It is currently Wed Aug 23, 2017 3:11 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 14 posts ] 

Daily maintenance dose
< .5mg/day 3%  3%  [ 2 ]
2-4mg/day 11%  11%  [ 8 ]
4-8mg/day 35%  35%  [ 25 ]
8-16mg/day 28%  28%  [ 20 ]
> 16mg/day 24%  24%  [ 17 ]
Total votes : 72
Author Message
 Post subject: IS IT IN MY HEAD?
PostPosted: Thu Jun 11, 2009 12:15 am 
Offline
Super Poster
Super Poster
User avatar

Joined: Tue Jun 09, 2009 10:19 pm
Posts: 104
Location: Youngstown, OH
I've been taking suboxone for almost a year now, I have a few posts explaining my story (addicted to posting now) and I'm still on 24mg/day. It seems like everywhere I look people posting on this and other sites are at a much, much, much lower daily dose. The average seems like 2-4mg/day. When I try to cut down on my own (mainly to lower costs by taking lowest possible dose) I get very irritable, feel like crap in morning, sleep a lot more, and generally feel crappy with lots and lots of cravings. The dose change is 8-12mg/day, with changes showing after only a day or two, and from all the info there shouldn't be ANY changes at all. IS IT ALL IN MY HEAD, OR DO I REALLY NEED THE 24MG DOSING? B.T.W.-Doctor says: "hang in there, it will be a lot cheaper soon, and your one of my success stories right now, keep up the good work."

- JayJay


Top
 Profile  
 
 Post subject:
PostPosted: Thu Jun 11, 2009 10:11 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 13, 2009 2:11 am
Posts: 427
Location: Fishers, Indiana
I'm not you obviously but my experience has been that there is absolutely no actual withdrawal dropping down to 2mg a day, the key I think is getting good absorbtion when you dose Dr. Junig suggests a method that's located several other places on the forum which helps quite a bit I think. When I first started Sub I was so hyper sensitive to anything that felt even remotely like withdrawal (sweating especially) but have learned that like others have suggested if you don't give into these fake withdrawals they dissapear pretty quickly. Ultimately I think you and your Doc should be the ones to decide what dose is right for you but after I'd been on 16 mgs a day after induction I went down to 8 because it's cheaper and haven't noticed a difference yet and it's been almost 2 years. I think we're just really prone to fears of withdrawal, especially if we've had some really bad experiences in the past.

_________________
"If you're going through hell, ....keep going!"
-Winston Churchill


Top
 Profile  
 
 Post subject:
PostPosted: Fri Jun 12, 2009 12:44 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
I started on 16mgs and dropped down to 4mgs in like 2 steps. I had some of those "pseudo withdrawals" that are really just your mind faking you out. You can tell they're fake casue if you don't give into them they never really progress into full withdrawal and eventually they go away.

I used to feel like my Sub was wearing off every evening, then I figured out that I was just tired and my brain interprets me being tired as me needing more drugs. Hmm...

From 4mg to 2mg was really easy too. From 2 to 1 was a little worse, now I'm down to .5. There were a few rough days but nothing to miss work over, and now I'm fine again. I'll be doing another drop starting tomorrow so I'll keep ya posted.

So, yeah -- it's in yer head. That's ok though, it's just something to get through and overcome. You can do it. I found I felt much better at a lower dose anyway.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Fri Jun 12, 2009 1:57 am 
Offline
Super Poster
Super Poster
User avatar

Joined: Tue Jun 09, 2009 10:19 pm
Posts: 104
Location: Youngstown, OH
I know what you mean by "pseudo withdrawals" I was at work today (day 2 cutting down to 2 8mg/in a.m.) and while at work around 10:00pm I started getting cold sweats, chills, headache, and just a general crappy feeling. Well since this is the first time i've REALLY tried to cut down, and I'm new to the one daily dose (only a few days) I gave in, but I still think I did good, only took 1/2 pill rather than the usual whole one. My goal for the next two weeks until see the doctor again is to get myself to just taking 2 in the morning, and none around dinner time. This may also let me stock up on some extras so when I get down to like 1/8 pill or less I can do the last few steps on my own, rather paying the Doc. $200.00 for a few dollars worth of RX (hopefully we all get a nice break come sept. or oct. this year) Thanks for the feedback :)

