Bupe induction and waiting

[milagro]

I know there is a bupe megathread somewhere but my question would be buried and maybe answered while I would like some information from people who have been there and done this and hope someone can answer this soon.

My last induction made me throw up so violently that I had to go the hospital. I waited until the WD was becoming unbearable and it was 24+ hours. This time I am trying a different approach but the waiting to feel normal is troubling.

I discovered I only needed 6mg/day last time once I was stable. I am taking subutex and am a cpp who was on ~100mg/day oxy. It worked like a charm but the damn tolerance became an issue and I wasn't allowed any increase in dosage.

My question; This second induction scared the shit out me due to the last time but I tried a different approach. 2mg an hour until I start feeling stable. Problem is that while I feel slightly better, my legs are killing me. I am taking advil by the handful and I have had no nausea this time and that is a blessing.

I am at 8mg so far and really do not want to go higher. I know bupe takes its time to provide analgesia but I would like to know if I am doing this right? Doc is out of town. All I know is I am completely useless feeling this way. Should I take more or wait it out?

 

[The Doc.]

Hello there yes bupe does take time to provide complete withdrawal relief at times but it sounds like your withdrawal symptoms may be taken care of. Perhaps you are just expecting more pain relief than the bupe can provide. How long has it been just a day or two? If that's the case I would give it another day or two to let the bupe work. Do you usually have aches and pains from work or a condition? I know everyone is different but for someone with a small tolerance like 100mg oxy I wouldn't recommend raising it further by doing 4mgs or more of bupe but definitely not more than 8mgs per day.

Do you feel the pains more at night? If you cant seem to get stable afer a few days then What helped me immensely was instead of dosing once a day I dose 2-4 times a day. This way a more constant level of buprenorphine is flowing through your serum and its providing more pain relief(Buprenorphine is only effective on pain for the first 4 hours after being dosed).

But if its only been a day I would give it another couple days for the bupe to build up in your serum levels. Take some Tylenol and advil together that always helped me in detox waiting for the bupe to work. If it doesn't help still try some of the suggestions I mentioned. If you can't seem to get comfy then it may be mental you could try raising the dose if you really want but dont expect any miracles bupe seems to hit the ceiling point pretty fast.

 

[milagro]

Excellent response and full of information I needed. Yes, this is day 1 and it is a chronic condition. Mornings are the worst. What I do not understand is why the docs prescribe such enormous doses? I am/was taking less than half the prescribed dose and that was fine last time. An accident sent me back to the strong stuff. I was reading posts on this and other sites that changed my mind about dosage and efficacy.

It is a bummer having to wait so long and after the last time with the vomiting I am being very careful. When you say wait another day or two are you suggesting I remain at 8+ mg/day until I stabilize? Then lower it to 2mg/3xday?

 

[The Doc.]

Yes I'm suggesting you stay at 8mgs (4 mgs twice a day perhaps? Whatever works best for you to take it) until you feel more relief. Remember if its pain relief you want the more times a day you dose the more relief will be felt around the clock. I wouldn't lower until stable for at least a month if you want to stay on it a long time(matinence). If you want to stabilise then taper off right away to get off opiates completely then I would stay on your stable dose for 2 days then do a quick taper so your off the stuff within a week or two Max.
For instance a good taper I've done many times when switching from oxy to bupe to taper off is shown below.

Day 1- 8mgs
Day 2-8mgs
Day 3- 6mgs
Day 4- 4mgs
Day 5- 3mgs
Day 6-2mgs
Day 7-1mg
Day 8- 0.5
Day 9- Nothing
Day 10- 0.25mgs
Then home free with minimal withdrawal symptoms that can be taken care of with lopermide and other over the counter products.

If it's matinence you want then get stable stay there for a bit then you can taper down to a low dose to stay on so your not taking large doses for extended periods with all kinds of side effects such as constipation and lethargy.