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Bupe Told My Bupe Doc That the Bupe Dosages Commonly Scripted are Unnecessarily High

I would imagine that many patients would strongly resist downward adjustment of their dose simply due to fear. Back when I was on methadone, there was lots of chatter about "blind dosing" and patients would often claim that there dose was being reduced without their knowledge. This led to a rules change made it SOP for the nurse to show you the amount in the cup before adding water, and you had to confirm it was the correct dose.

I never went through an induction, I was simply placed on 16mg/day to start. Later, a dosage increase was proposed by a new doc, I tried it and discovered I felt more comfortable at that dose. It makes me wonder what would motivate someone who was comfortably-stable to experiment with going lower? You could conceivably attempt this for financial reasons, or if you were experiencing negative effects from the drug, but experimenting to see how low you can go before going into withdrawal and/or relapsing seems to be a fool's game.
 
I really don't think it would be suboxone withdrawal from just 3 days of use. You said you had 3 years of hydro use right??? uhh I think it's from that. You are at day 10. PAWS can last a long time. I was on opiates about 1-2 years and have detoxed cold turkey and with the help of like 5 days on suboxone, each time I had withdrawal symptoms lingering way past the 10 day point..however they were nothing like days 1-6

Probably the Suboxone, but either way, opiate withdrawal can be prolonged depending on how long you've used for.

You'll begin to feel better within the next week I'm sure. It normally takes 1-2 weeks before you feel "adjusted" in a sense.

Just try to get down to 2mg per day, and then see if it'll last you 2 days instead of 1 when you get down there. Good luck!



You're going to what's commonly referred to an in-patient clinic for ORT (via Suboxone).

If you wanted to, you could abandon that and try to find an out-patient clinic for Suboxone, it's a lot easier and you can dose yourself at home without having to be monitored by doctors, etc.

Some people fare better one way or the other. It's really up to you. Whatever you think will help your recovery out the most.
 
You could conceivably attempt this for financial reasons, or if you were experiencing negative effects from the drug, but experimenting to see how low you can go before going into withdrawal and/or relapsing seems to be a fool's game.

Well, side effects are a pretty big issue, and they are definitely dose dependent. Considering how so many of us enjoyed our lower doses much more than our higher doses, it only seems logical that others would want to have similar positive experiences. This doesn't even touch on the fact that higher doses are going to be harder to eventually get off of...

We're not opposed to people being on high doses in general, just to people unwillingly and unknowingly being on doses higher than intended.
 
I really don't think it would be suboxone withdrawal from just 3 days of use. You said you had 3 years of hydro use right??? uhh I think it's from that. You are at day 10. PAWS can last a long time. I was on opiates about 1-2 years and have detoxed cold turkey and with the help of like 5 days on suboxone, each time I had withdrawal symptoms lingering way past the 10 day point..however they were nothing like days 1-6
i took hydros for 1.5 years, the last six months or so around 30 a day.

the last time i detoxed cold turkey (last may or so) the first 3 days were hell but i got over it pretty quickly after the third day. obviously now i'm feeling it longer because of the prolonged use. i doubt the month off of hydros did anything to "break" the cycle of being addicted. and the mental side of it has been exponentially worse this time around.

even though i realize the worst of it is already behind me, it's tough knowing there is still a ways to go.

thanks for the input.
 
Yeah I always find the 2-4 week mark pretty tough to get over. Around week 2 I feel CLEAN, happy etc..then around week 4 it all sets in, i still feel little annoying paws like not bein able to sleep good, etc...

then bam

im fucked and back to square one

i took hydros for 1.5 years, the last six months or so around 30 a day.

the last time i detoxed cold turkey (last may or so) the first 3 days were hell but i got over it pretty quickly after the third day. obviously now i'm feeling it longer because of the prolonged use. i doubt the month off of hydros did anything to "break" the cycle of being addicted. and the mental side of it has been exponentially worse this time around.

even though i realize the worst of it is already behind me, it's tough knowing there is still a ways to go.

thanks for the input.
 
Probably the Suboxone, but either way, opiate withdrawal can be prolonged depending on how long you've used for.

You'll begin to feel better within the next week I'm sure. It normally takes 1-2 weeks before you feel "adjusted" in a sense.

