Bupe: The Less Is More Myth Exposed

[Tchort]

The harm is not in giving your opinion based on experience. There is no problem with you telling someone they may be dosing too high because based on your experience etc etc. The problem is when this opinion gets taken too far and is touted as fact with blanket statements being made by multiple people reinforcing these incorrect statements. This gives the impression that the answer being given by multiple different people is correct based on how many people say it is true.

I already said what the harm is:

I am not advocating higher doses of Buprenorphine, I am advocating the facts. To make recommendations to people, that people often do take literally especially when more than one person gives the same advice, based on incorrect informations is highly irresponsible. Especially when harm-reduction is the goal. Relapse and continued use of narcotics is pretty widespread from self reports and reports from Bupe doctors- often because of how the BMT system is regulating and the lax policies surrounding its use in maintenance. People who try to stay abstinent may indeed need a dose increase instead of a dose reduction. When they take away from a site like this where they ask for advice that they need to lower their dose, they probably will: What happens to that person when the lower dose does no better or does worse for them than the original dose? Anyone want to take responsibility for giving bad advice when someone relapses or overdoses?

We don't know what happens to people who ask these questions unless they report back. Look how many people who posted here are dead in the BL shrine. We can't afford to pretend opinions are fact when people put trust, for right or wrong, in what we as a whole advise them.

In the past I would post the following excerpt from the Suboxone prescribing guide as proof against this theory and set of ideas, because it states plainly that Buprenorphine has additional agonist effect in increasing doses at least up to 32mg based on the tests/studies done.

From the Suboxone prescribing insert:

Clinical Pharmacology
Subjective Effects:

Comparisons of buprenorphine with full agonists such as methadone and hydromorphone suggest that sublingual buprenorphine produces typical opioid agonist effects which are limited by a ceiling effect.

In non-dependent subjects, acute sublingual doses of SUBOXONE tablets produced opioid agonist effects, which reached a maximum between doses of 8 mg and 16mg of SUBUTEX. The effects of 16mg SUBOXONE were similar to those produced by 16mg SUBUTEX (buprenorphine alone).

Opioid agonist ceiling effects were also observed in a double-blind, parallel group, dose ranging comparison of single doses of buprenorphine sublingual solution (1, 2, 4, 8, 16, or 32 mg), placebo, and a full agonist control at various doses. The treatments were given in ascending dose order at intervals of at least one week to 16 opioid-experienced, non-dependent subjects. Both drugs produced typical opioid agonist effects. For all the measures for which the drugs produced an effect, buprenorphine produced a dose-related response but, in each case, there was a dose that produced no further effect. In contrast, the highest dose of the full agonist control always produced the greatest effects. Agonist objective rating scores remained elevated for the higher doses of buprenorphine (8-32 mg) longer than for the lower doses and did not return to baseline until 48 hours after drug administrations. The onset of effects appeared more rapidly with buprenorphine than with the full agonist control, with most doses nearing peak effect after 100 minutes for buprenorphine compared to 150 minutes for the full agonist control.

http://www.suboxone.com/pdfs/SuboxonePI.pdf

Another thread where this theory is spread as gospel to people with a question seeking answers:

http://www.bluelight.ru/vb/showthread.php?t=413346&highlight=suboxone+prescribing+insert

The entire purpose of this thread is to help do the job it was created for: propogate and advocate harm reduction philosophy. In my opinion, part of harm reduction is access to free and accurate information as well as subjective experience reports. Statements like, "there is no benefit to doses over 8mg on Bupe" and "24mg is a huge dose it is ridiculous you do not need that much" etc go against the science, the prescribing guide, the information given out by the company that makes and markets the Buprenorphine products, the inventors of the protocol for BMT, etc

A bigger harm than the chance of people following incorrect information which may lead to bigger consequences like OD or relapse, is that allowing one example of incorrect information to take root and spread on BL leads the door open for more inaccurate, unfounded or flat out untrue claims to be made and never disputed- which could lead to bigger individual consequences depending on the subject. Facts are facts, opinions are opinions. I want to keep it that way.

 

[Cane2theLeft]

Tchort, as always you're doing a great job spreading accurate information and you have gone to great lengths to find the truth and its so respectable. I have learned SO much from your posts here on bluelight.

