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PostPosted: Tue Sep 13, 2016 1:56 pm 
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Hey all!

I started on suboxone last Tuesday (9/5) after 2+ years on opiates. Did a lot of switching between pills and heroin, not to mention a lot of attempts to get clean on my own. Recently, I got a week clean using street suboxone then relapsed for 5 days. Needless to say the self treatment obviously wasn't working so I finally went to a clinic to get help. This last five day relapse, I was using .5 g a day of heroin (smoked, not IV) with some oxy here and there. I've had good experiences using street suboxone to detox after taking larger amounts of my DOC for longer so I thought this time would be cake.

Induction went fine- I started with 4mg 24 hrs after my last dose of h, and added another 4mg a couple hours later to knock out lingering discomfort. My doctor prescribed me 16mg a day (8mg morning, 8mg evening). I took the 16 mg for a couple days but had unbearable sleepiness and nausea, so on day 3 I dropped down to 12mg (6 morning, 6 evening). I still had intense side effects at this dose. I've now tapered down to 6mg (3mg morning, 3mg evening) and I'm still sleeping 12 hrs a day and almost nodding off at my desk at work.

I'm positive it's the subs, since my sleeping patterns have always been very regular, and the sleepiness happens about 2-3 hrs after my dose like clockwork. The nausea is lessened, but still there, especially after I eat. If I eat more than a few bites of anything, I get so nauseated I can barely function. I don't have any other withdrawal symptoms and I feel my dose is "holding" me just fine.

To make matters more annoying, no dose has seemed to even reduce cravings, let alone abolish them. All I can think about is using. 16mg, 12mg, 8mg, 6mg... doesn't matter. I've been going to 12 step and SMART meetings to keep my mind off the cravings, but I'm incredibly jealous of all my friends who have never thought of getting high again after getting on subs. It seems that my cravings are just as strong on suboxone as they have been when I've detoxed and been clean without it in the past. If suboxone doesn't help with cravings, what's the point in even being on it? I can go to meetings and counseling without paying for this drug.

Maybe a higher dose than the 16mg would help...However, I can't afford to take it for weeks and "ride out" the side effects in hope they'll go away. The side effects at 16mg are disabling, and I can't imagine how bad they'd be at 20 or 24mg.

I have a dr appointment for tonight, but I called the office last Friday about my side effects and their only advice was "deal with it." I'm looking for another clinic that is more compassionate, but in the mean time, what do I do? I'm so frustrated because it took a lot of courage to finally admit my addiction to a doctor and I feel like nothing is working out the way I'd hoped. I just want to feel like suboxone is a miracle drug the way that a lot of my friends and some of y'all do :(

Is it possible that my problems have to do with naloxone? I've never tried bupe alone, so I'm not sure if it affects me any differently.

For the record, I am really motivated to stay clean so I'm not going back to oxy or H no matter what. It would sure be nice though if I could find a dose of suboxone that made that goal a little easier.


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PostPosted: Tue Sep 13, 2016 4:48 pm 
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Hey ohno welcome.

First off, ur way to new on suboxone to be this defeated. Ur barley a week in, give urself a chance to adjust. 16mg is what u probably should have stuck with instead of immediately tapering to 6mg. Side effects of sleepiness will eventually go away, most of us went through that side effect in the beginning. U have to adjust, like u had to adjust to many medications before Suboxone. Ur jumping the gun way to quickly imo. It took me a good month to adjust completely. I also don't think it's anything to do with naloxone either, ur just gonna have to ride out the sleepiness til ur body gets used to it. The nausea feeling does happen to some ppl too (it didn't mean but it does happen) and I believe that will also go away. Most doctors won't give ya plain buprenorphine unless ur a pregnant lady.


If 16mg is still to strong then try 12mg. I believe ur cravings are not being taken care of because maybe ur dose isn't high enough. I get that u dropped ur dose down because of side effects but that dropped dose may not be strong enough for ur cravings. Controlling cravings is the main thing for u right now. Another thing that ppl confuse is cravings and mistaking cravings for missing the high or old life. I know it's confusing but it's true. Once we stop using, we find ourselves in a limbo like place. That's where u gotta fill ur extra time with new hobbies, new friends...ya know just adjusting into a newer chapter of life. I missed getting high...really bad in the beginning. I will tell ya that this does pass. I think u need to give urself a little more time, continue the meetings and believing in this process, it's definitely worth fighting for I promise.

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PostPosted: Tue Sep 13, 2016 7:00 pm 
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I totally get that I'm really new to it and need time to adjust. I guess I'm so defeated because the side effects were SO intense- sleeping 20+ hrs a day on weekends, nodding off at my desk, sleeping through 4-6 alarms, my husband freaking out and calling my mom cause he couldn't wake me, not to mention vomiting after every meal when I managed to get something down. The only reason I didn't get written up at work for sleeping through my alarms and coming in late 4 days in the last week is because I'm in my final week here. I start a new job Monday and can't afford to sleep through work anymore. If it was ANY other medication I would have immediately discontinued it, so I went the compromise route and dropped my dose. From what I understand, these are symptoms of a dose being too high, but how can it be too high if I'm not getting all the intended effects?

