Ingesting Suboxone Film with a high tolerance…Also, splitting the film into 4mg and 2mg pieces

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Ingesting Suboxone Film with a high tolerance…Also, splitting the film into 4mg and 2mg pieces

Post by ZenTrip »

So, I’d like for this topic to focus on two main things.
A couple quick questions I have, that I’d like to get some other users opinion on.

The first, very simple. Do you take the full 8mg amount? Or do you find yourself splitting the film into 4mg and even smaller 2mg amounts?
I’m sure a lot, if not most people practice this due to tapering process. But it says on the package not to cut the film…
So, what is your opinion? Do you find greater success with dosing the entire film all at once? Which side do you cater towards, left or right under the tongue…also imprint side up or down. Describe your process. If you choose to opt for 4mg halves or 2mg quarters, do you tend to follow up immediately after the first has dissolved? Any tips on how we can maximize the absorption of the medication?

So many different variables can affect the rate of absorption, including what you had to eat earlier for breakfast!

Okay, moving on the next question…
Which is actually the first question, for those going off the topic title. Tolerance! My tolerance for Suboxone is so much that I often don’t feel much different upon ingesting the medication.
Which I guess is originally intended for its use as a maintenance drug. So is taking one a day the general rule of thumb way to go?
Since first starting up again in 2017, I haven’t been off Suboxone for more than a couple of days at max. I’d sure love for there to be a way to lower tolerance, in an effort to make the film more powerful. Instead of relieving symptoms by keeping one stable, as I sometimes find the plasma levels of buprenorphine can often go unnoticed if you already have some sort of pre established tolerance! I think this is sometimes referred to as the ceiling effect, where adding more on top of what’s already there sometimes can have no effect…
So yes! With tolerance being the main thing that seems to change or alter the chemicals structure of buprenorphine. For example, with its 36 hour half life, I take the film and am only satisfied if the film is actively dissolving under my tongue.
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Re: Ingesting Suboxone Film with a high tolerance…Also, splitting the film into 4mg and 2mg pieces

Post by suboxdoc »

I hope you don't mind if I chime in. I fear that doing so sometimes interferes with discussion, but I also don't know if many people are still following the forum. The site was down for a couple weeks... I've mentioned that I'm no computer expert, so I did my best to get it back up and somehow it worked.... but I still don't know what was wrong when it went down.

A couple thoughts. The film is initially a liquid that includes buprenorphine. It is then spread and dried to make the film - so buprenorphine is evenly distributed in the film. Cutting it is very common, especially during tapering, and it is very unlikely that you will get different amounts of buprenorphine in two pieces that are the same size.

The ceiling effect is separate from tolerance, although the two concepts have impact on each other. Buprenorphine is a PARTIAL agonist or 'agonist antagonist'. It is NOT like oxycodone, methadone, fentanyl, or other agonists. Unlike those drugs, buprenorphine can only activate a mu opioid receptor to a certain point. For most people, that max occurs when dosing about 8 -12 mg/day. Any additional buprenorphine will increase the percent of mu receptors bound with buprenorphine, but will NOT increase pain relief or other opioid effects. Again, that is a manifestation of the buprenorphine molecule, not tolerance. The ceiling effect occurs in anybody, including someone taking buprenorphine for the first time. That's why overdose on buprenorphine, even in people first using opioids, is uncommon in the absense of a second respiratory depressant.

Tolerance is mostly a receptor phenomenon, and cannot be avoided. Most psychotropic drugs also cause tolerance through THEIR receptors. When you take an opioid or a benzo the first time, the effect 'feels' the strongest - but with daily use, receptors are changed. The number, and in some cases the conformation, changes so that it takes more and more substance at the receptor to get the same effect.

How they interact.... a person taking an amount of buprenorphine higher than the 'ceiling effect' will have a constant effect from buprenorphine, as long as the blood level remains higher than that ceiling effect. BUT... that person will 'feel' less and less of that effect, as tolerance kicks in. By a week or two, someone on buprenorphine feels nothing at all. If a person takes a dose that creates a blood level only slightly higher than the ceiling level, that person might experience very minor withdrawal near the end of a dose, and then feel a slight effect after dosing.

Hope that helps - and I hope people find this, join, and comment. I do NOT 'harvest' email addresses or use them in any way, and there are no costs, of any kind, for using the forum.
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