Bupe Buprenorphine Withdrawals

[PokePoke]

I was on 24mg of subs a day and personally have never gone through any sort of w/d. Again, this is my from my personal experience. I went from 24mg down to 0 within a day or 2 and felt no difference. If anything my cravings came back stronger with the assumption that they were always there, dormant or not. I think it's person to person and mostly psychological.

 

[Tommyboy]

Back when I first got on suboxone in 2006, i was told it did not cause withdrawals at all.. I have no idea where some of these doctors get that idea, as buprenorphine has been around for quite some time.

Well it's not like they had to learn much about the drug to be certified to prescribe it. Here's the criteria a doctor must meet in order to be allowed to prescribe it, and notice that it says they only have to meet 1 of the following criteria. I'm sure that they got the idea that it doesn't cause bad withdrawals from the good, honest folks at Reckitt Benckiser Pharmaceuticals.
For some reason most sub doctors don't seem to believe anything that their patients say that contadicts what the pharmaceutical reps for suboxone have told them, but also there was a lot less information about suboxone withdrawals back then since it was just starting to gain in popularity around the time you started on it.

I was prescribed suboxone around the same time as you, and even though it has been approved for the treatment of opiate dependency since 2002, it really didn't seem to be prescribed much until around 2008. In 2007 when I would go to any pharmacy to get my prescription filled, they never had the amount I was prescribed in stock, so they would have to order it for me. I had my "system" which was that I went to the doctor a week before my prescription ran out, and then I would drop off the prescription at the pharmacy, and let them know that it was too early for it to be filled, but since they needed to have the prescription in hand before ordering it for me (since it's so expensive they would only order it if I handed them the prescription first) I was just there to drop it off, and to have it filled a week from then. This way I wouldn't get stuck running out and having to withdraw for 3 days waiting for the order to come in, which is what happened the first couple of times I went. That's how I ended up getting the prescription a week before it could be filled since I kept seeing the doctor every 4 weeks even though it had taken longer to get filled those first few times. It was still completely legal what I was doing, I was still getting it filled every 30 days, but my doctors visit was a week before the prescription could be filled which gave me time to have it ordered.

By 2008 though, every pharmacy I went to had a good stock of suboxone, and could fill my prescription on the spot. It amazed me that in 2007 every pharmacist would look at me like I was insane for thinking that they would have anything more than 30 8mg pills in stock, let alone the 120 I was prescribed, but then a year later the same pharmacists were looking at me like "yea, why wouldn't we have this in stock?" when I would ask them at the drop-off window if they had it.

Another indicator for the growing popularity of suboxone is the amount of doctors certified to prescribe it. I didn't look for a doctor when I was put on it since the outpatient program I was court mandated to attend had me see a doctor as part of the intake process, and he happened to be certified and he sold me on the idea of using suboxone to treat my cravings. I had checked the "Doctor Finder" feature on the suboxone website around that time just out of curiosity, and there were less than 20 doctors certified to prescribe suboxone in a 20 mile radius of me. I just checked it now and it has 100 doctors listed in that same 20 mile radius, and I'm sure there are more but the search results just max out at 10 pages with 10 doctors listed per page.

ok couple months ago I take them only weekly but 3 or 4 week ago I'm taking from 5 to 8 a day or something up but the past week one day I couldn't fined some and that was when I was at work and I was filling very sick so I continue taking
now I'm on winter break that I take to get rid of this habit but I don't now how

Since you are on winter break the time to stop is now, so I don't think that tapering is much of an option. Most of the withdrawals are over in 5 days after your last dose of buprenorphine, so I would stop 6 or 7 days before you have to go back to school so that you have the withdrawals over with.

If you don't taper and just stop now, then take some loperamide for a few days after your last dose of buprenorphine. If you can get your hands on clonodine it is helpful for restless legs and calming you down through the withdrawal, or you can get some benzodiazepines for that, but only take them for a couple of days so that you don't become dependent on them. Here is a good guide for how to deal with opiate withdrawal, so I suggest reading through it since pretty much anything that people will tell you can be found in there anyway.

