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PostPosted: Sun Oct 07, 2012 12:26 pm 
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I've been reading this stuff on the internet and you can't believe everything on the internet but I am just starting to learn about opiate receptors and want to know if suboxone helps with the issue or just makes it worse

I'm having trouble finding this answer in other threads so if this is discussed somewhere else in another thread please just point me in the right direction

I've read that when people take opiates (like the first time), that the dopamine floods their opiate receptors like 100x as much as the brain is used to. To adapt to this environment, the brain creates more opiate receptors. Then, when there is no dopamine coming in at all, the brain is starved because instead of having the original 1 opiate receptor empty, it has tons of empty opiate receptors, and it thinks it is in pain and dieing because of all of the empty receptors. So to avoid dieing it tells the body to go seek out more opiates.

(In scientific terms I am sure this is the most basic way of ever explaining something us un-scientific people will never understand or maybe it's complete BS -- i would like your peoples' opinions)

So, when you stop taking opiates and are trying to kick your habit, that you get really depressed because any time you get a natural release of dopamine, your brain just thinks "that's not enough!" because it has tons of opiate receptors that are empty, starved, depressed, versus just that original 1 (or however many).

So when you take more opiates, you just create more opiate receptors and make the process worse.

But where does suboxone come to play in all of this? Does it act any different? Does it also make a lot more opiate receptors in the brain? Or does the blocking effect somehow help the brain go back to the way it used to be? I read that the brain never quite goes back to the way it used to be -- it cannot *destroy* opiate recptors, but it can close them. But once the addict tries opiates again, they all open back up and that's why it only take a couple tries to get your tollerance back to the way it was in active addiction.

So my question is, does the suboxone act any different on the opiate receptors?

and

If it DOES act on the opiate receptors in a similar fashion, is it possible that taking very small amounts of suboxone over a long period of time will make SOME of the opiate receptors *close*, therefore when you stop taking suboxone, the PAWS is not as bad because most of the opiate receptors are closed?

*Someone please tell me if this is complete BS to begin with*

I want to know because I think that if I take my time tapering that maybe when I finally stop, life won't seem so
weird and unfamiliar and depression and scary because I would have gotten comfortable to my environment with most of my opiate receptors closed. I know sub has some blocking effect and I want to know if that is in any way helping this opiate addiction that maybe from not doing other opiates the brain really is repairing itself on suboxone.


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PostPosted: Sun Oct 07, 2012 1:00 pm 
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So the big man has all these videos on youtube, its way easier for me to WATCH the videos than to read,
and I FAINTLY REMEMBER him talking about the 'partial antoganist' properties, making the receptors close,,,,,,,

so heres the FIRST video, if you go to the link at the bottom, I left for you, it will say "all 19 videos" and it lists them,,,,
if you go to that, and watch the 'series' on HOW it works, and changes the brain, I think you'll understand what you want to.
I DONT remember WHICH one, but its the SERIES of HOW suboxone works on the brain.

[youtube]http://www.youtube.com/watch?v=_Ls1F6vNhYw&feature=channel&list=UL[/youtube]






link, so you can find all 19 videos
http://www.youtube.com/watch?v=_Ls1F6vN ... el&list=UL

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PostPosted: Sun Oct 07, 2012 1:07 pm 
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by the way...........................

I think HOW exactly it works can be interpretted SO MANY different ways. becuase, YOUR RIGHT, thats its a bunch of scientific talk, and I for one will be the FIRST to admit, I dont understand too much of that. Need a house built?? I can TOTALLY help ya there!!!!!
but when it comes to this stuff, Im a little ,,,,, disabled.
So,,,,,,, I hope you find the answer your looking for here, if Im way off, please let me know, ALSO.
and,
if you find the EXACT video, with the answer PLEASE post it!!! since I dont really have time to watch all 19 right now, LOL
all you have to do is copy the address, and push the 'youtube' button, or if its NOT a youtube video, copy into the link it gives you on the 'upload video' button.

