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PostPosted: Sat Mar 05, 2016 1:20 am 
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I was on 3 mg per day of bupe for years with no difficulty. About six months ago I decreased to 2 1/2 mg, again okay, My doctor is encouraging me to taper and 2 weeks ago decreased my dose to 2 mg a day. I have not felt right since. I want to take more bupe, but know that if I do I will run out early and have withdrawal symptoms. Does anyone have an opinion on whether I will adjust to my current dose, or is it just too low? Thanks for any ideas.


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PostPosted: Sat Mar 05, 2016 1:26 am 
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2 mg could be too low as a maintenance dose for you. It's important to let your doctor know if you are feeling cravings for your drug of choice. That is a clear signal that the dose is too low to maintain you.

Will your body become used to this dose? Probably, in that you won't feel any withdrawal symptoms, but if you are starting to crave, it's too low.

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PostPosted: Sun Mar 06, 2016 2:16 pm 
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I agree! I have the approach of letting patients lead the way with dose reductions (or no dose reductions), but most docs seem to favor 'nudging' people. In case any physicians are reading this out there... I see this pattern so many times, where stable patients are pushed to a dose that makes them miserable, which causes them to become 'unstable'. If a doc insists on practicing that way, at the very least that doc should be willing to keep that patient in treatment until he/she is either stable again, or off buprenorphine and doing well. It is totally unfair to MAKE a patient unstable, and then kick them out for being unstable!!

There are ways to increase the absorption of buprenorphine, but that would not be a long-term solution-- especially since you will likely only be 'nudged' even lower at some point.

If your doc is a reasonable person (so sad that many are not!), have a talk about your position. Is it too soon? Or is he/she doing you a favor by nudging you in this way? Is the timing right? (the last semester of college, or when starting a new job, are NOT the times to taper buprenorphine for example). If he/she is intent on pushing in this direction, you would benefit at some point from clonidine, at least at bedtime-- a very low dose so it doesn't tire you out all day. But put what is going on out in the open, and see if this is really the best thing to do and if this is the best time to do it.


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PostPosted: Sun Mar 06, 2016 2:34 pm 
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I am not a doctor, rather someone who has been experimenting with buprenorphine for a few years. I have found that reducing a dose is sometimes easier after letting myself go into withdrawals. I know this probably sounds scary, but hear me out. Since you are already feeling a little off with reducing your dose by 20%, try not taking it one day. See how you feel after 24 hours and, if you are feeling strong enough, go another 12 without taking any. Let yourself get a little uncomfortable, and then take your 2mg dose. I bet, after coming from a place of having less in your system than you are used to, that 2mg will feel like your old dose. What is a withdrawal? It is your body acclimating to the absence of the drug in your system. So by letting your body acclimate to less in your system, it will be better suited for a smaller dose than you are now. In my opinion it is worth a shot. This drug is extremely addicting, and while bupe is usually meant to help people get off of other opiates, there is no drug to help you get off bupe. The less you take, the better, and the less time you take it, the way better. I wish you the best, and remember you are A LOT stronger than you think you are! We all are.


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PostPosted: Sun Mar 06, 2016 10:29 pm 
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obijuansoslowbi, wow what a screen name by the way! How do I even try to abbreviate that, anyhow I see you have not posted much here so I don't recall ever reading about your background but I think you are totally onto something with your suggestion. Ironically I did that very thing when being nudged to taper - so I guess I have double expierence with all of this. A couple years ago my doc wanted me to taper and stop bup. By this time I had been on for about three years and doing very well. He had gently nudged me down from 16 then 12 then 8 and I'm very greatful that he did as I did fine and needed the gentle push. I was less certain about stopping and still am. I finally got down to two mg a day but had an even harder time going lower. I don't know the exact cause but do remember I ran out the day prior to my appointment for a refill script. I was pretty hyper and anxious when I got to my afternoon appointment. I had already been doing less than 1 mg for a few days and then zero for the last 24 hours or close to it. Rather than dose at my regular 2 mg I did 0.5. To my surprise I felt great! It just about instantly put me at 1 mg per day 0.5 in the AM and 0.5 PM) Had I not been in moderate withdrawal I'd never been able to do that. I struggled again to go lower and got to near 0.5 per day total using a slow taper. Had I not ran out that time I would not give been able to do that large of a drop from 2 mg/day to 1/day in a few days time, all at once, but after several days with minor withdrawal followed by a day of moderate, my brain and body seemed to reset.

