9 Things You Should Know Before Taking Suboxone/Subutex

“I will never be clean.  I will never have a day that I don’t struggle.  Treatment doesn’t work.  Nothing works.”

—My patient prior to treatment. (Now clean and sober for several months since)

 

First things first.

How many people have died?  How many slaves to opiates?  How many with broken homes and hell on earth?  Too many, that’s for damn sure.

Luckily, there are now medications that can really make a difference in someone’s life.  Medications that help with withdrawal, cravings, and relapse.

Suboxone/Subutex is not the cure-all.  But it’s not snake oil either.

In case after case, I have seen people turn their lives around.  And if you are reading this, then maybe you are next.  Maybe today is the day.  The new day.  Your first day of a new life.

Now, let’s talk a little about some things you should know about a medication that could save your life:  Buprenorphine.   From here on out, I will refer to it by it’s commonly used names Suboxone or Subutex.

9 Things You Should Know Before Taking Suboxone

1) You need to be in withdrawal

Withdrawal sucks.  It is painful and often the largest hurdle for those trying to escape their addiction.

You need to be in withdrawal from opiates before starting suboxone/subutex.  Somewhere between 24 and 72hrs without any opiates will likely be enough.

Why is this necessary?  Because subutex will preferentially bind to the same receptors opiates bind to.  If you aren’t in withdrawal, it will push you into withdrawal and you will feel worse.

Many people have headaches and nausea when starting suboxone/subutex and it is often because they are not in deep enough withdrawal when starting.

2) Taste, Constipation, and Headaches

No medicine is without side effects.

These are probably the most common side effects/complaints that I have heard.  But there are others, so talk to your doctor and educate yourself.

It tastes horrible

There are different methods for taking buprenorphine: Patch (for pain), injected under the skin (for those already stable on sublingual form), absorbed via the buccal mucosa, or absorbed sublingually (under the tongue).

Most people that take Suboxone will take the form that dissolves under the tongue.  And I am told, it tastes horrible.  So be warned.

Here’s the other thing:  After taking your Subutex, it’s probably best to wait 15-30 minutes before eating/drinking anything.

Constipation

If you are taking opiates, then you probably already deal with constipation.  You may want to try increasing the fiber in your diet and/or some over the counter stool softeners.  Try to stay away from laxatives or enemas unless symptoms are severe.  Always tell your doctor if you are having problems.  Your case may be different.

Headaches

The headaches could be a side effect of medication or a consequence of not being fully in withdrawal when starting treatment.  If withdrawal is the case, then the headaches should get better after a few days.

Remember: Always tell your doctor if you have side effects.

3) There’s no easy way

You already know this.  But there’s no easy way.  No perfect way.

Suboxone/subutex can lead to dependence issues just like opiates.  And if you stop Suboxone cold turkey, you will have withdrawal.

4) Opiate dependence vs Chronic pain

You should know the difference.  And have an idea where you fall.  One or the other or both.   Suboxone/subutex are indicated for opiate dependence and not chronic pain.  (But buprenorphine has been approved for the treatment of chronic pain in other forms of medication.)  So take that information for what it’s worth.

5) Benzos (xanax, klonopin, valium, ativan, etc)

Taking suboxone/subutex with benzodiazepines or other CNS depressants should be avoided if at all possible.  There is increased risk of sedation, respiratory depression, coma, and death.

But here’s the thing.  If you are taking 200mg of oxycodone a day along with benzodiazepines, then you are at increased risk for this already.

So you have to weigh the pros and cons.  If you aren’t abusing benzodiazepines, then there may be a safe way to dose your medications.  You just need to talk to your doctor.  Hiding benzodiazepine use is not helpful or very smart.  Be honest and hopefully your doctor and you can come up with a solution.

Most doctors feel the benefits of Suboxone treatment outweigh the risks of not treating just because someone is still taking benzos.

6) Take your medication as prescribed

Self medicating is at the heart of addiction.

Maybe there was a time you were just trying to fix the pain. Or maybe you just needed enough energy to get through another grueling shift at work.  Or maybe you were trying to forget about your problems for a few hours.

Whatever got you here, it’s now time to make some changes.

Understand your body and be proactive in your health.

Find a doctor that you can talk to and work with.

Think long term and look at the big picture and do not take more of your medications than prescribed.

Here’s what seems to happen.  People get anxious or fatigued. So they take an extra strip/tab here or there.  And then they start to run low.  So by the week before their appointment, they have to decrease their dose to get by.

