"Microdosing as Approach to Buprenorphine Initiation" - Randall Brown, MD, PhD, DFASAM

[@samlazar1053]

Remember Opioid withdrawal has extremely negative reinforcing effect...So much that people get anxiety and panic attacks just thinking about it

[@lentinikhalsa1]

THIS WORKS, Bernese method. I painlessly switched from a relatively high dose methadone into buprenorphine with basically zero discomfort

[@nottoday.613]

This is really good to know! I’m down to 28 mg of methadone and just took my first 0.5 mg dose of Suboxone as directed by my Dr. I’m super nervous about it all but my research has made me feel better about it. Thanks for sharing!

[@lentinikhalsa1]

@@nottoday.613 how did it go?

[@grahamsgoneagain]

@@nottoday.613 please let us know how your doing!!??

[@SAMEntalhealth]

I used to do this before I have ever heard of the method. I always microdosed my fentanyl when I used so I figured if taking 4 mg of buprenorphine is throwing me into precipitated withdrawal, maybe I can just take little bits and pieces and slowly build it up in my brain. And it successfully worked for me when I had to come off fentanyl, this was before I have ever heard of the Bernice method and before it ever became popular haha I take the credit

[@lifewithzayandzavi2191]

How much did you take daily and did you completely stop using

[@lentinikhalsa1]

This Bernese method works wonderfully. I switched from methadone 40 Mg to suboxone 4 mg without so much as a sweat. Wonderful switch.

[@visalsao2136]

Did u use the bupe patches. Its my first day today but the pharmacist doesn't know what hes doing so Im a bit worried.

[@lentinikhalsa1]

@@visalsao2136 sublingually strips

[@freeflyer151]

That gives me hope, I can’t get it to work the other way even when taking a quarter of an 8mg strip I still get precipitated wd every time I try.

[@derek7017]

@@freeflyer151 1/4 of 8mg strip is way too much to start micro dosing. That is 2mg. You need to start at .25 mg

[@richardrardin9156]

@@freeflyer151 yeah 2mg is for SURE too much....take that quarter and cut THAT quarter into quarters. Thats 0.5mg You can TRY that, or cut that piece in half and start iut with 0.25mg, because thats what pretty much EVERY single set of instructions says for this method! Hopefully u have already succeeded and are off dope now🧡

[@lentinikhalsa1]

You have to really slowly induce the buprenorphine or you will precipitate withdrawals. But start at like 1/4 mg buprenorphine, continue your dose of whatever opiate you’re on, within a day or 2 increase the buprenorphine to 1 mg then 1.5 then 2mg, by that time the methadone will be “kicked off your receptors.” And you will be stable on buprenorphine. I’ve done it. Easiest thing I’ve ever done.

[@slump_nuggie]

How many days did you do this until you were able to go without the full agonist dose and your sub dose only?

[@lentinikhalsa1]

@@slump_nuggie prob by day 3 the full agonist is being blocked 100% by the bupe. But I’d say 5 days to be safe

[@slump_nuggie]

@@lentinikhalsa1 I'm on day two right now. Yesterday I took one .5 mg of bupe at night along with my daily dose of my drug of choice (blue m30's pressed fentanyl). Today I took .5mg bupe in the am and .5 at night. I can already start to feel like it's making my usual drug way weaker. I will go to 1 mg tomorrow twice a day, and keep jumping up a mg until Sunday. Crossing my fingers that this works. It has to. I cannot keep this lifestyle up. I'm about to loose what little I have.

[@slump_nuggie]

@@lentinikhalsa1 I really hope I can stop using fentanyl and just use Suboxone starting next week and it not effect my performance at work. I have a feeling like I won't be very comfortable but I have to keep with it. I know my receptors are going to be screaming for me to get some more dope but I can't give in. This is the last straw. I'm done with this shit.

