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PostPosted: Mon Aug 15, 2011 6:38 pm 
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what i was trying to say is it is not the subs that can do any thing to you. its all that abuse i did to my brain and then go on subs and wd can feel a lot like what happened to me with the gasoline sniffing. but the good thing out of this is that i'm on 20mgs subs for 15 months, and if we set our minds right'. we can go on living a normal life,after all the abuse, are brains can and will come back to normal. we should know we lived it for so dam long.


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PostPosted: Mon Aug 15, 2011 8:26 pm 
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hatmaker510 wrote:
I'm sorry, but I must respectfully disagree with you. And I'll say first off that this is from Dr. Junig. The mean half life of 37 hours DOES NOT APPLY when one is at low doses, such as 1 mg. That is why Dr. Junig often recommends going to twice daily dosing. The person tapering down that low could very well experience withdrawals before the day is over. Now, that's not to say that they won't get used to dosing at those low doses once per day. It's all about what the individual needs.

I suggest to you that you need to read and or watch some of Dr Junig's blog posts (Suboxone TalkZone) or his YouTube videos. I know for a fact that he discusses this in his blog, but I'm not so sure about his videos.

This paragraph is from his most recent blog post:

Quote:
As the dose is lowered, the effects of buprenorphine become shorter in duration. So the person tapering buprenorphine need to not only take smaller amounts each day, but must also divide that daily amount into two, then three, then maybe even four doses to avoid withdrawal symptoms at the end of the dosing interval.


So you see, I'm not making this shit up or talking out of my ass. Not that you said I was, but I want to make it clear that I don't post something on here if I'm not sure it's accurate. And if I'm not sure, I will say just that.

Now for a person on sub maintenance (one who is NOT tapering off), once per day dosing is best (I'm not talking about pain patients here). That's because it breaks the addict cycle of taking something whenever we feel we need a pill of some kind. It gets us to simply take a pill once a day, at the same time every day, then just forget about it. Just like any other meds we might take.

If you have more questions, or disagree further, maybe you might want to follow up with Dr. J's blog first so we're all on the same page. But I'm sticking by what I posted before and what I'm posting now.




Maybe I jumped the gun with the half life, but this wouldn't really be noticeable until you got to 0.5 mg and under. Maybe even less. I've been adjusted to 1mg before and it carried me through 24 hours. I would wake up the next morning medicated. I once gave my sister .2 mg and she was throwing up all day and said she felt it lingering the next morning. This has a lot to do with tolerance levels. It makes sense though that it would take 16mg longer to come out of your system than 0.6mg from a common sense point of view. I know a lot about bupe but I am not saying I wrote the book. If the mean half-life is 37 hours or so, what dose would that half-life be dependent on before the half-life started diminishing. According to what you and Dr. J are saying something like this is happening or it could be just what I said a few sentences before that it would take a larger amount of bupe to get out of your system than a smaller amount would.


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PostPosted: Mon Aug 15, 2011 8:46 pm 
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Romeo wrote:
Mike T said, "Even though we know what the right way is, it can be very hard to follow through...because we all have to battle with are frontal lobes every day, and sometimes the animal wins.", that's a BIG part of the reason I jumped from a high dose, I knew me doing a taper was a joke. If I had it all to do over again, I'd jump again for the simple fact that I would inevitably bugger up my taper.

Honest to goodness, I don't know how anyone maintains the discipline to taper, but they do and it's great. Tapering is certainly the best way to go for most folks, but there are several of us whose addict brain makes a taper all but impossible.

Lilly, I hope you get past this stumbling block that you're facing, be strong and don't give up!!


Romeo, I know this isn't too scientific, but sometimes you need to be strong. With that attitude and mindset you will fail in the long run. You need to take control of your sub, it shouldn't be the other way around. I understand that this is hard. I even struggle with it. I have a stressful life. I'm a full time time student doing a major/minor in biochem and bioengineering. Now that sucks. If I can taper anyone can.


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PostPosted: Mon Aug 15, 2011 8:53 pm 
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You guys have no idea how much this is helping me. Just reading everyone's input is giving me a lot of perspective on this.

Setmefree - what you wrote is exactly what I was unable to articulate myself (because I was in such a brain fog at the time). I feel like I used to feel a few hours after getting stoned. Not high, but just tired and irritable and foggy. I'm trying to stick to 1 2mg dose a day, like Mike said, but I find myself feeling like I have to take a 2nd 2mg dose on some days (like today I had to take a road trip through a torrential downpour, and I felt like I just couldn't do it (with my kids in the car no less) without getting to the ceiling level and feeling somewhat "normal"). But like you said it's not a real normal it's like I'm an actress playing myself in a role. There's some sort of a detachment or unreality to it - and I've just gotten to the point where I want to get back into my life. I know this isn't true for everyone, and that some people feel more normal on Sub than they've ever felt, and that Sub is giving their life back, so I don't mean any disrespect to anyone that finds Sub working for them.

