The doctor that gave me the Suboxone didn't really explain to me how to take the medication. i have 30 8mg pills and i don't know how much to take on my first dose and how much after that. I've been smoking .5 to a gram of black tar heroin each day for 6 months. Can someone please help give me some advice on the usage of Suboxone and what to expect. i want to start my detox asap! Thank You.
Starting Suboxone for the first time?
- Asked
- 28 Nov 2010 by dekaf
- Updated
- 28 Nov 2010
- Topics
- suboxone, opiate dependence, opiate withdrawal, detox
Responses (2)
First, google the COWS sheet, COWS stands for Clinical Opiate Withdrawal Scale, it is the quiz the doctor is supposed to give you in order to tell how far into withdrawal you are, in order to start suboxone. You need to be off H for about 24 hours to hit a score of 26 or above, if you truly are at 26 or above, you will not have precipitated withdrawal. Precip occurs when there are opiates still left on the brain receptor sites and the medications fight each other and neither sites on the sites at that point, so Major withdrawal sets in. Be honest on the test, you really don't want precipt to occur. You should ultimately be on as little subs as will control and stop withdrawal and craving. Subs start working in 20 to 45 minutes, but it will continue to activate for 2 hours after first dose and should hold you 24 hours. I would start with half of the 8 mg pill if I were you, you can always take more after the 2 hours mark. Get a straw and a glass of water, you may need to moisten your tongue somewhat. Place the half tablet under your tongue and wait for it to dissolve. It will take probably 15 to 20 minutes the first time since you are in wd and don't have much saliva, you can put a small amount of water under the tongue, just don't swallow the pill until it is dissolved. After 15, 30, 45 mins and then 1 and 2 hours marks, retake the COWS test, by 1 hours, you should be comfortable. It at the 2 hours mark you still are honestly having withdrawal ( and you probably WON"T) take 1/4 to 1/2 more of subs. Hope this helps.
Hi dekaf. Please listen to Patti on initiating sub treatment. She (and very few others) truly know about how this treatment works, what to expect, and more importantly, how to begin tapering when the time comes. That's down the road a bit. But you must be honest with yourself about the wd's. If you start too early, you will suffer. It may seem like forever before you can begin taking the subs, but it's vital not to jump the gun.
Congratulations on making this life changing decision. You will not regret it. And lastly, welcome to Drugs.com, the best site for moral support, information, meeting great people, and finding the answers you need. Be sure to add Patti and many others as friends so you can keep in touch and ask private questions if you need to. No one here will judge you or bad rap you. I can't begin to tell you how much the people here have helped me through the most difficult times of my life.
Best wishes to you and be safe,
chris

Further Information
- Suboxone Information for Consumers
- Suboxone Information for Healthcare Professionals (includes dosage details)
- Side Effects of Suboxone (detailed)
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