Bupe Told My Bupe Doc That the Bupe Dosages Commonly Scripted are Unnecessarily High

[Tommyboy]

Oh, the 4 different insurances that I have had over the years have all had a copay that was between 10-30 for generic. I was paying 60 for the suboxone, regurdless of quantity. I have used empire blue cross/blue shield, aetna, and my school insurance now is called markel I believe (it has like 3 names on the top of the card so not sure).
Well, paying half is better than paying full, I had just never heard of that.
My friends all come from wealth families too, so I am sure that is why I haven't. And the only other people that I know that get meds are old and I guess have medicare?

 

[tiimmmmmyyy]

off topic slightly yet i wanna know who here on bluelight actually had the 16/32 suboxone daily dose and it was necessary and i wanna know how much and what kind of opiates they were on and how long... all the general details.

I was on IV heroin for 3 months (0.1 g < x < 0.7 g/day), then got into a car accident. I was on high dose dilaudid and oxycodone for a few weeks (IV in hospital), then 60 mg < x < 120 mg of methadone for 2 months. I was then put on 32 mg suboxone after a weekend of "withdrawal" to prevent precipitated withdrawal due to the drug's mode of action.

I immediately felt this was too much, and I tapered to 8 mg/day within a few days of starting with ease. It took about 1 week to "normalize" my general feeling of well-being once I started suboxone. I felt like horse shit for that week though (emotional, physical... withdrawal persisted the first day or two I went on suboxone, but leveled out rapidly).

I've been on 8 mg for 6 weeks, and I plan to take 6 mg all this week, and 4 mg the week after and hang on the that 4 mg dose for a little while. 32 mg was RIDICULOUS even for my habit (and 120 mg methadone skyrockets your opiate tolerance like none other). 32 mg wasn't even superior for my pain relief (I shattered my femur; some horrible pain). I feel the same minimal partial agonistic pain relief at 6 mg as 32 mg.

EDIT:
Let me note that I do feel a change in my personality. I am more antisocial than when I am sober; this is the main reason I am titrating/tapering down. My intellect does not seem to be affected on 8 mg/day, however, at least not significantly. I just finished my first midterms week on suboxone and received top grades in upper div science classes at a top university.

 

[tiimmmmmyyy]

Oh, and prices/quantity...

Docs in California are allowed to hand out 1 month supplies at a time. Example: My doc has me on 1 8 mg pill a day. But he accidentally wrote 40 count for my prescription. I had to pay the premium price for those pills over the monthly 30/31 count. It was a few hundred dollars for the extra 10 pills my doctor accidentally put on there. I told the pharmacist to just put 30 in there, and the price went back down to my copay of $15. When I was prescribed 32 mg, I paid $15 for 120 pills, but the "non-insured" price was well over $700.

Youch.

 

[Captain.Heroin]

I haven't read the whole thread but, I agree on the high dosing. I haven't met a suboxone patient that didn't sell half of their script. That would be the one downfall aside from the cost because 9/10 they sell their bupe and use that money to buy a full agonist.

If they weren't hustling Suboxone they'd be doing *something* to get $ for a full agonist.

You can't really correlate "too much Suboxone" to relapsing.

Also, I have managed *not* to relapse for 15 months now, and I get more Suboxone per day than I can go through in a week.

I also don't sell half my script (or, really any of it at all, I like it too much to give it away to people for $), so consider me an anomaly.

Regardless, the fact is, if you live in the US chances are your insurance sucks and is embarrassing when compared to the health care benefits enjoyed by the rest of the modern world. -DG

Too bad I've got great health insurance and couldn't complain about it.

 

[myfriendemo]

this is the kinda stuff i bitched about in my "how i quit so easily thread" im glad other people are realizing that it shouldnt take more than a week or two to quit.

why trade one drug for another? if bupe didnt give withdrawal i'd be more willing to tolerate people that take it for such a long time. if you feel like shit getting off heroin, just remember that you'll feel pretty shitty getting of bupe.

granted - the psychological need has yet to go away. maybe bupe helps with that. then again, maybe a placebo would help with that.

 

[Pegasus]

^I don't see that discussed in this thread, honestly...

if bupe didnt give withdrawal i'd be more willing to tolerate people that take it for such a long time.

Why would you not "tolerate" other people using bupe? What difference does it make to you whether or not someone else uses it?

 

[previouslyhere]

I agree with you but my experience was very different and opposite of what a lot of people I've heard about have had to do.

Coming off Perc habit, 80 to 100mg/day (was doing the 10mg pills), I was able to do my induction at home and had to keep a log that my doctor gave me. I was given 8 2MG pills and told to start dosing when I went into withdrawal, doing 2MG every hour until I felt right. I ended up feeling "right" at 8 MG...

