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Bupe Suboxone taper necessary?

sxeandpure

Greenlighter
Joined
Feb 8, 2012
Messages
36
I kicked heroin on Sunday and began taking 8mg worth of bupe daily since Monday. Since heroin withdrawal only lasts 3-5 days, if I were to simply stop taking bupe, would I go back into withdrawal? Should I taper my dose of bupe down from 8mg even though I've only been on it for a few days?
 
Begin a taper right away would be my advice. 8mg is too high a dose to come off of, you'd definitely have withdrawals.

if you've been taking 8mg/day for more or less than a week (as in 0-10 days) the bupe withdrawals with be minimal. and as you implied you'll already be over the acute w/d from the dope. they will probably drag out for a week or two (at most three), but they won't be bad. if you have Advil, Aleve, something to help you sleep, eat well and get exercise (and have an orgasm via sex or masturbation 1x+ per day) you should be fine.

tricomb does have a point though. 2-6mg/day would probably have been more appropriate. but you're here now, so I guess you gotta deal with what you got.

if you have enough bupe to do a taper, it wouldn't be the worst idea, but I don't really consider it as necessary as if you'd been on 8mg/day for a month or something.

if you want to taper, drop from 8mg down to 2mg, stay there for four days. on day five drop from 2mg to 1mg, and stay there for four days. on day nine drop to 0.5mg and stay there for four days. on day thirteen drop to 0.25mg and stay there for a week. it won't make the minor w/d from the bupe much better, if at all, than if you were to just c/t it now.

if you feel bad going from 8mg to 2mg (you probably won't, but everyone's different), you can add another four days, dropping from 8mg/day to 4mg/day days, prior to starting where I began at 2mg.

you've been on suboxone for such a short amount of time though your body hasn't had much of a chance to become too dependent on it. tapering, in a way, would almost promote your body developing a dependency as you'll be extending the time its in your system.

this is why I say a taper probably won't be very significant for your needs (again this is assuming you've been on suboxone no more than ten days; when it comes to less than ten days of sub use, the less time you've been on suboxone, the less necessary your taper is - and if your choose to taper, the less rigorous the taper needs to be; i.e. I probably won't get off suboxone until I've used it for 2-3 years, and given the length of time I've been on it my taper will be absolutely necessary and extreme thorough, as I plan to take no less than six months to taper off from my 8mg/day dose... but that scenario is pretty much the polar opposite of yours OP).
 
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Suboxone withdrawals are no joke and have lead me to relapse many times. Yeah they are mild compared to dope/full agonist but any discomfort is a good excuse to use for an addict. Better safe than sorry
 
I don't disagree. But suboxone w/d after only taking suboxone for a seven days? You body doesn't have enough time to become dependent on them as it would if you were to be taking suboxone everyday for a month... It's the same principles for any other opioid (the w/d for taking heroin every day for a week will be nothing from those after taking it every day for a month).
 
In my experience suboxone and full agonist tolerance/withdrawals are not separate. He may only have been on suboxone for 7 days but obviously opioids for much longer. There will be some kind of withdrawal with complete abstinence, how pronounced is impossible to say.
 
True, there is a kind of cumulative effect with opioids (i.e. cross tolerance is indicative of this), but with the full agonist out of the OP's system the detox will be much less severe than it would be otherwise, if the OP hadn't used suboxone while the full agonist got out (mostly that is) of their system.

In other words, c/t from suboxone where the OP is at right now won't be nearly as bad as if he or she had c/t from their full agonist before they started taking their suboxone. Just as it won't be nearly as bad as if the OP had been on suboxone for a month.
 
You definitely want to taper with the buprenorphine.

I seem to be in the minority here... Really Capt'n? After only using 8mg/day for a week? I mean, I did this a number of time back in the day when I was using dope and I never suffered anything more than minor-moderate w/d. And those I used with at the time didn't ever complain either. In fact, we used suboxone for 5-10 days for this exact reason, albeit we normally only took 2-4mg/day as opposed to the OP's 8mg/day.
 
I think it's best to err on the side of caution and taper off the bupe. Everyone is different, we can't know exactly how bad the OP's withdrawals will be, so it's better safe than sorry. And there is a cross-tolerance between opioids, so using bupe for a week (or however long it's been) after using heroin daily for a long time is very different from just using bupe for a week when you weren't previously dependent on opioids. sxeandpure, were you saying you have only been on bupe for 4 days? I don't think the heroin withdrawals would be completely over in that amount of time. Plus how are you dealing with your mental addiction?

