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 Post subject: Checking in...
PostPosted: Sat Jul 18, 2015 9:54 pm 
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Hi everybody,
So, I started Sub therapy close to two years ago, and have spent the last year weaning down. I was started at a ridiculously high dose of 16 mg/day. I am now at 3.5 mg/day. Some of the drops have been more difficult than others (i.e. 8 mg to 6 mg was a cakewalk, but 6 to 5 needed Clonidine - go figure!).

What I am finding very frustrating is the seeming lack of knowledge surrounding Suboxone in the medical community. I do not understand it. My Suboxone is dispensed at a pharmacy that is supposed to SPECIALIZE in opiate replacement therapy, and the pharmacists' knowledge is, well, lacking. This is also the case with my "Addiction Specialist", who prescribes the Suboxone.

Today, I took 3 mg and plan to alternate 3 and 3.5 for a few days until I am comfortable with dropping to 3 mg. Then, I will make my way down to 2.5 and 2, and then start drops in the .25 mg range (which is difficult to do, as in Canada, the films are NOT available). The clinic I go to forces everybody to "jump" at .5, which I believe is possible, but unnecessarily difficult for some.

I have looked into Kratom, Iboga, Ayahuasca, you name it. Decided against all of them.

One piece of advice I read, which, if true, is useful, is that those patients who are taking an SNRI (anti-depressant specific to norepinephrine) should switch to an SSRI, as that final jump is purported to make your norepinephrine go crazy. This advice was not given by a doctor, so I do not know about its accuracy. Then again, my doctor hasn't been very accurate about a few things… Sigh…

Has anybody else used the "alternating doses" method to decrease dosing? Is this a smart way to go?

I look forward to any responses, and wish you all love and light!


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 Post subject: Re: Checking in...
PostPosted: Mon Jul 20, 2015 11:13 am 
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I haven't received any responses - perhaps I posted on the wrong portion of the forum? Or, maybe everybody was enjoying a sunny Sunday! Either way, if I could be directed to a place, where I could discuss alternating doses in preparation for another reduction, it would be GREATLY appreciated!

The physicians here are keen to put one on Sub therapy, but I do not know of anybody (personally) who has successfully quit. I know it can happen; I've read stories of people as they reduce their doses, eventually making it to zero. However, I am not convinced that the physicians are as keen to wean somebody as they are to induct somebody. It makes no sense to me (other than $$$, but I am trying to not think that way).

My physician lost it on me when I reduced my dose from 16 to 12 (which I didn't even feel), even though I brought in the unused medication so that it could be disposed of correctly and assure the clinic I wasn't out selling my Suboxone. He had me in tears… And, when I brought up alternating doses to him, he looked at me as though I was from another galaxy. I wasn't alluding to permanently alternating doses, simply to doing it long enough (i.e. a week or so) to prepare my body for the next reduction. Now, I do it without his endorsement. I feel better on 3.5/3 than I ever felt at 10, 12 or 16 mg, so my body tells me I'm doing the right thing.

I have a few fears: 1) Weaning from the "micro-doses" (below 2 mg or so), are purportedly difficult weans. I have looked into the liquid taper process for this, and think it would serve me best, but would like to communicate with somebody who has done it that way so that I can ensure I am doing it correctly; and 2) I have surgery upcoming. I have had surgery once on Subs, but didn't require any post-operative pain control beyond Aleve. I think he may have offered Tramacet, but I figured I'd be okay. The upcoming procedure, however, is extremely painful (this will my third round with the same operation, and my specialist himself stated that it is the most painful procedure he performs). I do not understand how to adequately relieve pain whilst on Subs. Before the last surgery, I was given 5-10 mg morphine (IV) every 3-4 hours, for a total of 20 mgs, and it ended up putting me in withdrawals - I had to take Clonidine and Zofran for a few days until the Sub built back up in my body.

I am tired of the dance with opiates. I am happy to say that I don't remember what it feels like to be high, buzzed, comfortable, whatever you want to call it, on opiates. But, I don't want to remember. If it were possible, I would like to divorce myself from opiates, including Suboxone. But, I realize I am on my way to exactly that, provided I wean carefully, in a way that my body doesn't go through all out withdrawals.

In the course of my Sub therapy, I have NOT used (with the exception of administration of narcotics in hospital). Every random UA is clean, and I am happy that Subs have given me the strength to not want any opiates. But, I now want off of the stuff.

