Aa
too much suboxone?
Hi! I haven't posted anything in a while but I just want to see what other people think. I have been a long time opiate user (loris, vicodin, oc, h) and I finally was sick of it so I started buying subs in the streets. Now for anyone who does this you know how expensive it is. So about a year ago I went to a doctor and was prescribed subs. Now when I was buying them from the streets I could get by on taking half a strip or 4 mg a day although usually I was taking 8 and sometimes 16mg a day. I explained this and my past to my doctor and he put me on 24 mg a day. On top of that he gives me a few extra just in case I have any cravings he advises I take a sub instead of anything else. I have been there for a year and I have not tappered down at all even though I have admitted to feeling better and wanting to come down. A couple months ago I was sick of not coming down so I tried to taper off and only take 12 mg but I even felt ****** taking 1 and a half! I just was wondering if this is normal to be on this much for a straight year without coming down at all? Thanks for reading.
Matty- It's not usual to be on that high a dose for a year and not the way SUBOXONE was meant to be utilized and then you were given EXTRA doses?? Geez!!
You jumped from 24 to 12 one time? Did I read that right? Too huge a drop! Tapering should be dropping small amounts over a long period of time. You know we can't say anymore about tapering or dosages you should take, etc...the guidelines prohibit that for good reason.
But, you've got the idea so good luck finding a new doctor and keep in touch with us!
You jumped from 24 to 12 one time? Did I read that right? Too huge a drop! Tapering should be dropping small amounts over a long period of time. You know we can't say anymore about tapering or dosages you should take, etc...the guidelines prohibit that for good reason.
But, you've got the idea so good luck finding a new doctor and keep in touch with us!
are you seeing a regular doctor or a pain management clinic?
IN MY EXPERIENCE it seems family docs have NO clue about addiction or help getting off of the meds. they are quick to write a script, but when you ask to be taken off of them they really pull the rug out from under you. i think ALL doctors should have to detox once to get through medical school. not just a vicodin detox, but a methodone or fentanyl detox. then they would have a clue as to what it is like for us
i suggest educating yourself by reading on this site and any others that have information. you may have to figure this out yourself as it seems dr feelgood doesn't really seem to know how to prescribe subs.
if you really want off of them, you will do it.
slow and steady wins the race. always.
IN MY EXPERIENCE it seems family docs have NO clue about addiction or help getting off of the meds. they are quick to write a script, but when you ask to be taken off of them they really pull the rug out from under you. i think ALL doctors should have to detox once to get through medical school. not just a vicodin detox, but a methodone or fentanyl detox. then they would have a clue as to what it is like for us
i suggest educating yourself by reading on this site and any others that have information. you may have to figure this out yourself as it seems dr feelgood doesn't really seem to know how to prescribe subs.
if you really want off of them, you will do it.
slow and steady wins the race. always.
Hey there, Nurse Girl gave you some brilliant advice to work with.
I would just add, your daily dose needs to be steady, not up and down. You cant do that.Your dose is all over the place, so its expected you will get sick, your not on the same exact dose everyday, just this alone, will cause you to be uncomfortable.
Im with the others in getting a diff doc, i would also report his behavior, giving you a few extra, how unprofessional of him.
Find a good taper plan that meets your needs, and do it under supervision.
12 months, in my opinion, is perfect to now start a taper. I believe im still clean from Subs because i was on it for 16 months and over another 5 months tapered and jumped.
This was perfect for me.
Oh and your question, my answer would be its normal where i live, my dose 32mg daily for over a year, but we get the best support possible, when we want to taper, the clinic sais, wonderful and gives us a plan.
We know they dont want our money, because our Sub doctors are FREE and so are our clinic Appointments and councelling sessions etc, everything to do with the Sub Program is free, so we are very blessed in my part of the world. We get personal phone calls checking in on us, urine tests etc
As Nurse Girl said, diff opinions on subs, i respect every country doing it differently.
Good luck and take care : )
I would just add, your daily dose needs to be steady, not up and down. You cant do that.Your dose is all over the place, so its expected you will get sick, your not on the same exact dose everyday, just this alone, will cause you to be uncomfortable.
Im with the others in getting a diff doc, i would also report his behavior, giving you a few extra, how unprofessional of him.
Find a good taper plan that meets your needs, and do it under supervision.
12 months, in my opinion, is perfect to now start a taper. I believe im still clean from Subs because i was on it for 16 months and over another 5 months tapered and jumped.