Feeling right to me at that time was getting a feeling similar to what I got when I was on the percs. My doctor definitely took this into account, and when I told him the dose I felt OK at (8mg) he cut it in half and prescribed me 4mg/day. He told me to get down to 2mg as soon as possible...which I did after like a week.

My doctor said that those high doses, over 8mg/day, are given to ppl with dope problems..which I wasn't on. Even then he said that such high doses should really only be in the adjustment period

I've been on it for 2 years and I've gotten down to 0.50 to 1mg / day. trying to taper now. All in all , it changed my life for the better. I know the taper I'm doing is gonna be tough but I have no desire to get high again. I couldn't imagine that feeling. I get sick thinking about it.

I think its crazy - some of my friends that had Oxy problems - one of them was doing less than me, 80mg/oxy a day , and now he's been on 16mg of bupe a day for over a year. Another kid I know was shooting dope he was doing 24mg/bupe a day for over a year. kinda bugged out

 

[Shambles]

Shooting a G+ worth of good quality heroin per day for 3 years is a case which might actually require 16mg to 32mg per day.

Buprenorphine may never fully satiate a long term/heavy user. This is why some people are prescribed up to 32mg per day.

I was scripted 32mg of Subutex per day after 10 years on daily IV heroin (average of a gram a day) along with being on and off methadone at various doses (and a range of non-scripted stuff) for most of that time. A single dose of 8mg in the morning held me fine (for up to three days) and got me plenty buzzed too. Methadone barely touched the sides. Bupe ftw

if bupe didnt give withdrawal i'd be more willing to tolerate people that take it for such a long time. if you feel like shit getting off heroin, just remember that you'll feel pretty shitty getting of bupe.

I'll gloss over the jaw-dropping arrogance and offensiveness and stick with the simple factual statement that bupe had little if any withdrawal for me when properly tapered. YMMV.

 

[barry351]

I have been on soboxone for two years now, I take one 8 milligram pill in the mourning and one shortly before bed. In my experience takeing any more was a waste, like many addicts I took more just to see what may happen, nothing happened, I was amazed, I later learned of the ceiling affect and thought, ya, its true, its hard to abuse buprenorphine. I to believe the makers of soboxone dont like this info public knowledge. A friend that sees a different doctor is getting 4, - 8 mill pills a day, I think why, for what ? I know I could easily cut down to a much lower dose yet, but I have not, what I have done is have my doctor switch me to the generic form of subutex ( buprenorphine ) for the cost is much less than soboxone. One thing I have found is that the straight buprenorphine pill, for reasons I cant explain, makes me feel better, my mom agrees also. The only difference between soboxone and buprenorphine is the soboxone has naloxone ( opiate blocker ) in it. I was told that the blocker would have no affect one me, and after trying both I would tend to disagree.

 

[barry351]

to simplyownage/your question what is a bupe ? Bupe is slang - short for buprenorphine the drug in soboxone and subutex.

 

[Shambles]

Or even Suboxone and Subutex

And Temgesic while we're at it.

 

[Captain.Heroin]

this is the kinda stuff i bitched about in my "how i quit so easily thread" im glad other people are realizing that it shouldnt take more than a week or two to quit.

why trade one drug for another? if bupe didnt give withdrawal i'd be more willing to tolerate people that take it for such a long time.

I don't get WD symptoms from buprenorphine. Otherwise I think I probably wouldn't keep using for...years now. It depends on how much you take, really.

Bupe ftw

For real.

I was told that the blocker would have no affect one me, and after trying both I would tend to disagree.

Some people are sensitive to naloxone. It's a rarity.

If you've been tapering lower, I suggest it's that which made you feel better, not switching to the generic.

 

[asouthern]

really hope i wake up feeling manageable in the morning. tonight is my 10th day off hydros (was taking about 300mg a day for the past 6 months and had taken them for another year at a lesser rate maybe 80-100mg daily with a one month sobriety period. no, i did not taper off. from what i've heard and read tapering tends to be pretty successful but i personally don't have the will power to taper.

a friend of mine gave me a few suboxones after i quit hydros that i took for only 3 days (16mg, 8mg, 4mg.. i realize now that these are pretty high doses.)

am i having WDs from the hydros or the suboxone? i understand (now) how strong a drug bupe is and its long half life so it makes sense that i would start WD wednesday, 3 days after my last dose of bupe. but now it has been an entire week since my last sub dose and i'm still struggling quite a bit. yesterday (day 6) was for me by far the worst

i know there are a million better ways to handle coming off of something but that's not really what i'm looking for here.

 

[Broken_LCD]

I haven't read all 4 pages of this so I don't know if this has been said. But I just started on the local Suboxone program. When I was on the waiting list for the program I was buying Subs off the street (8mg) I would use the pill cutter and cut it into 4 pieces and take 2mg in the morning and 2mg at night and I was "fine"... it kept away the withdrawals, still didn't feel 100% though.

