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PostPosted: Sat Feb 01, 2014 1:40 am 
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I'm 61 years old and I've been on 8mg film for approx 6-7 months and want to stop. For the last two months I've always bent the film in 1/2 and shaved off pieces from each half before I'd take it and I'd take one in the morning and the other half around 6pm. 6 days ago I started just taking 1/2 of the 8mg film around 7pm each evening and hope to taper off from there. I'm grateful for finding this site.

I guess my question is a basic one, am I suppose to be seeing/feeling withdrawals at this stage? If so, when should I be seeing something? I have the occasional chills and hot flashes, but I always blame that on age and winter. I am tired, depressed, have headache, sound in my head and my focus is really off, but I've felt this way since I started Suboxone and it's part of the reasons I want to stop.

I've read that the biggest withdrawals are at the lower end of the taper and I'm wondering if going from 8 to 4 is not big leap for symptoms? I've read about a lot of hard symptoms here and was wondering why I haven't really felt them or maybe it will take another week before more rear their ugly heads.

I had taken pain medication for several years for stomach issues and wanted to stop when I saw a TV commercial about getting ones life back and contacted one of the doctors, but after all the reading I've done I may have gotten the wrong impression of Suboxone.

I know it tapering won't be easy and I'm concerned about my age. I do take BP medication, .25 Xanax as needed for anxiety and Ambien to sleep. I also have a blood disorder called essential thrombocythemia - kind of a high platelet thing I take hydroxeurea for….so that's pretty much my meds. I will be talking with my doctor, but I also know a support community is also very important for success.

Thank you in advance.

Cathy


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PostPosted: Sat Feb 01, 2014 4:32 am 
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hi Cathy, that is a pretty good jump as I did the same, I really did't have any symptoms dropping from 8-4mgs. It really can get difficult around 1 - 2 mg. I just tapered from 2 - 1mg and am having moderate withdrawal symptoms. You may want to slow it down a bit. Go down .250 each time say , once a week or when ever you are ready. Everyone is diffent so you will have to try whats good for you.

Keep it up your doing great. Goog luck, you are at the best site out there. Everyone here is very friendly and helpful.


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PostPosted: Sat Feb 01, 2014 8:42 am 
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Hi Cathy,

Welcome to the forum!

As the above poster said, it's not likely you will start to feel any bad WD symptoms until you get down below 2mg per day. I don't know why that is, but most people report not having any problems with their taper until that point. I myself experienced the exact same thing. Any difficulties you have before that point are more likely to be related to the mental aspect of your addiction.

Yes, jumping from 8mg - 4mg is a bit faster than we would recommend, but it's really not that big of a deal if you are feeling ok. I would consider though, slowing it down a little bit from this point on. You will more than likely start to feel the drops a little bit more at this point. We normally recommend you dropping by .5mg each week until you reach 2mg, then slowing it down to .25mg after that. Yes, it will take a bit longer, but it is worth it when you don't have to go through the bad physical WD during your taper. It makes that final jump just that much easier.

I am very sorry that you got into suboxone maintenance without knowing exactly what you were getting into. I think the doctors should be a bit more careful to explain the whole process, but in all honesty some of them just don't know how hard it actually is to come off this medicine. I guess I can understand why you would feel that the commercial was misleading. But, the makers of this medication intended it to be used as a long term, if not lifetime maintenance medication. If you look at it from that view point then I don't really think they are being dishonest. True, they should make it clear that you are going to become physically addicted to the meds, but I don't see how they would do that on a commercial. I think that falls into the doctors area of responsibility.

LOL, I didn't mean to make this a defense of Reckitt-Bensicker, it was just a side note.

Anyway, good luck! Please keep us updated on your progress.

Q

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PostPosted: Sat Feb 01, 2014 1:35 pm 
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Thank you for your response.

Question iwilldothis - how long did you wait until you jumped from 4mgs? I was thinking about giving it another week, but in the process take the 4mg and cut it in half taking 2mg in the morning and 2mg in the evening. I get very confused with trying to understand the 1/2 life information and how that will effect me as I go through each step before moving to the next.

