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PostPosted: Wed Jan 01, 2014 2:36 am 
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OK, so I have been taking 1/8 mg of 2 mg Sub strip (put another way, it takes me a total of 15 days to finish a 2 mg strip.) Started out with 1 mg of a 2 mg, then shaved that down to 1/2, then 1/4, and now 1/8. Been on this does for about 3 weeks.

I was ready to shave it down to 1/16 for 10 days then jump off but then yesterday I went to my original Sub doctor and he said, "Oh, you don't need to do that. A doctor friend of mine in L.A. swears by the Butrans patch to get his patients off of Sub." He then prescribed it to me. Told me to take 4 patches, one a week (releases 10 mcg p/hour) and by the time I am through I can just stop? Without any withdrawal? Or even just put on half a patch the last week?

I haven't tried it yet, but I just paid $92.00 for four patches...and that was with insurance and with a manufacturers discount of $100!

So far, off all my withdrawal symptoms the worst has been the horrible anxiety attacks at night. Can't sleep whatsoever.
To finally solve this dilemma and with much experimentation, I took ONE 0.1 mg Clonidine, ONE 0.5 lorazepam for anxiety and my normal dose of 300 mgs Neurontin for daily migraines.

This formula worked like a charm last night—slept beautifully; however the next day (today) I was pretty loopy—all day. And yet, I didn't even have to take ANY Sub...it's now 10:30 pm and I have yet to take ANY Sub. No withdrawal of any kind and trust me, by now I would have been feeling really bad.

So now I'm wondering what to do. I don't want to get hooked on Benzos...no siree.

The $64,000 question is...


[b]Will this Butrans transdermal patch really work to help me complete my withdrawal?[/b] Or should I continue to taper down the old fashioned way? (Though I hate to waste $92 for nothing.)

Any experiences with this?

Thanks so much!


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PostPosted: Wed Jan 01, 2014 4:43 pm 
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Hi ptp,

As you know, the patch is just pure Buprenorphine. Why he gave you four is because that is a months supply and how it comes. I don't think he could have given you less. (not sure) One patch per week.

The reason you aren't feeling any w/d's is because you're receiving Bupe through the patch instead of sublingually. I had the 20 mcg patch and could not feel the Bupe at all. Once you are off the Butrans patch you will start to feel the withdrawal effects.

Here is what I would do if my goal was to get off the Buprenorphine. Increase the days by one each week before you put the next patch on. By the time you get to the fourth patch it would be around 11 days since the last one. See your doctor one more time and ask for the 5 mcg patch and do the same thing, but adding as much time in between as you can handle. Then with the last patch, leave it on for as long as you can. They tend to come off so use whatever tape you can to keep it on. Don't let hot water hit it directly or it will release more Bupe than usual and run out faster.

That should have you down to a low enough dose to jump from. What w/d's you'll feel no one knows. It could be a walk in the park or PAWS may come in and mess with you. Everyone is different.

That's my 2¢. See if your doctor agrees with my theory of tapering. This is only my personal opinion as one addict to another.

If this works for you, please post how it went. I am very curious to see if this is a good way to taper off Suboxone.

Good luck whatever path you choose.

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PostPosted: Thu Jan 02, 2014 12:26 am 
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First, Happy New Year! Thanks so much for your response...and your advice.

I do need to clear up one thing. I wasn't even on "the patch" when I was "feelin' no pain." I was still on the 1/8 mg (of a 2 mg strip) and had wondered why 18 hours had gone by since my last 1/8 dose with hardly any withdrawal symptoms.

THIS is why I was hesitant about even using the patch.
Perhaps I could have just jumped off at 1/8 and been more OK than I had anticipated? But since I dished out $92 dollars (this with insurance and a mfg $100 coupon) I didn't want to waste the money. Plus my doc is convinced this patch thing will work.

Your plan makes sense, though I might be even more aggressive and see what happens if I cut the 10 mcg does in half the second week. I was already down so low (relatively) on the film strips. I don't have to get a script for 5 mcg as my doctor said even though the mfg doesn't advocate cutting these 10 mcg strips in half, he claims it's perfectly safe to do so.

Really wish I know the equivalency of what I was taking (mg) to what the patch dose is (mcg). If anyone has better math skills than I do, it would really help to compare apples to oranges (or apples to apples as the case may be).