-JayJay


Top
 Profile  
 
 Post subject:
PostPosted: Fri Jun 19, 2009 2:00 am 
Offline
Super Poster
Super Poster
User avatar

Joined: Tue Jun 09, 2009 10:19 pm
Posts: 104
Location: Youngstown, OH
OVER 100 VIEWS AND ONLY 5 POLL RESPONSES!! NO ONE CURIOUS ON THE AVERAGE DOSE DOCTORS ARE USING FOR MAINTENANCE?


Top
 Profile  
 
PostPosted: Sun Aug 23, 2009 3:14 pm 
Offline
Average Poster
Average Poster

Joined: Sun Aug 23, 2009 12:03 pm
Posts: 4
Just joined this site. Haven't told my story yet. But the bottom line is this: 24 years on heroin, 2.5 years taking Suboxone devotedly, without "relapse".

I started at 8 mg. and gradually titrated myself, in consultation with my fabulous physician of course, to my current dose of 36 mg./day. Clearly my dosage is an "outlier", statistically speaking, when measured in reference to those who belong to this site/group. And my approach and beliefs seem to run counter to the norms of this forum. So I'm not sure how welcome I will be here.

As an opiate addiction/dependence/use (and these are distinct modalities) and opiate-related morbidity/mortality scientist, I can tell you with certainty that EVERYONE is different. Do you remember your days of using? Did you have exactly the same reaction as your fellow users had to the same drug? Did the drug(s) affect you in the same exact way? Was your withdrawal exactly like that of everyone else who was using the same stuff at a roughly equivalent level? Most likely, you would answer "No" to all of these questions. So why would we assume that everyone should be at the same dosage of suboxone? Every body (as in everyone's body) is different, and suboxone should be administered according to this fundamental premise. The standard dosage information we read about is based on large-scale treatment sample studies ... they may represent the norm ... but just because the average dose is Xmg, it does not follow that you therefore will feel good at Xmg. There is no more logic in this presumption than there is in the statement "The average lifespan for males in the U.S. is 73 years; therefore, you will live to be 73." That's ludicrous. So is the tendency to view suboxone or any other drug/medication in its statistically normative terms.

2mg/day does not work for me. NOr does 8mg/day. Or 16. Also, from an empirical/data perspective, the claim that beyond 8 or 16 mg. you feel no difference is ABSOLUTE BUNK. Look at research employing brain imaging technology to see the physiological phenomena that vary in response to variation in dosage. It's fundamentally untrue to say that in all cases there's no different between Xmg and Ymg ... or beyond Xmg you feel no difference. How this insidious myth got started is a mystery to me, but I'll work my tail off shooting it down. Similarly, the notion of "fake withdrawal" or "psuedo-withdrawal" is preposterous. While some aspect and manifestation of withdrawal may be psychosomatic, this doesn't mean it's NOT REAL. Many illnesses are "psychosomatic" (meaning that they emerge from or are inflected by a mind-body relationship), from various forms of cancer to many instances of cardio-pulmonary disease, etc. Would anyone claim that stress-induced illness isn't real, or is fake, or is "pseudo-illness"? Probably not.

Another issue I want to talk about is addiction vs. dependence. They're two different things. Very different. One can be dependent but not addicted. Addiction is a clinical diagnosis of a disease. Dependence is a clinical diagnosis concerning the body's orientation to homeostasis at any given point in time. I am chemically dependent on opiates. But I am not experiencing addiction at this point in my life. Addiction pertains mostly to manageability. When I was shooting dope, I was dependent and addicted for the most part. My life was unmanageable in nearly ever respect. As a suboxone patient, I am exceptionally functional--interpersonally, professionally, emotionally, cognitively, etc. I am an amazing father, a respected scientist, and a documentarian (film and radio). And I happen to consume 36mg/day of suboxone. Yes, I could take less. But I don't want to because I don't feel as good, I don't relate as well to others, etc. And yes, I could try to taper down, to quit altogether. But I do not want to quit. I enjoy opiates. "OH, that's the addict in you talking" would be the first response of many, to which I might say, "How do you know that?" or maybe "Yeah, so what?". Every day we engage in innumerable attempts to alter consciousness, to make ourselves feel better, look better, BE better. If suboxone assists me in this regard and does no harm to others, then what's the problem? Why do I have to adhere to your views on drug use, sobriety, etc.? Believe me, you'd enjoy my company a great deal more when I'm on suboxone than when I'm either opiate free or shooting dope. Ask my 12-year-old son which father he prefers: the 36mg/day dad or the 16mg/day dad. His answer beats everyone else's, every time.

