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PostPosted: Sun Nov 21, 2010 6:36 pm 
If its for pain thats one thing but i dont see the point in staying on 24mgs of suboxone for years or even a year for that matter like some people do. I was inducted at 16mgs but I think 8mgs is plenty, i realy feel no difference in dosing 8mgs vs 16-24. When I was early on in my treatment i will admit I would sometimes take more to try and get an effect and it just does not happen, feels no different. I'm on 4mgs now which I do feel is to low for me Id prefer to be on 8mgs but cant afford it but the other day I was having a hard time so I took 8mgs and I honestly felt there was not much difference between that and 4mgs. Unless insurance pays for it taking high doses just seems like flushing money down the toilet. The expression "less is more" with suboxone is 100% true to me. In the end it just seems people on these large doses for years are just causing more discomfort for themselves in the end if they want to get off. Not knocking anyone on a high dose I just dont understand the reasoning behind it.


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PostPosted: Sun Nov 21, 2010 7:03 pm 
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I agree with you, some people stay on too high of a dosage. Some people need to be on that higher dosage, I understand, but most do not. My doctor would only allow a higher dosage of above 16mgs during the first 2 weeks, and not everyday. She wanted me on 16 for the first 2-4 weeks, then 12 for 2-4 weeks, and at 8 after then. She encouraged me to lower myself as quickly as I felt comfortable. I was able to lower myself down to 4mgs before I jumped. I just split my daily dose into 3 smaller doses, then 2, then finally one time a day. I fully get that some people may need to stay on higher doses for longer, but I too think that a year is far too long to remain at such a high dose. But that's just my opinion. I didn't notice significant changes while lowering my dose either, and if I wanted(key word "wanted") another dose, I would suck on orange tic-tacs, which tricked my brain:)


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PostPosted: Sun Nov 21, 2010 7:22 pm 
The thing is tho once you are above the ceiling and your receptors are 100% saturated and a dose increase is worthless, so those people who need higher doses would only need them if they are getting poor absorbtion. Theres this guy on another forum who didnt understand that and he was on 24 mgs for 4 years and a thread was started explaining the ceiling and reported that after he read that he jumped immediately down to 12 mgs and felt zero difference and then after a couple days dropped down to 8mgs and said he has felt no difference vs when he was on 24mgs for all those years.


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PostPosted: Sun Nov 21, 2010 7:26 pm 
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I think you're both right. It is generally accepted that people do not need to be on doses of more than 16 mg if they are not taking it for pain control. With that said, there are exceptions. It really has a lot to do with the person's doctor. I've seen recommendations that the "normal" dosing is between 16-24 mg, I believe from the manufacturer. And we all know that RB hasn't a fucking clue. (Sorry to be crass.) Dosing is usually higher after induction than the dose they will eventually stabilize on. If I had to guess the reasons I would say it has to do with 1- the doctor, and 2 - if the person is unwilling or doesn't want to reduce their dose it's because they are taking it for the wrong reasons. By that I mean when they feel yucky or have increased stress. And the doctor tells them, "Okay, when you're ready we'll reduce your dose". That's just a guess on my part. And I can't stress enough that there ARE exceptions. I'm not telling anyone on this site that they are on too high a dose - it's not my place. That's between them and their doctor. But since you brought it up, that's my take on it.

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PostPosted: Sun Nov 21, 2010 7:35 pm 
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Ditto the above 2 posts, No one is saying to get off sub, just don't use as much.. I believe a lot of Dr.s know how hard and painfull it is to taper down and dont want to put up with the wineing and bitching from there patients !!! Hell my Dr never pushed me to taper, he always told me we have plenty of time, dont worry about it, there were months were he made me promise him I would not taper, I did any way . Mike