The whole debate on tapering vs just quitting CT is literally almost word for word the same debate I was involved in on another forum of people trying to get off a long acting opiate. Some people felt that their addict behavior prevented them from sticking to a disciplined taper. I'm starting to I feel like I fall into that category. It seems like sometimes no excuse is too flimsy to just go ahead and take some more.

On the other hand I made the argument that B Real made (about not suffering over and over again with each reduction and just getting it over with) on someone else's taper thread. Then about a day later that person suffered a major panic attack and acute withdrawal symptoms, and I felt terrible for giving someone advice that wasn't in their best interest. So, I think the "go ahead and jump" approach isn't for everyone.

Bottom line, I don't think I'm going to be able to do the slow taper. I'm hoping I can at least stay at 2mg for a week or so before I stop. I remember how I felt going off before at 2mg, and to be honest it felt only a little more intense than what I've been feeling since I got below the ceiling. I don't think I want to go through this for a week every time I drop by 0.5mg. But
I do realize that the consequences later might be worse.


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PostPosted: Mon Aug 15, 2011 11:06 pm 
Derealization
By Arlin Cuncic, About.com Guide
Created August 02, 2010
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
See More About:social anxiety disorder symptoms
Definition:
Derealization is a change in the way you perceive the world. Your environment may feel unreal or unfamiliar, and you may feel like you are in a dream or that everything is an illusion. Although derealization involves a change in perception, you remain connected to reality -- unlike in a psychotic episode.

Frequent or recurring derealization may be a symptom of depression, anxiety disorders such as social anxiety disorder (SAD), or post-traumatic stress disorder (PTSD). Derealization may also result from the use of drugs or alcohol.

This feeling varies and is very common in drug use and withdrawal. People that have experienced bad drug withdrawal I feel definitely have some PTSD...

I am sorry you are going through this. Lilly, why don't you taper every 4th day instead of jumping at 2mg. You will feel crummy the first day, going from 2mg to .125 may make things a lot more tolerable and give you breaks of hope in between, instead of crushing withdrawal symptoms and insomnia for days on end. Just a thought. I have been there... I did the mother of all benzodiazepine withdrawals, very similar from the derealization, depersonalization, PTSD standpoint and similar in many ways to opiate withdrawal, only benzos take much longer.......Robin sending you XXXs


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PostPosted: Tue Aug 16, 2011 1:06 am 
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My Doctor always says it's my body telling me I'm not ready yet. We always adjust it just takes longer the lower we get. I've been stuck at 3mg for over a year and every time I go below I feel like crap. Like you said not withdrawals, more of a disphoria or depersonalization. I also get very moody and short tempered. My doctor (god love him) keeps me at 3. Sometimes I wish he would push a little harder to have me lower but that's not his style and I feel good at 3mg so why fix it if it isn't broke. Certain drops that I had problems with he would rotate every other day. For example 3 one day then 3 1/2 the next, that ways made the transition easier for me. Good luck.

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PostPosted: Tue Aug 16, 2011 2:13 pm 
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Hey Mike,

I did take control of my sub, I threw 'em away, that was 1 year and 2 months ago. You said I had to be strong, you're damn straight I had to be strong, strength and determination is what got me through my withdrawal. That same strength and determination vanishes if I would have had access to Suboxone though. I know me a lot better than you know me, I've been off Suboxone for well over a year now and I did it by jumping from a decently high dose. I don't recommend my method to anyone, but I sure understand why some of us do it like that.

Telling an addict to be strong when he was trying to taper off a drug that he caught a small buzz from is kinda like telling a shark not to shit in the ocean. Ain't gonna happen.

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PostPosted: Tue Aug 16, 2011 5:10 pm 
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Romeo wrote:
Hey Mike,

I did take control of my sub, I threw 'em away, that was 1 year and 2 months ago. You said I had to be strong, you're damn straight I had to be strong, strength and determination is what got me through my withdrawal. That same strength and determination vanishes if I would have had access to Suboxone though. I know me a lot better than you know me, I've been off Suboxone for well over a year now and I did it by jumping from a decently high dose. I don't recommend my method to anyone, but I sure understand why some of us do it like that.

