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PostPosted: Thu May 10, 2012 8:23 pm 
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Just some thoughts on the idea. The forum has had many people in the past say things like "I've been on Sub 6 years. IMO I've been on it too long"... other people have stopped Sub perhaps earlier than they should, and paid the consequences. IMO for those of us who desire to get off Sub, this is a very important question and deserves to be explored.

Recently I reduced from 12 mg to 8 mg. Given my fast metabolism, being on 8mg left me significantly under the ceiling, and for 6 hours of each day I felt cravings and (as I later found out), later in the day my blockade was reduced enough that I was able to use with effect enough to find the effect rewarding.

It kinda made me discover, the fact that I wasn't at a stage to handle my cravings, that I'm well of the stage of being ready to get off Sub. I also had a really important realisation that, to a degree, I still permit myself to use. This is a definite red light! I believe I've addressed it as much as I can, as I haven't used since, but I'm nowhere near ready to try a slow reduction again. I need at least 12 months up without using before I will consider doing it again.

So anyway, for me, I feel I will be ready to stop once I can reduce my dose and not give in to any cravings or urges.

To be honest, at least for me, it seems to be more difficult to not use heroin when I'm on a low dose of Sub that doesn't fill my needs than it is to be on no Sub at all. So really, the best way for me to tell I'm ready to live without Sub is to reduce my dose and assess how well I handle myself on a sub-optimum dose.

While I do feel it is good to be cautious, there are cons to staying on Sub longer than a person requires. ie if a person stays on Sub three years when they could likely have reduced off and stayed clean after one year, that's two years they've missed out on the better quality of life one feels while abstinent (talked about in other threads)...

What are your thoughts? How do you gauge when you are ready to stop Sub?


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PostPosted: Fri May 11, 2012 8:26 am 
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I agree that for people whose goal is to eventually go off sub, this is something they definitely need to explore and spend a lot of time considering.

I noted this sentence you said:
Quote:
While I do feel it is good to be cautious, there are cons to staying on Sub longer than a person requires. ie if a person stays on Sub three years when they could likely have reduced off and stayed clean after one year, that's two years they've missed out on the better quality of life one feels while abstinent...


I'm going to play devil's advocate here and ask how do we know one's quality of life feels "better" while abstinent? It just sounded like an assumption that going off suboxone automatically means one's quality of life improves.

What about the pros of staying on it two years longer than necessary?...meaning...two years of a better chance of life without relapses (while on sub). At least that's how I see it. But then I'm a big proponent of long term sub treatment and for me, I'm perfectly happy on my sub tx and see no need to stop. So for me, I don't have too many cons and i see only improved quality of life since being on sub. To the point where I can't even imagine it getting better. Literally, I'm way better since I've been on subs than I've EVER been in my life.

Wow, was that a tangent or WHAT??? Moving on.....

I think for anyone wanting to stop sub, it would behoove them to do a slow taper. That way they can see how they respond to increased cravings on lower sub doses, just like you found out. (That and less w/d.)

In fact, I think you hit the nail perfectly. If a person starts a taper and begins having problems with slips when their cravings come back, that could be an indication that they aren't quite ready to be sub-free yet.

Excellent point, TJ. (As usual.)

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

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