I joined this board as a recovering addict who has found that suboxone is transformative in the best possible ways. I joined as a behavioral scientist who works very hard to conceptualize and examine his own addiction in the context of scientific studies of drug use and abuse. And I joined in hopes of finding a community of people who would support my decision to take suboxone indefinitely because it's the RIGHT CHOICE for me and my family and my colleagues and my community. I remain hopeful that this community will live up to these ideals. If not, I'll be happy to remove myself from the list.

So yeah, that's a bit about me and my orientation to the issues at hand. I'd really like to make some connections here, share stories, learn, teach, relate, and generally enjoy my time with others. Because in the end, all we have is borrowed time ... and I'd like to share some of mine with fellow suboxone-consuming recovering addicts.

BEst,
Greg


Top
 Profile  
 
 Post subject:
PostPosted: Sun Aug 23, 2009 6:05 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
Hi Greg, welcome to the forum. You said:

Quote:
Similarly, the notion of "fake withdrawal" or "psuedo-withdrawal" is preposterous. While some aspect and manifestation of withdrawal may be psychosomatic, this doesn't mean it's NOT REAL. Many illnesses are "psychosomatic" (meaning that they emerge from or are inflected by a mind-body relationship), from various forms of cancer to many instances of cardio-pulmonary disease, etc. Would anyone claim that stress-induced illness isn't real, or is fake, or is "pseudo-illness"? Probably not.


What I meant by "fake withdrawal" is the phenomenon that many of us (myself included) have experienced while on Suboxone. These are the cravings that hit during the day, sometimes accompanied by physical withdrawal symptoms. The reason why we call them fake or pseudo withdrawal is because they will go away after a little time even if you don't take an extra dose of suboxone.

Say the withdrawal symptoms usually hit around 5pm, as was my experience. I would get very grouchy & irritable, have chills, start yawning, hot/cold flashes, even bone aches. Instead of taking another dose - because I couldn't as I was in a clinical trial and I got my meds every morning so I didn't have any extras - I would do other stuff to distract myself. Hot bath, nap, eat, take a walk, whatever. And the craving and the "withdrawal" symptoms would usually pass within an hour. Then I would go to sleep, wake up fine, go to my appointment at the study and get my dose for the day.

Quite a few people around here have reported the same experience. The pseudo-withdrawal symptoms don't progress to full-blown withdrawals if you don't take a pill right away. They pass. And after a while, they stop coming as frequently. Are they not real? Well they are a legitimate feeling, a real experience. Are they really withdrawals? No. They are not. And that is why I encourage people to work through it and stay on a regular dosing schedule, which helps break the habit of taking a medication every time you feel unwell. Dr Junig, the admin of the forum, also recommends this approach.

I am glad to hear that you have found success on Suboxone. I don't think you will find that anyone here will criticize your choices for recovery. If you do, please let me or another moderator know, as that is against the policy of the forum. We are here to support each other, and opinions and advice are usually given in that spirit. Many members here have chosen Suboxone maintainence as a long term treatment and we've tried to make the forum a safe place for them. There are too many recovery forums where people on Sub are harrassed and told they will suffer dire consequences if they don't get off right this instant. That doesn't fly here.

I also don't think you'll find that anyone will give you any grief about your daily doseage. We all know that everyone is different - this poll was just someone asking a question and some of us answering out of our experience. I think that you'll find people here on doses of sub from below 2mgs all the way to your 36mgs and everything in between. What works for you is what works for you. All of us have gone through the process of finding the correct dose for our selves. Personally, I found that the dose I required changed over time. So I guess it's just a dynamic process.

