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What is Suboxone?
Suboxone is a medication that is federally approved for opiate detox. So many people are always asking me two questions. What will be my dose. And how long will I be on it.
A good approach to both questions, how much Suboxone to use, and predicting within reasonable limits how long an opiate dependent patient will be on it.
While there is very little medical literature to answer these questions, I here present opinion heavily influenced by federal guidelines and exiting success stories of patients of mine that I’ve completely detoxed from opiates using Suboxone.
How Much Suboxone Do I Need?
“How much Suboxone will I be on“ is the question I always get at induction to Suboxone, always at the first visit.
That depends entirely on your doctor and how correctly he or she induces this substitute opiate for your opiate or opiates of excess use or abuse or addiction.
In general, we are trying to find a dose that makes you feel about 85% normal. If you go much higher than that, that will be all the more drug that you have to come off from completely following induction, following some months of maintenance, and when you start detoxing from this drug. After all, that is the plan. To detox from opiates using this drug, Suboxone.
If you start on too much, that will be harder to come off it. If you misdose it, it will be hard to get off this medication, too.
Induction (i.e., finding your correct dose)
There are two main ways to find the correct dose of this medication.
One, your physician can guess based on your previous use and history what your dose will be. At follow up 2–4 weeks later, that dosage can be adjusted, Usually up, but often times down. And you can help with this guesswork. You may know what has worked for you because you may have been on it before or you may have borrowed it off the street. I am of course not encouraging to ever borrow off the street. But this is what patients do in their attempts to discover something to get them off opiate addiction. As long as you present to a physician and fully disclose everything you’ve been doing, right and wrong, you can help yourself.
NEED HELP WITH OPIATE ADDICTION?
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What is the Starting Dose of Suboxone?
A usual starting dose will be anywhere between one and three Suboxone 8 mg tablets or FILM (or subs off equivalence or Univel equivalence). And this buprenorphine does must be a single those first thing every morning only.
some patients, especially those that have injected high doses of hair went, would benefit from as much is 4.5 Suboxone 8 mg per morning. Unfortunately, many states have made doses higher than two or three Suboxone 8 mg per morning illegal. So, we all have to abide by their loss. The medical literature backs up the use of 4.5 Suboxone 8 mg as a maximum acceptable does. Insurance companies even cover these higher doses. But again, we have to abide by the laws of certain states if we are practicing within them.
Back to finding the correct dose of Suboxone in the process called in duction, usually taking less than one month.
When I said above “misdose it“, I was referring to patients that use this medication two or three or four times daily, often times with a physician’s order. That is completely wrong. That leads to Suboxone addiction. Such addiction will make it very difficult for you to come off Suboxone when you are beyond induction, beyond maintenance, and, as stated above, ready to start detoxing off this medication in the process known as tapering.
Maintenance and Tapering
“How long will I be on Suboxone“ is the question I get often when the medication is being started. Very little medical literature exists to answer this question.
I’ve come up with a bit of a formula to help guide predicting how long this will be.
This is based on the lengths of stay on Suboxone as generally experienced by opiate dependent patients I have treated.
Induction, finding the correct dose of Suboxone, it’s supposed to take under a month. It often times takes much less than that. So that’s one month.
Then, the federal recommendation is that you be on maintenance for at least three months. So, that’s three months. More.
So, then comes the calculation on how long you’ll be on it after induction and after the three months of maintenance, so after those 3 + 1 = 4 critical months.
As long as there are not any other significant comorbidities like chronic pain, major depressive disorder, or chronic anxiety, the length of stay on this drug is roughly a month per year of opiate abuse.
Examples. The patient that has abused opiate for 12 months. So. One month of induction or less. Three months of maintenance or more. And, for each year of opiate abuse, one month of detoxing or tapering, a process of lowering doses until you completely come off this medication. So. For this first example, 1 more month after maintenance. So, for this first example patient, 1 + 3 + 1 = 5 months. If you are motivated and your physician is doing his job, this patient should be off all opiates using Suboxone as your detoxing agent in a period of five months.
Long Term Opiate Abuse and Suboxone Treatment
Another example. You have abused opiates for 10 years. One month of induction. Three months of maintenance. 10 months of lowering Suboxone doses (1 month per year of abuse). So, 14 months that you would be on Suboxone.
These are all extremely rough guidelines. They would be severely affected by comorbidities.
General guidelines is what they are.