Now that I'm on the program I'm on 16mg a day. The day of induction I go to the center early in the morning and had to be in withdrawals. I get the script, fill it, and head back to the center for the day. The nurse cuts the 8mg pill and I am given 4mg every hour until I'm "stable". Every hour I get checked out by a nurse and finally a doctor at the end of the day.

My blood pressure, pulse, mild sweating (that to be honest I didn't even notice) didn't go away until I was hitting around 16mg of Suboxone. Even though I thought I felt okay after I took the first 4mg dose my body was stating otherwise when the nurse would check me out.

I know what I'm trying to say here, just having a hard time conveying it... urg.

Maybe I'm trying to say in my case I can understand why I'm on 16mg. I don't know if anyone else has been in a similar program, I wasn't just prescribed it and sent on my way. Like if they thought 4mg was appropriate then that's what my dosage would be, you know. It's a pretty intense program, compared to what I've done in the past.

Got this card that I have to carry saying I take Bupe and all contact info, folds out and tells docs what to do if I need anesthesia or painkillers too. Got another card from the makers of Suboxone R-B for some free program they offer and you get assigned a coach and support... anyone try this yet?

Mandatory meetings, and drug tests every week thrown in there... not too happy about that, but I'm terribly off subject now.

 

[Captain.Heroin]

really hope i wake up feeling manageable in the morning. tonight is my 10th day off hydros (was taking about 300mg a day for the past 6 months and had taken them for another year at a lesser rate maybe 80-100mg daily with a one month sobriety period. no, i did not taper off. from what i've heard and read tapering tends to be pretty successful but i personally don't have the will power to taper.

a friend of mine gave me a few suboxones after i quit hydros that i took for only 3 days (16mg, 8mg, 4mg.. i realize now that these are pretty high doses.)

am i having WDs from the hydros or the suboxone? i understand (now) how strong a drug bupe is and its long half life so it makes sense that i would start WD wednesday, 3 days after my last dose of bupe. but now it has been an entire week since my last sub dose and i'm still struggling quite a bit. yesterday (day 6) was for me by far the worst

i know there are a million better ways to handle coming off of something but that's not really what i'm looking for here.

Probably the Suboxone, but either way, opiate withdrawal can be prolonged depending on how long you've used for.

You'll begin to feel better within the next week I'm sure. It normally takes 1-2 weeks before you feel "adjusted" in a sense.

Just try to get down to 2mg per day, and then see if it'll last you 2 days instead of 1 when you get down there. Good luck!

I haven't read all 4 pages of this so I don't know if this has been said. But I just started on the local Suboxone program. When I was on the waiting list for the program I was buying Subs off the street (8mg) I would use the pill cutter and cut it into 4 pieces and take 2mg in the morning and 2mg at night and I was "fine"... it kept away the withdrawals, still didn't feel 100% though.

Now that I'm on the program I'm on 16mg a day. The day of induction I go to the center early in the morning and had to be in withdrawals. I get the script, fill it, and head back to the center for the day. The nurse cuts the 8mg pill and I am given 4mg every hour until I'm "stable". Every hour I get checked out by a nurse and finally a doctor at the end of the day.

My blood pressure, pulse, mild sweating (that to be honest I didn't even notice) didn't go away until I was hitting around 16mg of Suboxone. Even though I thought I felt okay after I took the first 4mg dose my body was stating otherwise when the nurse would check me out.

I know what I'm trying to say here, just having a hard time conveying it... urg.

Maybe I'm trying to say in my case I can understand why I'm on 16mg. I don't know if anyone else has been in a similar program, I wasn't just prescribed it and sent on my way. Like if they thought 4mg was appropriate then that's what my dosage would be, you know. It's a pretty intense program, compared to what I've done in the past.

Got this card that I have to carry saying I take Bupe and all contact info, folds out and tells docs what to do if I need anesthesia or painkillers too. Got another card from the makers of Suboxone R-B for some free program they offer and you get assigned a coach and support... anyone try this yet?

Mandatory meetings, and drug tests every week thrown in there... not too happy about that, but I'm terribly off subject now.

You're going to what's commonly referred to an in-patient clinic for ORT (via Suboxone).

If you wanted to, you could abandon that and try to find an out-patient clinic for Suboxone, it's a lot easier and you can dose yourself at home without having to be monitored by doctors, etc.

Some people fare better one way or the other. It's really up to you. Whatever you think will help your recovery out the most.

 

[Broken_LCD]

You're going to what's commonly referred to an in-patient clinic for ORT (via Suboxone).

If you wanted to, you could abandon that and try to find an out-patient clinic for Suboxone, it's a lot easier and you can dose yourself at home without having to be monitored by doctors, etc.

