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Unread 03-20-2016, 10:58 PM   #1
Iamready61
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All new to this. Hoping to get an appt this week to a Dr for Bupe...I have been reading everyone's posts.... Finally opened up to a friend that has been sober from alcohol for 19 months, she is taking me to a NA meeting tomorrow
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Unread 03-21-2016, 06:07 AM   #2
morphing
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IAmReady61,

Welcome! I'm happy that you are beginning your journey of recovery. I hope you find a doctor quickly. There is a "Find a Doctor" service in the right column of these web pages.

One bit of advice; I would recommend not mentioning that you are seeking Bupenorphine or Medically Assisted Therapy in the NA meeting. In some places the NA members are opposed to these treatments. You need to find what works best for you.

Keep us posted,
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Unread 03-21-2016, 06:12 AM   #3
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Hi Iamready61, welcome. Can you tell us a little more about yourself - what are you taking now and how much, have you tried to taper down and stop from that? Have you seen this thread with ways to find a doctor if you don't know of any:
http://addictionsurvivors.org/vbulle...ad.php?t=21259

As far as NA goes, if you do start bupe treatment, that might be something you don't want to mention. Some NA groups don't believe in medicated-assisted treatment. There is no reason to tell anyone any medications you take. That's between you, your doctor and who you decide to tell.

This is also a good thread to read as it's full of information on treatment, etc.
http://addictionsurvivors.org/vbulle...ad.php?t=21609

Good luck and keep us posted on the meeting and your doctor search.

Nancy
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Unread 03-21-2016, 07:59 PM   #4
Iamready61
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Is this post going thru?
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Unread 03-21-2016, 08:05 PM   #5
Iamready61
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Dr appointment Friday...keep getting error messages
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Unread 03-21-2016, 09:15 PM   #6
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Hi, are you getting a '403' error message? If so, we're working on it. It happens sporadically in different threads. Sometimes it works with only a few lines instead of a paragraph. Sorry about that, it is a pain in the neck.

Will you be starting in the doctor's office on Friday? Either way, this is an important read. It explains why you need to be in mild to moderate withdrawals before starting buprenorphine.
http://www.naabt.org/documents/NAABT_PrecipWD.pdf

Nancy
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Unread 03-22-2016, 12:10 AM   #7
Iamready61
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Nancy, yes about the error messages. The NA meeting was good, I realize every time I have tried to taper or do w out I was still just waiting on the next hookup. I have hope.
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Unread 03-22-2016, 12:13 AM   #8
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So if I see the Dr on Friday, do I decide over the next 24 based on the cows scale when it is time to start the sub?
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Unread 03-22-2016, 06:07 AM   #9
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Hi again, good to hear the NA meeting went well. Hopefully you'll find some good support there. When you made the appointment, did they say to go to it in withdrawals? What you could do is call them and ask if you will inducted in the office or send home with a script to do it there.

We're working on the error. Sorry for the inconvenience it's causing!

Nancy
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Unread 03-22-2016, 01:33 PM   #10
Iamready61
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Dr office ..pain Management group, got from doctor search, States they don't prescribe any meds on first visit.. I am confused...
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Unread 03-22-2016, 02:44 PM   #11
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Now have appt different pain mgmt group, they will give me script same day and how to taper
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Unread 03-22-2016, 03:08 PM   #12
NancyB
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Hi, please give this thread a read to see if a quick taper off would be good for your situation. Everyone is different, but this at least gives some guidelines.

http://addictionsurvivors.org/vbulle...ad.php?t=23809

Nancy
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Unread 03-24-2016, 09:40 PM   #13
Iamready61
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My appt is tomorrow at 3:00 - I am going to be honest and hope for the best. I have been using Ambien to sleep for years too, what is the opinion on that ? Thank you
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Unread 03-25-2016, 06:45 AM   #14
NancyB
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Good luck today! Hope it works out well for you. As for the Ambien, make sure you tell the doctor if they drug test you. For some, it has shown up as a false-positive for benzos. And some doctors are very anti benzo and bupe.

Let us know how it goes.

