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PostPosted: Mon Jul 04, 2016 5:00 pm 
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Hi all. I'm getting ready to start Suboxone. I take 2 mg of hydromorphone every 2 hrs as prescribed. I've been taking it for 4 yrs and have become dependant on it. It worked well to control severe back pain for the first couple years, but not so well now. Thats also probably because my back has gotten worse in the last 2 years. I know hydromorphone is a short acting opioid, but the Dr. I'll be seeing said ideally, I should be 24 hrs without my meds. I'm seeing him at 8 tomorrow morning and am going to try for starting the Suboxone the next morning. I'm pretty sure 24 hrs is going to put me well beyond "mild to moderate withdrawals". With a short acting opioid like hydromorphone what is the minimum and optimum wait time? Thanks-


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PostPosted: Mon Jul 04, 2016 6:23 pm 
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Welcome to the forum Bruce. And congrats for taking a step of recovery! I know hydromorphone is a short acting opiate, and withdrawals will probably set in early but I'd still just grin and bear it and just listen to the doctor. Some people like me were able to switch back and forth from suboxone to short acting opiates relatively quickly but others get really bad precipitated withdrawals, I wouldn't take a chance with that it might hurt your recovery. Yes it will suck but what's 24 hours really mean in the grand scheme of things, wish you the best and hope all goes well.


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PostPosted: Tue Jul 05, 2016 10:20 am 
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Hey Bruce welcome.

I wouldn't recommend any less than 24 hrs. I waited 32 hrs before my induction, I was coming off oxycodone which is another short acting opiate...I think. If ur taking hydromophone (sp?) every so many hrs then I'd wait at least 24 hrs if not longer. Precipitated withdrawal is no joke and u do not want to deal with that trust me. If u try to cheat and don't wait long enough before ur induction, u will get PW's.

I totally understand not wanting to wait and sit in withdrawal, I was not happy about doing it either and about drove myself crazy during that time worrying lol. But if u wanna start suboxone it's what u gotta do. We've all had to do it and I promise it's worth it.

Good luck!

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PostPosted: Tue Jul 05, 2016 1:42 pm 
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Time is less important than depth of withdrawal. There are several variables involved but one tool is the COWS.
http://www.naabt.org/documents/COWS_ind ... _sheet.pdf

I like for the person to score at least 15 prior to induction. It may be as short as 8-10 hours. It may be 36 hours. Precipitated withdrawals come from taking buprenorphine when not in deep enough withdrawal, not too soon based on time. Not for the OP but if converting from long acting opiates is a whole different thread/topic.
Even if you get precipitated withdrawal it is not the end of the world, just feels like it. Continue the Suboxone and it does resolve. Dr. Junig has some posts about this over at the TALKZONE.
good luck.


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PostPosted: Wed Jul 06, 2016 8:00 pm 
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Thanks for the plug for the blog-- I agree completely. Shortcuts are always so tempting... but the sicker you get, the better things will go!


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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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