So, what is the equivalency of a 1/8 mg of a 2 mg sub strip (remember it takes 15 days for me to finish a 1/8 mg film strip) to a Butrans patch that releases 10 mcg an hour??

Better minds than mine will have to figure this one out. (Sounds like an SAT math question...UGH)

Anyway, yesterday I took 1/8 mg film strip. This morning I put on my Butrans transdermal patch and so far ... nothing. By "nothing" I mean no withdrawal at all which I would have normally felt by this time on my 1/8 mg film strip. The box does say it takes 24 hours for the patch to kick in.

We shall see how I sleep tonight. But still wondering if I should have left well enough alone and never put on this patch and seen where jumping off the 1.8 mg film strip would have taken me.

Maybe it's not too late? Should I just take off this patch and let the $92 be a costly mistake?

Anyone used this transdermal patch after getting down to a low dose of Sub film like I did? Probably not, but hey, it's worth asking!!!


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PostPosted: Thu Jan 02, 2014 12:32 am 
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You are on a low dose of suboxone. I wouldn't even bother with that patch, just stop taking it. I am having trouble understanding how many mgs you're taking but if it takes you 15 days to take a 2mg strip, you must be on an extremely low dose, what? Less than .25mg right? You're going to be fine stopping at that low dose.

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PostPosted: Thu Jan 02, 2014 2:16 am 
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Hmm. Well there is the issue of the chronic neck and back issues. (Legit: 2 back surgeries; 7 neck epidurals, plus I have CRPD in my left index finger). This is how I got onto Vicodin in the first place, then Oxy, then Methadone, then Sub. (Never escalated my dose of Vicodin however....not once in 1.5 years so doctor said I was "dependent" vs. "addicted" though that may be a matter of semantics.)

Still I would like to know if the chronic pain can be managed without narcotics. I've heard stories of how people stopped Sub (or other pain drugs) and after the post acute withdrawal (PAWS) was over, so was the originating pain. Just plain 'ol Advil seemed to work for a lot of people. Not all, of course.

Anyway, I will never know if I don't try. And in a perfect world it would be better to be opiate free.

Been on Sub for 5 long years and never liked being on it: Detached, vivid, crazy dreams at night, rapid thoughts during the day, mood swings. Whole nine yards. May not be true for everyone but was for me.

Thoughts?


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PostPosted: Thu Jan 02, 2014 11:36 am 
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Oh, I'm sorry. I didn't realize there was a injury/pain management thing going on. I can't speak on that matter since I simply took pain medication recreationally because I was addicted, not dependent. After I got off the suboxone, I dealt with some back issues. I was surprised at how much and how constantly my upper back hurt. I think I was just so used to not feeling anything and that I had damaged my body's ability to handle any kind of pain on its own. I was taking lots of Motrin to try and combat the discomfort and my husband was getting worried about the copious amounts of advil I was taking so I stopped that after about a week or two, the pain subsided and really isn't there anymore. I think after we get off opiates, there will seem to be exasperated pain while our brains/body learn to produce it's on pain relieving endorphins. But again, I have no experience with actual injuries or chronic pain. I have heard, too, of people who deal with chronic pain being able to get by with Motrin alone. Actually, if I were being honest, I'd say an 800mg Motrin helps any actual pain I experienced better than like a vicodin.

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PostPosted: Thu Jan 02, 2014 1:12 pm 
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Seems I am getting conflicting advice. I just wish someone who had actually done the patch as a taper and had done so at the same level I was starting with (1/8 mg of Sub film to 10 mcg patch) would read this post and weigh in!


I feel a bit lost.

Here's my bottom line here: I DO NOT WANT TO BE ON ANY OPIATES. I would rather deal with whatever pain comes—real or “phantom” pain from withdrawal owing to the fact that my own natural pain fighting agents, i.e. serotonin, endorphins, etc. have been on vacation for five long hears.

Now I am calling them back from lying on the white sands and drinking pina coladas in the Bahamas. (Little humor there.)

The reason for my wanting to be off of Sub is that it has caused me to feel emotionally and spiritually detached from life, provokes vivid and crazy non-stop dreams at night and agitation and irritability during the day. In other words, I have never been my “true self” while on this drug.

HERE IS WHERE I AM AT TODAY, JAN 2. I have not taken the patch off yet though I am seriously debating it. It is helping with withdrawal…somewhat…though I was already starting to feel the worst of the withdrawal go away.