Thanks for YOUR HELP on this.
its a VERY good topic. I for one, would like to know what the general consensus is as well.

good luck

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PostPosted: Sun Oct 07, 2012 2:17 pm 
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Thanks, Amber!! It's like seeing a doctor without paying a million dollars! lol

Honestly... before this forum, the way i found out about it, was I saw a Dr. J video and it never answered the question I was looking for, he said the answer was in his tapes that you have to buy. So I had given up on his videos b/c I though they were all advertisement.

So to find out about his free videos with free information is AWESOME!

I as well don't have time to watch 12 videos all at once especially with the hours of lectures I'm supposed to watch by the end of today but I will watch his vids in between the schoolwork for my "1 reward an hour" study incentive... lol

and I will let you know what I find out!

that is so cool you know how to build a house! Women don't usually know those skills and they are so important in life like when maintaining your property or just building/fixing things in general, and I think it is cool you know how to do that stuff.

dr. j is so cute when he talks lol I don't know why he just has this baby face. hey somehow you've got to keep my attention when talking science mumbo jumbo lol


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PostPosted: Sun Oct 07, 2012 2:31 pm 
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I think that whether Suboxone would cause your brain to create more opiate receptors or not depends on a couple of things. One is what your level of opiate tolerance was when you started Sub, the other is your Sub dose.

"Creating more opiate receptors" can be thought of as another way of saying "raising your opiate tolerance." So if you already had a really high opiate tolerance, a higher tolerance than the maximum opiate effect of Suboxone, then no, Sub is not going to raise your tolerance. If your tolerance was lower than the max opiate effect of Suboxone, then yes, you could raise your opiate tolerance by taking Sub...depending on your dose.

Sub is weird in that it has a ceiling on the amount of "opiate effect" it will produce. With other opiates, you can keep on taking more and more and more and raise your tolerance indefinitely. With Sub, you can only raise it to a certain point and then taking more doesn't do anything. This plateau or ceiling effect is somewhere between 4mgs and 16mgs of Sub for most people.

So while Sub can raise your tolerance/create more opiate receptors to a certain point if your opiate tolerance wasn't really high to begin with, it is not going to keep raising it and raising it forever the way you theoretically could by abusing/using ever increasing amounts of full-agonist opiates.

Quote:
Or does the blocking effect somehow help the brain go back to the way it used to be?


I don't think doctors/scientists know yet the extent that our brains can heal or go back to normal after opiate addiction. Since my Sub treatment and being off Sub for a few years, I have had to take opiates for pain on a few occasions and they worked just fine. I passed several kidney stones and the medications they gave me, a shot of dilaudid at the hospital and a take home of either percoset or vicodin worked just as well as they did before I ever got addicted to opiates. But I know there are other people on the forum who have had issues with high opiate tolerance even after they got off Suboxone. Maybe it just takes time for things to go back to normal? I think there are probably a lot of variables involved.

How the blocking effect of Sub plays into this question is not something I really have a grasp on. My guess would be that the biggest benefit of the blocking effect of Sub is that it helps keep us from using other opiates on top of the suboxone. That and the fact that Sub stays active in the bloodstream for so long keeps us at a level state, stopping the ups and downs that come with shorter acting full agonist opiate use/abuse. This is supposed to help break the addictive cycle of using/reward/crash that we got trapped in during addiction.

I can't say that I fully understand everything that goes on in the brain around this cycle, but it seemed true to me at a personal level that stopping that cycle was helpful to my brain and certainly helpful to me in terms of getting my act together, working on my recovery, etc. Something definitely changed in me during my time on Sub, as I was ultimately able to taper off of it and stay off opiates, which I had repeatedly failed at before. Since my brain runs the show, I'm inclined to think some kind of positive change occured there. What exactly I should credit with creating that change I'm not really sure...it was probably a number of things. We are complex beings after all.

Somewhere around here I wrote a long explanation of ceiling effect with a graph and everything. I don't have time to look for it right now, I think the name of the thread is like Bupe: Less is More or something. I will try to find it later if you'd like to read it, right now I have to get to work!

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PostPosted: Sun Oct 07, 2012 3:54 pm 
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I am starting to think that suboxone can help but only to a certain extent.

