Journal - Plan for getting off buprenorphine...please give your opinions...

[Richard_smoker]

Here is a plan that a friend of mine has for getting off the buprenorphine (subutex/suboxone/buprenex). Please chime in with any suggestions, what you think he's in store for, if it might work or not work. thanks.

I have taken subutex for approximately 18 months now. My doseage has been 8mg/day, either divided in 2 or taken all at once. (4mg, twice a day for about 6 months now.)

I know of the amazing power of bupe to be effective at even the TINIEST of doses (i.e. 0.1 to 0.4mg); for several years ago, I managed to get off a rather annoying hydrocodone addictinon with doses such as these twice daily for a couple of weeks.

Over the last 4-5 days, I have been forcing myself to take 2mg, once per day...I have noticed that I am restless at night, and cannot sleep. For this reason, I think that perhaps I would be better off moving to a twice daily regimine.

I currently have 4 pills remaining. (8mg pills). I wish to get off these things as quickly as possible, but with as little grief and pain and suffering as possible.

My current plan:

to suspend the pills in water, in a syringe...one at a time. starting now with the first 8mg pill.

I will suspend 8mg pill in 8cc of water. then, I can dose myself 1mg, twice daily for the next 4 days...

at which point I will have 3 8mg pills remaining.

I am considering dissolving the next pill into 12cc of water, giving me 0.75mg/cc...which can be dosed 1cc twice daily for the next 6 days.

I hope to dissolve the next 8mg pill into 20cc, and spread it likewise over the next 10 days.

Finally, I will be left with 1 remaining 8mg pill....to dissolve, perhaps, into 40cc of water...to spread over the next 20 days, taking 1cc twice/day (as usual).

it is possible to secure a few more pills (at a very high cost: $20 per 8mg pill).

does anyone think this will work??

if not, please offer suggestions to improve my friend's chances of getting off. THANKS! -Dick

Reputation Comments on this post:

Please do not use slang or short hand versions of drug names, especially in thread titles. It gives people more of an i...

[JaWill88]

swim is in the same boat been on sub for almost two years. swim does not think it will do much good to taper beyond 1mg. swim is just going to take a lot of clonazepam that his doc prescribed oh yeah and clonidine which swim has never taken (anyone know anything about it) but was prescribed as well. swim knows the WDs last about a month. good luck.

[Richard_smoker]

thanks....so far so good though with the 1mg/cc dosing...thought today that could maybe go down even more because 2x/day feels like its more frequent than he actually needs!

one of the shittiest things about this drugs is how long it takes to kick in....takes forever before you realize whether or not its working.

i guess it really doesn't matter in the end. one time swim got his hydrocodone addiction down to one dose per day taken around 7:00 or 7:30pm. he had a giant desk calendar on his wall where he marked his daily consumption. for 2 months he wrote 7.5mg on each day (that's ALL he took for each whole 24hr period), but for some unknown reason, he still felt hooked! I guess that no one can really explain that one, except to say that it was a very strong mental association with a previously physical addiction---every day, he would look forward to his night-time "dose." sucks. hopefully this water-down bupe taper method will work! so far, so good!
-DICK

i think the clonazepam might be useful...for some reason swim always gets "self-righteous" around the same time he starts trying to get off something...starts feeling guilty if he takes something as an addiction-replacement...but i'd say that if the doctor actually prescribed those clonazepam, i'd say to take them, especially at night to help sleep.

The more i think about swim's idea of tapering bupe using of an exact liquid-measuring tool (like a big syringe), the more I like it. the old adage, "listen to your body" goes a long way here. fortunately, it's possible to "feel your body" before your first dose of the day...to realize if you probably don't NEED a dose yet...so tomorrow you'll try waiting til later, or even giving yourself a SMALLER dose (by measurement, or by watering down your syringe a bit more!!)

emotional roller coaster, I guess, but swim feeling real good right now! thanks all, DICK

[infekt]

ask your doctor about a clonodine patch, this can really help with the withdrawals. granted, swiy will still be uncomfortable, but it will be bearable.

