Bupe How should I use my subs?

[EarthBounded]

Ok main concern here, I have terrible leg pain and a bad opiate habit. I am on 12mg subs to prevent dope sickness however I obviously don't use anything else for pain besides gabapentin and weed. Now I wish I could find more pain relief from subs however I feel like I need to take 12mg a day to not get a fever, so how can I get down to doses like The Doc. is describing below? Also why would my doctor give me so much because she knows I just have had surgery and have a hypersensitive body? Do I just taper real low on subs ? She also tells me the longer I am on subs the better they work, does this mean the help reverse hypersensitivity ( the worst drug consequence I can describe )

"Well your dose is still really high and you also have to let your body become accustomed to the smaller doses multiple times a day instead of one big dose. But with a dose like 12 mgs a day splitting up the doses won't make much of a difference since you are filling up all your receptors right away,not leaving room for fresh bupe to attach to the receptors and convert to the full agonist metabolite we call Nor-Buprenorphine which is what is shown to kill pain the best. When large doses are used no room is left on the receptors for the conversion to Nor-Buprenorphine to take place and another problem with filling up all your receptors with huge doses is when you dose again 3 hours later you notice no difference because its only extending the duration of the drug. With small doses like 0.2-0.5mgs by the time you take your next dose 4 hours later most of the Buprenorphine has been processed leaving room for a fresh dose to attach to your receptors and convert more of the bupe to Nor-Buprenorphine once again.

So basically its best to use small doses so you leave room on your receptors so the next dose can attach more fresh bupe for another 4 hours or so. Also like i said using smaller doses gets more bupe converted to Nor-Buprenorphine which kills pain better than if the buprenorphine never underwent the conversion. "

Curtseys of The Doc.

 

[The Doc.]

Haha you could've just PMed me for a taper plan if you wanted one.

Doctors prescribe larger doses generally to keep a patients opiate receptors fully saturated 24/7 so they have a steady serum level of buprenorphine at a times. This is so the buprenorphine leaves no time for the patient to use other opiates such as heroin since the receptors are filled to the Max with bupe and unable to let any heroin or oxy whatever drug it is get you high. Another reason is so the patient does not feel any euphoric effects from the buprenorphine itself. Patients get used to having the steady serum level, there are no ups and downs so each dose they take carries on into the next and nothing is felt by the patient in terms of euphoria. Instead taking more bupe will simply extend the duration the drug stays in your body, no rush can be felt since there's always that constant level of buprenorphine flowing through you. This is good to get someone who is an addict to quit addictive behaviours and to keep away withdrawals but for someone in pain or wanting to get high this kind of dosing won't give you what you want out of the drug.

Now Suboxone is better than doing a bunch of oxy all day everyday in terms of giving you hypersensitivity but its still an opiate and if the buprenorphine ever leaves your body you will be very sensitive to pain you just dont notice it as much because when on bupe your serum levels stay pretty stable and hypersensitivity symptoms tend to surface once serum levels of the opiate your addicted to go below a certain point meaning another dose is needed or a dose increase. With Suboxone your tolerance doesn't go up the same way so hypersensitivity isn't quite as bad. But believe me if you stopped the sub you would be a very whiny and uncomfortable person who could get hurt by simple things like bumping your shoulder or pain is magnified more than it should be. I don't get what she meant by the longer your on them the better they work but she could be meaning the cravings for other drugs. In my opinion If it doesn't help pain at the dose your at now then just waiting it out won't bring a miracle one day where all of a sudden the sub's seem to work better.

You need to first start tapering down by 2mgs and if you fee any symptoms of withdrawal you stick with the dose for a few days until your body gets used to the lower level of buprenorphine then lower again once stable. If the symptoms were really bad you could bump it up 1mg so your going by 1mg at a time but that would take a while and the symptoms should be too bad if you even have any when going from 12 to 4 or 2mgs. Once under 2 it get tough to taper but you don't want to get under 2mgs anyways you just want on a lower dose. Keep in mind dosing 2 or 3 times a day will hell the taper tremendously because you can take a bit off each dose you could take say 7 and 3 instead of 8 and 4 and would feel no difference between the two most likely. I would stay on each dose for at least a couple days before dropping another 2mgs but I have done quick tapers where I go down from 8mg to 1mg in six or seven days with success its all about willpower.

 

[Johno88]

Hi doc. I'm in a similar situation. I suffer back pain and I'm an exheroin addict. I'm using suboxone to stay of H. I'm taking 4-5 mg sublingualy once a day and get a short euphoric feeling for about 3-4 hours. It also gives me pain relief for 3-4 hours too. This is great for me as getting a little bit of euphoria each day stops me craving the massive euphoria that heroin gives me, so I can live my life without it being revolved around it. Most people say the lower the dose like 1-2mgs the better the euphoria and painkiller effects. I figured most people IV their sub so because I take mine sublingualy I'm only getting 2mg because of the BA taken that way. To get better euphoria and to kill pain should I stick to 4-5mg or taper down to 2mg. And what dose would be best to take twice a day and not completely saturate the receptors so I feel the euphoric effects of each dose. I hope this makes sense. Thanks.