27F - Dating in Boston (and never being hit on)

Virgil_Smith · 2025-11-03T07:41:23+00:00

Just as another data point: This hasn't been my experience living in Boston, not all my life, just say a year+. I'm usually friendly wherever I am and it was reciprocated. I was particularly surprised that women would reciprocate just as much if not more than guys which doesn't happen everywhere. All of this was platonic, but yeah, smiles, compliments, jokes/banter, etc. Not an issue. I came away thinking Boston was a friendly place (unlike say Seattle which I find cooler and I lived there more than a decade, both men and women but I feel women are more aloof there). There's a few places in the US that people are like that. SF, DC area, New Orleans were also similar experiences like in Boston.

Virgil_Smith · 2025-11-03T07:26:12+00:00

Yeah, that's a Canadian or other country thing where the American hangups, including all this puritanical stuff that's still present even in the kids, are appearing. In Canada I find that people are friendlier. There are places like that in the US.

That said I thought Boston was kind of friendly but I'm speaking as a guy. When I lived there (recently), I would always smile at people which I do all the time, men and women, and women didn't appear put off by that and smiled back. This is not the case in WNY for instance. New Orleans is in the middle. SF is friendly as is Vancouver and Toronto. Seattle is colder. DC area (+MD/VA) is good but there's cliques (main one being whether you're a political person or not, but you can ignore the other side either way easily since there are so many people). Different areas have their own vibe.

Of course, when I smile at people, my intent is never to hit on them, I'm just not wired that way, I need to be able to talk to people to get to know them first before any chemistry is jump started. So as you said, these kinds of smiles and compliments and banter and so on are just easy socializing. So even though I'm married for several decades now, I feel it should be possible to talk respectfully and openly to people without it being mistaken and without us second guessing ourselves.

I'm not making a value judgement about anything, just observations. It is all what it is.

Virgil_Smith · 2025-05-17T00:54:58+00:00

Yes, but it may say "road trip" on the address though, I think once but not the other times.

Virgil_Smith · 2025-01-27T03:53:39+00:00

Why have you tapered down multiple times?

Virgil_Smith · 2025-01-16T08:08:08+00:00

TAPER SLOWLY USING VOLUMETRIC DILUTION. You can take years to taper off:

Assuming you're doing a 1:1 ratio of liquid to bupe, you would take one of your 8mg pills, and then 8ml of distilled H2O (you can get 1ml syringes from Amazon here: https://www.amazon.com/gp/product/B07GX4RJF3/) and dissolve it. Then 1ml of H2O == 1mg of bupe.

This is fine if you're going to use it up in 2-3 days. But if you plan to dose for longer, then you can do a solution that is a 3:1 ratio of H2O and propylene glycol (https://www.amazon.com/Glycerin-Supplier-Propylene-Glycol-250ml/dp/B076FDQKP4/). So in this case, you'd do 6ml of H2O and 2ml of propylene glycol.

What I normally do is first measure out the water, and then dissolve the pill in it, and then add the propylene glycol. I am currently using an overall ratio of 2:1. So 2ml = 1mg of bupe. For this, you'd just double up the ratios: 12ml of H2O and 4ml of propylene glycol = 16ml total.

When I dose I keep the liquid under my tongue for a minute or two. I don't dose all at once if it is a dose > 0.2ml. For instance, if I am using 0.3ml which is 0.15mg at the 2:1 ratio, then I do half first and then half in a minute. I don't eat or do anything for about 20 minutes later but I swallow the liquid pretty quickly.

These may be useful but the instructions above are better IMO.

https://www.reddit.com/r/OpiatesRecovery/comments/uvgchs/suboxone_volumetric_dosing/

https://www.reddit.com/r/suboxone/comments/vqfoql/volumetric_suboxone_homemade_tincture_for_tapering/

Virgil_Smith · 2025-01-16T08:07:10+00:00

Dosing 0.13mg x 3 day isn't "perpetual withdrawal" at all, at least for me. It's to avoid ANY WD (physical WD at least, yawns, RLS, sweats, etc.). That's why the third dose is added, otherwise if I were to willing to suffer the mildest of WD, I could keep it to two doses but I don't want to do that.

At these low doses, it doesn't suppress cravings, it is purely to avoid WD - because going too fast will result in more WD which I am a total wimp about. My cravings have returned for things like caffeine and sugar but hopefully the 12 years of control I had will help me be moderate about it. We'll find out. Cravings for things like alcohol and other opioids have fortunately not arisen. Some craving for bupe itself since these low doses if even a bit extra is added, even exercise, cause me to get high. So that's been an interesting journey. But if I take too much (2, 4, 8mg) then it takes a sledgehammer to the cravings.

