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daveatnite

Having issues weaning off sublocade/bupe injection, any advice on tapering?

NSFWQuestion

Sorry in advance for the long post:

Almost 2 years ago, I transitioned from methadone to bupe. My doctor recommended micro-induction which was much easier than the traditional method of stopping methadone for 72 hours, then starting bupe.

After 4 weeks of sublingual, I switched to the monthly injection. I've heard so many people say that tapering was so much easier this way because the shot lasts for months. Started with the recommended doses, 300mg for 2 months, then down to 100 mg. But the 100mg felt like it was wearing off before the month was out. On top of the onset of mild physical symptoms (insomnia, occasional cold sweats, loose stools, etc) I felt very anxious and emotional. We tried doing the 300mg one more time, but the headaches were so severe and I was on the opposite end of the spectrum emotionally. Like just completely numb and unmotivated, didn't feel like myself whatsoever.

After all that, my doctor switched me to 64mg monthly Brixadi for a while which did seem to have more consistency for me. I wasn't experiencing as many ups and downs, no severe headaches like before. Maybe some mild symptoms toward the end of the month but nothing intolerable.

However, once I tried to push the doses further out is when I ran into issues. We started doing every 5 weeks instead of 4 and I noticed more w/d symptoms coming on quicker each time. Of course, it's never as bad as opiate w/d like I had 10 years ago, but still bad enough that I couldn't get past 5 weeks between shots.

Last month, I asked if I could try the 100mg sublocade one more time since Brixadi has been known to wear off quicker for most people. My thinking was that maybe going from 300mg to 100mg was just too much of a jump, but since Brixadi offered a much larger dosing range, I was able to get to a more stable point. So maybe now it would be a smoother transition.

So now it's been a month since the last appointment at 100mg sublocade. Still getting intermittent headaches and feeling somewhat emotionally withdrawn but not as bad as before. But I've made it 4 weeks without supplementing and haven't noticed any physical w/d symptoms, which is great. Still, the idea of getting off of this seems so far away from me and I feel so hopeless. I hate the way I feel on bupe, I miss having energy, I miss loving to go places and do things. I just feel so emotionally tapped out.

Some important background info: for as long as I remember, I have always seemed to metabolize things faster than my peers. I used to drink heavily and still experience "hangovers" within a couple hours after I stopped drinking. With opiates, it seemed like I was always the first to experience w/d symptoms. Even with methadone I'd hear people talk about missing a day as if it was no big deal but I would wake up every morning around 4am to dose because I usually couldn't stay asleep past that point anyway.

I understand that there is a psychological aspect to all of this as well, but I still experience unmistakable physical w/d symptoms before they "should" be occurring.

That said, I'm just wondering if anyone else has had this issue and/or has any suggestions for tapering? I see so many comments about people going 3-4 months off sublocade and feeling little to no symptoms at all, and I am so envious. So any advice on what could potentially help in this process would be greatly appreciated!

TLDR; I am having a really hard time tapering off of either sublocade or brixadi and after 2 years I haven't been able to make it 6 weeks between shots, let alone several months. Any advice is appreciated. 🥲

Posted Sep 1, 2026, 4:34 PM UTC

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