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Addiction: Substance Abuse Community
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Avatar universal

The Bupe Diatribe: notes on kicking and beyond part 1

Hey Everyone,

[note: this was meant to be a comment to the thread "End of Day 1 on Subutex", but got rather long and winding, so I thought I'd rename it, and post it as a new thread. It contains a lot of what I know about Buprenorphine (brand name: Subutex, Suboxone), kicking, healing, and pulling out of it. Please comment, it would be nice to perhaps develop it. It is really long, I calculate 3 posts to get it all up. Perhaps it will be a welcome distraction to some...]

I know this comment is coming late, but I was reading this thread with great interest, as I am in a similar situation this time. My only comfort comes from the knowledge I gained from past experiences, this forum, and folks at my local NA meetings. This being the case, I would offer what I know to the person who started this thread.

Some important things to know about buprenorphine:

1.) It is an opiate. This seems obvious, but gets lost quite soon, as it does not produce a euphoric effect (a high). It is, technically speaking, a partial agonist/antagonist. This gives it some properties like Narcan(tm) or Naloxone, the opiates that are full antagonists. An antagonist will flush out any other opiates that might be in your system, hence the use of Narcan as an antidote to overdose. It also has some properties of an agonist, which is why it blocks most WD symptoms, and also gives you that funny fuzzy-headed, bad cough-syrup, too much coffee kind of feeling sometimes. The point in stating that it is an opiate is that there can be WD from "bupe", and there can most certainly be physical addiction, too. Just because you aren't getting high, doesn't mean your body does not need it.

2.) It has a long half life. Half life is a term that applies to several different disciplines. Radiation and radioactive materials have their potency measured in Radioactive Half Life. It basically (i.e. without math!) means that after the period of time that is the half-life, half of it will be left. The other half will decay into other isotopes of radium, and loose neutrons and such. So, you get a gram of Radium 226 for Christmas (not a popular stocking-stuffer, I admit) and you put it in the mantle to admire. When you check back on it in 1,065 years, you will notice that only half of it is there. That is because the half life is 1,065 years. Wait another 1,065 years and half of the half will be gone, leaving you with .25 gram. Each cycle will reduce the amount by half. Eventually, as you can see, the amounts will be so small it will be hard to measure. In theory, one day it will all be gone. This is BTW, the reason people don't like nuclear power, because depending on what type of reactor is used, the waste is the most toxic substance know to mankind, and has a half-life of 704,000,000 years(U235).
    Drugs have a half life, too. The half life for pharmacists works a little differently, but the principal is the same. The main difference is that total excretion is possible.  There are those who argue about that previous statement, and state that trace amounts of just about anything that goes into your body will stay there in amounts so small it's hard for them to measure. This is one of those things that will always be controversial, like JFK and Bigfoot I suppose. Figure that every cell in you body, spare a few categories, get replaced every 7 years (known fact), so where's it going to hide? The drugs most of us like (or hate, or used to like until they took over and tried to destroy our lives or anyhow got us in trouble) have different half lives. Heroin has a rather short half life, (~6 hrs.) Vicodin is a little longer (~8 hrs.). Generally speaking most of the good stuff has a short half life, hence the need to get well all the damn time. The exact figures are hard to come by, and anyhow vary quite a bit person to person. The point here is that there are two notable long acting opiates: Methadone and Buprenorphine. Again, depending on who you ask and how, the exact numbers will be different, but it is the relative difference that counts. Methadone has a half life of 24-36 hrs. Bupe has a 38-42 hr. half life. This makes it the leader in the field of sticking to your brain. The long half life of Methadone also explains why it is such a drag to kick. Clinicians argue that the long half life makes it easier, as stable plasma levels are achieved during detox, and that adrenal-pituitary balance can start more gradually. Then again, they're not the ones doing the kicking, are they? My M.D., who is also one of the attending physicians at a local detox/rehab clinic, says bupe takes 4 or 5 half lives to be metabolized.

     The A-#1 thing to realize about bupe is that what you take today will effect how you feel two days later.