You other option is to taper down even further before stopping, but that can only work if you can get more. If you get down to 1mg then stay on that dose for maybe 5 days and then drop down to .5mg. Take that for 5 days and then drop down to .25mg. You might want to take it every other day, and then every 3 days, and then stop.

There are a lot of different methods of tapering, so that's just one variation of one of them. The general rule is to take just enough to take the withdrawals away, and then continue to try lower and lower doses just to make yourself comfortable.

I was on 24mg of subs a day and personally have never gone through any sort of w/d. Again, this is my from my personal experience. I went from 24mg down to 0 within a day or 2 and felt no difference. If anything my cravings came back stronger with the assumption that they were always there, dormant or not. I think it's person to person and mostly psychological.

How long were you on that dose for? I was on a similar dose, well prescribed 32mg/day but rarely ever took that dose so I usually took 16mg but sometimes more and sometimes less. I did that for 18 months before moving to a place that ended up having one suboxone doctor and he wasn't seeing new patients for 3 months, so in 3 weeks I went from 16-24mg a day down to nothing.

While I agree that it the withdrawals vary from person to person, I wouldn't say that it is mostly psychological. I was in a town where I new I couldn't get any opiates when I kicked suboxone, and the symptoms were very much physical. I lost 25 lbs very quickly from running to the bathroom all the time and not being able to eat, I had restless legs, was sweating a lot, and I was so weak and achy that friends had to walk me to get food, only for me to just stare at the food since I couldn't eat still. The psychological effects were more from the insomnia than anything else, and I didn't have cravings since there was nothing around to crave.

 

[opiatekrzy]

they say 16mg of bupe daily plugs up 97% of your receptors, so therefore that is the ceiling dose which will prevent you from getting any buzz off of opiates. 4mg taken is yeah a blockade dose, but as the hours pass, you stilll can get high off opiates..i have taken 8mg in a day and used heroin later that night, and felt a buzz, not the high, but felt it..was a waste of money..but 8mg is all u really need to avoid getting the high from opiates throughout the dya. 4mg will block the effects for some hours of opiates. 16mg is the official ceiliging dose, 97% they say of ur receptors are used with that much bupe. idk why docs give subs out 4 times a day

 

[Jabberwocky]

Loperamide does not help withdrawl symptoms other than diarrhea. Tagamet is for acid reflux and wont help witdrawl either. My boyfriend came off .05 mg suboxone. And went through pretty moderate withdrawl. Too sick to travel thats for sure.

Really, 0.05mg?! How's he measure that out? It's not that I doubt you, it's just very very rare for someone to actually get that low before jumping off. I mean, 0.25mg is generally more than low enough to ensure minimal w/d effects other than some minor acute and post acute w/d symptoms. It's rather odd that 0.05mg would give him such a problem... I mean, if he had stabilized on 0.05mg, then what do you think gave him such a problem with it? I mean, everyone is affected differently, but still, this is kind of an outlier case.

There is a lot that has to do with what you're w/d feels like from suboxone/bupe. The most important factors are:

1. Dosage amount - 0.50mg-0.25mg is pretty much the gold standard in terms of ideal bupe detoxes
2. Frequency of dosage - as long as you have a low dosage this isn't too big a concern, although some find skipping days along with low dosage to be the most effective
3. Degree of dosage stability - if you've only been on 0.25mg a day or two, and say you dropped down from 2mg to 0.25, your w/d is going to be more like jumping off from 2mg than it will be from 0.25mg, as you haven't given the new dose time to stabilize (generally takes a min of four days to stabilize on a new dose)

Well, in terms of loperamide, haha, which I feel like I've been explain a lot recently, for many people, depending on their dosage, loperamide can do MUCH more than just kill diarrhea. Actually, in my case it has little effect on my GI tract, and dose a lot to get me through w/d without feeling much pain if any at all (then again, I'm generally taking higher dosages than the vast majority of people).

