Bupe How much suboxone would I need

[opiandy]

I am knocking around the idea of stopping H/Fent. I was on methadone for about 5 years, 2 of which were spent tapering down from 120mg to 20mg. Of course, I relapsed when I got to 20mg and stopped taking methadone altogether.

Fast forward to now and I'm roughly on 1g per day of H/Fent. I am thinking about gogin back to the clinic and getting on suboxone, but I'm afraid they'll do what they did with methadone and start me off on a very low, ineffective dose and I'll feel like shit until I build up.

My question is how much should I be taking as a 46yo male roughly 240lbs, 6', so that I do not experience withdrawals? Will the clinic start me off at a small dose like they did with methadone or do they typically start you off with a sufficient dose? How often do they increase the dose?

If I decide to take anything like Kratom or Imodium AD, does that need to be out of my system before I take the subs?

Any advice is appreciated.

 

[lovemissile66]

Hi. Wow! I am impressed with the methadone taper you experienced. I never went above 30mg and was only on it a couple months, mostly because I just wasn't ready to kick heroin to the curb completely. Also, never liked how I felt on methadone. Having been addicted to dope for almost 2 decades, I've tried to kick with just about everything but Kratom. Suboxone can be a great tool for recovery, also a double-edged sword. Depending on how long you stay on Sub, it can be a difficult to taper. Ask yourself if you have a support system in place, have learned the right tools to reach for when the urge hits to use H.

When Sub was first being prescribed, doctors didn't have a clue how to dose. A doctor only needed to take a brief course (a few weeks) to become certified to prescribe. So initially, it seemed like most patients were started out with the same cookie-cutter dose-TOO HIGH!!!

Sub is powerful stuff. Not in the sense that it gets you high. It really grabs onto the receptors in the brain that opiates have made their home. Thus, when you have determined you want to start Sub, you need to be clear of any opiates/opioids in your system. This is the part that sucks. You have to be in deep withdrawal before that first dose. Otherwise, you run the risk of PWD, which can be hell on earth. I always needed at least 3 days before I could safely start sub.

LOW & SLOW is the key. Sub is powerful, as I previously stated. It's a very individual situation. I knew I didn't want to be on Sub maintenance. I used mine for quick tapers, get through the worst of the withdrawals and then taper down right away. I'm talking about a starting dose of 2mg. If after a couple hours I didn't feel much relief, I would take a 1/4 of a strip and keep dosing like that until I felt better. I never stayed on sub longer than a week.

There will be withdrawal symptoms. No way around it completely but using Sub creates a bit of a softer landing. Also, maybe you want to be on a maintenance dose? Do you feel ready to quit dope this time? It took me years to finally break away. I honestly think I just aged out of using! Also helped that my dealer got locked up and Fentanyl was in the scene. I never enjoyed Fentanyl.

Hope some of this helps you & hopefully, other people will throw their 2 cents in.

Good luck

 

[opiandy]

Thanks for the reply. So I picked up a week's worth of 16mg per day. I was told to start out with a 1/4 of a strip then see how I feel in an hour and go from there. It's been about 26 hours since I used anything last, and I'm not real sure what exactly it was I used last as it wasn't my normal stuff. Drug screen came back positive for fent, methadone, morphine and MDMA, so I don't really know for sure.

I do know that I didn't do much of it, maybe a gram in the last 48 hours. I surprisingly don't feel that bad at the moment. I'm going to try to hold off as long as possible to take the first 1/4 strip of subs.

The doctor did say that if I go into PWD, to wait about 2-3 hours and try again. She said there's two schools of thought on that, one being the aforementioned, and the second being to take more. She advised on the wait a few hours method.

 

[Keif' Richards]

There is no good reason to induct on higher doses of Buprenorphine when it is at all possible to induct with lower dosages. It is not rational if you understand the context. Lower doses of Buprenorphine will produce lower levels of relief, yes, but the lower dosages will likewise mean a Precipitated Withdrawal (PD) of lesser intensity. The only reason someone should be taking 4mg Buprenorphine as their "test dose" is if they have no choice, like they are at a clinic or in a detox where there is no room for change.

I advise to start at 1mg Buprenorphine at the most. For those of you who are using Opioids weaker than Fentanyl, I typically tell you to go even smaller. Take the small dose, wait 30 minutes. Be mindful. You will feel either a small twinge of relief or a small twinge of anxiety/withdrawal. If you experience relief or no effects whatsoever, you take another small, but perhaps slightly larger piece of Buprenorphine and repeat the process.

There is no good reason to go all in on a single dose in which the penalty is a horrendous few hours of extreme withdrawal. You can greatly reduce you chances of this by starting small and working your way up over a few hours.

