It is currently Sun Aug 20, 2017 10:44 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 3 posts ] 
Author Message
PostPosted: Sun Jul 11, 2010 8:45 am 
Offline
Power Poster
Power Poster

Joined: Sat Jul 10, 2010 2:37 pm
Posts: 53
Hi all,

I became addicted to oxycodone and oxymorphone following major spinal surgeries two years ago. In the end, my pain doc cut me off and wanted me to go to inpatient detox- which I was unable to do since I care for a family member. We had some loud& argumentative words on the phone when I asked for Sub (he said I was "way too toxic") , and agreed that I'd call 911 if things got bad.

Having some Suboxone left from a previous induction, I carefully monitored my COWS score, induced myself, and followed the 7-day inpatient dosing schedule (I know, not smart to fly on my own, but I did and it worked).

So I jumped at 2mg, and things went GREAT...I was out of the woods, or so I thought....At day 13 off Sub, I developed a severe insomnia problem (I'm bipolar I and prescribed 800mg Seroquel qhs). Despite numerous sleep attempts with seroquel and prescribed benzos, I had no luck and knew that I was on the edge of psychosis.

So I caved in and took ~1 mg Suboxone- I slept like a baby. For the last 8 days I've been sleeping better than ever in my life, and have zero need for my prescribed anxiety meds (benzos) with the 1mg Sub. It's a tough choice, but I think I may just be a candidate for Sub maintenance. I've never used street-opiates, wouldn't even know where to get them and don't want to.

At issue is where I left things hanging with my pain doc. According to the sub-site, these docs are supposed to be receptive to honesty about abuse or misuse (in my case). I already have clonidine, benzos, sleep meds, zofran, and anything else, so I don't see how I can be helped inpatient beyond what I can do here.

Also, I've had the same psych for 8 + years. He's excellent, but does not do Sub or pain mgt. He's written me some norco here and there, and an inhaler or Z-pack when I needed it, but I'm pretty sure he'll refer me to one of his associates if I press with the sub thing. I MIGHT consider this, but only if I'm 100% certain I'm gonna stay on sub, it'd be a huge loss as he's a great doc.

Fact of the matter is, at this low-dose (taken at 6AM), I go to sleep at 7PM and wake up at 3:30 SICK, as in...feel like I Have to take Suboxone....despite the stated 70+ hr. half-life. I've only got 8 pills left, so should I go to pain doc, risk losing my psych, or try to get off the Sub?

Finally...I have seen studies about the use of low-dose opiates (methadone specifically) to manage bipolar disorder. Is there any validity to this ? Much of the allure I had to opiates was the fact that my bipolar "disappeared" when I took them, and I didn't need sleep or anxiety meds at all....plus I was for more productive...It was the first time in my life that I felt "normal"

What do I do ?

Thanks for any advice.


Top
 Profile  
 
 Post subject:
PostPosted: Sun Jul 11, 2010 10:27 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Hi runner and welcome to the forum. I hope you find as much support here as I have.

Nobody here can tell you what decision to make, but I'll give you my unofficial, non-medical opinion on some of what you've said. First of all, suboxone's mean half-life is 36 hours; 70 hours would be the high end of the scale. And since you're taking only 1 mg, which many would consider below the ceiling, I'm not surprised that you're waking up with what sounds like some withdrawals symptoms. At that low of a dose your opiate receptors aren't saturated and at that level it is my understanding it acts more like a full agonist. Most people on sub maintenance need to be at or above the ceiling, and I don't think you're there.

So am I to understand that your psych (psychiatrist or psychologist?) knows a sub doctor that s/he can refer you to? There's no harm in calling that doctor and asking how they feel about sub maintenance. There are also the doctor locators online (I believe there's 4 of them). Since you're looking for maintenance, don't be afraid to use that when calling prospective sub docs.

As for bupe managing or treating bipolar disorder, well, I've heard some people say it helps them, but I have no idea if there is any scientific evidence to support that.

I'm not quite clear, will your psych drop you if you get on a maintenance dose of sub? Can't you keep seeing him/her and get a separate sub doc? I have a separate sub doc, psychiatrist, and therapist and I don't think that's unusual. They each have their own specialty. If sub maintenance is what you're looking for if I were you I'd start getting some info for prospective doctors. It's a good place to start.

Again, welcome to the forum. I wish you luck in achieving what you're aiming for. Please stick around, keep posting, and let us know how you're doing. We're glad you're here.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
PostPosted: Thu Jul 15, 2010 9:02 am 
Offline
Power Poster
Power Poster

Joined: Sat Jul 10, 2010 2:37 pm
Posts: 53
Thanx Hatmaker!

I think you were very accurate in saying that I was below "the ceiling". This was not any accident, I felt that a higher dose or longer period on sub would be pervasive.

This past Sunday (4 days ago) I made the jump, my last dose being a teensy-piece (pile), perhaps .5 mg. This was as far as I could go without turning to a liquid method.

I am respectful of folks using sub as a maintenance med, and I think it takes a lot of courage to step away from full-agonist opiates no matter how you do it. Shoving 3x40mg Opanas up my face each day was asking for death. I'm a former paramedic, and have arrived on-scene with the narcan a little too late many times.

Unfortunately, several days off I found myself compelled to drink aclohol. An issue I'm still dealing with. I've heard anecdotal evidence that sub is also therapeutic for alcoholism- I never had an alcohol craving while taking it. And I think it far less dangerous than drinking.

I've been considering Kratom. Truth is, I'd probably turn to THC but have no connection for that- plus it eventually causes me to be paranoid and only worsens my anxiety.

Good or bad, that's where I'm at....


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 3 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 2 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