So I'm on 28mg Suboxone a day, and it's a pretty insane dose.
I've been on that dose for over a year now, and don't know what to think.
I kind of take all 3 strips at once. Usually in the morning before work, or sometimes I'll sleep in and take the 3 strips after 11am or maybe later.
I don't know what normal is anymore. I deal with hotsweats and hot flashes out of this world and those can be fucking miserable. Especially when I'm like working with customers and BAM hot sweats.
I want to step down but I'm afraid. I'm afraid because theres times where I'll take a 4th strip later in the day, and I just don't know.
I'm just writing this because I feel like I'm at a point where I can't step down because of the dose I take. I hate being on this shit like having to doordash or struggle just to get the $ to cover the pharmacy tab.
Just struggling with this shit. Does anyone have recommendations when dealing with hot flashes? Like is there something i can discuss with my doctor on something else that can help? I'm afraid he might step me down because I'm on a high dose, but I don't want to.. i do but I don't want to be told that I have too.
I'm also interested in Sublacade, I don't want to experience any WDs because that shit scares me. Like to jump from 28+ mg a day is like super frightening, so I'm worried I'm to about if the max dose of Sublacade would even work for me.
Just kind of sharing my experience with Suboxone. It's kept me off opioids which is good.
Honestly, your biggest problem is you're taking an insanely high dose.
You could probably halve that dose in a day & still feel fine. This is because of how buprenorphine works.
Buprenorphine has a ceiling effect, where once you reach a certain dose in your body, it stops working or doing anything. This can make you feel like you're just constantly in withdrawal & aren't getting any craving relief or anything. And since it takes 30-60hrs for half the dose of buprenorphine you took to leave your body, it builds up to the ceiling effect pretty darn quickly. At the ceiling dose, all of your receptors are completely covered.
There's honestly not much point to keeping people on 16mg+ of buprenorphine a day. The reason doctors put people on these insanely high doses is because
A) The higher doses are more effective at blocking full agonist opioids, so if you relapse, you won't feel it. But lower doses of buprenorphine can actually work in tandem with full agonists, as long as you have receptors open for the full agonist to attach to. And
B) Doctors don't want their patients to realize that they might actually feel a "high" (however mild it is) on the lower doses, versus the higher doses. This is because on lower doses, you will have receptors still open when you go to dose again & this will cause some effects.
So with that in mind, there's no real need to be on 28mg for over a year. It might be needed in the beginning when some one's coming off of a full agonist, but after a year, there's not much point. You could easily be maintained & feel better on a lower dose. Trust me, you're not going to have some "severe withdrawals" or anything by taking a little less. It'll be almost imperceptible due to bupe's long half.
I don't see why anyone would WANT to be on 28mg a day, especially if it's giving them hot flashes & problems. You'd have less hot flashes on lower doses most likely, so is that not worth trying a lower dose?
I once took 100mg of buprenorphine in desperation once to see if it would help my pain any better or anything. And absolutely nothing happened except that I felt really weird mentally for 3 days & became severely constipated like I had swallowed a handful of loperamide or something.
Personally, I have never gotten any "better" or increased effect by taking more than 8-16mg a day. Thinking you
NEED more than that, especially when you're not coming off of full agonists, seems more like a psychological thing rather than truly needing it.
Buprenorphine gets used for pain in people with no tolerance with doses as low as 75 MICROgrams. If 75mcg is enough to cause an effect in a human being, think about how absurdly high of a dose 28mg is.
Buprenorphine dosing works pretty much the opposite of other full agonists. The more buprenorphine you take, after a certain point, will not do anything else & can actually make you feel worse.