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 Post subject: 16mg still after a year
PostPosted: Wed Mar 12, 2014 5:06 pm 
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Ive been on 16 mg for a year and 5 months I notice many people are on less should I be on less since I've been on it for awhile I don't plan on getting off it any time soon if ever but do doctors generally bring people down after a year or longer period of time??


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PostPosted: Thu Mar 13, 2014 9:11 pm 
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Some docs, for some reason, seem to feel better if the dose is pushed downward. Because of the ceiling effect, it is not much harder to taper off 16 or even 24 mg than it is to taper off 4 mg.... and since we know of no dose-related toxicity, I generally keep people at whatever dose they are comfortable. Many of my patients are happy at 16 mg for years and years. Sometimes a person will lose insurance coverage, and find that they can push the dose to 8 mg or even less without any difference in effect-- and do so, to save money.

I think there is a general, unexamined bias out there, that 'less is better'. With buprenorphine, you need to take a critical amount for the medication to work properly-- but beyond that, the dose doesn't matter all that much. That would change, of course, if we ever found evidence for harm from buprenorphine over time. But at present, the only long-term effect is the lowering of testosterone levels in some men that is seen with all opioids-- and occurs to a lesser extent with buprenorphine as well. If I were in your shoes, I'd just enjoy the fact that my doc isn't a fascist....


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PostPosted: Tue Apr 22, 2014 9:25 am 
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Im on 16mg after close to 4 yrs. I will be for life.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
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