It is currently Wed Aug 23, 2017 5:17 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 8 posts ] 
Author Message
PostPosted: Wed Apr 06, 2016 6:38 pm 
Offline
Average Poster
Average Poster

Joined: Wed Apr 06, 2016 5:37 pm
Posts: 5
Hi I hope I get this right I haven't done this before but I've learnt sooo much from this forum you've already helped so much and I/we need help. Anyway my partner has been on 24mg of Suboxone for 3 weeks now, for an opiate problem he's had for over a year. From everything that I've read it's way too much but the docs are soo against dropping him, in fact they keep trying to up him to 32! It's really frustrating as he has to take it in front of the pharmacist here too. He feels constantly tired and his anxiety is through the roof is it likely to be from the Sub? I want him to keep trying to get dropped to 16 of preferably 8 but as we have stressful money stuff going on I know it might be coincidence. We are in a financial mess and he has things he needs to be able to start dealing with but right now he struggles just getting to work...we are in a stale mate right now. Should he be trying to get meds for the anxiety or is dropping the Sub down the way to go? I'm so confused and trying to cope with our other issues and him plus managing a family is making me crazy. When he told the drug place he attends how he's feeling the nurse told him he's probably just missing getting wasted. He's been on this before very short term and didn't feel like this but he hadn't racked up loads of debt that time. Sorry if this is all over the place I'm very stressed by all this and obviously can't talk to anyone really. Thanks A


Top
 Profile  
 
PostPosted: Wed Apr 06, 2016 8:29 pm 
Offline
Long Time Member
Long Time Member

Joined: Sun Feb 14, 2016 9:40 pm
Posts: 631
Welcome ukinnz33!

Yes, you did great posting in on this forum and in the right section. Others here are better at talking of dosages and will soon come along to better answer. In the meantime, a couple of questions that might help us, do you/your partner reside outside the US? Asking bc he has to take it front of the pharmacist. Daily? What opiate was he on for a yr? Best, P


Top
 Profile  
 
PostPosted: Wed Apr 06, 2016 11:19 pm 
Offline
Average Poster
Average Poster

Joined: Wed Apr 06, 2016 5:37 pm
Posts: 5
Hi P, we r in New Zealand and yeah you have to take at the pharmacy once a day, after a while they allow takeaways but I think that's a way off. And he was iv'ing 60mg morphine a day (or the baked version of) which is similar to H if that makes a diff. They also like long term here too, we got told 1-2 years before tapering starts which I get if he can get on with life in the meantime but so far he's still such a mess. I just don't know what to do for him and I can't get him to talk much I think he's still fogged up and everything just stresses him more.

Thanks for your reply A, I feel better already just rambling.


Top
 Profile  
 
Our Sponsors
PostPosted: Thu Apr 07, 2016 6:20 am 
Offline
Moderator
Moderator
User avatar

Joined: Tue Mar 11, 2014 10:48 pm
Posts: 1317
Hello Ukinnz33,

By reading here for years and learning as much as I could about this medication, it sounds to me that he could very well be taking to much. Ive also seen this first hand.
Im sorry his anxiety is though the roof.

While we can't know just what his dr is thinking or what the standard of care is there, the only way to change this is to keep talking to his Dr. Yes, over time his tolerance to Buprenorphine will rise and he could very well balance out. However with doses this high the side effects are greater, as you are seeing in him now. Imo, going from 60mgs of morphine to 24mgs of Buprenorphine is over kill. Most places in the states are using 16mgs as the highend of treatment.

Im no Dr, but I believe he would be better off taping to 16mgs, at least. Sub treatment is supposed to make you feel normal, a feeling of well being. Get in that drs ear if you have no control over his dosing.

There is much to read here, and over in Dr Js Talkzone. Please check that out as well.



Razor.


Top
 Profile  
 
PostPosted: Thu Apr 07, 2016 10:02 pm 
Offline
Average Poster
Average Poster

Joined: Wed Apr 06, 2016 5:37 pm
Posts: 5
Hi Razor,

Thanks for the advice you've said what I was thinking, I'll keep reading and do as u suggest n get in the doc's ear more. They say it's all client lead so I'll remind them of that for a start. I thought this would make him feel normal it was all supposed to be such a relief and a new chance but so far it's just changed to a different nightmare. I'll check out Dr Js Talkzone too thanks. I want him to go straight to 16 or even 8 too I've read it's ok and it feels like he's got nothing to lose, the dr wants a 2mg over 4 day drop. I'm just worried of him staying up there for too long. Cheers, Ali


Top
 Profile  
 
PostPosted: Sat Apr 09, 2016 6:57 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Thanks for the Talk zone plug! I agree that 24 mg is probably more than he needs... but at the same time, the high dose of buprenorphine is not likely the cause of his anxiety or other problems. The ceiling on the effects of buprenorphine prevents the drug from impacting brain function, although you can get more constipation with high doses from direct effects on the colon from norbuprenorphine-- a buprenorphine breakdown product that does not cross the blood brain barrier.