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PostPosted: Sun Nov 21, 2010 8:14 pm 
Honestly, i couldnt agree more. Although i will say this, its taken me awhile too figure that out. I take 16mg's right now and im in my 18th month. I would love it if some of you could maybe walk me through a comfortable transition because i've tried to lower my dosage and i always have a hard time with it. I become extremely psychotic when i try to lower my dose. I know that probably sounds crazy but all i mean is, i get so ill and just flat out ready to punch holes in the wall that i give up and go back to my usual dose. I dont really feel any urge or craving when i try to reduce. Just serious insanity. I know their is the whole ceiling effect thing an that 16mg's should be the same as say, 4mg's or whatever the ceiling effect is but i dont know if its because of how long i've taken 16mg's or what but i feel like hurting somebody when i try to lower my dosage. Its not a pleasant experience. I gotta lower it sometime and im ready now more than ever. I just gotta get prepared too deal with all the craziness that i go through. Another thing is, im not in an enviroment everyday where i can just feel any way my mind and body wants. I have to be stable and that seems almost impossible when i try a reduction. Im not trying to give off the wrong message to any newcomers or people interested in this treatment. This medication saved my life bottom line!! Im sure most people dont experience these things i've described. I have done a lot of damage to my mind in active addiction. I was a poly drug user. I used ecstasy, cocaine etc. along with staying awake for days on those drugs. I was the paranoid one playing peekaboo out the blinds all night. My brain and heart have been stressed to the max in about a 8 year stretch. Anyways, i feel like an idiot. Here i have done hijacked this thread with my life story. My fingers got carried away on the keyboard. Well, if anyone can help me with some possible ideas as to a somewhat comfortable way to decrease my dosage, i would be greatful. My doctor isnt in it for the benefit of the patient so im gonna try to work this out on my own. Not being my own doctor but just gonna try to get things moving. I have insurance is also another reason why i havent stress reducing that much because im only paying $40.00 for 60 namebrand subutex. Thanks for anyone who cares to read all of this and for anyone who may or may not be able to help me. ~PEACE~


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PostPosted: Sun Nov 21, 2010 8:20 pm 
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Don't try to jump too far down too fast. Just because 4 mg is around the ceiling doesn't mean you won't feel anything going from 16 to 4. Don't do that. The general rule is 10% - rounding up, you could cut your dose to 14 mg. Give it a couple or a few weeks then drop again - but only when you're completely stable on that lower dose. Now with that said, I'm not a doctor, this is just based on what I've learned in the past 2 years. I hope this helps a little bit. You could start your own thread, too, to get some support while you're going down. Good luck.

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PostPosted: Sun Nov 21, 2010 9:19 pm 
Thanks Hatmaker!! I will try 14mg's for a bit an see how it goes. I will also start my own thread so as you said, can recieve support throughout the process. Again thanks!! :D ~PEACE~


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PostPosted: Sun Nov 21, 2010 11:52 pm 
I started to lower my dose right from the get go because I knew the high dose thing was BS and most likely just a ploy so reckitt and benckiser can make a shitload more profit. I mean of course they are gonna say 16mgs is the target dose, they dont want it to get out that people can maintain on 4mgs daily just fine. Suboxone was going to be a short term thing for me when I started i had my mind made up that I wouldnt take it more than a month but then after awhile I decided it would be best for me to get on it long term. The most Ive taken is 24mgs when I used to try and get effects from it early on and it does nothing more for me than taking an 8mg tab except maybe extends the time before i need to dose again.


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PostPosted: Mon Nov 22, 2010 10:07 am 
I would agree that for myself 4mg is the same as 12-16mg. However, there is a difference between being at the ceiling (which is a steady state of bupe in the system) and having your opiate receptors saturated. The ceiling is generally accepted to be at 4mg or above, but the info. I was given was that the receptors ar 94% saturated at 16mg. Therefore, the only benefit to going above 16mg would be to try to bind the last 4% of receptors, which is a pretty low benefit to cost.

lifesaver - the reason I'm saying all of this is that you may be one of the people that needs to be at 16mg. If the sub is stabilizing you in terms of other psychological issues (and many people say it does) than you may need to just stay there and not worry that others are OK at 4mg. I think it's a good idea to just try 14mg, like you are planning, and see what happens. If you need to stay at 16 and don't have any serious side effects, then don't fight it. :)


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PostPosted: Mon Nov 22, 2010 10:17 am 
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Lifesaver - I agree with Lilly. The most important thing is your stability and that you stay in remission. If that's at 16 mg, then so be it. It's just a number after all. Don't compare yourself to other people.