Someone "in the know" abut Sub did some math calculations for me this morning and wrote this about the patch:

Quote:
But here’s the way I figure it. You are now taking around .13 mg per day. The 10 mcg/hr delivers .01mg/hr, so over a whole day I’d say that’s .24 mg per day. I’m not sure if that’s pharmacologically correct, but that’s what it looks like to me.

Seems like you would be better to go with the lowest strength, the 5mcg/hr which – I think – would be half of that. But talk with your doctor and see what he recommends.

No one knows if transition to the patch will work – no studies that I can find.Since it’s super long-acting, maybe the withdrawals will be more gradual. I’ve often wondered if it would work, so please write back and keep readers updated.



Here's the thing with all this—especially after reading what this Sub expert wrote. It worries me that I may be in fact escalating my dose of Sub from 1/8 mg to 1/4 mg by going on this patch. Is that what these math calculations concluded?

IF I continue on this patch, 10 mcg is about right for where I am at right now. I think perhaps I should wait a week before going down to 5 mcg. (Again, my doctor said that even though drug mfg would not advocate cutting a 10 mcg half he said it’s really not harmful if I do this.)

I say this because the withdrawal pain level I am at right now is tolerable. I don’t think it would be at 5 mcg…at least not right now.

Prior to my putting on this first 10 mcg patch 24 hours ago, I was following a careful plan. This plan given to me by a guy who has literally helped hundreds get off Sub successfully. It was very systematic and I was following it.

I had planned to jump off at a 1/8 or possibly even lower at at 1/16 sometime in the next two weeks.

Now….well I don’t know. I’m confused. Part of me just wants to rip off this patch right NOW, and jump off the 1/8 mg of Sub that is probably still in my system since I have only been on this patch for 24 hours. I have all the comfort meds I need at hand to do this and am mentally ready.

But I can’t use any of these meds (Clonidine, anxiety med, etc) while I am still on this patch. Can I?

Because it seems to be that this transdermal patch thing may just prolong the taper/withdrawal process. But no one can tell me for sure it seems. REALLY wish someone who had done what I am doing now will read this post and tell me.

And that, as they say is that! Any more comments/suggestions/advice would be most helpful. :)


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PostPosted: Thu Jan 02, 2014 4:06 pm 
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paythepiper wrote:
IF I continue on this patch, 10 mcg is about right for where I am at right now. I think perhaps I should wait a week before going down to 5 mcg. (Again, my doctor said that even though drug mfg would not advocate cutting a 10 mcg half he said it’s really not harmful if I do this.)


I want to caution you as I've seen you mention cutting a 10mcg patch in half to 'make it a 5mcg patch' a couple times The buprenorphine is not distributed identically or evenly on Butrans patches and as you are trying tapering mathematically correct, this would not be the way to go; going to the actual 5mcg patch pricey or not would be the way to do it. While I agree that it's n ot going to be dangerous or potentially fatal to do, it's not going to be a viable way to taper. What if all the buprenorphine is on one half of the patch, then you're still at 10mcg and when you use the other half you're not being delivered any buprenorphine; you can't predict how the buprenorphine is distributed.

Similarly, we've all heard of cases of people overdosing on Duragesic/fentanyl patches using this same logic, that half a patch equals half the dose or a quarter of a patch equals a quarter of the dose...It's just not true.

Good luck in your tapering, it sounds like it's going about as painless as possible for you. There isn't a lot of info using the Duragesic patches to taper, so I think it's great that you're outlining your journey here!

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PostPosted: Fri Jan 03, 2014 1:23 am 
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Don't cut the patch. Don't chew it. Don't heat it. The comments above are absolutely correct-- cutting the Butrans patch completely changes the release pattern.

A couple brash thoughts... over the years, prescribing buprenorphine products to over 800 people, I see a phenomenon over and over and over--- people who are convinced that their fatigue, dreams, anxiety, numbness, weakness, bad attitude, good attitude, weight loss, weight gain, or smelly feet are caused by taking buprenorphine. So many times I've gone back with patients to their admitting history and pointed out that the symptoms they have now, 'caused by Suboxone', were part of their presenting complaint BEFORE Suboxone. So many times patients who were convinced that buprenorphine or Suboxone caused 'blank' found that a year after stopping Suboxone, 'blank' was still present.