[@lentinikhalsa1]

@@slump_nuggie I promise it’ll work. The only concern you needed to have was inducing the buprenorphine too fast. Sounds to me like you’re already past that point. You’re on the downhill slope of this now. You could probably cease the fentanyl right now and not feel any withdrawals, tbh. But it’s just a matter of making the bupe takeover your receptors in your brain. If you’re already taking 1+ mg a day, the chances are that it’s already blocking the fentanyl

[@areecabral64]

ATTN IN NEED OF HELP>>>>>>So I am currently trying to start the bernese method and I smoke fentnyl about 5 to 10 pills a day no more than 10 so what is the reccomended dose of fentanyl each day? I got the scrpt from my old methadone clinic but the doc ther wasnt educated on the bernese method and still wanted me to go ahead and try it since I really want to get off fentanyl. can some one please help me I have 8mg suboxone strips and I smoke fentanyal pills so like expalin each dose for 7 days please I am a bit confused. And on the web it only has if your using herion and then they described taking sub pills and I dont have the tablets I have the 8mg strips. Thank you

[@reneecarver7041]

Start VERY SMALL. Like an eight of the strip a day ok? Call ideal options

[@reneecarver7041]

*eigth

[@isansimpson2056]

Friend was dealing with this from using the “blues” as he called them. We researched and he’s trying this. So far he started with the following micro-protocol: .25mg of bupe every 8 hours for a day, then .5mg every 8 hours for two day, then 1mg every 8 for one day, then 2mg every 8 for one day, then 4mg, etc.

[@msoto3647]

Did this work for your friend?

[@msoto3647]

@Isan Simpson I take the blues too and want to make the change to suboxone. Im so scared of precipitated wd tho

[@isansimpson2056]

@@msoto3647 didn't seem to make much of a difference from what he said. May be better off just trying to get even 24 hours then trying. I'm not really sure.

[@ryangulley7749]

@@msoto3647 me three it legit gave me ptsd

[@msoto3647]

@@ryangulley7749 me too! My potassium was completely depleted because of all the vomiting and I started seizing up. The drs did nothing and said it was a panic attack. Plenty of people told me the Bernise method works! Just start at .25 really low

[@nicktan205]

I don’t understand how this works from reading the comments. People aren’t waiting a specific amount of time while on H? Micro dose subs in the morning and then take more H? Continue taking h but increase taking subs? Wont you get an instant pw often?

[@StraightToThePoint217]

I was thinking the same cause suboxone has Naloxone which is what puts you into early withdrawal. I wish they would prescrib Subutex which is suboxone without Naloxone, but that's why the stopped making it cause people were abusing it so they added Naloxone so you can't abuse it now

[@SAMEntalhealth]

Nah the amount of buprenorphine isn't enough to throw you into it and yes you can keep using because the buprenorphine will bind to your receptors regardless. But tbh do it for 7 days. 0.25 for 2 days, 0.5 for 3, 1 mg twice a day for one day, then on 7th day 1 mg morning and 2 mgs at night. One you're at 2 you can stop your full agonist for 24 hours you won't feel withdrawal bup will cover the beginning of withdrawal. Then take 4 then 8

[@SAMEntalhealth]

​@StraighttoThePoint no nalaxone is only active for 30 minutes and is only in the suboxone to prevent people from shooting suboxone. Then it will have effect. Will block. The buprenorphine throws you into precip

[@josephmontervino7629]

I’m on 30mg of methadone which I take in the morning. Would I take the bup before my dose or after ? Thanks 😊

[@paulden3158]

​@@josephmontervino7629doesn't matter

[@charlessoukup1111]

So I might suggest a sparing use of the Suboxone start to finish & hopefully help a short term transition to total opioid abstinence, I'm committed to that outcome, so just looking for what may ease the transition. It just clouded the situation, and with unacceptable side effects, so... Oh and read about & tried mega vitamin C dosing for a few transition weeks...did it help? Hope I can attribute any mollifying of physical mental bad effects of the transition period, thinking we'll it might have been rougher if I hadn't done the C, whatever.

[@alexpratt99]

It can work but the problem for me is it takes a lot longer to feel okay taking micro doses it’ll take 2-3 weeks to feel better 2 a day only takes 5 days max

[@26nuttrees29]

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[@26nuttrees29]

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[@26nuttrees29]

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[@26nuttrees29]

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[@26nuttrees29]

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[@StraightToThePoint217]

Question the suboxone they are talking about to micro doses is the suboxone (Buprenorphine / Naloxone) correct?

[@hollywoodhiggins1576]

Yes

[@isansimpson2056]

Yeah this protocol doesn’t seem to be working. Once you get to 2mg you seem to get quite uncomfortable for a few hours after taking.

[@richardrardin9156]

Then slow your roll. If 1mg is tolerable, stay doing 1mg, and keep on lowering yiur opiate intake. Then, instead if switching to 2mg, switch to 1.5mg? Do a cpl days on that? Now, this is NOT certified medical advice but it IS common sense.

