Does too much saliva affect the absorption?

[Lmcampbell89]

Hello all!
I’ve been on suboxone for about six years. I’ve only been going to the doctor for it for about two years(I can’t believe it took me so long!) I’m currently on 6mg of the strips a day(2mg sections three times a day.) I’ve tried to take all 6mg at once in the morning but I always end up craving it in a few hours. I know it’s because my body is so used to taking it at the same times.
It’s probably just the addict in me but I’m always trying to figure out the way for maximum absorption, or the “correct” way to take it.. I’ve read Dr. Junig’s “painting the mouth” method but people always seemed like they were talking about the pills, not the strips. I’ve always done under the tongue and not swallowing for 20 minutes. I’ve tried a few times to put it on the roof of my mouth, wait til it gets gloopy, then use my tongue to paint it across the roof of my mouth. Am I supposed to spread it to other areas? My mouth always fills up with saliva and for some reason I’m worried that if saliva touches the suboxone it won’t work. Is that true?
Also, I tapered from 8mg to 6mg over a year ago and I can’t seem to taper any more. If anyone has any advice on that that would be great. Sorry this was all over the place. I’m a first time poster

[razor55]

Hey Lcampbell, Im a huge fan of the painting method, been doing this for 7 years. Not until I read Dr J s post on his Talkzone called Max Absobtion did I learn the 3 reasons why this works so well. And yes ive been on the films all this time. Its really about the time the med spends on the entire inside of the mouth. I paint for 20 to 30 mins just to keep the med moving over as much area as possble.. Anyway, welcome to the forum and keep reading. ...Razor.

[BlueLight]

I don’t know why people complicate this. You dissolve it under the tongue for 3 to 5 minutes for appropriate dosage. People who go an hour without swallowing, or spitting out salavia, or whatever are just ritualizing their dose. The 30% bioavailability of buprenorphine is absorbed in this time frame.

https://www.ncbi.nlm.nih.gov/pubmed/9048270

[Jess1208]

I really don't believe 3 to 5 minutes is all you need.

I agree that it is best to keep the film dissolving for as long as possible before swallowing your saliva.. but I do not use the "painting" method as I am on a lower dose and can't even taste the suboxone at all by the time it is dissolved (which really doesnt take very long anymore) so I don't feel a need to "paint".

However, doing so is not "ritualizing" your dose. I don't want people to see that comment and feel judged. Or feel accused of misusing their medication..


Nobody tells you how to actually take suboxone (or other related meds)... At least no one does at the place I go to, not even the doctors.. Sometimes I wonder if THEY even know the correct way to dose.

They just say "here you go, put it under your tongue" and thats it... I have talked to multiple people in my group who have been on Suboxone for 7+ years, and they say they just put it under their tongue, and any spit that accumulates they automatically swallow as the spit forms... because, well, why wouldn't they? No one told them NOT to.... (so the idea is that they are essentially swallowing all of their medication before it even has a chance to absorb)... and some of those same people have told me that they just cannot get below 16mgs/day.

I have spoke to people in my group about that, and shared what I have learned here, and they are all amazed when I mentioned to them they should try to take it WITHOUT swallowing all of their spit like that. I never said "this is how you take it", I just suggested to try holding in the spit, not swallowing for at least 10 mins, and they should see a difference, and be able to work on lowering their dose (if that is what they wish).
... I never said "this is the right way to take it", but instead explained WHY I believed this way would be more effecient for them, especially for those who want to lower their daily dose.

There are also so many people who smoke cigarettes while dissolving their med (I actually used to do that in the very beginning before I learned there was a "better" way), or drink/eat immediately before and after.. I would put my film under my tongue, then light up a cigarette on my drive to work, and as soon as any spit would accumulate, I would immediately swallow it.. Thinking I was getting the film to dissolve faster by swallowing any spit.

HOW you take your dose makes a huge difference once you get below the ceiling level and start working on a taper. I fully believe that.

But again, this is all just my opinion ...
Jess

[razor55]

The painting is just a way to put more medicine in touch with more area. It is the way to Max Obsorbtion, period. I cant see 3 to 5 mins, tomuch being swollowed, never make it to 30% this way....

[jennjenn]

Agree Jess, imo it 3-5 min is definitely not long enough. Heck in 3-5 min what are ya doing, it doesn’t dissolve that quick for me unless I push it around rushing it. I don’t think anyone is talking about an actual hour to absorb their dose but 3-5 min sounds not so good.