I tried to hurry the taper that I'm on now, and after 4 days I just couldn't stand it any more. I dropped down too fast, with only one day @ 2 mg. Big mistake. It anyhow flies in the face of my previous experiences. It's just that I felt quite poisoned and wanted to get everything OUT of my system, so made haste to great detriment.
    The previous time I went from bupe to nothing (and never went to meetings) I left from .5 mg/day. I believe that if you can stabilize on <=0.5 mg./day you stand a chance at kicking for good, without going backwards a few days later. Stabilize being the keyword here. Since we established that there is a long half life to bupe, and it will take 4 or 5 half lives to be metabolized, then 40 hrs. x 5 = 200 hours, or 8.3 days maximum until it's all gone. Minimum, say if your liver is still talking to you, would be perhaps 38hrs x 4halfLife = 6.33 days. This is important.

Why?

Figure that there are two phases to kicking. By kicking I mean the WD syndrome with a weight on the physical side.

Instead of considering kicking as the end of your addiction, think of it as the beginning of your recovery. I believe this is a good attitude to have, as I see so many folks who wish to reverse several years of opiate taking in a week or two on the couch, and then it's over. Though this can happen, it is quite rare. Indeed, the number of long or medium term addicts who just stop one weekend and then just go about their lives is so small it is statistically insignificant.

It is not the conventional wisdom per se, at least not stated very often, but I know many an addict who will agree: There is the detox phase and then the rebuild phase. Detoxing is pretty obvious; the **** you have been getting high with has to go. You body will not like this one bit, and will complain terribly once the poison is on its merry way. Then the reconstruction begins. Since there is not complete agreement on exactly what causes WD the medical facts grow scarcer here.
  The leading theory is that when you use opiates from outside you bodies own system, your natural opiates stop being produced. The other theory is that in the presence of excess opiates, be they natural or especially artificial, the cells in you body which have opiate receptors compensate by enlarging their capacity to receive them. These are simplifications, but the basics are there. Lucky for us, the exact nature of the physiology of opiate dependence is not directly relevant to our cause. I rather think that a little of both are going on, and since no one can disprove that, I run with it(!)

What are you trying to say?
[continued in part 2]
16 Responses
Avatar universal
[part 3]
That is what DNA/RNA does.

   There are hundreds of books and web sites that claim to "know" how this works. I do not, I only know what has helped me. Most of their “knowledge” requires buying something, mine does not.

Make sure you have enough protein in your diet, and take a supplement to get there. Nothing fancy, maybe extra glutamine (Glutamic Acid I think), which is believed to be a foundation to beta-endorphins. Any health food store will have racks and racks of vile tasting syrups and potions that will provide ample protein. They are all pretty much the same. Go for a good manufacturer, and the widest possible spectrum of amino acids. (remember that L-Tryptophan will help you sleep). Just don't overdo it, it can beat up your kidneys on the way out. Oh, yes the omega-3,6,9 stuff helps a lot, too.