I hope you'll continue to share your experiences with us. This really is a good, supportive community and your contributions will be valued.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject: Thank you!
PostPosted: Sun Aug 23, 2009 6:22 pm 
Offline
Average Poster
Average Poster

Joined: Sun Aug 23, 2009 12:03 pm
Posts: 4
Hello ....

Thanks for the wonderful, welcoming, and sympathetic reply. I feel a lot better about jumping into this forum. Regarding the "fake/pseudo-withdrawal" issue, I sort of figured that's what you meant. But I didn't want to assume or infer without clearing it up. INdeed, it's a real experience, one that demands attention. And I respect the ways people choose to contend with that experience, including the choice to use an illicit substance. As a harm reductionist, I advocate "any positive change as defined by the person" ... no judging, meet people where they're at, no preaching, no browbeating, no coaxing or cajoling or selling, and basically doing whatever I can to help myself and others stay as healthy as possible until even better choices become the normative options in life.

I also should have mentioned in my post that 20 years ago I was diagnosed (repeatedly) and institutionalized (repeatedly) for bipolar disorder and a constellation of anxiety disorders. Though I take issue with the term "disorder," I acknowledge the consequences of the behavioral patterns associated with whatever neurochemical peccadillos inside my head. Over the years I've seen nearly two dozen psychiatrists and have tried almost as many medication regimens. When I started taking suboxone, however, I found that I no longer needed most of the other meds I was taking (7 of them). Now I take suboxone and a very, very low dose of clonazepam (as needed ... rarely) and a super low dose of trileptal to take the edge off of the "swings". LIfe is so much better.

My guess (and my clinician's guess -- and we're all pretty much guessing, even the MDs) is that I require a higher dose for many reasons, some known or suspected, others perhaps hidden forever. With fewer mental health issues, I might be able to thrive on a lower suboxone dose. I might not. Hard to say. But a reasonable person with some knowledge of mental illness, addiction, and suboxone likely would be inclined to hypothesize that higher doses correlate positively with the number and severity of co-occurring mental illnesses. So yeah, everybody's different ... hehe.

Well, I'm really glad to be a new member of this forum. And your message means a great deal to me. I've never been part of a forum like this, and I look forward to learning a lot and forming some new and valuable relationships.

Best,
Greg


Top
 Profile  
 
 Post subject:
PostPosted: Tue Sep 29, 2009 8:37 pm 
Offline
Super Poster
Super Poster
User avatar

Joined: Tue Jun 09, 2009 10:19 pm
Posts: 104
Location: Youngstown, OH
By The Way Greg,
I started the poll and i'm also on the "high" (24mg/day) end of the dosing amount, whatever that means anyway. I got caught up in other web sites that looked down on me for the amount I take, and the length of time i've been on bupe, and the fact that I dose in the a.m. and the p.m.. This is the only site I go to now, because i'm accepted here, and this site has kept me from using time and time again. Good to have you. Good to have ALL of you!

Jay Jay Sober since July 9th, 2008


Top
 Profile  
 
   
 Post subject:
PostPosted: Wed Dec 02, 2009 8:54 am 
Offline
Average Poster
Average Poster

Joined: Wed Dec 02, 2009 7:01 am
Posts: 4
Just goes to show you how different we all are.

I also have a very long using history (nearly 20 years, mostly heroin).

I started at 16 mg, down to 12mg after about 2 weeks, then at my prescribing doctor's advice (but completely my choice) I dropped 1 mg per month, ending when I hit the 2 mg/day mark. I've remained there since, and if all goes as planned, I will remain on this dose forever.

I mention this because, through out the (many) months of decreases, I can honestly say I never experienced so much as a twitch, yawn, sneeze, sweat, sleepless night, or any of the rest, psuedo or otherwise. And I'm here to tell you, when it comes to being dopesick, I am absolutely the *worst* (probably the main reason I failed about 500 (no joke!) times at trying to detox myself when still using.