I have also heard the recommendation and read a bit about the research behind the recommended dose of bupe being 16mg/day, but practically speaking I find that cases where people truly need to take more than 8mg/day to be rather few and far between (I am assuming sublingual ROA). Likewise, even 2mg or 4mg (especially if IV) will effective block reasonable dosages of most other opioids for a period of days, so... yea. IME most doctors know less than an educated patient who actually is the one taking the drug...

 

[Dave82]

Suboxone is intended for short term use. With regular use, after a couple of months, there is a fairly high potential for addiction with this drug. So either take sub as a short term measure to get off opiates for good or view it as a long term maintenance program. If you're addicted to sub it can be really difficult tapering off it, particularly when you've been taking it at higher doses. That being said, there are things that can be done to help with the withdrawals and recovery. For more information about suboxone withdrawal click here.

 

[Jabberwocky]

they say 16mg of bupe daily plugs up 97% of your receptors, so therefore that is the ceiling dose which will prevent you from getting any buzz off of opiates. 4mg taken is yeah a blockade dose, but as the hours pass, you stilll can get high off opiates..i have taken 8mg in a day and used heroin later that night, and felt a buzz, not the high, but felt it..was a waste of money..but 8mg is all u really need to avoid getting the high from opiates throughout the dya. 4mg will block the effects for some hours of opiates. 16mg is the official ceiliging dose, 97% they say of ur receptors are used with that much bupe. idk why docs give subs out 4 times a day

Everyone is different. And the "ceiling dose" proper is something like 24mg. The insert just refers to 16mg as the general dose at which suboxone dose what it was intended to best (this is a generalization; does not hold true for me). The bottom line, many doctors don't know a clue about what they're really doing, and everyone is different.

Suboxone is intended for short term use. With regular use, after a couple of months, there is a fairly high potential for addiction with this drug. So either take sub as a short term measure to get off opiates for good or view it as a long term maintenance program. If you're addicted to sub it can be really difficult tapering off it, particularly when you've been taking it at higher doses. That being said, there are things that can be done to help with the withdrawals and recovery. For more information about suboxone withdrawal click here.

Ah-hem, have you heard of suboxone maintenance? Actually I believe the drug was CREATED as a maintenance drug (we're talking the standard recommend 16mg/day dose; read the package insert). But regardless there is no reason to think it was created in mind with only using it to detox patients, even if it does work quite well at such. And addiction to the drug, again for most, generally seems to happen well before "a couple of months" (although certainly it can becomes stronger as time goes on).

One absolutely becomes dependent on the suboxone, addicted if you will, but with a proper taper this doesn't mean really anything. Tapering off a high dose of suboxone, for the vast majority of people, is no much more difficult to tapering off a relatively lower dose (i.e. 4mg), although of course things won't always be the same for everyone. It won't be fun, but it's a HELL of a lot easier than tapering on any full agonist opioid I've ever encountered. Furthermore, it's significantly much harder to get from 4-o.25mg than 24-4mg. Night and day difference.

The point of suboxone maintenance is so that the opioid dependent can go on about with and improving their lives so when the time comes thta they're ready to get off it they will have enough to feel good about and distract themselves with, to put it very simply. This is what, other than the drug's actual mechanism(s) of action, make tapering on suboxone after longer term maintenance significantly easier than after short term maintenance.

The best hospitals and doctors I know of are not happy to "waste" suboxone on someone who just wants to detox, as the real benefits normally come (are generally only possible) with longer term treatment (including suboxone, but therapy as well, etc. etc.).

 

[batmanplaybaseball]

^

Completely disagree. I wouldn't wish suboxone maintenance on anybody. You can improve your life as much as you want while high, or 'maintaining', but two months of withdrawal and recovery is going to set almost all of it back, even in the most strong willed person.

In my opinion, all maintenance is a one step forward, two steps back situation.

 

[tricomb]

The best hospitals and doctors I know of are not happy to "waste" suboxone on someone who just wants to detox, as the real benefits normally come (are generally only possible) with longer term treatment (including suboxone, but therapy as well, etc. etc.).