The program you describe sounds like the methadone programs in the US. Methadone CAN cause problems in higher doses because it works as an agonist, meaning it has no ceiling to its effects. High doses of methadone often cause patients to feel sleepy and even 'dulled'. But buprenorphine acts differently at the receptor, preventing increased effects with increased dose beyond a certain level.

I spend a lot of time encouraging patients to lose the word 'anxiety'. Everyone has a different feeling in mind when they say that word. Anyone who is going to create a sober life must come to grips with the fact that things will be difficult-- and that everyone faces challenges. I sometimes get the sense that patients believe that other people have it easier; that their fears and challenges feel unique in some way. I will hear a patient say 'doc, sometimes I don't feel like getting out of bed in the morning.' My thought at those times is that I don't like getting out of be either! I think that most people struggle, from time to time, with finding the motivation to get out of bed. But we DO get out of bed, because we have all learned that there is no future in staying in bed!

I realize that these comments sound insensitive to the person who feels 'anxious'. But they shouldn't be taken that way, because I'm only trying to help. Your partner has to learn that there is no cure for 'anxiety' except to tolerate it. The only thing that prevented 'anxiety' was opioids-- and it is time to give them up, because they did what they always do, which is to turn on the person and destroy everything that is important to the person. Living without opioids is very different from living ON opioids. Now, your partner has to TOLERATE reality, instead of avoiding it.

The docs raised the dose of buprenorphine just to make absolutely certain that your partner isn't being held back by cravings or by withdrawal symptoms. There really isn't a downside to a high dose of buprenorphine. We know of no dose-related toxicity, for example-- and there are no dose-dependent side effects other than constipation. At this point, his/her problems are likely independent from buprenorphine or other opioids, and more likely related to personality or other longstanding issues. The goal for your partner is tolerating the feelings that come with wakefulness. That's what recovery is all about.


Top
 Profile  
 
PostPosted: Wed Apr 13, 2016 7:17 pm 
Offline
Moderator
Moderator

Joined: Fri May 01, 2015 9:58 am
Posts: 882
Hi Ali and welcome! I agree with almost everything Dr. J said and feel that you have received advice from the best. The only thing I do feel a little differently about is the anxiety. I do believe that people need to learn ways to deal with anxiety that can make everyday activities easier to get through. But I do also believe that people can have an anxiety disorder in which they are not able to control on their own. I feel the same way about depression. There are levels of both anxiety and depression that can be treated with cbt, psychotherapy and other tools and it not be necessary for medication. It is a very individual thing and one that the doctor and patient need to work on together. I hope that the doctor will begin to listen to what your husband is saying! Good luck and please keep us posted!


Top
 Profile  
 
PostPosted: Wed Apr 13, 2016 11:16 pm 
Offline
Average Poster
Average Poster

Joined: Wed Apr 06, 2016 5:37 pm
Posts: 5
Hi suboxdoc and Michelle F,
Wow it feels such a relief to get these replies, it's so hard trying to make sense of all this I feel like
I've been living on another planet for too long now and I knew nothing about all this stuff a year ago. What you said does make complete sense I don't think he's really ever had to face life without a drug of some sort so to him skipping the 'boring bits' comes naturally. Plus he's always pulled himself out of any potential danger not having to learn the huge impact this can have. This time he's in reality big time so I guess the anxiety does make sense and the constant tiredness is him choosing to hide??!! Plus he does have a tendency to stick his head in the sand and let me deal with stuff. Sooo freekin' mad at him tho he was totally clean when we got together and he was such a different guy. Ok so he's got money crap to sort, a job he hates (and he used to earn heaps so this does his nut in).
Add to that guilt at the life he's not given me blah blah...anyway building a picture he doesn't just have one thing to think about. I know again that's life, question is, Michelle you said it it's the anxiety, he needs to learn to deal with stuff but I think he needs lots of help to even start. I'm going with him to his next appointment for sure to make sure they take notice and see what they say. It just feels like he's suffering some of the symptoms as paws from what Iv'e read about it, and won't he still have to go through that when he comes off Sub? Would he be better tapering off and taking a natural anti-depressent/physchotherapy instead rather than keeping him in this horrible state for a year or more? Thx everyone I feel such a responsibility to help him help himself, sorry to ramble, Ali x


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 8 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group