Bupe Suboxone/Buprenorphine FAQ and Megathread v.1; 2007 - 2010

[Supeudol]

I just hit 25 days on Suboxone at 24mg a day from day one. My doctor recommended starting at the 24mg and staying at that level for 30 days and then dropping to 20mg for 4 weeks, 16mg for the next 4, and so on for a 6 month wd program. Aftering reading through the posts, I am beginning to feel a little mislead as to the proper dosage I could have started at in the first place. My habit was 180mg Oxy daily for about 6 months. I had been clean for 9 years prior to that except for dabbling with a few Vics a day for short runs of a month or two and then clean for a month in between.
The Suboxone makes me feel kind of dopey and dim witted, but I haven't felt any wd's from the Oxy since day one. Not a bad start, but now my concern is that possibly I started out way to high on the Sub. After spending a decade on Methadone in the '70's I sure would not want to repeat the months of wd from that again!
Should I be looking at cutting my dosage now (faster than doc advised) or am I already screwed with the 3 weeks at 24mg a day? I've cut it back 8mg over the past 3 days and don't really feel the difference other than feeling better, not quite so dim witted and a lot more energy on the lower dose. Have I just answered my own question? How far, how fast would be advisable to push it... zero cravings for Oxy at this point.

^^ Wow bud, you are so lucky its not even funny. I've been on both methadone and Suboxone, methadone when my habit was lower, but methadone made me sleep all day long cause the stupid doctor I had at the time raised my dosage all the way up to 170MG of methadone daily - (WHICH is INSANE) and this is when my Oxycodone habit was around 200mg/daily.

I am from Canada and live in Alberta, Canada, and the healthcare system is bloody insane here, you guys are so lucky in the US, its not funny at all. Get this:

I went to a detox/rehab facility just south of Calgary in Alberta, and I came in there with a 600mg/daily habit of Oxycodone, and also a benzodiazepine habit of about 6mg Clonazepam/day - roughly. I'm not going to get into the benzo w/d thing because its not a topic here and i'm currently tapering off the clonazepam still and my GABA receptors are totally fucked. Anyways, right away they brought me down to 420MG of Oxycodone, and then within a week they brought me down to 300MG of Oxycodone, and then within 2 days they took me down from 300MG Oxycodone/daily to 0.. ZERO.. and then I was in WD for 48 HOURS before they started me on Suboxone (Suboxone just finally became approved here in late late 2008, and there are only 2 doctors in Alberta that are able to prescribe it) I was in the worst withdrawal of my life, worse than Heroin withdrawal, worse than any other opioid I had used prior in my life, because incase some of you didn't know that Oxycodone has an ORAL bioavailability of 86%. I was using ORAL all the time, because Snorting Oxy's you only get a bioavailability of 56% or around there. Most of the time I was using Oxy-IR 20mg, and sometimes when I didn't have access to IR's I would chew up a bunch of 80's at once. I needed AT least 200mg just to FEEL NORMAL.

Now - after that 48HRS of withdrawals, severe high blood pressure (169/96) and rapid heart rate, sweats, and chills, and PAIN - the worst PAIN i've ever felt in my life. After the 48HRS of those withdrawals they started me at 4MG/Suboxone - FOUR FUCKING MILIGRAMS , and it didn't even touch the pain or withdrawals, and they kept me at 4MG for a week until I could see my addiction specialist who upped it to 8MG, and I was at 8MG for about two weeks after that and it seemed to be SLOWLY , very SLOWLY working somewhat, but still had severe problems with sleep. So after two weeks he upped me to 16MG/Suboxone which is what I am currently on. It works ok, and I've been clean for ALMOST 2 months (56 days). I just feel normal, but I still have some muscle pain and am SEVERELY depressed, and have been on Paxil for years off and on, and am currently on 60mg of Paxil (Yes, i've tried a lot of other SSRI's but its the same thing, they just make you flatlined with no sex drive).

The reason I wasn't going to go on methadone again, is because if I ever want to come off methadone it has an EXTREMELY long withdrawal (maybe not as intense as Oxycodone, but can last up to a month or more).

