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PostPosted: Fri Mar 01, 2013 10:26 pm 
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Hello all, I am here asking for some opinions and advice on a concern I have with my suboxone treatment.

I will start off by saying, I was using IV heroin and cocaine for a year, hydromorphone for 2 years before that. I started suboxone on February 5th, 2013.

On the induction date, I was given 2mg to start, an hour goes by and I feel surprisingly well, perfectly fine actually. Some minor stiffness but nothing I would attribute to being currently in withdrawal. He insists on giving me 2mg more, he says to last me to the next day. I agree and take 2mg more. No real changes felt, doses taken too close to each other to discern any difference if one was there anyways.

So day 1 of suboxone was 4mg basically taken at once (2mg 1hr apart).

So the 4mg of suboxone at once in the morning was not enough to see me through to the next day. I began feeling light withdrawal symptoms around 6pm and sleep was very very poor. Consistent wake ups, and early rising. I told the doctor this about 3 days after my induction, he increased my dose to 8mg. I was against this, as of this date I am currently at 18mg suboxone taken at around 10-11am at the pharmacy daily.

*This is where my questions starts to seep in. I requested to be put on a split dose, I have a very fast metabolism, but he refused. He said it's more effective taken all at once, I understand this helps against addict like behavior, but I felt fine with 2mg in the morning, I truly felt I did not need more. I felt if I took 2mg in the morning, and 2mg at night, my dose would not have to be increased further than 4mg/day total. My doctors philosophy is one dose in the morning, no matter what. I gave up after the first week because things WERE working, but I am young (21) and do plan to taper, and want to make that as simple of a process as possible. I believe taking 18mg/day will be more difficult to eventually get off rather than 4mg/day split dose. What should I do? Is it really not good to take a split dose? Should I just keep increasing until my dose sees my until my next one? As it is now I still wake up at 7:30am everyday and need the suboxone to be normal and to start my day. <-This means my doctor will increase my dosage. It does not seem to last past a certain time no matter how high he increases the dosage.

Basically, 18mg once a day or 4mg twice a day.

Please feel free to ask any questions, I imagine I have left something out. After passing 8mg I did attain a certain cloudiness, which has somewhat decreased but still apparent.

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PostPosted: Fri Mar 01, 2013 10:39 pm 
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Firstly welcome to the forum. You'll find that if you have any questions, there are people here who've probably gone through exactly the same thing you are.

I'm an ex-IV heroin and cocaine addict who started pretty young - 17 years old. It's a really nasty addiction, and it's fantastic you've found your way onto a program. I also did Subutex treatment quite young, and I really do believe that the most important thing is to make treatment as comfortable and accommodating as possible.

I have a very fast metabolism and dose twice a day. Like you, dosing twice a day means I don't need a much higher dose to hold me over the 24 hours. I can have 4-6mg twice a day instead of 18+mg once a day. The main benefit of the split dosing is less side-effects. Less foggyness, less headaches, less sexual blahness.

Downside of twice a day dosing is you gotta have that gunk in your mouth twice a day instead of once. After a while that can get to you.

It sounds like you have an intuitivate grasp of what's going on with your body which is great. But it's hard if your doc doesn't want to play ball. But what he doesn't know .... ???


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PostPosted: Fri Mar 01, 2013 10:43 pm 
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This is true. Next time I see him is Tuesday and I should be getting take homes.

Thanks a lot TeeJay, all of your advice has helped. :)

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PostPosted: Fri Mar 01, 2013 11:09 pm 
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I am supposed to be taking 16mg a day but I am on 8mg a day. What I do and it seems to work well for me and the DOC said that its up to me how I take it, but I do 2mg doses every six hours. If I take a dose of the morning, which usually allows me to get back to sleep after my husband leaves for work I am fine until about 1 in the afternoon. Then I take another dose, and another one at 7 in the evening. Some days I might just take it twice a day but during those monthly times, us women know what that is I do small doses in a analgesic method to take care of the crampies. I have horrid cramps, so that helps ALOT.
Its the worst time of the month for me and it gets me to the point to where I am curled up in my chair moaning. Hubby says that I should have something done but having another surgery is not my cup of tea right now.
I think if the dosing for you is better to do it twice a day because you start feeling yucky in the evening, that is fine. My doc said that he has patients that take it once a day and he has patients that break it up during the day in small doses. He said whatever makes you comfortable is the best thing for you to do. He is the type of doctor that basically just wants the patients to be comfortable and not have stresses. I told him at my last appointment if he wanted me to be stress free to write me Subutex LOL.

