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PostPosted: Fri Oct 21, 2011 1:29 pm 
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Who is telling you this? If it is anyone other than a doctor than Screw Em! Far too many people "play doctor" on the internet. Only you know yourself. In fact, it is dangerous to listen to people (other than your DR) who tell you to "start tapering now" or that "Suboxone isn't meant for "long term use" "

I am on a very very slow taper myself. I know that I would not be able to take large dosage reductions. I have talked to my doctor about this and he monitors me.

[youtube]http://www.youtube.com/watch?v=3GTbGEosxis[/youtube]


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PostPosted: Fri Oct 21, 2011 1:36 pm 
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Ironic wrote:

Opiophile link (I can't add links due to forum rules but I will come back tmrw and add it)

All of these hardcore junkies doing bundles of heroin a day agree that bupe works better at low doses. When I'm on a computer instead of a phone I will post scientific studies backing low dose bupe.



I was (guess I still am, haven't logged on) a member of opiophile since almost the day it started (a long long time ago 6+ years). Nowhere near everyone on that board was shooting "bundles a day". Furthermore, while there are some intelligent people on that board, they are not doctors. They have no better idea than you do of another person response to Suboxone. Its basically not your place to judge. Why do people care so much what another person takes?

That board has a very strong anti-Doctor/Medical Community tilt.


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PostPosted: Fri Oct 21, 2011 4:11 pm 
Lillyval wrote:
You know, Ironic, I really love irony, but I hate sarcasm, which is what your reply to me was. Hello!??

It's obvious from your other thread that you are misinformed based on the sources you are using. I am referring to the PDR while you are referring to opiophile.com. Temgesic is prescribed for pain, while Suboxone is prescribed for addiction. A 0.2mg dose of bupe has the effect on the order of a Lortab but is very short acting. A maintenance dose of Suboxone has a 36 hour half life in order to keep the receptors engaged and prevent cravings in addicts. And no, a 16 mg dose of Sub is not equal to 320 mg of morphine. If you had watched even one of the videos that Hat posted a link to, you would have understood that buprenorphine's effect is not linear, and in fact, a 2mg dose has roughly the same opiate effect as a 8 or 12 mg dose. The difference is in duration.

And yes, I do agree that the pharmaceutical companies, RB included, are a bunch of greedy bastards. But that doesn't negate the research and clinical success of Suboxone. Maybe many people would or could get by on a lower dose, but by your own admission you can "feel" doses below about 4 mg, which is counterproductive to maintenance treatment, which was what I was referring to in my post.

Like someone said above we're here to support one another in our recovery. We are happy to read about what works for you. But don't claim that everyone including Dr. Junig, who is not only and M.D. and Ph.D. but an expert on Suboxone who has treated over 500 patients with it, is wrong. That is just insulting and inappropriate.


You may not like sarcasm, so I apologize. I happen to dislike it when people put words in my mouth. I never ever ever ever said anything about knowing more than Dr. Junig, or about Dr. Junig's intelligence or anything like that at all. Anyone who would take a random person on a forum's word over that of a doctor is an idiot..unfortunately, a lot of doctors (not Dr. Junig) will write whatever amount anyone wants. Here in South Florida, at many clinics, people fill in-house. At $9 per 8mg pill for those without insurance. Unfortunately, some doctors taper patients totally off before they are ready. There has got to be a happy medium. Depends on the person.

You say you don't like sarcasm. I don't like your tone. The videos that Hat posted aside, since I know you don't like Opiophile, here is an official source:

From the SAMHSA website:
"The agonist effects of buprenorphine INCREASE LINEARLY WITH INCREASING DOSES of the drug until at moderate doses they reach a plateau and no longer continue to increase with further increases in dose—the “ceiling effect.”

If you read further, you will see that SAMHSA puts this "ceiling effect" dose at 16-32 mg for buprenorphine.

http://buprenorphine.samhsa.gov/about.html

Honestly, that is almost beside the point. My point is not to say, if you take ____mg Sub you will need ____mg of a full-agonist. My point is to point out that if you take a large dose of Suboxone every day, it is going to take a large amount of full-agonist painkillers, large enough that MOST (can't say all) doctors would refuse to prescribe, to receive adequate pain relief.

