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PostPosted: Tue Aug 16, 2016 7:32 pm 
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I am a 68 year old female. I have been on suboxone for over ten years after a 2 year history of abusing vicodin, sixty mg a day at my worst. Currently I take 2 mg of buprenorphine/naloxone a day .I have been trying to decide whether or not to taper off completely. I am tired of going to the doctor, peeing in a cup and having to pick up my meds every thirty days- exactly. I have to plan any trips around Dr appt and filling my meds. I really don't want to experience withdrawal. I have arthritis pain and it seems to help a little which is one reason why I still keep taking it. The other reason that I am reluctant to get off completely is that I am very sensitive to withdrawal. I have some stress incontinence and the last two Dr appointments I was in agony trying not to pee all over myself while the lab was getting the bathroom ready for testing. Every doctor appt is a major stressful event for me. After my appt I feel so bad that I spend the rest of the day and the next day in bed. I never had these issues until five month ago when I switched doctors. My previous doctor was a psychiatrist. I transferred my care to a Primary care doctor because there is a shortage of psychiatrists in my area and I don't take any psych meds. The new doctor seems nice enough so I don't know why I have such a bad reaction.
I have a few other thoughts. I have thought that I would like to have my dose raised a little maybe back to 3 mg a day. This might allow me to have a small stockpile in case of emergency. I have never felt totally comfortable on two mg. Sorry this post is so disjointed. Ever since I retired my writing skills have deteriorated.


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PostPosted: Tue Aug 16, 2016 9:40 pm 
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Hi Jeandiane, It is such a personal decision! I don't have an answer for you. I have tapered down to 4 mgs and my only reason for not having gone lower yet is laziness. I have not taken the time to cut the 2 mg strips in half! Please keep posting and let us know how you are doing!


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PostPosted: Wed Aug 17, 2016 7:48 pm 
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Definitely a tough call. I don't see relapse as a significant risk, given how long you've been on buprenorphine meds-- although I could be wrong about that. The main balance of risk is 1. the fear of withdrawal, vs. 2. continued anxiety about appointments, and perhaps an event that is problematic for a person on buprenorphine, such as major surgery. Surgery can be dealt with by competent doctors, but there are incompetent doctors out there, too, who refuse to increase their knowledge about buprenorphine.

My recommendation is to do a slow, patient, taper. People taper off methadone relatively easily in methadone clinics, because they decrese their dose by 2% every couple weeks. At that pace, withdrawal is minor and maybe absent altogether. The problem with buprenorphine is that there is no way to consistently taper at that slow speed. Depending on your financial situation, you may want to look into taking suboxone film, 2 mg dose units-- as they can be divided fairly easily down to very low doses. You could start with 2 1/2 strips per day-- 3 mg-- and every 2 weeks reduce your dose by an eighth of a strip-- which would be 0.25 mg of buprenorphine. That would be more expensive than, say, generic buprenorphine-- but it would be temporary. When you realize that a couple weeks in a detox unit costs over $20,000 the cost appears more reasonable!

To repeat an emphasize-- there is no NEED to have severe withdrawal when stopping buprenorphine. If you can taper it slowly, the withdrawal can be almost eliminated. The challenge is finding a way to reduce the dose consistently, and slowly.


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PostPosted: Sun Aug 21, 2016 12:13 am 
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Thank you Dr. Junig for your response. I do think that it is the time for me to taper off buprenorphine. I have a big issue with procrastination or maybe inertia. I have probably been ready to taper for several years.
I have been stable on 2 mg for several months and will decrease at my next appt on Sept 6. I don't have any time table, so will move to a lower doses when I am comfortable. I also have no prejudice about being a lifer if I ever feel unstable at any point in the future. I will keep you guys updated.


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PostPosted: Sun Aug 21, 2016 2:08 am 
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Hey JD,

Of course, agree w Dr J -- bc he knows far more than we can ever.. ever.. ever.... ever!!!

Hope you know a slow taper IS doable and has NO wds...

Separate from bup -- but on urinary flow - maybe TMI but have you considered a Uro-gyn? S/he deals w functional, stress, mixed, overflow, transient incontinence. My GF's mom did vaginal and pelvic retraining w a vaginal probe, which includes the MD and Physical therapist and had real success. Its NOT just kegel exercises which can worsen it. Its much more. GF's mom decreased from 4 X's/night to 1 x/night nocturnal visits to the loo.

Enjoy your posts, very helpful!! So glad you are here!! Peli

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Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


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PostPosted: Sun Aug 21, 2016 11:04 pm 
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Pelican, thanks for your reply. I had workup by uro gyn a couple years ago. Had pelvic ultrasound and CT scan. Uro gyn recommended surgery for rectocele and caruncle. I have done research online and it appears that surgery is successful about 50% of the time. I had chronic constipation on doses of 3 mg and day and up, so put off the decision until I was off buprenorphine. At this point I will have to go ahead with the surgery if the issues get worse. Constipation was probably the cause of the rectocele in the first place. I mentioned this issue as a cautionary tale for other women, especially those that are post menopausal.


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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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