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 Post subject: Taper schedule
PostPosted: Sat Jun 11, 2011 4:30 pm 
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Hi,
My name is Lori and I'm here on my father's Ken's behalf. I successfully tapered off benzodiazepens over the last year and want to help him to taper off Suboxone. He started taking hydrodone (3-4, 10's a day) after two failed knee replacements on the same joint. For the third surgery he went to a different dr. but only so much could be done to ensure a success. He has been left with leg pain that defies a reason for the residual pain.

Last fall I took him to see my pain mgmt. dr. and he gave my dad a plan to switch over to methadone. I don't know his doseage of methadone, but he was able to taper down some. His worst symtom of methadone was sweating profusely at random. Dad then went back to the dr. two weeks ago and it was recomended that he change over to Suboxone.

His current dose of Suboxone is 8mg/2mg sublingual film. I requested this as the pharmacist said it's easier to taper off from than cutting tabs. Dad would like to taper off Suboxone but he didn't want to consult with the dr. about this as he had declared to dad "you'll never get off this stuff" He had told me the same thing about benzo's and I took myself to an extremely knowlegable and helpful forum called Benzo Island. Nuff said, I can help him taper off myself.

What i can't find on this site is a recomended cutting plan. On BI it was .5mg every 7-14 days. I know that if you try to go off too fast you have a much slimmer chance of success. Once we get started with a taper plan and get under way we'll share our progress with the dr. he's a good guy and reasonable.

I know his advise to me about benzo's was way too fast of a taper on a benzo with a shorter half life. Had i tried his plan i would have had pretty severe withdrawal that would have had a lot of inter dose withdrawal symptoms due to the short 1/2 life. I also question whether i would truly have been able to withdraw on this plan.

Can you help me please? Lori


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PostPosted: Sat Jun 11, 2011 6:59 pm 
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Hello and welcome! I haven't tapered off and probably won't anytime soon, but I can give you what I've learned about it in the last 2.5 years. It is said to be best to do a long slow taper, like down into the micrograms, to help with both acute and post-acute withdrawals. Some people do well that way, others don't do too bad jumping from a higher dose. Most say sub withdrawals aren't nearly as bad as full agonist withdrawals. For example, it doesn't leave you in your bed all day, but it does tend to last a little longer, some say.

Dr. Junig recommends 10% drops at a time. The time in between drops that he recommends I don't recall exactly, but I think it's a couple to a few weeks in between. But every person's taper schedule will be individualized to their unique needs and history. Success seems to correlate greatly with the person strongly feeling they are 'ready' to get off it.

People spend months tapering off suboxone. Most would recommend not rushing it. Think of it this way, one isn't just going off suboxone, it's like they're withdrawing from years of taking opiates. That's how I see it anyway.

I wish you both good luck and I hope this helps a little.

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-I'm only responsible for what I say, not for what you understand.


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 Post subject: My Own Taper
PostPosted: Sat Jun 11, 2011 7:27 pm 
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Hi Lori, and welcome to the forum. If you do some research on previous threads here you will find plenty of taper schedules to guide your father with.

My doctor left it up to me to tell him if I wanted a dose adjustment, then recommended the proper drop. I started on a fairly high dose because I was taking a large amount of pain pills, and other fun drugs.

It started with three tabs 8/2mgs. That means 8mg's Buprenorphine and 2mg's Naloxone. We just call it 8mg tabs or film strips. The film is the latest and easiest to taper from as was explained. 6 weeks later I dropped to 16mg's as it just felt too high and I was too sleepy. Stayed at that dose for six months. Then started dropping by 2mg's every month until it got down to lower doses. I then went from 8 to 6 to 4 to 3, changing every month. Notice I dropped 1mg this last time. The trick is to go very slow to let your body adjust to each dose drop. If you don't do well, you can always go up a bit to stabilize.

So now I'm on 3mg's and my next drop will be to 2mgs. Then it'll be by halves, and then slivers, until I feel ready to stop.