Other alternative medicine. Ah, yes, herbs that cure cancer. Well, don't knock herbal medicine, it is not alternative in the slightest sense in many places. I once went to a hospital, as an outpatient, in Taipei, Taiwan. Taiwan is not a developing country, in case you were wondering. It is THE freest, most open, advanced democratic country in Asia. Sure, most countries in ASEAN want to be like Singapore, but that's mostly because Taiwan seems too far ahead. "In any case they cheat because they are best pals with the 7th fleet, and if we had that kind of respect we'd go for it, too". At least that's how I remember it when I lived over there. I think it was five different countries in SE Asia by the time I was done. One is still my second home. So here I am seeing a hepatologist, MD from Cornell, or was it Princeton...I forget, but I recall being impressed, that this dude was fully accredited in the West, AND had advanced degrees from Chinese Medical institutions. Why see a Dr. in Taiwan? Many reasons, but chief among them, it's free! My wife is an R.O.C. (Taiwan's real name is Republic Of China, or R.O.C., or ROC, or "rock" in the vernacular) Citizen, which makes me a Taiwan National if I want. Taiwan allows dual citizenship for people born there, so she carries a US passport and an ROC. I show up there and they go "Welcome, have free stuff". So unlike the ass-backwards expensive, slightly-better-than-Africa health care we have in the US, they keep the good stuff for themselves. Makes you wonder how we stand it. "Greatest country in the world" I hear people regurgitate this statement here in the US all the time, and every time I do I stop and think 'Really? How do you know?' It may seem great until you get sick, then God help you. You are on your own.  That's another story, though.
    So I go to see this Dr. in Taipei, he does the blood work, western tests, machines, graphs, probes and suchlike we are accustomed to here, then does the "Four Examinations", which I gather are the main diagnostic tool in Chinese Medicine (CM). Takes my pulse in a funny four-fingered way, looks at my tongue, sniffs around a bit (no kidding), looks me up and down, remarks that I have broken several bones in my past, proceeds to tell me which ones and when (and was correct), then changes the lab request to run specific tests. Tells me to come back a couple days later when they're ready, winds up giving me a prescription. Whatever, I'm cool with that, though I remind him that there isn't supposed to be any treatment for my condition. Sure he says, but this will help re-establish harmonies in my organ systems, which will in effect treat the symptoms and help restore liver health, etc. Fine, so off to the hospital pharmacy, down the hall, through the main lobby, right, right again, and there, inside one of the best hospitals in Asia, is what looks like a barn more than what I know a pharmacy to look like. Not a barn so much as a granary, just stacks and stacks of root powder, plant extract, herbs, leaves, branches, dust, droplets, and all manner of stuff that is not bottles of pills. It was a moment I will not likely forget, and of course the classic Ancient Chinese Secret dude running the place, reads my script, nods a few times, humms, looks up at me and says, in perfect English, "Yes, of course, yes, yes..." scurries back into the "stacks" and emerges a few moments later with about a pound of these small glassing bags full of yellow powder. Right, four times a day with water. Man do those taste foul. Yuk! And a 3 month supply takes up a lot of room. Kind of like $1,000,000 in small bills (20's) takes up a huge duffel bag and weighs 116 pounds. I knew a guy who worked in a bank you see...My liver problems improved, as measured by blood tests here, and my viral load went down, too. Plus I felt a bit better, too. This was several years ago, alas, sadly I stopped treatment as my addiction progressed, and my relapse turned into full uncontrollable, unmanageable drug use.
    All this to give you the background for when I say; do not discount herbal therapy, western drugs come from plants, a huge part of the world considers this normal, it is safe and effective so long as it's done by someone who REALLY knows what they are doing. The hepatologist I see here, or used to and will hopefully see again, happened to know of the guy I saw in Taipei (turns out he's a leading dude in the field) and had no problem with that whatsoever, but cautioned me over and over to be careful, it is still poorly regulated practice here in the US, and herbs can melt your liver as much as help heal it. Recounted a few anecdotes he did, about patients who went off to "herbal therapy camps" as he put it, and got very messed up in the process.
    I don't have any herbal advise for you right now, except to be careful and that it works.

I DID take part in a clinical trial of acupuncture once, when I was at a methadone clinic in S.F. many years ago. I had had acupuncture even before that, in a small clinic in Mass. from one of the original "disciples" of CM. According to them, and this was borne out in some research, St. Joseph's Hospital, in the Bronx, sent professors to China and Taiwan in the late '70s and early '80s. This was considered one of the pioneering West meets East trips and later research centers, that started to break down the barriers between the two. My acupuncturists at that time had studied under someone of that original group. Later, in SF I had a similar treatment, which was revealed to me to have been based on the work of that aforementioned group in the Bronx. It was effective both times. I'm not yet this time doing it, as I'm still mighty weak from the WD, and the liver toxicity that came with it this time. My energy is better spent at meetings right now, for my money, than anything else. Besides, every day brings improvement and any day now I'll make it out to a clinic. Finding a good one, and one that feels comfortable, will be the main task.

Acupuncture has been clinically shown to help WD. It has helped me in the past. It is not immediate, and not very strong, though you definitely notice it. It's not like taking a pill.

