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PostPosted: Tue Aug 16, 2016 10:13 pm 
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I just have a question out of curiosity. When does a suboxone Dr. usually does you down? Next week I will have been in the program for 3 months. I started out on 8 mg and moved to 12mg after a month. This is the first time I've ever been in a program so I'm not really sure how everything works. Thanks for reading!


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PostPosted: Wed Aug 17, 2016 10:48 am 
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Hey coolbeans!

Well there's actually not an answer that anyone can give ya for sure except ur doctor, because all doctors have their own individual way of doctoring their patients. There's doctors who want their patients to eventually taper off and there's doctors that believe that suboxone treatment is a lifelong treatment. So really it's hard to say. Imo u shouldn't have anything to worry about at 3 months in though. Ur honestly still in the newer phase of this medication. Hopefully ur dr will go by when ur ready....no matter when that is.

One way u could find out how he does things is ask other patients (if ur in a clinic type setting like I am but I also know not everyone is). I'm able to speak with other patients through our meetings or just the day I have my doctors appointment, if that's ur type setting then just ask questions. If it's not ur type setting then just ask ur dr how he/she usually goes about these things. There's definitely nothing wrong with asking and I'd be willing to bet u wouldn't be the first or last person to ask that question. It'd make u feel better about it just knowing the plan. Everyone deserves to know that, so don't hesitate to ask :)

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PostPosted: Wed Aug 17, 2016 7:37 pm 
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I'm always very clear about my bias when people start treatment. I do not think that forced dose reduction is reasonable, from either moral or clinical perspectives. I meet people often who have relapsed after being forced off buprenorphine. In all of those cases, they were forced to follow a doctor's schedule. There is NO evidence about the issue, so any decision to force tapering is based on a doctor's opinion and bias, nothing else. And yes, my approach is based only on MY opinion and bias-- but in cases where there is no evidence to support an approach, I believe it makes the most sense to 'first do no harm'. If a person is stable on buprenorphine, and we know of no risks from long-term use of buprenorphine, than I see no justification to experiment with forced dose reductions-- which introduce significant risk of harm.

I recognize that personal observations are not scientific, and so I cannot say that my own observations have scientific merit. But from my perspective, my OPINION is that some people on buprenorphine eventually want to stop the medication, and some people on buprenorphine never want to stop the medication. That choice belongs to the patient, who should be educated, without bias, by his/her physician.

I recently argued with a guy on psychcentral who blames his doc for keeping him on buprenorphine for 8 years. I get very annoyed with those people, who I see as 'blamers'-- the people in society who cannot accept responsibility for their role in things, who are always searching for someone or something to blame for their problems. I realize that some of my patients will eventually blame me for giving them a choice. But the alternative is to push people out of a treatment that prevents a great deal of misery-- and some of them would be injured, or even killed, by that action.

In summary for your question, there is no clear answer-- and hopefully, eventually there will be enough buprenorphine prescribers out there for patients to choose the prescriber with the attitude that they prefer.


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