Hi all,
I am currently on Suboxone to recover/detoxify from a Hydrocodone
addiction. There is a lot of confusion, misinformation,
misconceptions, etc about Suboxone out here on the web & in the
doctor=92s office as well. I=92ve done quite a bit of research & tried
several different taper methods myself to get off of this crap. First,
I want to thank the many Usenet posters who have shared information
and experiences that I have found to be invaluable. I have visited too
many sites to mention here (or even remember) regarding Suboxone/
Buprenorphine. Here is what I=92ve learned (I hope it is helpful to
people in similar situations):
YOU DO NOT HAVE TO TAKE IT TWICE A DAY:
No matter what your prescribing doctor says, it is not necessary to
take this medication more frequently than every 24 hours (unless
you=92re a heavy duty heroin addict, maybe). Once a day dosage is
effective and what I recommend (I am a user, not a doctor). Everyone
metabolizes opiates differently, but 99% of people will not need
another dose before 24 hours has elapsed.
The half-life of Buprenorphine ranges between 1 to 3 days (20-72 hours
with a mean of 36). This means that you will still have half of what
you took the day before in your system when you take your next daily
dose. You may even be able to handle a dose every 48 hours without
experiencing any withdrawal symptoms (try it, and keep to that
schedule if you can). I personally feel that I need a dose every day,
but the less you can get by on the better (if you don=92t want to stay
addicted to this drug any longer than necessary).
UNLESS YOU=92RE A VERY VERY HEAVY USER/ADDICT, YOU DO NOT NEED THE
MAXIMUM DOSAGE:
Buprenorphine is a VERY strong opiate. If you are a hydrocodone
addict, it is extremely unlikely that you will need 16mg of
Buprenorphine every day. You will probably take your first dose in the
doctor=92s office. It will probably be 4 =96 8 mg. I took 4mg in the
office, and another 4 in the car on the way home. I felt great. I
probably could have survived on just the 4mg, but the doctor
instructed me to take the full dosage (8mg twice a day). To tell the
truth, I got a small buzz that first day. I took another 8mg that
evening. After a couple of days I was addicted to a much stronger
opiate than I had been on the hydrocodone (and I wasn=92t even getting
high!). One site I visited likened using suboxone to relieve a 40mg
hydro addiction to trying to kill a fly with a shotgun. My heaviest
usage was about 90mg of hydro per day. I was 4 days into detox before
my first dose of sub. Totally unnecessary at that point. I probably
would have been better off taking just 2mg once a day, since my worst
withdrawal symptoms were nearing an end. Instead I wound up addicted
to 16mg a day of suboxone. Don=92t count on your =93addictionologist=94 to
know what you need. They probably wont believe you about the amount of
opiates you were or were not taking, and will treat everyone as if
they were using massive amounts of morphine/herion/oxycontin =93just in
case=94. This means you will probably be prescribed 16mg a day
regardless. Listen to your own body instead. Just take enough to feel
better, and no more. Start tapering right away. A 20-25% reduction
per week is what is working for me. I do get mild withdrawal symptoms
2-3 days after the reduction, but they only last about 2 days and are
easily treated with muscle relaxants and lots of coffee.
YOU WILL NOT GET HIGH, SO DON=92T EVEN BOTHER:
In a very depressed moment, I tried to up my dosage of suboxone to
feel =93fine=94. It didn=92t happen. You may feel that initial opiate warm
glow when the med kicks in, but that=92s as far as it goes. There is
some kind of =93ceiling effect=94 with Buprenorphine due to it=92s partial
antagonist/agonist properties. You can not get high off it. In fact,
you can=92t get high off another opiate either while the Buprenorphine
is still in your system because Bupe binds more strongly to the
receptors than other opiates do, and it will block their effects.
IT IS A PAIN KILLER:
I am a chronic pain sufferer, and the suboxone works just as well for
the pain as the hydrocodone did (even in low doses). This will be one
of the biggest challenges for me when I finally kick this addiction.
What do I do about my pain issues once I have no opiates to rely on?
Can I go back on hydro and use it responsibly? Doubtful.
