To Sub or not to Sub

[guessilovestraws]

Hey everyone, so I recently came off of methadone (on 45mg for 3 months) and just jumped off. I waited about 9 days since my last dose of methadone before inducing the Suboxone with the help of a couple short acting opioids and Clonidine during waiting period. I induced my 24mg Rx of Suboxone yesterday and I'm feeling ok. Nothing to complain about.

However, in the past, I was prescribed Suboxone for about 4 months straight (stayed sober) and towards the end of the first month on the medication it was simply remarkable in terms of relieving my depression. It's the only med that has ever touched, let alone lifted my severe depression. I even want to say 'cured'! My depression is what always brings me back to using. I have also never gotten any kind of euphoria when taking it.

So here's the question: Should I plan to continue to stay on a high/possibly low Suboxone regimen for the next 9 months to a year, purely for its therapeutic effects on my depression? Or would I just be putting off the inevitable of eventually get off the Suboxone and going through the horrific process of 're-wiring' my brain once again.

Any thoughts, concerns, or advice would be much appreciated. Thanks much in advance.

T

 

[_DankOpiAmp_]

Well that's a hella dose, if you are truly more functional now and the effect lasts long-term then staying on might be fine. If not than you better do a extremely slow taper or you'll be floating down shit river for ages. You get an enormous tolerance to opioids from suboxone so you are certainly not making progress towards normalizing your brain while your on it.

 

[guessilovestraws]

Agreed. I'm only on the high dose of Sub now since I jumped from methadone at 45mg. You're supposedly supposed to taper down to around 30mg before switching to Suboxone. So my psych wanted to make sure I had as much Suboxone in my system as possible to maintain tolerance during induction. He and I have already discussed going down on dosage and I took 16mg today (my 3rd day on Subs) for the hell of it and feel no different.

 

[Tommyboy]

Agreed. I'm only on the high dose of Sub now since I jumped from methadone at 45mg. You're supposedly supposed to taper down to around 30mg before switching to Suboxone. So my psych wanted to make sure I had as much Suboxone in my system as possible to maintain tolerance during induction. He and I have already discussed going down on dosage and I took 16mg today (my 3rd day on Subs) for the hell of it and feel no different.

IME, you don't get any more positive effects after 6mg. I've tried a bunch of times taking 2mg at a time every 3-4 hours, and every time I never felt anything more when I took the 4th piece (making the total dose for the day 8mg) so I stopped bothering with anything above 6mg. That's just my experience (seems to be a common theme around here though) so you will have to find out your own magic dose.

As for your question, well it's up to you. If you stay on it for a year then yes, you are going to have to face the music once you come off of it, and it will take longer for you to normalize. One possibility is that your depression is caused by PAWS, in which case the suboxone is only helping by keeping an opioid in your system so that you don't have to go through the acute and then post acute withdrawals that may be causing your depression.

Another thing to consider is that a lot of people have found that suboxone 'turns on them' after being on it for a while, causing worsening of the depression that it once 'cured' which can be a big problem since you would be depressed on it or off of it.

When it comes down to it though, if you can't stay off of opiates without the help of suboxone then it's probably best to just stay on the suboxone until your life becomes more stable to the point of being able to come off of it without running right back to opiates.

 

[guessilovestraws]

^ Pretty much where I'm at right now. Appreciate the input.