Opioids Advice on stopping (very) low dose suboxone

[ValaisFendant]

Hi all -

I am down to 0.25mg of suboxone a day while
trying to keep chronic back pain in check, but I want a way off of the last bit of subs (I am not taking any other controlled substances now, and do not want to).

I have been on suboxone for 18 months, after a few years of self medicating with opiates. I started subs at 2mg/day, and have been at 0.25mg/day for the last 6 weeks.

I want to get entirely off for a few main reasons

1) to avoid intraday withdrawal i have to do 3 micro-doses a day which is hard to measure and is a nuisance (the half life doesn't work the same way in plasma when doses are so small... 2mg was good for almost 24 hours, but 0.08mg only works for 6 hours before I feel it wearing off). It's not psychological, it's the plasma concentration falling below a minimum threshold.

2) it messes with my gut, even at 0.25mg. i still
have to take a low/medium dose of stimulant laxatives once every 5-7 days to keep things from backing up and i feel bloated half the time. i hate this + have to plan my schedule
around "laxative day" (i've tried everything else... osmotic, fiber, exercise, water.. nothing even in combination works well enough to stay off of stimulant laxatives entirely).

3) it reduces energy level, even at this dose + this is not how i want to feel everyday.

Before you say "just suck it up and do it, 0.25mg is nothing"...

... there is a legitimate is a chronic pain issue here (spine / cervical disc). I find suboxone to be better than full agonist opioids for pain, as even 0.25mg keeps the pain mostly away. (it's a wonder drug for pain IMO).

And when I tried stopping from 0.5mg a couple months ago, my back flared up big time within 24 hours. Its the first sign of withdrawal I get, which shouldn't be the case if its just phantom pain.

Is there a way to very very slowly taper? And see whether my spine can "adapt" to the gradual change? Is there some other way to mask the pain if i try cold turkey? (advil is useless)

Ideally I would try to reduce the dose very very gradually from 0.25 to 0.22 to 0.20 and so on, But there's no way to be this precise when the smallest strip size is 2mg.

i tried dissolving a 2mg strip into 2ml of water and pulled it into 2 x 1ml syringes. so, each unit of solution is 0.01mg. But it's hard to be precise when pushing it out of the syringe. I could dissolve it into 10ml of water and pull it into 10 syringes I guess, but then there's a lot of water for a little bit of bupe and it doesn't absorb as well under the tongue.

Really annoying to be 98% of the way through this journey but not have a clear path to 100%...

thanks for reading / sorry for length

 

[DeathIndustrial88]

I some what agree with the user above me.

I've had 10 years of experience with tramadol, 5 years with heroin and about 4-5 years with buprenorphine.

All opioids were somewhat stimulating to me in a way, but noddy at the same time. I find that over time buprenorphine loses it stimulating qualities very fast & becomes another really lethargic overly potent partial agonist, which makes you feel like crap.

On tramadol however, I found I had boundless energy, even after I grew tolerant to the opioid effect. I don't know how well tramadol would work for your pain though, but I think it's much more of a "get up and go" kind of opioid than buprenorphine is. Although bupe can be as well, with low tolerance, you will get that first 2 hours of feeling really chatty and motivated, but the rest of the duration is mostly feeling like trying to stay awake and feeling bored with everything around me.

The stimulation from tramadol would stay with me for a good 6-8 hours a day usually, with some residual (causing insomnia some times) stimulation lasting the rest of the 24hrs).

Everyone reacts differently though I guess. What works for some might not work for others.

I use miralax everyday on bupe. It's a must. And it wont' cause the kinds of problems you have with using stimulant laxatives. At this point, I rarely have an issue and can go once a day. I think once you gain tolerance, you also gain a tolerance to some of the constipating effects. But it still took me a long time and I still have to make sure I take things to keep my guts moving.

 

[GetMeOutOfThisCRAP]

Suboxone/subutex withdrawals are brutal if you've been on it for a very long time.. 18 months with that dose may not seem like a lot to people--but yes it will actually be very bad. I agree with the first poster.