When I said I can "feel" a dose, that doesn't mean I feel high. If buprenorphine magically started getting people high <4 mg, I bet a lot more people would be doing it. It is more like when I wake up, I feel kind of down (withdrawal coming on shortly if I don't dose. I have a hyperactive thyroid and a wacky metabolism). When I take my Suboxone I feel more awake and less depressed. No "rush" or "high." I have posted a link before about studies using low-dose buprenorphine for depression. It is in the links section of this website if you would like to take a look. The patients were dosed with .8-1.8 mg/day of buprenorphine, and the results were very promising. Are these people getting "high?" I guess that depends on your point of view..but I reject the fallacy that >4mg of Suboxone is "okay because it doesn't get you high," but <4 mg is not okay because it gets you "high" (that isn't even true..take 2 mg by itself one morning and see for yourself. It just isn't true). You are trying to rationalize that a higher dose of an addictive opioid medication is healthier than a lower dose, and that isn't true.

My point with that continues to be that people should TRY low-dose buprenorphine once out of the initial detox phase before they decide that they need a higher dose. A lot of people subconsciously think that more mg = feeling better, such as with a full-agonist. I read posts all the time on here about people prescribed 8, 12, even read a handful where someone at 24 mg/day was running out of Suboxone early. Cravings are partially mental, and can only be helped, not cured, by medication.

I wasn't really trying to get heavy into it in this particular thread. I have made my opinion known elsewhere on the site. Once again, I will say that I am happy and supportive of anyone who is succeeding in their struggle against opiates. I say what I say out of genuine concern. I am someone who used to take a high dose of Sub, and then tried lower dosing and was AMAZED at how much better I felt. Better mood, less side effects (sleepiness, constipation), less medication in my body.

I understand it is a very personal decision. I make NO personal attacks on anyone on high dose buprenorphine. I am not trying to attack anyone. So please don't attack me, and say things like I am insulting Dr. Junig and saying he is wrong..that is a false statement and I am personally very careful about making false statements on this site. I don't claim ANYTHING AT ALL AS FACT if I cannot back it up with research that some people may not have seen. I understand that this is life and death here.


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PostPosted: Fri Oct 21, 2011 4:32 pm 
stephent wrote:
Ironic wrote:

Opiophile link (I can't add links due to forum rules but I will come back tmrw and add it)

All of these hardcore junkies doing bundles of heroin a day agree that bupe works better at low doses. When I'm on a computer instead of a phone I will post scientific studies backing low dose bupe.



I was (guess I still am, haven't logged on) a member of opiophile since almost the day it started (a long long time ago 6+ years). Nowhere near everyone on that board was shooting "bundles a day". Furthermore, while there are some intelligent people on that board, they are not doctors. They have no better idea than you do of another person response to Suboxone. Its basically not your place to judge. Why do people care so much what another person takes?

That board has a very strong anti-Doctor/Medical Community tilt.


You misunderstand. I was not judging, I was being sarcastic. I am a member of Opiophile and I think their buprenorphine forum is great. I know that the way I described Opiophile is how many on this forum view it.


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PostPosted: Fri Oct 21, 2011 5:55 pm 
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Ironic wrote:
stephent wrote:
Ironic wrote:

Opiophile link (I can't add links due to forum rules but I will come back tmrw and add it)

All of these hardcore junkies doing bundles of heroin a day agree that bupe works better at low doses. When I'm on a computer instead of a phone I will post scientific studies backing low dose bupe.



I was (guess I still am, haven't logged on) a member of opiophile since almost the day it started (a long long time ago 6+ years). Nowhere near everyone on that board was shooting "bundles a day". Furthermore, while there are some intelligent people on that board, they are not doctors. They have no better idea than you do of another person response to Suboxone. Its basically not your place to judge. Why do people care so much what another person takes?

That board has a very strong anti-Doctor/Medical Community tilt.


