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 Post subject: Short vs. long taper
PostPosted: Tue Nov 13, 2012 7:48 pm 
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I am creating this topic because I am curious of everyone's opinion on whether a short taper would be better or worse than a long term taper. I want to stop suboxone all together soon but I am waiting for the right time and want to make sure I am ready and prepared for it. I am currently on 16mgs and take 2 films once a day.

There will be withdrawal symptoms regardless of how one quits suboxone. Tapering over the course of 5 weeks would spread the symptoms out and would give you less intense symptoms but for a longer period of time. I tried tapering after being on sub for a matter of months and decided to stay on due to me ultimately not feeling ready and the fact that I started to feel uncomfortable after dropping to 4mgs.

Tapering in the matter of a week or so would give you more intense withdrawal symptoms but for a shorter amount of time. I was thinking I could maybe go out of town for a week or so and stay busy doing fun things to keep my mind off of opiates where I wouldn't know any dealers. My doctor brought up the fact that he commonly gives patients Valium for the short taper that would keep you more relaxed and give you less anxiety about the process.

These are just my observations and I’m wondering what advice or input you all may have for me. Thanks in advance!


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PostPosted: Tue Nov 13, 2012 9:47 pm 
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Hey matey.

Yeah you make a really good point. While there are some real benefits to doing a long taper, there's also benefits to doing a short taper, or *gasp* a high-jump. I have not much experience with successful taperings, but a lot more experience with high jumps. The thoughts I'm giving are based pretty much on my experience only so your mileage may vary.

I found that high-jumping, or doing a rapid taper was good in that it was over with sooner. But I think the mentality that drove it wasn't a good foundation for long term recovery. I did it quite impulsively, in my head I just wanted to get off everything NOW. While I managed to kick it (for bupe with the help of a detox clinic, for methadone on my own) ... I don't think it helped me stay clean long term much. Mainly cos I carried that impulsiveness / wanting everything NOW philosophy post-Suboxone.

Doing a long gradual taper I feel may be more helpful to me to remember to just take my time, and be patient. Also I feel that if a person like me can survive on 1mg a day for a few weeks, I know I'd be ready to live long term without Suboxone. For me, staying on doses BELOW what I need (you know that dose you reduce to where you pretty much stop stabilising no matter how long you stay on it, and every day comes with feelings of withdrawal) .. yeah staying below what I need is a lot harder to stay clean with than being on no Sub at all. So if you can prove you can manage on doses below your "craving management" threshold and stay on the straight path, IMO it's a good sign for your future.

That being said, the physical pain and general malaise of staying on low doses for a long time can be too much for many people ... possibly myself included. If you do choose to do a rapid taper, find a month or two when you can "have the pressure off" a bit and go for it. Definitely get some clonidine and even a benzo (unless they're a problem) for when things get really hard.

Another potential benefit of a short taper is that you could use low dose benzos as a detox aid and you wouldn't need to use them so long that you'd get dependence. Where I'm from, they prescribe valium. I can go to pretty much any GP and say "I wanna do a home heroin detox" and they'd contact them pharmacy and get them to dish me out 4x 10mg diazepam a day for 7 days. The other meds they prescribe are Brufen (larger dose Ibuprofen) for muscle aches and Doloxene (mild opioid that I think may not be prescribed in the US).

If you're planning on doing a jump or a rapid taper, I'd see your doc and get a basic health checkup. If you have elevated blood pressure at all you may definitely need Clonidine. I watched a doco the other day called Last Days of a Heroin Addict (I think it's on youtube). Videos of a dude in heavy addiction, who passed away shortly after checking into detox. The withdrawals caused his blood pressure to rise and gave him an aneurysm. Kinda scared me a bit!


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PostPosted: Wed Nov 14, 2012 4:29 am 
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Hey,
I'm actually doing a long term taper. I've been on suboxone for 1 month. the first week and a half I was on 8mgs. Then I moved to 4mgs 2 times a day, then to 2mg twice a day, now I'm at 2mg once a day. There have been days where I swear I didn't need to take a sub. I was fine, didn't have any symptoms. The other day I went a day and half without taking one, but eventually did. I think the key is just to get down to a low enough dose. Your body can feel it and will pretty much do all the thinking for you. Just make sure you have enough suboxones.

After I taper completely off, I plan to keep a script and just use it as maintenance, just pop 2mg (or less) if I get a craving, or if I'm going to be put in a bad situation (i.e. a music festival), just sort of as a preventative measure if I start to feel week. Just my personal experience and thoughts. Let me know how it works for you.

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PostPosted: Wed Nov 14, 2012 5:46 am 
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Hey Ashcal.

Interesting idea re taking Sub occasionally post-taper. I remember when I got off Sub in the past, I wished they had a kinda "semi-maintenance" program of people who can just take it occasionally when they feel urges to do bad things.

There's a huge problem with doing that though in that . (bear in mind none of this is proven scientifically) . I really get the feeling that taking a couple of mg occasionally will set your "long term" brain recovery back. When we're in PAWS our brains are really sensitive to introducing any opioid. It's as if it associates opioids with addiction, so the moment we take an opioid we rapidly develop tolerance to them faster than we did before we became addicted.

Also, 2mg of Suboxone is a LOT for someone who's got no tolerance. In fact it'd probably make you feel quite buzzed. Sub can be a drug of abuse in itself if a person with no tolerance takes it occasionally. With a couple of months off, 2mg will be pretty strong. If you're just wanting to curb your cravings, you could do it with a lot less.

Something that might be better suited to the kinda use you speak is naltrexone. I do know some people who took naltrexone occasionally in their recovery when they started to consider using. Knowing that they couldn't get high if they tried was enough of an incentive, and they'd keep taking it until the cravings died.. even if it was for a week or two. The good thing about this is that compared to Suboxone, naltrexone won't push you backwards in your PAWS.

Can I ask what it is about music festivals that get you going? I always found opioids were a shit drug for music appreciation. MDMA on the other hand ..


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PostPosted: Wed Nov 14, 2012 6:19 am 
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Hey TeeJay,
I said 2mg (or less)... this is a touch and go process for me, I'm feeling it out every day more and more. It's not like I would take 2mg outta the blue. I'm just keeping it as a safety net. I was only using heroin for 3 consecutive weeks before I chose to go on suboxone. So comparatively, I wasn't that bad. Nothing is set in stone for me, and I'm really not worries about it. For me personally, I think it's good just to have. I really don't think I would take a piece of a sub no longer than 2 or 3 weeks after stopping... kinda get what I mean?

As far as music festivals go, there all sorts of drugs there. MDMA is always the drug of choice, I used to take a norco with it, really increases the high! Thats how opiates and music festivals go together for me.

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