The thing is while I did okay mentally on 1 mg/day, I suffered physically. In the end my doc changed his mind and said it was fine if I stayed on bup after all. He said I could go back to 2 mg which I did and felt "normal" at again. Now, two years later, he is again pushing me to stop, saying I'm depending on bup for my sobriety. - well yeah in part I am, duh. He again thinks 2 mg is hardly doing anything. It's almost like everything he came to learn and change his mind about, he's back to it all again. Very odd. Anyhow, that's a whole other story.

So my point is, it seemed to work for me and makes total sense. After all, is that not what we all did to induct? We were at high doses of opiates, had to go into withdrawal so sub could cover us and then felt great again after starting sub. We had to lower out tolerance by going into withdrawl. This is the same - going into withdrawal and resetting at a lower dose. Problem is, it's not easy but I really do think it works. The trick is forcing yourself into withdrawls.


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PostPosted: Mon Mar 07, 2016 2:21 am 
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Thank you to everyone who answered. I probably was not clear about why I was tapering my dose. I have been putting off an elective surgery and this year I am due for a colonoscopy. I have done both before (on suboxone, 12 and 6 mg respectively) and post op pain control was less than optimal. The colonoscopy had to be stopped because it was too painful. I live in a small town and doubt that the medical professionals know what buprenophine is. Anyway, I expressed my concerns to my sub doctor so the taper is really my idea. I do have some thoughts of using, but I have no access to opiates. My chart has addict all over it so unlikely I could get a prescription. I will not take non pharmaceuticals. I am 67 years old and retired so have time on my hands. I am planning to volunteer or get a part time job so that I am not so focused on myself. Hopefully keeping busier will help.


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PostPosted: Tue Mar 08, 2016 4:11 pm 
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Hi Jeandiane, Welcome! I too have been slowly moving lower and lower with my suboxone. I started at 24mgs a year and a half ago. I am now down to 4mgs, 2 in the am and 2 in the pm. My biggest fear was always if I should need some medical procedure, how would it go with the suboxone. Well, last Tuesday I had an endoscopic surgery to repair a problem with my stomach. I did fine! They gave me toradol after surgery and I was fine. I found being prepared to be the best plan. I met with the head of anesthesiology prior to the surgery. They were prepared for me! Just wanted to share my experience. I hope that everyone could have as smooth of a time with surgery as I did!


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PostPosted: Tue Mar 08, 2016 9:04 pm 
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I reckon there's a stage, when you drop your dose, that your body can no longer adjust to it properly. The dose is too low, and you always feel the dose wear off and experience withdrawal before your next dose.

For me that point is around 3-4mg. Even on 4mg I feel withdrawal in the morning. But on 3mg I notice it more, and even experience symptoms in the evening before I go to sleep. And I can stay on those doses for weeks and still get these effects.

Tapering would be oh so easy if the body miraculously adjusted to whatever dose you're on after a drop, whether it's 0.1mg or 6mg. But on some doses you can end up waiting forever to adjust entirely.


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PostPosted: Wed Mar 09, 2016 1:07 pm 
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Hi there,

What helped me when I tapered was to split the dose up ( just in half) so you get an even amount in your system throughout the day. This helped so much with sleep to be be able to take that small amount in the evening time.

Good luck with your surgery. There have been several here on this blog that have had successful- low pain - surgery with the correct direction and after care from their physician.


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