I read a long time ago that people have trouble not seeing their experiences as inviolable truth and this is so evident here. People take their experience which they consciously or subconsciously think apply to most or all people, see other people touting the same views and that just reinforces their beliefs so they feel justified in spreading them with even more certainty and using even more definitive language.

If you pay attention, you can watch the progression on this board of people making experiential claims than gradually become fact through unchecked repetition.

Bluelight at its best is a unique source for just about anything you'd want to know about drugs from a harm reduction perspective, however at its worst its merely junkies playing telephone. Its great that there are people like you here to cut the phone cord and spread truth.

thanks

 

[Johnny blue]

So what does you quoting me saying "24 could be too much" have to do with this? That is my opinion and a lot of the quotes you used as example are along the same lines. Where is the harm in someone saying you can get by on less?

 

[garuda]

When I was investigating bupe programs I talked to a few physicians, and described my small habit. IF they didn't discount me straight off they said I would be started on 8-16mg a day, but I never ended up doing it because of the cost.

Then when I tried subutex .5mg held me just fine.

So for those with small habits and low tolerances suboxone programs start them out at much too high of a dose.

 

[Cane2theLeft]

So what does you quoting me saying "24 could be too much" have to do with this? That is my opinion and a lot of the quotes you used as example are along the same lines. Where is the harm in someone saying you can get by on less?

Telling someone they are using too much could be detrimental, he THOROUGHLY demonstrated that some people DO need more and having all these people telling them they are using too much could lead to them LISTENING to them, using less and it being insufficient leading them to relapse or just feel like shit because the lower levels aren't holding them.

Less is good for YOU, some people need more and I don't see any reason why you should say or think someone is on too much... do you know how they respond to suboxone? have you felt what they felt?

As T said, its great to share your opinion but don't assume that applies to other people. Share your experience as YOUR experience and accept that some people need less and some need more.

 

[Johnny blue]

Telling someone they are using too much could be detrimental, he THOROUGHLY demonstrated that some people DO need more and having all these people telling them they are using too much could lead to them LISTENING to them, using less and it being insufficient leading them to relapse or just feel like shit because the lower levels aren't holding them.

Less is good for YOU, some people need more and I don't see any reason why you should say or think someone is on too much... do you know how they respond to suboxone? have you felt what they felt?

As T said, its great to share your opinion but don't assume that applies to other people. Share your experience as YOUR experience and accept that some people need less and some need more.

Dude was I talking to you? Have you read this thread? When did I tout anything as fact?

 

[Johnny blue]

For those just joining us like C2L here I've already said some need it. Hell I've even said if you can follow your doctor's schedule you should. What I'm asking is how is my Tchort quoting me saying "could" get by on less touting anything as fact.

Contrary to Cain's belief I think that most of Tchort's post outlining examples contradicts his entire point. I appreciate the work done in the thread but if I'm going to be made an example of I should be able to defend myself without having someone that obviously hasn't read through the thread butting in.

 

[chrisinabox]

Telling someone they are using too much could be detrimental, he THOROUGHLY demonstrated that some people DO need more and having all these people telling them they are using too much could lead to them LISTENING to them, using less and it being insufficient leading them to relapse or just feel like shit because the lower levels aren't holding them.

Less is good for YOU, some people need more and I don't see any reason why you should say or think someone is on too much... do you know how they respond to suboxone? have you felt what they felt?

As T said, its great to share your opinion but don't assume that applies to other people. Share your experience as YOUR experience and accept that some people need less and some need more.

dude read the entire thread, tchort already said what you did. he said ppl taking less and it being not quite enough might "relapse" or "od". i don't believe this. if someone mentioned to me to take less and it didn't work. guess what? i would just take more until it was enough!

usually when people talk about harm reduction and stuff, they say to never tell someone to take more of a drug cause they could od or something. but in this case, we are recommending to people that they try taking less and we are getting talked to like we are endangering peoples lives. i just find that kind of weird. i DO NOT see how i am stating anything as FACT, at all.

For those just joining us like C2L here I've already said some need it. Hell I've even said if you can follow your doctor's schedule you should. What I'm asking is how is my Tchort quoting me saying "could" get by on less touting anything as fact.