Nancy
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Unread 03-25-2016, 09:17 AM   #15
Iamready61
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Can I use Xanax to get me thru the WD...the anxiety is killing me
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Unread 03-25-2016, 09:50 AM   #16
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Mon/Tues this week I had taken two 30mg morphine each day...no norcos....and have been taking 5 mg norcs starting Wednesday.... I am ready
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Unread 03-25-2016, 12:18 PM   #17
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Quote:
Originally Posted by Iamready61 View Post
Can I use Xanax to get me thru the WD...the anxiety is killing me
Hi Iamready61, taking xanax may mask some of your WD symptoms, so it's really better not to. What time is your appointment?

Nancy
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Unread 03-25-2016, 02:18 PM   #18
Iamready61
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3:00 PST....
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Unread 03-25-2016, 02:22 PM   #19
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Nan, .would making WD symptoms mean the WD is not taking place?
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Unread 03-25-2016, 03:54 PM   #20
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Quote:
Originally Posted by Iamready61 View Post
Nan, .would making WD symptoms mean the WD is not taking place?
No, it would just hide them so you wouldn't know if you were in withdrawals or not. If you look at page 2 of the precipitated withdrawal link, http://www.naabt.org/documents/NAABT_PrecipWD.pdf
Restlessness and anxiety are two WD symptoms. So if you mask them with a benzo, you may be waiting longer than needed. UNLESS you want to take it at night so you can sleep and start the next morning which people have done successfully.

I hope that makes sense in how I explained it.

Nancy
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Unread 03-25-2016, 04:04 PM   #21
Iamready61
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Nan, you have been Wonderful.... Will speak honestly to Dr and go from there..I did read the attachment re: the WD signs and symptoms
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Unread 03-25-2016, 04:07 PM   #22
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I was talking to you on my dental post....I know you are going today and can't wait to hear how you make out. Don't be scared...starting bupe is 10x easier than being an addict. No more worries of running out! Now you can focus on why you were using as you adjust to the subs and hopefully you get some answers. For me, I had many underlying mental conditions that never had been diagnosed and I was self medicating plus to be honest-I liked the high....but it got out of control. It wasn't until 3months after my sub induction that I finally went to a Psychiatrist. I have really bad Panic Disorder and Bipolar and depression. All are finally doing way better now.

So get ready for success....you will end up loving it --I'm sure.
Linda
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Unread 03-25-2016, 07:27 PM   #23
Iamready61
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Got RX 8 mg three times day...insurance won't cover w out pre authorization so paying for five days worth up front $66.00... My heart is beating out of !y chest. He said I can take Xanax or Ambien to help. He said wait 48 hours.. WD will suck it won't kill !me.. Can't decide if I want to take what norcs I have left tonight....I am Five hours in now..
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Unread 03-25-2016, 08:45 PM   #24
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Got rid of the norcs I had left....bring it on
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Unread 03-25-2016, 10:06 PM   #25
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Hi Iamready61, I'm not sure why the doctor said you need to wait 48 hours. Also, are you to immediately start taking 24mg a day?

An induction is supposed to be a gradual increase of dose until cravings and WDs are gone. Typically, it would be 2mg to 4mg to start - wait an hour or more and see how you're feeling. Most people feel some effect within 20 minutes, but it can take up to 2 hours for full effect. If you're still experiencing cravings and withdrawals, then take another 2mg, wait another hour or so and if you're still having cravings and withdrawals, repeat.

Since buprenorphine has a long 37-hour half life, it's much easier to start low and titrate up than to start at too high of a dose because it will take that time to work out of your system. Too high of a dose can make a person feel tired, lethargic, perhaps depressed or anxious. So it's really in the patient's best interest to do a proper induction.

You may find you need much less than 24mg a day. Also remember that with the long half-life, it builds up in your system and takes about a week to stabilize.

Just something to think about. Hope it's helpful.

Nancy
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Unread 03-25-2016, 10:42 PM   #26
Iamready61
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He warned me about the precipitous WD....said 48 hors..f*** that. They are 8 mg three times a day
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Unread 03-25-2016, 10:49 PM   #27
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He didn't really look me in the face , looked at my feet.
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Unread 03-26-2016, 06:56 AM   #28
NancyB
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How are you doing this morning? Please think about NOT taking 8mg three times a day and do the proper induction. It's much easier to increase a dose than to take too much at first, feel like crap and then have to wait for the halflife to work it's way out. Sounds like this doctor just does the same thing for every patient. Which, in my opinion, is wrong, so very wrong.