This constant flux is not good.  You need to find a stable dose and learn to deal with the fatigue and anxiety.

Addiction isn’t just about bad choices but at the same time, you have to start making better choices.

So take your meds as prescribed and talk to your doctor if you think something isn’t working.

7) Everybody is different

There is no ONE RIGHT WAY.

In other words, what works for you may not work for someone else.  You may require a different dose.  You may not need to stay on treatment for long or maybe you will need maintenance therapy for years or even for your lifetime.

There are going to be people that criticize you.  This is a fact.  If you take medications to help you, there will be some people that think you are taking the easy way out or that you are not really clean.  This is a load of crap.  You have to do what is best for you.

Your path is yours and yours alone.  Walk it wisely.  And don’t worry about what everyone else is doing.

8) Point your life in the direction you want to go

Suboxone/subutex is not the answer to all of life’s problems.

I have written a lot about this.  No need to beat a dead horse.  Getting clean is just a part of the life you are building.  You need to make it meaningful.  You need a life worth living.

You do this by starting with something small.  Something you can control.  Something you can do that will make a small difference.  I have written about cleaning out a closet.  Psychologist Dr Jordan Peterson recommends cleaning your room.  The idea is take a small area of your life and make it just the way to you want it.  When you do this, it starts to spill over to other parts of your life.

You don’t have to be perfect.

Just do something.

9) Hope

Addiction is a demon with many heads.

There will be times you feel it has the best of you.  Don’t give up!  It’s the fight that makes the difference.

Some people define success in a way that is unreachable. In other words, they design a life in which they will always feel like a failure.

What is success to you?  Is it being off drugs?  Is it being off Suboxone or other medications?  Or is it having healthy relationships, a stable job, and a purpose in life?

Think past the drugs and define success with what you really want and in a tangible way.

Don’t just focus on goals.  Think about your values.  What you hold to be true.  And what you want your life to be about.

Hope is a weapon.

And in this war…..you need all the weapons you can carry.

 

p.s.

I wrote a book of devotions, but it’s not a normal book of devotions.

It’s not theology. It won’t cure a disease or get you into heaven. I’m not a theologian, preacher, teacher, or any one else with qualifications to write such a thing.

The book isn’t for baptists, methodists, catholics, calvinists, dunkers, or sprinklers.

It’s for misfits, pill heads, lawyers, prostitutes, junkies, manic depressives, shut-ins, zealots, anarchists, tax-collectors, thieves, and insomniacs.

In other words, it’s not for those that have it all figured out.

It’s for the rest of us.

The ones looking and searching.

The ones that know HOPE is the most dangerous idea of all.

You can pick up a copy at Amazon.

p.p.s.

Looking for a doctor or counselor? Give us a call 662-322-0996

p.p.p.s

This article was meant for general information.  It is not intended as medical advice.  Don’t get medical advice from the internet.  Go see a doctor.

 

 doctor on the phone

 

 

clp Written by:

48 Comments

  1. Teresa
    June 13, 2018
    Reply

    This article really helped
    Me to feel better. I signed
    Up for your newsletter.
    Thank You!

    • clp
      June 18, 2018
      Reply

      Thanks for the comment! Good luck with your journey. I know you will do great.

      • Sandi
        November 11, 2018
        Reply

        Hi,
        The old saying I’m asking for a friend but I really am asking for a friend LOL. She’s on Suboxone and wants to take a Percocet would she be okay? I just worry about her.

        • Sandi
          November 11, 2018
          Reply

          Please don’t ask me why she wants to take a Percocet because I have no clue but I’m pretty sure she’s in pain if she wants to do that. She also has chronic pain. My heart goes out to her.

        • clp
          November 12, 2018
          Reply

          She should talk to her physician before taking something like that. Some people on medication assisted therapy will need pain treatment (in rare situations such as surgery). But just taking something every now and then because of general pain is typically not considered a good idea. She should always discuss with her doc before taking a new med and not take meds that aren’t prescribed. Thanks for the question

  2. October 7, 2018
    Reply

    I’m at a crossroad once again dealing with this opiate addiction. You really brought up some good points and basically helped me get to an understanding of why I’m even looking thru this information. I have an addiction but still desire that better quality of life. Instead of the ups and downs, I think I’m going to do the subutex therapy and then one day get off slowly like I have already done once with methadone.

