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PostPosted: Thu Mar 29, 2012 9:45 pm 
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Hi folks,
Started suboxone strips on Tuesday and due to withdrawal symptoms the doctor had me on 16 mgs twice a day. I spoke with the doctor today and though I am not feeling typical withdrawal symptoms I still had very strong cravings after my second dosage this afternoon. The doctor said raise my afternoon dose to 24 mgs while leaving my morning dose at 16 mgs. I'm new to all this and admit I know little about how this stuff works but it seems to me that 40 mg of suboxone a day is an awfully high dose. Am I wrong? Are there benefits to such a high dose or is it a bad thing? Thanks!
Skelly


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PostPosted: Thu Mar 29, 2012 10:00 pm 
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welcome! yes, 40 is alot. personally, and everyone is different, but i see no difference after 16-20 mgs which is still considered high to some folks. some longtime opiate users start on 6 or less a day and are fine, dosage is very individual. i remember the first 2 weeks all too well-you will feel a little better every day, and will feel great in 2 weeks when your system adjusts. then maybe you could drop your dose a little. i am speaking for myself, i am no doctor, but have heard many of that same experience. others will probably respond with great advice, hatmaker, tearjerker, and romeo have great advice. congradulations for getting out of the rat race and back to your life!


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PostPosted: Thu Mar 29, 2012 10:01 pm 
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Hi SKelly,

First of all welcome aboard! I'm glad you found this forum...I have only been here about a week but have found alot of great support and answers to questions. Since I am fairly new to the Suboxone world I really don't have a great answer about whether your dosage is to high or not. I'm sure you will get an answer from some of the resident "experts" in a bit. I just wanted to let you know that my first few days I was getting those evening cravings too. I am only taking 8mg. once per day. It seems to me that those cravings got a little better after days 3 and 4. I think it takes up to a week for you to really stabelize on the meds. You will notice that you feel a little better every day for awhile. Now I must admit that I am not completely craving free. I am going to discuss it with my doctor when I go back on Monday, but I am not sure if he is going to be open to raising my dose....I'm keeping my fingers crossed!

I wish you all the best!


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PostPosted: Fri Mar 30, 2012 5:05 am 
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I had 5 teeth pulled about a month ago, and I barely took 2 1/2 Suboxone films each day for 3 days to get the pain management I needed for that. Now ask yourself how can I take 2 1/2 Suboxone (20mg) for 3 days and it worked for me GREATLY (because my doctor said that if I needed I could take more)...but you're taking 40mg for just withdrawals, and nothing pain management-related? I don't use Suboxone for withdrawals anymore...it's strictly pain management for me..and I can take 8mg a day -- 4mg morning + 4mg at night -- and I'm fine.

Withdrawals on mental...on such a high dose (40mg/day)

I bet nobody here has ever had a doctor, or heard of a doctor prescribe Suboxone like that. There's SO much misinformation among doctors in this field that it's almost dangerous. I'm glad Suboxone doesn't' kill people (yet)..but if they continue prescribing in these doses...it may just very well happen.

Unless you have a specific enzyme in your liver that breaks down the Suboxone quicker than normal people who don't have this enzyme (a "higher" metabolism for Suboxone), then you don't really gain anything by taking 40mg of Suboxone per day.

Since this is the beginning for you, you are experiencing the psychological addiction..your BRAIN tells you that you are craving, and tricks your body into thinking it's withdrawals that you are feeling..when it actually isn't.

To be honest, you should take your dose one time per day, for the entire day..and not be taking Suboxone multiple times daily to break the addiction cycle. You may think this is absurd and probably will stop reading here, because you're going to think I don't have a clue about what I'm saying.

But addiction to painkillers is a dose & reward type addiction..You take a dose of painkiller, you feel the euphoria (reward) from it.

In Suboxone treatment, you have to break that. Teach your body that you don't get a reward for taking a pill/film. You dose once per day (because to be honest, you could take 24mg of suboxone today, and you WOULD NOT FEEL WITHDRAWALS for AT LEAST three days from now, if you suddenly quit.)

I've been on Suboxone for 4 years now...and varied ways of taking it (all at once..multiple times per day with high dose..multiple times per day with low dose...)

I was a full blown oxycontin addict with a large habit of oxy when I went to Suboxone.

I took my Suboxone in the morning when I got up (when I first started treatment.) ALL AT ONCE. And I only started out on 24mg/day. So in the morning, I would take 3 pills, back to back. The rest of the day I made myself forget that I even had some kind of medicine to take..you HAVE to get to this point. You HAVE to break the addictive tendencies. If you don't, then you'll be using up your Suboxone before time to go back to the doctor...or you'll be so zombiefied from the Suboxone that you can't function..because with such a large amount, you're going to have side effects that are multiplied several times over.

Clinical studies show that the ceiling for suboxone is 32mg...that means there is NO CLINICAL PROOF that anything over 32mg/day does ANYTHING GOOD. And this has been researched over and over..plus all of us here have tried at one time or another to take more than our prescribed dose...and we can all tell you the same thing...you are NOT going to feel any different from 24mg to 32mg...unless you are hypersensitive.

That's a WAY HIGH dose..and the doctor that you're seeing is going to be a stumbling block if he doesn't do some research on Suboxone and learn how to treat people with it instead of assuming more is better.
Suboxone isn't like food..you don't eat more and more and more to make hunger go away.


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PostPosted: Fri Mar 30, 2012 5:28 am 
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Thanks for the replies. I came here because I thought 40 mg was a high does. I do have chronic pain but that's not what it is being prescribed for. Jonathan, yours are the responses I want to hear. I need to educate myself if I'm going to be successful. Maybe you can tell me a little more about this ceiling dose effect as I am ignorant on the topic. I also have no idea what people mean when they say a small dose of 2 mg is just as potent as an 8 mg dose. I simply don't understand nor do I even know if this mediation is supposed to take away mental cravings along with the physical withdrawals. Maybe the cravings are just something I have to deal with but I do have less cravings on a higher dose. I'm confused guys so please help!
Thanks in advance!!!