Contrary to Cain's belief I think that most of Tchort's post outlining examples contradicts his entire point. I appreciate the work done in the thread but if I'm going to be made an example of I should be able to defend myself without having someone that obviously hasn't read through the thread butting in.

ya man, it seems that its you and me that they keep talking about as touting this stuff as fact. i gone over the stuff i've written and not once have i said it was fact. all of it was me stating my opinion and my experiences and recommending that they try taking less. what is the harm in that?

they also keep saying when we say something and then other people say the same thing as us, that we are spreading it as fact? its not my fault if other people agree about the less is more thing with me. i can't help it if people actually are getting better results sometimes from lower amounts.

 

[Cane2theLeft]

For those just joining us like C2L here I've already said some need it. Hell I've even said if you can follow your doctor's schedule you should. What I'm asking is how is my Tchort quoting me saying "could" get by on less touting anything as fact.

Contrary to Cain's belief I think that most of Tchort's post outlining examples contradicts his entire point. I appreciate the work done in the thread but if I'm going to be made an example of I should be able to defend myself without having someone that obviously hasn't read through the thread butting in.

I see what you're saying, but I have been following the whole thread since he first posted this and I was simply reiterating some of what he way saying.

Harm reduction is my primary focus and advising people to take lower amounts in most cases is beneficial, in fact life saving at times. With buprenorphine, as has been demonstrated, sometimes people need more. I have seen many cases where people realized that they can be taking less and that is often beneficial. In cases where people DO need more, if they have people telling them repeatedly that they take too much, it can be detrimental for THEM.

I'm not saying you guys (Johnny or Chris) are saying anything as fact and I'm really not trying to attack anyone, I was just responding, so this whole adversarial, exclusionary tone and statements are really unnecessary. This is a community and I just want to share information and participate in discussion. All I want is to spread correct information with the aim of harm reduction. I'm not trying to attack or offend or anything and I apologize if it was taken that way.

 

[streezy]

I truly believe in the "Less is more" bupe statement.

I had a 240mg oxycodone/5 bags of h habit a day, and 1-2mg of bupe would do just as good for me as 8-16mg of bupe would.

 

[Johnny blue]

I see what you're saying, but I have been following the whole thread since he first posted this and I was simply reiterating some of what he way saying.

Harm reduction is my primary focus and advising people to take lower amounts in most cases is beneficial, in fact life saving at times. With buprenorphine, as has been demonstrated, sometimes people need more. I have seen many cases where people realized that they can be taking less and that is often beneficial. In cases where people DO need more, if they have people telling them repeatedly that they take too much, it can be detrimental for THEM.

I'm not saying you guys (Johnny or Chris) are saying anything as fact and I'm really not trying to attack anyone, I was just responding, so this whole adversarial, exclusionary tone and statements are really unnecessary. This is a community and I just want to share information and participate in discussion. All I want is to spread correct information with the aim of harm reduction. I'm not trying to attack or offend or anything and I apologize if it was taken that way.

There is nothing wrong with telling someone that they can TRY a lower dose. Christina and I have been saying this the whole time, TRY. I'm very selective in suggesting this or not, thanks. I'm plenty smart enough to know when it is and isn't appropriate as are most bluelighters.

The post you responded to was in defense of my self. A bit pretentious to reiterate or even speak for Tchort. Keep your half hearted apology. I know you think you're too smart to be wrong anyway.

Anyways... Cristina, I agree. I don't get how making "I" statements is professing fact. I also agree that bluelighters can figure out if they need more on their own. There is little to no chance of relapse because quite simply in order to take less you must already have more to fall back on. I thought people here had personal accountability.

 

[chrisinabox]

^i agree. but one thing, my BL name is: ChrisInABox, not christinabox,christina,etc... its not a big deal though, you would be surprised at how often people mis-read that name. but its Chris In A Box. i am a guy, not a female named "christina". i really wish i could change my name and put spaces in between. lol.

 

[Johnny blue]

Sorry bro.

 

[Tchort]

The reason I did not post names to along with quotes is because I was not paying attention to them. I don't care who said what.

