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Suboxone Dosing

M

messageoftheday

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May 5, 2017
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Hello everyone. This is my first post although I have been around this and many other communities in similar veins for a long time. I have an extensive drug use history ~ I wrote a list of the chemicals I have done that I can remember and hit 110. The list is currently posted up on my wall to remind myself I have done enough.

I have been to rehab 4 times in the last year (and a 2 week stint of bouncing around mental institutions) after a massive overdose and trying to get clean. I had accidentally consumed 50g of dissociative and had to cold turkey detox phenibut/diclazepam/kratom in a mental ward. But... Every time like clockwork, I make it to a month clean, and I relapse. I simply feel I flat out cannot function without chemical assistance. I feel a deep, deep pain in my body to be entirely clean and abstaining. After watching myself throw everything I had into the fire yet again, at the risk of losing my only place to go and relapsing again just to feel OK I decided it was time to look into chemical maintenance therapy. I decided to go on suboxone rather than methadone because of it's partial agonist property.

I still go to meetings every day.

I found myself a doctor and I was put on 8mg 3x a day. I am very aware that so many people advocate 2mg doses rather than anything especially over 4mg. I also am aware that one should be able to go with dosing once a day, not multiple times a day.

But I know there are always exceptions to opinion and so I wanted to ask if I could dose even more often, at smaller doses. I only feel relief from the suboxone for a couple of hours. I do not go into withdrawal or anything, but I start to feel edgy, anxious/depressed and negative/lost again after a few hours of a dose.

I was wondering instead of dosing 8mg 3x a day, if I could dose 4mg 6x a day. Would the doses lose total effectiveness, or would they still be noticeably active?

So far suboxone has felt like a life saver. I do not feel intoxicated, I feel OK. Maybe I can describe it for me like diet kratom. I do not get strong effects from the medicine, and euphoria is not there. But I feel centered, strong, willing to take on life again. I feel like what I always imagined normal people to feel like. I will likely be seeking 'permanent' (long term) maintenance rather than a taper.

Anyway ~ I am looking forward to what people think about the odd dosing regimen.

Thank you.
 
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Welcome to BL/SL!

24mg/day of buprenorpbine is a very high dose of buprenorphine. Why are you taking such a high dose?

Fact of the matter is that you are taking so much buprenorphine that I highly doubt you'd notice much of a difference between dosing 8mg three times a day versus 4mg six times a day. Everyone is different though, so you will be best off experimenting a little with your own dosing schedule to see what works best for you.
 
To be honest, I am not sure. My doc was terrible ~ he came close to not even speaking with me. I was the only patient in the building and he acted like he had much better things to do with his time lol. He was in the room for 2 minutes, left abruptly and came back with the script. He didn't go over the doseage, or anything about the medicine. When I first saw it, I saw it was 21 doses and assumed it was for 3 weeks, only to be REALLY surprised when I was looking at it closer in the car, when I learned it was for 1 week. That reminds me, I have to call him after I type this because he wrote me a 1 week script, but sees me in two weeks. So I need to call and find out what the deal is with that.

Previous to the prescription I was holding myself off with 20g kratom 3x a day. I had however managed about 5 days clean before I saw the doctor. 8mg 3x a day honestly feels like the perfect amount for me. I am not stoned or in bliss or nauseated whatsoever, I just feel extremely stable, something I am so very grateful for. The medicine seems to wear off on me pretty quickly though, which is why I was wondering about the 6x half-dosing possibility.

Thank you for the kind welcome and the response TPD. :) Now to call the doctor.
 
What kind of habit did you have before you got on the buprenorphine? In other words, what opioids have you been using, how long have you been using them and what is your average or preferred dose?

For those whom buprenorphine works well for, there really isn't much reason to take more than 8-12mg/day at most (and even then, that is a fairly high dose). Most people who are able to do well on buprenorphine seem to do best on 2-4mg once to twice a day, or 8mg once a day.

I'd strongly recommend trying to reduce your dosage to the lowest dose that holds you comfortably. You will need to experiment a bit with your dosing to find the schedule and amount that works best for you.

If you are taking the strips, use an ethanol based mouthwash (like Listerine) before you put it under your tongue. It will make it dissolve like butter on a hot pan, much faster than normal, and increase the bioavailability of the dose (making it a tad more effective).
 
For these I have used Oxycontin, methadone, heroin, acetylfentanyl, vicodin, u-47700, mt-45, ah-7921, tramadol, desmethyltramadol, tianeptine (id dose 1g at a time) and kratom. Honestly my preferred habbit was kratom and was my most common run with opioids because it was much more manageable and I found it to be the most enjoyable besides heroin. I would usually go through 4oz/day at least though. When I was using oxycontin it was 160mg/day. But I preferred kratom in high doses.

