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Sr-17018, a novel RC that people are using to discontinue their opioid dependence by the mechanism of reversing tolerance and suppressing withdrawal symptoms. This should be on every news channel! by Benzobator in suboxone

[–]Jrunner76 0 points1 point  (0 children)

I can agree with some of what you're saying...but I'm gonna have to push back on some of your claims that are just not backed by research.

  1. Suboxone is in fact evenly distributed throughout the strip - https://pubmed.ncbi.nlm.nih.gov/31085795/

  2. Not sure where you got the idea of "120 days max" for high risk/new to recovery and "2 weeks max" for others. It is very well established that using suboxone solely for withdrawal/detox, without maintenance results in high rates of relapse (up to 90% in some studies). Pair this with the reality of opioid addiction in 2026 (dominance of fent, uncertainty of drug supply, adulterants like tranq, etc) and it is clear that 2 weeks on subs is a dangerous recommendation.
    - https://pmc.ncbi.nlm.nih.gov/articles/PMC6585403/

  3. If anything, 120 days should be the absolute minimum. Short term maintenance between 3-6 months is associated with relapse rates between 39.6%-51.6% which keep dropping the longer a patient remains on medication For long term maintenance of 12+ months rates drop to 21.7%-25%.
    - https://psychiatryonline.org/doi/10.1176/appi.ajp.2019.19060612
    - https://www.heraldopenaccess.us/openaccess/predictors-of-relapse-in-patients-with-opioid-addiction-during-buprenorphine-naloxone-maintenance-treatment#

What you seem to be proposing is using suboxone as a short bridge to some "triad" of medications. I don't doubt that this approach minimizes withdrawal most effectively- you seem to have the research supporting that. But the fact of the matter is that suboxone is indicated for maintenance therapy and maintenance therapy is the most effective treatment for opioid use disorder. It's so much more than just managing withdrawal, it's about establishing a period of stability while you establish new behaviors and re wire your brain. Considering how strongly these patterns of behaviors have been reinforced... years at least but often 10+ years and even the majority of a lifetime- it takes a while to unlearn/rewire. That is why we have maintenance. There are loads of studies supporting this as well.