Like I said, I was just thinking that step as a possible next step and work down from there. I also know I have a little time to immerse myself in understanding how to use the Sub Cut Guide because it looks a bit confusing to me. I pictured myself with my glasses on, magnifying glass, tweezers and the guide trying to slice up an 8mg sheet…and at my age it looked like a silly picture in my head. All silliness aside, I do know I will probably be doing that.

So I have at least a week to figure it out.

qhorsegal2 - For me at 61, a lifetime maintenance program doesn't seem as logical as it would had at in my 20's or 30's. A lot of health issues start arising as you get older and balancing options will always be important. I don't want to have to worry about how to address my body if I have to go through a surgery…it's a more finite thing at my age.

I chose my doctor because of the BR commercial, there are limited doctors for this med. He's a urologist who does this on the side he says to "help" people. I also will say I seem to see him every 3rd visit, the other visits are his NP or an alternate doctor in the office. It becomes hard to establish a one on one with this type of doctor relationship, and I personally feel he's taken a short course on being able to prescribe this medication but didn't take a course in fully understanding what the medication is really is all about. Example, I was facing dental work and called the office and asked how to proceed and the NP gave me two responses (she said she spoke to the doctor) - 1st was this is a pain medication so just take a little more and the second was if you need to take pain medication just do it and then go back to the Suboxone. Honestly I wasn't comfortable with either answer.

But it is what it is now and I am making the choice to stop. I can't say enough how grateful I am that there is so much information and support on the internet. I've learned a lot over the last couple of days and will be setting up a calendar and schedule to work one day at a time.

And I am doubly grateful that you all are here with me.

Cath


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PostPosted: Sat Feb 01, 2014 4:31 pm 
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Hey Cathy,

I see your point totally. And yes, you're doctor probably only took the required course to be able to prescribe the medicine and it's something like a 2 or 4 hour class. That's it!

I just wanted to point out that if you aren't feeling bad while you are dropping there is no reason to not jump down by those larger amounts. The only reason to slow it down would be to minimize the WD you experience. You will eventually get to the point that you are feeling it, and that is the time to slow down and let your body adjust to the drops a little at a time.

I'm happy that you are so confident in your decision. It takes commitment, but it looks like you have that in spades. And I think the fact that you have been on the subs for a relatively short amount of time will work in your favor.

Q

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PostPosted: Sat Feb 01, 2014 7:02 pm 
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There is something I've been wondering - after reading all that I have been, how many people are over 60 years old and on Suboxone? And looking to taper?

Down the line I may start a post with that question to see if there are others of my age working through this process. It would be interesting for me to see how an older body handles the taper process vs a younger body. Just a thought.


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PostPosted: Sat Feb 01, 2014 8:20 pm 
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Hi Cathy,
Long time lurker here on this excellent forum. I had to register and respond to your post as we are quite similar.
I am 56, chronic pain patient, bad headaches on bup., and I have a blood disorder as well!
I tapered off in 6 weeks. My 3rd day off wasn't pleasant. At day 11, the headaches stopped. At day 17 I felt really good. It was over. Otherwise before day 17, it was tolerable except for the 3rd day. For the last few months, I successfully used meditation/mindfulness to fight or more accurately, float over "cravings".
You will be fine! May I suggest you go lightly on the Ambien now (if you can) so it will be more effective when you really need it while tapering and after.


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PostPosted: Sun Feb 02, 2014 4:09 pm 
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Thank you so much Gallatin for coming out of the shadows for me, I saw this post last night and misted up a bit.

I don't think I ever adjusted to Sub over the months, even in the beginning I would tell my husband I felt high and stoned, which I still feel even today. I'm not a pot person because I don't like the lack of control and when I started feeling that way it got scary - at times I won't even drive. Forget focus and energy, I have none. I have constant sound in my head too, with pressure and headaches, I once asked the doctor if Suboxone created tinnitus and he said he never heard of it, but I've also read posts in the last week of it happening to others too.

