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PostPosted: Fri Sep 25, 2009 7:14 pm 
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So I'm looking at switching Suboxone docs to get off of the Suboxone because the current doc seems to have no experience with easing withdrawal symptoms (my insurance covers an outpatient program that requires going every day for 2 weeks and the travel is a bit much while detoxing). So I'm talking to a doctor who a few people recommended and while we were discussing tolerances, he said something very interesting: He has a patient who's taken one Vicodin a day for years without developing a tolerance. He conceded that it's a rare occurance, but I'm curious how this happens. I know that someone's initial tolerance can vary but I've never heard of something like this before.


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PostPosted: Sat Sep 26, 2009 12:53 am 
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He isn't developing tolerance because he is coming off the drug totally for most of the day. The vicodin is only around for 4 hours; the other 20 hours are spent without Vicodin. I often dose benzos every OTHER day-- I don't know how many patients take them as suggested, but if you can take them every other day you can avoid tolerance, or at least slow it down dramatically-- same principle. Most addicts keep a level of opiate in their system for most of each day, so the tolerance only goes up-- there are no 'off' periods to pull it back down again.


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PostPosted: Sat Sep 26, 2009 1:08 am 
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Interesting, and Dr. Junig makes a great point. I took a single 5-10mg dose around 2-4 times per week because it didn't dominate my life and thinking. I LOVED it, but it didn't own me. I didn't take it daily, because I always kept enough supply that I could only use that particular amount. I wasn't until I hit the "jackpot" of supply that I began to indulge myself daily, and then tolerance kicked in, and after 2.5 years of 10mg doses twice or three times a week, it was suddenly daily. Not long after that it was twice daily, and 20mg to get it done, and so on.... (I think we all know where it goes from there....).


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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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