I'm not trying to put anyone on the spot, I don't care who is doing it. I'm interested in whats being posted, not going after who posts it, as I know that the intentions are good behind all of these posts.

Since you have put yourself on the spot, and won't let it go as if I'm singling you out, heres your answer.

To start, a blatent example of you spreading this misinformation directly:

You Johnny Blue said:

2-4 mg is way too much. I take 2 mg with a 120-150mg a day habit. You'd be a lot safer to use as little as possible which I believe is what is recommended in the mega thread. Some days even .5mg insuffalated does the trick all day and I still think that with such a small habit you should go cold turkey to prevent suboxone addiction especially if you are gonna be doing 4mg which is too much for me but YMMV.

In response to this statement:

Originally Posted by saveyour
starting dose should be 2-4mg (thats half an orange pill or the smaller dose comes in its own version) and should be taken about a day or two after the person has stopped taking their normal doses.

the higher tolerance to oxycodone the more suboxone you'll need to get yourself into maintenance. so 20-40mg might only need 4mg but someone taking 300mg will probably need like 32mg initally before tapering down

as for oxycodone to suboxone i dont know if there is direct equialency but they are both opiates so maybe someone else knows gday

Here:

http://www.bluelight.ru/vb/showthread.php?t=395580&page=19

An example of advice that goes against the available literature on Buprenorphine prescribing for opioid addiction via BMT. One very crucial point emphasized by RB and NAABT and anyone else who has written protocol or guides for physicians and patients is that Buprenorphine has a wide range of possible effects and benefits for people at different doses. There is no harm in initially using a higher dose of Buprenorphine when beginning intake for BMT. There is a problem with using too little Buprenorphine initially, which is why even with small habits Bupe doctors pick the middle of the dosing spectrum to begin (8mg twice a day)- there is a long history of underdosing in the first 15 years of Methadone maintenance, leading to increased drug use, lack of compliance, diversion, etc.

Now on to the quote I used in the previous thread, where you don't think what you wrote is a problem. It indirectly supports the 'less is more' misinformation being spread by the poster before you, with you further reiterating its validity. The more people that repeat or agree, the more likely someone reading or posting a question is to believe it is right.

I will post first the question asked, the first response which directly gives this 'less is more' advice to the person, followed by the quote I used from you earlier:

Question:

I'm having trouble with suboxone because I take it and I don't feel better, I still feel very cold and ill, not in full withdrawals, but not totally better, so after the first day I feel I have to use. Even taking up to 24mgs, I still feel cold and shivering and just not good.

First 'less is more' answer:

^ How long did you wait after your last opiate before taking it?

I know a lot of people that take the subs, and while they feel a hell of a lot better than they would in normal wds, they don't feel 100%.

Also, 24 mgs is just too high. You don't need more than 8 mg in most cases. 8mg has been fine for me even when my habit was up to over 1.5g/day.

And your indirect supporting statement:

I agree with kc, 24 could be too high of a dose. I've had similar feelings from dosing too high. Sixpartseven sums it up at the beginning by stressing that with bupe less is more. Just because you're not 100 percent doesn't mean take more. Also I believe the drug peaks at around 100 minutes so keep that in mind before you over do it and feel like shit again.

http://www.bluelight.ru/vb/showthread.php?t=395580&page=23

Which again, someone asks for help or advice, they are given advice that goes against the protocol/prescribing guides (that they do not need 24mg or more) with bogus rationale ('I used x amount of dope, and I only need x mg Bupe, so you only need x mg Bupe'), followed by supporting statements from you ('yes, you don't need x mg Bupe, you need less, like x mg Bupe').

Again, RB + NAABT both state two people using the exact same amount of a narcotic for the exact same period of time often need completely different doses of Buprenorphine daily to feel comfortable, held, have cravings controlled, etc.

I wasn't going to answer you because, like I already said, this is not about individuals, it's about the information and the way it is being spread. If you want to take it personally, I can't stop you.


And for anyone who doubts that people take this advice, reading this makes me depressed

thanks guys for answering my question.

im actually taking about 300 to 400mgs per day of oxyocdone... do you guys think that a 2 or 4 mg sub pill will do the job?

:/

If I need to get more examples of people acknowledging taking this advice, or considering it seriously, I can do that too.