 

[opiandy]

There is no good reason to induct on higher doses of Buprenorphine when it is at all possible to induct with lower dosages. It is not rational if you understand the context. Lower doses of Buprenorphine will produce lower levels of relief, yes, but the lower dosages will likewise mean a Precipitated Withdrawal (PD) of lesser intensity. The only reason someone should be taking 4mg Buprenorphine as their "test dose" is if they have no choice, like they are at a clinic or in a detox where there is no room for change.

I advise to start at 1mg Buprenorphine at the most. For those of you who are using Opioids weaker than Fentanyl, I typically tell you to go even smaller. Take the small dose, wait 30 minutes. Be mindful. You will feel either a small twinge of relief or a small twinge of anxiety/withdrawal. If you experience relief or no effects whatsoever, you take another small, but perhaps slightly larger piece of Buprenorphine and repeat the process.

There is no good reason to go all in on a single dose in which the penalty is a horrendous few hours of extreme withdrawal. You can greatly reduce you chances of this by starting small and working your way up over a few hours.

Thanks. I guess I was more concerned with how much they would give me to take home over the weekend and I wouldn't be able to go back to the clinic until Monday. Definitely plan to start low. I'm at 29 hours with nothing and only experiencing mild withdrawals.

 

[Pickledlemons]

Hi. Wow! I am impressed with the methadone taper you experienced. I never went above 30mg and was only on it a couple months, mostly because I just wasn't ready to kick heroin to the curb completely. Also, never liked how I felt on methadone. Having been addicted to dope for almost 2 decades, I've tried to kick with just about everything but Kratom. Suboxone can be a great tool for recovery, also a double-edged sword. Depending on how long you stay on Sub, it can be a difficult to taper. Ask yourself if you have a support system in place, have learned the right tools to reach for when the urge hits to use H.

When Sub was first being prescribed, doctors didn't have a clue how to dose. A doctor only needed to take a brief course (a few weeks) to become certified to prescribe. So initially, it seemed like most patients were started out with the same cookie-cutter dose-TOO HIGH!!!

Sub is powerful stuff. Not in the sense that it gets you high. It really grabs onto the receptors in the brain that opiates have made their home. Thus, when you have determined you want to start Sub, you need to be clear of any opiates/opioids in your system. This is the part that sucks. You have to be in deep withdrawal before that first dose. Otherwise, you run the risk of PWD, which can be hell on earth. I always needed at least 3 days before I could safely start sub.

LOW & SLOW is the key. Sub is powerful, as I previously stated. It's a very individual situation. I knew I didn't want to be on Sub maintenance. I used mine for quick tapers, get through the worst of the withdrawals and then taper down right away. I'm talking about a starting dose of 2mg. If after a couple hours I didn't feel much relief, I would take a 1/4 of a strip and keep dosing like that until I felt better. I never stayed on sub longer than a week.

There will be withdrawal symptoms. No way around it completely but using Sub creates a bit of a softer landing. Also, maybe you want to be on a maintenance dose? Do you feel ready to quit dope this time? It took me years to finally break away. I honestly think I just aged out of using! Also helped that my dealer got locked up and Fentanyl was in the scene. I never enjoyed Fentanyl.

Hope some of this helps you & hopefully, other people will throw their 2 cents in.

Good luck

It certainly can. I happened to noticed a long time ago that fent breaks a few of the rules with suboxone, like that it blocks the effects of opioids, it doesn't, it still works. So insanely smart me figured this must mean fent has higher binding affinity and therefore I don't have to worry about precip withdrawal as fentanyl will remain binded and suboxone will grab on whenever the fent decides to leave and no precip withdrawal to worry about. Oh how wrong I was. The experience was so intense I wrote an little essay about it in trip reports because I didn't want to forget what happened, but I didn't realize at the time that the forums get purged every few years or however often the schedule is. So that write up is gone unfortunately.

Still, I remember it being the most uncomfortable I have ever felt in my life. Not just physically, emotionally, I was not expecting it so I was my GFs house when it hit, and she was kinda aware what was going on with me, and I was so ashamed of my actions I was crying. And hallucinating... that seems to be opioid withdrawal effect only I get, its everything else plus it feels like I'm on acid, I'm not kidding, and given the feelings I was experiencing, its an acid trip from hell. I remember trying to take a shower cause they say showers help in withdrawal, well, it didn't in withdrawal this bad, I felt like I was in a storm in the middle of the ocean all alone and it freaked the f out of me. I got the hell out of there. I also seem to randomly remember seeing birds flying around people's heads. I know that sounds delusional, but it wasn't, it felt very psychedelic and not like I took 30 benadryl or something. I was very aware the birds were not actually there.

