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PostPosted: Sat Dec 22, 2012 4:06 am 
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Hey all,
I was reading around and found out that suboxone has a "dosage cealing" at 4mg's. If that is true, why should anyone take more than 4mg's, I am really confused?
I am asking becasue I am on 12mg's or 1 1/2 strips.


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PostPosted: Sat Dec 22, 2012 5:52 am 
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Hey Supavillin. Really good question! If the ceiling's 4mg's, why isn't 4mg the maximum dose?

First important thing is that Dr. J's amended that 4mg number. He now says the ceiling is somewhere between 8 and 12mg for most people. But that still leaves the question of why 12mg isn't the maximum dose.

I think the reason is mainly metabolism. The idea behind buprenorphine treatment is to have your blood levels over the ceiling for a full 24 hours. For many people, taking 4mg may have their dose hitting that ceiling level shortly after taking it, but over the next few hours the blood levels can actually begin to drop below that ceiling level. This is why they initially said 4mg is the ceiling. But it gave people the wrong idea. Really most people need 8-12mg for their levels to remain over the ceiling for a full 24 hours, long enough for them to take their dose the next day.

But there's some people who need more than 12mg. I reckon these people either (a) just believe they need a dose that high or (b) metabolise their Suboxone faster than most people. These people need more than 12mg's to keep their blood levels over the ceiling for a full 24 hour's, probably cos their livers metabolise bupe / norbupe faster than others.


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PostPosted: Sat Dec 22, 2012 6:53 am 
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[font=Trebuchet]Hey supavillan, I just wanted to expand a little bit on what teejay said. He is 100% right, but I also know
that there are patients such as myself that dose for pain. So my dose is 8mg in the morning, 8mg in the
afternoon, and 4mg at night. Sometimes I do forget that evening dose, but the two doses during the day,
keep me out of pain.
Suboxone has an analgesic property that lasts anywhere from 4~6 hours. So I take my dose every 6 hours or so.
In between, I take tylenol and motrin, and that takes care of the pain for me.
Like TeeJay, I do have a really fast metabolism, so it seems like the med wears off a lot quicker than
what I thought it would.
But I've noticed over the last 7 months, that that's exactly what happens. I start to crave a dose, if you will.
Not crave, like I did with opiates, but crave because I am in pain again, and know that a dose will have my pain
alleviatied. Does that make sense?
All patients are different. Don't compare your dose to anyone elses. This is a very unique program. I'm actually
in the process of taking 4mg, 4mg, and then another 4mg if needed at night. That significantly lowers my dose.
Along with lowering my side effects.
My head is clearer, and I feel like I can think straight on the lower dose.
Anyway, I hope that helped.
Take Care~Kelly[/font]

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PostPosted: Sat Dec 22, 2012 9:21 pm 
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Here's a whole video on how the cieling effect works.....

You've already got alot of good answers, just wanted to add my 'two cents"

i forget now if it was already mentioned, but we want to KEEP the "level" above the cieling,, meaning
the opiate receptors full, thus NO CRAVINGS>....
you know, your brain SCREAMING,,,,,,,,,,,,,I want opiates NOW
:wink:

the video does alot better explaining, than I do
merry christmas!!

[youtube]http://www.youtube.com/watch?v=lrqjJGoSQgc[/youtube]

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PostPosted: Sat Dec 22, 2012 9:43 pm 
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Hey guys,

I wanted to throw my little wrench in this topic. I was on 8mg 1x per day for around 2.5 years before I started my taper. Even when I got down to 2mg 1x per day I was fine. By "fine" I mean that I didn't feel the fluctuation in bupe wearing off in between dosing intervals. When I got to 1.5mg per day I did feel it and split that in two .75mg doses and eventually 3 .5mg doses and it went away.

This leads me to believe MY ceiling is around 2mg while say, teejay's might be 10mg. I believe this is a pretty good reason not to have a maximum level anywhere near 4mg for bupe therapy. We all react differently to this med.

Another thing is I put my film in below my front teeth and between my gums, I sometimes think I might be getting way better absorption this way as well...

Who knows

@_@


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PostPosted: Sat Dec 22, 2012 10:17 pm 
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glen bee wrote:
This leads me to believe MY ceiling is around 2mg while say, teejay's might be 10mg. I believe this is a pretty good reason not to have a maximum level anywhere near 4mg for bupe therapy. We all react differently to this med.