Nancy
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Unread 03-26-2016, 12:18 PM   #29
Iamready61
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I am 22 hours in....in 30 min I am going to take half of an eight...my upper stamch cramps have been bad
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Unread 03-26-2016, 12:38 PM   #30
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This may be against rules ..can I talk to you on the phone?
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Unread 03-26-2016, 12:44 PM   #31
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I am 22 hours in....in 30 min I am going to take half of an eight...my upper stamch cramps have been bad
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Unread 03-26-2016, 01:17 PM   #32
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These cramps almost feel like Kidney Stone cramps
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Unread 03-26-2016, 01:31 PM   #33
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Tokk 4 mg 30 min..ago....still stuffed up and crying.. But feel better
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Unread 03-26-2016, 01:31 PM   #34
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Hi Iamready61, Did you take the 4mg? If you think you're having a kidney stone attack, maybe call an ER to see what they have to say. Have you been drinking enough water?

Where are you on the COWS? http://www.naabt.org/documents/NAABT_PrecipWD.pdf

Nancy
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Unread 03-26-2016, 01:32 PM   #35
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We posted at the same time!

Are the cramps gone? Do you have any other withdrawal symptoms or cravings?
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Unread 03-26-2016, 01:41 PM   #36
Iamready61
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Been 40 min ..feeling better... Still crave
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Unread 03-26-2016, 01:44 PM   #37
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I did what Dr distracted told me I could and took ambien and Xanax to sleep. Selpt really good! Feeling better.. Going to drink some more water...do I wait 2 hrs till the second half of the 8 mg...I am sorry to be so needy
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Unread 03-26-2016, 01:49 PM   #38
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Please - you're not being needy! It's not an easy thing to do on your own! And Dr. Distracted doesn't sound like he takes everyone's individual circumstances into account.

If you can wait another 40 minutes to see how you feel, that might be a good thing. But if you are really having cravings that are driving you nuts, then you could take it sooner. But instead of another 4mg, maybe 2mg would be better. Just because you're feeling a bit better already. One of the mantras with buprenorphine is 'less is more'. That long halflife helps with that.
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Unread 03-26-2016, 01:49 PM   #39
Iamready61
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All the cows indicators are / were before first dose between 1-2 in all categories....still anxiuos....very glad I sucked it up, didnt take any of the norcs I had in my purse after 1130 yesterday am....I got rid of them. To my former connection. Sorry for my extreme neediness
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Unread 03-26-2016, 01:51 PM   #40
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This might help also - it's from an old thread, but explains the difference between cravings and urges and how to tell the difference.

Quote:
Originally Posted by NancyB View Post
One other thing to look at was it a physical craving or a psychological urge? If you have an urge, some people have distracted themselves and it usually goes away. If that's the case, then you don't need more medication. If you get cravings that you cannot distract yourself from, then you do need more medication. Here's the difference. From:
http://www.naabt.org/glossary.cfm

Craving: Powerful desire for a substance that cannot be ignored. Unnaturally strong desire/urge for a substance. An overpowering urge that people are ill-equipped to control through will. Usually it cannot be suppressed indefinitely and results in taking the substance. Cravings are a symptom of the abnormal brain adaptations of addiction.
Craving (formerly called psychological dependence ) is an intense desire to reexperience the effects of a psychoactive substance. Craving is the cause of relapse after long periods of abstinence.(N Engl J Med 2003;349:975-86.)(see urges)


Urge: Unlike cravings, urges can usually be suppressed by willpower. Urges are less powerful than cravings. Urges are often passing and temporary. Cognitive skills can be learned to effectively suppress urges. Urges can usually be traced back to a source like stress, depression, anxiety, etc. which provides motivation for the escape or comfort of the substance, while cravings may have no external source and the person may have no idea why they are craving and may actually not want to take the drug at all. (see cravings)

If you are experiencing urges rather than cravings and they pass, then you may not need an increase. Are you going to therapy at all? That's another important part of Suboxone. You might think about finding a therapist who is well versed in CBT (Cognitive Behavioral Therapy) which can help you to redirect thoughts from the urges. Some people here have found the CBT site in this thread very helpful also:
http://www.addictionsurvivors.org/vb...ad.php?t=22482

Are you taking the film or the pills? I'll see if I can find the film absorption rate, but in the meantime, this is for the pills:

•Absorption

...Buprenorphine is also readily absorbed following sublingual administration, with approximately 55% (range: 15–95%) of a dose absorbed systemically.


