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How long should someone stay on Suboxone/Subutex?

Written and emailed to us by an anonymous viewer of this site

      

"Not unlike any other disease, you should remain on the medication as long as it is needed and is effective in treating the disease.  This could be months, years, or indefinitely."  NAABT Brochure.

 

From reading the various web boards I've noticed a pattern of people who take Suboxone for a short time have poor results, and people who take it for a longer time have better results. This is true with other treatments as well. A general rule is; "it takes as long to get out of an addiction as it did to get in to it." That's years for most people. The problem with short treatment periods is although the physical dependence is gone all of the habits, friends, problems that were part the whole addiction package are still there.

 

The beauty of Suboxone is that it allows you to feel normal and gives you the ability to fix the things in your life that contributed to your addiction and will prevent you from staying clean later. You can get a job, move, buy a car, find new friends, repair damage to family relationships, and start a new lifestyle that does not include drugs. Then once all that is done, you no longer need the Suboxone you can begin to wean off it. The most recent studies report reducing no more than 2mg./month and if withdrawal symptoms start then go back up 2mg.

 

Unfortunately, some drug help groups frown on medication and compel people to discontinue before they have their lives in order. Also since there is a 30 limit per practice doctors tend to cycle people off treatment prematurely in order to help more people.

 

Buprenorphine (the active ingredient in Suboxone) has shown, in studies, not to produce a physical tolerance in people. That means you don't need more and more as time goes on like ALL other opioids. It also means that once you reach the ceiling of the dependence you do not become more physically dependent if you take it longer.

 

Most people have the best results if they stay on it as long as it takes to get their life back in order. This could be 6 months or 6 years depending on how fast they can rebuild and how big a mess they made of it.

 

Some people choose maintenance. This is when they take a small dose for a long time, to prevent relapse. 2-12mg. is the daily maintenance dose. Even a low dose suppresses the cravings and allows someone to carry on a normal life.

 

I think the minimum treatment would be 7-8 months. That would be 16mgs for 2 months, 12mg for one month, 8mg for 1 month, 6mg for 1 month, 4mg for 1 month, 2mg for 1 or 2 months, then 2mg. every other day or every three days until the patient feels comfortable in stopping. If withdrawal symptoms occur at any point go back up 2mg. for a couple weeks. I know several people who took this approach and are drug free now and did not feel any withdrawal, except some difficulty sleeping for about a week at the end. These individuals were professional people with good jobs, families and a short history of pain pill abuse.

 

People who try to do it in one month or less tend to have lower success rates.

 

Written and emailed to us by an anonymous viewer of this site

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