[@shaundavis1220]

I was on about 60 lopes a day to bridge me to my next Suboxone prescription because being on 2 a day wasn't enough for me after a really bad 20 year plus oxy addiction. So, i was taking 2.5 to 3 a day. So, i bridged with lopes and not that many as far as most ppl. So, i usually do about 5 days of 60 lopes a day. Every single time i tried to get back on my script I'd go through 3 days of PW's. I've tried the Burnese method 5 times now and it's never helped. What am i doing wrong? I start out at about .25 subs then regular dose of lopes. Then very slowly step up the subs each day until about day 7 when I'm on 16mg subs. The next day I'd do about .25 subs no lopes and still go through horrible pw's for 3 days. So frustrating. I'm just going to talk to my doc once again and let them know I'd be more comfortable on 2.5

[@davidroberts4248]

Wait at least 8 hrs after last opioid . To start suboxone or buprenorphine. Then every 8 hrs. On my 3rd day, can go 10hrs now in between. The micro dosing sounds longer than just doing in 8 he intervals.

[@MrAkaprimetime]

So how's it going? How did you do it

[@poepoe2828]

Well considering this is what I am doing right now and I'm on day 6 and I just did fetynal all day then I just took 1mg of suboxone 1 hour after my last use of fentanyl and some how I am fine and I actually feel the sub better then I did the fetynal dont ask me how but I do. So tomorrow or day after I'm going up to 2mg suboxone then I'm jumping off the fetynal after 3 months of use. The first time I took suboxone 3 weeks ago I took to much and was in precipitated w/d this time I actually listened and microdosed to my 6th day today and if I had to guess I think its actually working. But I'll no for sure tomorrow and next day ok. Thanks for the video any piece of mind I can get right now really helps alot!

[@Fasteddie-op6sd]

How are you now?? Did it work or are you sick?

[@MrAkaprimetime]

How's everything going??

[@JaredColanese]

Bro 3months is not that long.

[@DBToy]

I just jumped from about 12 -30mg fentanyl to suboxone I took .5 after taking a 30 3 and half hrs before and i was ok for about 30 mins then I got thrown into the worst withdrawals I ever had so I just kept taking more subs I took1 mg next then to my normal 2 mgs that I’m used to it lasted about 28 hrs the next day sucked too I’m on day 3 now and am finally back to normal so it does stop eventually I only know how to do to much of anything so this was the appropriate punishment to keep me straight on the subs

[@danwood4942]

So I quit the fake 30’s for 3 days and took 1mg sub and was thrown into worse withdrawals possible, needed up in hospital for dehydration after not eating or drinking for 6 days. Was throwing up everything and diarrhea. Now still been doing 10 30’s a day and started at .25 sun for a week twice a day. Then .5 twice a day for 3 days. Then 1mg twice a day for 3 days. Tried to bump to 2mg and had slight withdrawals after 3 hours. Runny nose and diarrhea and some shaking so took 2x30 ok again and at 1mg twice a day again. Gonna try 2mg twice a day again this week. Think I really need to slow down on the fake 30’s instead of doing 10 a day. I’ll try and keep ya all updated. These fake 30 stick to you fat cells and stay in system so long, that’s the problem. Next I may try to kick fake 30’s and try real ones for a week then do the taper up if I’m not getting results soon

[@jaysonsmiser8288]

@@danwood4942 bro I do straight fent I’m in so cal I do about a gram 2 a day smoking I tried going back to heroin didn’t even fill it. Subs I wait like 5 days cause subs throw me into pw but good luck on trying to get back to regular 30s waste of money but good luck I kick it with benzos and drink lots of fluids

[@MrProfit420]

I’m in the same boat, same coast. You know any programs out here in SoCal doing the supervised microdosing?

[@danwood4942]

@@MrProfit420 no but Chapman Global Medical hospital and doctor Lowingston can rapid detox you off everything. A little spends. In Orange Cali. Might look into it. Saved me

[@KillaCamPine]

@@jaysonsmiser8288 I only do 1 fake 30 a day, probably for 4 months, do you think I’d be good to start sub after like a day?

