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 Post subject: My first day on Suboxone
PostPosted: Mon Oct 04, 2010 10:15 pm 
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Hi everyone. Today I just began taking Suboxone 8mg. The doctor told me that it was vitally important that I take this medication as prescribed. $939.00 for 120 pills with no insurance. The instructions on the bottle say that I should take them 4x daily for the first 30 days. Since that would be 1 tablet every 6 hours do I need to set my alarm clock so that I take it when I'm asleep or can I tak 2 in the am then the other 2 every 6 hours? His office is closed now so I can't call him until tomorrow. What should I do? Just don't want to mess things up for myself since I have never been able to take any drug as prescribed with any success. Thanks in advance. I'm glad to have found this site. Joe


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PostPosted: Tue Oct 05, 2010 7:10 am 
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Hi Joe and welcome. Congrats on making the leap to addiction remission! You should be fine if you don't set your alarm to get up in the middle of the night. He started you out on a really high dose, just FYI. How are you feeling? Now I'm not telling you to disregard your doctor's orders, not by any means. You'll probably end up stabilizing on a lower dose anyway. It's not uncommon to start out high and then go down to a lower dose for maintenance.

Again, welcome, and when you're ready, maybe you can tell us more about yourself.

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PostPosted: Tue Oct 05, 2010 10:42 am 
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It would be helpful if you shared a little more about your situation, if you are comfortable doing so. 32mg a day is high and most people do just fine with half of that. Nobody here promotes not listening to your physician, we offer support and our own experiences to help. Suboxone is very misunderstood, misused, and under/over prescribed more than any other drug I have education about. Your best bet is to educate yourself in as much of an unbiased way as possible, stick to the facts and listen to what your body tells you- if you feel overly sluggish and unmotivated, it is highly possible you are over-medicated and you should address this with your doctor asap!

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PostPosted: Tue Oct 05, 2010 1:31 pm 
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I agree completely with shelwoy, that's a TON of suboxone. As I've mentioned on here many times, I had been abusing opiates (prior to December 2008) for over 30 years and at the end, just before getting on suboxone, it was not at all unusual for me to consume 600+mg per day of oxycontin, and I wasn't even getting "high" from it any more, I was just getting to a point of not feeling sick, and yet, when I got on suboxone at 16mg per day for the first week I was practically drooling on myself.

And OMFG :shock: $939 for 120 tablets? That's $7.83 per tablet. That just infuriates me to no end. :twisted:

Disclaimer: I am NOT a doctor

But with that said, Joe, I'd start with HALF that dose and see how I feel if I were you. And no, you don't have to wake yourself up at night to take anything. Subxone has a very long half-life, meaning, it stays in your system for a LONG time. If you take 8mg right now, 36 hours from now, you'll still have 4mg in your system. Taking 16mg daily will cover just about every (if not every) opiate receptor in your brain completely. Taking another 16mg per day on top of that, in my view, is a waste of money and medication.

Again, I am not a doctor, and generally, I do not advocate ignoring a doctor's advice, but sometimes.....I dunno, this just seems, well, like too much......

But we don't have the full picture. Would you mind telling us a bit about your drug abuse? Maybe there is a legitimate reason why the doctor has placed you on such an incredibly high dose.


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PostPosted: Tue Oct 05, 2010 3:28 pm 
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I started abusing opiates in the late 1970's up until October 2, 2010. In between that time, the most sobriety that I was ever capable of putting together was 2.3 years. My average yearly pill consumption was usually between 5000 and 9000 pills per year depending on resources, finances, etc. I did heroin very briefly in 1992 and never touched it again. My pill usage consisted of Oxycontins, percodan/percocet, lortabs, vicodin, codeine, morphine, darvacet, but the past 10 years have been primarily Oxy's, Perc 10's, Vic 10's, and Norco 10's. I sustained my addiction through doctors/dentists but mainly from off the streets. It's a lot of work keeping an addiction going. I am exhausted after this 30 plus year run. Not sure how I survived through it all. Believe me, a lot of damage was done being an addict. When I took my first Suboxone yesterday, it was like the weight of the world was taken off my soul. I have some peace right now and I simply cannot believe that I do. It feels surreal.
What I don't understand is why my dose is so high. I called the Doctor this morning to let him know that I didn't sleep well last night and he said that it will take some time. He wants me to take 32mg of subs for the first 30 days. I don't feel that I need that high of a dose. 24mg seems ok with me. Should I just take it on my own to lower the dose or have faith in what he is instructing me to do? Never in my life have I ever been able to take a narcotic as prescribed. Yet, here I go again wanting to change my dosing at day #2 on suboxon! What should I do? Thanks in advance for all suggestions. Joe


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PostPosted: Tue Oct 05, 2010 3:42 pm 
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What if the next time you talk to him you just tell him that with 8 hours sleeping you've been taking it 3 times a day and that you feel fine. That way you're being honest with him and staying at only 24 mg. Just a thought.

