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PostPosted: Mon Sep 28, 2009 2:20 pm 
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I have heard mixed thoughts on this question. "How important is it to take the same amount of Suboxone at the same time every day." My thinking is this... the suboxone reduces the cravings and obsession associated with opiate addiction. Another consequence of addiction is the habit that is formed in taking the opiate. There are both physical and mental forces at work here. The physical force is driven by the dependency the body develops. We are stimulated by the physical withdrawal feelings, respond by using the opiate, and then are rewarded by by the high and relief from symptoms. The mental force, in my opinion, is using when things aren't going our way, we are feeling down, and need to get away. Or, maybe the opposite, we reward ourselves when we feel we deserve it.

Now, the whole purpose of suboxone use is to stop using the opiates, and break away from the addictive routine and all of the evil associated with it. So my thinking here is that taking suboxone at precise regular intervals and doses puts you in control of the drug, not vice versa. Would it be detrimental to recovery to be using suboxone the way the heroin was used? For example, spreading out a 24 mg dose (8 mg 3 x daily) taking a halves and quarters throughout the day to ease the craving (while not exceeding the 24mg daily dose). This to me is defeating part of the purpose of recovery. Everything is telling me that a regular dose at regular intervals would lead to the highest rate of success in treating the addiction.

Anyone have any thoughts on this?... Thanks


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PostPosted: Tue Sep 29, 2009 9:23 am 
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I completely agree Dav and I think it's really important for people who are just starting Subxone to pay particularly close attention to the rule of dosing once per day at the same time of the same dose. I got into the habit soon after starting Suboxone of either dosing my prescribed 8mgs throughout various different times of the day and sometimes even taking another 2-4 mgs even though it did nothing for me physically it was me giving into the psychological aspect of addiction which as you pointed out is perhaps the most dangerous part of the disease. It has been easy to get back to taking 8mgs a day after really forcing myself back on to a once per day per same time per same dose schedule. I'm so much happier not feeling "controlled" by any medication as Dr. Junig has pointed out it's almost becomes like taking a daily vitamin. I think it's even debatable whether or not the person who doses whenever they "feel" like it with whatever dose they "feel" like taking is actually in recovery or not even if they aren't using any illicit substances.

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PostPosted: Tue Sep 29, 2009 11:12 am 
This is an interesting topic. I know it's nothing new and I think it's been made pretty clear throughout this forum by Dr. Junig's comments as well as the moderators' comments that once a day dosing is the "best" way to go.
I don't disagree with that at all. It makes perfect sense physiologically and psychologically to do it that way. However, my doctor and from what I hear, many other docs initially, at least, prescribe quarters or halves of tablets dosed several times throughout the day depending on symptoms. I understand that the premise for this is to try to get at an optimal dose for the individual. I find it interesting that there is such a wide variety of dosages amongst Suboxone patients. You'd think there would be tighter guidelines in place regarding appropriate dosing.
Anyway, so the patient is often initially set up to kind of dose as needed. I know that's the way my doc started me out. I do think it reinforces addict behavior to dose that way, but on the other hand, we're trying to do as we're told (NOT addict behavior) It seems to me that there is a learning curve with Suboxone just like there is with any other recovery method. I would hate to say that someone who is dosing their Suboxone a certain way is NOT in recovery. I just think a lot of times it's a lack of education about how this medication works and the rationale for dosing once a day. Anyone who has made the step to seek out, pay for and start Suboxone in my opinion is in recovery. To me recovery is a process. It is not really even a 'goal' as I don't think anyone ever truly arrives.
What I like so much about this forum is that anyone can come here, get educated, and find some support on this journey called recovery. I just think we need to be careful about judging someone else's methods. If taking Suboxone 6 times a day within the guidelines of their prescribing doctor is keeping someone off opiates and out of trouble, then hooray. And hopefully over time, as the fog continues to clear, they'll see that there may be a better way.
Just my thoughts.


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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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