 

[Johnny blue]

Ok in all of your quotes I said MAY and YMMV and COULD. You very first example ends in your mileage may vary. You understand that right? You outline examples of other people's posts that you THINK are some big huge problem and then get pissy because one of the examples says something back. Your bad, I don't owe you an apology for attempting to insult me and other bluelighters by showing their posts as wrong. Who exactly are you?

 

[chrisinabox]

Tchort, why does that make you depressed? because that person might start out taking a lower dose first instead of taking a high dose? if he takes the lower dose and it doesn't work for him, then he will take more.

Another thing you said was that dosage varies person to person. I agree with this very much. One person might of had a 2 gram/day heroin habit and only need 2mg of bupe to get by while another person might have had only a 50mg/day oxycodone habit and need 24mg. That means the person you quoted above with a fairly large oxycodone habit MIGHT just get better results from a lower dose rather than a high dose. But at the same time, he just MIGHT need a high dose. So while it fairs for you to say that we shouldn't recommend people take lower doses because they might need higher doses, at the same time, the person might NOT need a higher dose so you can't say that they need a higher one either.

Here is an example of someone who posted in the Suboxone mega thread about not getting the relief he was hoping for with suboxone. He is on 24mg/day and had a 250-300mg/day oxycodone habit. His BL name is: subisjustokay.

****So I have been on suboxone (24mg) for about 6 days now and I feel as though my cravings are coming back more and more each day... Also, after reading almost ALL the megathread I feel as though I'm taking WAY too much but that is what I was prescribed.. anyways... I am just wondering if suboxone was even really designed to stop the cravings or just help with w/d??? ****

After he posted that, some of us recommended that he try a lower dose of Suboxone and see if maybe that would help. And he did and this is what he wrote after he tried it:

****So I finally got my dose lowered down to 8mg a day and I gotta say THANK YOU... you guys were right... LESS IS DEFINITELY MORE with this drug... I don't feel lethargic at all and also I've noticed my cravings for other opiates have lessened even more... I think I'll stay at this dose until I'm ready to finally come off. Hopefully that will be soon because this prescription cost me $204.00 for 30 pills!!

** Thanks to everyone for the advice! ******


I strongly believe that our advice is helping some people, not everyone, but some. If our advice does not work for someone, then they can go back to where they were or try something else. There is nothing wrong with giving advice to someone based on our own experience. Just like there is nothing wrong with you, tchort, giving someone advice to take MORE of their bupe. But to say were endangering people's lives is wrong.

Also, you keep saying how we are going against "the available literature on Buprenorphine prescribing for opioid addiction via BMT". Yes, maybe our opinions do differ from theirs, but that is our right. Just because our experience is different from them, that doesn't mean we can't express our opinions and give advice to people about things that worked for us, just because its not the same as what "RB and NAABT" said.


tchort*****there is a long history of underdosing in the first 15 years of Methadone maintenance, leading to increased drug use, lack of compliance, diversion, etc. ****

this has nothing to do with buprenorphine and just because it happened with methadone does not mean it will with buprenorphine. yes it COULD happen, but it doesn't mean that it WILL. We should have the right to give advice to someone we feel might benefit from it if we want to.

I mean its not like we are going around telling everyone on a high dose to stop taking that much and get on a lower dose immediately. When someone comes on the board and says they are not getting the relief they want and they happen to be on a high dose, we recommend they TRY a lower dose to see if that helps. There is nothing wrong with trying something. They can go back if they want or try something else if they want. We are just offering people our advice when they ask for it. That is all.

 

[Tchort]

Look Johnny Blue, I'm sorry that you are taking this so personally. I certainly am not, and did not intend and do not intend to make this thread about individual members and what they or have not said.

I did not put anyones name to the quotes, because, as I have already stated, the information and way it is being given is what I believe is a problem. You have made a valiant effort to make me single you out, by repeatedly calling for me to respond to you specifically. I have tried to accomidate you, so if you do not have anything relevant to say about Buprenorphine and appropriate ways to advise people with questions and concerns, please stop replying with name calling and ridiculous accusations (who am i? As if I made this thread to attack other members? Please)

Tchort, why does that make you depressed? because that person might start out taking a lower dose first instead of taking a high dose? if he takes the lower dose and it doesn't work for him, then he will take more.