I don't think suboxone is "wasted" on people who want to use it for rapid-detox. Many people can kick their opiate addiction using a single 8mg suboxone pill, and significantly reduce the violent withdrawals that otherwise would have ensued.

^

Completely disagree. I wouldn't wish suboxone maintenance on anybody. You can improve your life as much as you want while high, or 'maintaining', but two months of withdrawal and recovery is going to set almost all of it back, even in the most strong willed person.

In my opinion, all maintenance is a one step forward, two steps back situation.

This may be how maintenance would affect your life, but for many maintenance is a life saving opportunity and certainly wouldn't call it "two steps back", when "two steps back" for some means death, disease, or prison/institutionalization.

 

[batmanplaybaseball]

I think the most telling statistic would be that the only people you ever hear advocating for maintenance treatments are people who are have either never been on them, or people who are still on them. I have found that people who are currently on maintenance programs are the most vehement advocates for them. It's like they want to convince themselves that what they are doing is fine, even in the face of absolute contradiction. You will almost never find someone who has actually been through methadone or suboxone withdrawal recommending that someone get on these drugs for long-term usage. To me that says just about everything.

Plus, I think if the only thing these drugs are better than is prison or death, then that doesn't say very much in their favor.

 

[xHippiexchildx]

It took me 4 months to get over a 2mg suboxone withdrawal.

I took an opiate for back pain the other night and it brought the fucking PAWS back again.

Gah damn it. FUCK Suboxone. Nothing would please me more but to hear of that drug becoming extinct. At least make Ibogaine legal first so people won't bitch about not having anything to help them quit.

Ibogaine = Instant cure for opiate/meth/alcohol addiction

Suboxone = 5 Years of tapering with a slight chance of withdrawals if you do it exactly right.

Call your local congressman right now and tell them to legalize IBOGAINE.

 

[Jabberwocky]

^As we have been over with you more than once before hippiechild, suboxone clearly didn't work for YOU. Nothing about that means it won't work for others. You have to remember, not everyone is like you. The world is thus a lot bigger than simply you and me (thank god)

Lol you know I don't think bupe's wasted on people who just want to use it to do a rapid detox or something, but I do feel that it was more intended to be used with maintenance/replacement type programs.

^^WTF are you talking about batman? Suboxone maintenance has significantly improved the quality of my life, as it has many others. I am friends with 8 different people who have successfully completed the same program I was on and were able to get off suboxone successfully after different periods of time (3 months, 6 months, 1 year, 1.5 years and 2.5 years). Not one of these people disliked their experience with suboxone. Not one of these people, as they had good MDs and support networks, suffered as a result of their time spent with suboxone. If you actually have a good MD to tell you what to do or plan well for yourself regardless, there is VERY little suffering inherent to w/d during a suboxone taper. Certainly there were ups and downs with their experiences (and mine) with suboxone, but overall it seems to have been an integral part necessary to their recovery.

Suboxone as a maintenance therapy is ONLY ONE part of a recovery program, it can certainly be crucial. Certainly, suboxone and methadone are not for everyone. And even more so, the majority of people (through no fault of their own or their own) on such programs either shouldn't be in the first place or are not using their medication properly (i.e. as a way to focus on other aspects of their lives as their "drug habit" is taken care of). And the most important thing about such drugs, sadly often overlooked, is that taking them is just a start. There is obviously a LOT more to success than just taking a pill.

The first AA freak "doctor" I met didn't even allow me to discuss suboxone as a form of treatment. Instead I was sent of to a series of inpatient rehabs, which essentially forced me to spend all my saving and sell my car to pay for (while the owner of one makes a high six figures salary...), and during which I was molested and traumatized in ways I prefer not to even mention.

Since then I've met some truly good doctors, who listen and allow me to express my wants, needs and goals. Do you know what I'm doing while I take suboxone? Getting my life back together. I'm happier today with my life than I've ever been, even more so than before I started using. And I'm certainly being more successful. Rebuilding relationships, started my own company, spending time with family, etc. etc. Used correctly, suboxone can be, just as AA or rehab can be for others, a god send. As part of a complex program, integrated into a life filled with healthy positive/constructive habits, suboxone has been one of the few things I can say specifically saved my life.

