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PostPosted: Tue May 11, 2010 5:19 pm 
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Basically I have been on Suboxone for years on and off, I am actually on subutex, cause that orange flavor literally makes me sick to my stomach. I was a test trial patient for the drug before it was ever released to the market. I have been on various doses. My concern right now is this. I have been a junkie literally for 14+ years I am now 29 years old. I just did the very best I had ever done in my entire life with around 8 or 9 months off dope on Suboxone. I live in Jersey where dope is just everywhere. I attend meetings/didnt stop, do what I am supposed to do etc. But I ended up f'ing up anyway. I was offered roxy's at a mtg. real cheap, I knew I had the 3 day window/couldnt use them/was just going to sell them.... Not the way it turned out, I stopped taking my subs for 3 days and went on a real nasty run. I ended up using (I know exactly cause I only got rid of 4 out of 500) 496 bags of dope in a 12 day period. Plus a bunch of oxy 60's on top of that. Then my dumb ass was ready to quit/knew I went to far so I decided it was time to quit again... I ended up taking a subutex to early and threw myself into that lovely precipidated withdrawl. Real nasty kick... And I mean real nasty... And I have been off and on dope, methadone, you name it for over a decade and a half. Now I am back on my subutex again, but I am taking more then my doctor feels I should be, or more he questions whether I need to be taking as much as I am. I was on 16 mgs for quite some time. Thats the dosage I relapsed at.... Now I have been taking 3 a day. And when I take 2 and a 1/2 either its mental or I actually really do notice the difference. (I apologize for the lenghty letter here) My doctor is an excellent doctor. Without him I quite possibly would not be here today. But I have been on and off of this medication like I said for many years now, way before it was ever in any pill form. Actually the first sublingual form I took was at a detox in Miami called Summer House where they had it prepared in a wax form that you put under your tongue. They were way ahead of their time/still an excellent detox facility to this day. Here is my concern though, I am taking 3 a day now. And I feel quite comfortable taking that amount. Of course there is no euphoria/anyone who has taken the drug for more then a few days knows that you are not getting high off of the stuff especially when you have had a heavy habit for as many years as myself. My doctor wants me back on 16 mgs and explains to me that the absorbtion rate between 16 mgs and 24 is very minimal/does not really make a difference. To me it actually does, and I notice that difference even froim 2 and a half to 3 8 mg pills. Do you have any suggestions for me that I can bring to my doctor on my next visit. I went w/o a relapse for the longest period of my life till just recent, and the last thing in the world I want to do is fall back into that nasty rut thats so close to impossible to get out of. Basically I know I feel better on 24 mgs a day then 16 or even 20. What do I do to present this to my doctor? Am I wrong? How do I get a doctors opinion on this forum so I can present that to my doctor? Is that a possibility? Any help or answers you can provide would be greatly appreciated, even a link showing differences in dosages etc. -Thanks for your time replying to my post. I have had doctors in the past have me on 32 mgs of suboxone, but my current doctor believe that is absolutely unnecessary and would never make any difference over 24 mgs. I do not want to be on the stuff forever, although if that is the case and thats what helps me to manage and never go back to heroin again then I have no issue with that whatsoever!!! But as of right now my doctor wants me on 16 mgs, and it is very difficult to explain to him the difference between the dosage of 16 and 24 making such an impact on how I feel both physically and mentally. If anyone can please help me by posting back with any suggestions I can bring to my doctor I would greatly appreciate that. I attend AA meetings on a regular basis and I have a few friends in there who are on suboxone as well. They understand exactly where I am coming from/know that there is a difference when it comes to the dosages. Well any replies would be greatly appreciated. And any help with what I can bring to my doctor so he can keep me on 24 mgs a day instead of 16 at least till I feel comfortable again. Maybe just a month or two and I think I would be able to drop back down again. But right now this is an isssue that is effecting me greatly/scares the hell out of me that I was able to relapse and I DO NOT WANT IT TO HAPPEN AGAIN. Once again thank you all so much for reading/helping me!!! -Nick G.


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PostPosted: Wed May 12, 2010 8:45 am 
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Hey Nick:

Welcome to the forum. I am no dosing expert at all, but wanted to share my personal experience with dosing with you. I am currently on 4mg after attempting to taper and jump unsuccessfully. I've decided that for now I am going to remain on suboxone indefinitely. 4mg is not working for me and when I see my doctor today I am going to tell him that I would like to increase my dose back to 8mg, which an amount at which I felt very comfortable and had NO thoughts of using or cravings of any kind.

I have also used TONS of heroin. My guess is (and this is only a guess) if you gave 16mg a shot for a month or so, you'd probably realize that it's an adequate dose to keep you stable. But it is true that every person is different....

Perhaps someone with more knowledge than I will chime in and help you.

Glad to have you here, man. I used to live in Paterson, where are you from?


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PostPosted: Wed May 12, 2010 10:37 am 
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Hi djkid,

Before I say anything else, please know that I'm not a doctor or a medical professional of any kind. Anything I can offer you is based on what I've learned since going on suboxone about 16 months ago.

16 mg is generally thought to be above the ceiling level. It's also thought that dosing once per day is best, unless that person is taking suboxone for pain. Dosing once per day helps us to reduce our old addict behavior of taking a pill when we feel down in any way. Have you and your doctor discussed dosing once per day? Just a thought. It's my opinion that when using suboxone for addiction only there's little need for 24 mg. Wanting to go from 16 to 24 may very well be all psychological. We addicts like to take pills to make us feel better. Although our opiate receptors are occupied at or above the ceiling level (thus stopping physical cravings), this won't prevent us from having psychological cravings. We will still have triggers. What we must learn to do is find other ways to deal with those triggers and subsequent cravings.

Keep in mind this is just the opinion of a random recoverying addict, albeit an informed one. Maybe you need to explore your cravings and triggers. Meetings are great and can be a great benefit. But I've also found that therapy of some kind can be very beneficial in helping us to deal with life without using. Just another thought.

I wish you luck and please keep us posted on how you're doing.

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PostPosted: Wed May 12, 2010 10:00 pm 
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I agree with everyone that there is technically no good reason medically (as far as I understand) to be on 24mg instead of 16mg. But I understand the mental part of it so that is what I would tell the doctor. I would tell him you know there is no difference but that psychologically it is rough and that you don't feel mentally ready but understand his reasoning. I would tell him you do much better when it is YOUR idea and not someone else's so you would like to know if in 2 months you can drop to 16mg as that is when you think you can get yourself together enough and mentally prepare for the drop. In the meantime, I would tell him that you will try going every other day with only 16mg but you still want to be prescribed the 24mg so your stubborn addict behavior doesn't kick in. I would tell him you are terrified of relapsing again and you really just want to take things slowly.

That is what I would do. If it doesn't work and he only gives you the 16mg, then you already know technically it really isn't THAT much of a difference and you will probably be ok anyways. Plus, although I do understand that feeling different when dropping your dose even when it is so high, I also know that after a few days you generally get over it.

I will admit that I am on 8mg per day and sometimes take 12mg for pain, but really prefer 16mg all the time. That is where I have always felt the best. Technically I believe I am supposed to feel fine on 8mg, but I really prefer 16mg.

Cherie


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