My point is that, you people that live in the US don't know how lucky you are, when you have both Subutex, and Suboxone approved down there. Subutex approved down there for people that are starting on bupe, and than they switch them to Suboxone. In the United States, Buprenorphine has been available since 2002. You guys also have access to 2MG Xanax bars, which we don't here in Alberta, Canada. The highest they come in here are 0.5MG xanax footballs. If you want the 1MG footballs or 2MG bars in Alberta, you have to get the pharmacy to order them in for you. And Canada is Completely Anti-XANAX which is ridiculous. Because up here they prescribe Ativan like CRAZY, and its the most popular benzo up here, and Ativan sucks, it does NOTHING for me. Xanax is the only benzo that REALLY helps me, and clonazepam as well - but still Xanax is #1 for me but nobody sells benzo's on the street here, and its extremely hard to get a doctor to even write you 0.5MG tabs of Xanax.

Anyways, point being, no WE DO NOT have free healthcare in Canada, we still have to pay premiums, and prescriptions are not covered at all unless you have your own work insurance.

I also have to GOTO the pharmacy EVERY single day to get my Suboxone and sit there for 25minutes to let it dissolve, and then after that, show the pharmacist that it has been dissolved completely. In Canada, you don't get take home prescriptions of Suboxone. I would move somewhere else in a SECOND if I had the money (which I don't right now because I have no job and just got out of rehab on Sept. 1st/2009, and went in there on July 27/2009.)

Sorry for the long post, I had to get some frustration out. Anyone that reads my entire post, thank you very much, because it shows that you care.

Cheers! %)

 

[nabbon]

^Wow, that's crazy. Yeah, I think your doc started you way too high, since I transfered smoothly from about 100mg OC/ day (at least 80mg, sometimes 120...) to 3mg bupe insuffulated (equal to me to like 6mg sublingually).

I would try to taper a little quicker, since you're still at the beginning, but I wouldn't be surprised if your body is used to it by now. I'd just experiment a bit and see, since you obviously have a ton to play with. No matter what, though, I'd try to go down to a reasonable number in as near of the future as is possible.

It sounds to me like the doc took the packaging a little too literally... and the pharm company wins if they get you addicted for a really long time, so it appears you have to look out for yourself, unfortunately. Once you have taken the step to get off and seen a doctor, you shouldn't have any more bullshit to put up with!

Thanks for the input. At this point, I'm feeling a bit foolish for accepting the docs program without question. I've always done it "my way" and this time around I thought I would adhere to a program from a medical professionals point of view. I hadn't even heard of Suboxone until a month ago.
I am set up now on dosing 3 times a day... 8 mg morning, noon, and 6 PM. From what I have been reading, most folks seem to be dosing only once a day or even every other day. What is standard? I know everyone is different, but there must be some kind of rule of thumb. We aren't that damn different! Past 3 days I've dosed 4 mg at 8 AM, 4 mg noon, and 8 mg 6 PM without noticing much of a change as I said earlier. Couple of hot flashes and maybe a bit "speedy" but that is it. At first, I loved sleeping through the night without even getting up to take a leak. But now I'm a little tired of waking up groggy and feeling hung over. Heh, no pleasing some people. Don't get me wrong I'm still grateful as hell not to wake up sick, but I feel like I am setting myself up down the road for some stretched out wd's.
The doctor is already saying that some of his patients never completely wd and just stay on a maintenance dose of 2 mg a day. It has the distinct feeling that someone is slipping his hand into my pocket and planning on doing so for some time to come.
Tomorrow I am going to see if taking 4 mg at 8 AM, skipping the noon dose and doing 4 mg at 6 PM gives me any type of wd symptoms. If anyone has a different suggestion or wean rate from where I am at now, put it out there. I must admit that I am out of my depth with this particular drug and am a bit stuck, heh.

 

[nabbon]

^^

Sorry for the long post, I had to get some frustration out. Anyone that reads my entire post, thank you very much, because it shows that you care.

Cheers! %)

Read it all the way to the bottom. Happy venting!

