This is my first week on Subs (never taken before). I'm coming off a pretty high roxy habit, over 200mg a day for the past 3 years. I inducted myself on Monday and it took 16mg of Sub to fully control my withdrawal. The next day I took 12 mg, Wed and Thursday I took 10mg ....it seems like at least for now, 10mg is the minimum I can take to keep withdrawals away, however I'd ideally like to get down to much lower levels as quickly as possible. I read how so many people are fine with 2mg or less.

So just a couple quick questions....do I need to stay at a consistent level for while, say 10mg, or should I continuously be making the effort to try and taper down? Also, can anyone provide me with a realistic goal in terms of time I should shoot for to get down to 2mg? A month, 2 months, 6 months..?

I'd ideally like to get off Subs sooner then later, just don't know if that's realistic yet.

Thanks so much.

Skinsboy, I have gone back to your old posts and I'm seeing some troubling issues and themes.

It took you a couple of years to actually start suboxone, in part because you enjoy your opioids. It took until now, and possibly a New Year's resolution to start MAT. You obviously don't have a doctor who is prescribing your medication.

You seem to be on suboxone with the almost immediate goal of getting back off of it. Please let me tell you that this is not how it works! The point is not to just use suboxone to wean off opioids. Especially since you don't seem to be at a place where you hate active addiction, hate your life in active addiction, think that your active addiction was the worst thing that ever happened to you!

Your mindset, if you really value your recovery, should not be about how you taper down as quickly as possible. It should be that you are going to use your time on suboxone to work on yourself, go to SMART Recovery meetings, go see an addiction therapist, get help understanding your triggers and what led you into addiction in the first place. Because if you don't use your time on suboxone to change yourself, you will be right back where you started as soon as you go off the medication.

So here is my advice. Stop worrying about tapering! Stay at a level that is both keeping your cravings and your withdrawal symptoms at bay. Don't focus on how you're feeling all the time. Focus instead on improving yourself. Spend more time with your family. Find a constructive hobby. Volunteer your time in an endeavor that improves your little piece of the world. You have a lot to give! And now that your brain isn't going to be 100% occupied by your next high, the world is your oyster. Develop new interests.

Take at least 6 months of not thinking about your suboxone. Just enjoy the feeling of being free from active addiction. I'm really glad that your induction has gone well and that you have found a dose that works for you. I urge you to put all of your energy into doing awesome things, and don't worry about tapering at this point.

I hope you keep checking in and telling us how you are doing and the ways in which your life has changed and improved. I'm pulling for you!!

Amy

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Done is better than perfect!

I think some ppl focus so much on tapering and thinking their recovery is going to be negative if they don't hurry and stop buprenorphine as quickly as they can.... they aren't realizing that rushing isn't going to do themselves a bit of good. In my opinion we shouldn't be starting this treatment already looking to taper. You have to adjust and work on urself and breathe just a little while, give urself time to be at peace and get ur head right before u even start to think about tapering down.

I understand that those who aren't lucky enough to have a doctor are a little more motivated to stop quicker but those are all things someone should think about before starting this treatment. If u rush urself down low enough then ur not going to have ur cravings covered and I think cravings are the absolute main reason we relapse. So if that isn't covered then why bother? I take suboxone because I cannot fight those cravings and win long term. I might can for a little while but it wouldn't be long before it consumed my every thought.... because I am an addict.

Everyone has their own pace, and we're all different on what milligram we take or maintain at, but it takes time to get there. If u do it before ur ready and before u stabilize, ur rushing urself. Don't rush urself, enjoy waking up in the morning with a day in front of u that doesn't involve panic and breaking the law because it's a wonderful feeling if u stop long enough to enjoy it

I'm echoing what Amy has said because I see so many rushing themselves and it just doesn't work that way, if it did then we'd all do it as quickly as possible. Let's face it, the financial part alone would be why I'd rush if I could but it just doesn't happen like that.

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Jennifer

Ladies,

Thank you both for taking the time to reply. You are both correct, I delayed going on Suboxone for a very long time mostly because I spent so much time reading forums and started debating if it was the right move for me. However, today is my fifth full day of suboxone and all I can say is that I extremely happy with the results. They are exactly as advertised, they stop all cravings and keep me out of withdraw. I honestly wish I pulled the trigger a long time ago.

Just to clarify, a while back I did ask about going back to oxy's after Suboxone and that was only as a worst case scenario if I didn't like the Subs, but I can say with 99% certainty after almost a week on them, that won't be happening. To put it this way, as long as no negative side effects or crazy surprises pop up in the future and the Subs continue to do what they are doing for me today, I can see myself on them for quite a long time. I'm just one of those people that likes to have a little opiate in their system, for whatever reason...I don't need to get "high" anymore, cuz its been a long time since I even felt any high, but just that little.. whatever you call it....