Like I said, it seems we're all a little different. Clearly,there is no "one size fits all" with suboxone.

[font=Comic Sans MS]-Auntie[/font]


Top
 Profile  
 
 Post subject:
PostPosted: Thu Dec 03, 2009 7:19 pm 
Offline
Average Poster
Average Poster

Joined: Thu Dec 03, 2009 5:52 pm
Posts: 6
New 24mg guy here.....Close to a 20 year habit on every/any opiate available to me....the last 10 years have been on Oxycontin 240mg atleast 3 or 4 times a day.

Now the last 2 years on Suboxone have not been without relapse, sadly....But I think about what would be, without the suboxone and I figure, things could be a lot worse.

I think what I'm trying to say is that I'm not ashamed of the high dose that I need to "feel normal" because the flip side isn't pretty.


Top
 Profile  
 
 Post subject: The dose discussion
PostPosted: Fri Dec 11, 2009 10:47 pm 
Well, when I first went to the doctor he gave me a script for 90 pills for a month and told me to find the dose that worked for me and made me "comfortable." So of course, being an addict, I took all three 8 mg's. For the first weeks I took 3 a day and when I went back to my doc he told me that the company that makes Suboxone set a "target dose" of Sub at 16 mg a day, so he wanted me to take two 8's a day. So I did that for two months, which is pretty expensive. Then I started reading on here about everybody doing fine on low doses, so now I'm doing great on 6 mg a day and my goal is to get down to 4 mg a day in another 2 weeks. I think that Beckitt-Renckerr is telling the doctors that we need high doses to try to sell more pills. BUT I do believe that some addicts will need much higher doses. Only the addict and the doctor should be able to decide the dose.
To each his own, I say.
But you want to know the real reason I'm tapering down? I don't care about cost b/c I have medicare paying for all of it. The real reason is that Suboxone has destroyed my sex life. I mean absolutely, totally obliterated it in every way. I don't even try to date anymore. And so I'm trying to bring it back by lowering the dose. My doctor added 300 mg of Wellbutrin XL but that didn't do a damn thing. If anybody knows anything that would help, hit me up.


Top
  
 
 Post subject:
PostPosted: Sat Dec 12, 2009 11:16 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 13, 2009 2:11 am
Posts: 427
Location: Fishers, Indiana
jd, I just wanted to say that it's been my experience that doctors try to start people out on a higher dose of Suboxone for two reasons: 1. To not leave the patient with severe enough withdrawals that they would attempt to "use" something to make themselves feel better (which won't work by the way it'll only make things worse) and 2. Higher doses of Suboxone make getting high virtually impossible. My doctor lowered my dose to 8mg a day after a year or so of clean drug screens and I've been really comfortable here ever since. Doctors don't benefit from prescribing higher dosages of Suboxone just as they don't recieve any benefit or compensation for prescribing Suboxone over any other course of treatment (naltrexone maintenance, abstinence based recovery, etc). It's absolutely illegal for drug companies to "bribe" doctors into prescribing their medication with money or gifts. All the drug manufacturers can really do is to provide the doctors with the results of trials and how well their medication performed compared other similiar drugs. So if you see a Reckitt-Benckis representative walking into your doctors office carrying one of those huge checks you see whenever someone wins the lotto it's gonna be ok for you to report him.

_________________
"If you're going through hell, ....keep going!"
-Winston Churchill


Top
 Profile  
 
   
 Post subject: drug companies
PostPosted: Sat Dec 12, 2009 4:35 pm 
hey matt2,
Yeah, just to clarify I meant the drug companies probably would prefer doctors to write for a higher number of pills, but yeah i'm aware that docs can't be bribed. My brother was a Phizer rep for years...its gotten so crazy, the reps can't even give the doctor's office staff catered lunches or branded pens and office items anymore.
I just have to say, Suboxone has been the most amazing thing that has ever happened to me. I really considered myself the most hopelessly lost drug addict on earth. I've spent 3 of the last 6 years in jail. This drug gave me my life back. And I will always be grateful.
JD


Top
  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 14 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group