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PostPosted: Thu May 07, 2015 11:31 am 
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Hi - I would have read all the great posts but feel so awful that I wanted to just post my situation.

I have had chronic headaches for years, and for the last 12 years was on methadone...a steadily reducing daily dose done on mt own.

Anyway my pain management dr started making me taper 10mg per month due to new state laws to achieve a dosage average dictated by the state I live in. This was no big deal and I got down to 70-80mg a day this month. I told him that I wanted to taper completely off. My headaches have been good and last week I decided I didn't want to wait 8 month to taper and went from 80mg on a Sunday to half a week of 10mg to a 10mg on Friday last week. No more methadone since or ever. I have clonidine and clonazepam so I know how awful methadone wd is. But I want off. So I have taken a couple,of ,t breakthrough meds a day to keep,the wd in check but I know u can't trade one drug for another. I rarely had to take opana but if I take it daily I'll get dependent on it.

So I went to my psychiatrist who does suboxone for addicts and he said he would help me,,he said I wasn't a classic candidate for suboxone because I wasn't an addict but we talked and decided on s 14 day trial. I had things to do the past few days and today is the day I've decided to be opana free so I can go into FULL withdrawal and start suboxone. I've been in some,kind of wd because I've already lost over 10lbs and have such mental clarity now that im crying about my situation in life...niot having a job or being married. The methadone clouded over that.

So anyway it's been bad but with the supportive drugs it's been tolerable but I need it to end prior to wasting away.

However I'm concerned about trading methadone for suboxone. Like I said, I'm not an addict. I've always dropped to the lowest therapeutic dose on my own. And then told the doctor to reduce the RX accordingly.

So I've read that it's very difficult to get off of suboxone too. I have a call in to the shrink who will be furious I have not started. He treated me like a junkie the other day and I came this close to firing him. He knew about my headaches etc. But I never discussed anything other than a short trial.

What's the implications of thst? After 14 days or whatever will I be back where I am now, in terrible wasting withdrawal? I don't want or need to be on suboxone or the one without Naloxone my whole,life. I'm not a heroin addict. I don't know what to do. What's the plan for successfully getting off of suboxone? Is it possible wo awful methadone like withdrawal? And now long does it last?

Thank you so much.


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PostPosted: Thu May 07, 2015 1:34 pm 
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Hi Mtrem, and welcome to our forum. Yes, we have many taper threads that will help you get off Suboxone whenever you are ready. It is a partial agonist unlike Methadone or Opana which are full agonists so the withdrawal won't be as bad. The main complaint we get is how long it takes to get it completely out of your system and feel 100% normal. Some are fine after a short period and others say it can take several months.

What is great about Suboxone is the ability to taper down to a low dose w/o feeling any discomfort. At least it's that way with most of us. I tapered down to almost nothing within one year so it's doable for me. You won't know until you're on it and get stabilized. And unlike Opana and Methadone it shouldn't affect your emotions. Some say it does and some don't. I can post both views for you to see. With me, I feel completely normal with the exception of a little fatigue if I don't keep busy. When I'm working on something I don't feel any ill effects at all.

Yes, you are trading one drug for another, but Suboxone is not like the other opiates and you'll find out for yourself how it works if you take it. If you can handle the headaches w/o any medication then go for it. If not, what choices do you have?

Welcome once more and I hope it works out for you.

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PostPosted: Thu May 07, 2015 2:57 pm 
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Hi rule,

Thank you so much for your help.

I have another question. I took my last opana like at 2 am eastern time last night. I'm also taking clomidine and clonazapam which have helped with my symptoms tremendously...stopping the awful skin crawling on my arm feeling etc.

I have the COWS sheet. Some of the things on the COWS sheet are going to be effected by the clomidine and clonazapam, correct? How will I known when to start the suboxone? My resting pulse is over 120. My nose has been running and dripping onto the floor on and off for hours. I'm becoming nauseous. I've had repeated terrible runs....despite taking 4 imodiums. The hairs on my arms are standing straight up. So I've got a lot of these symptoms. I'm wondering if the clomidine and clonazapam are messing up how I'd be on the COWS sheet if I weren't taking them. I'm a little restless but not as much as before I take clonazapam. Same with irritability. Without clomidine and clonazapam I would be awful to be around. My pupils are ok but I'm becoming very flushed. I'm also feeling the rapid sneezes about to start bc I have had them before. I'm having terrible chills and the room is warmish.

I read that a woman starting suboxone took her last,opana er and started I think a little,less,than 24 hours. It's been 13 hours for me. Still need to,wait?

I bought two drug urine tests the other day when I got my suboxone filled. Should I test my urine to see when the opana is gone, or do you know if it will still show positives bc of opiate metabolites?

Because of this I'm just a little confused as to when to start and I don't want to to precipitated Withdrawal.

I read that a woman starting suboxone took her last,opana er and started I think a little,less,than 24 hours. It's been 13 hours for me. Still need to,wait?

Thanks for your help.


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PostPosted: Thu May 07, 2015 7:19 pm 
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Mtrem,

Just to give you another example: My doctor wanted me to wait 72 hours from my last dose of morphine (which is not as long lasting as methadone). I waited 48 hours...actually 50 by the time I completed all the paperwork and pre-induction physical.

I was pretty miserable, but not so bad that I wanted to curl-up in a ball. I was taking 2 clonidine every 4 hours and Xanax and advil, and Tylenol, and immodium. About 30 minutes after the first dose of Suboxone I really felt great...not "high", just relieved of the withdrawal symptoms, and a great sense of "normal".