For example: someone on suboxone can only fill the receptors so high (ceiling effect). So it does help people get their tolerance down. But only to an extent. Also suboxone's blocking effect can prohibit people using other opiates to get the same dopamine release. So they get their tolerance down.

But as far as getting ALL the gates closed... (closing up the starved opiate receptors that have multiplied to an amount that the user previously did not have)... I think that it doesn't really do that. It instead opens them up and fills them -- thus, satisfied opiate addicts.

I guess I still have to worry about the whole "i have lots of starved opiate receptors" issue, and that I must accept that this is the hole I have dug for myself that I must deal with during PAWS. But I can imagine that doing .5 mg of suboxone every day for a month will slowly close up some of the opiate receptors verses staying at 4 mg of suboxone per day. And same for going to .1 mg. I always thought that, well if I do 1 mg for a week, then .75 for a few days, then .5 for a few days, and then .3 for a few days and jump, that I would not have any issues. But I guess it probably take months for the opiate receptors to close up and stop saying "feed me feed me". The dopamine system had not caught up yet. It takes more than a few days.

So I suppose being on, say .1 mg of suboxone for a few months before jumping actually may have some logic behind making the PAWS not so bad versus just staying at .1 mg for a couple days before jumping. It may take months for the brain's dopamine system to get used to that .1 mg of suboxone. Doing the whole "taper every couple of days" thing, for example, going from 4 mg to .5 mg in just a couple week and then jumping, would physically be like jumping from .5 but mentally be like jumping from 4 mg because it takes months for the brain to get used to the lower levels of dopamine.

*this is all in theory*

I would like to try it because at this point I want to have my psych in check before jumping next time.
I have jumped and failed so many times and always always ALWAYS end up going back to me last stable dose (stable meaning I had been at that dose for a few weeks)

Example: I keep jumping at these low doses, but I keep going back to .75. .75 was the very last stable dose I was at. I was at .75 for weeks. I love .75. Well some day I want to love .3.

I always thought a slow slow taper was a waste of time but boy was I wrong. At least I think I was wrong. Especially in terms of the dopamine release system. I feel stupid not believing the smart peoples' posts and successful stories of slow tapers, like laddertippers, and diary of a quitter.


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PostPosted: Sun Oct 07, 2012 5:34 pm 
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I always thought a slow slow taper was a waste of time but boy was I wrong. At least I think I was wrong. Especially in terms of the dopamine release system. I feel stupid not believing the smart peoples' posts and successful stories of slow tapers, like laddertippers, and diary of a quitter.


WELL you shouldn't feel stupid about THAT........ I think ONE of things EVERYONE of us has in common, or DID at one time, is since we ALL pretended to be our 'own' pharmacists/docotors/whatever we ALL think we KNOW EVERYTHING (OR DID!!) you know,
about any 'pain pills/drugs/whathaveyou'
LOL
At least I did. I could be way wrong, LOL
But I used to think the same thing.
There seem to be way more sucessful stories of tapering than NOT, but there are at least a FEW of jumping, at a somewhat high dose and people making it, excelling at it really. Like Romeo, and the Jumped w/o a parachute thread.

I do think for people who CAN taper, it definitely isn't a waste of time. . . . going slowly down, and like diary's said before, getting used to getting by on less and less,,,,
that may be better at preparing your brain for the big 'leap'

On the other hand, I can totally see the points people have about not being able to taper. It would be difficult for ME.
absoutely. . . . but ultimately worth it???
yes, I think so.

I was just adding my two cents, LOL
I think this is a REALLY GREAT discussion.
for anyone!!!!

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PostPosted: Sun Oct 07, 2012 7:19 pm 
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I'm with DoaQ on this...

If a person's on a high dose of methadone, then switches to Suboxone (which is relatively mild in comparison) ... their opioid receptors will upregulate to get used to the relative lack of stimulation compared to the high dose of methadone...

How much buprenorphine allows your receptors to upregulate / repair depends a lot on (a) your level of opioid use and tolerance beforehand ... and (b) the dose of buprenorphine you're taking. If a person who's been taking X amount of Oxycodone or heroin switches to Suboxone ... and takes a dose of Suboxone that prevents them from getting any cravings, then it's likely their receptors won't be upregulating much.

