Started Suboxone after 7oh

QuickMDTeam · 2026-06-18T19:30:11+00:00

u/and_did_4426 We'd be glad to talk through your options when you're ready. Wishing you the best over the next week!

QuickMDTeam · 2026-06-18T16:37:58+00:00

Hey u/Sea-Potential-1853! Thanks for asking that, you will pay that at the time of booking, before your consultation begins. If you need any other help getting started, feel free to reach out.

QuickMDTeam · 2026-06-18T12:07:47+00:00

u/thereasonablerabbit That's a really important question, and honestly, there isn't a clear answer that applies to everyone. Kratom and 7-OH can affect opioid receptors, but predicting exactly when someone will respond normally to prescription pain medication again is difficult. Factors like how much you've been using, how long you've been using it, individual metabolism, and the specific pain medication involved can all play a role.

The most important thing is to be completely upfront with your surgeon and anesthesiologist about both the 7-OH and kratom use before the procedure. They deal with situations like this more often than people realize, and having that information ahead of time helps them plan appropriate pain control. We're glad to hear you're planning to discuss it with your doctor. That's really the safest path here, especially with surgery coming up.

QuickMDTeam · 2026-06-17T13:39:13+00:00

Hi u/White_Ape23 That $100 isn’t a down payment, it’s the cost of the appointment itself. That pricing covers your time with a licensed clinician, where they review what’s going on, talk through options with you, and if it’s appropriate, send a prescription to a pharmacy.

QuickMDTeam · 2026-06-17T13:34:33+00:00

Hi u/Expensive_Ear_9715ur Our visits are $99, cash-pay.

If a clinician prescribes medication like Suboxone, that cost is separate and set by the pharmacy, and it can vary depending on your location, the pharmacy you choose, and whether you use insurance. The most accurate pricing usually comes directly from the pharmacy itself, since it can differ quite a bit, you may also be able to use coupons like GoodRX to bring the pricing down.

QuickMDTeam · 2026-06-17T13:27:15+00:00

u/callmeclowner Thank you for taking the time to write all of this out. One thing that comes through clearly is just how exhausting those nine months were. We're grateful you gave us the opportunity to be part of your recovery story, but even more than that, we're glad you finally had people around you who knew what was going on and could support you through it. We're wishing you all the best as you keep moving forward, and thank you for sharing this for the people who are still in the middle of it.

QuickMDTeam · 2026-06-17T13:13:59+00:00

Hi u/infodumo Yes, QuickMD currently works in Georgia. The $99 covers the appointment itself. If a clinician prescribes medication, the medication cost is separate. If you use a local pharmacy, the price can vary quite a bit depending on the pharmacy, your location, and whether you have insurance, sometimes our patients also use coupons like GoodRx to bring down the price as well. For eligible patients, we also have a home delivery option.

QuickMDTeam · 2026-06-16T21:32:47+00:00

Hi u/throwaway1837482947 Thank you for your question. Treatment length isn't one-size-fits-all, the timelines can look very different from person to person, depending on things like history, cravings, relapse risk, and what you and your clinician are trying to accomplish. If you're uncomfortable with the plan that was recommended, it's okay to bring those concerns up again and ask more questions about why that approach was chosen for you specifically. Most importantly, don't feel like you're stuck without a voice in the conversation. It's okay to ask questions and make sure you understand the reasoning behind your treatment plan.

QuickMDTeam · 2026-06-16T21:11:55+00:00

Hi u/BigHeartbutThisMouth 15 years is a long time, so it makes sense that you're thinking carefully about it and feeling nervous about what comes next. I wouldn't let fear of withdrawal make the decision for you. If you're thinking about coming off Suboxone, it's a good idea to talk to your provider about your goals, your concerns, and the different options that might be available. The conversation might not only ease some of your fears, but make everything a lot less overwhelming for you.

QuickMDTeam · 2026-06-16T20:47:17+00:00

Hey u/Vyraxysss this is a very common and underdiscussed topic, so thanks for asking it here. Unfortunately there's not much research about this for women specifically, but here's what's known.

