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PostPosted: Tue Mar 13, 2018 9:26 am 
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Hi guys, I am kinda freaking out.
Im in the middle of my taper, Ive been clean & on suboxone for almost 4 years and have slowwwwwwly been dropping my dose gradually over the years. I am now down to 2mg a day and have randomly been told by the nurse who runs our suboxone group that everyone is being forced to switch to bunavail or zubsolv.

Seeing as I prefer the films to cut (as I find it best suits a taper plan), I am freaking out about switching because I feel my plan is all messed up now & completely ruined and I have to start over with my taper plan and start a new one with one of these other meds (depending on the medication form via sublingual pill or buccal film/dosage differences and all that). I had it all planned out how I would cut and divide the films for each future drop. and Switching meds is really starting to freak me out and give me really bad anxiety.

I know Bunavail is a buccal film and that Zubsolv is a small pill and wondering how anyone could taper off of a pill thats the size of birth control...???

I dont know what I have to switch to yet as I might be able to choose, but it also depends on my insurance I think. Another thing that scares me is the dose differences for zubsolv, as I have heard a lot of people say they had to increase their dose after switching to the pill due to withdrawling feeling between doses or having a hard time making the switch.

I have been on suboxone films for almost 4 years now. Its just scary to think I am being forced to switch. and we have no idea WHY, but we dont have a choice, no one is being allowed to stay on Suboxone.

Is something going on with Suboxone?? Is anyone else being FORCED by their clinic/doctor to take a different brand?? I havent heard anything but I just find this VERY surprising and random!!!

What I am really wondering if people have actually completely TAPERED off of Bunavail or Zubsolv and HOW they did it??? Im scared to say the least. and my anxiety is taking over! Yes I have a little backup supply of my films but not enough to continue from 2mg to zero!

Thanks for anyone taking the time to comment. I appreciate you all <3
Jess

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PostPosted: Tue Mar 13, 2018 10:57 am 
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Quote:
randomly been told by the nurse who runs our suboxone group that everyone is being forced to switch to bunavail or zubsolv.


deep breath time. Wait until you actually talk with your provider. If you explain that you are actively tapering and have a plan to be done in the next 3-6 months I would expect that they will continue to provide the films.
If not, save the films that you have, use the Zubsolv to get as low as you can and then finish up with tiny pieces of film.
Do you have comfort meds to handle the last and final jump?


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PostPosted: Tue Mar 13, 2018 12:12 pm 
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I just looked up images of the bunavail film. It's smaller than a suboxone film, but I think you could definitely still cut little pieces off with manicure scissors. It may be difficult to figure out which dosage of the bunavail to use, because they have different absorption rates and therefore, different doses than suboxone. Hopefully your doctor could help you with that.

Also docm2 has good advice. Your doctor may be willing to work with you and still prescribe suboxone because of your special situation. Best to talk directly to the doc before getting super upset, ok?

By the way, I'm on Zubsolv and it would be hard to taper it in an exact way. But I do love the medication. It tastes so much better than suboxone.

Here is a link to a picture of the bunavail film next to the suboxone film for comparison.

https://www.buppractice.com/node/12161

Amy

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PostPosted: Tue Mar 13, 2018 3:13 pm 
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Thank you Doc & Amy for your replies. No I have not talked to my doctor yet, But we never do. The doctors at my rehab clinic (several Docs that rotate) just come in the group therapy room for a minute to sign our scripts then takes off... The nurse is the one who writes the scripts and everything. The docs just come in to provide their signatures and are off of the property within 10 minutes.

I do not have any comfort meds specifically for my taper. Although I did just get put on Clonidine (by my personal psychiatrist) for my anxiety that has been increasing throughout my tapering process. Im prescribed .1mg, 3x daily, but have been only taking half of the pills each time I dose to have a little stash saved up for when I get to lower doses. Next time I see my psychiatrist I plan on asking him to increase the dose a little but I'm not sure if he will. I'd like to try though. Then I can have even more saved up.