In a nutshell ... withdrawals and / or cravings are symptoms of your opioid receptors upregulating / healing. If a person isn't experiencing any cravings or withdrawals, their receptors aren't healing / upregulating. And last time I checked, the purpose of taking Suboxone was to prevent cravings.

The thing about withdrawal that a lot of people don't acknowledge ... is that the pain a person is feeling and the cravings we endure ... is actually the feeling of our opioid receptors healing... When we switch from our DOC to Suboxone, we don't allow ourselves to detox / experience withdrawal, so essentially we're postponing / delaying this process of healing.

Something else. While we were using, our levels of opioids in our blood were constantly fluctuating, going up and spiking every time we took a drug, then dropping to near low levels when we were experiencing mild withdrawals before copping / scoring and using again. Overall though, we wouldn't give our receptors a chance to upregulate / repair enough, so each time we'd use our tolerance would go up a lil bit more. On Suboxone, we have a moderate amount of opioids in our receptors 24/7 .. Our tolerance doesn't rise much at all (some people argue that people on Sub maintenance experience dose creep over time), but our receptors don't have any time in the day where there's NO external opioids. So overall, not much healing takes place ... UNTIL a person starts to taper, and experience cravings and withdrawals.

In a nutshell ... Withdrawal symptoms and cravings = opioid receptors healing.
No withdrawal / cravings when we switch to Suboxone = not much healing...

HOWEVER ... Suboxone does give the other parts of our brain a chance to heal - those parts responsible for impulse control, mood stability, decision making etc. ... and this shouldn't be forgotten.


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PostPosted: Sun Oct 07, 2012 9:05 pm 
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Amber - lol about thinking we know everything and being our own pharmacist hahaha

I used to think that I could tell myself to do anything, and that I really did know what was "best" for me

I seriously did not know the word "addiction" until like a couple weeks ago. I seriously thought that addiction just meant that your body goes through physical crap when you stop doing drugs, you sit it out, and then poof you are done. But no, there's all kinds of mental crap going on that I realized looking back I was addicted long ago when I started stealing my mom's meds. This was back in high school, I was a teenager, I mean, I did not hang out with bad people back then or anything. Mind you I would never even think about swearing in front of my mother, let alone STEALING?? That is NOT me. I still can't believe it to this day. But I realize now that I was addicted. And that is why I just did not think I needed to taper. I just thought Well I will sit out the sick part and just be done with it. But now I realize that I think that tapering would actually be a very very smart choice. I am not mentally as strong as I thought I was. I thought I could be my own little pharmacist and tell myself what to do and then boom I would be healed.

TJ and anyone else really - What do you think about a person that has been off of their heroin/other opiate drug for a year? And they have been on suboxone the whole time? Does suboxone allow for ANY repairing to be done in that years' time? I am guessing off your answer TJ that no, if the user has been taking lots of suboxone and never feeling any withdrawal symptoms, that no there is not any healing of receptors going on.

So..

what about if that person tapers all the way from 8 mg all the way down to .5 mg? And they still are not feeling any withdraw symptoms because they tapered very slowly? Has there been ANY healing go on in that past year you think? Or are they just as addicted as they were a year ago?

*If the answer is still No, no healing has been going on I am seriously starting to realize exactly how misled I was with this whole suboxone thing.. guess thats what u get tryin to be your own pharmacist.. lol*


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PostPosted: Sun Oct 07, 2012 9:39 pm 
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ur totally over analyzing this bro..

Just realize buprenorphine is an opiate...