    • clp
      October 8, 2018
      Reply

      Good luck! Let me know if I can help

      • Richard
        January 1, 2019
        Reply

        Man ty. I am a vicious opiate addict since they started me on painkillers in 2007 due to spinal stenosis and a severely herniated disc in my neck. I have tried and tried to stop taking them but they pull me back like a chain wrapped around my neck bc I have chronic pain and anxiety. Everyone’s demonizing this drug to me for years now. I have an appointment on the 9th to hopefully start subutex therapy. To hell with those people I don’t want to hurt my family especially my mother anymore. God bless you

        • clp
          January 2, 2019
          Reply

          Of course, I can’t say that it will help you but I have treated many people with chronic pain issues and using buprenorphine to get off the opiate roller coaster was a life changer for them. Good luck!

  3. TooWanda
    October 16, 2018
    Reply

    I imagine I’ll get some negative responses, that is if anyone cares. Or maybe not
    I’ve been on Suboxone since 2011. I felt I’d rather have to take this everyday than doing things illegal to get my next fix.
    What I didn’t account for was my chronic depression getting to the point my dosing went up and up as Suboxone has antidepressant properties. At this point I was on 12mg. Working with my doctor I went up to 30mg. I don’t remember how long it took to get to that dosage.
    Two years ago I went for ECT. It helped for a.while. My depression is once again so bad I need to get more ECT or maybe MST. I still am taking 28-30mg a day.
    I don’t know if I will ever get off Suboxone completely. My hope is these treatments will help and eventually get down to much lower dose.
    I feel like I’m alone taking this much. Am I?

    • clp
      October 16, 2018
      Reply

      I personally don’t treat over 24mg/day but I know some doctors will occasionally do that if they feel the patient needs a higher dose. I know a lot of folks that require the 24mg/day dose for extended periods of time so I don’t think you should feel alone. People get bent out of shape about high doses but the key is staying sober and getting the help you need. Good luck with your depression treatment. Don’t ever give up!

    • Kym
      November 6, 2020
      Reply

      I take 7 8 mg doses. I feel like a zombie and cry constantly and feel super insecure

  4. Tylergrace
    December 28, 2018
    Reply

    I just begun my treatment yesterday with suboxone , I’m addicted to herion. I’m prescribed 8mg/2mg every eight hours. I have high hopes that I will kick my addiction and also be able to kick the suboxone. But I had a question and know I should probably ask my dr. But it’s worth a try. If I take my next does but I’m not feeling the withdraws after the recommended eight hours will the suboxone kick in those bad feelings of with draw after administering the second does?

    • clp
      December 28, 2018
      Reply

      Congratulations! Getting off heroin will be the best decision you’ve ever made. The first few days of Suboxone can be tricky and if you aren’t in withdrawal when starting, it can precipitate withdrawal. That being said, if someone feels ok with the first dose, then they will most likely feel fine with the second dose. The idea of Suboxone maintenance is to not feel withdrawal or severe cravings once on a steady dose. Obviously everyone’s case is different and I can’t give you specific advice. I hope this helped. And good luck!

  5. Lisa Mann
    February 14, 2019
    Reply

    Thank you for the article. I have a question. I’ve been on Suboxone 8mg for year or more and recently my doctor switched me to subutex, well the generic, due to the high cost of Suboxone. I wss really struggling to pay for my scripts. It’s a shame cause Suboxone is very effective for me. Up to a couple months ago I was getting my Suboxone at a free clinic but I can’t do that anymore. Anyway my question is the subutex is making me feel weird. Almost like when I took to many oxycodone pills when I was using. I feel tired, a little drugged, spacey, and slow and sluggish at work. Why is this? Will this go away in few weeks. Suboxone made me feel like I had lots of energy focused even clarity crystal clear. Thank you.

    • clp
      February 14, 2019
      Reply

      Sometimes different meds, even if supposedly an equivalent dose, can affect you in different ways. I can’t give medical advice over the internet but I’d recommend you talk to your doctor and get checked out. It may be that the dose is too strong and needs to be reduced or there may be something else going on. Hope this helped. Good luck.

  6. David J. Vinzant
    February 17, 2019
    Reply

    Bro….,……… just got out of the joint…… 16 years…… 4 months….. 22 days….. absolute incomprehensible, unfathomable hell….. I WISH THAT SUFFERING ON NO OTHER BREATHING ORGANISM IN THIS EXISTENCE. I shot dope over half my life…… no exaggerating….. no BS….. I’m 49 today and I’m 100% FREE in many many different aspects of the word. I read every single thing posted on here….. by you and all the people that replied to you………
    I will post this and hope that it gets inside the person who needs it…..