If nothing else, posting at least allows me to sort out my thoughts regarding this. If anybody has anything they could add, it would be appreciated. If not, thanks for the forum and allowing me to to read your stories, many of which have prompted me to believe that I CAN do this.

All my best.


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 Post subject: Re: Checking in...
PostPosted: Mon Jul 20, 2015 7:10 pm 
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I'm sorry no one replied yet and I do think it has to do with our busy schedules in the summer. I can't even take time to really reply because I'm traveling and trying to keep up with 2 classes in grad school. Someone will be along to help soon. People will be reading your post. Please try to be patient with us! :)

Amy

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 Post subject: Re: Checking in...
PostPosted: Wed Jul 22, 2015 5:03 am 
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I just wanted to let you know that people are reading. You just have to wait for the right person to read your post. I am gonna bump your thread back to the top. Maybe it will help in getting a taper expert to respond. As Amy said, be patient, someone will be along soon. A lot of people, including myself don't log in to this forum everyday. But I try to swing by often. Summer is a busy time for everyone.
Hang in there
Happy


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 Post subject: Re: Checking in...
PostPosted: Wed Jul 22, 2015 11:56 pm 
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Many thanks, Amy and Happy. I go see the doctor tomorrow and am HOPING he will drop me to 3 mg. Wish me luck!

Love and light...


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 Post subject: Re: Checking in...
PostPosted: Thu Jul 23, 2015 8:53 am 
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Good Morning SearchingForFreedom,

Go to the Best of Suboxone Talkzone and read the articles on surgery ---> http://suboxonetalkzone.com/best-of-stz/

I am guessing that you are either from Canada, Great Britain, or Australia, so some of what I say may not be applicable in your situation. It is a shame your doctor treated you as he did. Can you switch to another, more caring and open-minded doctor? I would definitely start that process if you can. In the mean time, I would just continue on with the taper as you've been doing without involving him. I haven't tapered yet, so I'm only speaking based upon what I've read from others. You are right, it seems that below 2 mg it gets much more difficult. Many reduce very, very slowly below 2 mg. Like, 2 --> 1.5 --> 1.25 --> 1 --> 0.75 --> 0.5 --> 0.375 --> 0.25 --> 0.125, then skip days before quitting completely.

Others, with greater experience will likely respond Friday or Saturday.

Welcome,
Morphing


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 Post subject: Re: Checking in...
PostPosted: Thu Jul 23, 2015 5:37 pm 
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Well, I went to the doctor, and he reduced me to 3 mg - YAY!!! I am thinking about 10 days and then I will start alternating 2.5 and 3, stay there for 10 days, and be at 2.5 mg in 20 days. I find that my body "knows" when it is ready for a dose reduction. Well, maybe that is just recognizing the signs of withdrawal :)! If I'm okay for 10 days, I figure I've had time to stabilize. It's just so damn hard, sometimes. And, my physician REFUSES to prescribe 1/2 mgs, as he states it is too "iffy" when cutting down a 2 mg tablet (hence, my liking for the liquid taper method). Problem here is that if you are "caught" reducing your dose, you get kicked out of the program. So, I have to stay close to my rx'd dose, so that my norbuprenorphine levels are close to where they should be, given my rx'd dose.

When I spoke with him about the surgery, he suggested that I ask the surgeon to not use anything other than Advil or Aleve. My surgeon will laugh at this notion, as, in his words, "This is the most painful procedure I perform." Based on Dr. J's writings, it seems that full agonists can be administered concurrently with Suboxone. We'll see how it goes. As expressed in a previous post, I am of the opinion that the medical community does not understand Suboxone and its intricacies (Dr. J and one doctor out of Florida excluded!).

Yes, I do live in Canada - where, contrary to public opinion, medication is not free. At 6 mg/day, I paid just over $70/wk. At 3, the cost is $42/wk. My benefits ran out in February, so I am very grateful that most of the Suboxone, particularly the higher doses, was covered 100%.

Thanks to those who have responded. It makes me feel less "alone", as nobody in my family, professional circle, or personal circle takes the medication. So, nobody gets it. In fact, my boyfriend suggested I jump at 2 mg. I told him he was crazy to think this might be feasible. His rebuttal? Clonidine. It might work, but I have a feeling it might not - 2 mg is still a pretty high dose from which to jump.

