Reducing Buprenorphine Dosage.

[pharaoh]

Hi guys,

Long story short, I am on 8mg of Buprenorphine daily and I want to reduce my dosage. I would like to do this via official channels with my drug worker and they have said that I can reduce the dosage when services return to normal (after the pandemic lockdown) but I wondered if I could start the process myself. My 8mg tablets are easy to split in half so I thought of dropping down to 4mg per day. My question is whether this is doable - is this too much of a drop? Will I feel withdrawal symptoms? I've tried to come off of 8mg cold turkey before and it was hellish. However, a part of me thinks that dropping 4mgs wont hurt me too much.

Any advice will be appreciated.

 

[Jabberwocky]

From my experience drop from 8mg to 4mg was very easy. You shouldn't feel physical symptoms but could experience some psychological issues purely from thinking that it could be bad (or that it was better when you were on 8mg). If you are taking 8mg daily for long time than you shouldn't even notice any changes for first few days as the level of buprenorphine in your body is high. I know we are all different and that strange stuff with metabolism can happen even to the same person over time, but really 4mg of buprenorphine is still high enough of a dose to keep you "satisfied". My experience has been that under 4mg is when you start feeling the drops and they intensify as you go below 2mg. Jumping from 8mg is almost setting yourself up for painful failure. 4mg is not that different. I would advise, if you want to step off buprenorphine completely, that you taper into microgram territory. Like 0,25mg or even better 0,125mg. I have tapered down to 0,5mg and tapering was becoming to stressful so I decided to jump. It was not a pleasant experience to say the least but I am off of it for over a year. I was on it for 3 years with median daily dose of 4mg. So, I believe that you shouldn't have problems with reducing from 8 to 4mg, but you can reduce from 8 to 6 to 4, every 2-3 weeks if you want to take it slower. Just remember that once you go below ~4mg you should look percentages not mili/micrograms when reducing. Also give your body 2-3 weeks between dosage drops to really know that you are stable because otherwise you will go back up. Or you will lose patience and jump from too high of a dose. I don't know your threshold for not sleeping, being restless, anxious, depressed, in all sorts of pains and uncomfortable sensations...but I wouldn't push it. As I said, slow taper (over 6 months from 4mg to 0,5mg) and jumping from what at a time I considered a very low dose was very hard on me. Maybe I'm a wuss, maybe 3 years on buprenorphine with 3 years on other opioids before that was too much, or maybe it is individual differences, but it was hard enough that way. I don't want to scare you but at the same time I don't want to BS you. I have learned that there is no such thing as stopping opioids pain free. That is not to say that it can't be done wisely and with minimum shock to the body/mind. Tapering will take longer and you will be uncomfortable for longer time but I believe that it's absolutely worth it cause the overall shock to the body is lesser. And your chances to stay off when you jump are greater. I know that I have given you more data then you asked but I hope that I have helped a bit at least. Take care and good luck!

 

[pharaoh]

Hey thanks that was really helpful. Do you know anything about using Kratom when you get to the point of tapering off at low doses?

Again, many thanks for that really helpful post.

 

[Jabberwocky]

You can utilise kratom when you go below 2mg. Lower you go less kratom you will need obviously, and kratom will help more. I have utilised kratom for oxycodone withdrawal and if dose of opioid that you are jumping off is low enough kratom can really help. But so can pregabalin (Lyrica) and that is another substance worth exploring. If you will use something as a step down from buprenorphine.

 

[pharaoh]

Thanks again. I love pregabs and found that they're great for opiate withdrawal but my gf wont let me use them . I'll come back when I'm down to a low dose and ask again about using kratom to control w/ds.

Thanks again for your help dude. So sick of bupe and having to take it every day. I'll definitely use some valium when I get down to coming off it. I've found that it helps during wd/s

 

[Schizopath]

Drop till 1mg is easy since 1-2mg has 90% of effects, might be more subjective though. Almost nobody needs the amounts they give of bupre.