Bupe Suboxone taper ? 's & advice please!

[Brooke20]

Hi there, I'm new to posting but have been reading & getting advice here for years.

Opiate addiction since 2012. I relapsed this past August, I was doing oxys that turned out to be fentanyl. It made me feel disgusting and surprisingly made my complex grief & ptsd (daughter died 2019) so much worse. November I started on prescribed suboxone 16 mg. It was too much, I went down to 12 mg within a few days. I kept tapering myself down with each weekly visit, I'm now on 6mg a day, I take 2mg x3 daily. Tonight, I don't know why, but I took a a whole 4mg instead of 2mg and I got high. A light, opiate feeling high. It felt great, which is not good for me! I don't want to abuse this stuff. Is that a thing? When you taper down and take a higher dose, you can feel a high? Is it usually just a fluke and a one time thing?

I also plan on going down to 4 mg on Wednesday. Then 2mg the Wednesday after that. Then 1 mg that next week. Does or has anyone take your dose every other day or every 2 days with a taper? Maybe to help your body adjust even more, start opening up the opioid receptors more? I'd ask my sub doc but he's just a prescriber, he doesn't really know the best way to taper and I know it's different for everyone. I'm going on how I feel. I'm also prescribed 3 mg of Klonopin a day but have only been taking 1.5mg, a beta blocker, Cymbalta, and then lots of natural supplements to help ease any withdrawal that may come when I stop.

When I withdrawal, it is AWFUL for me since I have many other medical conditions. Any other advice on that - supplements to take as I taper, any tricks, any other advice in general is much appreciated.

Thanks!

 

[ValaisFendant]

Hi Brooke -

Suboxone has a very long half life, and as such, the tapering process is generally best done gradually. Think about the step-downs in percent terms, not MG terms (eg going from 2mg to 1mg is a BIG 50% reduction, not just a 1mg reduction). It's easier to go from 14 to 12, than from 2 to 1.0...

A key question here is how much urgency is there to get off of it? Many people will tell you that quitting cold turkey from 2mg/day can be very uncomfortable. For several weeks. And that slowly tapering to 0.25mg every other day is the least painful approach (but it takes time). To increase odds of success and to decrease discomfort, consider a long and deliberate taper during 2021.

I was on 2mg/day (primarily for pain), and over the last 4 months have reduced to 1.33mg. And - in my case - I've noticed it each time I stepped down (2.0 to 1.67 to 1.50 to 1.33...). Not bad - but my body could tell, and I would get sweaty and cold and yawn a couple hours before the next dose. Until my body adjusted to the new level after a couple of weeks. In February it will be 1.17, and in March 1.0... and from there TBD. It depends on whether the pain stays under control.

Listening to your body makes a lot of sense. If you can drop faster without consequence, then great! But - two main points if you want to minimize discomfort:
1) Try to get to a very low dose before stopping
2) Because the half life of this drug is very long, it can take a few days to figure out if you've cut the dose too fast... it can take a month to fully entirely clear it from your system...

You'll probably find suboxone easier to stop than clonazepam. It's just not as dangerous of a withdrawal. But it lasts a long time.

Many doctors won't prescribe benzos with suboxone because of the respiratory depression issue. Not sure what your situation is, but it's possible the clonazepam will help stave off the insomnia that can come with suboxone withdrawal.


Best

 

[Str8 Shewter]

I also plan on going down to 4 mg on Wednesday. Then 2mg the Wednesday after that. Then 1 mg that next week.

I actually think that’s a good idea, and I hope it works for you. I’m actually in Suboxone withdrawal right now. So far it hasn’t been that bad, but it’s only been a few days.

Definitely keep us updated. Hopefully we will both be off Suboxone and feeling okay. Sorry about your daughter too.

 

[factorygirl]

Slow and steady is the key.

I use bupe to detox and not for maintenance. When I was on OST, my taper took 1 month until I was taking 0.25 mg. I took that the last week and jumped from there. I was on other medication on the time (clonazepam) which helped ease any sx I may have experienced. I do not suggest this, but I am still prescribed the clonazepam for other reasons.

x

 

[drewbocop]

You need to take it slow, months. And taper down to sub-milligram levels as factorygirl suggested. If you're like me, Suboxone is a nasty one to get off of for reasons related to stimulation and RLS -> long-term insomnia. At least that's how I was every time. Gabapentin is your friend.

 

[factorygirl]

You need to take it slow, months. And taper down to sub-milligram levels as factorygirl suggested. If you're like me, Suboxone is a nasty one to get off of for reasons related to stimulation and RLS -> long-term insomnia. At least that's how I was every time. Gabapentin is your friend.

They're stingy with gabapentin in the UK. I didn't find it helpful. I actually microdosed oral naltrexone to speed up the process. But was also given a lot of comfort meds. I hope our friend has some pharmacological support and push vitamin B! It helps.

 

[ChinaGroove]

I'm no doctor but what do you plan to do after the taper?
There is nothing wrong with using Bupe for a period of maintenance, while the frontal cortex re connects with the mid brain and you can function as a member of society. Addiction is a long complicated process. Once you are on a steady dose and stable and don't even think about using or taking extra meds to feel high, then you're ready for a very gradual taper.
A quick taper is fine for the dependence aspect but does nothing to deal with the complicated addiction aspect.
You have to weigh what are the risks of being on Bupe maintainence for the present vs not being on. And you hace to be 1000% honest with yourself or you're just going to risk relapse.

Again I'm not a professional. This is just my experience/opinion combined with research I've done on the subject.
Most vital, I've been there before. I've been hooked on opioids, hooked on the needle itself, struggled with Sub doctors abd Methadone clinics. Addiction is so tricky. There have been so many times I thought I was past trying to get high, only for addiction to rear it's ugly head again.