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PostPosted: Fri Nov 12, 2010 10:25 am 
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I'm lucky enough to have an anaesthetist in my close family. Recently we were talking about my suboxone treatment, where he voiced a few ideas that I felt you guys might also be interested to hear.

Firstly, he was surprised to hear that the lowest available dose of suboxone is as a 2mg pill. According to him, 2mg is still a very high dose, much higher than what would be considered safe as a painkiller for the opiate naive. We didn't discuss this further. But it does beg the question of why RB don't make it easier for people to taper off their treatment and provide lower dosages? (cue profits over our welfare argument). Anyway.

MORE IMPORTANTLY! He mentioned that buprenorphine patches are widely used for pain relief. They provide low dose bupe at a constant level for 24 hours, and this could really help me when I eventually hit the last phase of my reduction. I did some research, and yea it sounds like there are numerous brands of patches like Transtec, Butrans, Norspan etc. After doing some basic match, I see they release anywhere from 0.12mg up to 1.68mg over 24 hours, depending on brand & dose.

Is it just me, or does this appear to be the perfect step-down from sublingual tabs? Almost like a nicotine patch for suboxone?

Has anyone had experience in using transdermal bupe to assist their reduction? Keen to hear you story.

T.


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PostPosted: Fri Nov 12, 2010 11:03 am 
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I think they only sell those in Europe unfortunately. But not sure. Others on this board will know. But I agree, a patch that can step you down like a nicotine patch would make a heck of a lot more sense than patients creating their own liquid solutions out of 2mg tablets. On that note, see the sticky at the top of this section on the Liquid Taper. I used it and it worked great. I created 1ml doses and took them twice per day.


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PostPosted: Fri Nov 12, 2010 12:50 pm 
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I'm pretty sure Butrans was just approved here in the US. It is meant for pain, that is true, but if it is available in those low doses then I agree it could be just the thing for tapering down and off. Another person brought this up recently: The doctor's brochure for Suboxone states that they don't know how to taper someone off suboxone. This would likely be why they don't offer anything less than 2mg pills...they have no clue, thus leaving us to our own devices.

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PostPosted: Fri Nov 19, 2010 5:58 pm 
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I've known for years they had those patches in Europe and couldn't understand why we couldn't have them here. I seem to remember there being something called Temgesic in Europe. Not sure about the name. 0.12 mg would be 120 micrograms, a nice dose to jump off at. I think Dr. Junig recommends getting under 200 micrograms, right?

It is interesting that when they gave the go-ahead to prescribe Sub, it seems like they weren't thinking at all as to how patients would get off it. My first Sub doc told me if I ever wanted to wean off, we'd just wean to 2 mg and I'd be able to discontinue it without any symptoms. Of course, you guys know that is a ridiculous statement. 2 mg is 2000 micrograms. A normal therapeutic dose of Bup is about 50 micrograms.

I just wonder if people on Sub will be able to find a doc who will prescribe these patches. In case they don't, at least now we have the film as an option. The film is really exciting to me. It's so easy to cut...just takes time and patience to get it accurate.

laddertipper


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PostPosted: Sat Nov 20, 2010 12:50 am 
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We have the transdermal patch here in the UK. It seems to be prescribed mostly to elderly patients who suffer from various bone conditions etc. Prior to February of this year, we also had a 0.2 mg subutex tablet for tapering, but all British addicts were switched to Suboxone to supposedly stop intravenous use. It's such a shame that Suboxone is only produced as a 2mg or 8 mg tab here. I actually posted a thread about these transdermal patches as a possible adjunct to tapering several months ago, it seems like they could be useful in those last tricky stages.

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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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