In 4 days swim went from 8 to 4 to 2 to nothing. Not the best way one wants to withdraw but swim was just ready to leave it (he was sick of it). The clonidine patch was put on when swim was 2mg and stayed on 7 days. It helped a great deal, as swim has tried to do this cold turkey before and couldn't make it. A Benzo would be probably be great for sleep and alleviating anxiety, if swiy is willing take them (if swiy isn't worried about becoming addicted to it). And I'm sure nonbenzos like Zolpidem would help even more in the sleep department (swim took zolpidem once in detox from heroin and it worked great for sleep). Hmm, come to think of it, perhaps Kava would be of some help as well..

Just remember, that swiy may not be able to taper himself down. If swiy has that type of self control, then thats awesome. Swim knows he wouldn't be able to do it himself, and that's why he chose to do it while he was rehab, so the nurses and doctors would have control over the bupe supply. But I guess if swiy knows enough is enough, than it may just be go time!

best of luck!

Reputation Comments on this post:

great tips, i appreciate it muchly.

[Richard_smoker]

wow. interesting. thanks for the input. swim had forgotten all about the clonidine patch...probably something he will obtain now that his memory has been restored.

an update to the taper: after about 4 days of rather abrupt decrease in dose (from 8-16mg/day to 1mg twice daily), he decided to make a semi-bold move, and try 0.85mg twice daily.

now, with that dose decrease, he's starting to notice some more pronounced signs of withdrawal. feeling hot most of the time, and sweating profusely. He doesn't have clonidine on hand, so he has been taking guanfacine 1mg tabs instead (alpha 2 agonist...just like clonidine).

only thing is, that after 3-4 days of the 0.85mg twice/day regiment, he is still feeling very hot & sweating profusely again. To combat this, he is escalating his guanfacine dose to 4mg spread over the day instead of 2.

He is now 9 days into his taper...and feeling pretty moderate signs of withdrawal. Sleep has become close to impossible, even taking 100mg benadryl (diphenhydramine) nightly. Beer has almost no effect. Today, started w/abdominal cramps and loose shits. He will begin loperamide (immodium) starting tomorrow. He will also probably give in to the urge to find & take some xanax or whatever benzos he can get. The insomnia and anxiety are close to driving him nuts. and he knows that everything will be this bad and worse for AT LEAST the next 3-5 weeks.

I guess there's just no easy way to do this... going with the currently-held belief that withdrawals take 4-6 weeks, he will try to maintain the 0.85mg twice/day until the peripheral symptoms resolve. at that point, he will decide on his next step: either lowering dose to 0.5 twice/day or just moving to once/daily dosing of 0.85...only time will tell.

Goddamn, this shit sure is a strange, and relentless beast. Using a quick bupe conversion and taper versus taking bupe chronically for years is almost like dealing with 2 totally different drugs. When used to quickly exit opiate addiction, it's great. When taken chronically, and trying to get off after 2 years, it's a MONSTER! I hope detailing this experience will be of help to others. Please... continue offering your insights, helpful tricks, etc. clonidine patch was a great bit of advice! thanks infekt!

-DICK

[JaWill88]

buprenorphine makes any opioid look easy to come off. nothing gives longer withdrawals than buprenorphine cause of the life of the drug. it is hell. swim has been on for 2 years mostly at 32mg per day. swim found it easy to go from 32 to 16. then 16 to 8 was a little harder. the thing that was working best for swim was from 8mg, get sick for at least 4-5 days and then try 6-4mg. while sick it is good (at least for swim) to just take his clonazepam at a decent dosage. then when he's real sick the low dosage feels like the one he was on. swim did that down to 2mg. but now that swim thinks about it. go as low as possible. swim highly advises getting sick from 2, then to 1, then to .5mg. then withdraw. for withdrawal the best meds seem to be clonidine, benzodiazepines (for swim clonazepam (Klonipin/Rivotril) ), and maybe Kava Kava with the benzo or another sleeping med for sleep. also for the worst most unbearable days, possibly use low dose Kratom ie 1-2 tablespoons. phenibut is really good especially if one can't get benzodiazepines. it is derived from GABA and actually crosses the blood brain barrier. this is swims plan and has started. what do others think? also swim would like to hear any personal experience with clonidine and what it does for what symptoms if anyone has any. thanks and good luck to all with this beast. knowledge really is power here.

