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PostPosted: Thu May 02, 2013 1:00 pm 
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Hi everyone, I am a new poster here, but I have been reading the forum for two years. :D

I have some questions about Suboxone side effects I wanted to talk about, especially to see if anyone else has experienced them. I'd also welcome input from people who are using nothing OR another opiate so we can compare our side effects.

My opiate habit started in late 2008, when I was taking Percoset for regular and breakthrough pain. Until late 2010, I was an infrequent to semi-regular user. In 2011, I started using heroin more regularly, and for most of 2012, I was heroin dependent. My pain includes joint pain, especially in my feet (old injuries), recurring body pain at random intervals (suspected fibromyalgia), severe diarrhea and intermittent vomiting (suspected IBD), and period pain that can be as intense as labor pain at times (endometriosis has been ruled out and I cannot take birth control of any kind). I am 34. My periods have gotten somewhat better since I moved away from a polluted stream and got into my 30s, but the other pains have gotten worse.

I got clean in Dec. 2012 and started on subs, titrating up to 4mg at the highest dose. I was insufflating the heroin and could use, at most, 3 or 4 weak bags a day before becoming profusely ill (overdose). I have been stable on the program and my doctor is beginning to regard me in the same category as his middle-aged pain patients. We are working to taper me down to a 1-2 mg maintenance dose.

Anyway, for the past 4-5 weeks, I have experienced the following excruciating side effects, and I was wondering if they were common to Suboxone use. I have tried to map them to a specific dose, but can find no correlation.

• Severe exhaustion. There are days where I will sleep for 12 hours and then need a 3-hour nap besides.
• Horrible depression, sense of hopelessness, occasional suicidal urges.
• Diarrhea alternating with occasional constipation. (This one is definitely dose-dependent; once I go under 4 mg, the loose stools return.)
• Severe pain in my knees, especially upon awakening, as well as right before bed, when changing positions, or when climbing stairs.

My husband, who was also an addict or pseudo-addict (labor job, OTJ injuries) quit when I did, but opted to go cold-turkey. Of the two of us, I was sicker, and he hates Suboxone for some reason anyway. He is also experiencing the exhaustion, so I do not know how much of this is PAWS. I guess I am laboring under the delusion that Subs take the PAWS away. What is your experience? Can someone give it to me straight?


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PostPosted: Thu May 02, 2013 11:53 pm 
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Hi VelvetUnderground719,

Welcome to the forum!!!

All of the side effects you listed sound exactly like wd symptoms.

It sounds like you're under 4mg now and that would put you well under the ceiling dose of Suboxone and it would make perfect sense that your symptoms are indeed wd. You may have cut your dose too quickly if the symptoms are excruciating.

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PostPosted: Mon May 06, 2013 12:52 am 
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OMG Romeo, I feel like such an IDIOT because I thought the symptoms meant the dose was too high or I had a bad reaction to it or something...wow!!

I screwed up at the doctor's then. I told him I was trying to cut back, so he put me on the new 4 MG strips, which are 3x as expensive. It nearly killed my budget for the month, and as my current job pays a salary that is rather like a joke, I almost had a panic attack in the Duane Reade. :cry:

This weekend, it took all of my strength not to cry, and after that didn't work out, it took all my strength not to 302 myself. I have been depressed, sometimes suicidally so, since January, and because the symptoms are much milder than kicking heroin, Percoset, or another full agonist, I suppose they either snuck up on me or I didn't recognize them. I figured I was just a weak, lazy baby who can't work like an adult.

Should I see him in 30 days or see him sooner? And what should I tell him regarding my need to go back up? He has been very impressed and complimentary that I've been "held" at 4 MG, and I feel so disappointed that it's not true. But looking back, I can see that it's not true.

Thank you SO much, and I would love to hear your thoughts on this (or anyone else's)!


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PostPosted: Mon May 06, 2013 7:51 am 
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Hi Velvet,

Is your doctor aware of the side effects you've been having? If so, I'm surprised he didn't pick up on this already. If not, you need to tell him exactly what has been going on and see what he says. If it was me I would put in a call to his nurse this morning and let her know exactly what your concerns and symptoms have been and tell them what you are thinking. Is there a reason you only started on 4mg? That is a pretty low dose to be placed on right from the jump with suboxone. Most people say that 4mg is the ceiling, which is the dose that keeps your receptors saturated and makes you not have those ups and downs associated with other shorter acting opiates. You really need to at least be at the ceiling level for maintenance for the first few months. It seems that some people need just a bit more than that to keep them level...it sounds like you might be one of those people.