Telling an addict to be strong when he was trying to taper off a drug that he caught a small buzz from is kinda like telling a shark not to shit in the ocean. Ain't gonna happen.


I don't really know about every one's back round in the forum since I really don't have time to actively participate unfortunately. I hope you didn't take that the wrong way...; and you are right...I still haven't been able to maintain the discipline to taper off sub the quote on quote ideal way, of complete control over the sub to jump off my imaginary nanogram set point. Slight exaggeration w/ the nanograms part btw. I may have to jump off a higher dose than expected, but I at least want to taper to 0.2mg to make it somewhat pleasant. Jumping off at 2mg and some other ridiculous doses I have read is just so unnecessary to me...it's just the way I look at it. If someone told me, "hey Mike, I could put you in a medically induced coma, wipe me receptors clean w/ some nalaxone like substance and when I woke up it would be like it never happened I would totally do that.

A slow taper at your own pace to low doses allows the brain to truly heal the best way IMO. As you lower the dose you allow your self to adjust to the new found anxiety you may be experiencing, the emotions you may be experiencing, etc...due to your brain creating new "micro" pathways and regenerating natural endorphins of all lacking types...the endocrine system getting back to normal and yada yada yada. The idea is if you do it slow enough and you do it the correct way...when you finally jump... PAW should be minimal if not non-existent. My friend George, the guy I mentioned before in my first posts on this thread did it this way w/ my advice. He had no knowledge of correctly tapering since he always refused to do his own research on forums... and he didn't experience any PAW w/ my instructions. I've always helped him, so he never really had to scourer the Internet for advice like many of us, which can be very misleading. I've read all the positive stories like the one I'm telling about my friend on NAABT and the bigger part of me believed it because it made perfect sense, but the other part didn't because of all the negativity on other forums...telling me that PAW was inevitable. Well that is all BULLSHIT. It can be avoided for most of us. The subsux forum was a major setback for me at the time. I hate that forum btw.

the rest of this post is just a rant
My friend is in a more stable point in his life than me, which is why he was so successful tapering...he has a good job, he met a girl that he going to marry, and basically everything is perfect for him. My life is just chaos because of my lifestyle from being a stressed out full-time student. It doesn't have to be as bad as I make it on myself due not taking sub the right way, eating the right way, or getting enough exercise/sleep...but this is what I'm trying to change right now before the Fall semester starts in 6 days. It will be the hardest semester thus far. It just keeps getting more demanding. It was easy in the beginning...but I haven't quite adjusted to the 300-400 level mind fuck classes yet. Sorry for the rant but I've been stressed out and I have very little outlets. I may not be able to jump off sub until I finish my undergrad, which would of been finished by now if I didn't get hooked on oxycontin at the ripe age of 18. I'm going to be 27 at the end of August. It has been a long battle. I consider myself very fortunate to be able to go back to school. I went back after I was inducted on Suboxone and found enough stability to make an adult decision. That sounds funny if you thing about it. How debilitating opioid addiction can be.


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PostPosted: Tue Aug 16, 2011 5:48 pm 
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I agree completely, tapering off of Suboxone is the best way to get off of it, there is no doubt about it. Some of us can't do it though. That's what I was trying to say. For me, jumping was the only way off.

BTW, rant away.....that's part of what this forum is all about. I know this much, when I talk about the issues I'm having in my life, it somehow takes power away from them. Again, rant away man, it helps.

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PostPosted: Tue Aug 16, 2011 5:48 pm 
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Smoothy1125 wrote:
My Doctor always says it's my body telling me I'm not ready yet. We always adjust it just takes longer the lower we get. I've been stuck at 3mg for over a year and every time I go below I feel like crap. Like you said not withdrawals, more of a disphoria or depersonalization. I also get very moody and short tempered. My doctor (god love him) keeps me at 3. Sometimes I wish he would push a little harder to have me lower but that's not his style and I feel good at 3mg so why fix it if it isn't broke. Certain drops that I had problems with he would rotate every other day. For example 3 one day then 3 1/2 the next, that ways made the transition easier for me. Good luck.


I read your post, and the part I bolded I feel someone needs to tell you that doesn't sound right. It sounds like your doctor is controlling too much of your treatment. Doctor's will NEVER know what is best for YOU. Only YOU will. I tell my doctor what's what, it isn't the other way around. I've educated that entire office and he even once admitted to me, in his way, that I have helped him better understand opioid addiction and the effects of buprenorphine on his patients at different doses and how his patients may be experiencing their sub. He recently went back to school himself and got his masters in addiction. I feel very fortunate to be his patient. He is a good dude.