I'm not saying that anyone reporting such symptoms is incorrect-- but after 30 years as a physician, Suboxone is one of the most well-tolerated medications I've prescribed. The things people put up with, for so much less benefit--- the heartburn from NSAIDS, myopathy from cholesterol-lowering meds, anorgasmia from SSRIs, hair loss and sterility from chemo... Yet people find it reasonable to blame buprenorphine for so many minor things... Of my current 100 patients, 2 or 3 still struggle with constipation. The other 97-- most of whom have been on Suboxone for years-- feel nothing from taking it except the loss of interest in opioids. People on buprenorphine are just like everyone else--- if they don't exercise, they feel tired. If they don't use good sleep hygiene, they don't sleep well. If they drink or smoke too much pot, they feel burned out. I prescribe many other medications, for psychiatry and sometimes for general medical indications-- and Suboxone/buprenorphine are the most predictable of anything out there.

Buprenorphine is a mu partial agonist. It has more complex actions at kappa receptors, which I suppose could cause more lucid dreams in some people. There is some evidence that the non-mu effects reduce depressive symptoms, which is why Alkermes is working on a buprenorphine-based anti-depressant.

Butrans... the conversion simply requires converting micrograms/hr to mg per day.... and then recognizing that only 30% of an oral or sublingual dose is absorbed, whereas the patch dose is what is delivered into the body. So a 20 mic patch puts 480 micrograms in the body every 24 hours. One mg of Suboxone film puts about 300 micrograms of buprenorphine in the body. So when people taper with the patches, a reasonable transition is from 2 mg of Suboxone to the largest Butrans patch.

BUT... by the time you are taking fractions of a mg of Suboxone, just stop it already. From addiction, we all become so obsessed with how we 'feel'... it is interesting to read the pharmacology texts from before the days of Suboxone, which say that 'there is no significant discontinuation symptoms after stopping buprenorphine.' Yes-- stopping a dose above the celing threshold will make you sick. But stopping the low amounts described in the first post of this thread is not the worst thing in the world. A patient of my practice recently 'jumped' from 16 mg after several years on buprenorphine; he made his factory job every day, because he had to. That's what I see with buprenorphine, over and over-- the people who are able to self-obsess for weeks will do exactly that. The people who are supporting families feel like crap but get on with life. People with cancer, another life-threatening illness, deal with symptoms 100-fold worse, for year after year. Stay on Suboxone, or stop it so someone else can benefit from your spot--- but don't spend years of your life tapering Suboxone. A few months, with slow and steady reductions, and then stop-- don't sweat the small stuff.

A small issue, but to keep the discussion accurate... endorphins do not go away in people taking opioids. They do not get depleted. The problem is that the receptors for endorphins and enkephalins become less sensitive from chronic opioid stimulation. The misery of withdrawal comes from bad receptors, NOT a lack of endorphins.

Realize that it is not legal for a doctor to taper opioids using opioids, EXCEPT for buprenorphine-certified docs or methadone clinics who must use either forms of buprenorphine indicated for addiction treatment, or methadone. It is not legal for ANY doc to taper people off Suboxone using Butrans. It IS legal for any doc with a DEA license (no buprenorphine certificatoin needed) to prescribe Butrans for any other condition, including pain. But the Harrison Act specifically prohibits tapering from opioids with Butrans. A patient treated for pain can be treated with progressively greater or lower-strength patches, based on need for analgesia.... but using Butrans to deliberately reduce symptoms of opioid withdrawal is a violation of Federal law.

Sorry for pissing everyone off.... been a long day.


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PostPosted: Fri Jan 03, 2014 10:42 am 
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paythepiper wrote:
Seems I am getting conflicting advice. I just wish someone who had actually done the patch as a taper and had done so at the same level I was starting with (1/8 mg of Sub film to 10 mcg patch) would read this post and weigh in!


I feel a bit lost.

Here's my bottom line here: I DO NOT WANT TO BE ON ANY OPIATES. I would rather deal with whatever pain comes—real or “phantom” pain from withdrawal owing to the fact that my own natural pain fighting agents, i.e. serotonin, endorphins, etc. have been on vacation for five long hears.

Now I am calling them back from lying on the white sands and drinking pina coladas in the Bahamas. (Little humor there.)

The reason for my wanting to be off of Sub is that it has caused me to feel emotionally and spiritually detached from life, provokes vivid and crazy non-stop dreams at night and agitation and irritability during the day. In other words, I have never been my “true self” while on this drug.

HERE IS WHERE I AM AT TODAY, JAN 2. I have not taken the patch off yet though I am seriously debating it. It is helping with withdrawal…somewhat…though I was already starting to feel the worst of the withdrawal go away.