I took pain meds for years and felt trapped with them and then I saw that commercial, it seemed so simple to help ween me from pain meds and have a normal life I thought, but I didn't do any real research…my fault. I took 3-4 #10 perc's/day and when the Sub doc first started me he gave me a script for 3 8mg/day and it made me feel really horrible so I immediately cut back to 1-8mg/day. Then I changed it to 1/2 in the morning and 1/2 at night, each time shaving a bit off. After all I've read, you have no idea how glad I am I adjusted it down myself at the start.

I will say I am scared and I'm not sure if my trembling now is because I've cut back and small bits of withdrawals or just plain old nerves. I am facing a sinus lift and bone graft down the line so going backwards is not an option for me - I don't want Suboxone to be part of the mix in my health care moving forward in my life, I can't see being 65-70 and still here and trapped…it's just not happening. Being young you think immortal…..being old things are different. LOL

Can I ask, at what level did you start tapering off to complete it in 6 weeks? Also, do you know if during tapering it's wiser to split up your daily amount into twice a day to help ease symptoms throughout the day? What I mean is I'm now down to 4mg and I was thinking of cutting it to 2mg in the morning and 2mg at night to break up some of the shivers. Is it all about the amount in your system per day?

Again, thank you for stepping up for me. I didn't mean to ramble, but I guess I needed to.

Cathy


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PostPosted: Mon Feb 03, 2014 3:35 am 
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Hi Cathy,
Why on earth did they switch you from an unremarkable 30-40mg of Oxycodone to 24mg of Suboxone? It makes no sense. What were they thinking?
I am happy to share my experience. It is very similar to yours. I had been on opiates for 8 years (from Tramadol to Oxy), at about the dosage you were at and like you to control chronic pain.

But then I had an incident. My GP had agreed a while back to increase my dosage.
A year later she left for maternity and I had to see her colleague instead. He did not like opiates for chronic pain and decided pretty arbitrarily to reduce back to my original dosage "for the time being". I couldn't believe it. I was completely at the mercy of a doctor's bias (or mood, who knows). I therefore had to taper very quickly back to the old dosage. Not that much fun and there was nothing I could do about it. I really wanted out at that point.

So I investigated and learned about Buprenorphine. That seemed like a good way to proceed. But then I was confused when I was inducted at 8mg and they wanted me to remain at that dosage for a few months. They couldn't make a cogent argument why it was necessary in my case. I understand the concept of saturating the receptors, maintenance, and it is fine. I just did not want to go that route.
Well, the next day I reduced to 2mg (still equivalent to about 35mg of Oxy, not insignificant), stabilized at that level, and went down from there. 6 weeks later I was off.

To be honest, the challenging period for me was when I was between 1mg and 0.5mg. I am not sure what the final dose was. Probably close to 0.2mg. I only made sure to cut smaller and smaller pieces but I am not sure of the absolute value. I switched to taking my single dose at night.
Nevertheless, there is not a single day when I felt like giving up. It was never that bad. I was basically on my own, so no clonidine or benzodiazepine.

The 17th day after coming off, I felt great. That day will forever be engraved in my memory. I felt free. Shortly after discontinuation, my vision improved dramatically and the colors especially became so much more vibrant. I started liking music again. My libido came back very quickly and I feel (almost) like my teenage self... I have to deal with the pain again of course but that is the choice I made and I don't regret it.

As you said it is hard to picture yourself on opiates for the rest of your life. I don't want to sound cocky and I am well aware of the relapse rate. I am certainly very cognizant of the risk.


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PostPosted: Tue Feb 04, 2014 1:53 pm 
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OMG Gallatin, you are a God send - your story gives me so much hope! I only wish I had done a little more investigation. I really didn't get any explanations about receptor saturations or others things it was just "here you go". I was surprised when you mentioned vision….because I feel it does effect my vision too. It's the first time I'm feeling it's not "me" with these side effects. I was feeling crazy because every time I'd ask the doctor/NP about them they said they never heard of it. I only wish I could use meditation…there is way to much noise in my head for that right now for me to focus. I sleep with the sound of a fan to help with the noise….mind you I did not have this noise, what I call tinnitus, prior to Suboxone.