So the reason I was asking about tapering down is only because its seems to be what so many folks recommend to do on various forums. I'm actually glad you guys are telling me to take my time because it seems like at least for now, around 12mg is the right dose for me. I'm just wondering how long should stay at this level for before I start even thinking about tapering? Is it simply when I think I'm ready or is there a physical reason I should stay at the same level for a while? Ive just read so many stories how people say they started at 24mg and within like a couple months they are at 2mg...Just seems like a huge drop...Guys thanks so much.

Skins I'm so happy to hear ur doing great right now! Good news!

The drug of choice at the time I inducted on suboxone was the oxycodone 30's too and my daily tolerance was over 150mg a day.... some days more some days less. My starting dose of suboxone was 16mg. Looking bk I do think 12mg would have been perfect though but it's fine regardless. I probably stayed on 16 for over a year before my doctor dropped me to 12. About a year or so after that I dropped myself (with my doctors blessing) to 8mg. That's where I've stayed. Years I've stayed at 8. Many many others would have done it a little quicker but everyone is different. Use ur own judgement on when ur ready. Knowing what I know now, I could have dropped from 16 to 8 and not tell any difference...... but I wasn't aware of all that at the time.

My point is that there's no rush. Don't put a time limit on urself. I guess u could if u wanted to but personally I did it when I was ready. As long as ur over the ceiling level, ur cravings are met, then just listen to urself on when u should drop a little lower. Everyone is different, but one thing I think we all need is time in the beginning of this treatment to just stabilize and breathe. Work on ur recovery, talk to a counselor or some type of meetings that fit u...... that's what I would do instead of worrying about tapering already. You'll read all kinds of horror stories and stuff online but those ppl aren't u and have no idea what ur journey has been or will be so don't listen to all that.

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Jennifer

Jenn,

I appreciate the great advice. It seems like you've been on subs for many years and I"m just curious what type of long term side effects you've experienced? I'm not talking about the typical stuff like maybe constipation or low libido, but like did any side effects pop up a year or two after you started that weren't there in the beginning? Thanks.

I don't think I can really report any long term side effects. Nothing has bothered me, I go through each day and probably wouldn't notice taking the medicine at all if it weren't for the actual routine of taking it each morning..... hoping that makes sense.

In the beginning I had a couple of side effects which was the sweating like crazy and some headaches but like I've said before, no matter what side effects I'd go through it would never be as bad as active addiction. I never worried about anything like that, I was so desperate to stop using that I would have accepted any side effect. That's just how my outlook was at the beginning of my treatment.

Some members here have complained of side effects over the long term but the vast majority of us have not. All I get is a little drowsy if I don't keep busy after dosing. Just have to keep busy and you won't notice a thing.

Go back and read some older comments and it appears Suboxone is responsible for the great plague and other human diseases. I mean really, some of the things people say it does is ridiculous.

Glad you found relief with it though. So many have suffered or died because they didn't want or know about taking Suboxone. Those of us who found it are very grateful we don't have to battle cravings everyday.

BD

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If there is no struggle, there is no progress.
Frederick Douglass

Thanks for the replies guys. As I said before I couldn't be happier with my first week on subs and I definitely regret waiting this long to try them. I'm gonna continue to post and let people know how it goes.

Good discussion. Yesterday I was talking with a patient who has been on buprenorphine for about 5 years. He is in the tapering process, and doing well. His case is similar to many other patients I've had over the years; he tried to taper earlier, but found that he would get to a certain point, and then he would go back up to 16 mg for the mild effect it provided at that dose. What we both noted is that one year is barely long enough for the best patients, and not near long enough for most patients. The goal is to see one's self differently; as someone who is not part of the using world. That takes time- sometimes a long time. But once a person gets there, the taper becomes much easier.... where the person no-longer has any desire to feel an opioid effect, and the taper is only about physical symptoms.

The hardest thing about being on buprenorphine from what I see is dealing with all of the ignorance out there from friends, family, pharmacists, and doctors, who blame all of your problems (and their problems) on you taking buprenorphine. As for side effects, I truly rarely have patients complain about them. Hot flashes and constipation are about the only thing. Yes, people blame Suboxone for tooth problems-- but there is no evidence of a connection, and really, think about it-- a person's teeth are exposed to all of the chemicals in cigarette smoke, bathed in gallons of soda each day, used to chew all of the food the person takes in-- and 10 minutes per day of a non-acidic, non-corrosive medication is going to rot the teeth? I don't think so.

Good luck with the treatment, and yes- don't go too fast. People do fine getting down to 8 mg, even quickly-- but you will want to go down by about 5% every couple weeks from there.

Thank you Dr. Junig!

Hearing about your real world experience with patients is so valuable. Thank you for sharing it!

Amy

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Done is better than perfect!