Right, this was interesting reading, how about a summary?
    Indeed, I though you'd never ask. Here goes:
[concluded in part 4]
Avatar universal
[part 4, summary]
Indeed, I though you'd never ask. Here goes:
Buprenorphine can work very well to help opiate WD, but is a scary opiate itself, and needs to be treated with a great deal of respect.
  Bupe has a really long half life, please keep this in mind when your taper schedule is designed( by you and whomever). WD can sneak up on you if you're not careful.
   Bupe maintenance is pretty much a bad idea, it will cause the same brain-bending problems that dope will, and yes will cause WD eventually.
    Use bupe to taper off other opiates, slow enough so you get started in recovery, drop to zero at a healthy time and avoid the (most of) destruction of kicking raw, and the lie that is methadone. Taper fast enough so you stimulate your body and mind to reconstruct towards something, sobriety.
   Eat well during this time, and take protein supplements to make sure neurotransmitters get made. Eat well does not mean eat a lot (ahem!) it means eat good QUALITY food, fresh, unprocessed, not overcooked. You know what it is :P
   Self esteem, the under looked savior of the addict. Don't let the little things get away. I contend that anything you can do to make yourself feel better about you will help. Not alone, but the small things will add up. I find it helpful to say to myself, when I do something that would otherwise seem irrelevant, "There, I did that for me." Try it...every day in these dark periods, do something small, like pick up your socks, and say that to yourself. I bet after a few days you start to look forward to finding the next thing like that you can do for yourself.
   Consider "alternate" medicine. Herbs, acupuncture, yoga, all that stuff. I know acupuncture worked for me, herbs, too. Other things I cannot speak for, but in any event, choose carefully.
   There are AA and NA meetings everywhere, though the traditions are upheld differently in different places. Go. Even if it's not for you, it will provide a distraction, you can find people who have gone through what you are/will/were going through and you can ask them about it. At the very least, you will be safe there, and afterwards you can say "There, I did that for me."

-----P&F

[end]
Avatar universal
[part 2]
What are you trying to say?
I'm getting at the fact that after the drugs are out of you, your brain and body still have work to do. This is why WD seem to go on forever. You are in need of physical changes to take place. We all know this because we feel it. You just don't feel right even after you are "clean".

There are, in my experience, many small things that one can do to help the reconstruction. Ultimately, you best friend here is time. One's brain chemistry and physique are not easily manipulated, it takes time. After all, think how much dope you had to take for how long to get where you are/were!
    The most basic reconstruction element is food. Sounds silly to some, but buckets of fried chicken, greasy pizza, frozen dinners and synthetic soft drinks are really NOT going to help you at all. Americans eat a lousy diet. I've lived in a few countries in my time, and I'm hard pressed to find worse food sometimes. There is a lot of it, and it's safe, and there are a lot of choices, and it's easy to buy, and it's inexpensive, but these things add up to an overall hit on quality. Yes you can have strawberries in the middle of winter, but they are often picked so far ahead of time that you might as well be eating wood. Sure throwing a box into the microwave is easy, but the amount of salt and fat you get from it are unspeakably high. Well I won't go on how fat and unhealthy Americans are, since we mostly know this. But I must stress the importance of eating the highest quality, freshest ingredients you can afford or get a hold of. at least for the first month or so after you start you recovery.
    Your environment is important. The reason people pay $50,000 for a few weeks in a detox clinic has less to do with the medical staff than it does the surroundings. I'd like nothing better than to haul off to one of these places and hang for 28 days, nice food, clean rooms, views, fresh air, etc. So take a lesson from that. If you have some cash, consider a catering/delivery service for food. Sounds like a luxury, but think that you don't have to fork over all your money for drugs anymore, you might be able to do it. Another possibility is to have your house/apartment cleaned. Again, a small thing that will help you feel better. Get rid of some old clutter, it will improve your self esteem.
     Self esteem is, next to exercise, the best thing for making natural opiates. This is a statement of opinion, and I know I'm going to get thumped for this, but I'm sticking to it. The better you feel about yourself, the sooner your body will come around.
   Strenuous physical exercise, almost everyone agrees, will help your body make natural opiates. The problem here is that it is the LAST thing you feel like doing either during hardcore WD or just afterwards. Indeed it's hard to get in the shower, because the feeling of water on your skin is quite uncomfortable at first. Then there's the fatigue. Walking seems like a task at first. Yet walking is the way to start, it gets you up, and out, and adjusts your circulation by being vertical. It really depends where you are in your WD and reconstruction, every day moving around will get a little easier, and the smallest thing that can make you feel more positive will start to add up. This is why I'm pointing them out; we need every ally we can get, so try not to let the small things go.
   Sleep is a tough topic (and my last), as there are very differing opinions on how to approach the sleep/wake cycle after kicking. A short taper or CT ["cold turkey" will require meds to get some sleep. You will find many an MD who will not only disagree, but also refuse to prescribe. Not sure this makes me happy at all. Their point is valid, in that by the time one is strung out on heavy opiates that person is very likely an addict in the true sense. We all know what that means, and drug substitution will bring you down as sure as the sun sets. MD's worry that you will become hooked on sleepers the moment you kick opiates. To me this is a rather simple world view, but then again, they aren't the ones having to kick, are they? To me sleep is essential, but so too is NOT  taking extra mood altering, addicting meds. My solution to this is a slower taper on bupe. We will all have differences here. I know it can be done, to taper to zero without sleepers, but it requires patience. You have to submit to being poisoned every day for a few weeks by bupe in order to have you life back. Seems worth it to me, but that is my situation. In fact, this is a good regulatory instrument for me: if I cannot sleep worth a damn, I figure I'm not stable on my dose. In any case I don't expect too much from sleep, as the last time it took me more than 6 months to sleep satisfactorily, and almost a year of complete abstinence before I slept "normally" again. I did have to adjust my life a bit, but it was not horrible, I just didn't sleep for longer than 6 hours for a while. I would rest in the afternoon, take it easy when needed, and life was good. One day I woke up and said "Hmmm, I just slept for a while and I feel good. What do you know...". Bu this is all later in reconstruction stuff, when it's early and it still hurts, do remember that sleep deprivation is a form of torture(!) No kidding, they keep those folks up at Guantanomo so they'll crack and talk. It can sure feel like that if you are not sleeping at all, or not nearly enough. Don't do that. Try to get stable and take nothing, if you can't hack it after two days, then take action. Taking action means with an MD, not self medicating. Though in the final analysis, I'd rather take a valium than jump off a roof. If it gets really bad, do what you have to do, just not with your "drug of choice". Eating Oxy/Vike/dope to get some rest is just plain wrong. It won't work anyhow, it'll wake your sorry ass up, and it gives CPR to shoulder-monkeys, demons, devils, and all else that goes bump in the night. Don't go back! Not for sleep. *****-slap an MD or two before that.
    The thing is you DO need to sleep, the path to getting there is long and thin, like walking a razor's edge. Remember to exhaust your natural methods first: adjust you taper schedule, move around a bit, do small things that will effect your self esteem, eat properly, change and enhance you environment, be hygienic, and finally, lower your expectations.

