scripted pure Codeine tabs.
And aye I agree, it's an Opioid that's hard to compare dosage-wise with other Opioids/Opiates plus Codeine metabolism is notoriously tricky and unreliable. It seems to be doing the job well for this person though - They can get a nod on still from taking the max dose of Codeine.

Anyhoo, cheers again Any more experiences would be greatly appreciated ♥

 

[suessmayr]

1600mg is almost unbelievable. There is no way the body can even use that much. Isn't it the case that 400mg is generally the limit?

Given the size of the habit I don't think switching to subs would be 'madness', although I agree that 8mg or certainly 20mg is too high. The problem is that most people, when getting on subs, are in a pretty bad place and can only think about feeling better. So they'll take as much of any opiate as they're offered. It's hard to think about the future and getting clean.

If I could have done it again I would not have gone about 8mg and that was for much stronger shit than codeine.


S

 

[macbrown21]

I've seen too many people get started by their sub doctors at 24-32mg a day. Too me it seems that anything over 8mg doesn't really add much, except making it way harder to kick. So you have to go to the sub doctor for a longer time, thus making them more money. Its almost like a lot of these guys don't have the best interests of the their patient ahead of their own interest of making money.

 

[suessmayr]

^ yeah, badly. Even in my country where the service is free it seems that doctors are more concerned to make absolutely sure that a patient can't use any other opiates than they are to just prescribe a suitable or sufficient dose. So they give 20mg + because at this level it is literally fucking impossible to get high on other shit without waiting like 7 days +.

S

 

[charlesr]

I know this is a really old post, but I can definitely shed some light on this post. I was admitted to a detox clinic about 10 years ago with a 1600mg/day codeine addiction. And yes my liver had nearly packed up, but I was lucky. I managed to stop just in time. Anyway, the doctor prescribed me 16mg of Subutex and this was more than enough. In fact, I reckon 12mg would have been a better starting dose.

Things weren't too rosy when I was tapered off to 0.4mg, 10 days later...