That "dysphoria or depersonalization" IS... mostly WD or PAW and the side effects of you endocrine system's reaction to the lower dose. Your brain needs time to adapt to the new situation. Just be patient and don't listen to that croaker doctor; he doesn't know what he's talking about. You guy's are just making shit up as you go along it seems. The answer to the question of how long will that take to go away is written in your second sentence. Don't fall into the "if it isn't broke don't fix it trap"...been there done that as they say. Good luck.


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PostPosted: Tue Aug 16, 2011 7:54 pm 
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If lowering your dose is making you miserable than why lower it. I always take my doctors advise, he's been working with addicts for 20 years and suboxone for 8. I don't go to my doctor to educate him, I tell him how I feel and where I'm at in my life then take his advise. We are all different and we are all going to respond differently to our lowering schedule. I still stand by my quote "if it's not broke don't fix it" but to each his own.

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 Post subject: Hey smoothy !!!!!!!
PostPosted: Tue Aug 16, 2011 8:09 pm 
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I agree with you and your Dr. 99.9 %...... the .1% you might think of is to try to get just a little lower than 3mg before having the " if it works dont fix it " attitude.... I suffered my ass off till I got down to 1mg a day... I really dont care how long I stay at 1mg, you know what they say smoothy " if it works dont fix it ...... Dysphoria when it comes to opiates can be suicidal , now add to that a psych issue like depression or being bipolar , Good Luck , Mike


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 Post subject: Re: Hey smoothy !!!!!!!
PostPosted: Tue Aug 16, 2011 8:40 pm 
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Painter wrote:
I agree with you and your Dr. 99.9 %...... the .1% you might think of is to try to get just a little lower than 3mg before having the " if it works dont fix it " attitude.... I suffered my ass off till I got down to 1mg a day... I really dont care how long I stay at 1mg, you know what they say smoothy " if it works dont fix it ...... Dysphoria when it comes to opiates can be suicidal , now add to that a psych issue like depression or being bipolar , Good Luck , Mike


Those other issues like depression and bi-polar are unrelated. Again, making things up as you go along, especially with % bs. The hard part is distinguishing between between mental illness and WD but don't try to combine these two issues...it's just the wrong way of thinking. Alot of people, especially on subsux would do this. They would blame their depression on sub and tapering...not the same thing. I'm trying to help you guys not argue btw, for those who are getting the wrong idea. I just don't like bs. I'm not here to stir the pot or lie you guys. I just tell it like it is. It saves time.


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PostPosted: Tue Aug 16, 2011 10:05 pm 
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I never thought you were trying to start an argument, if anything I like some disagreement on this forum and like to be challenged. If you can take it with an open mind you will grow and maybe learn something. Let me clarify one thing without going into too much detail. I just turned 40 and I honestly do not think I have too many years left on this planet. Again, way too much to go into but it is what it is. I think that is why my attitude is a little different when it comes to lowering or completely stopping suboxone. I want to live my remaining years clean, sober, and happy. That is why I am ok with staying on a maintenance 3mg dose. I know I could go lower and fight through any withdrawals, I know I am strong enough and surround myself with people who support me. This is where someone might not understand, not being in my shoes, I don't want to have even one bad day or moment. My attitude really changed when I found out about my other health issues (by the way, my health problems are directly related from abusing drugs for 15 years). So I think when I make statement like "if it's not broke, don't fix" they are really for my individual struggles. I have to remember that sometimes when commenting on someone else's dilemma, they are probably at a different period in their life so my advise should be regarded as my experiences.

MikeT, I like the way you challange people and comments. I actually left this forum for about 6 months because I thought it was way too lovey dovey. For a while no one would ever challenge or confront someone when they were obviously full of it. I don't want to be told every thing will be fine (that's what my mon and dad are for) I want people to be honest with me. Keep on posting.

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PostPosted: Tue Aug 16, 2011 11:20 pm 
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Mike in re: your reply to Painter, many of us have been diagnosed with mental illnesses completely unrelated to our addictions. I was diagnosed with clinical depression many years before I got hooked on opiates (and in a way I think I used opiates to self medicate). So I don't think Painter's statement is BS at all. I know that the last time I went off Sub my underlying depression got kicked into overdrive, and I have read others state that they were suicidal during Sub/opiate withdrawal. This isn't an exaggeration of the down and out feeling that anyone would get when going through WD. This is having the WD trigger an episode of an existing mental illness.

I've been thinking a lot about the tapering vs jumping off discussion, and I've come to believe that both approaches are flip sides of the same coin. Either you taper for a year and have as lot of bad days after each reduction, or you go off rather rapidly and suffer many bad days in the following year due to PAWS. I guess I'm not convinced that either approach is better than the other.

