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This is all my own info regarding sub. Its NOT a pro or Con post but it may shed some light.. Buprenorphine is the active ingredient in Suboxone, Subutex, and Buprenex. Suboxone has a added ingredient called Naloxone. This was added to prevent abuse, and the Naloxone in Suboxone will allegedly cause immediate withdrawal if the Suboxone is injected or possibly snorted. Naloxone has also been known to induce withdrawal (wd) symptoms when some people are initially starting treatment, therefore some Drs will initially induct patients with Subutex which is just Buprenorphine without any additives.

Due to the fact that Sub has only been available for a couple of years in the United States there are a lot of questions that arise. Doctors are very misinformed about proper dosages, discontinuation of use, the existence of withdrawal symptoms, and length of withdrawal. This is due in part that most documentation pertaining to treatment, has conveniently been written to promote this medication as a harmless, pain-free way of detoxification and treatment for addiction. Most people are unaware that buprenorphine is a potent opioid with a strength 50 times greater than morphine. The only reason it is considered safe is because of its partial agonist abilities, a partial agonist will only get you high or stimulate your receptors to a certain point, then it actually blocks itself out... so in actuality, taking more or high doses will do nothing but get you sick. A normal dose after you are stable for is around 6mg to 8mg. If your Dr is prescribing you amounts much higher than that (like 24mg to 96mg) then you Dr. does not have much practical experience with this medication.

So many questions have been asked regarding quitting sub, and dealing with the shockingly miserable and lengthy withdrawal symptoms that I have compiled a list of some of the frequently asked questions regarding this subject.

Prior to reading the FAQ section of this post please be aware that this stuff is NOT GOSPEL/ or written in stone there is always a chance that you have a fast metabolism, or just the right combination of brain chemistry to heal quicker. Everyone is different so please dont get discouraged no matter what you are doing, these figures are a compilation of many people that discontinued Suboxone -buprenorphine and posted their experience.

Question- How long should I stay on sub for?
Answer- This is a really tough decision, at least if you are armed with information you can make a informed choice, and be aware of potential pitfalls. The general rule of thumb seems to be that the shorter you are on sub the shorter the wds and recovery time.....However, if you are a chronic relapser, coming off years of MMT, or you just know that you are not prepared for sobriety then perhaps a longer stay might be in your best interest. Just remember that the wds from sub could last over a year if you stay on it for too long. A quick (less than 21 day stay on sub) always seems like the best/easiest option. Once you begin treatment with sub its best to get a sobriety plan in place right away. A plan can be any type of support that will help you stay away from the drugs that got you on the sub to begin with. Some people go to NA/AA meetings, some folks use alternative programs, support groups, or simply coming to this board for support. The posts that always seem to get the quickest responses around here, are from people that have cravings and need some help ASAP. People are almost always here if you need them for support.

When you hand a bottle of any type of opioids to a addict for self-administration, regardless of the partial-agonist properties (The inability to get higher) they will generally abuse them. Or in the very least try to feel "better than normal", this type of behavior is common in most addicts, and you could potentially run into trouble if, or when they decide to stop due to "behavioral dependance". Its better to think of this med as a treatment rather than a cure. Just try to be careful and remember that this is just another drug and not some magic pill or cure for addiction.

I am sure your Dr. Seems like a great/supportive/understanding person. But if they tell you that the wds from sub are going to be mild, or tell you to stay on it as long as you like, then they are misinformed. Sub wds are rarely mild and due to the extremely long life, they will last for a very long time. Most of the literature and research done on sub seem to promote this miracle pill mentality. Buprenorphine is just another opioid, and no matter what excuses you can come up with or rationalizations, this is still drug replacement therapy just like methadone. Sub has been nicknamed methadone-lite or the lesser of two evils. It is addictive and a real ***** to get off, just be aware of these factors when making a decision.

