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5 day suboxone detox for opiate withdrawal

brookles77

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May 26, 2018
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Hi, I have an opiate addiction, very high tolerance, my supply ran dry and I want to get sober so went to the docs. He prescribed me 5 x 2mg subutex to be taken 1 per day then stop cold. Is this quick bupe detox even a thing? I've been on suboxone for 2 years previously and it was a nightmare to get off so I'm not happy to have subutex again. Anyway I've taken 1 per day, but now what? I'm expecting withdrawals now. Should I see a different doctor? I'm thinking of trying to get Clonidine somewhere else, any other suggestions?
Thanks in advance. Brookles.
 
Can't help you source meds here, other than by directing you to find a doctor.

You probably want to find a different doctor though.

If you have a heavy heroin tolerance/dependency 2mg buprenorphine/day is going to barely (if at all) cut it. At the very least you'd also want to have stuff like gabapentin, clonidine and diazepam, but even then having more buprenorphine to work with is much more ideal. The option of 8mg/day for seven days for someone with a serious habit is advisable.

But also, you'll need to make plans for supporting yourself post buprenorphine. A longer, extended detox of six months on buprenorphine (basically a long slow taper over six months instead of just using it at a steady dose for five-seven days) is often advisable for individuals with a serious habit. It gives the patient time to stabilize a bit in life, figure out more of an effective support network, etc.

Methadone is another alternative, but I'll let you let us know if you're prefer that.

It can take a lot of effort and exploration to find an effective recovery support network for you. Doesn't even need to rely extensively or exclusively on formal recovery communities (I for one didn't find 12 steps very helpful, but I did find secular mindfulness communities very helpful), just a network of people/communities that you can draw support from while you transition away from opioid use IRL.

Here is a good place to start looking for options with buprenorphine prescribers in the US. At the very least, you'll want to get a second (and/or third) opinion: http://www.samhsa.gov/medication-as...cian-program-data/treatment-physician-locator
 
IMO short detox is just a start for a journey of a lifetime and atleast I need a support from various people and organizations to keep it going on atleast in this early phase.

I don't know about SAMHSA guidelines how to deal with in a case in which person is rapidly detoxed and then craves a lot or relapses shortly after but here in Finland it is possible to enter opiate replacement therapy quite easily and soon after rapid detox.

For myself the first time I detoxed inpatient I was able to pull through nearly a month until PAWS hit me and I decided to enter ORT for a while to get my life back together.
 
Most treatment is still like shooting from the hip in the US, alas. Hopefully one day we can follow your Finnish example =D

I can dream...
 
I just got out of rehab 2 weeks ago n i can tell u 2 mg wont even touch withdrawals. Once they really kick in bad, clonidine...benadryl...none of that stuff even phased me. I js stopped sub yest and started drinking kratom yest. The gradual change...might try no kratom tomorrow. My goal was to use sub only to get through physical, but ended up using a lil longer for energy. I was a relatively high opiate user on n off for 15 yrs with random sobriety in there. I've been down this road before so knew what to expect. Doesn't make it easy though. Can't wait for the day my energy level is normal with no substance. Good luck in your journey. Glad your strong to not have to go into rehab.
 
I really don't understand the 2mg a day 5 day sub taper that seems to be all the rage right now. The last rehab I went too tried the same thing and it wasn't even slightly effective. I
mean I guess if you have a small habit it could work but the move to one size fits all opiate tapering is a lazy habit.

The state of treatment in the US is abysmal at the moment. It pisses me off to no end. My advice is too find a new doctor and ask for gabapentin or Lyrica, cloninidine, and a benzo. You may not get the benzo but the others shouldn't be a big deal.
 
2mg buprenorphine is pretty good for a small habit, but anything moderate to large it's not going to come close to cutting it. Even with a small habit, 2mg twice a day is probably necessary.

And five days? Where the hell do they get that number? Oh, right, the philosophy is still that forcing someone to endure more suffering in withdrawal somehow is beneficial to long term recovery. Yeah, right...

One extreme to the next - first they were prescribing 24-32mg for small habits, now they're prescribing 2mg for moderate to large habits? What a joke.

I mean, of course it's hard for me to verify whether 2mg once a day for five days is appropriate for the OP, because I don't really know how much they were dependent on or their history, but if it was anything other than a (very) small habit, yeah... good luck :(

And I thought I was crazy... 8)

As the quote in my profile goes: "It is no measure of health, to be well adjusted to a profoundly sick society."
 
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