Please understand that if you do have to up your dose it doesn't mean you have failed or that you are not doing something right. You just need to get yourself to a comfortable place so that you can work your recovery and feel human for awhile before you begin to taper. Of course if you do decide not to go up your tolerance should eventually go down enough so that you will feel better on the lower dose, but who knows how long that will take. It's really going to be up to you and your doctor to decide what is right for you.

Anyways, welcome to the forum. I wish you the best of luck in figuring this out!

Oh, I forgot that I was going to ask you about the "new 4mg strips" you say he put you on...I wasn't aware they offered a 4mg strip. As far as I know they only come in 8mg (blue package) or 2mg (green package). I'm curious what yours looks like? Is it possible you are taking the 2mg strip thinking it is 4mg?


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PostPosted: Mon May 06, 2013 8:40 am 
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Okay, I was curious enough that I googled it...those 4mg strips are HUGE! Wow, I would NOT like to have that much crap under my tongue...LOL.

It's funny that I haven't heard these were available until now. I guess this will be a good addition to the line up of suboxone strips...I saw references to 16mg, and 12mg strips as well. Huh...sorry for questioning you Velvet... :oops:

Q


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PostPosted: Mon May 06, 2013 9:44 am 
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I have a sneaky suspicion that if you up the dose your not gunna change anything at all except bump up your tolerance, I bet it has more to do with your hormones or that this is what you can expect from suboxone, if I were you I would bump up the dose and if u don't feel better in a week go right back down......se an endocrinologist get your hormones checked they are likely screwed up by ALL of your opiat use/abuse.....but suboxone just totally fucks your endocrine system so if it ain't already fucked it will be....


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PostPosted: Mon May 06, 2013 10:04 am 
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One pretty good indication that tells me this is not w.d. symptoms is that your sleeping so damn much....that does not happen when u have withdrawals, I'm pretty damn sure this is not a dosing issue at all.....


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PostPosted: Mon May 06, 2013 11:47 am 
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I don't know at all about what the above poster just said. Suboxone is not the enemy. It helps many many people that have addiction problems. Everyone that takes Suboxone needs to get on the right dose for them. So I would increase the dose with your doctor's permission and see how you feel. I have been on Suboxone for many years and there is NOTHING wrong with my hormones. I have gotten them checked each year and its FINE.

But..it takes a while to see what dose is right for you. Good luck with getting the right dose that fits you. You are making the right decision by getting on a medication that treats addiction.


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PostPosted: Mon May 06, 2013 11:48 am 
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Gotta agree with semperfi here a bit. It could just be something else you haven't thought of causing your problems. Just doesnt sound like suboxone to me is all.


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PostPosted: Sun May 12, 2013 1:14 pm 
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Hey everyone,

Thanks for providing more information. The longer I sit on 4 mg with the side effects coming and going, the more I am convinced it's an autoimmune disease for which I need an extensive work-up. I started on 8 mg and tapered to 4 mg quickly since the 8's just had me sleeping (and very high), and having extremely painful urinary retention all the time. I was on opi's for pain initially and even at my worst, I couldn't do too much of them without getting sick (puking, dizziness, other symptoms of overdose). So the 8 mg, which I understand is a typical maintenance dose, wasn't cutting it.

Anyway, the exhaustion continues. I also notice I am sleeping during the day because I just can't get restful sleep at night, especially when the joint pain is bad. We also moved 7 hours east and now live in a very noisy city, which is not quiet or good for sleeping. But I've always had sleeping problems, since I was about 16. I also have severe depression now, which seems to get worse as I take more subs. The joint pain continues, as does the sluggishness and inability to concentrate or care about anything.

Also, severe bowel pain and intermittent loose stools that appear after an extended bout of cramping and pain. Sometimes I have pain in my hands too, and sometimes my hair falls out in clumps, but other times I break out really bad. My last psychiatrist said it could be something hormonal, autoimmune, etc., but without blood tests, no one can tell – but I wasn't responding to any anti-depressants or mood stabilizers, that was for sure. (I have a chart of approx. 50 psychotropic drugs that have caused adverse reactions and made me sicker without helping me.) I am on no subs today so far and already feeling better, but not 100%. I think something else is going on.

