Buprenophine Taper

Buprenorphine Post
Posts: 1

Re: Buprenophine Taper

Postby George » Sun Apr 07, 2019 11:45 am

I have found after 3 years treating severe street users of Opioids that 3 months only of Suboxone is not near long enough for heavy users! I follow the advice of experts that a user must be stable in all aspects of their life and that is possibly several years to life time usage! I would rather check urine for usage and prescribe monthly than loose touch with patient. Using generic now makes it much easier to use and know what the patient is doing! I have not seen a user ever get off using Suboxone in 3 months! If tapering I will do a 6 month taper jumping back to last higher dose if they have any issue at all that would lead to use of street drugs again. I would rather be prescribing Suboxone than have a user go back to the streets again.

Suboxone in my hands is a wonderful treatment for heavy street users. Make sure the user is not thinking they must stop the Suboxone anytime soon. Reinforce that they should not feel threatened by too quick a tapering off!

Posts: 1

Re: Buprenophine Taper

Postby lslade » Wed Aug 09, 2017 2:09 pm

Tapering is accomplished across 3 months start at 1 film 1 x daily for a month, then i film 1 x daily every other day for an additional month, then move to i film weekly for another month then you should be able to stop taking it completely after the 3rd month.

Posts: 180

Postby entjwb » Wed Jul 13, 2016 2:27 pm

I never want my patient to taper faster than 2mg every 2 weeks. I also allow them to progress as they can. I think it is important for the patient to be in control of the process with my direction.

Posts: 111

Postby fishdoc » Wed Jul 13, 2016 2:27 pm

I allow patients to taper at their own speed. ****uming an initial dose of 16 mg daily, they would go to 14mg daily, then 12, 10, 8, 6, 4, 2, 1, 1/2mg as they pleased. They are instructed to achieve this by alternating daily dose of 2 films, 8mg each with 1.5 films. Then working down. some will take 2 films for 2 days then 1.5 films the 3rd and work from there. I allow them to stay at the lowest dose at which the are comfortable until they desire to resume tapering. Some will stay at particular level for extended times, and I am also willing to allow them to do so.

I have 4 or 5 patients taking 1/2 mg Suboxone every other day. I know, probably not an effective dose, but as the first one told me, "I would rather pay you and stay on a low dose than risk relapse without Suboxone."

I have had only one problem with method, a pharmacist who refused to fill prescriptions that require films to be cut. the patient had to change drug stores.

Posts: 2

Postby jtkirchner » Wed Jul 13, 2016 2:27 pm

Does anyone really have any GOOD tapering successes / protocol / novel ideas?? I have seen essentially none

Posts: 32

Postby robertsonjon » Wed Jul 13, 2016 2:27 pm

I agree, from my reading on tapers, a decrease every 3 days is the fastest, but I read you decrease by 20% of the original dose the first decrease, then 10% thereafter, so it would take almost a month to get them off completely.

Dr Passer's advice will give the patient the best chance to be ready for jail.

Posts: 1404

Postby drpasser » Wed Jul 13, 2016 2:27 pm

How bout cutting the dose in half q 3 days?
The patient may need some Clonidine for Wdrl Sxs.
You may also want to ck back in the archives for this forum as most topics like this have had previous discussion. You can search for various topics.


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