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PostPosted: Fri Mar 30, 2012 10:08 am 
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Some people in the beginning do need the higher doses then once they start to stabilize they should be able to reduce their dose to what their maintenance dose will be. Every person is different, this is not a one size fits all treatment, there are many factors that contribute to what dose an individual needs. I wouldnt worry about the 40mg if thats what is working right now, you're right in the beginning of treatment. Once you get comfortable where youre at you can start reducing the dose to what you will maintain at. Right now just worry about feeling better and getting stable then worry about the next step. Read as much info as you can on the med to educate yourself. People will tell you only what they believe about doses, most forgetting that not everyone needs the same dose and some do need more, they will tell you what they believe without personally knowing what youre going through or how youre feeling, educate yourself a little bit about Sub and in regards to dosing, do what works for you and keeps you from relapse. I would hate for someone to tell you "no one needs more than 8mg" so you switch to that and end up so uncomfortable it ends in relapse cause you think the meds dont work for you. Also alot of people do find that dosing more then once a day helps, especially in the beginning. If you feel that you need to dose more then once a day to be most comfortable then do it. There is no right or wrong in your treatment as long as youre not using. People can give you advice and tell you what they do and believe but in the end this is YOUR recovery and you are not them, what works for them may not work for you. You are not the first to need a high dose to control cravings along with withdrawal and you def. wont be the last, Get stable where you are then reduce in a way that works for you. Good Luck & Keep us updated on your progress.

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PostPosted: Fri Mar 30, 2012 12:29 pm 
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I have never heard of anyone being on that high of a dose, so I think 40mg/day would be considered high.

As for pain control, since you do have chronic pain, it would probably be beneficial for you to dose more than once a day. I learned this here on this forum from others who dose a few times a day to help with their pain. And then I reseached it further and have read Dr. Junig state this as well. I can't remember exactly where I read this, but I'm sure you can find this discussion somewhere on this site. Even though the sub stays in your system for days, it is only effective for pain relief for about 4-6 hours (thanks hatmaker for that stat :wink: ).


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PostPosted: Mon Apr 02, 2012 12:27 am 
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sodone wrote:
Also alot of people do find that dosing more then once a day helps, especially in the beginning. If you feel that you need to dose more then once a day to be most comfortable then do it.


Amanda, can you please explain why administration multiple times a day is beneficial in the beginning? I am a newbie to Suboxone, and my DOC put me on 4mg 3x a day(t.i.d.) He gave me a script for a week only and during my intake interview he said that the most he does is 16mg/day for patients. Will he switch me to the once a day dose next week?

I do not care so much about the amount I am on as I'm sure he calculated it properly based on my honest description of past drug use. What concerns me, esp. after reading up online is that I have to dose MULTIPLE times a day. I would def. feel more comfortable with the once-in-the-morning route since that does help extinguish the "pill=reward, the more the merrier" behavioral associations that are so deeply engrained in my brain from a decade of substance abuse.

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PostPosted: Mon Apr 02, 2012 8:46 am 
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hi dopeless hopefiend! i am not amanda, but wanted to respond as i am in the same boat. i have been on sub over 2 years, my dod says twice daily. when i educated myself via internet, i saw once a day is best. when i asked him about this, he said the manufacturer only says that so you dose at home in the morning and leave your meds at home, therefor no one can steal your meds while at work or out and about. i only take for addiction, pain is required multiple dosing. i guess i have to agree that for addiction purposes only, once is ideal. which is what i am having a hard time switching to now{all in my head that i cant}as i have been following my docs orders for over 2 years now. so if you are taking for addiction only, once is the way to go. someone did state on this forum a while back, that taking after 10 am was best, got him through the whole day with no cravings.


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PostPosted: Mon Apr 02, 2012 12:08 pm 
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For some people in the beginning dosing 2 or 3 times a day helps them and then they get to the once per day dosing which is best. If you start out once per day then thats great but for some at first it just works better.. The daily dose that each individual needs depends on many factors, not just how much you used in the past or how big you are and so on. Nobody is the same and dosing will not be the same for everybody either.

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PostPosted: Thu Jun 28, 2012 9:47 pm 
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Hi, I'm new to suboxone, started taking it 2 weeks ago, my dr started me on one 8 mg strip 2 times a day. My question is, instead of taking one dose when I wake up and taking the second dose 12 hours later, could I take both 8 mg strips in the morning and be done with it for the rest of the day? The first few days, the sub worked great, but this week I feel as though it is not working as well, almost like it's wearing off faster? Thanks for any advise. Oh, incase y'all need more info to help with an answer to my question...I was taking 15 or so lorcets a day for almost 10 years, that's the reason I am on suboxone now.


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PostPosted: Thu Jun 28, 2012 10:23 pm 
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Lexi,
Congrats on the 2 weeks. And welcome to the forum. I am new as well. Saturday will mark 3 weeks for me. I was given 2mg (strips) once a day and I noticed week 2 that I started craving and maybe felt WD prior to taking my dose. I spoke with my Dr. and he tried to have me take 1mg in the am and 1mg in the evening. I still notice that I get the cravings prior to my evening dose. I have taken 2mg strip in the am and 2mg in the evening and that seems to work great for me. I have an appt with my dr on Tuesday and I will ask him then. It seems like maybe you have to find the right dosage for you and maybe that takes a little bit of time.

There are so many superstars in this forum that you will learn a lot from.


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