HOW TO USE AGAIN WITHOUT GETTING ADDICTED:
Ha Ha Ha=85 Can it be done? Damned if I know. I am not planning on
testing this one. My doctor who prescribed the hydro for me thinks
that addiction wouldn=92t be a problem if I used only the prescribed
amount (10mg 3x/day). Even if I trusted that I could use it that
responsibly, I still would be addicted (albeit to a very small
amount). Someone posted on Usenet that you could use recreationally
for 2 consecutive days if you always separated usage with 4 days
clean. I have not tested this, and frankly don=92t think anyone with a
history of addiction could safely use again recreationally. I=92m not
sure I could safely use for my migraines either, although I am
planning on keeping some hydrocodone in the medicine cabinet just in
case. Maybe getting a loved one to help you control your meds would be
useful if you have pain issues (intermittant or chronic).
YOU WILL WITHDRAW AND IT=92S NOT =93MILD=94:
Doctors & Medical Publications state withdrawal from suboxone is
longer but milder than from other opiates. Having experienced this
withdrawal, I don=92t think the term =93mild=94 is very fitting. You will
be=
miserable for about 5 days, and still slightly unhappy for about
another week (longer for some). It is manageable however, especially
if you follow a slow and steady taper schedule. Where cold turkey from
full agonist opiates makes you long for death, withdrawal from
suboxone will make you miserable but able to endure provided you have
other meds to help (muscle relaxants have been my savior).
IF YOU PUKE, DON=92T SWALLOW:
At the end of my first day on suboxone I was puking my guts out.
Called the doctor and he told me not to swallow the pill as it
disolved (I hold in my spit as long as possible, and then spit only
when necessary until the pill is fully disolved. Then I spit out
what=92s left and rinse my mouth thoroughly with water before swallowing
anything). This worked and I have kept my stomach contents since then.
KEEP IT UNDER YOUR TONGUE FOR A FULL 20 MINUTES:
The drug info card said the pill would disolve in 5-10 minutes. Not
true. You will need to hold it under your tongue for a full 20 minutes
to ensure you=92re absorbing the full dosage.
THE NALOXONE IS A NON-ISSUE*:
The naloxone contained in suboxone is a weaker drug than
Buprenorphine, and really does not have any effect when absorbed
sublingually or through ingestion. Buprenorphine itself is what causes
most of the withdrawal in opiate users who are not already in
withdrawal. *Naloxone may have a much greater effect if you crush and
inject suboxone tablets.
YOUR DOCTOR DOESN=92T KNOW EVERYTHING:
My =93addictionologist=94 told me suboxone has a weak analgesic effect
similar to 2 ibuprofen. BS. It=92s analgesia is comparable to high dose
hydrocodone. My =93addictionologist=94 said withdrawal from sub was mild
and not a big issue. BS. Withdrawal from sub is very unpleasant. My
=93addictionologist=94 said I needed to take the max dosage 2x per day.
BS, see above.
THE OASIS AND RETURNING TO THE DESERT:
One thing my addiction doctor said that rings very true; Suboxone is
not a cure for your addiction, but an =93oasis=94. Once you get off
suboxone (NOT an easy thing to do), you will be right back where you
started. Odds are you will not be feeling just fine. If you don=92t have
an addictive personality, and this addiction was a one-time accident
then maybe you=92ll be okay. You know yourself, and if you have any
doubts at all about your ability to stay clean, then get thee to a 12
step program. Go to meetings. Get out of the closet and tell people
about your problem. Build a sup****t system. Go to the meetings.
Practice constant vigilance and unrelenting honesty with yourself and
others. You can do this. It=92s not easy, but you can do it.
Links:
I can=92t locate all the sites I have visited, but here are a few (good,
but not the best). I highly recommend doing your own research on the
web. Also use google groups search for some really helpful information
on Usenet. Suggested search term =93withdrawal from suboxone=94.
http://en.wikipedia.org/wiki/Suboxone
http://www.thatspoppycock.com/addiction/suboxone.htm
http://www.drugs.com/suboxone.html
Good Luck and God Bless :o)
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