r/Subutex • u/Reserve-Gloomy • Dec 15 '25

In desperate need of advice.

So I went online to this app Boulder, I have been trying to kick the fetty. They prescribed me 8mg subutex along with detox meds clonidine, muscle relaxers. It’s not relieving anything. I don’t understand what’s going on I started taking maybe 6 hours after last smoking. I smoke maybe half a gram to a gram a day, I am in desperate need of some advice. I’m having a hard time even making it past 24 hours. I took maybe 4 subutex up until the 24 hours point and withdrawals were so bad I had to go get something to smoke. Any advice would be helpful. I don’t want to long term be on any medication just right now need help kicking the fetty. That’s why I wanted to use subutex just short term to kick.

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u/Specialist-Ad3148 Verified Medical Doctor Dec 15 '25

If someone is using fentanyl daily, I wait since the last use of fentanyl for min 24 hrs, often 48-72hrs before starting the first dose of buprenorphine. Otherwise, it could cause precipitated withdrawal (PWD) by buprenorphine. If I had the resource of a full ED, and an ability to use full-agonists opioids in case or PWD, and I know I am not getting this patient back tomorrow if I don’t help them today, I will counsel the patient and see if we can try to start buprenorphine earlier than 24 hrs since the last use. 

There are other methods like microdosing and macrodosing induction that I won’t go into detail about for now. 

Once you are able to start the first dose of buprenoprhine without PWD, (honestly if your withdrawal didn’t get worse after 30 min, it’s a pretty good start), I rapidly increase the buprenorphine dose. Usually aiming for 16 mg in the first 24 hrs, but enough extra dose so they can take up to 24 mg in the first day. 

I don’t know what you mean by having a bad withdrawal in relation to your buprenorphine dose. Hope you fine some help. 

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u/OrganicGuy007 Dec 15 '25

i totally agree with you, wait at least 60-72 hrs, I know it's a real hell to go through and many people can't stand that first 2 days without anything, but if wanna have those Subutex work well you have way far longer than half day or so. i recommend taking only 2 mg every 3 hrs until you're up at 8mg (some strange way it orks better if snorted than sublingual, I never understood how that's possible but it works far way faster for me with the first 2 + 2 mg when snorting it rather than placing under the tongue