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PostPosted: Tue Mar 10, 2015 11:26 pm 
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Good evening everyone!

I am new to this forum, to my recovery, and to Suboxone as well.

I am looking for some advice, and I am hoping someone here can help me.

I've started going to a local treatment center for my opiate addiction (Dilaudid) and was prescribed to Suboxone. My initial prescription dose is 8mg. Unfortunately, the doctor who prescribed it did not really give me a time frame in which to take my first dose.

From my own medical knowledge, I have heard that taking Suboxone too close to your last or previous dose of a narcotic can land you in some pretty serious precipitated withdrawal. I have also heard of people almost completely detoxing cold turkey before taking their first dose of Suboxone. I asked my drug counselor what the correct time frame was, and she told me to take it whenever, but I'm still nervous.

I would appreciate any advice anybody can give me on this matter. I do want to start on the Suboxone, but am awfully nervous of the side effects right. Any insight or suggestions would be a blessing!!!

Thank you, everyone :-)

xo; A


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PostPosted: Wed Mar 11, 2015 12:04 am 
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If I understand you are not inducing under medical supervision in an office? Tuck that away as I think it is a red flag regarding quality of care.
If you must induce yourself you need to be in moderate/severe withdrawal.
Most clinics use the COWS to guide us
http://www.naabt.org/documents/cows_ind ... _sheet.pdf

It is difficult to rate yourself because some of the measures are subjective and it is a tendency to over estimate our own suffering.
For Dilaudid 16 to 24 hours should be adequate. If ER forms of other opioids expect to go 24 hours + and methadone much longer.
Even if you precipitate withdrawal just wait it out, stick with the Suboxone, it will pass.
Dr. J has some blog posts regarding this over at the Talk Zone, under induction

http://suboxonetalkzone.com/category/bu ... induction/
There are other threads here with your similar question in the induction section.
Don't over think it or get too wrapped around the axil with this. There are far more difficult nursing tasks than inducing Suboxone.
Glad I went back and looked at your initial post, start with 2 mg (1/4 film) as an initial dose. Wait 1/2 hour and no problems but still withdrawal symptoms or craving take another 2 mg. Take the rest of the film a few hours later then continue with the prescribed dose the next day.
More history regarding usual opiate use and dose may change this. These are guidelines only that I have found helpful.


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PostPosted: Wed Mar 11, 2015 12:06 am 
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Oh, you may be ANON but you will find great folks and help here. PAX


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PostPosted: Wed Mar 11, 2015 12:09 am 
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Thanks so much for the quick and educated reply. I will def. look into, and use, the COWS system as an aid in this.

And you are correct - I will be inducing at home, not at the MD office.

Lastly, in terms of substance of use, I last used IR Dilaudid 12mg at about 2130 EST.

Thanks again, and I'll also review the similar questions throughout the forums here


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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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