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PostPosted: Mon Nov 22, 2010 12:15 pm 
Im definitely stable at 16. Actually im very stable but the only problem is, and i've posted a thread about this, i feel like i have too pee 24/7. When i was at 24mg's i had this problem so i lowered to 16mg's and the problem got better. Well for some reason now the problem is back. So i dont know what to think other than maybe i should try a lower dosage. If you want, you can check out the other thread, "I feel like i have too pee 24/7". Again thanks for the advice.


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PostPosted: Mon Nov 22, 2010 6:06 pm 
Yeah like I said Im not knocking anyone or telling anyone what dose to take. Im just going by my experience from taking anywhere from 24mgs to 4mgs and not noticing much difference in effects. I for sure needed to be on a higher dose the first few weeks of induction but after that I felt it was wasting money. Even if I got my subs for free I would take no more than 8mgs. I read that 8mgs saturates 90% and anything higher will raise maybe to 95%. I take what I read on the internet with a grain of salt but it seems logical to me since 4-8mgs seems so similar to 16mgs or even above.


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PostPosted: Tue Nov 23, 2010 9:47 am 
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I think that people on a High dose are on it to help more so with the mental part of addiction. Just the fact that they are doing something helps with it mentally. I think it's because it is addiction and a habit of using drugs at certain points during the day. Kinda like people who have to have a cigarette when they drive or after they eat. Just a hard habit to break I think. I am no doctor and this is just my opinion

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PostPosted: Tue Nov 23, 2010 9:54 am 
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I think that people on a High dose are on it to help more so with the mental part of addiction. Just the fact that they are doing something helps with it mentally. I think it's because it is addiction and a habit of using drugs at certain points during the day. Kinda like people who have to have a cigarette when they drive or after they eat. Just a hard habit to break I think. I am no doctor and this is just my opinion

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PostPosted: Sun Dec 05, 2010 9:21 am 
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I would probably agree that anyone taking 24mg of suboxone per day is probably not receiving much of a tangible benefit from up to 1/3 of that dose (8mg are likely just wasted). Now, clearly everyone is different. Some folks just have a higher tolerance and there are definitely some psychological factors that come into play here. We've all heard about the mood altering properties of Suboxone, and how it seems to help some people with depression. Now, personally, I believe this type of depression is probably derived from the fact that the person suffering it is on opiates to begin with, and suboxone, being such a strong opiate, tends to displace some of that depression, but who knows? As I mentioned, everyone is different.

Here's my personal experience with dosing:

When I started on suboxone, I was inducted at 16mg. For the first two weeks, frankly, I was high as a kite. In fact, I was beginning to think I had made a mistake getting on it, because I chose suboxone precisely because I was told that it was NOT the same as Methadone (meaning, you cannot abuse it like you can methadone) and I did not want to be on something that had the potential for abuse. But after about two weeks I noticed that I didn't "feel" my dose any more. I just felt....."normal" :roll: (whatever the hell that is, right? )

So, after a month on that dose, my doctor said to me, "I want you to start taking one 8mg tablet in the morning and a half of an 8mg tablet in the evening." (12mg daily) and at first I was scared to death! :shock: But I didn't even notice anything different. For me, 12mg "felt" the same as 16mg.

It was at this point that I embarked on a long slow taper. Each month I would go see my doctor and each month he would prescribe me 1mg less than the previous month. And I've gotta tell you, everything went just fine, until I got to about 3mg......

