My journey towards freedom - slow liquid taper process

How to stop Suboxone? How long should I be on buprenorphine? Is Suboxone withdrawal bad? How do I detox?
walk_in_the_sky
Average Poster
Average Poster
Posts: 18
Joined: Sat May 30, 2015 4:27 am

Re: My journey towards freedom - slow liquid taper process

Post by walk_in_the_sky » Tue Aug 31, 2021 7:36 am

Thank you so much for your response, rule! It really helps a lot to get some feedback!

I'm using the liquid taper method: I dissolve the 8 mg Subutex-pills (I have no experience with Suboxone-films, I use those: https://cache.pressmailing.net/thumbnai ... /image.jpg) in 8 ml of water and dose it with a 1 ml syringe (without a needle). So it's really easy to dose such tiny doses! I could even dose much smaller doses without any problems (down to 0.01 mg).

Yes, I still feel the sub. It's just a subtle feeling of comfort/relief, but it's still noticeable.

These last few days I had some withdrawal symptoms, because it was kind of a big reduction from 0.15 mg to 0.1 mg. Especially when I consider that the last reduction before that was just 3-4 days ago and also big. But for me it's important to be as long as possible (within my assigned time frame) on the final dose before the jump, so that my body and mind can adjust to this tiny dose and the final jump will (hopefully) not be too hard.

I'm planning on doing the final jump on September 12 or 13. Because in that week I'm going to finally start the psychotherapy. For me it's important to immediately get this professional support as soon as I did the jump. I really need to work on my (long long) history of addiction in a special program for addiction issues.

User avatar
suboxdoc
Site Admin
Site Admin
Posts: 1680
Joined: Sun Feb 24, 2008 9:03 pm
Contact:

Re: My journey towards freedom - slow liquid taper process

Post by suboxdoc » Wed Sep 01, 2021 6:47 pm

Yes, congratulations! I usually recommend that people 'jump' at 300 micrograms or lower. You will have a few days where you will miss dosing, but it is hard to tell if that is caused by chemistry or by psychology. In either case, it doesn't last long.

If you ever have problems, get help FAST. I have had several hundred patients taper off buprenorphine over the past 13 years, and most have done well. But some have relapsed, and some have died from overdose. Opioid relapse can occur after many years, even in people who were absolutely positive that they would never use again. My own relapse, 20 years ago, occurred after 7 years of solid recovery.

I always have to remind people --- the issue isn't 'getting off Suboxone'. The issue is recovering from opioid use disorder -- which for most people started with opioids other than buprenorphine. The unique pharmacology of buprenorphine helps some people stop using other, more addictive opioids. But resolving tolerance still falls on each patient. Congrats on getting there!

walk_in_the_sky
Average Poster
Average Poster
Posts: 18
Joined: Sat May 30, 2015 4:27 am

Re: My journey towards freedom - slow liquid taper process

Post by walk_in_the_sky » Tue Sep 07, 2021 5:11 am

Thank you, suboxdoc! :)

These past few days weren't too easy, I was in another town on a further training (for work), which was really exhausting and I had to deal with some obvious withdrawal symptoms. One night in the hotel I woke up at 3 am with really annoying withdrawals and I wasn't able to go back to sleep for several hours (which was particularly hard because at that point I already had a huge sleep deficit which built up over 4-5 days), so after 1,5 - 2 hours I finally took a bit of additional sub (~ 0.03 mg) just to be able to get back to sleep. The second night in the hotel I took a bit extra sub right before bed time to avoid withdrawals and sleeplessness at night. I just needed some sleep!

So for two days I increased my dose to ~ 0.13 mg a day instead of 0.1 mg. Since I'm back home from the training I'm back to the 0.1 mg a day. And I think I've finally adjusted to that dose.
suboxdoc wrote:I always have to remind people --- the issue isn't 'getting off Suboxone'. The issue is recovering from opioid use disorder -- which for most people started with opioids other than buprenorphine.
I totally get your point and I agree with you. Yet my case is a bit different, because I was never addicted to heroin or oxycontin or something like that (even though I used them on occasions). For me sub is the most potent opioid I was ever addicted to. Yes, I was addicted to other opioids before sub, but those were less potent opioids like tilidin (I'm not sure, if you know that in the US, in Europe and especially Germany that's a big thing).

For me sub is my "drug of choice". It's the most potent opioid I was ever addicted to. For me it's not a medication to overcome more destructive opioid addiction like heroin or something like that - so in a way sub for me is what heroin is for some of you guys. (Which does not(!) mean that I think bad of sub, no way! I'm just trying to explain my personal addiction because it's obviously different to those of many other people.)

I also never got my sub from a doctor! All the years I bought it from a drug dealer. So for me personally it's not a medicine that "keeps me away from worse drugs" - no, sub is the drug that I was and still am addicted to in the first place.

I totally get that for many people sub is a life saving medicine which they will continue to take maybe for the rest of their lives. I get that! And I think that's a great option and I really think those substitution programs are extremely important!