You misunderstand. I was not judging, I was being sarcastic. I am a member of Opiophile and I think their buprenorphine forum is great. I know that the way I described Opiophile is how many on this forum view it.


Some people do, however the bupe forum on opiophile is very different from this one. This site is very recovery focuses (not 12 step, recovery). Many on that board are so ridiculously paranoid that it is not even funny.


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PostPosted: Sat Oct 22, 2011 12:28 am 
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Joined: Thu Jul 21, 2011 10:43 am
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Ironic, here is the thing you don't seem to get. You can say all day long how great low dose bup makes you feel, what we do not do on this forum is tell others what they should try. Everyone here has their own way of doing things and staying in recovery. We are here to support each other and not tell others what they should be trying. Also there is the matter of you thinking you understand more about bup than Dr. J, it was his video posted by me explaining the ceiling EFFECT of bup. You notice how I said effect and not dose. Dr. J says that around 4mg sub has a ceiling effect to where their will be no more increase in opiate effect and doses above 4mg are for stopping cravings. You repeatedly claim this to be false. So yes you do claim to be right and that Dr J is wrong. We all get it you think everyone is getting ripped off and HAS to try low doses like you, you have posted it repeatedly. I do not understand why you keep repeating your self.


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PostPosted: Sat Oct 22, 2011 1:44 am 
Breezy_Ann wrote:
Ironic, here is the thing you don't seem to get. You can say all day long how great low dose bup makes you feel, what we do not do on this forum is tell others what they should try. Everyone here has their own way of doing things and staying in recovery. We are here to support each other and not tell others what they should be trying. Also there is the matter of you thinking you understand more about bup than Dr. J, it was his video posted by me explaining the ceiling EFFECT of bup. You notice how I said effect and not dose. Dr. J says that around 4mg sub has a ceiling effect to where their will be no more increase in opiate effect and doses above 4mg are for stopping cravings. You repeatedly claim this to be false. So yes you do claim to be right and that Dr J is wrong. We all get it you think everyone is getting ripped off and HAS to try low doses like you, you have posted it repeatedly. I do not understand why you keep repeating your self.


I don't like talking to you because you cherry pick things out of my posts and then harp on them.

From my last post: I never ever ever ever said anything about knowing more than Dr. Junig, or about Dr. Junig's intelligence or anything like that at all. Anyone who would take a random person on a forum's word over that of a doctor is an idiot.

I understand it is a very personal decision. I make NO personal attacks on anyone on high dose buprenorphine. I am not trying to attack anyone.

The forum rules say I cannot be abusive, which I NEVER ONCE HAVE BEEN. EVER. If I have, you would have reported me to the moderators and they would have banned me long ago. I can kindly suggest whatever I please.

I have never countered Dr. Junig personally on any statement. I have never made a factual statement without citing it. Therefore, I am very comfortable with people reading this conversation interpreting it for themselves. I set the evidence out for what I claim, and it is there to read. I am entirely comfortable with people drawing their own conclusions from there.


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PostPosted: Sat Oct 22, 2011 11:55 am 
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This will be my last post, firstly I never said you broke a rule and I am not sure if you noticed but I am a moderator so I wouldn't have to report you. 2nd, I was telling you how we treat eachothers recovery here and we do not tell people what they should do unless they ask. 3rd, I never said you out right posted that Dr J is wrong and you are right but you do claim something he states to be false and that you are right. You do not have to type the words Dr J is wrong and I am right, you have made it clear you believe him to be wrong about the 4mg ceiling effect. Lastly, and my biggest question you have already repeatedly told everyone that low doses are better it seems nobody is interested in your advice. As far as I can tell your only reason for posting here is to try and convince others to do as you do and frankly its getting old.


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PostPosted: Mon Mar 05, 2012 6:05 pm 
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Location: Phoenix, AZ USA
i too get tired of people telling me i am on too high a dose and that i need to cut back. i listen to my doctor period. only he can determine what is best for me. i am currently on 32mg a day for the past year and feel great! subs have given me my life back! i am eternally grateful for it and am at peace with the fact that my doctor said i will be on it for life.


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

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