 

[Pegasus]

Thanks for the input. At this point, I'm feeling a bit foolish for accepting the docs program without question. I've always done it "my way" and this time around I thought I would adhere to a program from a medical professionals point of view. I hadn't even heard of Suboxone until a month ago.
I am set up now on dosing 3 times a day... 8 mg morning, noon, and 6 PM. From what I have been reading, most folks seem to be dosing only once a day or even every other day. What is standard? I know everyone is different, but there must be some kind of rule of thumb. We aren't that damn different! Past 3 days I've dosed 4 mg at 8 AM, 4 mg noon, and 8 mg 6 PM without noticing much of a change as I said earlier. Couple of hot flashes and maybe a bit "speedy" but that is it. At first, I loved sleeping through the night without even getting up to take a leak. But now I'm a little tired of waking up groggy and feeling hung over. Heh, no pleasing some people. Don't get me wrong I'm still grateful as hell not to wake up sick, but I feel like I am setting myself up down the road for some stretched out wd's.
The doctor is already saying that some of his patients never completely wd and just stay on a maintenance dose of 2 mg a day. It has the distinct feeling that someone is slipping his hand into my pocket and planning on doing so for some time to come.
Tomorrow I am going to see if taking 4 mg at 8 AM, skipping the noon dose and doing 4 mg at 6 PM gives me any type of wd symptoms. If anyone has a different suggestion or wean rate from where I am at now, put it out there. I must admit that I am out of my depth with this particular drug and am a bit stuck, heh.

I've always done once a day, but have heard of people doing twice (2x 8mg in that case, usually)... The long half-life makes me think once should be sufficient really, though.

2x a day doesn't sound like a bad idea in your case, though. Whatever you're more comfortable with; you'll still have a ton of bupe in your system at all times, regardless.

 

[Captain.Heroin]

Why do you always merge these threads Captain Heroin?? They go nowhere when you merge them because they get changed into a completely different topic. Like now you guys are talking about tapering-- what the hell buddy? Can't you have a little respect for some individuals on this forum? 8)

If I let everyone have their thread stay open in OD, the whole first two pages would be all about people talking about Suboxone.

Sorry, we have to talk about Suboxone in here, especially if you feel that strongly about it. But it's just not feasible for OD to not merge them in here.

Why don't you go ahead and bring up your concerns in this thread which discusses splitting opiates out of OD, so that maybe something like that could be possible.

This is not the thread to discuss this.

Plus, you haven't voted in the poll yet, so I'm sure you will enjoy ranting in there.

I just hit 25 days on Suboxone at 24mg a day from day one. My doctor recommended starting at the 24mg and staying at that level for 30 days and then dropping to 20mg for 4 weeks, 16mg for the next 4, and so on for a 6 month wd program. Aftering reading through the posts, I am beginning to feel a little mislead as to the proper dosage I could have started at in the first place. My habit was 180mg Oxy daily for about 6 months. I had been clean for 9 years prior to that except for dabbling with a few Vics a day for short runs of a month or two and then clean for a month in between.
The Suboxone makes me feel kind of dopey and dim witted, but I haven't felt any wd's from the Oxy since day one. Not a bad start, but now my concern is that possibly I started out way to high on the Sub. After spending a decade on Methadone in the '70's I sure would not want to repeat the months of wd from that again!
Should I be looking at cutting my dosage now (faster than doc advised) or am I already screwed with the 3 weeks at 24mg a day? I've cut it back 8mg over the past 3 days and don't really feel the difference other than feeling better, not quite so dim witted and a lot more energy on the lower dose. Have I just answered my own question? How far, how fast would be advisable to push it... zero cravings for Oxy at this point.

If the Suboxone is making you feel dopey and dim-witted, that is a sign you are taking "too much" Suboxone, mostly because Suboxone at its ideal dose will have a pleasant, stimulating edge, which shouldn't leave you feeling "dim-witted" at all.

Yes, I would lower your dose. 24mg is too much if you feel dim-witted from it.

to 3mg bupe insuffulated (equal to me to like 6mg sublingually).