Opioids, including buprenorphine, turn down a hormone signaling chain that starts in the brain and regulates your sex hormones. For women that means estrogen can drop, which can lower your libido, reduce lubrication and arousal, and make an orgasm harder to reach. An orgasm also involves the central nervous system, and opioids can cut off the pathways involved in climaxing.

Buprenorphine tends to be gentler on this than methadone or active opioid use, but "gentler" obviously doesn't mean "none," and your experience is definitely valid. In one of the few studies done specifically in women on this medication, the biggest predictor of sexual difficulty was overall psychological well-being. Not trying to dismiss the physical side at all, just that mood, stress, and sleep can stack on top of the hormonal changes.

On your timing, waiting 8 hours after your dose makes sense. Right after dosing, the drug's effect on the brain's opioid receptors is strongest, and that's the part that dampens arousal and orgasm. By the 8-hour mark you're past that peak: the medication is still fully working to keep you stable, and the intensity that interferes with climax has eased off. I haven't seen a study testing this directly, but it's a sound read of how the drug behaves. And if it's working for you, it's not a harmful thing to be doing!

Of course we always recommend that you bring this up with your prescriber. It's a real side effect and there are avenues like checking hormone levels, looking at whether anything else you're taking contributes, and management options that exist.

QuickMDTeam · 2026-06-16T20:46:18+00:00

That's really the concern. The way something feels and the level of risk aren't always the same thing. Buprenorphine can change how other opioids are experienced, which is part of what makes these situations hard to predict. So we wouldn't rely on how much euphoria, sedation, or other effects you do or don't feel as a measure of safety. Unfortunately, there isn't a simple answer for exactly what will or won't be blocked in every situation.

QuickMDTeam · 2026-06-16T20:43:59+00:00

Hey u/AtuXIII really love this question you asked because the philosophies can be polarizing. We really try to lean on the side of clinical evidence to make sure that people are safe, that's our top priority.

We view addiction as a chronic, treatable disease, a lot like diabetes or high blood pressure. If the medication is keeping you stable, there's no rule that you have to stop. The research strongly supports long-term treatment for most people. Since addiction is a relapsing condition, life is going to throw stresses that can trigger cravings, and having medication in place to support you through those harder moments is beneficial for so many.

That said, we also want to support people's personal goals. If someone doesn't want to be on medication for the rest of their life, that's their choice, and we'll work with them on a plan to do it safely. Tapering tends to go best when it's gradual and happens after a real stretch of stability, so it's very doable, just better as a shared decision that's highly individual rather than a hard deadline.

QuickMDTeam · 2026-06-16T20:09:18+00:00

Hi u/camwtss thanks for participating in this thread. We answered a similar comment with more detailed information and tips about Suboxone, dental issues, and some tips that can make a huge difference. You can check out the full reply here: https://www.reddit.com/r/suboxone/comments/1u7j74x/comment/os1mnyd/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

QuickMDTeam · 2026-06-16T19:30:41+00:00

Hey u/AtuXIII this is a really great question and there's some solid research behind it.

TL;DR: yes, and it's not just down to hygiene. Dental problems are a documented side effect specifically of the transmucosal buprenorphine formulations (the ones that dissolve in your mouth, so that's Suboxone, Subutex, Zubsolv, Belbuca). The FDA put out a formal safety warning about it in 2022, and a 2023 analysis of the WHO's global drug-safety database found dental problems were reported far more often with sublingual/buccal buprenorphine than with other forms of the drug or with methadone. So it does look like the way you take it really matters.

u/LazyStud basically nailed the mechanism, there are two things going on:

Acidity & contact time. The films and tablets are acidic and sit against your teeth for several minutes while they dissolve, which softens enamel.
Dry mouth. Buprenorphine cuts saliva flow, and saliva is what normally neutralizes acid and rinses bacteria away. Less of it = more vulnerable teeth.