Many thanks!


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 Post subject: Re: Checking in...
PostPosted: Mon Aug 03, 2015 12:16 am 
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Well, ten days at 3 mg have passed, so this morning, I took 2.5 mg and will alternate that with 3 mg for 10 days before dropping to 2.5. Getting nervous - see my surgeon on Tuesday and that will shed some light on the situation.

It is really funny now to think that I was once at 16 mg. I feel the same, although some say I seemed "high" on 16 mg, and seem to have reclaimed my brain at the lower doses.

I am worried about drops below 2 mg, but I suppose that is where the liquid taper method will come in handy.

Have a great long weekend, everybody!


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 Post subject: Re: Checking in...
PostPosted: Wed Aug 05, 2015 1:44 am 
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So, I have now taken two doses of 2.5 mg, with a 3 mg dose between. Tomorrow is 3 mg again. But, I can feel it. Don't get me wrong - it's not full blown withdrawal, just watery eyes, sneezing (histamine receptor action) and so forth.

I figured it out mathematically, and even at 3 mg, I am on less than 20% of my original dose. I have to admit, that made me happy! If I can get down to 2 mg, that will be 12.5% of my initial dose of 16 mg (note to any inductees - no matter what your doctor says, you DO NOT need high doses for more than 4-5 days, and I encourage you to reduce your maintenance dose as early as possible. Less really is more with Suboxone. I am not a physician, however. This is based on my experience with the med, which has done a great deal of good for me).

Many people discuss Gabapentin for "jumping". Is this in lieu of, or in addition to, Clonidine? They have separate actions, but I do not know if the effects are similar in opiate withdrawal. If anybody has any answers, please, speak up!

My plan is to alternate 2.5 and 3 for about 10 days, stay on 2.5 for ten days, and then alternate 2.5 and 2 (although I am thinking of doing 2 mg every three days to start - again, opinions and input are highly solicited!).

That's all for now. Happy to know I will, eventually, quit riding the Suboxone train. As wonderful as it has been, I want to try it without ORT.

Love and light!


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 Post subject: Re: Checking in...
PostPosted: Wed Aug 05, 2015 2:10 am 
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I think some do both clonidine and gabapentin. You can always experiment with what works for you. I'm glad that your progress feels good to you. You've worked hard both mentally and physically so give yourself plenty of kudos!

Amy

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 Post subject: Re: Checking in...
PostPosted: Sun Aug 09, 2015 12:42 pm 
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I've done about ten or eleven days alternating the 3 and 2.5, and feel ready to drop to 2.5. It's a bit nerve-wracking, as I start a new job tomorrow, but that in itself is motivating enough to continue to get off of this stuff. To be perfectly honest, I'm not even sure I want totally off (although that is the direction I'm headed in). The thought of staying at .5 indefinitely is somehow reassuring, but I will cross that bridge when I approach it.

I have trolled through the posts and have definitely received more information here than anywhere else regarding the upcoming surgery. I think that it was Dr. Junig who suggested that a three day cessation period can be desirable for scheduled surgery. This makes sense to me, as it gives enough time for some of the receptors to clear out a bit. Then again, the thought of "feeling opiated" scares the hell out of me. It is the anaesthetist who decides on post-operative pain control here, so I hope this anaesthetist is educated on Suboxone! I'm not even certain what my dose will be at that point, so perhaps I needn't stress myself out over the situation. Pain doesn't kill anybody - it's just uncomfortable. Some have suggested cannabis post-operatively (I can't stand the stuff, but I think it would be less harmful - to myself, as an addict, than opiates or opioids). Time will tell…

Bottom line, effective tomorrow, my dose will stay at 2.5 until I feel I have adapted and I will then start alternating with 2. I do not understand how people handle 1 mg drops at this level, and am not convinced that I could do it. The last full mg I dropped was 5 to 4, and that required Clonidine for a day or two. However, I am aware of the power of mind over matter. At one point, I was on Methadone, and jumped at 25 mg without a problem. However, I was pregnant, and those "my baby will NOT have opiates in its system" hormones were abundant.

I will keep posting. If nothing else, it serves as a diary of sorts that I can refer to. Amy, thank you for your words of encouragement. You are truly an angel, and your encouragement is appreciated.

Have a great Sunday!


