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  • BDD Moderators: Keif’ Richards

Appropriate dose of Suboxone for someone who liked 60mg codein/day?

bupropion

Bluelighter
Joined
Feb 29, 2008
Messages
373
I found 60mg of codeine per day (taken every 4-5 hours; 60mg was the total daily dose) helpful for anxiety for a month, but it ended up causing bad dreams. Would 0.5 or 1mg Suboxone be helpful for me? Also, I found 15mg oxycodone per day similarly helpful, but I would have prederred 20 or 25. 30 seems like it would have been somewhat impairing. I also like fentanyl 100mcg (or I think it might have been just 50mcg) injection to reduce anxiety. The equivalent of this dose twice daily, taken orally or transermally, may be capable of producing adequate calming effects and helping me stop the long-acting benzodiazepine I am currently taking.
 
What is the benzo you're taking?

You shouldn't be using opiates to relieve anxiety, this will most likely end up in an opiate addiction.
 
Clonopin, recently 4mg/day. I find most BZDs depressing but Clonopin seems OK, although I have gotten angry in a drunk sort of way from taking it sometimes (at similar or lower doses). Would Librium or flurazepam be better in either of these regards?

The codeine was needed for tooth pain, but I did take slightly more (15mg doses usually) at night and in the middle of the night. The most I took semi-chronically this year was around 60mg/day. I understand they have a "Codeine Contin" product in Canada??
 
I live in the US, not Canada, but you should be able to purchase codeine over the counter in Canada.

Sometimes Benzo's can cause people to sort of flip out, I'm not sure if the other 2 would be any better than klonopin.

You would be best to try to avoid using anything at night, when you should be sleeping, not worrying about anxiety. If you can't sleep look into a non-narcotic sleep aid, plenty of options.
 
I have heard that some doctors will prescribe Suboxone for anxiety and/or depression and there was a 9-patient study using Buprenex nasal spray (specially formulated) called "Buprenorphine Treatment of Refractory Depression". For some people it worked, for others it caused serious addictive problems.

If someone wants to go into a math or science field, would opiates or sedative/hypnotic/anxiolytic cause more impairment of cognitive brain function? I saw an abstract for a study saying that lorazepam was overall more impairing than morphine, but someplace else it was said that morphine decreases ability for abstract thought, even for high-functioning users. It was a while ago that I took codeine for a month.

One of my questions is "What is the equivalent Suboxone dose for the following (NO OPIATE COMBINATIONS THOUGH)?

60mg oral codeine per day (for someone who is probably a good metabolizer of codeine)

15-30mg oral oxycodone per day

50-100mcg fentanyl 2 injections per day spaced 12 hours apart
 
Check out the bupe mega thread on this page, and that should help with the dose question.

Between benzo's and opiates I would say that most likely benzo's would slow down thinking more than opiates. Atleast that's how I've personally found things. Benzo's (at least at higher doses) can cause a fog, whereas with opiates you're just going to get a jam. So in that sense I can see why benzo's cause more impairment in thinkin


I've never read the study on opiates reducing abstract thought, but personally, I wouldn't find that a problem.
 
anxiety is the one and only [withdrawal] symptom that suboxone doesn't relieve for me. i realize you're not in opiate withdrawal, but it doesn't seem like it would do anything for anxiety at all. now i very well could be wrong on this, but maybe you're experiencing anti-anxiety effects from the codeine/oxycodone/fentanyl because you're getting high off of them...? when i am high on opiates, literally the last thing i feel is anxious! the doses you specified aren't high doses at all, even for an opiate-naive person, but they are definitely substantial enough to feel/alter your state of mind and even achieve a "high" feeling therefore eliminating your anxiety/depression.
i wouldn't think suboxone would be a very good choice for this purpose because the only people i know of (or have ever heard about) that have achieved any kind of "high" off of Buprenorphine are extremely opiate naive people, and they had to dose a pretty decent dose (8mg) to achieve that feeling.
Judging from the description of your "semi-chronic" daily doses, i kind of doubt that you fall into the category of extremely opiate-naive, so i wouldn't think you'd feel anything at all.. but then again, i could be wrong and it could be just enough to put you over the threshold. i'd say the only way to find out is to talk to your doc and try it out.. none of us are going to be able to tell you that it will or will not work for you.
Just keep in mind, bupe is a long-acting opioid so if you do get addicted, which is very likely, it's going to take longer and be harder to kick than the short-acting fent, oxy, or codeine.

am i right guys?
 