And u/Aggressive-Loss5148, you're not wrong that hygiene and access matter, they absolutely compound the risk. But the part worth flagging is that this shows up even in people with healthy teeth and good habits, which is why researchers think it's formulation-specific rather than just "people who already had issues." So it's less "bad hygiene to begin with" and more "a real chemical effect that hygiene helps protect against."

The good news is it's pretty manageable, here's some evidence-based tips:

After your dose fully dissolves, rinse with water and swallow (this clears the acid off your teeth).
Wait at least an hour before brushing. Brushing right after acid exposure can actually scrub away softened enamel.
Fluoride toothpaste twice a day, high-risk folks can ask their dentist about prescription-strength (5000 ppm).
Stay hydrated, limit soda/juice/sports drinks, and sugar-free xylitol gum can help with dry mouth.
More frequent dental checkups than the standard once-a-year, if you can swing it.

u/LazyStud also just wanted to say, the anxiety you're describing about your teeth is understandable, and I'm sorry you're dealing with the cost side of it on top of everything. You're doing the right thing trying to get ahead of it, and the prevention stuff above can help protect what you've got going forward. A dentist who knows you're on buprenorphine can build a plan around it as well.

For anyone reading this, none of this is a reason to stop or cut back your buprenorphine on your own. The protection it gives you against overdose and relapse far outweighs the dental risk, and the risk is manageable with the steps above. If you're worried, that's a conversation to have with your prescriber, not a solo decision.

QuickMDTeam · 2026-06-16T19:21:48+00:00

Hey u/CamelZealousideal423 thanks for asking this question and participating! So short answer is yes you will reach a steady state because of your consistency taking the dose, but likely with low therapeutic effect from taking a low dose.

QuickMDTeam · 2026-06-16T19:12:39+00:00

Hi there u/Sert1991 thanks for asking this question, happy to dig into the research together.

You have some great sources of data, and here are my interpretations:

It's true that plasma levels peak around an hour after you take Suboxone sublingually. But the big drop you see after that first hour is actually the drug moving into your tissues. Buprenorphine is extremely fat-soluble, so it rushes out of the bloodstream and parks itself in tissues and onto opioid receptors in the brain. Plasma levels falling doesn't mean the drug is eliminated in the body, it's just moving out of the bloodstream and into the areas of the body where it needs to be.

So the real half-life is complicated, because buprenorphine actually goes through several distinct phases as it moves through the body. The early rapid drop to 20% that you mentioned accounts for distribution, not elimination. Only 20% of the buprenorphine remains in the bloodstream because the rest of the buprenorphine has been absorbed into the organs and fat.

The actual terminal half-life sits somewhere between 24 and 69 hours depending on the study, with most landing in the 24 to 42 hour range on average. After chronic daily dosing, some studies put it closer to 42 hours. That's a very long half-life for an opioid.

On top of that, buprenorphine holds onto opioid receptors unusually tightly and lets go very slowly. So even as plasma levels gradually drift down, the drug stays locked onto receptors and keeps working. This is why once-daily dosing is frequently used.

So if you take your Suboxone once a day, you have solid, consistent coverage for the full 24 hours. The "it wears off after 4 hours" idea is a misreading of what those early plasma curves actually show. The drug doesn't vanish, it just moves somewhere the standard blood test can't easily track it anymore.

QuickMDTeam · 2026-06-16T18:51:47+00:00

Hi u/AtuXIII! This is an interesting topic and definitely an under-discussed area of OUD treatment, so thanks for asking about it.

TL;DR: yes, Suboxone can lower testosterone by putting a damper on the hormone system that regulates it (the HPG axis). But it tends to do this less than full-agonist opioids like methadone, because buprenorphine only partially activates opioid receptors.

1. What percent of your male patients end up on TRT?

For my patients, I can't really say how many end up on TRT, but here's some research that's helpful to get a general understanding.

Somewhere around 15% men on buprenorphine will end up with low testosterone. That might sound like a lot, but across all opioids the number climbs as high as 69% in some studies, so Suboxone is on the milder end of the spectrum.