One last note about brain chemistry.

What is known today, 2007 A.D., about neuropharmacology is both a lot and nothing at the same time. Science has names for things, and thoughts about actions, studies up the wazoo, snapshots of methods, and fragments of proof here and there. It adds up to bold statements about how it is, yet our best therapies are blunt instruments at best. Addiction is a matter of science only for scientists, for us it's different.
    Take what we do know, and add it what we know works, and the result is pretty simple: supply raw ingredients for chemical balance. By this I mean take a few protein supplements, to give your body a chance to rebuild. Neurotransmitters are large molecules. They are regulated in ways we do not yet fully understand. We do know that they need raw materials to be made. These raw materials are amino acids, and proteins. Really, if you polymerize amino acids you are making proteins. The order and structure of these acids is determined by  DNA. That is what DNA/RNA does.
[continued in part 3]
Avatar universal
I don't know quite what to say after that. Alot of interesting information. Thankyou!                   Cathy
Avatar universal
Wow! I have to say that was an incredible read...thanx. Right now I am taking suboxone, just started today...unfortunately under a friends *care* and not a doctors. I have taken it before and I have had great results from it, however, I do have physical problems that require me to take pain meds usually monthly.

What I have been doing is taking my pain meds when I need them, normally 1 1/2 to 2 weeks a month but because I am addicted to them I take more than is needed or prescribed so I do have w/ds. When my physical problems start to get better I will take the suboxone...I take 2 mgs in the morning and 2 mgs around 6:00. Even though this seems to work I do worry if I am doing more harm than good. *The lesser of the two evils*?

Ya know, this whole process scares me and after reading your *diatribe* I am more convinced that this process needs to stop.

I am not sure how this post will be received but I found what you said to be insightful plus entertaining and I found myself writing your advice down because I do believe the amino acids, accupunture and the SELF ESTEEM do play an important role in the recovery process. Let me explain...

For 5 yrs or so I have been suffering from a disease that took close to 5 yrs to diagnose properly and during this time I became extremely depressed (always had problems w/ depression) and that coupled with some meds that made me gain weight really reaked havoc on my body and my mind. The depression instead of the disease is what almost did me in but with the help of a wonderful MD who wouldn't give up I have finally found some relief. I was taken off of the meds that contributed to my weight gain and I started to lose weight and I felt like I was becoming me again. Even though I still have problems the mere fact that I am not ashamed of ME anymore has been crucial in my fight against my addictions. Shallow, I know, but it is true. Self esteem is key. I believe that many addicts have underlying mental conditions and that is why we self medicate.

