Bupe Suboxone Detox - What Should I Expect From Here?

[*=Regulator=*]

Hey guys,

Not sure if this would be better in TDS - if so, please move!

So, over the past 5 weeks, I've been tapering my Suboxone dose. My tapering regime has been:
-Start: 12mg
-Week 1: 8mg
-Week 2: 6mg
-Week 3: 4mg
-Week 4: 2mg
-Week 5 (now): 1mg

I've also been drinking four standard drinks a day and smoking around 1/2g of weed throughout the entire 5 weeks. I've also been taking 25mgs of Valium and 10mg of Zolpidem (Ambien/ Stilnox) daily. I'm focusing solely on kicking the Suboxone at the moment and will decrease the benzos next.

Anyway, I'm now at the end of week five so have been on 1mg for the past few days. Throughout last week and earlier this week the symptoms have been pretty severe (nausea, diarrhea, cramps, restlessness - the usual) but I've noticed a definite decline in the intensity of the symptoms in the past few days.

I've got a few questions:
- My theory is that with a starting dose of 12mg, 1mg is now such a significant dose that it is essentially doing nothing at all. It's so close to zero that I may as well not be taking it (this makes sense as my symptoms have started to decline since I've hit 1mg). Does this make sense or will a dose as low as 1mg (for someone who is used to 12mg) actually have an effect?
- If my assumption above is correct, does it follow that my WD symptoms shouldn't get any worse when I step off completely?
- If I'm wrong, would it make sense to go to .5mg for my last week of tapering?
- If I step off to 0mg from next week, how long should I expect my physical WD symptoms to continue?

Thanks a lot in advance for any advice!

 

[SkagKush]

you are drinking which is not helping.....

everything but the pot is not helping actually.....

i tapered down to 2mg with comfort....and 1mg is going well aswell.....

id for sure go down lower.....your taper plan could be better...... this could be the stem of the issues......

 

[*=Regulator=*]

Can you please elaborate on how my taper plan could be better? The taper was in lieu of going to detox (which I didn't want to do) so was deliberately planned to be over as quickly as possible.

I now the drinking isn't good at all but I'm at best a 'heavy drinker' and find that a few drinks will potentiate the other anxiolitics enough that I can relax and sleep.

Thanks for the reply.

 

[SkagKush]

your suffering WD because your not fully adjusted to your new dose.....

you should remain at your new dose for about a month to minimize and WD

 

[*=Regulator=*]

Thanks philip - one question; what was the highest dose you were on, and how quickly did you taper down? Might have a bit more of a read through the sub mega-thread and come back here if I have more questions.

Cheers all

 

[SkagKush]

i only stayed at 8mg for a week and a half before i started to taper...........

 

[stray cat]

i definitely recommend going lower than 1 mg. i would try to get as low as possible, e.g. .25mg/day-that low, before i stopped completely. it doesn't really matter that you started at 12, the 1 mg is still a lot of buprenorphine, and stopping suddenly would not be pleasant in my opinion.

 

[SkagKush]

.25 mg is a good dose to taper down to, this should minimize WDs.

 

[ATLL765]

I would definitely suggest tapering further to .5mg/day and even going down to .25mg/day before you jump off completely from the suboxone. At .25mg/day, I can't imagine the withdrawals being all that bad, plus from what I've heard suboxone withdrawals are pretty weak compared to withdrawal from full agonist opiates, such as heroin, oxycodone, morphine, etc.

 

[SkagKush]

pretty much the lower you go....the better...

 

[*=Regulator=*]

Just had an appointment with my Dr. and he's pushing pretty hard for me to jump-off now. He's a great Dr. but he's not an addiction specialist and I can tell he's doing the 'tough love' bit - I can tell he thinks that I'm loosing my will to kick the Sub and want to draw it out as long as possible.

He said 'if you jump off now, you'll have withdrawals over the weekend and should be over it by Monday or Tuesday". If that's actually correct, I'm happy to have a weekend of pain. However, if he's wrong and I'm going to be feeling withdrawal symptoms for a week or whatever, I'd much rather go down to 0.5mg for a week.

It's kind of strange but with BL as a resource and all the first hand accounts here, I probably know more about how to do this than he does but I don't think he'd appreciate being told that. He's already said (kind of jokingly) that I 'know too much'.

So, questions:

- If I jump off now, would you expect the WDs to last a few days or longer? If longer, how long before the symptoms peak and start to decrease?

- [edit - leftwing] if i could convince the doctorDr for another week on 0.5mg would be better for me than jumping off now? I can't exactly say "there's this awesome website called Bluelight and all these former addicts have told me to drag it out another week". As far as he knows, it's merely my uninformed personal opinion that is pushing for the extra week of tapering. From his point of view, that would just look like a strung-out junkie trying to cling on to the drug for as long as possible. I somehow need to convince him that I'm actually informed and not just scared about the withdrawals. Any ideas? Help here would be most appreciated.

Thanks in advance!