Question- What is a good taper plan?
Answer- For a quick, less than 21 day detox a 1mg reduction every other day seems to work for most people. The less than 21 days time frame is assuming that your body has not yet become re-addicted to the sub. People that stay on sub roughly past the 21 day mark seem to report a much more difficult time discontinuing sub when they try.
The first few days of sub induction its important to stay at the highest doses that dont make you sick. Most people start out between 8mg or 12mg, and after about 3 to 5 days the wds from your previous drug will begin to fade and that is when its best to start reducing your dose. Everybody is different, so if you really begin to feel wd symptoms when trying to taper, just take a little bit more to make yourself comfortable. For most people initially taking sub, a dramatic reduction will rarely be felt at all, and like previously mentioned..if it does, just take a little more!

A pill cutter or razor can be used to achieve the lower dosages, sub is also available in 2mg pils.

Day 1 (8mg to 12mg) - If all you needed was less than simply find your dose and reduce a little slower or in 1mg doses.
Day 2 (8mg to 12mg) Once a day.. or split into (2) 4mg or 6mg doses
Day 3 (8mg to 12mg)
Day 4 (6mg to 10mg)
Day 5 (6mg to 10mg)
Day 6 (6mg to 8mg)
Day 7 (4mg to 8mg)
Day 8 (4mg to 6mg)
Day 9 (4mg to 6mg)
Day 10 (2mg to 4mg)
Day 11 (2mg to 4mg)
Day 12 (2mg to 3mg)
Day 13 (1mg to 2mg) (at around this point you may start to feel the reductions)
Day 14 (1mg to 2mg)
Day 15 (1mg to 2mg)
Day 16 (.5mg to 1mg) (you can stop at this point if you are ready)
Day 17 (.5mg to 1mg)
Day 18 (.5mg to 1mg)
Days 19 to 21- (.25mg to .5mg) if you can break/cut the pills this small, this low amount will make the wds as mild as possible. A long drawn out taper is not really needed if you are not yet physically addicted to the sub, so feel free to make up your own plan, just try to jump at around the 1mg mark for the easiest overall time. (Short term sub detoxes only)

FOR LONGER TERM USE TAPERS- You can follow the same schedule as above, due to the long half life sometimes it takes up to three days to feel dose reductions. Also try to drag out the .25 and .50 mg as long as you can, if you can get away with every other day dosing that would be even better. The reason for such a long drawn out taper towards the end is to reduce the amount of sub you have in your body when you do finally stop. People have reported much milder wd symptoms that have used sub for longer periods of time if they paid their dues with a long drawn out partially painful/uncomfortable taper at extremely low doses. These low tapers lasted weeks up to a month at .5mg doses. For a lot of us addicts, this method for controlling our dosages is pretty difficult. If you just jump when you get down to .5mg your wds wont really be too bad. The problem with stopping sub is not really the severity of the wds, but the length of time they last for. And then there is always a very good chance that the PAWS (Post Acute Withdrawal Symptoms) will follow after the acute wds have subsided or stopped.

Question- What happens if I jump off at a higher dose?
Answer- Most people that have jumped off at higher doses that have been on sub for long term have reported extremely severe acute WD symptoms. Its best to get as low as possible, if you are a risk taker or just have have a extremely high tolerance for wds then just going for broke without a taper will be rough. We all started sub to reduce wds, so this method wouldnt be any easier than going cold turkey off our DOC (Drug of choice) and even if you were able to handle it, the PAWS would not be any shorter.

Question- Once I stop how long will it take before I feel any symptoms?
Answer- The half life of sub is about 37.5 hours, this means that it will take your body about a day and a half to expel 50% of whatever you took 37.5 hours prior. { If you took a 8mg dose at 8am you will still have about 4mg of sub in your body at 9:30pm the next day} You also have to take into consideration all the doses you took prior, they also stack up. So a 8mg dose you took almost 5 days ago will still be equal to around 1mg still in your body, plus add the amounts of all the doses after that together. This is why a low long taper is so important once you decide to quit. Especially if you are physically addicted to the sub. A lot of this half-life stuff has to do with how fast your metabolism works, but you will normally start feeling actual wd symptoms 24 to 72 hours after your last dose..The onset of the ACTUAL wds are watering eyes, yawning constantly, feeling tired and sluggish, about 12 hrs later the more harsher symptoms begin to appear.

How long the sub wd's will last, depends on two very crucial factors.
1) How long have you been on the sub for?
2) Did you taper? What stabilized dose did you jump off at?

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