A lot of the this stuff isn't known for sure and a lot is speculation; we generally know what is going on...No offense to Dr Junig but his videos are very generally speaking...

as far the brain healing etc.. does the brain ever return to normal.. etc etc.. and all the other questions ...who knows

But basically like someone else said when on Bupe your brain is pretty much stimulated 24/7 with opiates so thats how u can achieve some sort of stability in life;


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PostPosted: Sun Oct 07, 2012 10:49 pm 
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Hey IM,

I think your question about the brain healing itself needs to be broken out into two different segments. As far as "physical" healing of the opiate receptors while on Suboxone, that's probably not going to happen for most of us because Suboxone is so strong. You would have to be taking Suboxone in a dose that is weaker than your previous opiate (Lortab, Vicodin, Oxy, Heroin, whatever) dose. So, say you were taking 100mg of Lortab a day, which let's say is equal to 8mg of Suboxone. If you went from 100mg of Lortab to 16mg of Suboxone, you'd actually be taking "more opiates" than before, thus no healing. The opposite would also be true. (taking 100mg of Lortab, then going to 4mg of Suboxone would equal some healing)

The other part of your question, which I'll call the "non physical" or the "mental" part of healing, Suboxone surely helps us heal there. This is all the addict behaviors we learned while in active addiction. The lying, cheating, stealing, being completely self absorbed, etc, etc. Suboxone most certainly allows for healing in those departments.

Does that make sense? If not, let us know and we'll try to explain it some more. Believe me, it took me a while to figure all this shit out!! :wink:

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Last edited by Romeo on Sun Oct 07, 2012 10:50 pm, edited 1 time in total.

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PostPosted: Sun Oct 07, 2012 10:49 pm 
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When I think of Suboxone, I don't really see my opioid receptors doing much healing. However I think overall my brain is getting a lot better, because I'm studying, I'm thinking about my actions before I make decisions etc.

I dunno about you, but in my addiction I knew some really damaged people, people who'd been using heroin non-stop for decades ... and it damaged their brain. Not so much their opioid system, but their thinking and functioning in general. I remember speaking to a doctor when I was interstate ... while NA migght disagree, he was of the belief that if a person's addiction is damaging enough to their brain, they can actually cross a "point of no return" where their frontal lobe loses its functioning to the point where they're incapable of making the decision to try and stop using.

IMO Suboxone and methadone prevent this from happening. Since being on Sub I've matured a lot in my thinking, I'm less impulsive, I'm thinking more clearly and caring of others. These changes aren't just spiritual. This is a result of our brain healing, repairing the links to the frontal lobe allowing us to make rational decisions.

But for our opioid system to repair I think requires us to start reducing our Suboxone, or stop taking it. It's when we experience withdrawal and PAWS that the real healing of our opioid system begins.


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PostPosted: Mon Oct 08, 2012 2:34 am 
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amber4.14.11 wrote:
There seem to be way more sucessful stories of tapering than NOT, but there are at least a FEW of jumping, at a somewhat high dose and people making it, excelling at it really. Like Romeo, and the Jumped w/o a parachute thread.


I wish that parachute guy would come back and let us know how he is doing. It's been quite a while since that thread. The way he posted I really would have thought he was the kind of dude to at least log on every few months to say "hey I jumped from 8mg, been clean XX months and you can too!"

I hope he is still drug free and just forgot all about us I guess... I remember he worked a few gigs so maybe too busy.

Hey parachute guy I challenge you to come update us, we care about you man!

-gb


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PostPosted: Mon Oct 08, 2012 11:14 am 
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Yes you all are right, even if the subs are still filling in those opiate receptors, it's not like there is NO healing of any kind kind going on at all.

I too have changed in the past year and I really like my life right now and if I did not switch to suboxone I certainly would not be in graduate school and well... I guess this thread made me realize, that I'm not completely powerless to addiction, because I made the switch to subs didn't I

I guess this was a stupid thing to worry about. I have forgotten all of the great things that have happened in the last year

Yes it is sad to think about the very bad drug addicts, the older ones, in which their logic of thinking is all out of wack. I guess I should stop worrying about this because I've obviously only hit the teenie tiny tip of the addiction iceberg, I am so young. Of course my brain will heal. And it probably won't even take that long.

Lol I remember that thread the vivitech guy.. veritech.. something. I remember he went to work every day and did manual labor and had like a 2 hour commute or something. That thread has a lot of hope in it for people


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PostPosted: Mon Oct 08, 2012 5:46 pm 
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OK, I have watched 2 videos from Dr. J called "how suboxone works" parts 1 and 2 and they kind of sort of answered my question. And I watched a vid about how to stop suboxone but it was the advertisement to buy the other videos pretty much. So, yes suboxone fills the receptors but only up through 4 mg and they don't fill them as much as how much say heroin can if you do enough heroin.