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 Post subject: Re: Checking in...
PostPosted: Sun Aug 09, 2015 12:48 pm 
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I mentioned that this serves as a diary of sorts - by looking back, I have only taken the 3 and 2.5 for a week. I suppose I should give it another couple of days. Darn. I was looking forward to being on 2.5 - it will have to happen later this week!


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 Post subject: Re: Checking in...
PostPosted: Sun Aug 09, 2015 5:23 pm 
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Keeping a journal of sorts here is always a good idea. I hope that your new job goes really well! I know it can be hard to start out new.

Let us know how going to 2.5 works for you. We read even when we don't always respond. :)

Amy

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 Post subject: Re: Checking in...
PostPosted: Sun Aug 30, 2015 1:50 pm 
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So, I've stayed relatively stable at 2.5. However, I had a BIZARRE experience, earlier this week. Prior to returning to work, I would pop my sub in my mouth about one hour before I had to get up, move to a seated position, and breathe through my mouth so as to minimize the dilution of the sub. Since returning to work, I need every precious moment of sleep, so began taking my sub when I got up and would just do the usual "let it dissolve and (hopefully) absorb". On Tuesday, for no reason whatsoever, I was awake about an hour before I had to get up, so took my sub the old way - popped it in my mouth, breathed orally, and switched to a seated position.

Tuesday afternoon rolls around, and I got a creepy feeling in my body. It was familiar - I knew that feeling of being disconnected from my body. Suddenly, it hit me. I was high, and I was terrified. I had been happy with the fact that I had forgotten what it felt like to be opiated. Fortunately, I did not like the feeling AT ALL. I felt nauseous, and it reminded me of the first time I ever took Percocet - it was not the nice opiated buzz to which I had become addicted.

Spoke with my pharmacist about it. He said that allowing the sub to dilute in my saliva had reduced my tolerance further, and I gave my body too much by allowing the slow absorption. Now, this is interesting for people who want to maximize absorption on the lowest doses possible. However, my goal is simply to reach and sustain a level where I can comfortably lower my dose and know what to expect.

Moral of the story - stay consistent with how you take your Suboxone. The difference in absorption was insane. I realize that if I were above 4 mg, this likely wouldn't have occurred, but, at the lower doses, whoa - watch out!

Starting to contemplate alternating 2.5 and 2, so that I can drop to 2 at my next appointment (end of September). I realize that some people can drop every four days. I am not one of those people. My histamine receptors go crazy, teary eyes, yawning, and a general feeling of being unwell overtakes my physical being and I can't concentrate. I am going out of country for a few days, and think that, upon my return, I will embark on this next reduction.

All in all, it's going as well as I could ask for it to go. It blows my mind that I once took 16mg/day of this stuff. I think that dose now would do me in. So, for those who are starting Suboxone, be aware, this medication is one heck of a lot more potent that what we might think at the onset of ORT. I read that mg for mg/, equinalgesically, Subs are 40 times more potent that Morphine. It kind of freaks my out that I am taking the equivalent of 100 mg of Morphine per day (as far as analgesia goes), as I still have aches and pains that make Aleve a necessity.

Anyway, that's my check in. Have a happy Sunday, everybody!


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 Post subject: Re: Checking in...
PostPosted: Sun Aug 30, 2015 2:44 pm 
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Wow since I've been here on this forum I'm learning soooo much about how diff docs handle the prescribing of Suboxone! I can't bellieve he brought you to tears when you told him you were tapering down, or that you could be kicked out of the program for doing so! Also I never thought they were testing my urine for the ammount of bupe, only for its presense. Because there were times I didn't need or take my whole dose and they never said a word to me. Maybe Cananda is a lot diff? And you can't get the films there? Why in the hell not, I wonder?


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 Post subject: Re: Checking in...
PostPosted: Sun Aug 30, 2015 2:45 pm 
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Anyway, good luck with your taper. It sounds like your doing it the correct way and will have minimal discomfort when you do jump. Hope your doc is willing to support it.