[@jeffreymclean3358]

did this work for anyone to comfortably get off dark? I’m about to start tomorrow but was thinking maybe I should start at as low as .25 of 1 mg after waiting as long as I possibly can( 14-24hrs) before I start first dose and then introduce.25 every 2-3 hrs to comfortably switch over from dark to Suboxone until I’m at 12-24mg sub. Last time I waited 36 hrs before taking Suboxone and it was hell and I felt like maybe I didn’t have to wait that long or go through all that pain. And now learning about micro dosing slowly during Suboxone introduction it sounds like it should be a lot less painful. I hope it’s working out for some of you and can get on a healthy life as we all desperately need and desire.

[@PatrickHockeyNYISLES72]

Remember everyone is different! So, what worked for me may not work for you? I was told to stop to clear off the Mu receptor’s for 1.5 days minimal!! That’s just to long after being hooked on this junk for 11.5 years!! Meaning, the withdrawal is absolutely miserable! So, because everyone is different, react differently, I stopped mid-day before & started Suboxone the next day (2/0.5), at 13:00 & within 20 minutes to .5 hour I was feeling fine, Normal again!! I cannot believe how well Suboxone works to stop that horrible, fearful oxy withdrawal feeling in such a short time! I can get up , eat breakfast, go about my business & begin to save money again!! There’s No going back to that Junk & I don’t care because it almost ruined my Life!! I also have a Great support team; a GF that honestly cares about me for once & great family & friends! Thank You God ! A second chance at Life(that everyone deserves). Just do it & don’t look back!

[@lentinikhalsa1]

@@danwood4942 yea this is correct

[@freeflyer151]

I pulled myself out of pw by taking more of my opioid but I just can’t get it to work. I keep going into precipitated wd. I am going to try micro dosing again tomorrow. I can’t see waiting days, that’s when I need relief the most.

[@KillaCamPine]

@@freeflyer151 did you ever figure this out?

[@freeflyer151]

@CameronPine yes I am on day 5 and I feel amazing. I took slivers at 9 hrs every hr then took half at 15hrs and I slowly got better. 3 days were rough but not as bad as it would have been wo subs. By day 4 I felt great. I still haven’t slept a entire night but I sleep more every night so that’s getting better too.

[@josephmontervino7629]

Does anyone know if your supposed to take the bup before or after your full agonist which in my case is methadone. Help anyone thanks 🙏

[@JoshMcCoy-wu9mu]

Did you find the answer to this?

[@alexwhite3158]

All ill say is god please let this work, im currently using almost half a gram of fentanyl every 24 hours, i lost my job so no income and tryinf to balance somehow buying fentnyal everyday is a f******g nightmare, i took 4mg once of sub and was incredibly sick but i have 15 subs and need to switch

[@MrProfit420]

Is there a microdosing program in Los Angeles CA?

[@angelinagiovinazzi766]

Honestly in the United States not many doctors are even using this Microdosing method and I think the reason is because the pharmacies here will not prescribe Suboxone while prescribing any type of opiate or opioid. Also it’s not widely practiced here at all they are doing a lot of research overseas which has been starting to get the attention of our doctors and clinicians here in the United States but I honestly don’t know of any where within the United States that will assist you using this method. There may be a very select few and where they are located I have no idea. Best of luck to you. I do however feel as though we will see this start to be used here I just don’t think it’s gonna happen very soon this is a very very new and relatively unknown method with very little studies so we need more progressive clinicians and doctors willing to try this method and I have a feeling that as fentanyl becomes more and more the norm for heroin users that they will have no other choice but to start using this method. I’ve only tried this method on my own at home without the supervision of any doctor and I have failed each and every time but I get fat and all where I live in my heroine and that makes it nearly impossible to do this correctly

[@valeriebravo1467]

The jails in WA state are doing the microdosing. That's how I first heard about it.

[@scarlettsunz2099]

Ive got my 2mg subs, just waiting for me to get the courage to take it. My Dr says to take 1/4 of a 2mg strip...but can still use my DOC (smoke heroin/but it might be fentanyl) I'm terrified! Every day I wake up, wanting to start but too scared to start. I am scared of PW so badly. If you are still using whilst starting the suboxone by microdosing, what's the best time? After using? Won't that make me sick? Can't anybody tell me what the best time to start your first microdose? I can't wait very long after waking before I need to use. This is keeping me from starting. I am desperate to.stop using and I need advice

[@CensorWars]

I just started 3 days ago. I took my first piece of sub in the morning, then smoked my H

[@angelinagiovinazzi766]

I am getting ready to start right now I did this maybe several months ago and it really did work but I didn’t reduce my DOC enough so I did go in to get it withdraws but this time I am confident to microdose .5 mg and not overdo it and die don’t smoke but I use it nasally/sniffing

[@CensorWars]

@@angelinagiovinazzi766 it didn't work for me. I got on methadone for a while, but now they are forcing me to do a 21 day detox, hoping to try to get on subs during this. I have a good job, car, and apartment I don't want to lose. Everything is going good for me except this stupid habit....