But I kind of wanted to know if I still have to worry about them screaming at me when I quit suboxone off of say .5 mg or lower. And the videos kind of answered that question. He said at one point that when you stop taking opiates (subs included), that your receptors do not produce the pain-relieving chemicals that they should because over time, after taking lots of opiates, they simply stop making them altogether because opiates make them fire rapidly and the body tries to stop it from firing so rapidly and so it tells the brain to stop making its own chemicals. So then you have to take the drugs for your brain to receive the chemicals that they naturally produced.

So I want to know -- how long does it take for the brain to start making the chemicals itself again?

I don't know. But the video said that the result of you stopping taking opiates and your brain still not making its own chemicals is withdrawal. Your body gets in physical pain because your brain is not making/releasing pain-relieving chemicals.

So it makes me think that once the physical pain is over, it means that your brain has started to make and release those chemicals again that your receptors were starved from during withdrawal. I mean, this could simply be over in a matter of a couple of days to a week. So I guess I am not going to worry about it anymore.

Any mental "pain" that is PAWS and whatnot probably has to do with the dopamine reward system. This is where suboxone can really help. Because after you are on suboxone for a long time and do not take other drugs like heroin or OC, you stop your little reward-seeking behavior because you are not "high" on suboxone. THerefore you learn to do things that make you happy besides drugs such as baking or reading or snowboarding.

The problem is that if you get used to do a small level, say 1 mg of suboxone per day, which is under the ceiling, you might start back up that reward-seeking behavior because now, when you take an extra dose you DO feel it, and you DO get high, and you start looking forward to your dose, or turning to suboxone for a reward, or turning to it when you are mad. So I suppose that still one would have to realize that their dopamine system still might be relying on drugs somehow in certain ways.

So maybe a lot of mental PAWS has to do with those things people learn in therapy of learning how to talk to yourself and how to do rewarding things. Also this is where a support system would help with PAWS because people encouraging you makes you feel good about yourself and release dopamine.


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PostPosted: Mon Oct 08, 2012 8:11 pm 
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invisiblemovement wrote:
OK, I have watched 2 videos from Dr. J called "how suboxone works" parts 1 and 2 and they kind of sort of answered my question. And I watched a vid about how to stop suboxone but it was the advertisement to buy the other videos pretty much. So, yes suboxone fills the receptors but only up through 4 mg and they don't fill them as much as how much say heroin can if you do enough heroin.

But I kind of wanted to know if I still have to worry about them screaming at me when I quit suboxone off of say .5 mg or lower. And the videos kind of answered that question. He said at one point that when you stop taking opiates (subs included), that your receptors do not produce the pain-relieving chemicals that they should because over time, after taking lots of opiates, they simply stop making them altogether because opiates make them fire rapidly and the body tries to stop it from firing so rapidly and so it tells the brain to stop making its own chemicals. So then you have to take the drugs for your brain to receive the chemicals that they naturally produced.


For a bit of hope in the whole thing. I spoke to a girl on the phone lastnight who used to be a using friend. I hadn't spoken to her for years. She used to be a hopeless addict, one I thought would struggle to get clean even more than myself. And she's 100% opioid free! Went on Suboxone for a couple of years, got her degree ... and that gave her the first bit of belief in herself and her ability to live a normal life she'd ever experienced... and that was enough to help stop her using occasionally on Sub, reduce off and live 100% clean and happy. So the brain DOES repair...

Another thing. The old "4mg" ceiling has been revised by Dr. J in recent months / years ... It seems to be closer to 8-12mg. Whether that's been revised to keep levels above the ceiling for a full 24 hours I don't know. But it would be good to have Dr J come in and help us out on this.

As for how long it takes to return to normal. I had a doctor who's spent his life treating addiction, and who's probably treated every heroin addict in my city at one point ... tell me it can take 18 months for levels of "protein kinase C" to return to normal after being on buprenorphine maintenance. That's the protein kinase responsible for regulating levels of endorphins - our body's natural opioids. So it takes a lil while. But in the picture of your whole life, 18 months isn't that long.

