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PostPosted: Mon Jan 16, 2012 5:25 pm 
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Hey All,

I just joined this today and have been browsing through and have a question. At this point, and pretty much since the switch from methadone to sub in 2006, ive been taking my 7mg dose spread throught the day, in 1mg increments. my schedule:

1mg at 7am, 11am, 3pm, 7pm, 9pm and .5mg right before bed.

i realize this is the worst possible way to do this if i ever want to decrease and get off..but i felt that in the middle of the day i was getting the sweats and other WDS, and it eventually came to this schedule. the 3 drs ive seen insist that theres no way this could possibly happen...they have not been on it though. theyve taken a DEA course or whatever that briefly tells them administration procedures. (as far i\as i know)

so, has anyone else done this? any advice as to how to get back to one dose a day (besides "just do it") would be appreciated. i did, at one point, try to "just do it" and felt WDS. i cant really say whether they were "real" or psychosomatic. I dont know how to tell the difference. If anyone has any thoughts on that as well, that would be VERY helpful.

thank you so much!


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PostPosted: Mon Jan 16, 2012 9:42 pm 
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hi! I am also pretty new here, and also switched from methadone. (yuck). I also want to dose once a day, breaking the cycle. My dr actually prescribes dosing twice a day. After reading everyones posts, I was certain I could dose once a day but had the same problems as you. I know it wasn't all in my head, cuz I had it in my head that it would work. What I had learned from everyone here, is that it takes 4 mgs to saturate all of the receptors, so try 4 then 3 on a day off, so if you feel crappy you could ride it out that day instead of having to take more to get through the work day and not run yourself short.just a thought, keep posting and letting us know how you are.


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 Post subject: Saturation needed
PostPosted: Mon Jan 16, 2012 9:54 pm 
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I think there is a certain need for saturation and what you have done is the opposite of that called titration. Well u said I think you actually told your doc what you had doen and did he not offer some advice to fix that? If not or you can't ask fear of consequences I would think best to go from 7 times a day to 3 heavier dose then 2 then one to get saturated. Is 7 mgs the most you can rake in a day?

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 Post subject: i never knew that!
PostPosted: Mon Jan 16, 2012 10:39 pm 
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you know... if one of my drs had just sat down and explained that to me... i didnt know the saturation point thing! on methadone, i was fine w/ one dose per day and all drs i spoke to ASSURED me that it was all in my head and that sub is EXACTLY the same as methadone, so i assumed it was in my head and just decided to go with my made-up WDS anyway and split the dose.

i brought this up w my past 2 drs (i just visited a new one a few days ago since moving in may-- to be honest, i think id rather drive 150 miles to the city to see my old one) and it was never even brought up as an option to split the dose at all.

so, thanks for this. knowing that there are other people on split doses is very reassuring-- also now i can set a reasonable goal to go to 2 doses a day.


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PostPosted: Tue Jan 17, 2012 3:48 am 
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I am on methadone split dose not bupe but there are many people that take bupe twice a day heavier in the morning dose smaller at night and it works great that way.

But as far as doctors or staff explaining well the only time I ever learned any rules at my clinic was when I or someone I knew broke a rule. So effin backwards.

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PostPosted: Tue Jan 17, 2012 6:50 am 
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Hello,

I'm new to Sub also and here's how I do it. 8mg in the morning and 4mg in the afternoon. I am on 16 mg a day but I try not to take it all so I'll split the afternoon dose. For some crazy reason though, I keep breaking my afternoon split into little pieces. It's pissing me off too !!! I cant lose any med while splitting it in half. That's the only problem I've had. My doctor also said to dose once a day, but I understand your feeling uncomfortable throughout the day, I get that too. I do however, try not to just pop a little when I feel it (although that's what my doctor told me to do in the first few days starting on this). I just feel it's to much like when i was taking pain pills. Feel bad ? Take a pill. So I am trying to break that cycle. I also read where we have to keep above the 4mg saturation level.


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PostPosted: Tue Jan 17, 2012 8:16 am 
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Hi Fridayscall, as I said, my doctor prescribes dosing my sub twice a day. When I told him that everything I read says to dose once, he said that is what the manufacturer wants, to deter theft or diversion.? He is a great doctor and a true professional, so maybe it is true, to take the dose in the morning and leave the rest of the script safely at home.???


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PostPosted: Tue Jan 17, 2012 10:12 am 
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Unless using sub for pain Dr Junig recommends once daily dosing. The reason for it is to break the habit of taking pills thru out the day. As addicts we are too in tune with every little ache and pain and we want to take something for it. Dosing once per day allows you to get out of your head and eventually be able to take your sub and forget about it. It's just another way to help break our addictive behaviors.

The ceiling effect happens around 4mg, however everyone is different so your body could require a bit more. Dr. J also recommends taking a dose comfortably above the ceiling so that your blood level stays steady and you do not feel the ups and downs. This is just my opinion but the way you are taking your sub now is not beneficial to your recovery. Your whole day still revolves around taking an opiate.

If it were me I would slowly start decreasing my doses until you can comfortably reach once a day dosing. It is rare that some people require a split dose because there body uses sub at a faster rate but for most once a day dosing is fine. If you want to get to once a day dosing and you find 7mg isn't holding you all day then you could always raise your dose just a bit. It is possible that some of the symptoms you feel are mental. Our brains want us to take opiates and can cause a lot of chaos trying to get us to do so. I wish you luck on whatever you decide and congratulations on getting into recovery.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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