While Suboxone can be a miracle medication for those of us who have suffered from opioid dependence, there comes a time when you must eventually start a Suboxone taper. After enjoying it’s benefits for weeks, months or years, the honeymoon comes to end and reality sets in. Many of us have thought to ourselves, “am I ever going to be able to enjoy life or function normally without subs?” To which our internal voice swiftly replied “no”.
If you can relate to these words, you’re not alone.
Over three million Americans have been prescribed Suboxone for opioid dependence, and I’d bet there are thousands tapering right now as I write these words. I wonder if the numbers would be this high if everyone knew how hard it can be to taper off Suboxone.
What if I told you there was a way to complete your Suboxone taper with minimal discomfort that didn’t last very long? While I don’t believe it’s ever easy, there are profound ways of reducing physical and psychological Suboxone tapering symptoms that you can utilize.
I’m a former opiate addict, Suboxone patient and counselor at an Opiate Treatment Program. I like to think I know what I’m talking about when it comes to opiates, medications and alternative treatment modalites. I’m going to teach you the same holistic method I used with my patients who were on a Suboxone taper, which often led to outstanding results.
The 4 Pillars Method
The most effective way to taper off Suboxone is using a balanced approach. Too many times I saw patients try and fail, coming back to treatment beat up and begging for mercy. In the addiction field this is known as “the revolving door”. Sadly, most addicts are in and out of treatment the majority of the time, while rarely stringing together any substantial clean time.
There are many reasons for this. In the case of Suboxone treatment, I’m of the opinion that this is due to treating drug addiction with more drugs, while failing to treat the root cause. I don’t say that because I think poorly of Suboxone. On the contrary, I believe it is an amazing medication that brings much more good than harm.
However, it being the powerful medicine that it is, most patients fail to realize that just having a great Suboxone taper schedule is probably not good enough for long-term success.
While I am going to go over Suboxone taper schedules in detail towards the end, they will be part of a complete Bio/Psycho/Social approach to transitioning off medication. I call this approach “The 4 Pillars Method.”
Subxone Taper: Pillar 1 – Physical
A Suboxone taper can leave your body feeling all sorts of unpleasant symptoms. Even though it’s only a partial opioid agonist, coming off can be challenging nonetheless. Despite your efforts at tapering slow, the nagging and persistent physical symptoms can be enough to make you give up.
As opiate addicts, there is nothing we fear more than the feeling of withdrawal. Even a slight feeling of withdrawal if prolonged over weeks or months can be devastating to our endeavor. When developing a Suboxone taper plan using The 4 Pillars Method, it is essential that you do all that is in your power to address this physical aspect.
The Importance of Exercise
There are so many benefits you get from exercise I could write an entire article about it.
On your Suboxone taper regular exercise can:
- Relieve symptoms of depression and anxiety and improve mood
- Improve sleep
- Produce endorphins
Endorphins are the bodies natural morphine. Morphine is a powerful painkiller. We actually have the ability to produce these neurotransmitters simply by exerting our bodies. The best part about this natural morphine is that it’s free and our bodies make it in the precise amounts that we were designed to handle.
One of my patients would go on long runs a few days per week on his Suboxone taper. He said at 1mg he felt great, and he attributed his sense of physical and mental well-being to the massive amount of endorphins produced from running.
I don’t say this to suggest that everyone should run on their Suboxone taper. I say it merely to provide an example of what one person did who effectively tapered his medication.
Note: You can choose any exercise you like. The key is picking something you enjoy. That way you’re more likely to stick with it.
The Importance of Nutrition
Proper nutrition on a Suboxone taper can translate to:
- More energy
- Better sleep
- Improved mood
Note: Everyone of us is biochemically unique. So I’m not going to be able to tell you exactly which type of diet you should be eating. The best diet to build endorphins for a Suboxone taper is one that is rich with protein, 20-30 grams per day at least 3x per day. I highly recommend reading The Mood Cure for more detailed information on nutritional therapy for addiction.
No matter what type of diet you choose, always try to follow these guidelines:
- Drink half your body weight in ounces of water daily – More when exercising or if it’s hot outside.
- Chew your food slowly for better nutrient absorption.
- Don’t drink with meals – Wait 30 minutes after eating and 15 minutes before – Drinking with meals dilutes digestive juices.
Note: Becoming health conscious can be a process. Take small steps daily and over time this translates into big changes in health, vitality and enjoyment of life.
Suboxone Taper: Pillar 2 – Psychological
The psychological aspect of a Suboxone taper can be the most difficult to face. Due to the decreasing levels of buprenorphine in your system, your brain is now functioning at a lower capacity than it was at a stabilized dose. Most people certainly notice this drop, and as a result emotions can get out of control.
Some common psychological symptoms of a Suboxone taper include:
- Low self esteem
There are many ways to combat these mental side effects. Exercise actually helps with all of these symptoms. Along with exercise, the following should be considered adding to your holistic Suboxone taper plan:
I read a book a few years ago that absolutely blew my mind called End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free. I urge everyone struggling with addiction to read it as soon as possible. In the book the author, Dr. Charles Gant, states that most opiate abusers are severely deficient in endorphins.
To help balance your brain chemistry, he lists these as the primary nutrients that are usually low in endorphin-deficient individuals:
- DL-Phenylalanine (DLPA) – Up to 2,000 mg, three times daily, one hour before meals.
- L-Leucine – Up to 500 mg, three times daily, one hour before meals.
- L-Methionine – Up to 500 mg, three times daily, one hour before meals.
- L-Glycine – Up to 2,000 mg with each dose of DLPA.
- L-Tyrosine – 2,000 mg, twice per day.