Another thing you said was that dosage varies person to person. I agree with this very much. One person might of had a 2 gram/day heroin habit and only need 2mg of bupe to get by while another person might have had only a 50mg/day oxycodone habit and need 24mg. That means the person you quoted above with a fairly large oxycodone habit MIGHT just get better results from a lower dose rather than a high dose. But at the same time, he just MIGHT need a high dose. So while it fairs for you to say that we shouldn't recommend people take lower doses because they might need higher doses, at the same time, the person might NOT need a higher dose so you can't say that they need a higher one either.

Here is an example of someone who posted in the Suboxone mega thread about not getting the relief he was hoping for with suboxone. He is on 24mg/day and had a 250-300mg/day oxycodone habit. His BL name is: subisjustokay.

****So I have been on suboxone (24mg) for about 6 days now and I feel as though my cravings are coming back more and more each day... Also, after reading almost ALL the megathread I feel as though I'm taking WAY too much but that is what I was prescribed.. anyways... I am just wondering if suboxone was even really designed to stop the cravings or just help with w/d??? ****

After he posted that, some of us recommended that he try a lower dose of Suboxone and see if maybe that would help. And he did and this is what he wrote after he tried it:

****So I finally got my dose lowered down to 8mg a day and I gotta say THANK YOU... you guys were right... LESS IS DEFINITELY MORE with this drug... I don't feel lethargic at all and also I've noticed my cravings for other opiates have lessened even more... I think I'll stay at this dose until I'm ready to finally come off. Hopefully that will be soon because this prescription cost me $204.00 for 30 pills!!

** Thanks to everyone for the advice! ******


I strongly believe that our advice is helping some people, not everyone, but some. If our advice does not work for someone, then they can go back to where they were or try something else. There is nothing wrong with giving advice to someone based on our own experience. Just like there is nothing wrong with you, tchort, giving someone advice to take MORE of their bupe. But to say were endangering people's lives is wrong.

Also, you keep saying how we are going against "the available literature on Buprenorphine prescribing for opioid addiction via BMT". Yes, maybe our opinions do differ from theirs, but that is our right. Just because our experience is different from them, that doesn't mean we can't express our opinions and give advice to people about things that worked for us, just because its not the same as what "RB and NAABT" said.


tchort*****there is a long history of underdosing in the first 15 years of Methadone maintenance, leading to increased drug use, lack of compliance, diversion, etc. ****

this has nothing to do with buprenorphine and just because it happened with methadone does not mean it will with buprenorphine. yes it COULD happen, but it doesn't mean that it WILL. We should have the right to give advice to someone we feel might benefit from it if we want to.

I mean its not like we are going around telling everyone on a high dose to stop taking that much and get on a lower dose immediately. When someone comes on the board and says they are not getting the relief they want and they happen to be on a high dose, we recommend they TRY a lower dose to see if that helps. There is nothing wrong with trying something. They can go back if they want or try something else if they want. We are just offering people our advice when they ask for it. That is all.

I will respond in greater detail, but for the moment this is where I disagree mainly:

I mean its not like we are going around telling everyone on a high dose to stop taking that much and get on a lower dose immediately

In my opinion this is exactly what is going on, and it is being reinforced by multiple people in dozens of threads (many of which have been condensed into the Bupe megathread).

 

[Cane2theLeft]

Here is an example of someone who posted in the Suboxone mega thread about not getting the relief he was hoping for with suboxone. He is on 24mg/day and had a 250-300mg/day oxycodone habit. His BL name is: subisjustokay.

****So I have been on suboxone (24mg) for about 6 days now and I feel as though my cravings are coming back more and more each day... Also, after reading almost ALL the megathread I feel as though I'm taking WAY too much but that is what I was prescribed..anyways... I am just wondering if suboxone was even really designed to stop the cravings or just help with w/d??? ****

After he posted that, some of us recommended that he try a lower dose of Suboxone and see if maybe that would help. And he did and this is what he wrote after he tried it:

****So I finally got my dose lowered down to 8mg a day and I gotta say THANK YOU... you guys were right... LESS IS DEFINITELY MORE with this drug... I don't feel lethargic at all and also I've noticed my cravings for other opiates have lessened even more... I think I'll stay at this dose until I'm ready to finally come off. Hopefully that will be soon because this prescription cost me $204.00 for 30 pills!!

