subutex question

[Impurrfect]

I know this has probably been discussed here before, but I'm too lazy to look

My stepsister recently got out of treatment for Klonopin addiction and they have her on subs. She said she thinks the dose is too high (8 mg 3 times a day) so she just stopped them but now is getting shaky.

I told her to call her Dr. 'cause I thought this is something that needs to be tapered, not stopped abruptly. Am I right? I remember reading that people sometimes have to have the doses adjusted. She's been out of treatment for about 2 weeks, if that matters. She has other medical problems, so I know I'm right about telling her to call her doc, just wasn't sure about the tapering?

Thanks!

Amy

[exjunky]

8mg three times a day is a huge dose. I had a really bad habit, and by that I mean "worst than most" -- I was fixing 6 times a day and if i couldn't get my drug of choice I would use oxycodone to the tune of 400mg-500mg per day. As bad as that sounds, I got by on 16mg a day suboxone no problem, and very quickly scaled down to 1mg a day. I can't imagine how bad a habit would be to justify 24mg/daily.

I think that if she's taking too much she can very quickly scale down to a better dosage. The fact is that even with the worst of cold-turkey opiate withdrawals, real physical danger is extremely unlikely as long as the addict is relatively healthy.

Anyhow that should be discussed with the doctor. Even a phone call might settle the question. I bet he or she will say "take 2 daily instead of 3" or something like that.

[Impurrfect]

Thanks exjunky -

I told her that I didn't know if subs is something that can be halved but her Dr. could tell her if she needs to take it only 2 times a day instead of 3. I know this is out of my area of knowledge, but stressed to her that she MUST call her Dr. before she just stops it.

She only has about 30% of her heart function, fibromyalgia, and migraines, so has several doctors, but they are all working on this together to determine the best treatment plan. She's also tiny - weighs about 98 pounds, so I thought the dose may be too high for her (don't really know if body weight has anything to do with it).

Thanks again for the quick reply. I'm going to call her back and make sure she calls her Dr.

Amy

[exjunky]

I'm a little confused about something that I missed earlier. You say her addiction was Klonopin (a benzo) but she was prescribed subutex, which is for opiate addicts. Something there doesn't add up. Maybe she was on Oxycodone and Klonopin, or something like that?

Maybe there is some other purpose of buprenephrine (subutex) that I don't know about but it sounds like madness to give it to somebody who has never used opiates.

[tanyapmc]

I totally agree with exjunky. Subutex is for opiate withdrawl, not benzo withdrawl. There is not anything (like subutex) for benzo withdrawl.

[Impurrfect]

You're right....sorry about that.

She was also on fioricet and lortabs for pain from fibromyalgia and migraines. She used to only take it when she absolutely needed it, used mainly imitrex for migraines. Apparently, though, when she went overboard on the Klonopin, she would be so out of it, she would take too much of everything, including fioricet and lortabs.

Now, they have taken her off everything except her heart medicine, lexapro for depression, the subs, and ativan 0.5 mg once a day. She knows the dangers of ativan and is only going to be on it for maybe another week and is not abusing it. She was actually prescribed ativan years ago for 3 times a day, and realized that she couldn't remember what she had done the day before, so stopped it and is scared of it now. They told her it was for seizure precautions and she told them she didn't want to take them any longer than she had to.

exjunky - I told her what you said about 24mg being a high dose of subs and reminded her that she doesn't need to just stop them. She was going to take one of the pills tonight and will call her Dr. first thing in the a.m. (he was already gone for the day) and see about tapering down.

Sorry I forgot to tell you WHY she was on the subs. Hopefully, they will find a way to treat her legit pain. I warned her about tramadol, too, thanks to everything I've read here.

Amy

[Carrie]

Every body is different when it comes to meds. I am taking 2.5 pills of 8mg subutex, yes subutex not suboxone, daily. Three times per day. (1 8mg pill in the am, 1/2 pill in the afternoon, 1 at night) My dose was changed. I was on 2 8mg tabs per day of suboxone. Still had withdrawals and felt sick on the suboxone. I was shaky, had a headache that wouldn't go away, felt like a person was sitting on my chest when I took the suboxone. My doctor switched my meds after a week. Yesterday was the first night I took the subutex, and there is a big difference in how I am feeling. She may want to ask about Subutex as she could be having a reaction to the naloxone. Thing to remember though....the benzos....I was also on xanax. Never abused it. My DOC was morphine, and lots of it. The Xanax withdrawals are awful. It's been two weeks clean for me and I am still feeling it. My guess is she is still feeling the effects of withdrawing from the klonipins. She has to hang tight with it and get through it a day at a time. I am surprised they are still giving her any kind of benzos (ativan) with the sub. My doctor won't and most won't. It can be deadly. However, that seems to have only happened when people shoot up with a cocktail, but the doctors I have spoken to will not prescibe benzos with the sub. I wish they would for me because I can't sleep well now.

Good luck to your step sister.