Just try to get down to 2mg per day, and then see if it'll last you 2 days instead of 1 when you get down there. Good luck!
i don't intend to take any more suboxone but if i end up in this situation again i'll know to taper off better rather than going straight from abusing an opiate, going into WDs, taking subs for 3 days then quitting cold turkey again. that certainly wasn't my brightest decision.

i've made it this far though. i wish i could just fast forward another week or so :D
 
Yeah I always find the 2-4 week mark pretty tough to get over. Around week 2 I feel CLEAN, happy etc..then around week 4 it all sets in, i still feel little annoying paws like not bein able to sleep good, etc...

then bam

im fucked and back to square one
that's essentially how it went for me the last time i quit. first week or so was the tough physical WDs, then after 2 weeks or so i felt great about being clean. i was happy, hanging out with my friends a lot more often, etc. then right around the 1 month mark i got into an argument with my gf over the most trivial bullshit ever (i can't even remember what) and asked my friend for 4 norcos and it was on again. i don't remember not being able to rest well at night or feeling achy or anything like that, but i was on a short fuse with my gf.

unfortunately she is also addicted to pain meds and is currently nibbling on suboxones the way i probably should have rather than quitting the way i did. so we'll see how strong our relationship is when we are both trying to kick opiate habits at the same time. sounds like a good idea for a sitcom.
 
question re:low dosages

for the experienced bupe users, a question~ if one is looking to get off a 1200 mg IV oxy + 2 gr H habit a day (been at this stupid level for past 6 months) for the first few days would the low doses of 2-4 mgs a day of bupe be okay or would i be in horrible w/d's? i don't have unlimited supply of the stuff (no doctor, street score of liquid bupe vials) and not looking for maintenance, just detox off the opiates. can't afford my habit anymore and had 10 years clean before this last run that was started by extreme need for pain management 3 years ago and like any good addict went from using the oral pain meds drs. Rx'ed to full blown insanity. things just got outta control and i have to stop all this. help. i also have valium and gaba and tramadol and few other non-opiate things to help me through this. i know how much and when to use those, but bupe is such a different animal i could use some guidance for dosing. reading this thread so many are saying the lower doses work better, i'm guess what i asking is this true (low dosing working better) for the actual switch/detox from opiates to bupe or just maintenance? is 2 mgs a day going to be a sick joke for such a habit? have only a few days left of stuff before i have to dive into this detox, and i am hoping to do this with the least amount of w/d's possible. (hey did you hear my breathing quicken and heart start pounding at thought of w/d's from there? last time all those years ago w/d'ing off a habit like this before bupe was around was so f'ing bad. :(scared).
 
for the experienced bupe users, a question~ if one is looking to get off a 1200 mg IV oxy + 2 gr H habit a day (been at this stupid level for past 6 months) for the first few days would the low doses of 2-4 mgs a day of bupe be okay or would i be in horrible w/d's? i don't have unlimited supply of the stuff (no doctor, street score of liquid bupe vials) and not looking for maintenance, just detox off the opiates. can't afford my habit anymore and had 10 years clean before this last run that was started by extreme need for pain management 3 years ago and like any good addict went from using the oral pain meds drs. Rx'ed to full blown insanity. things just got outta control and i have to stop all this. help. i also have valium and gaba and tramadol and few other non-opiate things to help me through this. i know how much and when to use those, but bupe is such a different animal i could use some guidance for dosing. reading this thread so many are saying the lower doses work better, i'm guess what i asking is this true (low dosing working better) for the actual switch/detox from opiates to bupe or just maintenance? is 2 mgs a day going to be a sick joke for such a habit? have only a few days left of stuff before i have to dive into this detox, and i am hoping to do this with the least amount of w/d's possible. (hey did you hear my breathing quicken and heart start pounding at thought of w/d's from there? last time all those years ago w/d'ing off a habit like this before bupe was around was so f'ing bad. :(scared).


Its pretty impossible to say, since it seems some people can have massive tolerances to opiates and still get by on small doses of bupe, while others require large doses.
I would answer that it is certainly possible that 2mg per day could hold you.

Let me add though that when coming off such massive doses of full agonists like you are, you are almost certainly going to experience some discomfort when switching to bupe (a partial agonist), even if you were able to take extremely high doses. So, the first thing you need to do is accept that you will experience some discomfort during this transition period, regardless of your bupe dose.

So, my advice is to try low dose bupe and see how you feel. Wait until you are feeling definite withdrawal from your oxy/heroin, and then try 2-4mg of bupe. But be sure that u are in withdrawal before taking the bupe (you would not want want to experience precipitated withdrawal from that high of a dose of opiates). You don't need to be sick as a dog, as long as you are starting to feel that cold-sweat, creepy crawly. nasty feeling, you can dose yourself with bupe.

After dosing with 2-4mg, see how you feel over the course of the next hour. It will almost certainly make you feel physically much better, but you may still have some mental cravings. However, if you are truly still feeling physically dopesick, then you likely need to take more.

