Today's question is on when it's a good time to start tapering off suboxone.
I used to be an opium addict then became a heroin addict and used everything for almost 20 years. I started going to AA + NA and could stop for a while and start again. Then my doctor prescribed me Suboxone 8mg/2mg and since that time (2004) I've been taking Suboxone. Well, I'm 59 years old and I asked my doctor when should I stop taking this Suboxone. He said as long as I have a sponsor and go to the meeting and am close to program, I have to take this. My question is should I stop taking Sub or just be on a maintenance program for the rest of my life? Thank you so much in advance. - David.
Larissa Mooney: David, you bring up an important question that almost all individuals on Suboxone have wondered at some point: “How long will I have to take this medication?” I recently answered a related question about the risks and benefits of Suboxone, which is a combination of buprenorphine and naloxone approved for opioid dependence treatment, so I encourage you to refer to last week’s September 2 post for more details.
The length of time someone will remain on Suboxone will vary depending on his or her individual history of addiction and relapse and how well he or she is doing on the medication (as evidenced by abstinence from opioids, functioning in daily activities, etc.). I encourage you to discuss your questions about discontinuing Suboxone with your doctor, who has evaluated you over time. If you are stable, feeling well, and tolerating the medication, you may be advised to continue your current treatment plan since it is effective. Your history of prior relapses, both on and off medication, will be taken into consideration when deciding how best to proceed.
We know from prior research that buprenorphine treatment lowers opioid relapse rates, and that longer-term treatment seems to be more effective than short-term. Though certain individuals are able to maintain abstinence off Suboxone, it is not always easy to predict who will be successful and the optimal duration of treatment. Thus, if you have reasons why you wish to reduce your dose, it is best to do this only after a detailed discussion with your doctor and under close monitoring and guidance. For some individuals, we are able to find the lowest effective maintenance dose that still provides protection against cravings and withdrawal, which are common triggers for relapse.
Larissa Mooney, MD, is the Director of the Addiction Medicine Clinic at University of California, Los Angeles, and is a board certified addiction psychiatrist with expertise in the treatment of substance use disorders and psychiatric co-occurring disorders. She is also Assistant Clinical Professor of Psychiatry at UCLA.www.LarissaMooneyMD.com Full Bio.