I think the reason everyone is saying that 32 mg is extremely high is that's the maximum dose and most people are on between 4-16 mg. (I won't go into the ceiling effect right now.) Personally, I dose for pain control as well as addiction and take between 16-24 mg and many people consider that too high. If you feel good at 24 mg and are not lethargic or overly sleepy, then maybe that dose is right for you. Usually if someone is on too high a dose they are really tired all the time, practically nodding off.

I think you can probably be honest with your doctor and stay at a consistent dose at the same time (24mg). No one here - aside from Dr. J - is really in a position to tell you to disregard your doctor's orders. I surely am not. Good luck and just take it one step at a time. It will work out fine.

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PostPosted: Tue Oct 05, 2010 4:01 pm 
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Yeah, I agree with Hatmaker, it's a slippery slope to get on, lying to the doctor for any reason.....but your drug use sounds a lot like mine, except I was an IV heroin abuser for about 16 years.....

If he wants you on 32mg, well, I guess you have to decide if you're going to take the entire dose or not.

There were days when I first started taking suboxone that I would skip my evening dose. I was taking 8mg at 6am and 8mg at 6pm and I found that I seemed to sleep better when I didn't take that second dose. And I'll be honest, I didn't tell my doctor that I had skipped those doses. I'm not saying you should do that, I'm just telling you what I did.

I started tapering after my first month and I really thought that the best dose for me was right around 8mg until about 3 months ago when I realized that I was sick of having zero sex drive, so I'm currently on my way back down to a dose of 4mg per day, where I will likely remain indefinitely.


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PostPosted: Tue Oct 05, 2010 4:49 pm 
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Just like 99% of us here, I am not a physician either. I often wonder why I even bother saying that but in the interest of full disclosure... I'm not a doc. However, I do have nearly 25 years of experience in direct patient care, including having a state license to take care of patients in the emergency care setting.

I won't tell you what to do. You have to figure that out on your own. However, I can and will tell you what I would do if I were in your position and that is I would at least attempt to take less medication than is being prescribed. I hasten to add in that what your doctor is telling you to do concerns me on a variety of levels and for a variety of reasons.

1. If you ask 100 doctors who prescribe Suboxone, I am pretty certain that at least over 50% of them will agree that it is rare that more than 16 mg is needed. I'm also pretty certain that over 50% would agree that dosing more than twice a day is not a good idea.

2. From all I have read, it seems very clear that the current best practices of Suboxone entail dosing with no more than 16 mg and dosing once a day. It really does seem that the "typical" doctor is now practicing this way.

3. COST MATTERS!!! Let's say for sake of argument that 16mg works just as well for you as 32 mg does. That means you will have wasted over $450. That is not chump change.

4. I guess above and beyond all of this, I would question whether I had the "right" doctor or not. I obviously can't make the determination based on the small amount of info that I have. I am just saying that anyone who tells me they are being told to dose Suboxone four times a day with a total of 32 mg, I would really question where that doctor is getting his/her info from. It just simply flies in the face of what many doctors today suggest - including the doctor that owns this web site.

5. Now, this dosing and frequency does meet current best practices for treating pain with Suboxone. Are you treating pain as well? Does your doctor for some reason think that you are needing to treat chronic pain?

So if it were me, I'd try taking 8 mg in the AM and 8 mg in the PM and see how I felt. If I felt like I was in withdrawals, I would try a third 8 mg dose. I guess the other alternative to this might be taking 4 mg, four times a day. Let me also add in that when I was induced onto Suboxone at an in-patient center ayear ago, the doc treated EVERYONE the same. It did not matter who you were, your history, how long you had been an addict, how much you took - any of it. We all got 8 mg / twice a day. I'm not at all saying this is right. I'm just saying that everyone that I was there with felt fine on this dose. The nurses told me they have never seen a patient started on anything else.

Take this info and put it together with everything else in order to figure out what is best for you. If nothing else, I would remind this doc of the out of pocket cost to you and implore upon him that you not waste any money on Suboxone that you don't have to. You may also want to ask him why doctors across the USA have received bulletins suggesting that they not prescribe more than 16 mg/day. There must be a reason for it.

Hope that helps you!


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