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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are There Any Drugs For Stepping Down From Subutex With Less Intense Withdrawal Symptoms?

in 2008 i was injured in Iraq and placed on opiate pain killers. I receive 40 percent disability from the VA as a result of the injury. by 2010 I believe I went from dependence to addiction as a began to crave the opiate drugs so I went to a new doctor who was licensed to treat opiate addicts with buphenorphine (subutex). I am currently on .5 mg (that s half a milligram) a day of subutex. I have no desire to use any opiates and have not for several years. I never broke the law in my addiction and served my country honorably so much so I was offered a job by a state law enforcement agency and accepted it passing all drug tests and background checks in 2012 even getting approval for the subutex. I have this monkey on my back being prescribed a narcotic used to treat addicts. I am reminded by the pharmacist every month I fill my script who treats me like a common criminal. I don t feel I am an addict I never stole or lied or cheated or anything for drugs I simply enjoyed how they made me feel and it concerned me so that is why I switched to subutex being a partial agonist. I want off the subutex I feel like such hypocrite being on it. When i run into addicts on suboxone they are prescribed 12-24 mg on average so I know my dosage is abnormally low. Still the physical dependence kills me. are there any drugs my doctor can prescribe me to step down from the subutex that can be used for short term detoxification with less intense withdrawal as the .5 subutex I am on? I have tried cold turkey and tapering but at .5mg the withdrawal is still debilitating for me and they do not make a smaller dosage then 2mg pills so its hard to taper any lower.
Mon, 13 Jun 2016
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Addiction Medicine Specialist 's  Response
No, they do not make a lower than 2 mg. But here are several suggestions. First of all subutek is not generally preferred to SUBOXONE which contains a second drug that is a plain blocker of narcotics. The second drug precludes other narcotics from doing anything. The second drug slightly modulates the effects of suboxone and lowers its effects slightly but significantly.

Second. Film can be cut into smaller parts, so a part of a 2 mg film can be used and this would lower the dose the way you are considering.

Third, and most important. At a low dose, if you note what symptoms you get going plain cold turkey they will not be as severe as coming off of a higher dose of a more abusable narcotic. BUT you will mind it more since generally you have zero problems. Getting used to some withdrawal by either doing a lower dose every other day and then returning to the usual dose OR every other day skipping some/all of the drug will allow one to be more used to withdrawal after only 2 weeks.
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Are There Any Drugs For Stepping Down From Subutex With Less Intense Withdrawal Symptoms?

No, they do not make a lower than 2 mg. But here are several suggestions. First of all subutek is not generally preferred to SUBOXONE which contains a second drug that is a plain blocker of narcotics. The second drug precludes other narcotics from doing anything. The second drug slightly modulates the effects of suboxone and lowers its effects slightly but significantly. Second. Film can be cut into smaller parts, so a part of a 2 mg film can be used and this would lower the dose the way you are considering. Third, and most important. At a low dose, if you note what symptoms you get going plain cold turkey they will not be as severe as coming off of a higher dose of a more abusable narcotic. BUT you will mind it more since generally you have zero problems. Getting used to some withdrawal by either doing a lower dose every other day and then returning to the usual dose OR every other day skipping some/all of the drug will allow one to be more used to withdrawal after only 2 weeks.