Thank you for the suggestions. I will definitely keep it in mind. Its just the current dosage works so well for me, which is odd, because I always read about how 2mg is really the optimum dose effect-wise. The effect I feel at 8mg is minimal, but just enough to keep me perfectly stable in a way I am very pleased with. So I feel an aversion to trying to go down, maybe at least yet. Ive had a really rough year and its so good to feel stability ~ something I have not had in a long long time.

I will certainly look into the ethanol mouthwash, thank you for the reminder, I had read about that. I spent forever reading the main suboxone megathread before I had my appointment :p
 
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It's only a matter on a little bit of on going experimentation playing around with how you dose yourself, the while keeping some awareness as to how the way you dose affects your mood state and behavior.

Ultimately the dose that works best for you will be specific to you; just like no two of us are totally alike, the dose that ends up working best for any individual is ultimately defined by their needs in specific and particular needs.

How long has it been since you start regularly using opioid type substances? Not really necessary info anymore, as it seems like most of your question has been answered, but who knows. It may be useful in terms of triggering a viewer to mention something you end up finding helpful that they wouldn't have otherwise :)
 
The dose and the frequency are both fairly irresponsible for a chemical that has a half-life of 37 hours. I think the effect of putting the strip in your mouth (or pill under your tongue) is providing you more of that "ease and comfort" than the actual chemical and that is why after a couple hours it "wears off" and you get anxious. Bupe is not "wearing off" in a couple of hours. The idea of the bupe is "wearing off". If bupe didn't have a ceiling serum level you would already be pushing up daisies. Unfortunately, many bupe pushing doctors are uneducated and irresponsible because they can afford to be. Some are only prescribing bupe so they can appease the suddenly hyper-vigilant DEA. Their clientele is cut from the same cloth and their clientele needs them rather than the converse. I do wish you the best as crafting your own dosing schedule is a dangerous game. At least in the short run bupe is more benign then the alternatives. It will be interesting to see what a detox from bupe is like with a super frequent dosing schedule. I am guessing cycle and increasing waves of withdrawals.
 
If they are still taking the same amount of the medication throughout the day, I doubt a more frequent dosing schedule will have much impact any particular way (this was my experience with experimenting with it).

messageoftheday said:
For these I have used Oxycontin, methadone, heroin, acetylfentanyl, vicodin, u-47700, mt-45, ah-7921, tramadol, desmethyltramadol, tianeptine (id dose 1g at a time) and kratom. Honestly my preferred habbit was kratom and was my most common run with opioids because it was much more manageable and I found it to be the most enjoyable besides heroin. I would usually go through 4oz/day at least though. When I was using oxycontin it was 160mg/day. But I preferred kratom in high doses.

Thank you for the suggestions. I will definitely keep it in mind. Its just the current dosage works so well for me, which is odd, because I always read about how 2mg is really the optimum dose effect-wise. The effect I feel at 8mg is minimal, but just enough to keep me perfectly stable in a way I am very pleased with. So I feel an aversion to trying to go down, maybe at least yet. Ive had a really rough year and its so good to feel stability ~ something I have not had in a long long time.

I will certainly look into the ethanol mouthwash, thank you for the reminder, I had read about that. I spent forever reading the main suboxone megathread before I had my appointment :p
Click to expand...

How are you doing OP, have you been finding anything that works better for you?
 
Here's a quick response to your question. Yes, you can split the dosage up. That's what I do. For me, I'm trying to take the least amount that I have to because one day I want to get off but also because for me I would rather have a little left for later and sometimes that full pill on an empty stomach would both me. I work long hours and stay up for 2 days at a time because of work so for me breaking them down helps give me that boost later without taking more than I really should. It is perfectly okay to do that. But on the downside. Of you take a to small of an amount, it may backfire where you will want or need more later to get it to work effectively. But what I mean by that is, I am down to 1 a day. So sometimes I will take less than a quarter for my first dose and then shortly later may end up needing a bigger dose to feel right. But if I take a half of one to start and then break up the others half later im typically good. So basically for me a quarter for my first dose of an 8mg or taking smaller pieces of a quarter at later times may sometimes not work effectively. Quite possibly be in my head but that how I feel anyway. But if you are prescribed 3 8mg daily taking a half at a time should work for you especially if you have been on it for a week or two.

And to answer the last reply to you regarding your dosage and how high it is, it's really not and a typical dose that many doctors start you out on. While 8mg 3x daily is a high dose it is not high when you are first placed on the medication. When I first went onto suboxone I had a very strict, by the book, check everything get around nothing kind of physician and he also initially prescribed me on 8mg 3x a day. I was taking Lortabs prior (heavily taking them) and was heading down a super destructive road when I realized the stuff I give to my patients at the hospital is the best euphoria you could ever have. It got out of hand pretty quick and i seeked for help immediately in order to save my ass, my future and career. Anyhow, the physician did not push me to taper at all from that first script but I did on my own.