This was perfect for me.
Oh and your question, my answer would be its normal where i live, my dose 32mg daily for over a year, but we get the best support possible, when we want to taper, the clinic sais, wonderful and gives us a plan.
We know they dont want our money, because our Sub doctors are FREE and so are our clinic Appointments and councelling sessions etc, everything to do with the Sub Program is free, so we are very blessed in my part of the world. We get personal phone calls checking in on us, urine tests etc
As Nurse Girl said, diff opinions on subs, i respect every country doing it differently.
Good luck and take care : )
There are some conflicting views on the exact ceiling dose, but the more current info is that 16mg is closer to being accurate than the 32 mg (which was originally thought to be the case in it's earlier days, 2002+). It isn't an exact science obviously, and can vary depending on the patient's history, how opioid experienced they are, etc.
The current Sub education classes for physicians really pushes to not exceed 16 mg/day after the induction process and adjustment is complete.
Here's some info:
"In opioid-experienced subjects who were not physically dependent, acute sublingual doses of buprenorphine/naloxone tablets produced opioid agonist effects which reached a maximum between doses of 8 mg/2 mg and 16 mg/4 mg buprenorphine/naloxone."
The same article further goes on to describe some research done and how at almost every dose tested, there was a dose that didn't increase the therapeutic effects:
" For all measures for which the drugs produced an effect, buprenorphine produced a dose- related response. However, in each case, there was a dose that produced no further effect."
It's definitely a little confusing. In MY experience, I would say that after the induction process is complete, I think it would be EXTREMELY rare to find a patient who required more than 16 mg/day.
http://www.rxlist.com/suboxone-drug/clinical-pharmacology.htm
The current Sub education classes for physicians really pushes to not exceed 16 mg/day after the induction process and adjustment is complete.
Here's some info:
"In opioid-experienced subjects who were not physically dependent, acute sublingual doses of buprenorphine/naloxone tablets produced opioid agonist effects which reached a maximum between doses of 8 mg/2 mg and 16 mg/4 mg buprenorphine/naloxone."
The same article further goes on to describe some research done and how at almost every dose tested, there was a dose that didn't increase the therapeutic effects:
" For all measures for which the drugs produced an effect, buprenorphine produced a dose- related response. However, in each case, there was a dose that produced no further effect."
It's definitely a little confusing. In MY experience, I would say that after the induction process is complete, I think it would be EXTREMELY rare to find a patient who required more than 16 mg/day.
http://www.rxlist.com/suboxone-drug/clinical-pharmacology.htm
Great replies!!!
Like motye said....sllllllloooooooowwwwwwwww!!!
Amen! Less people would have nightmare stories if they tapered properly!
Like motye said....sllllllloooooooowwwwwwwww!!!
Amen! Less people would have nightmare stories if they tapered properly!
Hi, I have been prescribed subs after a detox. I go to an addictions physician, and he prescribed me 6 mg tabs once a day to start. 3 weeks later because I was nodding off in the early evening, he tapered me down to 4mg. I felt uncomfortable, and have stayed at 5 for a week now. As I shared with Miami, I don't want to feel I can reach out for a Sub when I have cravings. It defeats the purpose of tapering. Because, as an addict, more is better. I see the doctor on the 28th and I am going to request only a one week script, whereby I won't abuse it because I will run out. I am serious about this getting off tabs. It is life or death for me.
Having said that, I totally understand where you are coming from...please see if you can see a doctor that believes in a taper plan. The doctor is ALSO abusing this drug with their patients.
You know what is right......I know the uncomfortable times remind me that I am doing the right thing, and it is temporary. I clear my mind and schedule, and just look after me...that's why its good for my family to be on the same page...you can push through this...you are NOT alone..
Having said that, I totally understand where you are coming from...please see if you can see a doctor that believes in a taper plan. The doctor is ALSO abusing this drug with their patients.
You know what is right......I know the uncomfortable times remind me that I am doing the right thing, and it is temporary. I clear my mind and schedule, and just look after me...that's why its good for my family to be on the same page...you can push through this...you are NOT alone..
COMMUNITY LEADER
Just FYI...when I said I couldn't taper, I meant the ssssllllloooowwww *** taper that subs require in order to not have w/d. And when I say slow, I mean like turtle pace, which I still don't understand. It seems to me that any med that takes that long to get off of, something's wrong?
COMMUNITY LEADER
Hey Matt and welcome back....