Someone "in the know" abut Sub did some math calculations for me this morning and wrote this about the patch:

Quote:
But here’s the way I figure it. You are now taking around .13 mg per day. The 10 mcg/hr delivers .01mg/hr, so over a whole day I’d say that’s .24 mg per day. I’m not sure if that’s pharmacologically correct, but that’s what it looks like to me.

Seems like you would be better to go with the lowest strength, the 5mcg/hr which – I think – would be half of that. But talk with your doctor and see what he recommends.

No one knows if transition to the patch will work – no studies that I can find.Since it’s super long-acting, maybe the withdrawals will be more gradual. I’ve often wondered if it would work, so please write back and keep readers updated.



Here's the thing with all this—especially after reading what this Sub expert wrote. It worries me that I may be in fact escalating my dose of Sub from 1/8 mg to 1/4 mg by going on this patch. Is that what these math calculations concluded?

IF I continue on this patch, 10 mcg is about right for where I am at right now. I think perhaps I should wait a week before going down to 5 mcg. (Again, my doctor said that even though drug mfg would not advocate cutting a 10 mcg half he said it’s really not harmful if I do this.)

I say this because the withdrawal pain level I am at right now is tolerable. I don’t think it would be at 5 mcg…at least not right now.

Prior to my putting on this first 10 mcg patch 24 hours ago, I was following a careful plan. This plan given to me by a guy who has literally helped hundreds get off Sub successfully. It was very systematic and I was following it.

I had planned to jump off at a 1/8 or possibly even lower at at 1/16 sometime in the next two weeks.

Now….well I don’t know. I’m confused. Part of me just wants to rip off this patch right NOW, and jump off the 1/8 mg of Sub that is probably still in my system since I have only been on this patch for 24 hours. I have all the comfort meds I need at hand to do this and am mentally ready.

But I can’t use any of these meds (Clonidine, anxiety med, etc) while I am still on this patch. Can I?

Because it seems to be that this transdermal patch thing may just prolong the taper/withdrawal process. But no one can tell me for sure it seems. REALLY wish someone who had done what I am doing now will read this post and tell me.

And that, as they say is that! Any more comments/suggestions/advice would be most helpful. :)



I don't know why you're saying you're getting conflicting advice.

Yes, it seems like with the patch you're increasing your dose. Like I said in my original response, you shouldn't even try to taper with the patch. You've ALREADY tapered! You're lower than most people who've stopped on this thread. If you want to be off all opiates, stop taking the opiates. I seriously cannot see how stopping at apprx .1mg could be a painful withdrawal experience.

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PostPosted: Wed Jan 08, 2014 9:19 pm 
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Helpful post. Sorry I didn't respond right away, I was too busy obsessing over my Sub taper. Ha!

Seriously, you raise some very interesting points. Weird about my doctor breaking the law by prescribing Butrans patches to help me complete my taper off of Sub. The guy wrote on a book on Suboxone (won't mention his name for obvious reason). You think he would know better.

No matter. It's a moot point in my case, as I did, in fact, rip off the patch after wearing it 48 hours. I did this upon advice of a guy I know who has helped hundreds of people all over the world get off Sub successfully. He himself used to be on Sub and was a hard-core addict. That was not my issue but that is not relevant to this post.

It's now been 6 days since I took any Sub, if you don't count the one 10 mcg patch I wore for 48 hours (which did nothing) and one tiny sliver of a Sub 2 mg strip that I had to take in order to stop the HORRIBLE anxiety/panic attacks that I have had every night since my second day of jumping off at 1/8 mg.

Doctor, would you please, please explain why I am having this torturous anxiety/insomnia attacks at night but not during the day? Even two Lorezpams (0.5 mg x 2) and one Clonidine (0.1 mg) isn't enough to stop this attack completely. Only slightly.


My other doctor (not the doctor who gave me the Butrans patch) prescribe the anxiety drug and I really, really prefer not to take it. She also prescribed a very low dose of Vicodin and while I don't want to take that either, I have been taking ONE 5-325 p/day and doing so ONLY to take the edge off the Level 8 pain in my neck and shoulders. The Vicodin does not give me a buzz or ANY sense of euphoria...it only takes the edge off...bringing a level 8 pain down to a 6 or 7.

