Bupe Question about suboxone

[zagor]

I am currently on 10 mg. I was on it on and off sometimes using oxycodone and sometimes bupe.

In 2019 while on oxy I gotta bad akathisia. My doc switched me to 2-4 mg of suboxone sublingual and akathisia had stopped. Over time I increased the dose and I have noticed it helps for my depression.

If I miss one day I start getting body restlessness and that scares me if I stop the bupe the akathisia might return. But I have to get off because it's negative side effects are real bad. Weight gain, dizziness, nausea, appetite, and so on including potential long-term effects that are possible.

My question is, if you were me, how would you quit the sub in order to minimize potential depression and avoid akathisia?

Cheers

PS. Bupe also calms me down but can often put me to sleep if I take 1 mg extra

 

[darvocet21]

I am currently on 10 mg. I was on it on and off sometimes using oxycodone and sometimes bupe.

In 2019 while on oxy I gotta bad akathisia. My doc switched me to 2-4 mg of suboxone sublingual and akathisia had stopped. Over time I increased the dose and I have noticed it helps for my depression.

If I miss one day I start getting body restlessness and that scares me if I stop the bupe the akathisia might return. But I have to get off because it's negative side effects are real bad. Weight gain, dizziness, nausea, appetite, and so on including potential long-term effects that are possible.

My question is, if you were me, how would you quit the sub in order to minimize potential depression and avoid akathisia?

Cheers

PS. Bupe also calms me down but can often put me to sleep if I take 1 mg extra

I would take the Suboxone in divided doses... 3,4 or even 5 times throughout the day. Which is easily done with the sublingual strips. I'd get used to that with my current daily dose before starting to taper. I would take 2mg when I woke up followed by 2mg every 2-3 hours until I reached 10mg. After adjusting to this, I'd reduce my total daily dose across all the doses. So if I wanted to start w a 10% reduction, instead of taking 1mg less in a single dose, I would take 0.2mg less in divided doses of 1.8mg each.

This regimen should make tapering more tolerable, but also has the advantage of minimizing your exposure to naloxone, which in higher doses of Suboxone can create a seesaw effect of delaying onset of buprenorphine. How much variability there is between people and how much of this is subjective rather than objective is up for debate. There's data showing that people who completely taper off Suboxone have higher incidences of fatal overdoses compared with patients who taper off Subutex, in the article below

Frontiers | Reconsidering the Usefulness of Adding Naloxone to Buprenorphine

www.frontiersin.org

 

[zagor]

I would take the Suboxone in divided doses... 3,4 or even 5 times throughout the day. Which is easily done with the sublingual strips. I'd get used to that with my current daily dose before starting to taper. I would take 2mg when I woke up followed by 2mg every 2-3 hours until I reached 10mg. After adjusting to this, I'd reduce my total daily dose across all the doses. So if I wanted to start w a 10% reduction, instead of taking 1mg less in a single dose, I would take 0.2mg less in divided doses of 1.8mg each.

This regimen should make tapering more tolerable, but also has the advantage of minimizing your exposure to naloxone, which in higher doses of Suboxone can create a seesaw effect of delaying onset of buprenorphine. How much variability there is between people and how much of this is subjective rather than objective is up for debate. There's data showing that people who completely taper off Suboxone have higher incidences of fatal overdoses compared with patients who taper off Subutex, in the article below

Frontiers | Reconsidering the Usefulness of Adding Naloxone to Buprenorphine

www.frontiersin.org

There is something in using sub multiple times a day vs once per day. I did use 3-4 times a day in lower doses for a month and that I think made me more high unless it was just a placebo.

 

[darvocet21]

There is something in using sub multiple times a day vs once per day. I did use 3-4 times a day in lower doses for a month and that I think made me more high unless it was just a placebo.

Was it when you just started out using it? At any rate some people have better results with that which means you could probably start dropping down fairly easily

 

[drewbocop]

When I was on 8mg I would cut the pills into quarters and snort them 4x a day but that was just the junkie in me. I think it did help me when I begun to taper. Ultimately, however, Suboxone withdrawal proved to be far too torturous for me personally when I jumped at [too high of a dose] at around 1mg. I feel like if you have problems with restlessness or akathisia, RLS/RAS, etc. Suboxone might be a bad choice. It provided the worst of those effects of ANY opioids I was ever addicted to. And not by a little bit. It's so stimulating. Just my personal 2 cents.

