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 Post subject: My dosage experience
PostPosted: Tue Nov 15, 2011 1:30 pm 
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I just want to share my experience/opinion about proper dosage and use of Suboxone. Of course it's true that everyone is different and is in their own unique situation (ex. if you're taking several fentanyl patches a day or anything close then this probably doesn't apply) and may need treatment beyond suboxone, but I was addicted to vicoden, oxys, pretty much whatever I could get my hands on including street heroin a couple times. At my worst I was taking up to 15-20 10 mg vics a day (which I know for some may not seem too bad..but it is. believe me). At that point I found suboxone purely by chance on the street and was fortunate enough to be told that all I needed was a 1/4 (2 mg) a day and that I should be fine. I had no withdrawal symptons while on the subs, however I took a 1/4 a day for about maybe 6-8 days then stopped. I was completely fine for about 3 days and then had what I would consider minor withdrawal, cold sweats, little achy, which lasted a couple days and then I was clean...and at the time I knew far too little about suboxone and didn't even know for sure that I was feeling WD from the subs. Unfortunately I was young, dumb, had other friends who weren't ready to stop, and I ended up in a pattern of relapse, subs, relapse, subs etc. After the last big relapse and getting up to 15 pills a day again, I decided to see a Dr that a friend recommended who had prescribed him subs. I was appalled that this Dr prescribed my friend 16 mg a day to start even though he too was on about 15-20 vics per day! The poor guy was spending as much on the script as he had been on pills, plus he was taking waaay more than he needed. When I saw the Dr I played kinda dumb and told him I couldn't afford that much and that I'd like to try a smaller dose to see how it goes. But since I was still in the dark about sub WD I took his advice and started on a slightly higher dose, anxious to stop my vic WD. Because of the amount he prescribed I got into the habit of taking 2 strips (4 mg) a day for months, thinking it was better than relapsing again. Sometimes I took more because I was stressed and felt the slightest high from it, I had trained my brain to need SOMETHING to be ok. But then I found it nearly impossible to get myself back to 2 mg a day. I was on it for over a year and it's only in the past couple months that I weened myself slowly down to 1 mg a day for a week, then took the last 1 mg dose on Thursday morning. It's now Tuesday (3rd day of work missed). We all know the feeling so I won't detail it, but Friday was horrible, Saturday was much worse, Sunday was barely better, yesterday was not quite as bad, and so far this morning I'm feeling a little cold, a little less energy, but mostly normal. It's been coming in waves though so I expect some more discomfort and lethargy today and probably little bouts of it over the next week.


So, sorry for the long post, but the main point is that many Dr.s really know very little about how this stuff should be used, aside from what their drug company rep (pusher) tells them. And obviously the drug company is banking HUGE profits from this stuff and the Dr.s get a piece of the pie. That's not to say all Dr.s are bad, or that none of them know the best thing for their patient, but I can tell you from personal experience and from the experience of my friend who is still spending $700 a month on the stuff and struggling to ween down to less than 8 mg a day, that there is no need whatsoever for anyone to be taking 24 mg or more per day for months and months. Even if you have a habit much heavier than mine I can be reasonably sure from experience that you can get by with a much smaller dose and that it should be taken for as short a time as you can without the chance of relapse. The only reason to remain on it for a long period is if you're simply not ready to stop using opiates, and even then you should be tapering and using as small an amount as is necessary to stop cravings and keep from being sick. I am glad that I found suboxone and I do believe it can help people immensely, but I wish so much that someone had explained to me in the beginning the dangers of prolonged use and the fact that in the end you'll be going through the same pain (or some believe worse pain) than just quitting whatever other opiate you're on.

My advice to anyone thinking of using it is to take as little as you can manage without discomfort and slowly taper to as low as you can before stopping. I'm on day 5 and I'm almost free of this horrible sh*t (again). Then comes the biggest challenge....staying off for good.

This forum is a great resource and I really appreciate what Dr. Junig is doing for those of in this terrible situation.

Good luck everyone.