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 Post subject: Re: Checking in...
PostPosted: Thu Sep 03, 2015 4:45 pm 
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This the best taper I know of. It has a calculator so you can enter your dose and receive a custom taper. It was created by the folks at NAABT and they're very knowledgeable about suboxone. I know three people who've used it and they had very minimal symptoms. All three were very surprised at how easy it was. Good luck.http://www.helpmegetoffdrugs.com/taper


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 Post subject: Re: Checking in...
PostPosted: Sun Sep 13, 2015 11:35 am 
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Many thanks to those who have responded. Reckitt has not even applied with Health Canada for the films (leaves room for competitors to jump in, so that one confuses me). I so wish they were available here, but they aren't, so that is the status, and I have to live with it. No matter - I am certain that I am not the first person to wean off of the tablets, and won't be the last. I just have to live with the circumstances.

My rx'd dose remains at 3 mg (although I see the doctor in two weeks, at which point I will ask him to reduce me to 2 mg). I haven't taken the full 3 in some time. I am currently alternating 2.5 and 2, and have been doing so for five days. So far, nothing crazy has happened - watery eyes, yawning, the predictable early withdrawal symptoms. I just remind myself that it is my body healing itself and is a natural process, and, if things are icky enough, I feel better knowing that the next day, I will get the 2.5 that my body has become accustomed to. I just have to get it ready to become accustomed to 2 mg. As I noted previously, I use about 10 days for these transitional periods, so I should be at 2 mg by the time I ask the doctor to reduce my dose. I don't know how other patients do a full milligram drop at the lower amounts. Hats off to all of them - I couldn't do it. I mustered up the courage to take the Suboxone that I had been cutting off of my dose and took them it to a different pharmacy to have it safely discarded. I was worried they'd want my name, etc. But, there were no issues, so I no longer have 1/2 mg corners of Sub in my car - it was looking a little messy. We have to dose once per week (at minimum) in the presence of our pharmacist, so I would break off what I didn't need in the car and spit it out (gross, I know, but better than taking too much).

I have looked at the taper schedule that somebody was kind enough to post - thank you!!! It seems a bit aggressive for my body, but the numbers were fabulous as far as the reductions go. I think I will go with the recommended reductions, but hold them for my customary ten days before reducing again. I laughed when it read that I will need a TOTAL of 36 mg to taper off - that's barely more than I took in two days when I started! We don't realize how potent (and unnecessary) the high doses can be, because we were so used to feeling how we did whilst using. It's sort of ironic. I'm quite convinced that if I were to take even 4 mg, I would be high. To think I once took 16 mg/day makes me both shake my head and feel pleased with my progress to date.

The taper schedule that was posted allows for an optional "loading" or "super" dose at the end. This confused me, as I don't want to be down to .25 and then take a 2 mg dose as my final dose. It seems counter-intuitive. But, if somebody has done this and it was successful, please chime in!

For personal reasons (I had a lot going on), I chose to stay at 2.5 longer than I normally would have remained at a dose. But, it has not made this current reduction any more difficult. It has taken me over a year to reduce to where I am at. I'm not in a race, and the quickest taper is not necessarily the winner.

Well - that's about all I have to say right now. Hope everybody has an awesome Sunday!

Love and light...


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 Post subject: Re: Checking in...
PostPosted: Sun Sep 13, 2015 11:44 am 
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Wow, awesome job!!! Sounds like u definitely have ur head in the right place and facing this with a positive attitude. I know it would be hard to stay positive when u feel bad, but it sure does make u see the blessing in what ur doing.

Very big high five! This post just really lifted my spirit today. I always try to look at the bright side of everything even when it seems like there isn't one.

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 Post subject: My weaning progress
PostPosted: Sun Sep 20, 2015 1:49 pm 
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I've decided to change my subject line to "my weaning progress", as, effectively, that is what I am using this board for. I am now on day four at 2 mg. While I was alternating 2.5 and 2, I started to find that I was feeling fine, and knew my body was ready for the reduction, so I chose to seize the moment. Thus far, no symptoms have presented, so I think I'm in the clear - it's usually days 2-4 that the withdrawals start to set in.

This week, I will ask my dr. to reduce my dose to 2 mg, which will be nice. The scary thing, to me, is that "by the book", my next reduction would be to 1 mg! That's nuts! I don't get it, and can see why so many people have such a difficult time getting off of Suboxone.

My next reduction will start with the liquid taper method. While I haven't employed this to date, i know that Suboxone is water-soluble, so, scientifically, it makes sense. I will have to watch for psycho-somatic symptoms, as I am most fearful of drops below 2 mg.

Well, I suppose that is it. Many thanks to those who take the time to comment! It makes me feel less alone in "me vs. Suboxone".

Happy Sunday!


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