I'm so glad someone took the time to post this because while many people might have interpreted "less is more" as related to the ceiling effect, I have seen NUMEROUS posts which had people asserting quite strongly that anything about 8mg is absurd and completely unnecessary. Their "less is more" argument was quite literal in the sense that they truly belief and state as fact that taking less bupe will do more for a patient and that high doses will only make you sick. Of course this isn't true but I have seen so many people writing this to new BMT patients as though it were a fact. So while a few of the above posters might think it's funny and the original poster didn't understand what "less is more" really meant, I have to disagree and say that maybe those individuals haven't seen all of the posts that tout "less is more" in the literal sense.
Exactly the point.
"less is more" is simply a slogan used by people on this board for some time now to spread false information relating to how Buprenorphine works. I don't mean it in a literal sense, or anything other than a label for the core ideas of bad advice and misinformation going around.
Yes, RB and NAABT advocate using the lowest dose that controls cravings and withdrawal symptoms. So? That wasn't the point. And I have never quarreled with this point. Latching onto this is pointless, it is not what this is about.
I don't believe I've misunderstood anything given the quotes from posters here in the original e-mail. Plus I explained what constitutes the theory that I debunked.
R-B and NAABT have acknowledged:
-Some patients do indeed
need 8-32mg a day to control cravings and withdrawal symptoms.
-Some patients do not feel held or have their cravings controlled on any dose of Buprenorphine.
-The idea that no patient could
need more than 8mg a day is a misunderstanding and misconception
and so on.
People seem to be changing their tune now about what they meant, or said. I would be happy to go over the megathread and other 'self-serving' Bupe threads as of late where incorrect information stemming from these false ideas of how Buprenorphine works is spread
as fact to people with questions about going on or off Buprenorphine maintenance.
I don't hold anything against anyone for giving their opinions, or explaining their experiences with BMT to people with questions about it. But there is a big difference from that to transferring your experiences as scientific fact;
i.e. because you did not need 24mg a day, does not mean that no one needs 24mg, or 32mg, a day.
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.