    Addiction……. is darkness…… there is no light….. it is an all consuming darkness.
    Those who do not survive it…. get lost in the darkness, never to be seen again. Those who do survive it will comprehend and understand what I’m saying here. You have to look, search, locate, find, grab, hold, the part of your life you never want anyone to know about…… get hold of it….. bring it to the surface…….. to the light…… once you have done that…… your journey will begin. I’m speaking from experience people…. if you want to live…. not simply be alive, but really really LIVE….. then you grab that part that you’ve kept hidden….. you’ve kept covered up and called something else….. get it up to the light and go through the pain…. suffering for a few days or weeks will not be as bad as suffering for the remainder of the awesome life that’s been patiently waiting for you to find your way out.
    I’m a demond that gave the evil up…..

    • clp
      February 17, 2019
      Reply

      Wow! Thank you so much for sharing this. It will change someone’s life for the GOOD!

  7. Scott
    February 21, 2019
    Reply

    I am currently tapering off suboxone very slowly, this is my 10th year on the drug. I have been compliant with the program I agreed to with my doctors, I just got down to 1mg. I plan to stay here for a bit. so far I haven’t had too many bad withdrawal symptoms. the first time I tried to taper off I got to alternating days with 1mg and got quite sick, and had to reboot to 4mg. now back to 1mg i feel fine. I have always had health coverage that paid for this, if I had to pay out of pocket I wager I would be off it already. I concur with you that this can be a life saver, it was for me. And its easy to let the time slip by. The main reason for getting off of it now is because i travel a lot, and for months at a time. I have kept the 4mg dose for this reason, and am able to take less when traveling to make it until i return. My doctors have so far been agreeable to this situation. but I would like to be finally be free of this habitual substance now. I will say for me, I have not experienced many bad side effects from suboxone. only when withdrawing from it. I kicked methadone cold turkey once in a county jail. I dont think I slept for 3 weeks. You would think that would be enough to quit. but that aint how addiction works! So to my quick question. I believe i read that the only hepatotoxic compound in suboxone is naloxone. and since we dont absorb it much if at all, suboxone should not lead to liver problems. but I do know there is a warning on the box, and they do check my liver every year, or they are supposed to. Do you know if this is true, that it is only the naloxone that is toxic to liver? And if so, does that mean subutex is not hepatotoxic at all? Thank you, and thank you for your work and your blog.

    • clp
      February 21, 2019
      Reply

      There have been some reports of liver disease with buprenorphine. (It appears these are mostly in conjunction with abuse of medication such as intravenous use) In general it is considered “safe” and is often used with patients that have active liver disease such as Hepatitis C. That being said, routine labs are a good thing.

      https://livertox.nih.gov/BuprenorphineBuprenorphineNaloxone.htm

      Thanks for the comment!

  8. February 22, 2019
    Reply

    I guess I was supposed to find this blog to read as I have FINALLY just received my script for Suboxone! And needed some reassurance. I’ve been using pain meds(and on/off again heroin) for close to 35+yrs. I’m a chronic pain patient. It makes me sick to think of all the time I’ve wasted being involved with meds/drugs! I was on Suboxone about 2 yrs. ago and it gave me my life back. I felt the best I’ve been in 20yrs. I slowly titrated myself off the Suboxone with NO withdrawals at all. Things we’re going very well. But, I agrevated my condition that started this mess and started to use “just a couple” of Vicodin. VERY quickly became addicted again. I had such a hard time finding a Suboxone prescriber. I begged for help! BEGGED! And I was turned away with b.s. excuses or just never returned my calls. FINALLY I got to a Dr. that helped me today! I wanted to break down a cry when he handed me the prescription. I then went to 3 pharmacy’s that did not have it in stock!! I felt like, what the hell is going on! The opioid crisis is REAL for sure. But if addicts can’t get opioids (legally) and then can’t get subs for help!! I was white knuckling it and so close to going for heroin. I was able to get three days of Suboxone. I still have to find a pharmacy tommorow to fill my months supply. I don’t want to do this shit any more. Just wanted to say thanks for the support 😊 I wish everyone success. Keep asking for help.