Here something new that has come up in the last week and may work to my disadvantage. Being the new year our insurance company changed from Medco to Caremark and it seems Caremark does to want to cover the Sub film so I ended up paying January's prescription out of pocket. They want the doctors office to confirm I've tried two other meds first, the NP said what they were but I didn't pay attention to the names I just said I'd pay cash for the film. After thinking about it I'm getting worried that something can go wrong and I get denied the film by the pharmacy in the middle of my taper so I just called the NP to get the specific names of what the Caremark wants to change me to and will investigate them.

When I take my dose tonight it will be my 10th day on the 4mg stabilization stage and I've not yet made the commitment to the next taper, but it will be very soon and will let you know when I do. Right now with living in the north east, all my focus has been snow storms, ice storms, shoveling, caring for 5 dogs during this frozen world and cabin fever. Today will be filling water buckets prepping for an ice storm, all I'm hearing on the news is be prepared for possible power loss, but lets hope not. The world "taper" is always at the forefront of my everyday though with a calendar on my table next to my box of Sub so I don't loose track.

I'll also let you know when my NP calls back with the exact pill change Caremark is requesting. Gallatin, what happened to your chronic pain? I remember a doctor once told me my chronic pain would become much worse before it got better if I decided to come off of meds and that's probably one of the reasons I didn't because I'd hit a serious pain wall. I've wondered if my pain is still there.

Cathy


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PostPosted: Tue Feb 04, 2014 5:35 pm 
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Caremark probably wants you to switch to Subutex generic tablets. That probably would be fine too but I am no expert. If you want to continue with Suboxone, the pharmacy should be able to tell you about discounts from the manufacturer.

Regarding chronic pain, yes indeed it is there. In fact during tapering, I suffered from Hyperalgesia or some sort of rebound. Not only my chronic pain was very present but old wounds started to be felt (old knee injury and such) during the acute withdrawal phase and after. But that went away too.
It is hard when the honeymoon period is over, Buprenorphine is a distant memory, and you have to face your chronic pain again. Back to square one. The pharmaceutical options are limited. You need to be prepared with a plan.

I may get chewed up but I believe that chronic pain has a psychological component in many cases (not all of course) . I am not a psychologist but I have been a moderator on a chronic pain forum for many years and it is my belief after having corresponded with a lot of people that there is almost always an emotional trigger (I include myself). It doesn't mean the pain is not real, all in "our heads", or it is easy to get rid of. Many of us have cycles. Sometimes it is not so bad and we don't know why. Some say pain is a maladaptive solution to existential problems we have. In other words, we are distracted by the pain from very dark/disruptive thoughts and some primitive parts of our brains see that as a solution. Who knows.

You may want to explore meditation and alternative ways. Our natural inclination dealing with pain is to brace against it. By observing the pain instead as simply a sensation without judging it can be helpful. Easier said than done but it works to some extent. Another technique is to switch your attention between the painful area of your body and a neutral area. You go back and forth and eventually you should feel less pain. The key always is to feel, to experience, but never to think. There are many other techniques but those are two examples.

There are many books, classes etc on the subject... A lot of schlock too but serious scientists like Peter Levine, Ph.D or Robert Scaer, MD for example (but there are so many others) have good books. Robert Scaer is a neurologist and chronic pain patient himself. He studied whiplash when he was at the head of a rehabilitation unit and couldn't explain what he was witnessing (bad wounds and no pain in some, puny problems and debilitating pain in others).


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PostPosted: Thu Feb 06, 2014 3:37 pm 
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The rebound pain you mentioned is exactly what a pain doctor told me about many years ago - he said the problem with coming off pain meds is the "rebound " pain that occurs - it's worse then the normal pain and if you can get through that rebound wall then you're on the road. My pain is in my gut and part of IBS…which will be difficult because one of the withdrawal symptoms is part of IBS (soft stools/diarrhea). So I will be back to that as a constant. I've worked with many GI doctors, but IBS comes with it's own problems and a pain that subsided with pain meds….and it seems, Suboxone.

