What's the deal with Suboxone? Is it good or bad?

[bvaljalo]

I will say, though, in total agreement, that the training level of the world's bupe doctors is sorely lacking. Most people, in my experience, are given way too much of the stuff, and aren't instructed to get down to a low enough level before they step off of it. And will also add that OPTIMALLY, yeah, using bupe for a week or two, then going through w/d's is a better option than being on bupe for months or years. Sure, it's better ... it means you are CLEAN SOONER. But it's not always practical or doable for certain people in certain situations, you feel me?

And given the OTHER OPTIONS, those being methadone, or just keeping on shooting heroin or gobbling pills and all that goes along with that lifestyle? I still vote for bupe, hands down.

[butterflylover]

Good post bvaljalo. About over rxing, you're right. I'm glad you gave me your opinion (not medical advice) on that in an earlier post because it is working for me. As you know I was rx'd 16mgs a day and on the 3rd day I started on 4mgs a day. Why start on such a high dose when my 4 'lil mgs a day work great (but that's for me) and will hopefully be easier to taper off of as opposed to 16. You always have such good info.


Off topic but I like your new avatar ! Cute kitty! Siamese?

[bvaljalo]

That's daddy's boy, his name is Little Willie John, which was the name of a 60's blues singer who's name I always thought was cool. I got Willie as a xmas present the month my grandpa died. Gramps' first and middle names were John and William, so, he's named after him, really.

And Siamese is ... well, 99% correct. He's actually a mix between a Lynx Point Siamese and a Snowshoe (which were in turn derived primarily from Blue-Point Siamese stock). So he looks like a blue point siamese with light Lynx stripes ... and little white mittens on all four paws!

If I say so myself, he is a gorgeous animal. He's unfixed, extremely strong, and believe it or not, he actually has more attitude than me! Very much a one-man cat, he LOVES me, but basically doesn't give a rats @ss about any other human, as far as I can tell.

And like most Siamese, I should add ... he LOVES to TALK. Well, perhaps PROTEST would be a better word for it.

So, Willie's like the kid I never had ... my pride and joy

[jane_668]

BV-right on spot as usual.I would like to give my opinion on this issue.I've started taking subutex 3 days ago.So I'm fairly new in this.However,I'd like to point out something.As many here know,my doc is Tramadol which is a weak opiate .I abused it along with codeine for 5+ yrs.During this period my usage jumped up to 20 pills a day .I was hospitalized 5 times for OD .In the las year I was on and off Tramadol becoz I simply couldnot keep on using it.I was vomiting daily and yet couldnot stay off it more than 35 days.I tried medical detox ,anti depressants,benzoz....nothing helped.You can simply read my erlier threads and you'll understand what I'm taking about.For many reasons,I could not check into a rehab .Thankfully, I'm still working.I work as a chief accountant in a huge firm.I execute transcation worth millions of dollars so mistakes are deadly in my worl.Now can you imagine how it's like to be nodding all day long,vomitting and carrying on my work.It was hell on Earth.So I am basically ready to try any thing to get off this painful ride.

Today would be day 4 of my wds.I'm still not feeling any wds.Yesterday,I managed to sleep 8 long hours which was impossible before.I feel normal.That's not high or depressed.I'm on haf a pill of subutex dily.Sure,I would like to get off it as soon as possible but my problems don't end here.My answer to life has alwasy been in a pill form.I mean sometimes I can get completely crazy and lose it when facing problems.I may end up taking 30 or 40 pill without thinking twice.So what do I think?What damage can half a pill does in damage terms that other drugs won't do.What? Depression,lack of energy, insomnia,suical thinking......? At least now I can focus clearly and straight.You wnat to say I'm not clean.I don't care at all.At least I can have my life back and start working on my problems mean while.I don't care even if I have to do a mdical detox to get off bupe in few months.For now,I just want some stability.And no I'm not even think of abusing subutex.Why would even want that when you can't get a high?

[jershua]

I was not putting down the drug and I know it is a lifesaver for many people, I was simply telling my story and how the drug affected me. I am an addict! And I would take more bupe than prescribed. Why? I don't know, I thought it was because I felt tired without it or maybe it was psychological but I could not function without. Also, I did not mean any harm by what I said, I was just giving my account of what happened to me so that another addict somewhere might relate and not make the same mistakes I have, I thought that was what this site was all about.

[marle]

I will not post the link here but there is another website full of positive experiences with Bupe. I guess you find what you are looking for Hugs, Marle

[bvaljalo]

Originally Posted by jershua

I was not putting down the drug and I know it is a lifesaver for many people, I was simply telling my story and how the drug affected me. I am an addict! And I would take more bupe than prescribed. Why? I don't know, I thought it was because I felt tired without it or maybe it was psychological but I could not function without. Also, I did not mean any harm by what I said, I was just giving my account of what happened to me so that another addict somewhere might relate and not make the same mistakes I have, I thought that was what this site was all about.

Actually, referring to the drug as poison and basically implying that it's rare for people to get off of it without becoming suicidal for months on end constititutes 'putting it down', at least in my book

Had you stuck to sharing your own personal experience rather than trying to make sweeping generalizations based on that experience, I wouldn't have felt the need to point out the logical and statistical flaw(s) that could well be inherent in those generalizations.