Unless there is some major reason to stop the bupe cold-turkey (like don't have any more bupe and can't get any more) I would highly advise tapering it. Even just a quick taper over 5 days like 6mg, 4mg, 2mg, 1mg, 0.5mg, or even every-other-day dosing like that, sounds a lot better than stopping without any taper. The addictive brain will use anything as an excuse to rationalize going back to using, so even getting relatively mild WDs can be a big hurdle, plus the brain will need to get used to not taking opioids anymore too.

Generally what my doctor suggests as an absolute minimum is 3 weeks: 1 week on the bupe to make sure the worst of the heroin withdrawals are gone and then tapering over the period of 2 weeks. But there is a very high rate of relapse with being on bupe for such a short time and not getting treatment for your addiction. The bupe is only treating your physical dependence, not the mental issues and the reasons you were using opioids in the first place. Are you self-treating with the bupe?
 
You definitely want to taper with the buprenorphine.

Yeah, for the record, I wasn't saying anything about the severity of withdrawals, just that my personal experiences with buprenorphine indicate that a taper would be advisable if possible.

Don't get me wrong, I'm all for cold turkey of opioids where it's appropriate.
 
All I can tell you is that you want to use as little suboxone for as little time possible. Back when I was put on suboxone my doctors told me there weren't any withdrawals and that I should use it as a maintenance drug. I wish I could strangle him for that. I ended up just using it as a hang-over pill for my recreational opiate use until I finally decided to quit altogether. Four years later after being on subs, I tapered down very slow and gradual to about .5 mg a day and then quit and it's been over 2 months and I can function decently, but I still have minor withdrawal symptoms like diarrea and lethargy.
 
Actually, I've been on subs less than 7 days, today would be day 5. I was thinking of cutting my strip in half, taking 4mg today and then breaking up yet another strip for 2mg for the following two days. Does cutting the film strips with scissors work?
 
You should definitely taper. I once stopped taking my subs when I was on 2mg/ day, after gradually coming down from 8mg/ day, and I ended up relapsing 2 days later due to wd's and went back to herion. I was taking subs a lot longer than you have though but I'm pretty sure you will still withdraw.
 
I think you're in a perfect position right now to get clean. A short term taper is very possible given your circumstances. Apologies if other people have posted similar im just replying to the op. I have done short tapers myself and will post you a link privately as I think this info will benefit you and I've bored bluelighters enough with it already... :) good luck
P.s it's a bit of an essay but stick with it
 
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In my experience suboxone and full agonist tolerance/withdrawals are not separate. He may only have been on suboxone for 7 days but obviously opioids for much longer. There will be some kind of withdrawal with complete abstinence, how pronounced is impossible to say.

Agreed. I've been on suboxone for over a year!!! I feel like it has me trapped by the hypothetical balls. Some days are easier and I can go all day without dosing.
 
Actually, I've been on subs less than 7 days, today would be day 5. I was thinking of cutting my strip in half, taking 4mg today and then breaking up yet another strip for 2mg for the following two days. Does cutting the film strips with scissors work?

Yes, you can cut the strips, scissors or anything will work. I just rip them apart when I don't need to be super accurate. As someone else said, unless you're looking for LONG term maintained, which the OP is not, the less time you're on suboxone the better off you'll be (because it'll be easier to get off).

Your plan -

Day 1-5 @ 8mg/day
Day 6 @ 4mg/day
Day 7-8 @ 2mg/day

This will work find for your purposes. You'll have very minimal w/d either way, if you were to go c/t or do this rather short taper (the taper is so short it's not going to be like a long term taper... if nothing else it'll be good for your mind).

Again though, if you've only been on suboxone for 5 days, a taper, even a quick taper, is by no mean necessary. But it's good to make your own decisions, and a taper certainly wouldn't be a bad decision...

As someone else stated, the sooner you get off suboxone (as in tomorrow versus three days from now) the better off you're going to be. Besides, if you end up not using your last strip for this "pseudo-taper", you can hang on to it and use 4mg at another date if you're having a really bad craving or something.

I'm almost certainly people who are saying a taper is necessary have not taken into consideration that the OP's only been on it for five days... After using if for a month or months or a year or years, a taper would be ABSOLUTELY necessary as I've said. But five days? Even the most sensitive person would require a taper next to those longer terms users I just mentioned.