I recommend taking these supplements along with the following opiate withdrawal supplement starting as soon as you feel symptoms from the Suboxone taper:
One of the best ways you can build this psychological pillar is to outgrow your problem. How does one do that, exactly?
- Read self-help books
- Journal on a regular basis
- Work with a counselor, therapist or coach
- Listen to self-improvement CDs in your car
Note: Personal growth is the antidote to addiction. If you harness the power of the strategies above, you’ll be well on your way to completing your Suboxone taper.
Suboxone Taper: Pillar 3 – Emotional
Being able to control your emotional patterns is one the most valuable skills you can acquire in life, regardless of whether you have a drug problem or not. Most people don’t know they have the ability to change their emotions in an instant. This is a skill you should develop before trying to taper Suboxone.
An easy way to change the emotion you’re feeling is to change your focus. If you think about negative things that happened in the past this can cause you to feel bad. If you’re thinking about the future, worrying about what may or may not happen, this can also make you experience unwanted feelings.
While it’s necessary to think about the past and future, most people spend much more time doing this than is necessary. This means they aren’t spending time enjoying the present moment. Practicing present moment awareness can dramatically help your Suboxone taper. Next time you realize that you’re obsessing over the past or worrying about the future, notice that is what’s happening. Bringing your awareness to this is the remedy. By noticing that you’ve drifted into the past or future it brings you back to the present moment.
Note: Try this exercise for an entire day. You’ll see how the mind likes to obsess about things until trained otherwise. It’s one of the most common diseases in the world! To learn more about present moment awareness, I highly recommend reading The Power of Now: A Guide to Spiritual Enlightenment.
Suboxone Taper: Pillar 4 – Spiritual
If you’re atheist or agnostic I don’t expect you to follow the guidelines for this pillar. Replace it with something you feel will be useful for your taper. If you believe in some type of Cosmic Intelligence than I recommend you tap into the power of spirituality to supercharge your Suboxone taper.
If you have a solid relationship with God, or whatever you choose to call Him/Her/It, then ask for strength when tapering. Do this on daily basis and do it with sincerity. You might be amazed with the results. If you believe in some kind of Higher Power but don’t pray or communicate with it, give it a try. Ask that it provide you with strength and courage to overcome the physical and psychological Suboxone taper symptoms.
Suboxone Taper Studies
In one large study in 2010, persons tapering with buprenorphine during a nine month period, whether initially or after a period of substantial improvement, led to nearly universal relapse. Considering how I relapsed after using Suboxone the first time, and also considering how many times I saw patients of mine come in and out of treatment, this doesn’t really surprise me.
In another study, two groups of opioid addicted-youth were evaluated to monitor the effectiveness of different taper approaches. One group was detoxed for two weeks. The other was given Suboxone for nine weeks then tapered for three. The results showed that the longer taper was more effective, although after 6, 9 and 12 month evaluations there were increased rates of opioid use in both groups.
Many other studies look similar to these. The results confirm the poor prognosis. Opioid dependence is in fact a chronic, relapsing condition.
Note: The odds are not in your favor. In fact, it’s more like the tale of David versus Goliath. Don’t let this get you down! I’m here to tell you it can be done using the 4- pillars Method coupled with a strategic Suboxone taper schedule.
Suboxone Taper Schedules
To help you achieve your goal of having a successful Suboxone taper, I’ve put together the following guidelines to adhere to until you reach 2 mg:
- Use the least amount of medication possible to feel well enough to get through the day.
- Resist urges to use a little extra when you’re not feeling great – This messes with the taper.
- Try to take it only once every 24 hours.
- Listen to your body and adjust tapering speed as needed.
- Don’t obsess about it.
Tapering is usually not too difficult for most people until somewhere around 2-4 mg. At this point any decreases are usually noticeable and can be difficult to adjust to.
A conservative Suboxone taper schedule I recommend from 2 mg down is:
- Days 1-14: 2 mg
- Days 15-28: 1.5 mg
- Days 29-42: 1.0 mg
- Days 43-66: 0.5 mg
At this point you start dosing on every other day, rather than daily:
- Day 67: 0.0 mg
- Day 68: 0.5 mg
- Day 69: 0.0 mg
- Day 70: 0.5 mg
- Day 71: 0.0 mg
- Day 72: 0.5 mg
- Day 73: 0.0 mg
- Day 74: 0.5 mg
To finish the Suboxone taper you only dose every third day:
- Days 75-76: 0.0 mg
- Day 77: 0.5 mg
- Day 78-79: 0.0 mg
- Day 80: 0.5 mg – “Final Dose”
Note: If this is too drawn out for you, you can change the frequency of decreases to every 10 or 7 days from 2 mg down to 0.0 mg. I used 14 days as an example of a very conservative taper. Also, it may be necessary to go even lower than 0.5 mg on your taper if you’ve been on Suboxone for a long time. In that case, you could taper your dose down to 0.1 mg or lower.
- This is just a sample of what a Suboxone taper looks like – You might want to change it up to fit your individual needs.
- I broke up the Suboxone dosing to every other day and every third day at the end because this method works wonders.
- If you don’t harness the power of The 4-Pillars along with this Suboxone taper schedule, it won’t be as effective.
You have the opportunity to overcome a great obstacle. I sincerely hope with all my heart and soul that you find the powerful resources within you to meet this challenge head on and prevail. I believe that all our so called “problems” in life are happening for us, not to us.
By breaking through these walls we grow stronger and are able to contribute more to the world. Do not fear the Suboxone taper. Instead let it be the catalyst for your breakthrough. Click here now to view my best home detox program.
If you have any questions on tapering off Suboxone, please don’t hesitate to leave it in the comment box below.