Suboxone saved my life and am thankful but now wish I could get off it. When I first waited until 2pm to take the medication for th3 first time, I was in the beginning of withdrawels. I remember expecting to feel hell at least for a few weeks even with the medication. Well, I took it and low and behold full blown withdrawals didn't come and the symptoms I did have subsided after 30 minutes. For the first week, I did take 3 a day and then I believe within the 2nd week I was down to 2. I don't know if it had to do with anything with me working for 12 hours and it was hard for me to take that 3rd pill because they are sublingual (and I damn sure didn't want anyone knowing at my job what I was on or taking- none of their nosey business). But I was perfectly fine on 2 pills for I think as fast as the 2nd or 3rd week. By the 4th to 8th week (can't really r3member but was fairly quick) I was down to 1 a day. A couple months later I was even down to only a half a day. But then my life for screwed up again and now I am back to 1 a day and feeling I need more. Honestly, i,think it has to do with the brand of pill though.,i don't care what those pharmacist say about them being the same, they are NOT. Not to mention, a pharmacist should be aware that a non-name brand medication is only required to have I think 53% of the medication in it. I know it's around 50%. Crazy. So this mess about they being the same is not the same.

Also, another top. Persobally, I ABSOLUTELY HATE THE TASTE OF THEM that is of course if I am withdrawing ... But anyhow. I know your not suppose to techinically drink anything when you take it but typically i put under my tongue with a tiny bit of sweet tea to help the taste because my mouth fills with saliva and such anyway. I try to keep the medication in my mouth for AT LEAST 15 minutes if I'm in a hurry but if not I leave in for 30 minutes. May also be in my head but I feel that the medication works better if left in longer . it makes sense though because even after 30 min you can still taste the medication so obviously it hasn't all absorbed I would assume . anyhow. Just don't swallow because it does not work because of its first pass .

Good luck. If you ahev any other questions just ask. Oh and if 3 work for you then keep them at 3 !! Don't feel because I was down that you have be. Oh and even when I was downt o 1 a day I didn't tell my doctor because I wanted to be sure in bad extra. Now that I had to find a. New doctor because mine required I screwed up (my pride and shame) got the best of me and told them I am on on my 1 a day which is what I get now. So now this assh9me doctor just leaves on a whim without calling you or leaving you anything to leave town and suffered last week without any. I was so fucking pissed. Now this week I have to leave town for my dad having a transplantand they won't fill them early and they won't fill them across state line as far as I know either . so really my suggestion to you is get more than what you take to put away for emergency if you can manage to set them aside and not take because I wouldn't be so screwed now had I not told them the trust ugh. So pissed. Probably why I'm searching these forums again lol.

Good luck
Sorry for long post
 
Why do you say that captain? I don't see much benefit to dosing multiple times a day particularly if you are taking 8mg or more.

I did however find dosing twice a day as I went from 12mg to 8mg (once a day) to 4mg to 2mg twice a day to be very helpful. Taking lower dosages twice a day actually seemed to work far better than a larger dose once a day (or twice a day for that matter, as I always found buprenorphine to be more agonist-like a lower dosages). I have heard many similar stories from people about this.
 
I will have to pull up a study later - it implied 1x/ day bupe or 2-3x/ day methadone was preferable as it repressed dopamine receptors less

Quite unfortunate as methadone normally is given 1x/ day
 
My dose ended up so high (32mg) because I was still waking up sick so they just kept upping it to no avail. As soon as I started splitting it (someone on a forum suggested this) I was a lot better and therefore could have stayed lower. Some people metabolise opioids differently (there is some blood test that proves this) so yeah, there are exceptions. I would take it in 2 or 3 doses per day.

I have just swapped to methadone and finding it a lot better (for me). Best of luck.
 
I am now scripted 16mg. I am excited that my recent flare-up of spinal nerve pain is subsiding (hehe), but this leaves me with a choice: should I remain at this new increased dose which was for the break-through pain? Return to my old dose of 10? Or follow through with my brilliant idea of tapering down to 4mg, even as far as 2mg to see if analgesia is better like they say??
It feels so good to have the relaxed analgesia of 14-16mg. But might this too disappear, like happened over time with taking 10mg? Something tells me to stay at the elevated dose tbph.

My god it would have been terrible to have allowed my pain to push me into surgery, heroin, or the methadone clinic (methadone can kill some nerve pain son!). I spent the last month shut in the house growing depressed as fuck. I could not be upright. Today I jumping for joy as the pain disappears!

OP: Dosing 6 times a day is too much! It will cause you to not drink enough water, and dehydration ruins any type of good feeling, lol!
4 times max.
 
I'm actually on the monthly subcutaneous injection because I am a fucking dickhead and I think 8 months 3 times over is a substantial enough time to fix a long term opiate dependency.

I hate daily dosing and end up resenting the chemist pickups and the stigma.

I also misused the strips by shooting, smoking and snorting them to no effect.

And I skipped doses to use.

All up the injection has changed my life. I haven't even had a passing thought of using opiates in a year and this has been my longest time in treatment.

I'm also not chained to a chemist and I can holiday wherever I want.

It is a miracle.
 
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