I noticed this question in the search terms tonight. I would think I have covered this topic, but Then again, perhaps this is one of those things that seems to be a part of so many posts, but yet never gets a post of its own.
The simple answer, I suppose, is however long your doctor allows you to take it. Wow… talk about unsatisfying answers!! But really, the attitude of your doctor is probably going to be the thing that impacts this decision the most. I frequently receive notes from people that say ‘help—my doc is making me go off Suboxone and I don’t know what to do!’ On one hand, this is not the end of the world; if a person does happen to relapse, at least the person can get right back on Suboxone. But what if the person lives in one of those areas where people who relapse are treated like pariahs by the treatment community? What if the person cannot get back on Suboxone? THAT would be a real shame.
Opiate dependence is a relapsing illness. Yes, ideally people avoid relapse. But it is not a reasonable expectation that nobody will or should relapse. There must be a contingency plan for dealing with people who ‘slip’, providing that there is an understanding that at SOME point the person will run out of options.
In my opinion and in my practice I don’t have an ‘end point’ for Suboxone treatment. There are things that will result in termination of treatment, including illegal behaviors, diversion, ‘lurking’… but I do not taper a person off Suboxone for simply being at it too long. I have some general guidelines that I like to abide by; I think that stopping Suboxone after less than six months is almost always a bad idea, for example. I usually shoot for a six to twelve month period of taking Suboxone; that generally allows enough time for the person to find new friends and start to establish a non-using identity. But I look more at where the person is at, rather than how long the person has been there. I have some patients in their 40s or 50s who have been on a stable dose of Suboxone for several years.
So when you evaluate physicians who prescribe Suboxone, I suggest that you ask about the doctors’ attitudes about the time frame for Suboxone treatment.
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