Suboxone dosing PRN

[Effect]

Did I read correctly that your daily habit was 7mgs of oxycodone per day? Sorry for not reading every post if this was cleared up. If so, 2mg of bupe would no doubt have you feeling messed up if you were only used to less than 15mg of oxycodone/day.

 

[rocket808]

The brutal truth is for many people once your addicted to opiates there is no going back to abstinence. I know their isn't for me anyway. Suboxone and methadone give people a chance to live a normal life without the insanity of the black market.

I think people fuck up logically when they put complete abstinence as the goal to get over addiction. The goal should be a fufilling life. If dissolving some shit under my tongue everyday allows that then sign me the fuck up.

The best part is the data backs up maintenance as the best treatment for opiate addiction. People on Suboxone live longer healthier lives then people who use abstinence only based treatment. The mortality difference between the two treatments is striking. That doesn't even get in to the economic costs of having a high percentage of patients who will constantly relapse during abstinence only based treatment.

Its an individual decision. But don't pretend like people on maintenance are doing something wrong or aren't recovering. That's simply not true

CJ, I agree 100%. I hope it didn't sound like I was disparaging buprenorphine maintenance therapy. I owe my life to it, and I will probably be on it until I die because I am an opiate addict. It lets me lead a normal life instead of being a dope fiend, or dead.

My point was that for a <7mg a day habit, 2mg of buprenorphone is an absurdly high dose. If Nayda was taking 7(I'm assuming 7.5, from Perc 7.5/325?) a day, physical withdrawals would be minimal to non-existent. Withdrawal from .25mg of buprenorphine a day is incredibly unpleasant.

At that level of drug use you are physiological addicted, but probably not physically. Something along the lines of congnative behavior therapy might be more appropriate.

 

[rocket808]

Thank you. I feel really really unsure about everything I am doing right now so thanks for saying I am doing great. That kind of support is the antidote to the shame.

Nadya, You are doing great. Easier said than done, but you don't need to feel shame here. No judgement is allowed here. Addiction is chemical, it is an illness, it is not a moral failing. You are doing exactly the right thing. You have recognized the pattern and are seeking treatment, and unlike me you are doing before you destroyed your life. I would urge you to see a doctor who specializes in addiction treatment, who has an extensive history of treating patients with buprenorphine. So few doctors really understand this drug. Also, don't take medical advice from random junkies on the internet

 

[cj]

CJ, I agree 100%. I hope it didn't sound like I was disparaging buprenorphine maintenance therapy. I owe my life to it, and I will probably be on it until I die because I am an opiate addict. It lets me lead a normal life instead of being a dope fiend, or dead.

My point was that for a <7mg a day habit, 2mg of buprenorphone is an absurdly high dose. If Nayda was taking 7(I'm assuming 7.5, from Perc 7.5/325?) a day, physical withdrawals would be minimal to non-existent. Withdrawal from .25mg of buprenorphine a day is incredibly unpleasant.

At that level of drug use you are physiological addicted, but probably not physically. Something along the lines of congnative behavior therapy might be more appropriate.

Oh yeah I agree the doses prescribed for maintenance are absurdly high. Hardly anyone needs over 8mg yet they start everyone at 16mg. I have certainly seen Suboxone turn a small habit into a much larger one

 

[JessFR]

Oh yeah I agree the doses prescribed for maintenance are absurdly high. Hardly anyone needs over 8mg yet they start everyone at 16mg. I have certainly seen Suboxone turn a small habit into a much larger one

Yeah, I tend to think methadone has a similar issue. Not so much with starting doses, for me one of the big problems, the reason methadone didn't work for me for so long is their utter refusal at my original clinic to increase my dose faster or start me on a higher dose.

But the doses people get stable on are a whole other story. Once I went to a clinic that increased my dose properly, I found it quite eye opening how much I actually needed compared to how much many other people I've seen were on. Many of them seemed to wind up on doses much higher than mine dispute having originally had smaller heroin habits.

Many methadone providers are super sensitive about how fast you increase your dose to start with, but so long as you don't miss doses, the sky's the limit.

Now, I'm not saying that they should stop letting people get on high doses, all in all I tend to think the risks of them fucking up trying to predict a suitable ceiling dose is an even bigger problem than increasing people's tolerance, but it was still quite surprising to me how little methadone I needed to how much I might have expected going off other people.

I certainly wouldn't say, at least where I lived, that there was a problem with excessive starting dose. The problem was they wouldn't increase my dose fast enough, so I'd use heroin. And doing shit to make money for heroin would make me miss dosing which would mean I'd remain stuck on a starting dose. So many times I wanted to slap them for telling me how easily I could die if they put me up faster. Which was a total joke. Cause not only did a better clinic do just that, it's just total bullshit with the habit I had. But that was the other issue, they never seemed to believe how much I was using. It's a little hard to blame them, the amount of money I was able to spend at the time was just stupid.

Also most of the staff were just disrespectful assholes. It was quite amusing to me to see how much less security my next clinic had, which I soon realized was because they didn't need as much. People were just much better behaved. And the reason they behaved better was because they respected the staff, and the reason they respected the staff was because the staff showed respect to them.

All that money saved by just not acting like pricks.