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Harm Reduction Short-term Detox or Down-regulating Addiction: BEST USE FOR SUBOXONE?

darvocet21

Bluelighter
Joined
May 31, 2021
Messages
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SHORT-TERM REDUCTION OF DEPENDENCE & DETOX: one of the best uses of Suboxone / Subutex for addicts in despair. (Note: sublingual strips are better since they can be easily cut into smaller sizes to give you more control of how much you take)

Because buprenorphine hangs around your body for so long and loves your receptors so much it suppresses withdrawal symptoms long after its 6 hour analgesic effect you can use it to lower your dependence or even quit opioids outright with much less physical suffering.

***IMPORTANT WARNING: LOWERING YOUR DEPENDENCE PUTS YOU AT INCREASED RISK OF OVERDOSE SHOULD YOU DECIDE TO RESUME USING. YOU CANNOT TAKE YOUR USUAL AMOUNT, START OFF SMALL***

How it works
The key is taking a sufficient dose for a brief period of time and ONLY when you need it, tapering ONLY if you want to, then stopping.

For most addicts 8mg is plenty, 4mg may do the trick. If you have a heavy habit you can err on the side of 16mg (with the caveat that you're taking twice as much naloxone, 4mg instead of 2mg). Strips are better since by cutting them in half & then half again etc you can custom tailor the dose that's right for you. You can also titrate your dose, which means take half and then wait 90 mins before taking the other half; you may find you need less or don't need it at all. A sufficient dose should NOT be intoxicating but will hold you for a MINIMUM 24 hrs (though 36-48 hrs intervals are doable, especially after you've taken a few doses)... For most addicts 24 hours without thinking about dope is welcome, 48 hours is a f****** vacation.

Taper if you can without undue suffering but not to zero, and then stop. Since you're not hooked on Suboxone or Subutex there's no need to do a complete taper. Since you're taking advantage of the drug's long half-life (24-60+ hours) to lower your level of addiction or quit entirely, and doing it in a (relatively) short amount of time, your last dose will help in whatever you decide. Notice I haven't given any timetable. Personally I think 7 to 10 days is ideal but that's just my opinion. Because at the end of 10 days you've cleared out all the metabolites of heroin or fentanyl or whatever it was while resetting your opioid receptors to a healthier level.

As I'm reposting this from another thread another strategy occurs to me that may suit certain individuals perfectly: use this technique to transition to a safer opioid. Switching from junk/fentanyl to kratom overnight is unrealistic, and this puts it within reach.
* * *
Basics everybody should know:
•You MUST STOP TAKING your drug of choice long enough to be in withdrawal before taking your first dose of Suboxone or Subutex or else you will precipitate even worse withdrawal syndrome. Typically stop for at least a full day and night if you use heroin or semi-synthetic opioids like hydrmorphone, oxycodone etc. and 36 hours for fentanyl although these parameters will vary between individuals based on metabolism and habit size... At least long enough to feel dope sick although it isn't necessary to be in full-blown withdrawal syndrome.

•If you take subs everyday for ~2-3 weeks you risk the dilemma of addiction to the very thing that was supposed to free you and or give you a respite. I'm not pushing for total detoxification of anybody until they're ready emotionally and psychologically. I'm a big believer in maturing out of addictions (but less in starting new ones!)

•a note about methadone: clinics used to offer 7-Day Detox along with longer periods of detoxification and maintenance. But it didn't work very well because methadone doesn't have as strong a bonding affinity w your receptor sites as does bupe. If you've ever known somebody on maintenance for years who slams everyday you know what I mean. Incidentally I'm sure this can work for methadone but there are special problems to be considered (e.g. methadone's long half life, length of treatment) and though this could be attempted by someone on a moderate dose of 50mg, it would be preferable to taper to a lower dose and/or use a less potent, shorter acting opioid (Tramadol, hydrocodone) to mitigate withdrawals and bridge the time necessary (2-4+ days) for methadone and its metabolites to clear from the body enough to be in withdrawal.

Good luck! Best of all you can be doing this within a few days or sooner if you find someone who has an opening.
A video appointment with an online provider (there are many) costs $100 & up and roughly $50 for a 2-week supply of medication (typically the most they'll start you with). Suboxone is covered by most health insurance plans.
* * *
If you are at the stage in your process where you've become somewhat stoic and the simple absence of the warm fuzzy feeling isn't enough to make you obsess over obtaining your next dose, BECAUSE YOU AREN'T DOPE SICK, this is for you

EDIT— see below for the latest updates on this technique
 
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Thank you I have been on low dose of hydrocodone for years ( due to chronic pain & Dependence ) I want a simple easy way off, and not do any work 😵
So after reading your wonderful post, I will just need to Accept the discomfort, and move through the physical, and mental pain that , mild withdrawals present 👍🏻
 
Depending on your dose, you will do fine on between 1-4mg buprenorphine (.25-1mg naloxone) and should not suffer any withdrawals, aside from the discomfort of 24-48 hours off hydrocodone before starting Suboxone
 
I am just wondering? If I get through the 48 hrs of hydrocodone withdrawals, is it just better to take the Bit in the teeth and muscle through??
 
No, in my opinion is isn't worth the risk of harming your chances for success. And it's unnecessary given hydrocodone has a short half-life (mean 3.4-3.8 hrs) in healthy individuals without impaired liver function. Typically after 5-6 half lives 94%-97% of a drug has been metabolized and excreted, which for hydrocodone is under 20-24 hours.

Keep in mind that I don't have a lot of experience with hydrocodone apart from taking it. I've never been addicted to it. I'm just passing on this information but you know yourself better than I do.

If it was me I would start the Suboxone no more than 24 hours after my last dose of hydrocodone. IMPORTANT: *And I'd divide the first dose into 1mg squares (much easier to do if you have sublingual strips) and take one and wait a full hour. If your symptoms of withdrawal haven't improved, repeat 1mg/hr up to a MAX dose of 4mg. *This modification is based on new info that's come to light (see below). After the first day: take the lowest dose of Suboxone necessary to suppress most withdrawal symptoms no more than once daily and otherwise follow the recommendations as described in my first post.


*I don't have time enough now to go into it but I've learned that it is possible to initiate Suboxone treatment in such a way as to avoid precipitating withdrawal even in patients who have not abstained, even ones on moderate to high doses of their opioid of abuse. Bear in mind that the procedures described below were developed in clinical settings under close supervision. Here's an article that describes this off-label use...

 
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