So, by all means give it a try. If it can help you get down from that massive habit you have now, then that would be awesome. Good luck-DG
 
but experimenting to see how low you can go before going into withdrawal and/or relapsing seems to be a fool's game.

Actually, it's called tapering. It also allows your endogenous endorphins to get back up and running, and furthermore helps allow your opiate tolerance to drop down.

There's nothing wrong with taking less to see what best suits you.

If you are afraid you'd relapse, then of course don't taper until you're ready.

I would hate to be on a larger dose of buprenorphine than I am now, and I don't even take 1mg per day. Today, I have had 160mcg of buprenorphine thus far (probably won't go over 240mcg in the entire day).

i don't intend to take any more suboxone but if i end up in this situation again i'll know to taper off better rather than going straight from abusing an opiate, going into WDs, taking subs for 3 days then quitting cold turkey again. that certainly wasn't my brightest decision.

i've made it this far though. i wish i could just fast forward another week or so :D

Try meditation, showering/baths, exercise, and treat yourself to good food, and great entertainment. Curling up with a good book can help the time go by too.

Of course sex and masturbation help even more as well.

Then after all of that come back on BL and post about it some more. :)

Hopefully the next week will fly by before you know it!
 
IMO low dosing works better for maintanence. I don't think it works better for the initial induction and first 3-5 days. Now I am not saying it WONT work, because that is not true at all.

If it were me, and I generally have around a 2 bundle a day habit east coast powder (which I doubt is actually close to 2g's), I would probably aim to use like 4mg the first 3 days then go down from there.

If you are going to have a hard transition (which is not definite, depends on a lot of variables) I think the first 3 days are the worst until everything kind of levels out.

I know you have a very limited supply.

If I would start your induction with 2mg (dunno if your injecting or not). Give it time to see how you feel, then take it from there. That's really the only sure fire way to predict what you will need.

As far as maintanence goes, I think most will agree that it's generally better to stay at lower doses if possible to avoid side effects. Also, theres more of a reported high/buzz once you level out at lower doses..something that is non existant at 8m or more imo.

is this true (low dosing working better) for the actual switch/detox from opiates to bupe or just maintenance? (scared).

Also, you mention that last time you did it without the help of bupe. I dunno if you just cold turkeyed it but I tihnk you will be surprisingly delighted with the power of bupe.

Just make sure you wait long enough for your initial dose..the longer the better! Honestly, if you could tough it out long enough, I think 2mg would be less of a problem, like if you were able to hit the 48hr mark or somethin with no opiates
 
In my opinion and experience with these bupe docs, they definetly prescribe way too high dosages. I was coming off of 2 bags a day and he tried to put me on 32mg of suboxone a day. I mean, come on. I found out on my own that I only needed about 2-4mg to satisfy me practically all day. Of course, with my insurance paying for it, I kept telling him 4 a day was sufficient just so I could maintain a steady supply of pills, just in case. But all in all, yes, you were right in confronting your doctor. I don't know if it's the pharmecuetical companies or what pushing these dosages on the doctors or they're just misinformed, but these ceiling type dosages for bupe are being prescribed in ridiculously high dosages.
 
I agree that some doctors are in it for the money and volume of patients..but I don't get it..whats the scam?? On one hand you say suboxone doctors are in it for the money, there for it sucks..then you say meth doctors are in it for the money too?? I don't get the scam? Is the doctor tricking you into giving him money or something?

We don't know your doctor..but we know our doctors, and accordin to you, all sub doctors are in it for the $.

Just a warning...you complained about how bad suboxone withdrawals were, and now your on methadone..thats all I am gonna say. Ever wonder why pepole on methadone taper as low as they can go then start on suboxone??haha

yeah whatever dude. You must know everything right? Since you have met my old suboxone doctor and know how he works right? He was completely in it for the money dude. You think these doctors just have hearts and wan't to desperately help some drug junkie? NO WRONG!!! they are in it for the cash bro. Thats is all they care about! suboxone sucks, It is on of the biggest drug treatment scams there is here in america. Sure methadone clinics are just as worse for money, But at least they know what they are talking about, and you get an effective opiate maintenance drug for a reasonable price!
 
i have never seen a doctor for bupe but was just curious if you have to go every single month in order for the doc to continue writing scripts. so if you are given a large amount bupe daily is it possible to just take maybe half of your prescribed dose, make it last two months, then see the doc again on the third month. again, just curious how these clinics tend to operate.

Most of the private bupe doctors tend to have guidelines or rules you have to follow. Generally, they make you make an apt. A lot of doctors kick you off the program if you miss an appointment so in most cases skipping a month then seeing the doctor wouldnt work

What you could do is just keep going to the doc on a regular basis and take the bupe at the levels you feel are correct.