Reputation Comments on this post:

Great idea!!!! sounds very useful. thanks.

[Richard_smoker]

day 28 on 0.8mg twice/day...jumping out of skin...this sucks worse than anything eveer...

Richard_smoker added 0 Minutes and 20 Seconds later...

any suggestions??

[Figaro]

I took my self down to less than 1 milogram per day, by cutting the 2 milogram in 2. I did not feel any withdrawl syptoms at all. I was so surprise I was unbelievalble to me it was like I have never been strunged out at all. Of course I was on that loNw dose for quite some times, several month and some days I forgot to take it. Nevertheless, I most have gone for several month taking this 1/2 of a 2mg dose. Before I noted I was not noticing it any more and my body got used to normal feelings etc and did not feel like I was sick, etc.


I most have been real lucky or bupernorphine was designed specially for my body, because I did not suffered at all. I am still shaking my head wondering where or when or how I was ever strongout on heroin. Because when I got off it was like I had never done opiates at all.

[Richard_smoker]

wow, swim spent all yesterday and last night, with heavy shaking, couldn't stop...driving him nuts. went for a jog last night and today...seemed to help somewhat...last night more than today.

he feels like he might need to start going to meetings or something like that.

[Figaro]

Originally Posted by Richard_smoker

wow, swim spent all yesterday and last night, with heavy shaking, couldn't stop...driving him nuts. went for a jog last night and today...seemed to help somewhat...last night more than today.

he feels like he might need to start going to meetings or something like that.

If it was me, I wouldl give myself a little more Bupernorphine and brake those tabs down more and more. For me the more I feel withdrawal symptom the more I feel like using the heroin.


When I full was without symptom when I got off bupernorphine I felt and thought about it less. but I have learned a long time ago, that each person has to do it how it works for them. Some people said that when they get off without symtom they do not appreciate the conditions that much.

I learned a long time ago every one is wired differently and what worked for me does not work for someone else. Is n't that the shits? I wish there was like a glass tube experiement that every thing works for every body. Some kind of special formula. I suppose there is some similarities and some difference in how people do things. But it is the determening factors that we have difficulties with.

[Richard_smoker]

yeah, i appreciate the feedback, figaro... very true, not sure what to do at this point...only wish that this was simpler, shorter, easier. i assume that's too much to ask for at this point.

[chillinwill]

swirichard has been on suboxone for a while now and is trying to come off of it right? by upping the dose now, that would totally defeat that purpose as we all know of course it would make SWIY feel better but the goal is to come off of it completely

Reputation Comments on this post:

great tips. thanks a bunch.

[Figaro]

Originally Posted by chillinwill

swirichard has been on suboxone for a while now and is trying to come off of it right? by upping the dose now, that would totally defeat that purpose as we all know of course it would make SWIY feel better but the goal is to come off of it completely

You go up with the intention of having your body catch up with the detoxing process.

Maybe I have a different body than everyone else but I felt no withdrawls that I could speak off. Compare to any other opiate I know.

My sense is that if you are feeling withdrawl then you are doing it too fast

[Richard_smoker]

yeah, i figure that you're both right... perhaps swim's been trying to speed things up too much. For some reason, he thought that 1 month would be plenty of time, and we're at the 1 month marker right now, with no end in sight...

...well, maybe that was a bit harsh. guess i just figured that after 24 hours of shaking, that would = being finished, but of course, it doesn't.

current regiment is kind of a day-to-day thing...if possible, i'd love to have him come down to once/day dosing. but that was very difficult yesterday... swim was trembling with 0.4mg dose at 1:30am this morning; followed soon thereafter by another 0.4mg.

since swim's got shit to do this weekend, he thinks he'll boost his dose fri & sat with extra, and back to the routine on sunday.

thanks for the help guys.