 

[Jabberwocky]

how long you've been on the program is also going to depend on the length of withdrawals as bupe's physical withdrawals can last be a month + in the more extreme cases.

if this has just been a fast taper then do as your doctor said and jump off otherwise, yeah, you are just prolonging the inevitable.

noone will be telling you how to convince your doctor, we're not here to give that advice.

 

[*=Regulator=*]

Thanks Leftwing. To clarify, I'm not asking anyone to tell me how to 'con' my doctor. I've been extremely honest with him and if I really push for it, I think he'll let me go for another week. I just don't want him to think I'm doing it because I'm not committed to getting off the Suboxone and trying to cling to the drug as long as I possibly can.

I'd been on 12mg for 3 years prior to my current 5 week taper and it seems that the prevailing wisdom on this site is that jumping off at 1mg is simply a poor approach in comparison to dropping down to 0.5g or even taking another step to 0.25g after that. Is it not in the interest of harm reduction to make my withdrawal plan as effective as possible to minimise chances of relapse and withdrawal symptoms?

My Dr. is a GP, not an addiction specialist so more than advice on how to 'convince him', I'm after credible evidence I could present to him that shows dropping another level would be beneficial overall, rather than a 'weak' attempt by me to prolong the inevitable. To be fair, I should have made that clear in my post above.

I am honestly simply looking for opinions on the withdrawal plan that will best help me meet my goal of getting of Suboxone while minimising the worst of the withdrawal symtoms. On that note, I'm also after opinions on what I should expect if I do jump off now at 1mg. If doing this will get me through the withdrawals in a few days, I'd actually rather get it over with than drag it out another week or two weeks.

Bottom line:
- On the overall balance of things, is the pain of jumping off now worth getting it over with a week earlier or should I stretch it out by dropping down another level?
- If I should go the extra week on 0.5g is there any factual information that I can present to my Dr. that will demonstrate a better patient outcome (i.e. less chance of relapse, reduced withdrawal symptoms)?

 

[SkagKush]

also, lope can help when becoming abstinent from bupe....

i used when i did tapers with bupe.....after i stopped the taper....

 

[Carl Landrover]

I've tapered off sub a few times now and you will definitely still have WD symptoms from 1mg.

I'd recommend going as low as possible.

Are you dosing at similar points throughout the day each day? You should try to taper down to a lower dose (under 0.5mg) and then work on making the dose last for a longer and longer amount of time. If you're taking that amount every 24 hours, start taking it every 36 hours, then maybe 48 hours (or something similar). This can help slowly lower the amount that has been built up in your body.

Sub lasts a long time and jumping off too quick can make you feel crappy for longer than a week.

 

[*=Regulator=*]

I think what I'll do is ask the Dr. if I can go down to 0.25mg / day. That's only one 2mg for the week so I doubt he'll have a problem with that. I think I'll be OK to jump off after a week at 0.25mg. I'm getting some Clonidine tomorrow as well which should hopefully help a bit.

@SkagKush: Lope = ?

Thanks guys

 

[Jabberwocky]

my bottom line is don't keep going on about convincing your doctor or even alluding to the fact that you're not trying to convince him. what you wrote initially certainly read like that is all. be discreet.

Is it not in the interest of harm reduction to make my withdrawal plan as effective as possible to minimise chances of relapse and withdrawal symptoms?

we're here to give you infomation on it, yes. but it's ultimately in your hands what you choose to do, we're not liable for what happens to you. we won't assist you in obtaining drugs is the point i'm trying to make clear.

 

[Cane2theLeft]

Lope is loperamide, the active ingredient in imodium AD.

 

[SkagKush]

^ thanks for clarifying Cane...

my apologies regulator

 

[*=Regulator=*]

my bottom line is don't keep going on about convincing your doctor or even alluding to the fact that you're not trying to convince him. what you wrote initially certainly read like that is all. be discreet.

we're here to give you infomation on it, yes. but it's ultimately in your hands what you choose to do, we're not liable for what happens to you. we won't assist you in obtaining drugs is the point i'm trying to make clear.

OK, I'll drop the references to the Dr. and focus on talking about my treatment plans. No harm intended

Thanks Skag and Cane.

So here's my plan:
- Drop from 1mg per day to 0.25 per day, starting tomorrow
- Stay on 0.25 per day for 8 days and then re-assess
- Pick up some imodium AD to relieve the cramping / bowel discomfort (Imodium is OTC, right? If not, please let me know so I can grab a script for it)
- Pick up some Clonidine (already have a script)
- Continue on 5*5mg Valium daily (worry about that habit next)
- Smoke moderate amounts of weed daily
- TRY MY BEST to cut down on drinking but realistically I think I'll be going through around 3 standard drinks a day

Do you experts think that's sustainable?

I'm not in much danger of relapse since I wouldn't have the first clue where to obtain any opiate stronger than 12 packs of OTC codeine (the shit I was hoooked on in the first place but it's not going to do a thing for me after a Suboxone habit). The sole aim is to kick the Sub as quickly as possible with as little discomfort as possible.