Some people fare better one way or the other. It's really up to you. Whatever you think will help your recovery out the most.

I do get a weeks worth at a time right now, then it goes to bi-weekly, then finally monthly. They only had to watch me for the induction to figure out my dose. They also count the pills too.

It does suck that I have to do a urine test every week and can't take my beloved benzo's anymore but I think I need this strict rigid program to stay in line... as much as I bitch about it. I'm sure I'll get used of it. I'm already starting to like having extra money to buy comic books again. Crazy, the little things taken for granted before. I suppose I will deal if this is the reward

I did call other doctors in the area for bupe but they either had insane waiting lists or didn't accept insurance, only cash. Which is insane to me, I have insurance for a damn reason and you're a doctor... lame, but it's the way it goes. Just happy to finally quit my full time job as junky.

 

[Captain.Heroin]

I do get a weeks worth at a time right now, then it goes to bi-weekly, then finally monthly. They only had to watch me for the induction to figure out my dose. They also count the pills too.

It does suck that I have to do a urine test every week and can't take my beloved benzo's anymore but I think I need this strict rigid program to stay in line... as much as I bitch about it. I'm sure I'll get used of it. I'm already starting to like having extra money to buy comic books again. Crazy, the little things taken for granted before. I suppose I will deal if this is the reward

I did call other doctors in the area for bupe but they either had insane waiting lists or didn't accept insurance, only cash. Which is insane to me, I have insurance for a damn reason and you're a doctor... lame, but it's the way it goes. Just happy to finally quit my full time job as junky.

Congratulations man.

Personally, I would rather use benzos. There's nothing better with buprenorphine than a fine dose of temazepam, or midazolam, or flurazepam.

I also have a lot of stress in my life (that's an understatement) so that may be why. I don't use them too often though and still have a very low benzo tolerance though.

Plus, I shouldn't have to do a UA to get Suboxone. The idea behind Suboxone is you don't just get on it without having previously used opiates...so a UA is pointless. Just my 2 cents.

If it helps you get clean I'm glad it has helped you out!

 

[NCUK]

i definately agree with start out doses are sometimes exagerated in the begining and this can be accounted for in terms of the client or patiant exagerating how high their tollerance is with the intent to get high, most of them are also terribly dope sick at this point... and at least at my clinic there are a lot more people the past 5 years who are getting on meth for a small percocet habit. i myself got on because i had an extreme heroin habit almost 10 years ago. now these people are treating their addiction to oxycodone with a drug "ie methadone" that is much more potent and addictive. more blood work can be taken in the begining by these docters to determine the addicts tolerance level instead of going on the addicts word which is what most clinics do

 

[Broken_LCD]

Congratulations man.

Personally, I would rather use benzos. There's nothing better with buprenorphine than a fine dose of temazepam, or midazolam, or flurazepam.

I also have a lot of stress in my life (that's an understatement) so that may be why. I don't use them too often though and still have a very low benzo tolerance though.

Plus, I shouldn't have to do a UA to get Suboxone. The idea behind Suboxone is you don't just get on it without having previously used opiates...so a UA is pointless. Just my 2 cents.

If it helps you get clean I'm glad it has helped you out!

Thanks!

The doctor had to rework my meds, been prescribed benzo's since I was 16. I have crazy panic attacks and just pass out cold. Sucks so bad. I hear ya with the stress. I run my household since my dad passed, I drive everyone everywhere, groceries, bills, clean house, etc... I'm sure you know exactly

The UA is to check you only have opiates in your system. They catch you with weed (some docs let it go, depends who you get stuck with), benzo's, or cocaine and you're out. I don't agree with it either.

Keep your head up Capt. I know it sounds trite but I'm sure whatever stress you are going through will eventually pass. Been noticing that this year, that just when I think things can't get any worse, I handle the situation and it gets better eventually... only as long as I deal with it head on.

 

[Pegasus]

Now that I'm on the program I'm on 16mg a day. The day of induction I go to the center early in the morning and had to be in withdrawals. I get the script, fill it, and head back to the center for the day. The nurse cuts the 8mg pill and I am given 4mg every hour until I'm "stable". Every hour I get checked out by a nurse and finally a doctor at the end of the day.

My blood pressure, pulse, mild sweating (that to be honest I didn't even notice) didn't go away until I was hitting around 16mg of Suboxone. Even though I thought I felt okay after I took the first 4mg dose my body was stating otherwise when the nurse would check me out.

That's pretty interesting. I think the most interesting thing is that they didn't allow for your input at all. You clearly were fine with 4mg, but they moved you up to 4x that amount anyways... This attitude of going way overboard is exactly what we're talking about in this thread. I'm sure you're getting side effects from that dose that you wouldn't be getting at a lower dose.