When I got to the 3mg point, I remember that I started feeling a little bit depressed, anxious, restless, lacked energy, etc.......but I toughed it out, and went down to 2mg, and the depression got worse, but I was determined and I went down to 1mg (each reduction was one month apart, btw) and at 1mg, I actually came very close to calling my Oxycontin dealer, that's how bad it got, the cravings, the desire to use, the fixation on getting and using drugs, it was all back. I felt terrible, and desperate, and just awful, and so.......

I grabbed my suboxone bottle, gobbled up about 4mg of suboxone (which was about all I had left at the time) and called my sub doctor's office. They told me to come in immediately. I went to see him and he said "good job not using, but I hope you're not offended that I need to get a urine sample from you" I was not offended at all, I expected it. He took the sample, which came back clean, and then he prescribed me 4mg daily. For a while that was OK, but I still didn't feel "right" so I asked THIS forum what they thought and Dr. Junig actually spoke up in that thread and made the point (I'm paraphrasing here) "there's no point in being on suboxone if you're just taking enough to barely stave off cravings"

I printed out that thread and when I saw my doctor again, we talked about it, and I showed him the doctor's post and he agreed to raise my dose to 8mg, where I stayed for a couple of months. I am now down to 7mg with an eye towards stabilizing for the long haul at 6mg.

As a HepC patient, ALL of my doctors have told me that I need to accept the fact that I am going to be on ORT for a long time, probably the rest of my life. As a drug addict who, at 46 years old, has finally, for the first time ever, achieved almost 2 years of not taking drugs from the street, I'm perfectly OK with that.


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PostPosted: Fri Jul 29, 2011 11:53 am 
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I am on 24 mgs a day, (3--8mill tables) because last year I got a compression fracture in my back playing with my grandkids on the trampoline. After reading about the above what somebody mentioned about the ceiling level etc, I think I will cut back down to 8 mill a day and see how I do. I lost my suboxone provider because he lost his liscence for writing prescriptions. We don't have hardly any doctors in Whatcom county Wa and my doctor is getting a referrel through to a doctor in Ferndale that is not accepting new patients, except by referrel. That is making me a bit nervous though I am going to have faith that he will take me. Just in case I can't get a doctor, I will have to figure something out and maybe get a psychiastrist to prescribe me the medicine.


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PostPosted: Fri Jul 29, 2011 11:58 am 
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Desi - Forgive me for not recalling, but are you taking sub for pain, too? If so, do you feel the 24 mg is what you need? Don't compare your dose to anyone else's, if that's what you feel is right for you. There was a time when my pain was such that I needed 24 mg. And yes, I received quite a lot of shit for it. My pain is lessened now and I'm down to 16 mg, but that's just me.

If you do decide to drop down, don't just do it all at once. Do it slowly. Although going from 24 to 8 is still all above the ceiling, I'd still do it in increments.

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PostPosted: Fri Jul 29, 2011 12:29 pm 
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Thanks for the advice. I do have some pain issues. I know my back would be much worse if I didn't have anything. I didn't even realize that I had broke my back until a few days later after playing with them on the trampoline. About 3 days afterwards, boy was my back bad! Even though for my age, I work out on a stairstepper and I am very very active, even after my masectomy, I started to work out a week after the surgery despite they told me not to. I don't regret it. It didn't harm me and I have never had lymphodema either.
Is is true that psychiastrists can prescribe suboxone? If this doctor does not take me, I will have to resort to that. I only have a month's prescription left and no doctor yet for prescribing. Makes me a tad nervous. I do have faith that God will take care of me.
By the way, I notice that 24mg of suboxone also gives me a big adversion to alchohol. Even though suboxone is only for opiate addiction, it does affect me to not want to drink either.


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PostPosted: Fri Jul 29, 2011 12:54 pm 
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Only psychiatrists with the waiver can prescribe sub, just like any other sub doc, but the thing with them is that they often don't advertise and sometimes you can get in easier with them.

Many of us have noticed that once on suboxone, we have very little desire to drink. In fact I believe they are currently doing studies with regard to sub and alcoholism.

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