I'm really moved by the stories that have been shared on this thread. It has turned into more than I expected. I really feel for johnboy in that he felt like he wrecked his brain huffing gasoline, and it makes me think of the times I've done serious damage to myself. I totally respect Smoothy's conviction not to put himself through unnecessary suffering because he wants to make
the best of the rest of his life, and I applaud Mike for sticking out college after losing years to addiction. I know I haven't mentioned everyone, but trust me, I have read and related to every post here. This is a great forum and to me it feels like therapy sometimes.


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PostPosted: Wed Aug 17, 2011 9:58 am 
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Mike T wrote:
You guy's are just making shit up as you go along it seems.


Mike - please take care with statements like this. It's divisive and takes the discussion from our experiences, etc, to a more personal level. Discussion are great and differing opinions are great. And obviously we can disagree with what each other is saying, but let's continue to respect each other as individuals. No one has to respect what someone says, but we do expect to see respect for each other throughout discussions like this. Mike if you have any questions about what I've said, feel free to PM me. Thanks :)

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PostPosted: Wed Aug 17, 2011 2:43 pm 
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Yeah, sorry about that comment. It was too strong and doesn't help much. I was just trying to entertain myself probably. I have been a little bored these past few days adjusting to 2mg, which is funny because most of us including myself can't remember what it is like to feel such a dull emotion, such as boredom on some of the higher doses. Time sure does fly on sub. I really wish I could get off this shit one day. Four years and counting.


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No sweat, Mike, it happens to the best of us. Thanks for understanding.

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I truly truly truly believe that a lot of people who get addicted to opiates are self-medicating for some underlying psych issue.. and I'm not making up excuses for being an addict... by the time I got my spinal fusion ( took tramadol all 4 yrs while my neck was getting bad enough for surgery ) I could not stop taking the tramadol.... I believe I had some bipolar or depression shit going on and the tramadol helped make me feel so much better.. sorry we dont all know as much as you, Mike T.. ( Hat, I'm sorry I wrote that, it does nothing for the discussion )


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 Post subject: same boat.
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Lillyval wrote:
You guys have no idea how much this is helping me. Just reading everyone's input is giving me a lot of perspective on this.

Setmefree - what you wrote is exactly what I was unable to articulate myself (because I was in such a brain fog at the time). I feel like I used to feel a few hours after getting stoned. Not high, but just tired and irritable and foggy. I'm trying to stick to 1 2mg dose a day, like Mike said, but I find myself feeling like I have to take a 2nd 2mg dose on some days (like today I had to take a road trip through a torrential downpour, and I felt like I just couldn't do it (with my kids in the car no less) without getting to the ceiling level and feeling somewhat "normal"). But like you said it's not a real normal it's like I'm an actress playing myself in a role. There's some sort of a detachment or unreality to it - and I've just gotten to the point where I want to get back into my life. I know this isn't true for everyone, and that some people feel more normal on Sub than they've ever felt, and that Sub is giving their life back, so I don't mean any disrespect to anyone that finds Sub working for them.

The whole debate on tapering vs just quitting CT is literally almost word for word the same debate I was involved in on another forum of people trying to get off a long acting opiate. Some people felt that their addict behavior prevented them from sticking to a disciplined taper. I'm starting to I feel like I fall into that category. It seems like sometimes no excuse is too flimsy to just go ahead and take some more.

On the other hand I made the argument that B Real made (about not suffering over and over again with each reduction and just getting it over with) on someone else's taper thread. Then about a day later that person suffered a major panic attack and acute withdrawal symptoms, and I felt terrible for giving someone advice that wasn't in their best interest. So, I think the "go ahead and jump" approach isn't for everyone.

Bottom line, I don't think I'm going to be able to do the slow taper. I'm hoping I can at least stay at 2mg for a week or so before I stop. I remember how I felt going off before at 2mg, and to be honest it felt only a little more intense than what I've been feeling since I got below the ceiling. I don't think I want to go through this for a week every time I drop by 0.5mg. But
I do realize that the consequences later might be worse.




im in the same situation. im at 2mg and feel that crap feeling daily. im thinking ill just stop at 2mg this fall after classes. i cant imagine the wd to be much worse than this , and then to be done with it after a week-ill take it.
i quite methadone CT at 40mg per day, and felt like SHIT for about 4 days. after that, with trazadone and melatonin, i slept fine and was working out a week after i quit.

any input is appreciated and i would love to know when you are going to jump? i may jump with you.


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

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