I just wanted you to know that I really appreciated that you took the time to write this post because for some reason it has struck a cord in me and I for one will have to start reavaluating my life and my motives. Thank you and God Bless you with your struggles.
177036 tn?1192290235
Yes one of the best things you said was treat the bupe with respect, a great deal of it.  
Avatar universal
Thanks you guys,

I'm glad to hear at least some one liked it ;-) I posted with some trepidation after I realized how long it wound up being. I decided to go ahead, hoping that people would just skim over it if they did not find it to their taste. A fair amount of effort went into it as well, and I did not want to toss that away. The information is, to the best of my knowledge, accurate.

I suppose that bupe is the lesser of two evils, though if you think about this deliberately, then bupe is still evil.

Evil may be the wrong word, it is so overused these days. Perhaps Fishmeal restated it best: "Respect, a great deal of it". Amen to  that.

Good luck green eyes

----p&F
Avatar universal
Encore........Encore...........what a intelligent meaningful talk. i, as in me am a drunk waiting to happen.spent 25 years loving,losing,then loving again a opiate addict.......i know the score ok from this side of the fence. we tried and tried.3 years ago she came to me for help and that was early in the bupe, sub stuff. for 3 years she maintained on sub, 32 mg's a day and still is........maybe not....?, says she is, but i did see the orange tongue 2 months ago, we are apart for good, but know what/.......she is long gone, with the sub she never was herself, before that she was the addict,before that she was my wife and lover....Peace dude, thanks for writing
Avatar universal
Damn that is a sorry tale. I'm sorry to hear you lost so much. I also hope you take care of yourself, if you think you are a drunk waiting to happen, for heaven's sake take action. Do what you need to do. You've seen the result, if you can at least save yourself, and lose the romantic inclinations that surround addiction, you will at least make us happy. One less troubled soul, one more on the road to recovery, that gives us power. The best revenge is a happy life. This bears repetition:

The best revenge against addiction is a happy and meaningful life.

At least have yours, my friend.
    Your bupe story is appreciated. I am trying to collect and disseminate useful, valuable, correct and meaningful information on bupe, it's successes and it's failures, it's history and it's future (that long post above is only the tip of the iceberg). I think others should know your story, though I leave it to you to post it or not.
    In particular, and if you do not mind, when you say "with sub she was never herself"; could you elaborate?

Here is an interesting analogy:
    Bupe is sort of like that little tire you carry as a spare, sometimes called a "skinny spare": It looks like a mini-tire, and  you can get to a place to get a new tire, but you would not want to drive around for too long with that little slippery tire on your car. You would not expect your car to be safe or handle that well at all. The purpose is to save weight and space while being stored, then to use in an emergency ONLY to get you to a place where you can replace it with a new one. So just like bupe, you can't really drive that fast when you are on it, you can't take corners real fast either, and at high speeds it makes a noise like zung-zung-zung-zung and bothers you. Changing one tire after this is like the "reconstruction phase" I talk about in the diatribe, it is mandatory to at least fix the blown tire, but, if you want to get anywhere, three bald tires and one good one is perhaps not such a good idea. Recovery is new tires.

I wish you the best, and I hope you can recover from your loss and your disposition.

------p&F
Avatar universal
Thanks for all your comments.  I've been looking around for some information about kicking Sub and haven't found much that's encouraging.  Everything I've read has indicated it's almost impossible to get off Sub, but everyone seems to be taking 8 mg a day or more.  I'm not surprised they would be having problems with WD when they try to stop.  I'm only surprised they can still function while taking that much per day.

I started taking Sub 11 months ago to get off 5 years or so of Norco/Vic abuse, through a doctor who was new to the Sub medication.  He went through the certification process to help me out and didn't know too much about it.  

I started taking only 4 mg a day, and that turned out to make me feel too drugged.  I dropped to about 2 mg a day and stayed at that level for months.  Over the last 3 or 4 months I've only been taking about 1/8 of a mg twice a day, for a total of about 1/4 mg a day.  