Those 18 months correlates roughly to the timeline of PAWS. However, this long term recovery and repair is a lot more gradual than acute withdrawal. You don't feel yourself "improve" as such. The process of healing is so gradual that you only notice it in hindsight... ie at 9 month you notice how much better you're feelign than at say ... 3 months.


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PostPosted: Tue Oct 09, 2012 12:24 am 
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i would say 18 months to few years for full brain recovery; just my opinion

i once made it 15 months and relapsed..

fuck man now here i am years on sub again


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PostPosted: Tue Oct 09, 2012 1:39 pm 
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That is interesting TJ, and makes sense. It reminds me of something my high school science teacher passed along to a friend of mine about chronic marijuana use. I can't remember everything he said, but after some long scientific explanation of how marijuana dirties/clogs some kind of receptors, he said it takes 18 months for the receptors to be clean again. I think you are totally right about how you will not notice differences right away, but after many months, looking back you will realize, Hey I feel better. After about a year of not smoking any marijuana after years of daily use, I remember feeling so much better about myself that I never wanted to use ever again. I think the marijuana was making me depressed. Of course there are triggers almost every day but they are not strong enough to make me want to use. Not that marijuana is really looked down upon. It's just that after seeing how much easier and happier life was without smoking weed, that was enough to make me not want to use it ever again. Of course I had replaced the addiction with OCs so that's why it was so easy to just stop one day without even thinking about it.

But this information gives me a little more motivation to stop using opiates, in hopes that the same thing will happen -- after a year/18 months, look back, and realize how much better life (hopefully) is, and then battling the cravings will not be so hard.


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PostPosted: Tue Oct 09, 2012 3:04 pm 
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I read through the replies quickly and I don't think the following was mentioned, which may help answer your questions:

1. Dr. J once said that Suboxone maintenance (whether it's at 4 mg or 16mg doesn't matter because of the ceiling effect) is equivalent to about 60 mg oxycodone or 80mg hydrocodone a day. So if your drug use was above that your tolerance will go down. If it was below that Sub will actually increase your tolerance.

2. Dr J recently did a post about Sub withdrawal (blog 9/23/12). In it he stated that opiate receptors actually regenerate after the drug is withdrawn, and it takes about 8-12 weeks for the NEW receptors to be formed. It is all a function of the endorphin pathways, not dopamine pathways.

Ive been looking at opiod equivalent dosages (which only work for bupe at doses below the ceiling). Taking into account that only 30% (at most) of a sublingual dose is absorbed, the sources I used would put 0.75mg Sub as equivalent to 10mg Percocet. So that is definitely far less than going off a maintenance dose.

Actually I was thinking about starting a thread about this. 0.375mg Sub is = to about 5mg Perc. If it were possible to taper off of oxycodone (which it's not) would people taper below 1 Percocet? Would they go to 1/2, 1/4, 1/8? I don't think so. The smallest dose that you can cut a Sub film down to easily is about 0.25mg. With that being equal to less than one 5mg Percocet, why would anyone want to taper lower? It would seem to only be for psychological reasons, and if that works for people then great. For those who will reply that bupe is given for pain in 0.08mg doses, please keep in mind that those are INJECTABLE doses - which are much more potent and direct than Sublingual doses.

So I think staying at a very low dose for several weeks is a good strategy. It will give the unoccupied receptors time to downregulate. Then when you do go off, it will be from a low tolerance.

What does everyone think?


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PostPosted: Tue Oct 09, 2012 3:24 pm 
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That is great information, Lilly!

I have tried figuring out those opiate conversion things, and I have such a hard time. Also different websites sometimes say different things. I think the last one I looked at said 1 750 vicodin was some crazy small suboxone dose, and I thought omg my dose is so high, but sometime the calculators are for different kinds of bup, and it is all just such a mess to me.

So to find that out that 5 mg percocet is .375, that is awesome. I'm not as familiar with percocet as vicodin, but I image that 5 mg percocet is like a vicodin 500? I always wanted to taper down to an equivalent to a vicodin 500 to jump.


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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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