3mg snorted = 5mg sublingually, if you're using the 30% sublingual BA, and 50% insuffulated BA figures. Obviously there will be slight differences (depending on how efficiently you can snort Suboxone seeing as each tablet only has 8mg of active ingredient, and each tablet weighs in between 300 and 400 mg), but just thought I'd throw that out there.

I am from Canada and live in Alberta, Canada, and the healthcare system is bloody insane here, you guys are so lucky in the US, its not funny at all.

I am not aware Canada was so far behind, but I was aware of how lucky people in the US are.

Most reputable doctors would not give most addicts 8, 16, 24, 32 mg of Suboxone a day. But, it's a blessing to have here so you are more than adequately covered in terms of staying clean.

Thanks for the input. At this point, I'm feeling a bit foolish for accepting the docs program without question. I've always done it "my way" and this time around I thought I would adhere to a program from a medical professionals point of view. I hadn't even heard of Suboxone until a month ago.
I am set up now on dosing 3 times a day... 8 mg morning, noon, and 6 PM. From what I have been reading, most folks seem to be dosing only once a day or even every other day. What is standard? I know everyone is different, but there must be some kind of rule of thumb. We aren't that damn different! Past 3 days I've dosed 4 mg at 8 AM, 4 mg noon, and 8 mg 6 PM without noticing much of a change as I said earlier. Couple of hot flashes and maybe a bit "speedy" but that is it. At first, I loved sleeping through the night without even getting up to take a leak. But now I'm a little tired of waking up groggy and feeling hung over. Heh, no pleasing some people. Don't get me wrong I'm still grateful as hell not to wake up sick, but I feel like I am setting myself up down the road for some stretched out wd's.
The doctor is already saying that some of his patients never completely wd and just stay on a maintenance dose of 2 mg a day. It has the distinct feeling that someone is slipping his hand into my pocket and planning on doing so for some time to come.
Tomorrow I am going to see if taking 4 mg at 8 AM, skipping the noon dose and doing 4 mg at 6 PM gives me any type of wd symptoms. If anyone has a different suggestion or wean rate from where I am at now, put it out there. I must admit that I am out of my depth with this particular drug and am a bit stuck, heh.

Some people do better with once a day dosing, others do better with splitting their dose up over the course of a day.

I personally like the latter (3 to 4 times a day instead of one dose), but others do better with one dose in the morning.

I think your plan to try 4mg in the AM and 4mg at 6PM should go well for you, you will probably not wake up as "groggy" the next morning. You may experience mild WD symptoms in the beginning, especially when you wake up, but this is normal as you're still recovering. As the weeks go by, you will start to feel better as you stabilize on your dose and you possibly keep tapering further. Suboxone made me feel better when I was taking lower doses of it. Taking more Suboxone than I need has yielded only dysphoria and unpleasant side effects.

 

[Pegasus]

You seem pretty angry today, Mr. Supeudol...

 

[Captain.Heroin]

Supeudol also believes if you shoot Suboxone you go into precipitated WD's.

He's just kind of gullible, so I feel pretty bad for him. He's obviously having a bad day.

 

[PinK~cloud]

If i was the doc of Supeudol i too would put him on 170mg of methadone daily so i didnt have to hear him blabber.

 

[PinK~cloud]

My point is that, you people that live in the US don't know how lucky you are, when you have both Subutex, and Suboxone approved down there. )

Subutex isn't readily prescribed, hell, i dont even know if it ever is in the US. Jesus dude you fucking canadians get fed all sorts of crap

 

[nabbon]

Skipped my morning and noon dose. So far no ill effects. In fact, I feel my thoughts beginning to clear and energy level improved. I know it is probably just the positive attitude from a new direction to take, but I'll take whatever can I get and it didn't cost anything.

No nap for me today! The "less is better" comment is proving to be accurate.

 

[Captain.Heroin]

Skipped my morning and noon dose. So far no ill effects. In fact, I feel my thoughts beginning to clear and energy level improved. I know it is probably just the positive attitude from a new direction to take, but I'll take whatever can I get and it didn't cost anything.

