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 Post subject: Your detox story!
PostPosted: Wed Nov 11, 2015 7:53 pm 
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Hello to all. As I am getting to the end of my taper I had some questions for those who have already made it off suboxone. What mg.did you jump from? What days were your worst? Worst symptom? Did you go back on dub? I ran out early once and that was a lesson learned. I love to hear other people's stories. I need a boos of encouragement.


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 Post subject: Re: Your detox story!
PostPosted: Sat Nov 14, 2015 12:50 am 
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I suppose I'll write before the thread disappears from the page...

I've had a number of patients stop buprenorphine. In fact, since I only have 100 active patients and I've started about 8-10 times that number of patients over the past ten years, the large majority of my patients have 'stopped Suboxone'. Most of those patients simply disappeared at some point in the treatment process. Many of those people are dead, in prison, or on methadone. Some are still using opioids, mostly IV heroin at this point. Some have returned and gone back on buprenorphine, and dropped out again. And some have gotten off opioids entirely.

The exact odds of each outcome are very difficult to determine. I have my own estimates, but I have no real science to back up my estimates. I know, for certain, that most of the people who use buprenorphine for less than a year end up on opioid agonists again. That is the one number that has been studied many times. The relapse rate is over 90% in all of those studies.

On the other hand, I have a number of patients who took buprenorphine products for several years and then tapered off, who are now doing well. I also have patients in that group who did well for a year or two and then relapsed. Usually the relapse happens when they are physically sick, or depressed, or after using opioids for surgery.

Things that improve odds of sustained abstinence include being older, being employed, losing all 'using' connections, and not having chronic pain. From my perspective, having some sort of life-changing event seems to help-- such as having a child, getting involved in a church, finding a sober partner, etc. I have not seen studies that validated those impressions though.

During the taper process, people usually seem to get to a point where they feel 'stuck'-- as if they are experiencing a setback. If they make it past that point-- which seems to occur after about 2 weeks or so off buprenorphine-- they can see the end of the tunnel, and things improve every few days. ANY use of opioids during the detox period sets things back significantly, and seems to make success much less likely. I think that if a person can rationalize using one time, it becomes too easy to rationalize it a second, third, and fourth time.

The main thing to keep in mind-- it is ALWAYS temporary. Yes, some people write about feeling lousy 'forever'.... but if those people truly feel miserable because of long-term PAWS, understand that they are in the minority. Most people who stop buprenorphine just get on with their lives.... or return to using. In either case, most of either group have little interest in writing about buprenorphine.

I hope things work out!


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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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