That sounds like next to nothing and it seems that it would be easy to drop down to zero from there, but it never really gets easier to go to less.  After about 12 hours I start to feel the WD symptoms start to creep back.  I get the hot sweaty feelings, the general discomfort, and if it happens to hit while I'm sleeping I get the twitchy legs and the restless thoughts that make it impossible to get back to sleep.

I haven't tried to go for a couple days without yet, but I'll have to give it a try pretty soon.  I hate the fact that I've already gone almost a year with this stuff, but it has definitely helped.  I'm just wondering if it's also hurt by having my body build up a tolerance to it.

I was spending a lot of money on Norco/Vic and got into debt.  Having the Sub as a replacement has allowed me to start getting back on track financially and to move away from my drug contacts.  I haven't had any kind of Hydro since I started the Sub.  I don't even get much of a desire, and have had a dozen or so around my house for months without even thinking of taking them.

My only real worry now is cutting the last ties to the Sub.  Like everyone else I hate the WD symptoms and everything I've read about quitting them says it's horrible and lasts forever.  

Your information makes sense.  I'm physically active playing in two basketball leagues a week and usually work out regularly.  I'll try your suggestions about diet and supplements and may look into acupuncture as well.  Thanks again for all your information.
Avatar universal
i will try and elaborate as much as i can. my wife started with codiene,then doctor shopping,then er visits,then the streets,then to rehab,then to streets,then to rehab,then to streets,then to me.i had read and digested as much as i could about opiate addiction.when she came to me she was in full blown withdrawl even though she had taken 24 vicadin that day, by midnite she was sick as hell,by 5 that next day she agreed to go to detox.when we arrived the docs said wow your in full withdrawl and we met with a nurse from the detox ward,where i brought up the bupe thing.she had her fill out a question sheet,actually i wrote she answered in between the sweats,shaking,leg jerks,sneezing,eyes running,bathrrom runs,vomiting and goosebumps.then off to the detox ward. in the AM her addiction doc and nurse gave her a 2 mg sub. i will never forget her response,wow i feel normal,like i just did a 40!...she stayed with me and went on the sub program, but she was at 32 mils or more a day. now here is where it gets foggy,for 3.5 years she was on it i believe,like i said i saw the orange tongue ok. she did say her doc said she may be a lifer on it. it changed her. she was moody,secretive,never happy,full of energy then none.. she was hooked on that as bad as anything. she left again in jan. all of a sudden is getting remarried, but again the cops ask about her.im not a rat but i know why they ask.........if you want to ask me anything please do,  jim
Avatar universal
Very informative.. Thanks for the post..
Avatar universal
Very good reading indeed.  Thank you for taking the time to write this.  I am on day 25 without Suboxone after taking it for 3 years.  Before I took it I was on a lot of diluadid, so I did not see any other way out at the time.  Many people told me that a very little bit of Sub or Bupe goes a long way and to respect it.  Of course I did not listen to them and decided my Dr's knew more about this drug than other addicts that were taking or not taking it.  So the Dr's swiftly got me to a level of 32mg a day.  I am an addict with kidney stones at least once or twice per month and SUB did help with the pain of these up to 6mm, I could pass them without surgery during the last 3 years.  Fast forward 3 years later.  Severe constipation led me to start quitting SUB, I then found out that going down to 24mg, then to 16mg then to 8mg was a very difficult thing to do.  I took 2mg to 4mg over the last five weeks and then I was just taking small pieces for days before dropping off.  After 36 to 72 being off of SUB things got very bad indeed.  I won't go into all the details but the first 20 days were by far the worst...ever.  I am better now and have started to go back to NA.  I was clean for over  5 years before (going to NA) so I am no stranger at how to get clean .  I wish I had only used sub to get off dilaudid for a 10 day period not as a pain med or to combat addiction.  A few days ago my wife and I flushed over 50 8MG Sub Dragons and I have never felt better than watching that s*** go down the drain.  Disclaimer: every one is different and your reaction and long-term use of SUB or BUPE and WD reaction(s) may not be the same as mine.  I would say gook luck to all but it is not luck that gets us off drugs, IT IS EFFORT and willingness.        
Avatar universal
Hello,