Oh boy cant wait for pharmacies to start getting the new generics gonna make some phone calls tomorrow.

Have a good evening fellars


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PostPosted: Sat Mar 02, 2013 3:25 am 
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Oh hey one more thing. Are you on any medications other than Suboxone? Some medication can speed up metabolism of Sub in some people.

Also you mentioned take-homes. Does this mean you get dispensed your dose daily from the pharmacy like in some countries (Australia / UK)?

I get 5 x take-aways per week, and have to go to the pharmacy at least twice a week to pickup my doses. Fortunately my doctor seems more understanding than yours and prescribes me split-doses, so I go to the pharmacy to take my morning dose, and am given the PM dose as a take-home.


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PostPosted: Sat Mar 02, 2013 5:50 pm 
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I do exactly what pitbullmomma does


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PostPosted: Wed Mar 06, 2013 12:09 am 
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Def try the split dose, specially in the first month or two. Then when you get used to it start thinking about one dose daily. 18mg single dose is hilarious, do you have Dr. Greg House?lol.. Thats way too much, your receptors are max out at 8-10mgs. The rest is just a waste. You could take 70mg and have same effect. Once you hit the ceiling and max your receptors with bup thats all you get. They made suboxone this way to prevent build up effect and abuse so your "doctor" should know that. Most docs dont know anything about subs so best if you do alot of research.


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PostPosted: Wed Mar 06, 2013 12:54 am 
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Rick Balls wrote:
Def try the split dose, specially in the first month or two. Then when you get used to it start thinking about one dose daily. 18mg single dose is hilarious, do you have Dr. Greg House?lol.. Thats way too much, your receptors are max out at 8-10mgs. The rest is just a waste. You could take 70mg and have same effect. Once you hit the ceiling and max your receptors with bup thats all you get. They made suboxone this way to prevent build up effect and abuse so your "doctor" should know that. Most docs dont know anything about subs so best if you do alot of research.


That's not really true. The reason some people need to take up to 32mg is so their receptors stay maxed out over 24 hours. 10mg may max out receptors for a full day for some people, but OP is a rapid metaboliser of Sub, so may be finding their plasma levels of Sub drop below ceiling level within a few hours of dosing.

Buprenorphine has a variable half life of 20 - 70 hours. It's varies so much because people metabolise sub at different rates. A person with a rapid metabolism will need over 3x the dose of a slow metaboliser to keep their levels over the ceiling for the same amount of time. Some people with crazy metabolisms may need a 32mg dose to sustain blood levels over the ceiling for 24 hours.


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PostPosted: Wed Mar 06, 2013 12:15 pm 
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That sounds good on paper but I have enormously fast metabalism and could testify against this theory. The best part of suboxone in my experience has been the long lasting effects. Not having to watch the clock anymore or worry to much about rapid wear off effect. From my own research have found that when your receptors are full that is it. Anything more will be excreted or wasted. Your body doesnt store extra bup for latter. Some people get used to taking large doses and mentally cant lower it but in reality they are wasting alot of meds. My tollerence and metabolism of opiates is scary high. They used to give me enough pain meds in one day that would last normal person a month. Still was not working for me at all. I was questioning if they even gave me real meds because didnt feel anything off of a 500mg dose. Thats why I started subs because there was no med left to give me. Completely max out on all opiates with no effect. Everyone has diff experience but some doctors go crazy with the milligrams on subs. I think they try to get new patients deeply hooked on subs with high doses. Maybe they think your a possible relapse case or just trying to milk your insurance.