Yesterday I cut my 4mg into 2mg and took one at 10am and 10pm. Today I didn't take the 10am yet (it's around 2:30 now) and will wait as long as I can before I take the next 2mg…maybe I can make it until 10pm. I've just gone through a cold sweat & chills bout and I have headache but nothing I can't handle at the moment. The problem with meditation at the moment is the sound (tinnitus) in my head, there is no way to find a quiet place because it so distracting….even to read. I find if I keep in motion it helps as a distraction from the sound/headache so I am though focusing on one jigsaw puzzle after another. LOL

I don't know about the pills yet, my doctors NP didn't call back yet, I may just wait until my next appointment. To talk to her about them.

If you don't mind, I'd like to keep this conversation up while I go through the taper….it will sure be appreciated.

Thank you.

C


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PostPosted: Fri Feb 07, 2014 5:20 am 
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Sorry about not getting back to you sooner, about the taper I did. I'm probably not the best person to talk about a proper taper. But I think I gave it a couple of weeks, maybe 3. All I can tell you is the lower you get the slower the taper. I am 54 years old. Been on this for almost 5 years. When you get to 4 mg, it would be easier to drop to 3mg rather than cutting it in half again and going to 2mg.

My experience tapering down from 2mg is don't do what I did. I went from 2 - 1mg. There are a lot of good threads to read (if you already haven't) on tapering.

There are a lot of great people on this forum. Most positive one I've come across.

Just make sure you feel good for a week or so before you taper any further. Only you will know if your ready to taper further. Don't rush it.

Good luck and sorry about the late reply.


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PostPosted: Fri Feb 07, 2014 12:35 pm 
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Thank you iwilldothis….Gallatian has been keeping me company. Out of curiosity, what happened with your jump from 2 - 1 and how long were you on 2 before your jump to 1?


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PostPosted: Fri Feb 07, 2014 1:31 pm 
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Cathy, IBS is a tricky one. Opiates block the activity of the muscles of the small intestine therefore work well for IBS. That is in addition to the pain relieving and emotion numbing properties of opiates.

You really need to have a plan of action for your IBS. You will see that as soon as you recover from the acute withdrawal phase, your emotions will be raw. Like you have never felt them. You will at that point have to deal with pain and vivid emotions. Everything that you have been repressing (thanks to the opiates) will come to the surface.

My long rambling about emotions and chronic pain in my previous post was just to warn you that meditation will only work if you can accept that parts of your chronic pain has a mind-body connection. If you believe that your IBS is 100% a physical issue (and it may be the case of course, I am not speculating at all), I am sorry to say that meditation won't help very much.

Regarding tapering, I tapered quickly down to 1mg with no problem. Then slowly to 0.5mg. And again quickly until my last dose (but more because I really had enough of this). Still, it was never horrible except for day 3 post jump (and even on day 3, it lasted only something like 6 hours).


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PostPosted: Sun Feb 09, 2014 12:49 pm 
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Thanks Gallatian. You are not rambling at all and you're definitely helping me mentally prepare. It's like mini-meetings. I too believe that there is a big mental side to this and the fear of the unknown can wreck many a good intention when it comes to addiction.

Here is where I'm at so far: I'm on day 14 of my taper from 8mg, I spent 10 days at 4mg, 1 day at 3mg and for the last 2 days at 2mg. Today is actually day 14 and I'll take my 2mg dose at 9pm and I'll stay at 2mg for possibly a week. So far I've had chills and shivers and I'm tired and lethargic, but nothing that's bad. I'm not really sure what I'm suppose to be expecting yet at each taper point….I'm sure my body will tell me more as time goes by.

I'm thinking of moving my dosage up to earlier in the day so I can test extending my time w/o the meds from 24 hours to 30 and so on, but I'll play that by ear. I just don't want to wake up in the middle of the night with unexpected symptoms and rush to take something - that would wake up the entire house. We have 5 dogs and the moment I step out of bed they start barking thinking it's time to get up….I don't think my husband would appreciate that.

Like you I too want this to be over with, so I will take steps as my body tells me it's OK. I was in AA recovery and clean for over 20 years so I have that mental support in my head. Once we get out of this winter weather I know where there are some lunchtime meetings I'm going to start attending. It's funny how at my age winter keeps me in more then when I was young, I guess that's why so many people head south for the winter. LOL

Best regards,

Cathy


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