Thanks for your mesage, you sound like you are a good candidate to make a clean break with opiates. I would urge you to think about some form of recovery program, be it NA, AA, SMART, RR, drug councelor, group therapy, whatever. I say this because as far as I am concerned,  the 12-step programs have got one thing right: "The power of one addict helping another is without parallel". So even if you choose to not participate beyond what you feel you need, these types of things can be very effective. This forum is kind of  like that, I suppose, but it is another thing to see people face to face. Many are calm, clear-eyed, quite serene and can provide you with excellent advice.
    Apart from that, I'm always glad if I have been of some help or amusement to anyone. Though I must ask one favor...please get rid of any and all drugs in your house! I can almost guarantee that if you stop the sub, having these around will at a minimum drive you nuts, saying you don't eat them all one day. The catch here can be dangerous, the bupe will block most of the hydro from having an agonist effect, but not all, and crunching hydro can cause respitory relaxation. Since you will not be able to "feel" the hydro for 2 or 4 days after your last bupe, you would not be the first person to OD without even knowing it.
    So I hope you do start to taper to nothing, you could be a model case for all of us to look up to. It sounds like you are doing everything right; you have tapered down to .25 mg/day, and even that on a 12-hour schedule for smooth plasma levels, you exercise, hopefully now start amino acid supplements, and get with other addicts for support. You have put your finances back together, which will alleviate a major stress factor from your life this time, and you have gotten out of the habit of taking pills all the time to cope.
    Last time I was stable at that dose, I got on a big show(work), and one day, I though to myself "Hey, I forgot to take my bupe today". And so it was. I would skip days for a week or two, then I could skip two days, then one day I just didn't take it anymore. Yes I felt a very pale WD about a week or so later. Compared to CT from pills or dope, it was a mere annoyance. I was working out, which seemed to hide most symptoms, and all else was good, and mega busy with work.
   That's where I'm trying to get back to now, though this time, I'll be armed with surrender. Sounds odd, but my addiction will always win a fight, so I intend to sue for peace. Fighting addiction will most likely leave you toothless and blind.
   So I'd love to be where you are now, really. I took only 1mg of bupe this AM, and will hold off on the other half as long as I can. If it gets too hairy, I'll have to take the other half. But by extending the time between doses, I feel like I'm making progress towards the ultimate goal. I want my sobriety (complete) back.

I hope you decide to make the move, we could use a little cheering up ;-) We will be here to help no doubt, should you need it.

------p&F
Avatar universal
I've been thinking about attending some kind of group meetings, although they have never really been my thing.  I figure maybe someone has gone through getting off Sub and could give me some good advice on how to approach it.  Your advice sounds solid, but I'd like to see what someone else has to say.  

You're right about getting the pills out of the house, of course.  They can do no good, and have the potential for bad.

This isn't my first experience getting clean, just my hardest.  I had a heroin habit for a couple years in my early 20's, but in the late 1960's and early 70's.  I tried a variety of treatment programs before getting into a methadone program that finally worked.  I don't remember getting off the methadone as being as hard as this, but maybe time has dulled the memories.

It's really hard to understand how such a small dosage can be so hard to get away from, but maybe it won't be as hard as I think once I simply stop taking the Sub.  I keep telling myself I'll start cutting down a little more tomorrow (sound familiar?) but something always seems to come up where I need to function without any WD symptoms.  I will probably take a week vacation from work and try to just tough through it at home sometime soon.  I'm just so damn sick of being tied to a drug tether every single day.

I plan to take your advice about supplements and diet, and hopefully that will help.  My doctor will prescribe whatever I need in terms of sleep medication or whatever, but I'm leary of taking any prescription drugs to help with WD.  So I'll give your suggestions a try and let you know how it works out for me.
Avatar universal
I wanted to thank you for your positive comments on this forum.  When I started taking Sub I looked for information and found very little that wasn't negative.  I started to feel like I'd never get free of dependency and then I ran across your postings on the Bupe diatribe.  They were encouraging and I took your advice about diet, exercise and taking supplements to help rebuild neurotransmitters.  I can't say for certain that following your advice helped make a difference, but I can't argue with the results.  

I've been off Sub for a month now after taking it for 13 months, and I feel like I've been let out of jail.  I can't say how wonderful it feels to be able to leave my neighborhood on a trip and not have to worry about having the appropriate amount of some medication with me.  

I posted a string of my own titled "I got free of Sub, and so can you" to give my own experiences.  But I wanted to thank you for you input here.
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