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PostPosted: Tue Nov 15, 2011 3:18 pm 
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Hi and welcome! I am sorry you had a bad experience with sub. I see this is your 1st post here, so I wanted to fill you in on how the forum works.

As you did state everyone is extremely different and we respect that what works for one may not work for another. Or in your case what didn't work for you may be exactly what another needs. It is absolutely fine to post your experience and to state that for you only a low dose is required and you feel you should have been off sooner. In future posts please take care to not post things such as "nobody needs doses of 24mg or above" or "people should only stay on it for a short time and the only reason to remain on sub is that they aren't ready to stop using opiates".

The truth is there are reasons for higher doses for an extended or indefinate amount of time, one example would be an addict with a chronic pain condition. Also studies show that an addict on long term or even life sub maintenance has a much better chance of remaining in recovery, once an addict gets off sub that chance drops to single digit percentages. The reason behind sub maintenance is to keep the addict out of withdrawl but to also address the addicts cravings.

Sub has a ceiling affect around 4mg, meaning this is the amount of sub a person requires to have their receptors covered. When the receptors are covered the patient will not have any highs or lows and just feel "normal". In order to keep the receptors saturated it is recommended to prescribe doses comfortably above the ceiling, 8mg is an average dose. This keeps the patients blood level from dropping below the ceiling thru out the day (avoiding the highs and lows). Another reason for doses above the ceiling is to address one's cravings. When it comes to cravings we are all extremely individual and for some this requires high doses, although the goal is to find the lowest dose that will address your cravings.

I wanted to share with you a bit about how sub works. I would suggest watching Dr. Junig's videos on you tube, they are extremely informative. Now all that being said I do agree that for you and your friend's habit 16mg seems high. I also agree that there are sub drs out there that have no business prescribing sub but there are also many knowledgeable and caring drs.

We have many members that have successfully tapered off sub, reading thru the stopping sub section can give you information on how to properly taper off and lessen or avoid withdrawl symptoms. Starting your own taper thread can also help you out a great deal. It will allow you to see your progress and let other members know where your at so they can offer their advice. Please don't hesitate to ask any questions along the way. I hope you have a smooth, successful taper!


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PostPosted: Tue Nov 15, 2011 6:59 pm 
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thanks for the quick reply ann. i didnt mean to give the impression that i have had a fully bad experience with suboxone, and ill say again that im glad i found it. i do agree with you and thats why i tried to make sure and express the fact that there are situations which differ greatly from mine. however i felt it my duty to let people who are in a similar situation as my own,and i believe there are MANY (and it is my honest opinion that the reason is partly due to the over -prescription and unnecessary prescription of painkillers to people who could do just as well with a non narcotic medication), that they really do need to educate themselves before simply accepting a dr.s word about how much suboxone they need. none of this is cut and dry, but it is my guess that the majority of prescription and other opiate abusers out there are closer to my situation than some of the other examples you mentioned. and in many of those cases the dr.s themselves may share some small part of the blame (though i do believe that as opiate addicts we make our own choices and have our own biology to deal with), whether by choice or ignorance. i think its fair to say that any dr. who has been through opiate addiction would hesitate to help begin the same process for a patient who could otherwise heal or deal with pain in a different way. and so when a general practitioner, which is probably where most people go first when they want help, knows only what a drug rep from reckitt benckeiser has told them, even if they are a good well meaning dr (and i believe my dr is just that), they may make the mistake of prescribing incorrectly and prolonging the financial burden and dependency of someone who could do much better on a smaller dosage.

i hope thats a fair and accurate assessment of where im coming from. again, i do very much appreciate these forums, and i have watched dr. junigs videos, but there are many levels to this struggle, and any element that makes it even harder than it already is, is something that i wish to help eliminate or at least offer education about. im not against suboxone, i just want to make sure people take it the right way for them and dont end up in another financially draining trap, no matter how helpful, if they dont have to.

thank you for the well wishing...im halfway through day 5 and feeling WAY better. back to work and the real world tomorrow...

thank you.


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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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