Dec 25, 2008
I personally found no amount of tapering, even when the schedule was stuck to, made the withdrawal any less uncomfortable/painful.
I went from 32-40mg/day of sublingual Buprenorphine, tapered to 2mg every other day over the course of 1-1.5 months, then to 1mg every other day after about a month. There was no discomfort during this period, from 40mg a day to 1mg every other day. Buprenorphine is very easy to taper down with, at least I found it to be.
But even at 1mg every other day, the withdrawal syndrome for Buprenorphine was identical to that of Heroin in most respects, some symptoms were hardly present that normally are for me in dope withdrawals, but other symptoms were exponentially worse with Bupe than for dope. Specifically, the psychological trauma of Bupe withdrawal syndrome is the worst of any opioid I've felt withdrawals from. It seems a sizable minority of Buprenorphine maintenance patients have a much, much harder time with Bupe withdrawals than others. My guess is it has to do with the anti-depressant activity of Bupe and possibly its effect on the kappa, delta and/or ORL1 receptors.
Anyway, no matter what, have a contingency plan in place in case you cannot withdraw from the Buprenorphine successfully. Try to have your doctor phone in a refill, and don't fill it unless you can't manage the cold turkey.
I made the mistake of lining up my taper at the end of my 3 month Buprenorphine script- no more Suboxone without another $300 visit to the Bupe mill doctor I went to (who is now facing several felony drug distribution charges BTW). Ended up going back to shooting dope for a few weeks (at much higher levels than I was using pre-Suboxone) then onto Methadone maintenance.
Make sure, no matter how good your taper plan is or how well you stick to it, that you have an emergency plan other than going out and scoring your drug of choice that you became addicted to in the first place- if the Bupe detox does not go well.
posted by Tchort