I was on 24mg of suboxone for almost 7 years and NO, this is not right! It wasn't until I came on this website that I realized my dose was WAY too high and not necessary. I know how much they cost on the street, for sure, but I'm quite suprised your dr gave you extra's if you have cravings???? I believe, from what I've read, different drs believe different things when it comes to the subs; some use it for short term detox and some claim it to be a lifetime maintenance! Horse **** on being a lifetime maintenance! Subs should ONLY be used as a short term solution b/c you are going to catch 10x's a hell when you try to get off these things! I know I did.
You've been on them for a year, get your dr to start the taper schedule (unless you think you can do it yourself) and start getting off of 24mg for sure! Someone told me that subs have a plateau effect anyway which when I think back, they kind of did, so taking 24mg is kind of overkill. Going from 24mg back down to 16 shouldn't be too bad.
The decision that I had to make was do I want to stay on this medicine for the rest of my life, because all I had done was traded opiates for suboxone? I tapered for about 1 1/2 weeks from 24mg to 0mg which was total hell, but I did it! I couldn't taper, I'm an addict, and tapering is not something I could do. It's time to do some real soul searching and decide what you want to do? You've already passed the "short term" usage point, so do you want to not have to rely on something to function or not? Seriously think about it????
I was on 24mg of suboxone for almost 7 years and NO, this is not right! It wasn't until I came on this website that I realized my dose was WAY too high and not necessary. I know how much they cost on the street, for sure, but I'm quite suprised your dr gave you extra's if you have cravings???? I believe, from what I've read, different drs believe different things when it comes to the subs; some use it for short term detox and some claim it to be a lifetime maintenance! Horse **** on being a lifetime maintenance! Subs should ONLY be used as a short term solution b/c you are going to catch 10x's a hell when you try to get off these things! I know I did.
You've been on them for a year, get your dr to start the taper schedule (unless you think you can do it yourself) and start getting off of 24mg for sure! Someone told me that subs have a plateau effect anyway which when I think back, they kind of did, so taking 24mg is kind of overkill. Going from 24mg back down to 16 shouldn't be too bad.
The decision that I had to make was do I want to stay on this medicine for the rest of my life, because all I had done was traded opiates for suboxone? I tapered for about 1 1/2 weeks from 24mg to 0mg which was total hell, but I did it! I couldn't taper, I'm an addict, and tapering is not something I could do. It's time to do some real soul searching and decide what you want to do? You've already passed the "short term" usage point, so do you want to not have to rely on something to function or not? Seriously think about it????
That definently doesn't sound right. And yes... i know how expensive they can be on the street. You need to start tappering down. It sounds to me like your taking more and more and it's only going to be that much harder to stop. I would talk to your Dr. again and let them know you want to tapper and if he/she gives you any **** then move on to another. I feel like the dr's know thats a steady monthly income so the less people they tapper the more income they get. When you tapper you eventually (hopefully) get clean so then no more dr visits no more money in there pocket. And one of the side effects that I ALWAYS had was shortness of breath like I could never breath and I was only on 4 to 6mg's a day I can't imagine on 24mg's you can do this and you will. <3
FIRST order of business....It sounds like you need a new sub doctor.
To be honest, while sub IS indeed a good tool for some people in recovery (not a "cure", but a step in recovery), it's VERY difficult for people who have used Subs improperly to change and adhere to a regimented sub plan.
There would be VERY VERY few instances where ANYONE would ever need to be prescribed 24 mg/day, with the exception of maybe the induction dose initially. Sub has a ceiling effect at 16mg, so pretty much, anything prescribed over that is not beneficial in any way, and is just stacking the bupe on. Again, an exception would be an induction at a higher dose for a very heavy user, and that dose wouldn't be maintained for long.
If you really want to go the sub route, please find a GOOD doctor. You can find a sub doc at www.suboxone.com
There are so many misconceptions and plain old inaccurate info out there about subs, so be careful. You will hear some people say that it should never be used for more than a few days. The mechanism of action and long half life of subs makes that statement inaccurate generally speaking, unless a person is using it as a short term detox (which, again, with the mechanism of action, detoxing with sub makes no sense for a lot of people).
A recovery program that involves sub, for people trying to STAY clean of their DOC, and gain back some normalcy, a typical sub program will be about 6-12 months. That's because there are adjustment periods (initially), and of course, a sub taper should really be pretty slow and gradual. A GOOD sub program will also require therapy and aftercare plans...which is the MOST important part of a sub plan. If a person JUST takes the subs, with no "work" on their addiction, they will be no better off than when they started, and in many cases, they'll be worse off, as sub tapers can be rough. They definitely are longer in duration, and almost always more severe.