Someone wanting to maximize absorption is not ritualizing their dose necessarily, I don’t think that’s the case in this thread at all. We don’t know why someone is concerned about how to get maximum absorption, there’s plenty of reasons. I pay over $8 out of pocket for each tablet, you better believe I’m not going to waste it. Someone new to this medication, could also get nervous that they aren’t getting the best dose they could be and scared of withdrawal. We don’t always start out knowing every single thing about buprenorphine... I didn’t at all. I think it’s pretty normal to want max absorption.

Of course too much saliva isn’t a great thing so maybe try different things like taking your medicine first thing in the morning before you start drinking a lot when your mouth is most dry. Keep your tongue firmly closed to block away as much saliva as possible. If it becomes too much of a problem, there’s always Bunavail, it’s a strip that goes on the inside of your cheek and you’re allowed to talk while it’s in because it’s protected.

[BlueLight]

The 3 to 5 minutes is for the strips, not the tablets. Obviously, the tablets will take longer.

When I said ritualizing your dose, I wasn’t referring to simply not swallowing your spit, and taking 10 minutes. I was referring to the endless nitwits at Reddit and other forums who say they don’t swallow for an hour, or brush their teeth, tongue, and gums, gargle with alcohol, wait 5 minutes, then dose while spitting out salavia, or refuse to eat or drink for an hour before their dose, plus 30 minutes dissolving, and another 30 minutes no eating or drinking after that, or “boof it” (stick a tablet or strip up their butt, or sit in a dark room with prayer mat bowing to Invidior headquarters, and all sorts of nonsense.

[Jess1208]

or sit in a dark room with prayer mat bowing to Invidior headquarters,

LOL "all praise Indivor!!!"

[jennjenn]

Now that kind of stuff I agree is going too far. I don’t ever run into many of those ppl who go to that extent so I guess I didn’t realize that is what you were referring to BL. I definitely didn’t know ppl discuss stuff like that on Reddit. You know what, the only time I’ve ever really looked around on Reddit is when I’ve googled something about a true crime thing and read other ppls opinions or whatever on the subject. Gosh, I guess they talk about everything there don’t they? I have noticed that some do go overboard for sure, but I don’t think the original poster is to that extreme of course

[suboptimus]

Hey Lcampbell, Im a huge fan of the painting method, been doing this for 7 years. Not until I read Dr J s post on his Talkzone called Max Absobtion did I learn the 3 reasons why this works so well. And yes ive been on the films all this time. Its really about the time the med spends on the entire inside of the mouth. I paint for 20 to 30 mins just to keep the med moving over as much area as possble.. Anyway, welcome to the forum and keep reading. ...Razor.

Why would you paint it across the roof of your mouth ? There is a reason it is sublingual. The largest veins in the mouth where chemical absorb are under the tongue.

[razor55]

Only the tinest capilaries uptake the med. Thoses larger veins do not. Read Dr Junigs Maximizing Obsobtion in his Tlkzone to get the whole story. In the end the intire inside of the mouth ,meaning more area, will uptake med...I not making this shit up, it comes from my boss.....

[TeeJay]

Hey Lcampbell, Im a huge fan of the painting method, been doing this for 7 years. Not until I read Dr J s post on his Talkzone called Max Absobtion did I learn the 3 reasons why this works so well. And yes ive been on the films all this time. Its really about the time the med spends on the entire inside of the mouth. I paint for 20 to 30 mins just to keep the med moving over as much area as possble.. Anyway, welcome to the forum and keep reading. ...Razor.

Why would you paint it across the roof of your mouth ? There is a reason it is sublingual. The largest veins in the mouth where chemical absorb are under the tongue.

That's not really true. Look at Bunavail - it's a buccal medication and it has higher bioavailability than suboxone. Because skin is thin all around the mouth medication can be absorbed all over. Dr J talks about this on his TalkZone.

Before I got on the injection, I'd often leave my dose in my mouth for 20-30 mins. If I had 3 or 4 strips, I'd put one on each cheek, and one or two under the tongue.

Also regarding tapering, what are you finding occurs when you taper further? If cravings are returning, then I'd look at finding tools to manage the cravings so you can taper further. Peer support groups, counselling, team sports, rock climbing, kayaking, change your job, abuse telemarketers. Something to give your life a boost. The other option would be to just stay on 6mg for the long term.

[Amy-Work In Progress]

"...abuse telemarketers..."

hee hee

Amy