I need to get tests done, go to the doctor, etc. but I have bad insurance that doesn't cover it. We need to start applying for low-income insurance and other benefits. I'm supposed to be looking for a better job, but just don't have the energy. My current boss is very abusive and is bipolar, refuses to get it treated, so that is adding to the situation. I can't work a full day, and haven't been able to since my second month on subs. I've had this issue on and off throughout adulthood, but it gets worse as the years go by.


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PostPosted: Sun May 12, 2013 1:16 pm 
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Oh, another symptom, and sorry for the TMI...recurring yeast infections. Treatment made them come back with a vengeance, and for half the month, it is torture. Sorry for TMI. Just another freaky symptom. I am starting to agree, it's not the sub...something else is going on. I have every symptom of fibromyalgia, but I hear it is a multiyear, highly expensive process of elimination to get a diagnosis.

Thanks everyone, for all the help and insight.


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PostPosted: Sun May 12, 2013 8:09 pm 
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I'm sorry that you're having such trouble, velvet. i have to agree with the others, it sounds like some other underlying issue(s) going on. I can't say that i have experienced any of that during my time on suboxone or while tapering to lower doses.

I hope that your doctors can pin point what is causing these symptoms. You mentioned autoimmune. How is your diet? Do you have any idea if your allergic to wheat/ gluten?

Good luck to you. (hugs)


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PostPosted: Wed May 22, 2013 9:18 pm 
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Thanks everyone! We are leaning toward a diagnosis of Crohn's disease or potentially fibromyalgia at this stage. I will have to see a GP and neurologist to confirm, but I am on sub, which is very constipating, and even when I up my dose, the bowel flares are worsening. (Sorry if TMI...) My meals go right through me. My groomsman at our wedding has Colitis, so I will at least have someone to commiserate with about IBD if it does turn out to be that. Thx for all your help in pointing out that it was not the Suboxone – I am taking 5 MG this week and am as miserable and sick as when I was taking 3 MG and 4 MG.


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PostPosted: Wed Jun 05, 2013 3:52 pm 
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I read everything you posted, all of your symptoms etc. I do not think the suboxone is causing your illness, however the suboxone could be making whatever underlying medical issue you have worse. Thats actually exactly what is sounds like is happening. OR have you considered that you may be allergic to the suboxone or one of the inactive ingredients it contains? Some people have to switch to subutex because they have bad reactions to the naloxone in subs. I have heard of some actually having to try different brands of generic buprenorphine before they felt better and were able to get stabalized on their meds. I have found during the three years I have been in therapy through researching this medication that it is rare for patients to find they are allergic to suboxone or any of the ingredients contained, however on the rare occasions a patient does find they are allergic almost all of them throw in the towel and go back to their DrugOfChoice thinking the subs are bad for them. Please do not give up too easily on the treatment, it may take a while for you and your doctor to find the right dosage and the right bupeprenorphine for you. There are some different generic brands of buprenorphine/subutex they do not contain the naloxone like the suboxone does, but they still work the same and block your receptors from full agonist opiates. If I were you first I would go see your doctor and have a full blood work-up done and try to figure out if you have some type of illness not related to suboxone that needs to be treated. Then if you find that you do not have any other medical illness tell your sub doctor exactly what has been happening and discuss trying subutex or a different brand of buprenorphine, but please Don't give up like so many others do.


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PostPosted: Wed Jun 05, 2013 4:09 pm 
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You posted about you hair falling out in clumps, I have been wondering about that for a while now myself because my hair has been coming out in large amounts since i have been on the sub therapy. My pdoc recommended vitamin supplements and this did help some, I went to my local wal-greens and picked up a vitamin called hair, skin and nails. It has the the vitamins/nutrients that help because the amounts are higher for the specific needs of whatever your body is lacking. You also posted about yeast infections, I have not had this issue, but I would recommend getting a pro-biotic supplement and also eating lots of yogurt to build up the good bacteria that prevents yeast infections and also the bro-biotic supplements DO help with any digestive issues you may be having. If you are constipated it straightens that out, and if you are having diahreah it straightens that out as well. They Regulate your digestive system is what I am trying to say. Sorry for rambling, I have a major headache today. It's kinda throwing me off so forgive me.


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