[Figaro]

Like methadone, due to the long acting half life of the Bupernorphine. It takes quite of bit of time for your body to catch up to the detoxification and

The reason why most methadone detox fail is that clinics use to give the patients there last dose in a very wreckful manner. The clinics would take a patient from 10 to there last 5 milogram and tell them good bye all in the same day. Yet the patients body was still catching up with the detox. That was why there was so much failure in Methadone clinics detoxing.

The fact was that the patient was still on 10mgs even though he was taken to 5mgs. They should have kept them on 5 milogras for weeks maybe a little over a month. and take them down to 3 or even 2 or 1 milogram before walking out.

Reputation Comments on this post:

great points in your post

[Richard_smoker]

Originally Posted by Figaro

Like methadone, due to the long acting half life of the Bupernorphine. It takes quite of bit of time for your body to catch up to the detoxification and

The fact was that the patient was still on 10mgs even though he was taken to 5mgs. They should have kept them on 5 milogras for weeks maybe a little over a month. and take them down to 3 or even 2 or 1 milogram before walking out.

very very interesting... i can see sparks of daylight. brilliant, beautiful daylight. but these moments seem to be very spread-out in time..

a moment of clarity, then an eternity of hell (actually a few hours), then clarity again.

thanks for the moral support.

[chillinwill]

Originally Posted by Richard_smoker

yeah, i figure that you're both right... perhaps swim's been trying to speed things up too much. For some reason, he thought that 1 month would be plenty of time, and we're at the 1 month marker right now, with no end in sight...

...well, maybe that was a bit harsh. guess i just figured that after 24 hours of shaking, that would = being finished, but of course, it doesn't.

current regiment is kind of a day-to-day thing...if possible, i'd love to have him come down to once/day dosing. but that was very difficult yesterday... swim was trembling with 0.4mg dose at 1:30am this morning; followed soon thereafter by another 0.4mg.

since swim's got shit to do this weekend, he thinks he'll boost his dose fri & sat with extra, and back to the routine on sunday.

thanks for the help guys.

i agree with what SWIY is doing.....raise the dose if one has shit to do or an important workday or whatever so they can feel normal and get their work done but if they have a day off or not anything to do in a day, tough it out and keep the tapering up

[Figaro]

Originally Posted by chillinwill

i agree with what SWIY is doing.....raise the dose if one has shit to do or an important workday or whatever so they can feel normal and get their work done but if they have a day off or not anything to do in a day, tough it out and keep the tapering up

I do not know why you would want to make it hard on yourself. Just take it easy, slow down your taper. I can not sware how it will be for you if you do that. But I truly and in all honesty can tell you, that the way I did it. I have never ever ever ever ever ever ever had a much easier detox. I swear to God and my mother grave, that I did not feel any withdrawl symtoms and I can't think why would one want to rough it, tough it, macho type of shit if it can be done easy as fucking hell. by taking your time.

At least, I have no desire to use, I had thoughts but my detox again was easy as fucken shit.................. I have detox from Heroin, and Methadone before................. Those mothers were rough, very rough and I continued to want to use and had very a lot of desiere reinforced by the fact that I was feeling like shit. When I did it easy, those desire desappeared and they were just thoughts that I would choose to pay attention to them or not. and I swear that they were not very intentense those thoughts, while the desire while I made it rough were a lot more intensen an bad.


I don't know if I am making the point of how it was for me, and maybe how it can be for you...... I mean I am not in your skin, but I can imagen that it could be the same for you, you can only tell for yourself and then later reported. I got to the point that I would brake an 8mg in 4 and then take that 1/4 and brake it in 1/2 again to make it less than 1mg and do this for over a month because I had plenty. The doctor had prescribed me three 8 mgs per day for 30 days. So if you want to do the count you figure out that I had many month of this last prescription that the doctor did for me. It most have lasted me maybe 5 or 6 month, while some time I take two and other time a littlemore but always taking me down with committment and all of the intention that I could mustard.