Doc, I will take your advice and ask to speak with my prescribing Sub Doctor. They didnt give us a specific date of when we have to make the switch, but I am assuming it will be soon since I only go one time a month for my refills/drug tests.

I havent talked to my Suboxone doctor about comfort meds. They make it a big deal if you want to take the time to sit down with your doc. Any time you do, its just sitting in the group room before you head out, to ask or say what you need to. Not personal or private in any way.

I honestly dont think my clinic does that (prescribes other meds, such as comfort meds). The doctors just prescribe suboxone and thats it. When we get billed for the "doctor visit" it is through their private practices. When I was seeking help for my depression early last year, my prescribing sub doctor said he was all full and could not see any more patients, so I asked who he would recommend for a psychiatrist (and that is the doctor that has been treating me for my mental issues for about a year now). I like him a lot. Maybe he can prescribe me some comfort meds if my sub Dr won't. He is very supportive and knows that I am in the process of tapering.


Anyone else have experience or want to chime in, please do. We all know how good it feels to know that you are not alone, things will be okay, etc., and I appreciate anyone taking the time to read or comment!!!

Jess

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PostPosted: Tue Mar 13, 2018 4:14 pm 
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A thought Jess,
You could ask your psychiatrist if they would take over the Suboxone (maybe you already have). Thousands have done the training and have their waiver but never actually prescribed it. If you are stable and doing well then all the 'hard' stuff is done.
Many waivered providers have 1-3 patients, it is a relatively small percentage that are anywhere near their caps.
The clonidine dose being prescribed is a modest dose, you would have room for an increase if needed but would need to be cautious regarding rebound hypertension when you come off of it.
That generally becomes a consideration when consistently taking .1 - .2 mg three times a day.
Another comfort med used commonly is gabapentin. Many psychiatrists will use it off label for a variety of anxiety conditions.
I did a face palm when you described the clinic set up. Bizarre came to mind. whether ethical or malpractice I'll leave to others.


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PostPosted: Wed Mar 14, 2018 8:25 am 
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Docm,
Thank you for your insight on the clonidine medication, I have been on beta blockers and other blood pressure meds in the past for migraine prevention and fortunately have never had any type of issue whatsoever with my blood pressure due to these type of meds. I also have a Blood pressure cuff at home, the same one my psychiatrist uses in his office. He made me promise to get one before taking the clonidine, So I have been checking it regularly at home. Thanks again for all your advice,

I have a feeling my doc would not feel comfortable taking over my suboxone treatment, but I will seek out counsel from my sub doctor and see what he says. He is a very smart doctor and I respect him but he is just SO extremely busy that its almost impossible to receive any personal care or counsel from him.

I agree that my outpatient rehab needs improving. The way they do it is for max money/patients possible. Having multiple doctors that rotate & come in to sign scripts. we never know who will sign each month, or what doctor will be billing us. I wish it was different. But I live in a pretty populated city, (Toledo OH) and Its extremely hard to find suboxone treatment in my area. I go to the most reputable place that I know of. Unfortunately there is not much in the way of personal care. Its a group setting.

Thanks again
Jess

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PostPosted: Wed Mar 14, 2018 11:39 am 
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Hey Jess!

I have to admit that I experimented with Bunavail for about a week, that was a long while bk and it was because I had heard they were better than the strips and I was considering switching. The reason I didn't just switch through my doctor was because I was afraid of making a mistake. Trust me, I worry so dang much and if I was going to make a decision like that, u bet ur butt I was going to have a plan.

Anyway, I thought that the Bunavail worked great. I was able to talk with the medication in my cheek and it was pretty unique. As far as that medicine working as good as the strips.... absolutely in my opinion it did. They have a really good taste, like a weird gum taste. Now I wasn't tapering or on a low dose at that time, so I don't know how all that would work for u. I think I was taking 12mg at that point so I was on a much bigger dose than u.

