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 Post subject: the ceiling effect????
PostPosted: Fri Dec 24, 2010 4:16 pm 
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I am wondering what the ceiling effect is that I hear everyone talking about. Will someone explain it to me thanks

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PostPosted: Fri Dec 24, 2010 4:29 pm 
The ceiling effect means that once buprenorphine saturates all your receptors that using more bupe is pointless after that and has no effect. I guess the ceiling is somewhere around 4mgs and after that anything more is just going to possibly add more duration to the effects. Full agonist opiates apparently will increase in effects when taking more even when the receptors are saturated. Im not an expert on it or anything so I hope that makes sense its just what I have heard on this forum.


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PostPosted: Fri Dec 24, 2010 5:24 pm 
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so do you have to be on subs for awhile to get the 'ceiling effect'? and can the ceiling effect come from 4 mgs for everyone or does it vary from person to person?




""Full agonist opiates apparently will increase in effects when taking more even when the receptors are saturated.""

I am not sure what this means.
I do notice that if i take 4 mgs I am still having cravings so I try and take about 2 more mgs and I dont really feel any different. I dont know I am confused about the whole topic

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PostPosted: Fri Dec 24, 2010 5:58 pm 
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4 mg is generally accepted to be at or around the ceiling. Like was said, it means that your opiate receptors are saturated. It does vary from person to person. Once at the ceiling, you can take more and more and not suffer additional respiratory depression - this is why people rarely if ever overdose on suboxone alone. However, some people simply do better at a higher dose, like 8 or even 16 mg when it comes to addressing the cravings. (And people taking it for pain often dose even higher than that.) Just because the ceiling is theoretically at 4 mg doesn't mean you'll be most stable at that dose. So don't worry about forcing yourself to stabilize at 4 mg. Take the dosage that you and your doctor determine is best for you.

The difference between full agonists and suboxone (a partial agonist) is that full agonists do not have a ceiling. You can take more and more of a full agonist and get more of a high, have more respiratory depression, build up more tolerance, and can therefore overdose with full agonists. None of those things happen with suboxone. This is also why with sub, you can take the same dose for years and never build up a tolerance and needing to increase the dose.

I hope this makes sense and helps you understand it. I know for me it took me a while to understand the ceiling effect. Be sure to ask more questions if any of this isn't clear.

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PostPosted: Fri Dec 24, 2010 6:37 pm 
Oh yeah and I forgot to say that even though the ceiling is at 4mgs you will not be at or above the ceiling by taking only 4mgs because only 35% or so is absorbed sublingualy so in order to get at or above the ceiling you would have to be taking like 8-10mgs. I too am only on 4mgs because I cant afford the 16mgs a day that Im supposed to be on and I have cravings frequently its frustrating. Once Im accepted to the patient assistance program I will go back up to my normal dosage and hopefully do better, I was going to switch to methadone indefinitely but I will give a higher dosage of sub a chance first and if that doesnt help then I'll go to methadone. I think I'm going to tell my sub doc that Im realy considering methadone since I cant afford the proper sub dose and hopefully if he hears that he will understand Im not being maintained well at all and change his mind about not Rx'ing generic subutex so i can afford it. Im gonna print out all the info about the generic being so much cheaper and hopefully he will change his mind.


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PostPosted: Sat Dec 25, 2010 2:39 pm 
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I am understanding more on the ceiling effect. Thanks for the help. I just am not completely on the right page. if that makes any sense. Being new on subs is probly why. The longer I am on them the better the understanding will be I am sure. Thanks though!! Merry Christmas

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PostPosted: Sat Dec 25, 2010 5:15 pm 
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There is a difference between the dose required to HIT the ceiling level, and the dose needed to STAY above the ceiling level until the next dose. 4 mg will sturate most of the receptors but it takes a higher dose to keep them saturated for 12 - 24 hrs!

See my videos for more on the ceiling effect- link at addictionremission.com.


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PostPosted: Sun Dec 26, 2010 9:43 am 
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Thanks so much, Dr. Junig for adding that important bit of information. What you just said is an important part of the explanation of the ceiling effect. THANKS!

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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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