    • clp
      February 22, 2019
      Reply

      I’m glad you found a doc that could help you. Some pharmacies may not have med in stock but will order it for you (may take 24-48hrs to get in) and some pharmacies won’t help you. I’ve found small town “Mom and Pop” pharmacies to be the best and large chain (cough, cough…walmart) to be the worst. Good luck and stay strong!!

    • Leigh
      February 28, 2019
      Reply

      Walgreens will order it for you if they don’t have it in stock, and they usually don’t have a lot in stock. So, what I do is call the pharmacist and let him know a couple of days before I drop off my prescription so they can order it if they need to. Now this is ONE Walgreens, not every one is the same. Everyone there is so helpful, friendly, and the best thing is I’ve never felt judged like I have at other pharmacies. I hope you find a good pharmacist, and staff whether it’s at a Mom & Pop or a chain. Good luck! I would love to know how you quit Suboxone with no withdrawal, I’m tapering off now but seen to be stuck at 8mg a day. I’d love some advice, thanks!

  9. Cory hudson
    March 19, 2019
    Reply

    Dr. Park, firstly I want to thank you for being an advocate for buprenorphine assisted treatment alongside other elements to aid in recovery as well. I’m on Suboxone film myself and have maintained sobriety over 2 yrs. However, when first starting I wasn’t educated on benefits vs risks, a furthered treatment plan besides just Suboxone, or even self help meetings. I thought taking a little gross tasting orange pill 1 or 2 times a day would miraculously solve all my addiction problems. I couldn’t really have been much more wrong or nieve than I was back then. Due to a large number of addicts on Suboxone who share the same thought as I did, along with those who abuse it, or who have a prescription for the wrong reasons Suboxone has a negative stigma and bad reputation and it’s truly unfortunate because it can help save lives. Myself and some others who are alive today thanks in large part to Suboxone advocate as best as we can, like most others who had success with this medication. It’s always encouraging when I see/read about medical professionals that are advocates themselves when it’s used properly. It’s got a better and more profound impact coming from an MD than from recovering addicts alone. What you’ve done here WILL 100% save lives and help to disprove some of those afformentioned negative sterotypes plaguing the recovery community as a whole. Sorry for the long winded post but I had to thank you for what you’re doing and share my positive and life changing/saving experience on my road to maintained recovery with the help of proper Suboxone use. Thanks again

    P.s., to those out there on the fence and unsure if Suboxone could help you with your opoid dependence struggles. Talk honestly to your Dr, good physicians aren’t medication police, and won’t criticize you for suggesting it and wanting to try it. If for some reason they do, find a better physician, one with experience in the field of addiction treatment. They’re out there, but you have to put the work in and be straight, upfront, & honest

    • clp
      March 19, 2019
      Reply

      Thank you for sharing your story and for the kind words! It means a lot.

  10. Rahul
    June 13, 2019
    Reply

    Hi doc i am from india i want to tell you that I am currently on bupernorphine for heroin addiction . I am using 2mg a day from last three days . All my withdrawals has been diminished .i feel good but i am not been able to eat att all my appetite has been gone since i am using it. I want to let you know that my heroin addiction was to so severe but for my avoiding the unpleasant withdrawals i have to take an substitute. But i was not aware that bupernorphine withdrawals are also same as heroin am i little bit afraid now because my doctor who prescribed me does not told me this thing. I am now want to slowly tapper off bupernorphine aswell so i want help from you doctor please tell me how should i do it .Currently i m taking 2mg a day half tablet during day and half before i go to sleep. Please tell me how to do it as soon as possible as i fell very nauseous after taking it. I seriously want to get of bupernorphine but without facing the withdrawals plz help.i m dying to get ur valuable reply opinion on my situation

    ThankYou Sir

    • clp
      June 13, 2019
      Reply

      Congratulations on stopping heroin! Never go back. Keep pushing forward and you’re going to have an amazing life. Check out my Youtube videos, I have several that talk about how to taper. Go slow with the taper and you shouldn’t have withdrawal. Good luck brother!

  11. Steve Jensen
    June 13, 2019
    Reply

    Dr Park, I think it is amazing how you go out of your way to help people that are in the misery of addiction, you are a great man and thank you…
    I have a question that I am hoping you could help me with…
    Unfortunately fentanyl pills are rampant in Arizona (and all parts of the country) and many people are using them since they are cheaper and more powerful than the usual opioid pills. I have had a few people tell me that when trying to come off of the fentanyl pills they are using Suboxone/Subutex and neither of them are effective at taking away the withdrawal symptoms. This is even after waiting 12+ hours after the last dose of fentanyl in order to prevent precipitated withdrawal. Have you heard of this issue from other people and should Suboxone/Subutex actually work for fentanyl withdrawal? Is it possible the dosage isn’t high enough or could there be any other reason?
    I am a graduate student for addictions counseling and this is something I would like to better understand, Your insight and response would be greatly appreciated!