FWIW I get the difference between those two types of cravings. It's definitely not lifestyle nostalgia. I'm still close enough to the negatives of my using to be consciously repulsed by the idea, yet here I am. It feels psychologically like quitting CT. I was under the impression it is supposed to be a bit less intense than that.

I WANT to be on a higher dose, and I understand there's probably a dose up there that'll work on my cravings. I want that more than anything. I'm not sure though how to deal with the side effects in the mean time. Sorry if I seem like just a whiner. More than anything I need this to work well enough that I can take the steps I need to in order to move on from my addiction. I'll deal with the cravings if I have to in order to be on a dose that allows me to function, but half the point of subs was to make functioning easier during this process you know?


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PostPosted: Thu Sep 15, 2016 2:27 am 
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In my opinion and in my case buprenorphine never took away cravings and never will. Buprenorphine just keeps me out of physical withdrawal. I no longer have cravings because I stopped wanting to get high years ago. I was physically unable because of withdrawal. I still do not take my suboxone as prescribed. I take much less and I take small amounts via injection thorough out the day. A lot of people will yell at me for this but I could care less. Nobody has any say over how I choose to stay off heroin. I'm far from caring about what other people think sobriety and recovery are. I rather get 100% bio-availability via injection and only have to take 3-4 milligrams a day at different intervals.

Buprenorphine never did anything for cravings. So I do this as my own solution. You will come up with your own way to successfully take your medications. Your Dr probably knows nothing about Buprenorphine! Who cares what he says. Buprenorphine cannot work for cravings in my opinion because cravings are psychological. Bupe works on physical dependence. Therefore if you have a craving it is your boredom. In this case take another small piece.

You will hear Drs tell you to only take one dose per day. And that taking a substance throughout the day is addicting behavior. So what? As long as your slowly making better choices you are making progress. Eventually you will get to a point where you will realize cravings are your weakend willpower towards substance. You will eventually become more confident and in control of life and your medication. But you can only achieve this by staying on suboxone.

Most suboxone Drs have no clue about the drug they prescribe. I've had 3 Drs not even consider writing me generic subutex. Each Dr said " subutex can be injected, suboxone has a blocker inside to make injection impossible". In each case I replied " I'm injecting my suboxone right now that statement is false Buprenorphine out competes naloxone at the mu receptor". These ignorant Drs cost me thousands!

Take what they say as guidelines. Nobody needs 16mgs of Buprenorphine! Nobody! 8 is even on the large side. Take the bare minimum to keep yourself out of physical withdrawal. When you have a craving take half that amount. Experiment and find what works for you! Just do not use any opiates besides the Suboxone. Start with just that. Start with only taking suboxone and no other opiate. Keep tweaking your dosage and you will succede. This medication is a miracle, one you stableize. Use this forum for information and when you have a craving come on here and share with us! Somebody else may be experiencing one as well and together yous can empower each other


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PostPosted: Fri Sep 16, 2016 4:30 pm 
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Suboxone took care of my cravings 100%. I was past physical withdrawal numerous times but couldn't handle cravings. If suboxone didn't take care of my cravings, then I wouldn't still be taking it.....so I disagree with u on that. And I take 8mg and I see nothing wrong with that dose. I agree with u that nobody will ever define my recovery either but myself. I don't give anyone that power over my recovery anymore. I'm not here to judge, these are all just advise and opinions to support each other in times of need. Except for Dr Junig and Docm2....who are actually real suboxone doctors. I think the reason why suboxone treatment is so successful is because of how well it takes care of cravings, so if someone isn't receiving that benefit then they need to up their dose because suboxone does help with cravings. I hope others will chime in with their experience too.

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PostPosted: Sat Dec 10, 2016 5:16 pm 
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I just wanted to update a little.

I got a full genetic metabolic panel done after complaining about side effects to my doctor for eight weeks and turns out I metabolize all kinds of things strangely...essentially, my body is really good at metabolizing some drugs, and really bad at clearing other drugs. It was expensive, but worth it to explain all the bizarre medication reactions I've had throughout my life. I'm one of the 10-15% of people who doesn't clear oral naloxone 100%, so some slips through and causes funky effects like nausea and headaches. My doctor put me on subutex after getting the results of the metabolic panel and the headaches and nausea have gone away.

I stayed on 6 mg for a month or and two didn't have any abatement of side effects, so I dropped down to 4 mg, did another month or so there, then dropped again to 2mg, taken around 7pm. I STILL have sleepiness at that dose but taken in the evening it kicks in right around when I'd want to settle down anyway. Turns out the sleepiness is another effect of my jacked up metabolism. My body is crummy at clearing suboxone (and many other drugs) so the half life for me is say, 72 hours vs 36 hours for normal people. As you can imagine, with that going on in my body, at high doses like 16mg I was hitting the ceiling effect in 2-3 days, which apparently was WAY too high of a dose for me. 2mg a day still doesn't work on my cravings, but it is what it is. It's not easy, and I've just accepted that. Subutex at a low dose in the evening has very positive effects on my mood and anxiety, so that makes it easier to stay clean even with cravings still happening.

So, yeah. The moral is listen to your body, not everyone reacts to drugs the same way. Pharmacogenetic testing is really useful if you have strange side effects from medications, which I have throughout my whole life. Hope everyone is doing well!


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Dr. Jeffrey Junig, M.D., Ph.D.

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