Figaro added 19 Minutes and 18 Seconds later...

I just thought about something? SAMHSA put out some books on both Methadone and Bupernorphine I can not remember their names but you get them though the National Clearing House for Alcohol and Drug Information. The stuff they have is Free and they will send it to any body, including patients.

Website http://ncadi.samhsa.gov/ find their 1 800 number and I think they are open 24/7

here is info about both methadone, subonxen and detoxing, I look the shit up for you.
They have a big ass fuck catalog of shit. One can become a pro reading their stuff. Except that they are part of the War on Drug scam, nevertheless they do have some good info.

Detoxification and Substance Abuse Treatment Training Manual Based on TIP 45
Provides a training structure for introducing substance abuse treatment professionals to the role of detoxification in the continuum of services for individuals with substance use disorders. Includes information on the physiology of withdrawal, pharmacological advances in the management of withdrawal, patient placement procedures, and the management of detoxification services in comprehensive systems of care.


Here is their whole list catalog on Buprenorphine

http://ncadi.samhsa.gov/search/googl...ct=NCADI_STORE

And their shit on Methadone, which is actually excellent.

http://ncadi.samhsa.gov/search/googl...ct=NCADI_STORE


THE good thing about it is that most of their stuff is FREE they evern send it to you at no cost and you do not have to be a professional. I also found it to be extremely easy reading. I initially thought it would be extremely technical and at least most of the stuff I read was not.

Figaro added 10 Minutes and 31 Seconds later...

One of the first publication they did was TIP #1 The State Methadone Treatment Guidelines. They might not publish it any more. But it did TRANSFORM the Clinic System from a very user UNfriendly process to a more demanding ON THE CLINIC and less on the patients. The Methadone Clinic Sytem such to the point that a lot of patients blame methadone rather than the clinic system. And not to sophisticated patient have a real hard time in clinics, but back in like in the early 2000 the clinics system was change moved from the Food and Drug Administration to the Subtance Abuse Mental Health Service Adminsitration and they started demanding better services to patients, based on all of the research that have been done on methadone and what they now call Evidence Based and Best Practice. Most of the clinics where doing their own thing and fucking with the patients a lot and didn't have any worthy stardards that would be considered patient friendly. In fact when I took the publication to the County Methadone Clinic, I had the impresion that the administration of the Clinic did know how to read, because they were telling me things that were totaly off the bat and fauling and sticking out on what they were saying. They were realy fucked and I think I put a wrench in their system and couse them an epileptic attach. Because their brains became somewhat blaaaaaaaaaa with new information, and did know how to think.

Figaro added 13 Minutes and 22 Seconds later...

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since swim's got shit to do this weekend, he thinks he'll boost his dose fri & sat with extra, and back to the routine on sunday.


Dont take too much, just take like 1mg wait maybe an hour of two, if still feel shaky do another 1mg, but only if disconfort and can no do the stuff you need to do this weekend. You want to keep you confortably but not too too high dose, just enough to be a little above withdrawl and get to do your shit.

So what I am saying is don't take 8mgs right of the top. Start very low, you can alway take more, but you can never take less.

Reputation Comments on this post:

good tips, appreciate input.

[Richard_smoker]

nice. i appreciate all of that. excellent info in there. -DICK

[rxpo1111]

hey how goes it. Yeah ive been on suboxone for a long time and it is so hard to kick. I finally did it(after 1000 attempts) and the only way it really worked was for me to taper the dose as low as I possibly could. ( like .25 mgs a day) for a week of 2 and then go cold turkey. It was still bad and I was sick for 3 weeks, it's not nearly as bad as coming off of dope, but it lasts for what seems like forever. If you really want to do it you can, just don't give up and don't go backwards. In my opinion suboxone should not be used for more than a week or two, because it's just a substitute. Wish you luck. You can do it if you really want it.