 

[opiandy]

So at what point should I start taking my first 1mg? I don't feel fantastic right now, but I also don't feel that bad. My stomach is a little upset and I have mild body aches, but zero hot flashes and zero nose running/sneezing, and those are both things that are usually the most intense with my withdrawals. I'm currently 30 hours with nothing but 6mg of Imodium AD and 50mg of Robitussin DXM, both about 19 hours ago.

 

[Johnthevirgo]

I am knocking around the idea of stopping H/Fent. I was on methadone for about 5 years, 2 of which were spent tapering down from 120mg to 20mg. Of course, I relapsed when I got to 20mg and stopped taking methadone altogether.

Fast forward to now and I'm roughly on 1g per day of H/Fent. I am thinking about gogin back to the clinic and getting on suboxone, but I'm afraid they'll do what they did with methadone and start me off on a very low, ineffective dose and I'll feel like shit until I build up.

My question is how much should I be taking as a 46yo male roughly 240lbs, 6', so that I do not experience withdrawals? Will the clinic start me off at a small dose like they did with methadone or do they typically start you off with a sufficient dose? How often do they increase the dose?

If I decide to take anything like Kratom or Imodium AD, does that need to be out of my system before I take the subs?

Any advice is appreciated.

Fuck Imodium, kratom can be helpful if used properly. I’m 55 and got off Suboxone after 17 years before + 3 years of methodone before 6 years of heroin. It’s hard to recall because the longer your on something that more difficult it is for your body and mind to readjust. I remember quitting herion in early days and it was like 4 days of misery and at 2 weeks I would feel good so would have coarse relapse and do the merry go round over and over. Don’t remember it being unbearable or drawn out but always went back. Methadone sucked as I had to go in every morning but I had 4 young kids and had to attempt to stabilize my life. I should mention there was a couple very dangerous years of heroin and cocaine mixed together. I finally went to rehab in 2003 and found a wonderful place in Galax VI which continued methadone which was necessary as I was. Cross addicted to several things and couldnt quit all at once. Best thing I could have done after fighting idea for many many years. Although I keep my opioid habit I was still able to heal and focus on recovery. After leaving I believe I found an wonderful older lady in Baltimore that sold me her take homes for next couple years. This forced and allowed me to taper down to around 40 milligrams a day. I moved back to CO in 2006 and wanted to switch to bufrenorphine. There was one Psychatrist in entire Southwest CO licensed to prescribe. It wasn’t pleasant but as all maintenance drugs you adjust to dose. Put on 24 mg and started an alt medicine regiment to help get better faster. Lots of supplements, acupuncture, meditation, walking then starting a small business that kept me accounted. This went on for 17 years of jumping through hoops to see doctors monthly always paying out of pocket until last 3 years or so. Covid and I had trouble keeping up regiment and my Doctor was flaking in general so I lost him and had to move 6 hours north. Because of Covid you could do 6 months online before bloodwork and drug screening so I started cutting dose and went down to smallest amount feasible. When I stopped completely I used whatever I could except coke, opiates, etc to help. I have to say it was a struggle for at least 6 months. Main withdrawal was restless leg syndrome which I introduced Keaton and homeopathic RLS PILLS TO WHICH HELPED ALOT it was clear I wasn’t getting off 20+ years of opiate use scott free. All I can say it was the most tolerable out of the 3 even though the RLS was a bitch and didn’t sleep well for 6 months before started to lessen. The Kratom use just went down with symptoms until I started forgetting to take so I think it’s magical if used correctly. Never do extracts. I quite anti depressants after this and that was a total bitch and not positive it was right decision. Main thing is circumstances, sick of going every month and still being a slave gave me a resolve. I tend to abuse a drug like crack or opiates or whatever and just make a final decision that I had my chance or privilege to use that drug and zi fucked up and lost that privilege. Therefore I didn’t at least later in life go and try to get it which you can always anywhere. I know I’ve seen some addiction Doctors doing some indicative stuff with the buff. Shot and even. Claiming to be able to help the dirty 30 crew come off a lot easier as normally they have to wait slit longer for introduction of Suboxene. I always hated being a slave and still do. I have hardest one left to take as psychiatrist in 2006 put me on Xanax without me even asking and I am preparing to do a long taper as soon as life becomes less stressful. Long winded but I hope this gives you one persons take on their experience. Drugs aren’t bad what people choose to do with them are. “Chocolate to Morphine” Book by Andrew Weil I’ve had for 30 years. There is an endless amount of info on here, harm reduction sites and you tube. I’m not at all against microdosing or use of psychedelics if it help to save your life which is what’s at stake. Peace and keep up the good fight every moment every day. Johnthevirgo