Oh, the 4 different insurances that I have had over the years have all had a copay that was between 10-30 for generic. I was paying 60 for the suboxone, regurdless of quantity. I have used empire blue cross/blue shield, aetna, and my school insurance now is called markel I believe (it has like 3 names on the top of the card so not sure).
Well, paying half is better than paying full, I had just never heard of that.
My friends all come from wealth families too, so I am sure that is why I haven't. And the only other people that I know that get meds are old and I guess have medicare?

My insurance pays 50% brand name and $15 copay for generic

Oh, and prices/quantity...

Docs in California are allowed to hand out 1 month supplies at a time. Example: My doc has me on 1 8 mg pill a day. But he accidentally wrote 40 count for my prescription. I had to pay the premium price for those pills over the monthly 30/31 count. It was a few hundred dollars for the extra 10 pills my doctor accidentally put on there. I told the pharmacist to just put 30 in there, and the price went back down to my copay of $15. When I was prescribed 32 mg, I paid $15 for 120 pills, but the "non-insured" price was well over $700.

Youch.

That is just insane to have to pay so much extra. If insurance doesn't cover the meds the MOST you should legally have to pay is retail which CAN NOT be more than $10 per 8mg suboxone which in itself would be extremely high

this is the kinda stuff i bitched about in my "how i quit so easily thread" im glad other people are realizing that it shouldnt take more than a week or two to quit.

why trade one drug for another? if bupe didnt give withdrawal i'd be more willing to tolerate people that take it for such a long time. if you feel like shit getting off heroin, just remember that you'll feel pretty shitty getting of bupe.

granted - the psychological need has yet to go away. maybe bupe helps with that. then again, maybe a placebo would help with that.

what the fuck are you talkin about read the thread

what I have done is have my doctor switch me to the generic form of subutex ( buprenorphine ) for the cost is much less than soboxone. One thing I have found is that the straight buprenorphine pill, for reasons I cant explain, makes me feel better, my mom agrees also. The only difference between soboxone and buprenorphine is the soboxone has naloxone ( opiate blocker ) in it. I was told that the blocker would have no affect one me, and after trying both I would tend to disagree.

I feel better on subutex too and most of my friends agree. It might be placebo but I dunno, maybe spending less just feels better. All I know is when I used to do my first few doses with suboxone i would get a horrible headache. I dont knwo if it's related or just coincidence, but on subutex that is completely gone.
 
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I agree

Thats because they are. My dad was a suboxone dr before he retired. We've both done the research. 24 mg's is the ABBBSSOOLLUUUTTEEE most someone should need. My sub dr now told me 10 mg's is a low dose 2 weeks ago. Fuckin idiot.
 
My story is not unique. I convinced myself that my own pharmaceutical knowledge qualified me to know what was best for myself regarding medications. I became very adept at manipulating doctors and considered any doctor who refused to play along to be an asshole and an idiot. That kind of thinking nearly landed me in prison and damn near killed me.

I've found that, even now that I'm not playing those games anymore, I still find myself disagreeing with what all sorts of medical decisions my doctors make, but life has been SO much better since I started to try to take what is offered, as prescribed, rather than continually tinkering with my meds and trying to figure out ways to get high without consequences.
 
Question- I was comfortable on 4 mg. for a couple months, but recently I started working longer hours, and I began to have anxiety/mild withdrawl symptoms late in the day, so I increased my dose. For the last few weeks I've been between 8-12. Even as much as 16 once or twice. Increased tolerance? Anyone else get the anxiety/chills during periods of increased stress? Am I tripping? Symptoms just in my head? Doesn't feel that way, but after reading some of the theads/posts, I think I'll try to taper back.
 
Sidenote- My Dr. originally prescribed 32 mg. a day and I met or exeeded that dose in the initial stages of my maintenence. I had a pretty huge habit and I think the ritual of dosing throughout the day was analagous to my heroin schedule. I soon found no true increase in effect with increased dosage and hence tapered down to 4. Which seemed to work for me, but yeah, see above.
 
I've got nothing much of value to add but this thread was a great read. OP, good on you.

Thanks for the compliment.
I think I just got real annoyed regarding how the manufacturers of suboxone have convinced doctors that patients require such a high dose. They clearly are motivated by profits and made the decision that by convincing docs to prescribe higher then needed maintenance doses, they sell more pills and make more money. Unfortunately the patient ends up paying for this greed-both in terms of financial costs, and due to the fact that by being put on such a high maintenance dose, it is much harder to taper down from.
So I decided to mention this to my doctor so that he could hear the patient's side of the story. -DG
 
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