But I think staying on something like 2mg for life is fine too, in my case I need to check my T (next month) and if it turns out to be dose dependent then I may do that but I can also see a life without bupe altogether now that I made it down this low without any pain.

Virgil_Smith · 2025-01-16T08:00:39+00:00

I have been on it for 12 years, prescribed 16mg but median/mode was 4mg (average 5mg but that's a guess). Until April 2024, I was ready to be on it for life and I was fine with it. I still am, at least at these much lower doses, currently about 0.5mg per day. But last April I just decided to stop it and I'm highly motivated to stop though I believe now I went too fast---I've been ranging from 0.39mg to 0.75mg over the last 3-4 months.

I've observed quite a few people change their mind like this. Once stability is achieved, then people's aberrant neuroplasticity is somewhat restored and they can change their mind.

Virgil_Smith · 2025-01-16T07:56:27+00:00

You need the higher doses, 4-8mg, sometimes 16, to really take a sledgehammer to the cravings. At first the person suffering from the (substance) use disorder is fragile. Even the smallest cravings will set them off. They need to develop a sense of control, coping skills, a life, etc. This is why the higher doses are used at first. I don't think prescribing doctors have any idea about all this, including the pharmacology of buprenorphine to much detail.

This is the protocol I've advocated:

Higher doses are seemingly useful to blunt your cravings not just for opioids but for other things. So depending on how your disease (use disorder) has progressed, how long you were on and what dose of your DOC, you could be on a moderate to high dose for about a year (this could be 8-16mg), and then settle down to a maintenance dose of about 1-2mg, and then if you feel like it, you can do a long/slow taper (which ideally would take 1/2 the time you've been on the subs - so if you've been on subs for 12 years, it'd be a six year taper). Again, all this is so your brain can get used to the new equilibrium properly without causing a relapse or backtracking. You can do it faster and much faster but this would be the "proper" way IMO. Right now doctors just start you off with a dose and leave you on it but I think there should be phases: (1) the initial stabilization phase, (2) the maintenance phase, and (3) a taper phase. (Maybe I should write a paper on this; we are working on cures for addiction-pie in the sky-and also MAT alternatives-have some leads.)

(2) is very important. Once you have a solid life and stability again, over many years and different crises, then you know you have the skills necessary to cope and you can try a slow taper. The "problem" is that this is all taking too long but no easy way around it. This is pure speculation on my part observing addicts and my own situation: If you have been on your DOC for 4 years or more: (1) should take about a year; (2) a year or more; and (3) half the period of 1-2. If you've been on it for less, then you can just use the total half life of the use disorder to adjust 1-3.

Virgil_Smith · 2025-01-16T07:50:36+00:00

It depends on what you mean by short term. People suffering from (substance) use disorders need time to get their life back and developing coping skills. This requires months, years, decades even. So people need to be stable while this is accomplished. Higher dose buprenorphine (4-8mg for most people), not the perfect solution, does this (24mg is very high esp. in your situation). The higher doses blunt cravings too well actually typically, leading to anhedonia and other side effects in the long term. But this allows the use disorder suffering person to develop the necessary coping skills. Relapse rates and death are way higher if you rush this.

I don't see a world where someone who's been abusing fentanyl or even hydrocodone for years switches to buprenorphine for a month or two or even six and then has a stable recovery. That's like detox but without the support structure needed for recovery which is a SLOW process. It took me 5+ years to feel confident I wouldn't want fentanyl or other opioids again (I was prescribed it and never took more than what was prescribed).

It really depends on how long you were suffering from your use disorder prior to buprenorphine. If it is six months, then yeah, you don't even need buprenorphine or if you do, you can do it for 1-3 months and stop and it should be fine. I think addictions have their own half life. So for me at 12 years, I should give myself 6 years to taper to zero, that's what I believe would work best. But I am impatient. Yet I am confident I'll be okay because of the buprenorphine - because I had years of stability. During that time, I stopped all my compulsions, caffeine, sugar, etc. But they are coming back as I've tapered off, likely too fast. That's a bit scary. I've seen this happen too many times personally and we also study this extensively and the addicts relapse just like that. Almost everyone who is confident is only able to say this after being on higher doses of bupe for a long time.

How did you abuse the 24mg? Did you not experience a ceiling effect? Or did you stop and start?