The only thing that I didn't like about Bunavail was this gel stuff that is left on the inside of ur cheek. It lasted forever! I don't know if I wasn't patient enough or what but that gel, ugh. That ended up being why I just stayed on the strips... well that and I was afraid it wouldn't be abundant in my pharmacy or something. But I will tell u this jess, if my doctor told me tomorrow that I had to go to Bunavail, I'd be ok with it. I wouldn't panic or stress out very much. It's actually a good option. That's my opinion and I just wanted to share it because u don't hear a lot about it. I can't believe more ppl don't try it.

As far as zubsolve, Amy should be able to answer all ur questions on that because that's what she takes. I know she has no issues with it and I think that Bunavail is a good option if u were forced to switch, so personally I think you'll be ok no matter what happens.

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PostPosted: Thu Mar 15, 2018 8:37 am 
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Hey Jen, Thanks for sharing your experience!

I would have no problem switching if it wasnt for the fact that Im currently tapering. Im currently at 2mg and that is what scares me. How I am going to CONTINUE my taper with these new meds, having to split the pill/film and the dosage differences and all is very confusing to have to do it with a different form of medication. I dont like change :( and I felt so confident with how I had my taper planned out, cutting the films and whatnot for each future drop. Having to start over with a brand new plan is scary. I dont feel like the bunavail or zubsolv makes it easy for those who want to taper :( I just wish they would manufacture lower doses for those trying to taper!!!

Thanks for your comment. I really appreciate those who have taken the time to add their thoughts!

Jess

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PostPosted: Thu Mar 15, 2018 8:47 am 
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Hey jess!

I do think Bunavail comes in 4mg, I don't think it comes lower but I'm not positive on that.

Hey I totally get it, I absolutely hate change. That's why I ultimately didn't change from the strips. I always think that if it's working why mess with it..... that's all stemming from my resistance to change. Don't blame ya at all there.

Hopefully things will be ok since ur at a lower dose, like docm2 said, maybe they'll leave u where ur at :)

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PostPosted: Thu Mar 15, 2018 12:29 pm 
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I don't blame you for not wanting to change, Jess.

If I were in your shoes and had to make the change, I think bunavail is your best bet because it can also be cut.

Amy

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PostPosted: Fri Mar 16, 2018 9:16 am 
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I just dont get why they are forcing us to switch, is something going on with Suboxone name brand that I am unaware of??? or maybe its just that the doctors are being offered more money to prescribe these 2 other brands? I just think its strange they are forcing this change upon us. But I do have a little of the 4mg films stored away at home that I can cut into the small doses if i really need to, when I get down to fractions of a milligram, but I guess I shouldnt worry myself until I actually get to that point.

I generally have pretty bad anxiety. and I just really want to make sure I do this taper properly, as I want to be successful in my recovery. I feel good about where I am at and would be so disappointed if I somehow messed this up! I think I probably put too much pressure on myself. Im sure we all do, as addicts in recovery, trying to do the right thing and not "mess up" any more. But I plan on taking it very slow and not trying to push myself too quickly on dosage drops! Its just such a shame they dont manufacture lower doses, for those who wish to taper. :/

Jess

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PostPosted: Fri Mar 16, 2018 12:18 pm 
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Hi Jess,

i just wanted to chime in here. I also had to make the switch from Sub strips to Zubsolv, but that was because of my work insurance only covering Zubsolv. That being said. I am able to cut the Zubsolv in 6 pieces using a pill cutter. Since Zubsolv is 5.7mg that is equiv to about Just under 1mg each piece. I take one piece in the morning and one piece in the afternoon making that around 2mg a day.

Later on if i cut down more. I will just take the 1/6 of the pill in the morning only. IF i go lower, I am going to use the Liquid taper method and dissolve it in alcohol and use a dropper to get my exact mg . If you search for Liquid taper , there is a great post on it.

Hope you get this sorted out, and you wont even have to do this . But... this will make for a - Plan B- if you don't get the meds you want.


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