I'd also like to know if buprenorphine is good for anxiety, depression, etc., I am not presently taking opioids, and this was getting more responses in OD. Can it be moved there again?
 
Buprenorphine can work well for depression but not really anxiety. I'm prescribed it and find no relief of anxiety from it. I had to take benzodiazepines for that.

According the conversion chart 60mg Codeine is equivalent to 0.1mg Buprenorphine and 30mg of oxycodone is equivalent to 2.4mg. Can't find the equivalent to Fentanyl.
 
Why the huge difference? I must have multiple copies of hte enzymes that metabolizes codeine to morphine?
 
Regardless if Codeine metabolizes into Morphine, its one of the weakest, if not the weakest, non synthetic opiate that there is on the market. On the other hand, oxycodone is very strong. That is why there is such a difference in the buprenorphine equivalence. Although I believe that the difference shouldn't be as big.
 
I think he was asking if it would help him with anxiety or not. I believe. But if I read wrong and he wanted to know what dose would help him with withdrawals I'd easily suggest cold turkey. There is absolutely no reason at all to switch to Suboxone for withdrawals from 60mg of Codeine. They would be so mild, it would just be best cold turkey.
 
Do not be fooled. Codeine is highly addictive, and the withdrawals from it, can range from a nicotine-like withdrawal to mild cold turkey. I have experienced withdrawal from a 500mg a day pharamceutical-grade morphine addiction, which was horrendous. I have also experienced withdrawal from a two year codeine habit. By the time, I quit, I was taking about 100mg/day. I gradually tapered off, but it was an unpleasant experience. My advice, is to taper off the 60mg, by 10mg every other day, and do plenty of exercise. This increases natural endorphin release, which will help with the cravings....
 
I don't think Suboxone will do much better for the anxiety than the opioids. Although Suboxone and benzo combination is synergistic (together they relieve my anxiety, and I can function much better than on other opioids). (All opioids and benzos, I think.) It's worth a try, maybe, if you're willing to take the addiction risk. What's the issue? You DO get sufficient relief from those opioids + benzos, but you want to get on Suboxone instead? You want to drop the benzos (I doubt that Suboxone alone will be that effective -- certainly not for me!)? You want a "high-cognitive-function" opioid? (Suboxone would work for that.) I think low-dose benzos might actually timprove your cognitive function (or productivity, at least) -- that is, if the anxiety is bad enough to obstruct working.
 
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You want a "high-cognitive-function" opioid? (Suboxone would work for that.) I think low-dose benzos might actually timprove your cognitive function (or productivity, at least) -- that is, if the anxiety is bad enough to obstruct working.

How can benzos possibly help your cognitive functioning? They make it worse due to mental impairment.
 
How can benzos possibly help your cognitive functioning?
Like I said, "if the anxiety is bad enough to obstruct working."
They make it worse due to mental impairment.
Yeah, benzos cause mental impairment to some degree, even in therapeutic doses. I also have a science and math type job so I have to have my wits about me (to quote william wallace in braveheart) and deal with this exact issue.

I just meant that if your anxiety is truly out of hand, you may not be able to do anything cognitive, period. I can't, anyway. Forget about doing any work; I'll just hide until I become homeless and/or starve (at least for a few days at a time). Use benzos and, sure, you might not be at your highest possible level of functioning, but you may be able to function better than without, even at cognitively-demanding tasks. That's assuming your dose is therapeutic not recreational and your anxiety is really so bad you can't function without it. (Some kind of non-benzo treatment would be better if it was effective, but I haven't found that myself.)
 
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