Don't take it personal, man, just understand that I've steered a lot of people around these parts onto buprenorphine, so if someone randomly comes along (such as yourself in this case) and tries to put the fear of God into them about what they're going to be going through when they get off of it, I'm going to have to take some issue with them.

I've read the sorts of 'accounts of bupe experiences' you are talking about, I'm aware of the vocal minority that says this drug gave them PAWS (pardon the pun!), etc. Trust me when I say, I have done my research. None of what you suggest is 'out of the blue' to me.

I do appreciate you bringing up some of the points you made (even if I'm the one who's spelling some of them out on your behalf).

You DO need a good doctor, and good guidance with this drug. The drug CAN BE abused, some people WILL do so. You CAN make your addiction (and subsequent withdrawals) WORSE if you are stupid about how you use this drug. If you FAIL to take it responsibly (and this INCLUDES in some cases, taking it exactly how you're being told to take it by the Doctor, unfortunately), if you FAIL to taper down your dosage before quitting ... yes, you can end up really F***ED in terms of withdrawals.

One thing people should REALLY realize about this stuff is that each 8mg pill is enough to basically 'cover' your withdrawals in a way equivalent to what 200mg of morphine (taken orally, not IV) would do, and that it's half-life is 72 hours instead of like 4 hours for morphine. This means that if you take 8mg each day, on day one you have 200mg of morphine in you all day. Day 2, take it again, you now have like 350mg of morphine in you. Day 3, take it again, you have like 500mg of morphine in you. Continue doing that every day, and you will stay at like 500mg of morphine at all times. Trying to get off at that level would throw you into MASSIVE withdrawals, and those withdrawals would hang around for A WHILE.

Truth is, I've noticed SO many doctors handing out 8mg pills to people when they really should be giving them the 2mg pills. 16mg a day is for people who, like, have been shooting a gram+ of friggin smack a day for years.

So, yeah, this drug is nothing to be trifled with, yeah, you can make your addiction WORSE if you're not careful, yeah, you need to educate yourself because many docs are clueless, and most importantly, you need to wean WAY DOWN if you don't want to go through *potentially really bad* withdrawals from it.

[jershua]

perfectly said!!!! i agree totally....

[jane_668]

"]ok BV now you're the one who's scaring.you're basically saying that getting off Bupe is like getting off massive doses of Morphine.Cool.well what about those who are -can we say addicted to a weak opiate and they experienced mild physical wds? would I be actually getting myself addicted to a stronger opiate drug and thus getting addicted to harder drugs.I've nver got problems with the physical aspect .My main problem was the lack of energy,insomnia and the cravings and many relapses.I've changed my mind.I won't listen to my doctor.I'll stay on a 4 mg subutex pill for 2 weeks then wean down to 2 mg the other week. So I'll get off it in 2 or 3months max.I'll not stay on it for like 8 months as my doctor advised.In the end my doc is Tramadol and not morphine or similar drugs.So getting off it would really be scary for me.My theory in life has always been zero tolerance to pain.You really scared me man......I've got some buzz in the first 3days and I'm supposed to be in Wds.That's how I know it's a stronger drug.Thanks for the info.[/color]

[Puddy]

Suboxone -

When you absolutely, positively can not or will not completely commit to a sobriety program and need "harm reduction".

[petey999]

ill give this from a prespictive from ireland,first of all i think you are talking about what is marketed in europe as subutex,the cheaper alternative to methadone,i personally was on methadone high dose maintainence 100mg for 12 years and during that period i underwent a detox 5 in hospital using benzos and naltrexone an opiod blocker i think it was a money making racket of no benifit what so ever ,subutex is not available in ireland but i have seen it being used in the uk,its success is very minimal,i got off the methadone by doing a 5ml a day reduction over 20 days with high dose lofexidine i went through withdrawals for another 3 months after finishing the detox i wouldnt have stayed clean except for going into a theraputic community(coolmine tc ireland) to deal with the behaviours i had learned during my time addicted.i was a poly drug user crack iv cocaine and heroin,i think this quick fixes like methadone subutex naltrexone are useless unless you do work on yourself in a long term residental setting

[bvaljalo]

Originally Posted by jane_668

"]ok BV now you're the one who's scaring.you're basically saying that getting off Bupe is like getting off massive doses of Morphine.Cool.well what about those who are -can we say addicted to a weak opiate and they experienced mild physical wds? would I be actually getting myself addicted to a stronger opiate drug and thus getting addicted to harder drugs.I've nver got problems with the physical aspect .My main problem was the lack of energy,insomnia and the cravings and many relapses.I've changed my mind.I won't listen to my doctor.I'll stay on a 4 mg subutex pill for 2 weeks then wean down to 2 mg the other week. So I'll get off it in 2 or 3months max.I'll not stay on it for like 8 months as my doctor advised.In the end my doc is Tramadol and not morphine or similar drugs.So getting off it would really be scary for me.My theory in life has always been zero tolerance to pain.You really scared me man......I've got some buzz in the first 3days and I'm supposed to be in Wds.That's how I know it's a stronger drug.Thanks for the info.[/color]

Janey, no offense sugar, u know I love ya, but either I'm not writing too clearly (something that I've rarely been accused of, I must say) or ... you don't READ too closely. I said an 8mg pill of bupe will COVER YOU like 200mg of morphine would COVER YOU in terms of keeping you out of withdrawals.