The neck is where most of my withdrawal pain is centered. I am sure this is because I have had 5 injections on my neck and have six things medically wrong with it. (Severe Reversed cervical curve, stenosis, arthritis, bone spurs, hernitated discs and an an issue that caused CRPD in my left hand...stemming from my neck.)

All that to say, it is not worth being on opiates—partial or full—because I do no like the emotional numbing, the detachment, and with Sub, the obsessive thoughts and dreams. In other words, I would rather deal with the originating physical pain.

In summary, to deal with this withdrawal, I take mostly 800 mgs of prescription Advil which does take the edge off somewhat. It does not however work for those times of the day when the pain level goes above a 7, in which case, as already stated I will take one Vicodin. At night, another story. HAVE to take the anxiety meds/Clonidine or I would get NO sleep whatsoever,

Yes, I exercise (though probably not enough), take the the hot baths, etc., but I am still getting only 2-3 hours a sleep at night. And this is not acceptable as I have to be in good enough shape to help take care of my 93-year-old father who has dementia. (I do this 3 days a week.)

So, what do you suggest ( I wont take this as medical advice, not to worry) I do to STOP the horrible anxiety/panic attacks after I close my eyes to go to sleep?

Thanks so much. :) (I was on Sub for 5 years if that helps)


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PostPosted: Thu Jan 09, 2014 3:31 am 
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It sounds like you have some serious chronic pain issues that have been managed by narcotics. I'm thinking perhaps your DR was prescribing you buprenorphine (Suboxone/generic Subutex) off-label for pain and not addiction. Dr J is absolutely right in that under DATA 2000, the only current formulations of buprenorphine that can be used to treat addiction in an office-based setting currently are Suboxone/Subutex, generics of those two and now Zubsolv.

It was probably a bit of a grey area in your case with his prescribing Butrans to taper off sublingual buprenorphine, I've seen it done before, I even know of a case of a DR prescribing Buprenex ampoules to someone 'for pain,' but wink, wink for maintenance before Butrans existed. He is no longer a practicing physician for many reasons, however.

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PostPosted: Fri Jan 10, 2014 6:04 pm 
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paythepiper wrote:
Doctor, would you please, please explain why I am having this torturous anxiety/insomnia attacks at night but not during the day? Even two Lorezpams (0.5 mg x 2) and one Clonidine (0.1 mg) isn't enough to stop this attack completely. Only slightly.


I'm not the doctor, but will take a stab at a guess..

paythepiper wrote:
My other doctor (not the doctor who gave me the Butrans patch) prescribe the anxiety drug and I really, really prefer not to take it. She also prescribed a very low dose of Vicodin and while I don't want to take that either, I have been taking ONE 5-325 p/day and doing so ONLY to take the edge off the Level 8 pain in my neck and shoulders. The Vicodin does not give me a buzz or ANY sense of euphoria...it only takes the edge off...bringing a level 8 pain down to a 6 or 7.


If you are taking one vic a day, you could be holding back your withdrawal constantly. It may not be doing much, except taking the edge off, but it's enough to keep you from feeling full blown w/ds in the day time. By the night time you could be (repeatedly) experiencing the beginnings of withdrawal all over again, which is usually anxiety. Anxiety always came first for me in the withdrawal department. It's pretty par for the course.

You will never fully heal, and get off opiates, until you actually stop taking them. You are just going around and around with the vics and the patches.. etc. I know you're taking them for pain, but if your goal is to stop taking opiates, eventually, well.. you'll wanna stop taking opiates. You've repeatedly said you'd rather deal with the pain. Part of that pain also includes the shitty detox process. This is it. This is what we all go through. Insomnia, anxiety, panic attacks, body jerks, diarrhea.. Most people here do it without any anxiety meds or short acting opiates. It's a process and one that is not for the faint of heart.


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PostPosted: Sat Jan 11, 2014 10:17 am 
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This person needs a plan. Dr J mention above, " using Butrans to deliberately reduce symptoms of opioid withdrawal is a violation of Federal law" I think this is the least of paythepiper problems!


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PostPosted: Sat Jan 11, 2014 1:26 pm 
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tinydancer wrote:
paythepiper wrote:
Doctor, would you please, please explain why I am having this torturous anxiety/insomnia attacks at night but not during the day? Even two Lorezpams (0.5 mg x 2) and one Clonidine (0.1 mg) isn't enough to stop this attack completely. Only slightly.