@_@


Worddd. It's impossible to put some arbitrary number on something that has so many variables.


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PostPosted: Wed Dec 26, 2012 11:27 pm 
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I spent a lot of time wondering about this too since reading about everyone taking different doses, and the fact that my doc wrote my scripts for 16mg........... and I never needed that much. I wondered why, but I think like glen bee mentioned, I am getting "maximum absorption and that helps me tremendously. My husband gives me my 4mg every morning about 5 am, long before it's time for me to get up and I put it under my tongue and go back to sleep. I don't have any saliva or the need to spit, I'm asleep....... I really think this helps me get the most out of my dose and keeps my receptors satuarated good so that that's all I need all day.

I may have a slower metabolism too, but I don't think that's the case. Never was with any other med, but I have read that the longer you keep it under your tongue without talking, eating, drinking, spitting, swallowing, ect., the better absorption you get and the more medicine gets into your blood stream.

I have been taking 4-6mg pretty much the whole time I've been on suboxone, only now I strictly take 4mg, since my dr lost his license and I'm having the worst time trying to find a new one, I'm taking 4mg only and not ever taking the extra 2mg I sometimes feel like I need for pain because I'm too scared of running out. Right now I have enough for almost 5 months, IF I only take 4mg. I hope I can find a doc before then tho, a lot of offices are closed right now due to the holidays so we shall see what happens at the beginning of the new year.

I just think there's a lot of factors that go into play with why some people do fine on 2mg, some on 4mg, and some have to dose at 24mg a day. Pain, metabolism, addiction needs.... there just can't be a "magic number" for everyone...

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PostPosted: Thu Dec 27, 2012 1:14 am 
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Invisible_sHadow wrote:

I have been taking 4-6mg pretty much the whole time I've been on suboxone, only now I strictly take 4mg, since my dr lost his license and I'm having the worst time trying to find a new one, I'm taking 4mg only and not ever taking the extra 2mg I sometimes feel like I need for pain because I'm too scared of running out. Right now I have enough for almost 5 months, IF I only take 4mg. I hope I can find a doc before then tho, a lot of offices are closed right now due to the holidays so we shall see what happens at the beginning of the new year.



I just think there's a lot of factors that go into play with why some people do fine on 2mg, some on 4mg, and some have to dose at 24mg a day. Pain, metabolism, addiction needs.... there just can't be a "magic number" for everyone...



First,,, I HOPE you find a GOOD DOCTOR SOON!!!!!!!!!!!!!!!!!
and I'm glad you have such a stockpile,,, that's soooooo great... seriously. HATS OFF TO YOU for that!!! 8)


Secondly,,,
I love what you say about the "magic number"
the magic number for ME, was 24mg for the first year,, anytime I tried taking less, the end result was either, stiffness, or HORRIBLE thoughts of using, dreams of using, ugghhh, it was rough.

NOW, twenty months in,,,
I'm taking 8mg to 12mg a day.
as long as Im on my ADHD medication anyways, I went off that for awhile, and WA LAAA, I was back up to 16 and 20mg a day.
So I kinda "put it together" that I was trying to medicate my adhd symptoms w/suboxone.
whatever the case, Im doing better now, and that's what matters :wink:

I've tried taking less than 8mg, I don't know, I just cannot do it, yet. . . . I try,,,,, but ALWAYS end up taking the other half.
It's my addiction I guess, the "impulse"
that takes over, and I just take it. then I don't think about it again.....
unless I hurt REAL BAD....... then I take another 4mg at night to help me sleep......

anyways,
thanks for the insightful post invisible shadow :wink:

suboxone is SO MUCH better than active addiction..... I mean, whether you take 16mg,20mg , 24mg, or WHATEVER ,
your making SPACE from pain pills/drug of choice,
and working towards a goal.
that's so much more than I ever thought I could do, ever :arrow:

CHEERS, everyone,
may the upcoming new year give us all strength to beat the SHIZNIT outta our monsters (addictions) :P

_________________
anyone can give up,
its the easiest thing in the world to do, but to
hold it together, when everyone would understand if you fell apart
That's TRUE STRENGTH
http://almostoneyearclean.blogspot.com/


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