How do you wean off soboxen?

Answer 1

Decrease your dosage slowly over a period of weeks or months.

Do not decrease your dose on a daily basis, however, as your system needs time to adjust to the decrease in order for you to feel normal.

If you are taking a dose greater than 2-4 mg per day, the ceiling of buprenorphine will allow you to decrease your dose relatively quickly until you reach somewhere around the 2 mg mark, although it varies from person to person. At high doses, most of the discomfort experienced from decreasing until reaching around 2 mg is psychological. The hardest part for most patients is the last 1 mg.

Decrease your dose about once a week, though you can do every two or even three weeks if you feel more comfortable that way, and if you really wanted to, you could decrease your dose more rapidly than this. A good way to split up your dose for tapering is to dissolve a tablet in a known quantity of water, then using an oral syringe to squirt a small quantity of this water under your tongue and allowing it to absorb sublingually, as you would normally do with the suboxone tablet.

For example; let's say that you want to take 1 mg per day for the next 8 days. Using an oral syringe or labelled medicine dropper of some sort, place 16 ml of water into a glass or some sort of vessel for storage. Place an 8 mg suboxone tablet into this water, and stir until the tablet is totally dissolved, in order to make sure that the solution is roughly homogenous. When you are ready to dose your first 1 mg, pull 2 ml of water (16/8 = 2, so in each 2 ml of water, there will be 1 mg of buprenorphine, the active ingredient in suboxone,) into an oral syringe or some sort of dosage dropper, and squirt it under your tongue, then allowing it to sit in your mouth and absorb sublingually, just like the tablet normally would.

It's important to be as exact as you possibly can with measuring and dosing! If you accidentally take too much some days, you will be inadvertently increasing your tolerance and making your taper more difficult and causing it to take longer.

An example taper schedule:

Let's say that you're starting at 4 mg per day. At this dose, you can simply break a tablet into two pieces.

Starting dose (week 1:) 4 mg per day

Week 2 dose: 3.5 mg per day

Week 3 dose: 3.0 mg per day

Week 4 dose: 2.5 mg per day

Week 5 dose: 2.0 mg per day

Week 6 dose: 1.8 mg per day

Week 7 dose: 1.6 mg per day

Week 8 dose: 1.4 mg per day

Week 9 dose: 1.2 mg per day

Week 10 dose: 1.0 mg per day

Week 11 dose: 0.9 mg per day

...

Week 15 dose: 0.5 mg per day

...

Week 18 dose: 0.25 mg per day

Week 19 dose: 0.2 mg per day

Week 20 dose: 0.15 mg per day

Week 21 dose: 0.1 mg per day

Week 22 dose: 0 mg per day

Obviously this is a very slow taper schedule, and involves tapering to a VERY low dose before stopping the drug entirely. The purpose of this is to make this as comfortable as possible, and to give you time to adjust to sobriety before stopping the use of your medication entirely. A lot of people taper more quickly than this or drop by larger amounts, a lot of people also taper more slowly than this at the higher doses. Do what works for you, but two things that I recommend are to ensure that you're going only as quickly as feels right for you, if you need to take six months to taper off then take six months, there's no prize for finishing quickly. Also, drop down to as low a dosage as possible before jumping off entirely, and the lower your dose gets, the smaller the amount that you'll want to decrease it by each week will be, because the lower your dose, the bigger a portion of your dose each individual 0.1 mg makes up.

When you get down to the very low doses, it will be easier if you dissolve a smaller quantity of the drug in a larger quantity of water than when you started. If you dissolve 8 mg in 16 ml of water, that's fine for dosing 1 mg or 0.5 mg at a time, but when you're only dosing 0.1 mg per day, it makes more sense to, for instance, dissolve 2 mg in 20 ml of water, so that you'll be working with a non-miniscule quantity of water for ease of dosing.

Good luck! There are a lot of great resources on the internet that can provide you with more information on tapering, along with personal anecdotes and advice from individuals who have been there. Seek them out, you'll find lots of helpful advice out there. What I've suggested here is but one method, but it is by no means the only one out there.