    • clp
      June 13, 2019
      Reply

      That’s a great question. There is some concern about the way fentanyl binds and that it could be more difficult to treat. That being said, Suboxone can still work for people. It just might take more time and possibly a higher dose. I will normally wait at least 24hrs from last dose of fentanyl, then start micro dosing Suboxone. Up to 16mg the first day. Some people may require up to 24mg. This is a patient to patient basis. And it sometimes takes a few days to fully stabilize with medication assistance. Good luck with your training. We need more folks like you in the fight.

      • Steve jensen
        June 14, 2019
        Reply

        So suboxone is the preferred way of treating fentanyl withdrawal? Do you see a lot of patients and have any experienced what I described? Thank you!

        • clp
          June 15, 2019
          Reply

          Yes, Buprenorphine tends to be first line treatment and in my experience works well.

  12. Steve jensen
    June 14, 2019
    Reply

    That will be my last question on the topic 🙂 thanks again.

  13. Heather
    July 15, 2019
    Reply

    I am having a minor surgery today on my back and used only a very small amount of suboxone yesterday morning (I tried to quit the past 3 days and felt too sick so I broke down and took a quarter of an 8mg strip… I usually take 8 mg a day) They are putting me under a twilight anaesthesia. Do you know if it will still work on me?

    • clp
      July 15, 2019
      Reply

      Most recommendations are to continue the Suboxone and not stop it or possibly just lower dose depending on situation. Obviously talk to your doctor because your circumstances could be different. Here’s a link to a video I made about surgery. Good luck with everything. Will be praying for speeding recovery!

      https://www.youtube.com/watch?v=ojQoYmJuXiM

  14. August 26, 2019
    Reply

    It’s interesting that you need to be in withdrawal from your opioid addiction for suboxone to be useful for you. My brother has a problem with heroin use, and I want to make sure that he can get clean. I’ll share this information with him so that he can look further into his options for entering withdrawal and then starting the use of suboxone.

    • clp
      August 26, 2019
      Reply

      The reason is because the Suboxone will preferentially bind to the opioid receptors and if you aren’t in withdrawal yet…you will be. That is caused precipitated withdrawal and it can be severe. Sometimes patients mistake this for side effects from the Suboxone and don’t continue treatment. A good rule is 24 hours off short acting opiates and 48 to 72hrs off methadone. This varies from patient to patient though, so he should discuss with the physician. Thanks for the comment and good luck to you and your brother!

  15. mike persan
    March 20, 2020
    Reply

    thanks for the words of truth. GOD rules and you have wisdom. it is great how you said the thing about stigmas. those who don’t abuse medicine don’t have anything to worry about. I take butro and it does not hurt, rather helps. people don’t get it cause it used to be the norm to call an addict a moral failure. id love to help anyway I can for those lost. im disabled mentally but I don’t think it makes me any different. to everyone out there struggling; I think your worth it. posts like these are what id love to do but im computer illiterate for real. but I need to keep helping me and espessially others with addiction or ANY other signifigant problem. GOD bless you. yea, you! have a good one, mike p

    • clp
      March 20, 2020
      Reply

      Thanks for the comment and keep up to GOOD work Mike!