What is the absolute contradiction that I face? What does this say to you? Do you really think the world would be a better place w/d suboxone and methadone maintenance/replacement programs? How has suboxone been worse than prison or death for me?!

Just as has been said to hippiechild, just because it hasn't worked for you, or to your knowledge, does not mean it can't for many, many other people...

And I'd REALLY like to know more about this absolute contradiction I face?!!?

 

[tricomb]

Great posting ^

 

[batmanplaybaseball]

hippiechild followed by toothpastedog...

One person who has gone through suboxone withdrawal and the other who is still taking it...

...

Look toothpaste I'm not trying to target you. I'm not saying that the world would be a better place without these drugs available for people. All I know is that I will personally never recommend them, and that if the question ever arises as to whether they are a good option, I will say no.

 

[Jabberwocky]

My question being: Why?! What is your experience with them? If you're asked where they're a good option for whom?

(I would hope you only mean yourself, for YOU and only you truly have the right to you own wants, needs and desires, and not coerce them upon others, even if they might be your kids or something...)

P.s. You seem to have avoided answering any of my questions. Again, what is this absolute contradiction I face? I'm really not seeing it... I get the feeling you didn't even take the time to read my post. Either that, or you're just as brainwashed and narrow minded as that first AA "doctor" who wouldn't discuss abstinence based approaches to addiction treatments.

Please, prove me wrong. Show me you're not a narrow minded brainwashed drone. I know you're more than this, even if you don't wanna let it show.

And I know you're not targeting me, but frankly given experience with such treatments I can't help but to feel a little bit targeted...

 

[tricomb]

Before I was a chronic pain patient, I used both methadone and buprenorphine to get completely off other opiates. They both worked great and served their purpose. Neither is without flaws, but the benefits far outweigh the drawbacks, although this must be determined on a patient per patient basis.

 

[Jabberwocky]

Before I was a chronic pain patient, I used both methadone and buprenorphine to get completely off other opiates. They both worked great and served their purpose. Neither is without flaws, but the benefits far outweigh the drawbacks, although this must be determined on a patient per patient basis.

yar

we're all different (beautiful) people (freaks)

let that freakflagfly

But anyhoo, because I am on suboxone does that mean I'm not going to do anything but tell you how it's all positive (something I didn't do btw; nothing is perfect). Again, I'd like nothing more but to be proven wrong, and I do mean that, but you (^^) seem significantly more narrow minded than I do here...

 

[batmanplaybaseball]

I'm not saying that the world would be a better place without these drugs available for people.

The contradiction is that these drugs advertise themselves as an alternative to drug use, when they are in fact a drug themselves with consequences which can be even more severe than the drugs they are being taken to substitute.

I really don't want to get into my whole history of opiate use, but I have been through both methadone and suboxone maintenance at different times and at different variations each time. I am currently eight months opiate/anything clean.

These arguments get needlessly tiresome because everyone seems to pull unverifiable people out of the woodwork who support their claims. For this reason I will say simply what I already said, that I will never personally recommend these drugs to anyone and that I will personally say so when given the opportunity so that others know the risks associated. Suboxone is particular in the lack of information people have regarding its consequences. I wish there had been more people like me saying something before I ever started taking it.

 

[tricomb]

What consequences of maintenance or suboxone rapid detox can be more severe than the drugs they are taken to substitute?

I may agree in a few cases, but for the vast majority, I highly doubt it.

 

[batmanplaybaseball]

I have found the withdrawal to have far longer lasting consequences than typical opiates. You don't have to look far to find the testimonials of people who have had the same experience. That is all. I can't prove anything to you obviously.

 

[tricomb]

The withdrawal certainly can cause more consequences than if someone had gone cold turkey off their full agonist of choice, I certainly agree.
However, the risk of this happening is minimized by tapering properly, failure to do so can result in terrible PAWS, as people here on bluelight can attest to.

I agree that more people should be told about what will happen if they fail to taper off properly, or remain at high dosages after induction.