As a last note, if you want to make the most of your taper, I'd suggest the following (and again, if I were you I would not taper... but I'm not ;) )

Day 1-5 @ 8mg/day
Day 6 @ 4mg/day
Day 7 @ 2mg/day
Day 8 @ 1mg/day
Day 9 @ 0.5mg/day
Day 10 @ 0.25mg/day
Day 11 @ 0.25mg/day

It's significantly more difficult to go from 2-0mg than 8-2mg, so focus your taper on the lower end of the dosing. And yes, that wasn't a typo. 0.25mg. But that's if you're only anal like me (again again again I really just suggest getting off the suboxone).

If you want to taper that's the most thorough way to do it. Again, as the most time you're on suboxone @ almost any dose the hard it will be to jump off it totally, I wouldn't suggest using more than the 8mg strip (as in don't use more than 8mg to taper down from days 6-11).

Given that you've only been on suboxone a couple of days, you can really taper according to pretty much any schedule you want. In some ways your proposed taper, where you jump off @ 2mg, might actually be better than my proposed, if more rigorous schedule, simply because it will further limit the total time you're taking suboxone.

To directly answer the OP's question: Is a suboxone taper necessary (given they've only been taking it for 5 days)? No. A taper is not necessary. Advisable? Maybe, especially if the suboxone has been getting you high the last five days. If the suboxone has merely been keeping you from getting sick while getting the other opioid out of your system, a taper really won't make a huge difference, as it would in my case (I'm a long term maintenance sub patient). A bad choice to taper? Absolutely not. But absolutely necessary? No.

Bottom line: The sooner you get off suboxone, totally I mean, the better off you will be in the short and the long run.

Kapiesh?

Good luck OP!!! Let us know what you decide to do, and how it works out for you. <3

EDIT:

You should definitely taper. I once stopped taking my subs when I was on 2mg/ day, after gradually coming down from 8mg/ day, and I ended up relapsing 2 days later due to wd's and went back to herion. I was taking subs a lot longer than you have though but I'm pretty sure you will still withdraw.
(underlining me)

Compared to me or Matty here, the OP's w/d from jumping of the 8mg suboxone/day will be nothing compared to what longer term patients like us would have had to suffer through, if we were to jump off 8mg/day after using it for a year(s).

OP, you will feel minor w/d (and I mean minor) if you've only been on 8mg/day for five days. The w/d will manifest itself most noticably in a crabby mood for a week or so (but this isn't really possible to avoid; I don't mean soul crushing dope sickness depression, just a little irritability).

Furthermore, c/t at this time from 8mg won't be significantly worse than if you were to do a super quick taper and jump off at 6mg, 4mg, 2mg or even 1mg. Why? Those doses won't have time to stabilize in your system (which in my experience you need 2-4 days minimum for this to happen), so, if four days from now (after taking 4mg tomorrow, and 2mg the next two days) you were jumping off from 2mg as you propose, it'll still be more like you're jumping off from 8-6mg. That being said, there's no need to worry though. You've only been on suboxone for five days after all.

You have nothing to worry about OP. No matter how you manage your taper, or even if you choose to go c/t, you'll end up feeling pretty much the same. But if you choose to use more suboxone for your taper or continue using it for whatever reason, in that case you'll need to be more careful tapering. Not to mention you'd suffer significantly more by doing such.
 
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I'm almost certainly people who are saying a taper is necessary have not taken into consideration that the OP's only been on it for five days...

We are taking that into account. We just think a taper is advisable. There a big difference between being on subs for 5 days for someone with no tolerance, and going from a major dope habit to 5 days of subs. Yes, you are correct that the withdrawal after 5 days of subs will not be anywhere near as bad as if he just cold turkeyed the heroin, but in my experience at least, it will still be quite bad and a taper will be necessary to remain functional. As much as I wanted to be able to just skip over heroin withdrawal with a week of subs, that has never worked for me and I have always had tremendous problems getting off the sub after that.
 
Well, I guess as someone also pointed out - we're all different and react differently do different drugs. [/my.dickery]
 
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people have no idea how powerful Subs are, 8mg is a fucking huge amount, people throw numbers around like 8mg, 16mg around like the are talking about Oxy. That is where people get in trouble with Subs. You start at lowest amount possible by taking 2mg during induction and wait an hour, take 1mg if need and repeat until withdrawals are minimized. Look up some equivalent charts and ceiling effect, you may be surprised. Some charts have 1mg of Bupe = 40-60mg of Oxy. So, people need 800mg of Oxy to get relief from withdrawals? Come on, the idea is to relieve withdrawals not launch off on Subs. That is just trading one for another
 
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