  16. LVM
    April 24, 2020
    Reply

    Hi Dr Park,
    I have seen your YouTube videos while researching and learning about Suboxone. I just now found your blog. Thank you and I love your faith insights coming from a fellow believer!
    Briefly, heres my story and eventual question. I am a chronic pain patient. Have been on OxyContin and Percs for 10 years (dose recently as high as 130mg/day), I’ve had 10 orthopedic surgeries, etc in this time. But, I’m tired of the developing tolerance and they are becoming less effective as time has gone on. They feel like a ball an chain on me now. I hate the stigma, frequent urine tests, and the up and down feeling all the time, etc. I have never dabbled into any illicit drug use and frankly I wouldn’t even know where to look to find any, lol. At the end of 2019, I decided that 2020 was the year to get off Oxy and onto Suboxone! My PCP has a partner who is wavered to prescribe Suboxone so I started seeing him. To prepare to make the transition he has had me wean off the OC as well as cut down the IR Oxy use. I now am now on 50% less oxy (around 55mg/day) than I was before (which I never thought I could ever do)! . AND, this taper happened all during this “lock down”. What a blessing and a God thing! I would have never tolerated trying to live a normal life with normal demands all the while weaning to less than 50% over 30 days. Anyway, here is my question. My Dr has said that Subutex will not cause PW (but Suboxone will). He said I can continue my oxy doses throughout the day and then at the same time take a Subutex dose to replace one oxy dose a/day. Then the next day 2 of my daily oxy doses will be substituted with Subutex. And so on until I replace all oxy doses with Subutex. He said it will be like escalators in the mall…the oxy will go down while the Subtext goes up over the period of a few days. He also mention something about micro dosing. Taking Subutex while still on Oxy goes against most all of what I have learned and read. There are so many opinions out there! I am just deathly afraid to do it and be thrown into PW! At the same time I don’t want to do my own thing behind his back either. So, first, what is your opinion of being put on micro dose of Subutex while at the same time being on approx 40-50mg of Oxy/day? If this is not a good idea, meaning it will put me into PW, how do I respectfully tell my Dr that he is wrong? As a Dr I thought you could help me with how to do this. Right now we are doing video visits and emailing back and forth. I hope all this makes sense to you and thanks for putting great content out there for us!
    God Bless you

    • clp
      April 25, 2020
      Reply

      It is possible to take some amount of opiates with buprenorphine and not experience PWD. The key is in the transitioning and if your doctor has done this before, then I wouldn’t worry too much about it. No matter what method you use to start, often there are a few days of headaches and nausea. This tends to get better quickly. I think you made the right decision changing from opiates to subutex. Good luck and let me know how it goes.

      • LVM
        April 25, 2020
        Reply

        Thank you so much Dr Park! I feel a lot better now! I will let you know how it goes.

      • LVM
        May 4, 2020
        Reply

        Well, the transition to Subutex went great! NO PWD! I took my first dose of Subutex (4mg) about 6 hours after I had an early morning Percocet. I took a few more Subutex doses (4mg) later in the day for a total of 12mg Subutex on day one. I felt great the entire day! I did have a little bit of nausea and mild headache as you mentioned the first few days. I am to continue a morning dose of Percocet for a few more days then off completely. Then the plan is to switch me over to Suboxone as I have better insurance coverage for Suboxone compared to Subutex. I am so happy I made this decision. It truly is going to be life changing for me.

  17. Johnna baker
    March 6, 2021
    Reply

    Ty for this video I am on suboxone and needed to hear this. You made me feel good and understand more about my disease.

  18. Terie Jo Walker
    August 2, 2021
    Reply

    It is 17 hours since I last used. I have my suboxone strip ready. I am going to wait 24 hours because I have had 2 instances of precipitated withdrawal. I have no words to describe the hell that was. If you’ve been through it, you already know and if you haven’t, you wouldn’t be able to imagine it. I just wanted to tell someone that I’m trying to make a change, and I could use any and all encouragement. Thanks for reading this.

    • clp
      August 3, 2021
      Reply

      Good luck to you and congratulations on the first steps to a new life!

  19. Garry
    March 21, 2022
    Reply

    On 4mg of bup.daily,after 20 years of 150mg daily of 10 mg Percocet and 40mg of the old school oxy,I can function but am at about 50% of feeling ok,need to get to at least 80% feeling good,I was thinking of doing
    supervised mushrooms or LSD,I’ve had it,I’m healthy for 61 and all I’ve been through,I can handle it, please let me know how can I do thi

  20. Taylor
    October 14, 2022
    Reply

    I’ve been struggling a lot recently trying to get off suboxone and transition back to my natural neurochemistry but haven’t been able to achieve zero dose. After much contemplation my heart is continuing to urge me to pursue this goal as I feel it is integral to my spiritual development. I am wondering in your experience what the best way to go about this is? Any help would be greatly appreciated

    • clp
      October 18, 2022
      Reply

      I have videos on YouTube discussing various methods of tapering but you should not attempt making any changes without the direction and advice of your physician. Talk to your doctor first and begin to formulate a plan. Remember, “success” has nothing to do with being on medication or off medication. Nor how quickly one goes about it. Tapering often takes years. The important thing is you are clean and healthy. Good luck and keep posted on your progress!

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