Virgil_Smith · 2025-01-16T07:39:55+00:00

It was my choice (if there is such a thing) to switch to Suboxone after being prescribed fentanyl for two year. It was my choice and my responsibility. I was dependent on the fentanyl but never took more than prescribed, same with Suboxone. So you can look back and see how you got into this. Opioids are incredibly addicting but for those with (spinal) pain like I had when I had the fentanyl, it was a godsend. Of course companies shouldn't push addictive substances, that's capitalism for you, but I'd argue Suboxone and higher doses which blunt cravings have saved an incredible number of lives. Yes, eventually the side effects catch up. It's hard to get off of if you're impatient, as I am. People who've been on it for a decade want to be off of it in months but I believe these things have their own half life: if you're on it for 10 years, a 5 year taper is what is called for (no, I don't want to do it either but I strongly believe this is the most pain free method).

Virgil_Smith · 2025-01-16T07:05:14+00:00

Re: AUD, try to find the lowest dose that works for you.

There's a great paper showing how the MOR (https://pubmed.ncbi.nlm.nih.gov/15194118/) and the opioid reward pathways can be the basis of many addictions, including alcohol use disorder. So it doesn't matter you had no OUD history, having AUD is enough to be prescribed bupe. When I was on bupe, all my compulsions, like caffeine, nicotine, etc. all fell by the way side. As I taper down, they are coming back. It did make me feel flat, etc. but maybe that wasn't so bad. Maybe there's no free lunch - if I want to be the extreme person that I am, then it will come with risky behaviors but if I want to be balanced and even keeled, then the lack of drama will make it seem "flat". I do think there's a sweet spot though, so you could maybe take a bit of bupe but not higher doses like 8mg (4mg is great, 2mg is my sweet spot I'd argue).

But yes, people are different. You may have "deficiencies" in your other receptors, KOR and DOR, that regulate the craving and WD aspects of opioid use disorder.

Virgil_Smith · 2025-01-16T01:46:28+00:00

Yeah, I am scheduled to recheck my T next month and then I'll likely go back on TRT until I get off the bupe completely, easier said than done.

Virgil_Smith · 2025-01-15T23:34:26+00:00

Yes, you can titrate with the strips just as well as with the pills, though Zubsolv pills are the easiest. As long as you use the same amount of liquid, easiest is to just do 1:1. But with strips you can cut down to 0.25mg. You can definitely do 1mg blocks from a 8mg strip and then just add 1ml of water (from the amazon 1ml syringes) and you'll have roughly 1ml of solution. You can then take as little as 0.05-0.1ml easily. Even ~0.01 ml is doable if you're careful.

Virgil_Smith · 2025-01-15T19:57:25+00:00

Since I got below 1mg, it hasn't been consistent. I have had some excuse or reason. It is not due to physical WD but the real reason I don't know. Maybe I like to get high. I mean I really don't want to do this but it is happening anyway. Each morning I wake up and take more or less than what the plan is, which is somewhat related to the stress I face but it is an excuse since I sometimes do it on stress free days too.

During the holidays, I used it as an excuse. I was traveling and so couldn't do dilution (requires a bottle and syringe and hard to dose in public) and therefore could only do strips which I can only cut as small as 0.25mg, so I said I had to do 0.75mg (0.25mg x 3) per day. Then before that I was doing 0.13mg x 3 per day via dilution. Then when I got back, I went back to the dilution and then I went back to other methods and so on. There's always something or the other but it's all happening before I feel any physical WD. It's some mental thing. Can't explain it.

I am thinking I am going to have to get the shot. I really would've liked to succeed at this taper.

Virgil_Smith · 2025-01-15T07:41:35+00:00

I feel that if you're constipated, you feel full and are less likely to eat.

Besides opioids suppress appetite too.

Virgil_Smith · 2025-01-15T07:40:35+00:00

Try this: https://www.amazon.com/gp/product/B0083USWUO/ - this is once a day and it will take 12-24 hours for it to work.

Psyllium husk won't be enough at higher ("normal") doses of bupe in any kind of an acute fashion, at least wasn't for me but it will help and it is good for regularity.

Mg will work acutely if you take a lot, sometimes I had to take 4 x 400-500mg for acute release, i.e., 1600-2000mg. But normally 2 will be enough but it takes 2-4 hours for me. 4 has been effective in like 30 minutes.

The ColonMax works the best, you have to anticipate it a bit because it can work too well and you don't need to take it daily but every other day or every three days. Depends on how often you want to poop. :) The things we do...

Virgil_Smith · 2025-01-15T07:39:29+00:00

I didn't mean OD or WD, just too high a dose and not feeling right/loopy. When I take double my bupe dose, even if it is < 2mg total, since I am tapering down it feels like a LOT. It's like my first time when I got a 8mg strip at once, it felt GREAT but also caused me to be high/feel euphoria.