No nap for me today! The "less is better" comment is proving to be accurate.

I'm glad it works for you. I definitely get by on around 1mg per day, it's very effective. Some days I only get 0.5mg and I still feel fine the next morning I wake up.

 

[ruffneck81]

ok got a problem...i fell off the suboxone wagon, and i really want to get back on it.
here is what im afraid of. when i started on suboxone i got extremely sick, and wanted to literaly die, i have never been that sick.
so i was on suboxone for 4 weeks before switching back to oxy...im afraid that if i get back on oxy that ill go through severe wds again. can someone share any info as in relapsing, and then getting back on suboxone.

thanks

 

[i.am.mookie]

^^ wait at least 24hrs after taking your last dose of oxy before taking the subs. if you wait that long you will be fine. depending on your habit, that determines how much sub you need. they say 8-10mg can sustain a person with a pretty good dope habit, so i wouldnt suggest taking anymore than that unless you really really have a bad habit.

 

[nabbon]

I've always done once a day, but have heard of people doing twice (2x 8mg in that case, usually)... The long half-life makes me think once should be sufficient really, though.

2x a day doesn't sound like a bad idea in your case, though. Whatever you're more comfortable with; you'll still have a ton of bupe in your system at all times, regardless.

At the end of the second day on a 2x 4mg/per and felt a bit anxious waiting for the 6 PM dose. Last night I was a bit restless but still managed to sleep 7 hours, only waking up a couple of times. The day before I started this regime I did 8mg in the evening only, skipping morning and noon doses. I assume the day's doses prior to that at 20mg prevented me from noticing the skipped doses originally.

Thinking of cutting it again tomorrow with same 4mg in morning and 2mg evening. See how I am feeling and make the call then. Starting a little stockpile with the skipped doses. Maybe I won't have to fill the next 2 week script at 8 bucks at pill.

 

[Pegasus]

^Keep in mind that Suboxone's long half life means that when your body feels the w/d, it's because your overall levels have dropped a noticeable bit (not just that last dose, but the one before and the one before that...). If you're already not feeling too good, be careful going down too much too quickly, cause your body is probably just now getting adjusted to the dose you're at. I'm sure you'll figure this part out on your own... just giving you a little heads-up.

You're doing awesome from 24mg already! Keep it up!

 

[Captain.Heroin]

Gotta love that stockpile.

 

[ruffneck81]

do you guys think that my body will recognize the bupe, and not put me into severe wds...im going to wait 20 hours just like last time, but even after 24 hours i was put into severe wds...so im hoping since i went through this once before that my body will recognize the bupe, and not put me in severe wds, and that it will actually help me. im so pissed i got off bupe the first time.

stay on bupe do not ever get back on oxy...i promise it aint worth it.

 

[nabbon]

If i was the doc of Supeudol i too would put him on 170mg of methadone daily so i didnt have to hear him blabber.

Standard dose at my clinic in 1971 was 200mg. Five of those huge orange 40mg wafers at a time. Practically needed a shopping bag to pickup a weeks worth for two of us.

 

[nabbon]

^Keep in mind that Suboxone's long half life means that when your body feels the w/d, it's because your overall levels have dropped a noticeable bit (not just that last dose, but the one before and the one before that...). If you're already not feeling too good, be careful going down too much too quickly, cause your body is probably just now getting adjusted to the dose you're at. I'm sure you'll figure this part out on your own... just giving you a little heads-up.

You're doing awesome from 24mg already! Keep it up!

Thanks for the encouragement and heads-up. I figured the long half life is what is keeping me from feeling any w/d thus far as well. Hoping I can get the doses down much lower before it catches up to me. Don't want to get too cocky!

I did the 4mg morning and 2mg evening yesterday, slept well and no cravings or w/d symptoms. Took 4mg this morning and planning the same 2mg tonight. For tomorrow, 2mg AM and 2mg evening and see how that goes. Splitting the 8mg tabs down to 2mg is far from precise, but I'm sure that it is not so critical at this point with the half life being so long.

 

[nabbon]

Gotta love that stockpile.

Oh yeah!