sub taper used by the pain mgt group at my hopsital

[worried878]

A suboxone taper that is used at the hospital pain clinic and seems to work well...my pain mgt doctor is very frugal with narcotics as he is an x addict himself..guess it can happen to anyone.  he has found that 4 mgs of sub will cover just about any addiction...a heroin user may feel a bit of discomfort so at times the start at 8-16 mg but for pill users 4 mg is the most people are started at.  they do not do long term suboxone there often and will refer you out for that as they said they r a pain mgt group and not an addiction treatment group for long term needs who need extensive counseling.....no subutex either...they do the 21 day rule ...the taper they use is virtually standard except some start at 2 mg instead of 4 mg and like mentioned...for iv drug abuse in heavy doses and methadone,..they sometimes start at 8 mg but for only 2 days..it is not a money making outfit either

it goes like this:

4 mg x 4 days
3 mg x 4 days
2 mg x 4 days
1 mg x 4 days
1/2 mg x 4 days and the crumb from the extra 1/2 mg may be used sparingly for a few days if absolutely needed but most do not need it.
so a total of about 41 mg is needed to get off oxy/hydro habits....aftercare twice weekly is required/meetings with a counseler and the script is written for 5- 8 mg pills and 1- 2mg pill ....they say that way they dont have to worry about anyone selling them/selling the leftovers etc as this has become a problem
They are doing long term sub care and after u r assessed if they feel like it  is a long term treatment needed,,,they try not to exceed 8 mg long term but do start some out at 16 mg...never anymore than 16.  I thought it sounded like a good plan and thought i would share.

[worried878]

been learning alot about this drug thru research at the hospital...found this article interesting

-comparison chart for buprenorphine—the one that says that 1 mg of bupe is as potent as 15 mg of methadone (which is true)—and projected it out to predict that a certain dose of bupe would be appropriate for a higher dose of methadone. In other words, if 1 mg of bupe is as potent as 15 mg of methadone, ‘that means that 10 mg of bupe is needed for 150 mg of methadone’. This is just plain incorrect; bupe has a ‘ceiling effect’ that is responsible for its usefulness for addiction, and the writer was assuming ‘linear kinetics’. In reality, 1 mg of bupe equals 15 mg of methadone; 2 mg of bupe equals 30 mg of methadone, and 4 mg, or 8 mg, or 16 mg of bupe also equal… you guessed it… 30 mg of methadone!

so anyway after a certain point sub just "ceilings out" and no longer can cover a super high addiction.  with this being said..then what good does it do to put someone on 32 mg of the stuff in the first place? I guess that is whay people can get down to 2-4 mgs without a problem then the pain begins...doses over that are pretty much wasted and the sub company is making a fortune!  it is amazing when u start researching this stuff!

[ochooked]

This is great information Worried.   Especially for those who are considering a Sub treatment because most doctors who prescribe it do not know how to.  These doctors are only required to take an 8 hour (on line) course to get certified to prescribe so have no real knowledge of its power.  Even after my bad experience, I believe that it can be a most effective tool to help a pill addict -- they normally just start at too high a dose so get so hooked that it just becomes a new DOC.  I think that if more of them knew at the beginning that it was only a tool and would not do all of the work, they may be more inclined to get off of it more quickly.  Thank you so much for sharing this with the group.  All the best.

[christos24]

i think it is great that people can get off of suboxne after only a month or 21days that is wonderful.i unfortunately was at the ceiling dose at 32mgs a day and i would ahve been on it for years i know i would have relapsed or started the vicious cycle all over again.after destroying my wrist i ended up having to switch to methadone and that has been a life saver for me. but everyone is different and different levels of addiction and that plays a crucial role in seeing how long and how much youll need of suboxone.i was on suboxone for a little over 8  months so if you have any questions about it ket me know-christos