But for me personally falling back to sub would be like for some of you falling back to heroin or something like that. Even though I totally get that sub isn't as destructive as heroin. I mean I experienced it myself: Sub didn't destroy me physically or emotionally, it would have been totally possible to just continue taking it for the rest of my life! That's not the point why I want to quit. The point is that it still took my freedom. My freedom of thought, my freedom of decision-making, my freedom of traveling the world etc. (Those are just a few examples, I have a lot of reasons why I want to quit sub.)

User avatar
suboxdoc
Site Admin
Site Admin
Posts: 1680
Joined: Sun Feb 24, 2008 9:03 pm
Contact:

Re: My journey towards freedom - slow liquid taper process

Post by suboxdoc » Tue Sep 07, 2021 12:58 pm

I understand. I have had a few others come in for help over the years with similar stories. Yes -- buprenorphine is VERY potent(!) I think people make the mistake of thinking that a tiny piece of a strip isn't a big issue.

As you suggested, addiction to buprenorphine is generally less destructive. There are several reasons for that... the slow onset time and the long half-life are probably the biggest factors. The cap on effect also plays a big role. More specifically, a person on buprenorphine has an opioid tolerance that is about the same as a person taking 40 mg methadone per day, and most people addicted to heroin or oxy have tolerances that are 2 or 3 times higher, or even more. The methadone program where I used to work now has no concern about their doses (I always worked to keep doses low), and they have people in their clinics on over 500 mg methadone per day.

At your current dose, don't you think it might be best to just dump any remaining buprenorphine and ride it out? If you were my patient, another idea would be to give you some clonidine and some clonazepam, then have you take 0.5 mg of naltrexone each day for a week. That would help to reset your tolerance and recover your natural opioid tone.

docm2
Long Time Member
Long Time Member
Posts: 710
Joined: Thu Aug 08, 2013 4:40 pm

Re: My journey towards freedom - slow liquid taper process

Post by docm2 » Tue Sep 07, 2021 2:57 pm

Regarding the .5 mg a day of Naltrexone; are you using a compounding pharmacy or having patients try and take just a crumb off a 50 mg tab?

walk_in_the_sky
Average Poster
Average Poster
Posts: 18
Joined: Sat May 30, 2015 4:27 am

Re: My journey towards freedom - slow liquid taper process

Post by walk_in_the_sky » Sun Sep 12, 2021 7:02 am

suboxdoc wrote:
Tue Sep 07, 2021 12:58 pm
At your current dose, don't you think it might be best to just dump any remaining buprenorphine and ride it out?
But why? What should be the benefit of that? What should be the benefit of tossing my plan out of the window - just a few days(!) before the planned jump date? After I prepared for this planned date for over 6 months?

Quitting sub isn't just about dosages, withdrawals and biochemistry etc. The much bigger part is psychological. You might think that at such a low dose as 0.1 mg I could just drop the sub right now as if it doesn't matter anymore. But of course it matters! I still take two doses a day, I still feel the sub, I'm still addicted. And the day, when I finally make the jump, isn't simply exchangeable. I planned for this exact date for months, so why the sudden rush just so close (days!) before getting there?

I really don't get that.

Throughout this topic I explained several times, how I'm planning to do the jump and why I want to quit the way I planned to. I thought about it a lot, I have good reasons for this approach and I think, it's a really reasonable and realistic plan. So why are you questioning it?

Jumping is a really big thing - mentally, psychologically, emotionally. Even at such a tiny dose! As I wrote before, there are several reasons why I decided to jump at that specific day. Because: Then my psychotherapy finally starts - which, as I explained at least 2-3 times, is a fundamental thing for me. I want and need the psychological support immediately after the jump. Besides that it's also about timing! I chose this date because it's the best option regarding work and private stuff. I don't want to have challenging appointments within my first days of sobriety! Etc, etc.

There are a lot reasons for this plan. And I really don't need anyone to question it without any need. And there is no need, because it's not that kind of plan that you need to talk someone out of.

walk_in_the_sky
Average Poster
Average Poster
Posts: 18
Joined: Sat May 30, 2015 4:27 am

Re: My journey towards freedom - slow liquid taper process

Post by walk_in_the_sky » Mon Sep 13, 2021 3:20 am

Day 1.

walk_in_the_sky
Average Poster
Average Poster
Posts: 18
Joined: Sat May 30, 2015 4:27 am

Re: My journey towards freedom - slow liquid taper process

Post by walk_in_the_sky » Tue Sep 14, 2021 2:38 am

I made it through day 1 + night 1. Yesterday was tough. The first day without sub after 8 years of daily use was a regular working day, but I decided for this consciously because from previous withdrawals I know that it doesn't help me to sit home alone and focus on every withdrawal symptom. So I decided to stay busy and just work while going through day 1.

It was an emotional roller coaster, I thought of it as "emotional tourette". Because my emotions changed so quickly and intensely. One minute I felt completely insecure and anxious and the next moment I smiled and laughed uncontrollably. One minute I felt completely socially awkward and "afraid of people" and the next moment I consciously went to colleagues for a chat.

The night was bad. After 1,5 - 2 hours of sleep I woke up and after that it was a gnawing on-off sleep with a lot of sleepless rolling around, completely insane dreams and a lot of muscle pain.

Now I'm starting into day 2. Later this day I have my first psychotherapy session.

Post Reply