From: http://www.medscape.org/druginfo/mon...387004&secid=9

As you can see, there's a vast range for the absorption rate of Suboxone. Here are a couple of things that have helped others get better absorption, if you want to try them:

• Tips for taking Suboxone.
-No caffeine or nicotine for at least 30 minutes before taking your Suboxone – both may constrict the blood vessels that the medication is absorbed through.
-Right before taking it, rinse your mouth out with as warm water as possible – this may dilate the blood vessels for better absorption.

Just remember that it's better to increase your dose (it could be as little 1 to 2mg) than to suffer unnecessarily with cravings...
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Unread 03-26-2016, 01:52 PM   #41
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We posted at the same time again - there's a post by me at the same time as your last post.

"Please - you're not being needy! It's not an easy thing to do on your own! And Dr. Distracted doesn't sound like he takes everyone's individual circumstances into account.

If you can wait another 40 minutes to see how you feel, that might be a good thing. But if you are really having cravings that are driving you nuts, then you could take it sooner. But instead of another 4mg, maybe 2mg would be better. Just because you're feeling a bit better already. One of the mantras with buprenorphine is 'less is more'. That long halflife helps with that."

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Unread 03-26-2016, 01:54 PM   #42
Iamready61
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Been about an hour, going out to feed my horses....through all This addiction I have still been able to ride. Looking forward to riding and completing more, with out giving too much away I compete in long distance riding up to 100 miles in 24 hours....I have completed 1550 in 50 mile increments on my beautiful boy

Last edited by Iamready61; 03-26-2016 at 02:06 PM..
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Unread 03-26-2016, 01:59 PM   #43
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I am on the pills. I mentioned that I have found support on this Web site he said he had heard of it and was glad I have reached out for support.... bTW I have had a kidney stone and nothing compares to that pain
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Unread 03-26-2016, 02:14 PM   #44
morphing
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IAmReady61,

Please listen to what Nancy is saying. My doctor did about the same thing as yours. I probably only needed 4mg (1/2 of a strip), or 8mg at the most. Instead, I was started at 20mg (2 and 1/2 strips). I have been tapering myself for a year now and am currently at 4mg. That was from 180mg of morphine and additional oxycodone.

Keep us posted,
Morphing
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Unread 03-26-2016, 06:03 PM   #45
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Got really dizzy, CV I think I am getting the Xanax out of me, plus need to eat. I don't know what to do now.
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Unread 03-26-2016, 06:18 PM   #46
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Hi again, please do get something to eat and see how you feel. You've been through a lot physically and emotionally these last few days, so be gentle with yourself.

Nancy
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Unread 03-26-2016, 07:07 PM   #47
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I took 4 mg while brushing my ponies. Been so long since all I thought about what how !any pills I had, or relentlessly checking my phone's for a text about updates on getts the pills. I am feeling normal for my first day, I have no idea. Thank you
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Unread 03-26-2016, 07:09 PM   #48
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Just to be clear 4 mg under tongue, then 4mg six hours later....
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Unread 03-26-2016, 08:16 PM   #49
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So 8mg total? Hopefully you'll be able to get a good night's sleep. Then tomorrow think about taking the full 8mg at once - kind of like a vitamin - once a day and forget about it until the next morning. Also think about keeping a little journal of how you feel, especially during the first week or so while you stabilize. That way you can see if you need a dose adjustment either up or down.

It really doesn't seem like you'll need more than that. 16mg, in my opinion, would be way overkill and probably make you feel overmedicated. Bupe has a ceiling effect which means once you reach your ceiling, taking more will only exacerbate any side effects like constipation or headache and can make you feel lethargic and just plain crappy. Yes, that's a technical term.
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Unread 03-26-2016, 08:22 PM   #50
Iamready61
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He gave me 8 mg pills 3 times a day....I think I still feel the Xanax I took at 530 this am....tomorrow am I will take full 8 mg and see, I have started a journal.. Not are those pills bitter! Getting groceries for Easter dinner w my honey...hugs
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