I did NOT say it's the SAME THING as taking 200mg of morphine. I could have just as well picked some amount of TRAMADOL that 8mg of bupe would be the equivalent to in terms of covering withdrawals, it's just that I don't happen to KNOW that number off the top of my head, and I'm not just gonna make it up.

I used morphine as an example cause it's considered a 'yardstick' in a lot of studies. IOW, because it's such a basic form of opiate, a lot of times you'll see 'morphine equivalent' when you're looking at studies.

The point is that you DON'T want to step off of bupe at a level that high, or you will feel like utter and total crap.

I hate to break it to you, but in the end, tramadol is JUST LIKE 'morphine or similar drugs'. Morphine, tramadol, buprenorphine, heroin, oxycodone, methadone, dilaudid, vicodin ... all fall into the class of opioids. The withdrawals are very similar with all of them.

The point I'm conceding here is that the withdrawals from bupe can be very bad, just as bad or worse than those from any other opioid IF YOU DON'T WEAN DOWN first. It's the same as it is with any other opioid, basically.

In terms of withdrawal effects from any opioid, the severity of them is primarily predicated on how much you have been taking RECENTLY (i.e. the past few months) before you quit. What you've been taking exactly, and how LONG you've been on opioids DOES enter into the equation somewhat, but it's a less important factor overall.

To be honest, Janey, I don't think I ever suggested you go onto bupe, did I? If I did, it was only because of your CONSISTENT refusal to do anything ELSE towards the direction of recovery. Because you've been in the hospital multiple times. Had SEIZURES. Are afraid of losing your job. And none of this has been enough, Janey. If I suggested bupe to you, it's because I don't wanna see you end up dead, okay? GENERALLY speaking, I don't recommend bupe to people unless they've demonstrated to me that they are living dangerously and for WHATEVER reason seem unable to break the cycle they are in on their own. You, my dear friend, have demonstrated this to me.

Now, had you ASKED me about dosages and schedules, given the level of tramadol you were taking, and the fact that it is tramadol, I've have suggested to you that you start out at 4mg/day of bupe at most, that within a week you should be down to no more than 2mg of bupe/ day, and that you should plan on weaning down over the course of perhaps 3 months to a level of about .5mg every other day before quitting. *IF* you do this (most importantly, the getting the dose low part of the equation, more than the timeframe part), I can GUARANTEE YOU that your w/d's will be significantly less severe (and shorter lasting) than they would have been had you just up and quit your 20-50 tramadol pills a day habit. Mentally and physically.

And btw, no you're NOT supposed to be in withdrawals the first three days on bupe. The first day, maybe. The whole POINT of the stuff is avoiding withdrawals. And yeah, copping a little buzz in the beginning is not that unusual, especially if you're being given more than you really need.

What I'm saying to you (or anyone else) here is don't get all hung up on bupe's 'relation' to your DOC on the 'overall opioid scale of strength'. Bupe IS very strong in terms of keeping you OUT of withdrawals. But in terms of getting you HIGH, it is very WEAK. Physiologically, this is because it BINDS WELL to your receptors, but it does not STIMULATE very well at all. When 99.9% of the WORLD thinks about the relative STRENGTH of an opioid drug, what they are talking about is the receptor stimulation effect, NOT the receptor binding effect. Because the STIMULATION is what gets you high.

Furthermore, in terms of being to able to provide you with a normal LIFE, in terms of helping to break the cycle of 'highness', in terms of actually facilitating YOUR weaning down before you stop (as opposed to the 'getting high' type of opioids, which almost NOBODY can wean down off of on their own!), it is a great choice. No matter what other opioid you started out on.

[bvaljalo]

Originally Posted by Puddy

Suboxone -

When you absolutely, positively can not or will not completely commit to a sobriety program and need "harm reduction".

On this point, we are in total agreement my friend.

[hairgirl]

I almost bought into the "hate sub" campaign, but I have realized that all experiences are different for specific reasons.I know firsthand, that my body was not ready to drop the dose at one point because of the way my body felt.Then months later, there were no physical symptoms with the same situation.Most people want to be done with this drug far sooner than suggested, and there is a reason you are usually told to stick to every intricate detail while weaning.We all heal differently, and in different time frames.I only know from what I have experienced personally.I do not like the fact that people bash this drug so much.It is a tool to living a better life, but nobody promised me it would be easy.All I need to do is consider the alternative, and I know I made a wise choice.I am into my treatment 10 months now, and it is just fine.

[kj3880]

I'm going to start a new thread to discourage moralizing on drug replacement therapy (suboxone, subutex, campral, antabuse, and methadone). Are there any others I should include? I can't take it any more. Happens in real life too much, too.
kj