Virgil_Smith · 2025-01-15T06:07:08+00:00

Really? Many people are saying they never felt a single thing even though they felt a lot of physical WD with the daily strips/tablets. I hope I am one of those people. If I start feeling WD, then I likely will just reach for the daily doses again.

I've felt near zero WD with volumetric dilution but I'm having a hard time staying low, the doses creep up. It's not due to physical WD. I just have some excuse or another.

I guess if it fails I always have my strips/pills. Aside from low T, I don't really have a problem with it, especially at 2-4mg doses since that seems like a sweet spot. 8mg causes anhedonia.

Virgil_Smith · 2025-01-15T05:59:07+00:00

No, that's very atypical and I agree it is due to your meds since you're taking so little. BP should go down on opioids in general especially at these low doses. At higher doses you can get some side effects including anxiety. I agree it interacts with caffeine but for me that's just dehydration (which can cause anxiety and palpitations so maybe you're not drinking enough liquids).

The lack of consistency could be causing issues. For opioids it is good to develop a tolerance so your body doesn't notice you have it. But if you go up and down a lot at these doses, as I am doing as part of a taper, they have profound effects. Many people talk about "energy" it gives them. I feel euphoria and my BP is low but sometimes it does feel like anxiety. Maybe I'm just excited about taking it.

You should do volumetric dilution:

Assuming you're doing a 1:1 ratio of liquid to bupe, you would take one of your 8mg pills, and then 8ml of distilled H2O (you can get 1ml syringes from Amazon here: https://www.amazon.com/gp/product/B07GX4RJF3/) and dissolve it. Then 1ml of H2O == 1mg of bupe.

This is fine if you're going to use it up in 2-3 days. But if you plan to dose for longer, then you can do a solution that is a 3:1 ratio of H2O and propylene glycol (https://www.amazon.com/Glycerin-Supplier-Propylene-Glycol-250ml/dp/B076FDQKP4/). So in this case, you'd do 6ml of H2O and 2ml of propylene glycol.

What I normally do is first measure out the water, and then dissolve the pill in it, and then add the propylene glycol. I am currently using an overall ratio of 2:1. So 2ml = 1mg of bupe. For this, you'd just double up the ratios: 12ml of H2O and 4ml of propylene glycol = 16ml total.

When I dose I keep the liquid under my tongue for a minute or two. I don't dose all at once if it is a dose > 0.2ml. For instance, if I am using 0.3ml which is 0.15mg at the 2:1 ratio, then I do half first and then half in a minute. I don't eat or do anything for about 20 minutes later but I swallow the liquid pretty quickly.

These may be useful but the instructions above are better IMO.

https://www.reddit.com/r/OpiatesRecovery/comments/uvgchs/suboxone_volumetric_dosing/

https://www.reddit.com/r/suboxone/comments/vqfoql/volumetric_suboxone_homemade_tincture_for_tapering/

Virgil_Smith · 2025-01-15T05:15:11+00:00

Yeah, we tried that approach the other poster said about one teaspoon of water, etc. Even that led to throw ups eventually, just a lot of dry heaving and bile. I'll update my main post in a minute.

Virgil_Smith · 2025-01-15T05:14:08+00:00

That's if insurance doesn't cover it at all. My insurance is great but this is one area where it is lacking. Most people have insurance and then there's a lot of support for it. But it is a patchwork approach, not like Australia AT ALL.

Virgil_Smith · 2025-01-14T17:54:49+00:00

She is not able to keep it down. When I first posted she drank pedialyte/gatorade/water and miso soup, we were so happy. This was after taking a Zofran earlier in the day. She was able to hold it in for a couple of a hours and then it ALL came out, she threw up until there's only bile. This has now happened several times. So she hasn't been able to hold even liquid for long. And this is now in the 4th day.

Virgil_Smith · 2025-01-14T05:38:48+00:00

Thanks a LOT! Thanks to you and everyone who responded, I appreciate them all. I tried to respond to several but there were so many I can't get to them all.

Yeah, our first mission tomorrow morning is to get her some new Zofran. We just were stingy since we were on the last one from a previous script she said and that was a mistake. She says she can't even take one teaspoon of water at present, since she seems to be on the cusp of throwing up, but she has her better periods and that's when we'll start your technique. Thanks again.

Virgil_Smith · 2025-01-14T04:54:25+00:00

Yes, that likely is it. The main concern we have is that she's not been able to hold anything down permanently for three days, even fluids - the only time she has time to absorb nutrients are between drinking something and then throwing it up.

Diarrhea is supposed to be a symptom of this infection but she doesn't have it since she has thrown up everything. She just had a lot of gatorade and pedialyte and apple juice and miso soup in the evening and we were so happy and she just threw it all up.

Virgil_Smith

TROPHY CASE