Suboxone

[steiny1]

Dear Dr.,

I am taking Suboxone for addiction to Lortab.  My Dr. Started me off on 24mg and now I am down to 2 to 4 mg.  I have tried to stop taking and wein myself off of the low dose I am on but I keep getting whacked by w/d symptoms.  Is there a schedule that I can use that will help me go from 4 mg's to 0 mg's without going through the symptoms.  I tried a few weeks ago and it was a VERY difficult 4 days!!!!

[notmenow!]

Doctor I too am on suboxone prescribed for me through my pain md. I was on a lot of opiates before. I was taking 40mg of oxy tid, and 6 tablets of norco 10/325 prn for breakthrough pain. After 6 months of this I was told I had to have my back surgury that it should not be put of any longer as it was causing neuological problems for me that would only worsen with time. I had the surgurey but only got about 50% pain relief. We tried to continue with the narcotics but by this time my tolerance level was so high it scared me at the amount of narcotics they were willing to prescibe me. My pain md had just rec'vd her license and dea # in order to  prescibe subutex or suboxone, So I was told not to take any narcotics after 10pm. I showed up at her office @9:00am with friend, She gave me 4mgs of subutex and a nurse watched me for 30 minutes, the Dr came in again and said give me another 4 of subutex. After 2 hrs I was given 16 mg suboxone, within 20 minutes I felt like I did before if started taking pain pills, We talked for a while and she decided I would do best on 32 mg of suboxone, along with 300mg of lyrica tid. I'm doing great only minor pain from time to time that goes away quickly. I an down to 8mgs of suboxone 4mg am and 4mgs early pm. I have read may stories about getting past that last 2mgs daily, I think the naltrexone should be increased to 50, and clonodine .1mg q 12h, This is what my pain doc and I have discussed we would use subutex because they come in 2mg tablets, Which would allow me to step down from 2mg to .5mg and if necessary .25mgs. Then she would sedate me allowing me to sleep for 1 day while off the subs. I trust her she is an board certified anesthesia MD, Do you think this is a practical approach?

[Roger Gould, M.D.]

yes, the best schedule is to get yourself to the lowest dose daily, then one week every other day at that dose, then the third week evey third day, then stop.