I'm not the doctor, but will take a stab at a guess..

paythepiper wrote:
My other doctor (not the doctor who gave me the Butrans patch) prescribe the anxiety drug and I really, really prefer not to take it. She also prescribed a very low dose of Vicodin and while I don't want to take that either, I have been taking ONE 5-325 p/day and doing so ONLY to take the edge off the Level 8 pain in my neck and shoulders. The Vicodin does not give me a buzz or ANY sense of euphoria...it only takes the edge off...bringing a level 8 pain down to a 6 or 7.



You may be right...the Vic could very well be holding back the withdrawal process...or more accurately, prolonging it. But what else can I do when I have to help take care of my 93-year-old father with dementia? ...not to mention do my other jobs (writing and eBay) so I can earn a living.

Jumping off at 1/8 may not seem like a "big deal" as the other poster on this thread so breezily claimed but as another poster on another thread correctly pointed out, I have been on Sub for five long years and in my case this drug is not taking its deeply entrenched claws off me so easily.

I'm quite sure this is why detox centers exist. Because really, you can't do much else (at least do it well) when you feel like crap, are in a lot of pain, and get no sleep. It's a real quandary. Too bad I'm not a celebrity then I would have the time and money to go to a fancy rehab place and just bask in the notoriety of it all. :wink:


If you are taking one Vic a day, you could be holding back your withdrawal constantly. It may not be doing much, except taking the edge off, but it's enough to keep you from feeling full blown w/ds in the day time. By the night time you could be (repeatedly) experiencing the beginnings of withdrawal all over again, which is usually anxiety. Anxiety always came first for me in the withdrawal department. It's pretty par for the course.

You will never fully heal, and get off opiates, until you actually stop taking them. You are just going around and around with the Vics and the patches.. etc. I know you're taking them for pain, but if your goal is to stop taking opiates, eventually, well.. you'll wanna stop taking opiates. You've repeatedly said you'd rather deal with the pain. Part of that pain also includes the shitty detox process. This is it. This is what we all go through. Insomnia, anxiety, panic attacks, body jerks, diarrhea.. Most people here do it without any anxiety meds or short acting opiates. It's a process and one that is not for the faint of heart.


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PostPosted: Sat Jan 11, 2014 1:36 pm 
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Quote:
I don't know why you're saying you're getting conflicting advice.

Yes, it seems like with the patch you're increasing your dose. Like I said in my original response, you shouldn't even try to taper with the patch. You've ALREADY tapered! You're lower than most people who've stopped on this thread. If you want to be off all opiates, stop taking the opiates. I seriously cannot see how stopping at apprx .1mg could be a painful withdrawal experience.


Uwillbeloved:

Respectfully, I don't think you realize that while 1/8 mg may seem like a low dose to you, you have to remember two things: (1) Sub is 20-30 times more powerful than morphine (do the math) and (2) length of time on Sub is a greater factor than amount...I've been on Sub for 5 years so suffice it to say it's "claws" are very deeply entrenched and is clearly not releasing it's hold easily. I'm sure those with more scientific knowledge than I could give you a better sounding explanation than this but the gist is still the same.


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PostPosted: Sat Jan 11, 2014 1:44 pm 
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By the way, I ripped off the Butrans patch. Agreed with some of you that it's better just to jump off and get it over with. But it has been very, very difficult. No sleep, lots of pain, and super irritable. Not the best place to be in when you're taking care of a 93-year old father with dementia. (See my other latest thread about sleeplessness and anxiety... I chronicle it more in depth there.)


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PostPosted: Sat Jan 11, 2014 5:44 pm 
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I think people have hinted at this and flat-out-said-it but there is NO painless way to totally stop using opioids if one insists on doing so. There are ways to draw out the inevitable and keep oneself in an almost constant state of withdrawal but to stop like Tiny said, you've, at some point, just gotta stop. If you want off opioids, I'm not sure why you even have hydrocodone and what ever other drugs laying around or being prescribed.

There are schools of thought that support complete abstinence from all mood altering chemicals and schools that support the least-harmful options for people unwilling/unable to cease use completely, these options are typically long-term to indefinite buprenorphine or methadone. I think you need to pick your poison at this point or you are going to be on this ride for a long time, and it's not a fun amusement park ride, trust me. It won't be a walk in the park to completely stop all opioids, but there will never be a 'perfect time' to do it, so if that's the goal try it and assess from there. Or stay on buprenorphine. Either way, best of luck.

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