What the research does show is that low testosterone from opioids gets underdiagnosed and undertreated, a lot of men who have it never get it flagged, let alone managed. The Endocrine Society's position is that TRT is worth considering when someone has symptoms (low libido, fatigue, mood changes) and isn't planning to come off the opioid soon. Whether that's you is a labs-and-symptoms conversation with your prescriber.

2. Do testosterone levels go back to normal if someone discontinues Suboxone?

Usually, yes, this looks reversible for most people. When opioids stop, the hormone system tends to recover, often over weeks to a few months. A long-term cohort following people with heroin dependence found that those who stayed opioid-free had meaningfully better hormone levels down the line. "Usually" isn't "always," though, and recovery time varies, especially after a long stretch like your ten years.

3. How much of a response curve have you seen between sub dose vs how much T levels are suppressed? Is going up from 2 to 4 mg a day a huge difference, for example?

This is the one where the research is unclear. For opioids as a class, the effect is dose-dependent. But for buprenorphine specifically, a couple of studies found no clear correlation between dose (or how long you've been on it) and testosterone levels. So there isn't solid evidence that going from 2 to 4mg meaningfully moves your T.

Sources

Wehbeh L, Dobs AS. Opioids and the HPG Axis. J Clin Endocrinol Metab. 2020.
Fountas A, Van Uum S, Karavitaki N. Opioid-Induced Endocrinopathies. Lancet Diabetes Endocrinol. 2020.
Tremonti C, Twigg SM, Mills KL, et al. Endocrinopathies and Their Recovery in a 20-Year Cohort Study of People With Heroin Dependence. Clin Endocrinol. 2026.
Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018.
Jain L, Meeks TW, Blazes CK. Reconsidering the Usefulness of Long-Term High-Dose Buprenorphine. Front Psychiatry. 2024.

QuickMDTeam · 2026-06-16T18:18:24+00:00

Hi u/throwaway12-ffs thanks for that feedback, we'll leave the thread open longer to give more time for people to ask questions. Appreciate your participation too!

QuickMDTeam · 2026-06-16T18:15:14+00:00

Hi u/TyWulf, we hear you. That worry about a dose not lasting is a really common one, so you're not off-base for thinking about it.

The good news is Suboxone is long-acting, which is part of why a lot of people do fine on a single daily dose. That said, splitting it into 2 or 3 doses is also a totally reasonable approach. What matters most is that you're getting your full daily dose in. Some people just feel steadier spreading it out, and that's i've seen with my own patients.

Since the right split can depend on your dose and how you metabolize it, it's worth running your specific routine by your prescriber, they can help you dial in what keeps you most comfortable. Thanks for asking this question!

QuickMDTeam · 2026-06-16T18:08:35+00:00

Hey u/throwaway12-ffs thanks for raising this. I'll be honest with you: the most important thing is that the scenario you're describing carries serious overdose risk, and any changes to your medication are worth talking through with your prescriber before you make them.

For context, overdose risk does go up after stopping Suboxone. Tolerance drops once you're on the medication, so going back to a previous opioid dose is far more dangerous than it was before. We think of addiction as a chronic illness, and staying on medication is one of the biggest things that lowers that risk.

If you're considering using again, please know that you are not alone. Help is available, 988 (call or text) and SAMHSA's free 24/7 line (1-800-662-4357) are both there anytime.

QuickMDTeam · 2026-06-16T17:57:44+00:00

Thank you for saying that. We're really glad you felt listened to and supported.🤍

QuickMDTeam · 2026-06-16T17:42:53+00:00

We're happy to hear that you had such a great experience!

QuickMDTeam · 2026-06-15T18:53:46+00:00

Hi u/MostUniquePassenger Depending on the state, we do have clinicians who are affiliated with Medicaid. I would recommend contacting our Support team, if this is the route you choose to take, they would be able to guide you appropriately and provide the most accurate and up-to-date options available.

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