Tapering off Buprenorphine (with the Taper calculator)

[Chip (OP)]

source: http://www.helpmegetoffdrugs.com/taper

Tapering table: http://www.helpmegetoffdrugs.com/taper#form

note: These are only the introductory excerpts so see the source link above for the full article

Tapering off Buprenorphine

A comprehensive guide to tapering off buprenorphine

Summary: The purpose of a taper (instead of just stopping) is to gradually reduce tolerance, thus distributing withdrawal symptoms over a longer period of time minimizing the discomfort experienced on any single day.

Ending the taper at the manufacturer's lowest available dose (2mgs for Suboxone Film® and generics or 1.4 mgs for Zubsolv®) can still result in significant withdrawal. Here we lay out the rationale for tapering to much lower doses. As the data will show 2mgs/day is closer to the midpoint of a typical taper than it is to the end.

General rule: Pace the taper with the body's ability to adapt to each decrease. Dose decreases of 25% separated by at least 10 days has been reported to be tolerable by many.

Are you ready to taper?

A taper should only be considered once a successful treatment period is completed.

The whole point of buprenorphine treatment is to suppress cravings and withdrawal so that you can make big changes in behavior, routine, living situation and thinking. It's these changes which, in effect, rewire the brain and reverse some of the craving-causing brain adaptations. If this is not done first the taper will likely be shortly followed by relapse.

Have you made significant changes in behavior and had a period of time to gain experience with those behaviors? Have you been able to deal with stress, anxiety and depression without craving drugs? This takes time and doesn't happen on its own, it is a deliberate effort. If you have been in stable treatment less than six months, tapering is NOT advised.

Buprenorphine is NOT a detox medication, it is a treatment medication. If you are not clear on this distinction go to the treatment page and understand it before tapering. But assuming you are ready to taper there are some things to consider.

Tapering to very low doses minimizes withdrawal

Before we continue, it should be noted that the following is a detailed explanation for those interested in the nuances of tapering and not necessary to conduct a taper. It does however help make sense of why certain protocols are likely to be more effective than others.

Fig. 1. Suboxone Film can be cut into small pieces. Accuracy is not that important when cutting the dose. Blood levels will average out over a few days. Also, it is not a certainty that the medication is evenly distributed throughout the film or tablet, so super-precision in cutting isn't warranted.

To understand the tapering process there are a few concepts you should understand so go to the source link. You will also find the Buprenorphine Taper Schedule Calculator there.