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PostPosted: Mon Apr 01, 2013 7:44 am 
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I find that dosing twice daily works well for me but to each his own. I've tried once daily in the morning but in the afternoon I start feeling bad although that maybe in my head.


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PostPosted: Mon Aug 18, 2014 9:43 am 
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I'm very education on nutrition and drugs. I quit methadone on 90mg cold turkey and never got sick. I wanted to switch to Suboxone because I could not deal with the line every weekend and the people telling war stories. So 14 days clean I started on Suboxone. Not one time did I feel anything but that I was cold. I NEVER GOT SICK Okay. So let me tell you my experience and opinion. Im not a Dr or a Scientists. Well at least not with a licence lol. Okay so For one half life means if you are on lets say 100mg of anything that has a 24 hour half life. At 24 hours you still have 50mg in your receptors. Your metabolism does not effect this much period. That is bullshit you heard and believed in the methadone line. Nonsense! Know the reason you might feel withdrawal symptoms is because your body needs more than 50mg to feel ok. On your first day. Now on day two you take another 100mg. Now you're receptors have 150mg working in them. So now you feel great. So this 100 to 150mg range is what feels best for you. So taking that 100mg in two doses the first day isn't going to tell you shit. Now let's say you been on for a few days and you decide to try splitting up your dose. Day one 100mg you add 100mg but 50mg of day one is gone. Its not going to matter much if you take 50mg then eight hours later take another 50mg or if you take all 100mg at once. Because you're receptors have a constant 100-150mg maybe more because Its compounding and you feel good at 100mg. You might feel a little different but not enough to be thinking about it so much. Either that or your just week minded. This is why when most people stop lets say methadone. The first day isn't to bad. The second day you start feeling it. But then the third day your in hell. Because although it has 24hr half life it takes well over that for it to actually come out of your receptors. Everyone is different yes. Some arent as healthy as others. Some have strong minds or willed some are weak. Some Fat some skinny. It doesn't mean shit. Where all drug addicts period. The half life and compounding is much more technical than I can explain so I hope this makes some sense of it all. Stay Blessed not a mess! And remember everything is easier with God the Holy Spirit and his Son.


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PostPosted: Mon Aug 18, 2014 9:02 pm 
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I know that this is well over a year ago since this conversation started but someone will read this in search of help and I just wanted to recap about what I wrote. And also back it up with proof because in the world of addiction and trying to get clean my opinion.. Is that Facts always out Smack..
So here it is.. On 8/1/14 at 8am I took my last dose of methadone at 90mg. 14 days later with zero withdrawals I walked into my Suboxone Dr. Office. At noon and after a full examination she gave me half of a 8mg pill. A hour later I was feeling great and whent home. As directed six hours later I took the other half. Now here is where I stopped doing exactly as directed. The only reason I did this is to prove what I know about nutrition and drugs to be true. suboxone has a 24h half life and that means at 12h it should have already started to slowly drop in my receptor cites. Now the original question was should you split up your dose I believe. Now Saturday at noon I took 4mg and eight hours later i took another half. My dr only wated me to take 8mg on day one and 4mg Four times a day after that. I am still doing so but only the first two days and this is to get it built up in my receptors. Then on Monday at Six am I took both 8mg pills back to back. This was to provide you with proof that you don't need to split up your dose. And if you're still wanting to get a slight buzz. Wich is what happened to me and I honestly am way past the wanting to get high days. I never felt any withdrawal symptoms and I am ready to go to bed and wake up at six am take my medicine and start working on my life again. I had to leave my job just so I could quite methadone and make the transition to suboxone because although I didn't have any withdrawal symptoms I was lacking energy and depression started to set in. This life is not easy and most of the time we are our own worst enemy. You can call me a drug addict looser or whatever you want. But in the end you will see that I'm a Soldier in a Spiritual battle who is winning his war so keep on judging me and in the end we will also see who you bee...
Stay blessed and if anyone needs help please don't be afraid to ask... STAYSTRONG!!!


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