[Figaro]

Originally Posted by rxpo1111

hey how goes it. Yeah ive been on suboxone for a long time and it is so hard to kick. I finally did it(after 1000 attempts) and the only way it really worked was for me to taper the dose as low as I possibly could. ( like .25 mgs a day) for a week of 2 and then go cold turkey. It was still bad and I was sick for 3 weeks, it's not nearly as bad as coming off of dope, but it lasts for what seems like forever. If you really want to do it you can, just don't give up and don't go backwards. In my opinion suboxone should not be used for more than a week or two, because it's just a substitute. Wish you luck. You can do it if you really want it.

This is exactly my point, take your time and take a 8mg cut in Half then cut that half in another Half and then chip off another half from the !/4 of 8 mag that you have in your hand.

But I do not feel many symptoms. Like I said my body most have been disign to detox from Soboxen cos I bearly felt the detox symptom. But I did it very very slow and with bearly any making of a big deal about it. In fact I skipted on day a couple of times while I was detoxing

[Richard_smoker]

well, great advice... i really appreciate all the tips. they're all helpful in their own way. granted each person is different, but the basic physiology & psychology are the same.

you'll all be proud to know that swim is down to 0.5mg twice/day, sometimes only once. (you're right, it is becoming increasingly easy to totally forget a dose)

after about a week of this, swim will be down to practically nothing. something like 0.25mg dosing.

thanks for everything. knowing that someone cares and has been there before is probably the biggest aid to motivation and boost to self-confidence that there is! thanks a bunch all. -DICK

[dyingtomorrow]

SWIM is on suboxone right now. SWIM did a lot of research about it, and most people who stay on it for months say that no matter how small the taper their last dose, they end up going through horrible withdrawals for a week after completely stopping.

SWIMs friend detoxed with suboxone in 10 days, with almost no ill effects.

SWIM is on day 10, and down to 2 mg, starting from 8 mg. Every 2-3 days SWIM goes down 2 mg, and he's had NO bad effects at all, aside from the first day. The first day was rough, but day 2 was fine. The only other bad thing was it took 4 days to sleep normal, but SWIMs friend had xanax and said it wasn't a problem at all for him.

The point - being on bupe for too long seems to make the withdrawals really hard for a large percentage of people. The best way to do it is fast. SWIM is 100% functional, even going from 4 to 2 to 1 (which is halfing each your dose, and which otherwise sounds like it should cause discomfort - it didn't).

Reputation Comments on this post:

very true...thanks for your support.

[Richard_smoker]

well, it's been approximately 6 and 1/2 weeks since swim started his taper.

he has gone from ~16mg/day--stepwise, decreasing--to currently taking 0.35mg once or twice/day.

yesterday, he tried once/day dose, and he COULDN'T SLEEP from damn RESTLESS LEGS!!

Took 3 benadryl at 10pm...no sleep after.

Took 3 more benadryl at 1am...no sleep.

Took 3 more benadryl at 4am...no sleep.

FINALLY...took 0.35mg buprenorphine, and slept from 6am until 2pm.

WHAT IS SWIM DOING WRONG!???

He was MISERABLE trying to sleep last night...gooseflesh, sweats, too cold, then too hot, then covered with icy sweat...

Several people have said that one can 'jump off' below 1mg/day.

SWIM has found this to be IMPOSSIBLE.

Guess he'll just keep decreasing dose gradually... but I gotta say, after 6+ weeks, this is getting VERY OLD! Sorry for bitching....thanks for the encouragement guys. -DICK

[dyingtomorrow]

I have the 8mg pills so it is hard to dose below 2 mgs, but it sounds like that's not a problem for you if you are doing .35 mg. Can you just keep shaving a little bit off?

I really feel for you, and you got me a bit worried. Even tho my tolerance has dropped to 1/4 of what it was 10 days ago with no problem, everyone seems to say the last step is super hard.

Consider this though, and maybe it will cheer you up - if you just keep waiting until you feel shitty to take it (not just 24 hours on the dot every dose) , and take lower amounts each time, your tolerance is definitely going down. So you're making progress.

I hope you'll keep us updated, and I hope you can make the last step as pain free as possible. Good luck!