 

[deficiT]

Do a slow taper, I jumped off after going from 16 to 8, to 4, and then alternating days, and then 2. I didn't have too many problems doing it like that, but it sounds like you might be more sensitive to the withdrawal.

 

[zagor]

When I was on 8mg I would cut the pills into quarters and snort them 4x a day but that was just the junkie in me. I think it did help me when I begun to taper. Ultimately, however, Suboxone withdrawal proved to be far too torturous for me personally when I jumped at [too high of a dose] at around 1mg. I feel like if you have problems with restlessness or akathisia, RLS/RAS, etc. Suboxone might be a bad choice. It provided the worst of those effects of ANY opioids I was ever addicted to. And not by a little bit. It's so stimulating. Just my personal 2 cents.

How long did restlessness/akathisia last? Did you take anything for it?

 

[zagor]

Do a slow taper, I jumped off after going from 16 to 8, to 4, and then alternating days, and then 2. I didn't have too many problems doing it like that, but it sounds like you might be more sensitive to the withdrawal.

Yea I think slow slow slow taper is the key. Man you did high jumps. How long were you on it and how long did it take you to stop completely once you got down to 2mg?

 

[deficiT]

Yea I think slow slow slow taper is the key. Man you did high jumps. How long were you on it and how long did it take you to stop completely once you got down to 2mg?

Under a year. I was on opioids in general for several years leading up to being on subs. Yeah, I mean I had to because my insurance changed and I could no longer get it, so I could only taper for so long I only had so much supply. I was on 2 for maybe a week or two, but like I said I was alternating days. I dropped down to 2 over a couple weeks. Would take it one day, then none the next. That seemed to help a lot.

I get that it might be difficult for those that have been on it longer, but for me it really wasn't that bad as long as you taper.

 

[zagor]

Under a year. I was on opioids in general for several years leading up to being on subs. Yeah, I mean I had to because my insurance changed and I could no longer get it, so I could only taper for so long I only had so much supply. I was on 2 for maybe a week or two, but like I said I was alternating days. I dropped down to 2 over a couple weeks. Would take it one day, then none the next. That seemed to help a lot.

I get that it might be difficult for those that have been on it longer, but for me it really wasn't that bad as long as you taper.

My main problem is as soon as I miss 1 day the restlessness in my thighs starts which scares me it may lead to akathisia. But a lot of it is psychological. Good job for quitting it man.

 

[exxplorer]

Hi, if I can help a bit.
I was once put directly to Suboxone, after opioids issues..
It wasn't really strong enough, was on 2*8mg (+2mg at beginning after adjusting dosage) a day, but I was seeking brown many times.. was on it for about two-tree months..yes it is antidepressant, Methadone also, in my point of view, but less so..completely different feeling, more of a "happy" state with Bup.

So as I was still craving for others things, I would not take my Bup, just to feel what I take (it blocks almost all effect, not in low doses).
That's why I went to Methadone.

I completely stopped everything.
But I've gone to brown again, some months after cessation, so it was failure.
After going in and out by myself I decided to ask help, was on 70mg Methadone, tappered it, then switched to Bupe, and again I stopped for sever months, then ...yes...went again into that bad habit.
So again on methadone, now it's years since no opioids, I'm on 25mg methadone and plan to go to 20.
What you described is a common feeling during withdrawal, very strange that you feel as bad..very sensitive.

If you feel such disconfort, like leg pain and such it's that the dosage is too low (I had that first time on Bup), that's also why switching to methadone.

To taper as said cut you dosage and take it through the day, and then you can slowly go down like that.
Walking helps a lot also..
That was just my experience with it.
I was going to say try a very low dose methadone, but if 1mg more Bup put you to sleep you are very sensitive to it.

Try half the dosage one day then normal,.then again half dosage...it can help a lot also. I did it like that also.

Divide your dosage trough the day, like 3 times a day, not so bad.
But maybe (talk with your healthcare) 2.5mg * 2 methadone could help, don't know everyone is unique.
And don't really know if it's good idea as you seem to be sensitive to opioids and their withdrawal..
Drink lots of water also.

All good.