** Thanks to everyone for the advice! ******

I'm glad that your (or whoever's) advice was beneficial to that poster above but I found one portion of that particularly interesting- he said, "... Also, after reading almost ALL the megathread I feel as though I'm taking WAY too much but that is what I was prescribed.."

That poster read through almost all of the suboxone megathread and what was the general impression that he got? After reading through all of that he was left arbitrarily with the feeling that his dose was too high. In that case it was and it worked out but that seems more incidental.

The point isn't that one person is suggesting someone MIGHT want to go lower, but that there is a near echolalia coming from bluelight and other sources suggesting or advising people to take lower doses or simply that in general, lower is better. It is impossible to quantify how many people have benefited or been harmed by this advice so pointing to specific examples of success or failure is futile.

As I said, SOME people will undoubtedly benefit from lowering their dose and other people DO need higher doses and reading this repetition of 'lower is better' or similar sentiments is doing a disservice to THOSE people (perhaps the minority, who knows?) so I think its good that Tchort and other people are pointing to facts demonstrating that some people do need more. So people reading bluelight who feel their dose might be insufficient don't feel hopeless that lower doses didn't work and they can feel confident about talking to their doctors about trying a higher dose.

 

[Johnny blue]

Did you read your first example of me giving wrong info? In the first post (which was conveniently left out) I said" start small and go up" then you go on to say saveyour responded to me when in fact your first example was my response to him.

You can't even get this shit straight and you say I'm blatantly giving wrong information.

Look Tchort, you did great sending out 2 emails. Your examples of this problem you're crusading to fix contradict everything you are saying. I'm not doing anything but pointing out that 98% of all your examples don't even fit your complaint. You apparently aren't gonna admit that you have no point as you've been dodging this up until now only to spin things out of context.

There can very well be something VERY wrong with taking too much bupe to start with. Many people try to rapid taper with bupe and its quite obvious that they should as I said in your conveniently left out post "start small and go up".

Your whole thread is based on something that hardly exists and your presumption that everyone is too dumb to take more if they need it. Sorry dude, great first post but now you're forcing shit and if you're gonna use examples to prove your point you MAY want to see if they fit.

 

[Johnny blue]

Here is an example of someone who posted in the Suboxone mega thread about not getting the relief he was hoping for with suboxone. He is on 24mg/day and had a 250-300mg/day oxycodone habit. His BL name is: subisjustokay.

****So I have been on suboxone (24mg) for about 6 days now and I feel as though my cravings are coming back more and more each day... Also, after reading almost ALL the megathread I feel as though I'm taking WAY too much but that is what I was prescribed.. anyways... I am just wondering if suboxone was even really designed to stop the cravings or just help with w/d??? ****

After he posted that, some of us recommended that he try a lower dose of Suboxone and see if maybe that would help. And he did and this is what he wrote after he tried it:

****So I finally got my dose lowered down to 8mg a day and I gotta say THANK YOU... you guys were right... LESS IS DEFINITELY MORE with this drug... I don't feel lethargic at all and also I've noticed my cravings for other opiates have lessened even more... I think I'll stay at this dose until I'm ready to finally come off. Hopefully that will be soon because this prescription cost me $204.00 for 30 pills!!

** Thanks to everyone for the advice! ******

I think this is a good example. The result in people suggesting others try less resulting in one happy OP. And yet still no examples of anyone complaining about getting screwed from this advice.

Why anyone would stop trying to help others using bupe for maintenance is beyond me. I'm glad people take this advice regardless of how its presented. So far IME people are happy with the results of such advice and until that changes I see no logic in changing presentation. If its not broke then don't fix it.... right?

I guess it doesn't matter what your concept is as long as you stack it high enough people won't bother to read it and will just say good work. The "less is more" idea continues to work and help others. Now if you'll excuse me I'm off to start a thread about how people answer the same way to any other dosing question... Oh shit they really do there's so much arbitrary work to do!