A Sub program can be very helpful for some people, but in order for the addict to be successful, the RIGHT doctor/clinic is a must, as well as attitude...knowing that the recovery process involves a lot more than GETTING clean, and recognizing that there should always be progress in the program....meaning, the doc should always be monitoring the patient, with ongoing discussions of goals, taper plans from visit ONE. The only exception would be someone who has decided to be a sub lifer. That's pretty uncommon, and even those people should be encouraged to try to be maintained on the lowest dose they can.
Best to you....please, if you're going to do this, do it right. Find a good doc, and be compliant, you cannot be varying your dose. Stick with the prescribed dose, and work HARD on your recovery. Sub isn't like taking a Tylenol. People shouldn't be directed to take an extra sub in the event of a craving. Other than the psychological aspect, that wouldn't do anything anyway physiologically, as the body takes several days to about a week to adjust to a new dose.
If a person is having cravings, and the patient and doc determine that a higher dose is needed, the prescribed amount should be increased, and the patient reevaluated (usually in about 2 weeks). At 24 mg/day, you would not benefit from taking any extra sub. The only thing it's going to do is prolong your taper, and probably make you feel lousy, because subs at high doses come with lots of side effects.
Hang in there!!
To be honest, while sub IS indeed a good tool for some people in recovery (not a "cure", but a step in recovery), it's VERY difficult for people who have used Subs improperly to change and adhere to a regimented sub plan.
There would be VERY VERY few instances where ANYONE would ever need to be prescribed 24 mg/day, with the exception of maybe the induction dose initially. Sub has a ceiling effect at 16mg, so pretty much, anything prescribed over that is not beneficial in any way, and is just stacking the bupe on. Again, an exception would be an induction at a higher dose for a very heavy user, and that dose wouldn't be maintained for long.
If you really want to go the sub route, please find a GOOD doctor. You can find a sub doc at www.suboxone.com
There are so many misconceptions and plain old inaccurate info out there about subs, so be careful. You will hear some people say that it should never be used for more than a few days. The mechanism of action and long half life of subs makes that statement inaccurate generally speaking, unless a person is using it as a short term detox (which, again, with the mechanism of action, detoxing with sub makes no sense for a lot of people).
A recovery program that involves sub, for people trying to STAY clean of their DOC, and gain back some normalcy, a typical sub program will be about 6-12 months. That's because there are adjustment periods (initially), and of course, a sub taper should really be pretty slow and gradual. A GOOD sub program will also require therapy and aftercare plans...which is the MOST important part of a sub plan. If a person JUST takes the subs, with no "work" on their addiction, they will be no better off than when they started, and in many cases, they'll be worse off, as sub tapers can be rough. They definitely are longer in duration, and almost always more severe.
A Sub program can be very helpful for some people, but in order for the addict to be successful, the RIGHT doctor/clinic is a must, as well as attitude...knowing that the recovery process involves a lot more than GETTING clean, and recognizing that there should always be progress in the program....meaning, the doc should always be monitoring the patient, with ongoing discussions of goals, taper plans from visit ONE. The only exception would be someone who has decided to be a sub lifer. That's pretty uncommon, and even those people should be encouraged to try to be maintained on the lowest dose they can.
Best to you....please, if you're going to do this, do it right. Find a good doc, and be compliant, you cannot be varying your dose. Stick with the prescribed dose, and work HARD on your recovery. Sub isn't like taking a Tylenol. People shouldn't be directed to take an extra sub in the event of a craving. Other than the psychological aspect, that wouldn't do anything anyway physiologically, as the body takes several days to about a week to adjust to a new dose.
If a person is having cravings, and the patient and doc determine that a higher dose is needed, the prescribed amount should be increased, and the patient reevaluated (usually in about 2 weeks). At 24 mg/day, you would not benefit from taking any extra sub. The only thing it's going to do is prolong your taper, and probably make you feel lousy, because subs at high doses come with lots of side effects.
Hang in there!!
Ummm no! Suboxones are only meant to be used short term and any dr who would give you extra just incase you have a craving is feeding your addiction. That is insane. Withdrawal from suboxones are worse then opiates. Find another dr! Stuff like that makes me mad because here I am doing everything legit and even turned down higher doses from my dr but yet I had the dea at my door
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