According to my doctor, there was a Fall, 2004 conference in Paris (where Buprenorphine therapy was pioneered) and they all agreed that many of the initial assumptions about Buprenorphine were wrong. Make sure you get a sufficient dosage. I was at 32mg by the end of my first week. You cannot OD on this stuff (so long as you do not drink or use benzos), so higher doses are fine. My doctor had a patient who was unresponsive until 70mg. That is common in Europe where they have had more success.

You insurance company will complain, but it is worth it. Methadone can be pretty devestating. I swithced off of it ASAP. I have been very happy with Buprenorphine, but I do believe that a high dose in the beginning really dose help. Higher doses are the best indicator that someonw will continure treatment in the first few weeks. For your current meds it is better to dose liberally.

Also, if you ever do need pain meds after taking Buprenorphine, remember that only Fentynal can override it without complications. Morphine and oxycodone can, but they often require a respirator. It is a bad deal. So if you are hurt, tell the doctor to use "IV Fentynal titrated to effect." I hope that helps. I have really liked Buprenorphine. I have tapered off of it after a car accident, and now I am back on at 4mg. It is really a great way to taper off opiates, or for side effect free long-term maintenance.