[@angelinagiovinazzi766]

@@CensorWars omg I’m in the same damn situation, i have a house, car, jobs, my kid back, but this is a huge secret I’m keeping & I can’t afford it & will lose it all if I don’t stop

[@CensorWars]

@@angelinagiovinazzi766 I'm trying to slowly ween down, I have a doctor appointment on Wednesday. Dope sucks

[@celtiberian07]

I've waiting 3-4 days and went into precipitate withdrawal I think I am gonna try this like 1mg or less . I've tried 1or2mgs waited a hour and was sick as hell this sounds like a good idea half a mg maybe then next day maybe 1 mg

[@celtiberian07]

@Vicky west I am not into that stuff I don't smoke weed or drink o just got caught up again after being clean 12 years from opiods other then that I am very straight I don't even take them to get high I take them to avoid withdrawal

[@wedontlikenoneofyou]

been doing this for 15 years everyone said i was doing it wrong and i always said i know what im doing even my plug wouldnt want to when i was in precipitated withdrawal and i told him from sub hed be like "its gonna block it its gonna block it" you just use to drop the the precipitated wuthdrawal until you build up the sub in your body usually takes me 3 to 4 days of micro dosing

[@areecabral64]

Can you help with how much of each you take I did dose on subs for 2 days continued my use didnt feel withdrawl at all but i took like .25 each day of the strip. but I didnt keep taking bcuz I wasnt sure how much fentanyal to keep smoking

[@celtiberian07]

I did 4 bags yesterday and Mico doesed around 9pm did a bag a dope around 6am now it's now 9am gonna try Mico does now and at 9pm then slowly increase through out week hopefully won't fuck me up and will work

[@nicktan205]

You didn’t wait to micro dose? You didn’t get pw?

[@MrAkaprimetime]

How's it going??

[@michaelneal7079]

Bupe is the devil in disguise

[@tylerthompson1842]

I got of that shit pretty easily years ago with Kratom

[@xanjose]

To each their own. It’s helped a lot of people get off opiates, however I’ve heard long term it’s not the play. Should just try to use it to get off opiates and cut it off after like a month at best

[@StraightToThePoint217]

I kinda a agree, but its a devil wearing a halo. It helps get off the street shit and sometimes literally the person off the street, and its legal so it can give a person to start living again.

[@MrAkaprimetime]

​@@xanjose have you tried that way or what???

[@steve-tk5zv]

Suboxon fine if you decide to stay on rest life. Detox nitemare

[@steve-tk5zv]

Withdrawals as bad as heroine !

[@elliottpatch9810]

Does this work for fentanyl?

[@gudda2glory326]

👀 Need to know for myself. I believe it does work, I think it had to come up with it because of fet.. Other opiates leave your system in a day or so where fet stays 4-5 days.

[@gudda2glory326]

I need to know for sure tho. Don't take my advice

[@drenn1759]

Can I smoke subutex (* buprenorphine).... not suboxone.

[@bethhoward9986]

I would say no. Look I understand why you would ask that but come on dude just take it as directed. It's supposed to help you get off drugs and discontinue the behavior that would drive you to even want to try and smoke it. Anyway good luck dude I hope you are able to find peace and recovery.

[@danwood4942]

Noooo that’s why it has the naloxone in it so u can’t. Just do this taper everybody’s talking about, and stuff but it works I’m on it now

[@Fasteddie-op6sd]

Ok so this is the 2nd time herd of this but didn't know it worked.. 2 months ago I took 1/4 sub and went into PW so BAD for days until I got more blues. I want to get off these stupid things SO BAD! I want my life back I don't even want to stay on suboxone either. I just want to be normal and alive. If I get this right, I keep using blues but take a very small dose of sub.. and keep using blues then after a few small parts of subs then I up the amount of subs and lower the amount of blues.. and keep going on this track until I'm off blues with no withdrawal and then no sub and I'll be good????

[@26nuttrees29]

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[@kameid.2464]

Hey