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 Post subject: Tolerance question
PostPosted: Sat Oct 11, 2014 6:28 pm 
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Hello all. I have a question....most people who are on suboxone/subutex once had a pretty high tolerance when it came to their drug of choice. For example: Before I started taking subutex, I was taking 300-400mg of methadone a day. Now Im prescribed 32mg of subutex a day. I know thats pretty high but Im going to start working on coming down to a smaller dose. Ive been off of methadone for almost 2 years. Anyways, my question is this...would my tolerance for methadone still be what it was 2years ago since Ive been taking subutex the whole time or would my tolerance have became lower after all this time. I know if I wasnt on subutex or anything else for that matter that 2 years w/out it would lower my tolerance. Just not sure how that works if you have been on suboxone/subutex. If anyone knows the answer or has any experience with this I would really like to hear from you. Thank you so much.


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 Post subject: Re: Tolerance question
PostPosted: Sat Oct 11, 2014 8:33 pm 
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Hi jellybean,


Buprenorphine has a ceiling to its effects meaning that taking a dose higher than around 8mgs, (the ceiling for most people) won't have any additional opiate effects.
Because of the ceiling effect of buprenorphine, a person on 8mgs, or 16mgs or even 32mgs,in other words a dose at or above the ceiling, would have the tolerance equal to about 30-40 mgs of methadone. 32 mgs is considered a high dose of buprenorphine, however, because of the ceiling effect, lowering your dose shouldn't be too difficult at all. You could likely lower to twenty four mgs easily and quickly without feeling any change at all, and continue lowering your dose to 16mgs relatively easily too. Dose drops usually aren't felt until you get to the dose where your blood level of bupe doesn't stay above the ceiling for the whole 24 hour dosing interval. It's a bit different for everyone, but for most it's around 8mgs. A typical prescribed maintenance dose is 8 to 16mgs/day for most. You can read an even more detailed explanation of the ceiling effect at http://www.suboxonetalkzone.com,also run by Dr. Junig, and using the search feature, enter the words "ceiling effect".


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 Post subject: Re: Tolerance question
PostPosted: Sat Oct 11, 2014 9:03 pm 
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Thank you so much. I appreciate the response.


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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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