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PostPosted: Mon Nov 02, 2009 12:30 pm 
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Firstly, thanks to the Doctor and to all that are involved, engaged and helping others.

I have been on our orange hexagonal friend for about a year and a half. I’ve been tapering for about 4 - 5 months very slowly and with no problems or symptoms. I was taking up to 32 mg for about a year and have tapered down to 3 mg/day (1.5 mg bid). I thought that 3 mg a day was really a very low dose…NOT! From what I have read on this forum I’m just starting the very beginning of making my sub-descent. How does my taper plan look to those that have bravely gone before me? I am flying blind. My well meaning doctor has no clue. She took the 8 hour CME on-line Bupe course to get her DEA “X” qualification so she can write for Suboxone but really had no idea what she’s doing.

I read many posts about stopping suboxone and I’m concerned. I did read many similar posts about the hell from stopping benzodiazepines and those really concerned me too. But I stuck with my benzo taper plan and I got off of an insane amount of Xanax and had ZERO symptoms. So, that helped my perspective (and confidence) a lot. I’m off of Xanax for over 2 years now, by the way.

Currently, I am reducing every 7 days. I am going down .5 mg and alternating evening dose reduction, then morning dose reduction, etc. Planning to reduce this Friday to 1.5 mg/1.0 mg then in 1 week 1.0 mg/ 1.0 mg. I am excited to be on a single 2 mg tablet per day, seems like a milestone.

When I get to 2.0 mg per day I am going to slow the reduction down further to increments of .25 mg, and then again slower still when I reach 1 mg per day to increments of .125 mg (I used a scalpel and a lot of patience to cut 2 mg tablets into .5 mg, .25 mg and .125 mg pieces!) I have even read about “dust doses” after that.


So here are my basic questions:


I was thinking of staying on 2 mg per day for about a month before reducing further. The rational being to let my opiate receptor sites “calm down” (reduce in number, surface area, level of excitement, etc.) Or is this a waste of time if I am symptom free…are they ‘calming down’ along with my taper?

How sound is this plan going down from 2 mg/day:

.25 Incremental AM/PM Weekly Reduction Schedule (in mgs):

1.0 – 1.0
1.0 - .75
.75 - .75
.75 - .50
.5 - .5

Once I get to 1 mg/day I go slower still with .125 mg Incremental AM/PM Reductions (again, in mgs):

.5 - .375
.375 - .375
.375 - .25
.25 - .25
.25 -.125
.125 - .125
0 - .125
0 - 0


I am flexible and if symptoms arise I will adjust the taper if they become intolerable…but that's my basic plan. I can protract the length of time for a reduction dose if need be but I don’t want to ever INCREASE a dose unless I’m in serious hell. I can also take a small dose every other day at the end, even every three days.

What do you pro’s think (and by pro’s I mean anyone with the courage to try to regain your health).

I have read about some people that have tapered very slowly, seriously ramped up their exercise and used minuscule doses at the end that claim they got off of suboxone and never had any symptoms at all. Many say they were ‘waiting for symptoms but they just never came’.

I don’t mind a bit of suffering I guess but I want to minimize it the best I can. That's a lie...I am terrified of symptoms!

I very much appreciate your input.

Regards to All - Steven


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PostPosted: Mon Nov 02, 2009 12:43 pm 
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Hey there Steven glad you're with us and you deserve a big congrats for getting clean! Alot of people have seemed to have had better success not using a very rigid tapering process. There will be some discomfort obviously but people like Diary of a Quitter who did a very slow taper, basically only reducing after she had stabilized and become comfortable with her previous reduction. I certainly don't think there's anything wrong with tapering off and I do know a couple who have been successfull and still currently clean. I would however just say there is nothing wrong with staying on Suboxone if it's working for you or you can afford to do so. There is a long thread Diary started back when she started her taper using a water method that allowed for smaller and more precise dose reductions. Basically dissolve a tablet of Suboxone in a precise amount of water and use one of those childrens medicine oral syringe to measure the liquid with. The key is to go SLOW as in taking as long as neccessary for you to be comfortable after reducing probably meaning taking a month to months after reducing rather than a weekly basis. If you check out Youtube using the search "suboxdoc" Dr. Junig has a video about tapering off Suboxone, how one should approach the taper, how to stay clean after tapering off etc. I'd definately reccomend you check out the vidoe and let us know how you're doing.
Glad to have you with us and the best of luck,
Matt

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"If you're going through hell, ....keep going!"
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PostPosted: Mon Nov 02, 2009 12:43 pm 
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I got off Suboxone by doing a long, slow taper with very small reductions and I had pretty minimal withdrawal symptoms. I won't say I had no withdrawal, but what I had was really manageable. I didn't miss work or anything and I only needed a few doses of ambien for the insomnia. Exercise and a positive attitude definitely help.

Your plan seems solid. Once I got below 1mg, I dissolved the sub in water to make it easier to measure out the doses. I went down about 100mcg every 10 days except for a few times when I stayed at a dose longer because life circumstances made it an unideal time to decrease again. Having that flexibility helped a lot.

Though the acute withdrawal wasn't bad - about as annoying as a mild cold - I will say that it took about 8 weeks off the Sub before I really felt 100% like myself again. And there were a few mild symptoms involved with some of the drops in dose but they only lasted a few days each time.

Good luck.

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PostPosted: Mon Nov 02, 2009 12:59 pm 
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WOW! Thanks for the replies…so quick! DQ, are you in Europe where there is a 200 mcg tablet available (why don’t they have that here…it would be very helpful).

I agree that I should be flexible in my dosing and reductions. I probably seem more anal that I am…my plan is a guide line so your advice is well received.

I was looking at my own post and realized that my basic plan takes 3 months to get off of 2 mg’s a day! That just seems reasonable to me. But again, it’s about listening to your body.

I thought you would be surprised that I got little chips into .125 mg pieces…but DQ did smaller than that!

And I agree that being on and staying on suboxone is useful, I’m just ready, able and done with it all.

Thanks again you solders of victory!


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PostPosted: Mon Nov 02, 2009 1:37 pm 
Steven, I have little to add to all the good advice you've been given.
Your plan sounds very realistic and reasonable. I'm working on tapering as well. I'm down to 3-4mg/day. I had such ease with reducing from 16mg to 8mg then to 4mg, that I got in a hurry and tried dropping from 3 to 2 too quickly. I did not experience outright "withdrawal" symptoms with the drop to 2mg, but I just did not feel good with it. I found myself feeling very tired, unmotivated and a little achey in the legs. It's possible that it was all "in my head". It's also possible that it was related to my hormonal cycle (PMS). Regardless, I decided to just slow it all down. I've only been on Suboxone for 4 months so as much as I'd like to be done for financial reasons and just to be done I am realizing that it's going to be best to take my time with this.
I'm also working with 8mg tabs which will make it more difficult to taper in the smaller doses unless I use DOQ's water taper (which I may eventually do), or get an Rx for the 2mg tabs and divide them the way you have been doing. In any case, I'm going to stick with 3mg/day, as I was feeling okay there, for another couple of weeks or so and then try again to drop to 2mg. I think your idea of staying at 2 for a while is a good one. I plan to do the same thing - stay there for a month or so giving plenty of time to feel stable at that dose.
Keep us posted on how it's going for you. We're all in this together and it's so good to have someone who is pretty much where I'm at with tapering.
Congrats on how far you've come!


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

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  • Asst Clinical Professor, Medical College of Wisconsin

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