Keep in mind that this is only me and others have different opinions and histories. No two people are alike. Your father will have to monitor his taper based on just how well he feels and if there are any cravings.

By staying on for just over a year now, I've been able to adjust to life without taking my beloved Norco, Soma, Ultram cocktails. My behavior has changed for the good. Nice and slow makes a successful recovery. And what's the worst that can happen? Stay on Suboxone for life? Even that is no big deal. A perfectly legal drug that allows a person to live normally. Hmmmm, sounds about right to me.

My hat is off to you for helping your father this way. Keep reading the older posts for more info.


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 Post subject: dads suboxone taper
PostPosted: Sat Jun 11, 2011 8:59 pm 
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Thanks for getting right back to me Rule and Hatmaker, really appreciate it. So we'll start with a 10% cut and see how it goes, not looking forward to that minute measuring of the film. That gives me a baseline to start from and I really understand about personalizing each person's taper by how they react to the cuts.

Just had no idea where to start and wasn't getting anywhere reading posts. I found a lot of information to be sure, just not a general number to start with.I might not have typed in just the right words in the search box to find what i needed. Now i can show my dad how to get started navigating around here.

Thanks so much again, Lori

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Lori writing on behalf of my dad

Previously taking Hydrocodone 10's (3-4 per day) then switched to methadone for about 5 mos. Cut down a bit, then dr. switched him to suboxone. Done with suboxone on oct. 8, 2011 after @6 mos.


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 Post subject: film cut
PostPosted: Sun Jun 12, 2011 12:01 pm 
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Hatmaker,
Dad came over this morning and i cut his morning film by 1/10th (10%) Now it's correct that i just make that one cut today, right? By 10% cut i think you mean 10% of total for day. Oh geez i think i just answered my own question, if that's the case we should cut each film by a 10%. He takes a total of 24mg per day and if i only cut one film it's not 10%. I stink in math, sorry if i sound like a ditz, pretty sleep deprived here. ~ Lori

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Lori writing on behalf of my dad

Previously taking Hydrocodone 10's (3-4 per day) then switched to methadone for about 5 mos. Cut down a bit, then dr. switched him to suboxone. Done with suboxone on oct. 8, 2011 after @6 mos.


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PostPosted: Sun Jun 12, 2011 12:13 pm 
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What I failed to clarify to you is that at higher doses such as 24 mg, the drops can be larger until he gets down to approximately 8-12 mg (it varies among individuals). He can probably drop from 24 mg down to 16 mg and not feel a thing.

This is because the ceiling of suboxone is generally accepted to be at or around 4 mg. As you can see, 24 mg is quite above that ceiling, as is 16 mg, therefore, a drop like that can be done with minimal if any discomfort at all. With suboxone's long half life (average 37 hours), if he does feel anything it would be 2-3 days after that drop happens. So if he does feel that drop, you can always bump him back up to say 18 or 20 mg.

The most important thing I believe in a taper is to listen to one's own body. If he feels the dose drops too much, then consider making the drops smaller and slower.

Sorry for failing to include this information the first time around. I hope this helps. Ask more questions if need be.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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 Post subject: That's It
PostPosted: Sun Jun 12, 2011 1:14 pm 
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Hatmaker said it all. 24mg's to 16mgs, I didn't feel a thing. That's how I knew it was way too much, especially if one is paying cash for the Sub there's no reason to take more than needed.

The film strips work really great folding them to get a good half cut. That or measure it and make a score cut with an exacto knife or razor blade. It only makes a difference when you get down to low doses so have no fear, your Dad will be comfortable.


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 Post subject: Dads taper
PostPosted: Sun Jun 12, 2011 4:26 pm 
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Thanks so much Hatmaker and Rule, MUCH appreciated! Lori

_________________
Lori writing on behalf of my dad

Previously taking Hydrocodone 10's (3-4 per day) then switched to methadone for about 5 mos. Cut down a bit, then dr. switched him to suboxone. Done with suboxone on oct. 8, 2011 after @6 mos.


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Dr. Jeffrey Junig, M.D., Ph.D.

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