Last edited by Morphing on Thu May 07, 2015 9:56 pm, edited 1 time in total.

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PostPosted: Thu May 07, 2015 8:24 pm 
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Please hold out as long as you can!! I don't know if you are on short acting or long acting opana. If you are on long acting you will need to wait longer! I'm not even convinced that all of the methadone is out of your system. (Please if another member has a better idea about the longevity of methadone, please let us know.) I waited 48 hours after my last percocet. I was definitely in withdrawal at the time, but I had comfort meds that made it manageable. When you start the sub, take a small dose first, say 2 mg. Wait 45 minutes and see if you're feeling better or worse. If you start throwing up and have terrible withdrawal symptoms, don't take anymore sub for another 8 hours before you try again. Once you are inducted on sub you'll feel much better.

If your doctor will prescribe a buprenorphine product without naloxone (since you're not an addict), it's in your best interest. Naloxone actually causes headaches in people who are sensitive to it. Chronic pain patients on bupe usually take a dose every 4 to 6 hours. The analgesic properties of bupe only last that long. For example, a chronic pain patient may take 1 or 2 mg 4 times a day. Once a day dosing doesn't work for chronic pain.

Since you are not an addict you should have no trouble tapering off suboxone if that's what you decide to do. As long as you have the patience to go slowly and steadily you will barely feel any discomfort (except for your chronic pain.) The people who have such a terrible time getting off sub are usually not ready to go off. They have not been on sub long enough to improve their lives and work on recovery. They feel no cravings on sub so they think they're cured of addiction. However, they're often of two minds about going off, or they don't have the patience for a slow taper. Without the component of addiction, you should be able to go off bupe easily.

Amy

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PostPosted: Fri May 08, 2015 5:49 am 
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Hi Amy!

I'm ok!!! ;)

It was the nom extended release Opana 5mg that I took at 1am or so early Thursday morning.

My problem was I didn't know not to take comfort drugs like clonodine or clonazapam be they screw up the COWS sheet. I took the comfort drugs at 8 or 9 am and no more. It took all day for them to wear off.

I was 20 COWS at 4pm. 24 at 6pm, and it was hard not to start then. But I had done the research and knew to wait to an honest 26. Well at 8pm I was 27 or 28. I was still scared because I'm not a nurse and the answers are mostly subjective but the hairs were standing on end, my pulse rising rapidl, I was flushed, dripping nose, and even my pupils went from normal to dilated. It was kind of interesting to see all of these weird side effects of moderate to,severe withdrawal.

In my impaired mental state I got out a ruler and tried measuring the film and figuring out what 1mg of,the 8,g strip would be. I couldn't think. Didn't realize I could cut them in half,or thirds and do,it much more accurately.

So at 8:15pm I started with approx 1mg. Once it dissolved and I swallowed it I laid still,in bed...not knowing if I'd find relief or precipitative wd. Thankfully my runny nose stopped dripping so quickly. My stomach started getting better. Less chills. So two hours,later I took a second 1mg piece. And a few hours,later I took approx .5mg. And that's it so far. 2.5mg instead of the 8 my dr wanted.

I feel great it's 5am and I woke up,with an appetite for the first time in 2 weeks. So I'm eating Hagen Das ice cream for breakfast. I think I deserve it. I'm still a little dehydrated though. And those two weeks took a big tole. Almost 20lbs now that I didn't want to,lose.

Amy I thank you for your info and concern.

One thing I want to know about is the naloxone and headaches. How prevalent is this? And should a suboxone qualified doctor be able to write scripts for the med without the naloxone? This is a concern....the headache thing....and something my doctor,should have been aware of.

As for pain relief I have done very well with headaches for the first time in years. The opiates I started in 2000 at pain mgmt doctors saved my life but I still had headaches at times. Not nearly to,the degree as prior to opiates. But lately I've done well enough that I needed to see how I do,without methadone. That's why I'm here. But if I went on say subutex for headaches if they return and I'm,unable,to,function, can I still take breakthrough meds or,will I be put into withdrawal for anything but the bup in my system?

Well,thanks again. Ill,post here again if i have any more questions or,problems.

Mark


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PostPosted: Fri May 08, 2015 8:42 am 
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Hi everyone,

Around 8 this morning I woke up feeling like I needed my first dose of the day. So as I was looking at the pieces left from the first envelope of subs, they looked smaller than I thought they should. So I opened a new one to compare and I think last night in my mental confusion -(which has been bad...for almost 2 weeks I wasn't eating, probably dehydrated etc) - I thought and reported in my earlier post that I took a total of 2.5mg last night. So I opened a new one and it looks like I took a total of 5mg last night. I guess I cut them wrong. I hadn't been able to think right last week. Stupidly, instead of cutting it in half and then those pieces in half etc, I used a ruler and tried but it was wrong and I obviously took more than I thought and I'm worried.

This concerns me bc the best success is seen between 2-4mg total induction. And I'm at 5. Have I wrecked this from Wd induced mental confusion?? So I took 2.5 mg this am. I know that the first few days are for adjusting induction doses. Can they be adjusted down as well as up during this time?

And generally how long does the dose last? If I take first dose at 8am how long until most people need second?

Next, while I feel 1000x better, I still don't feel the best. Am I now allowed again to take the comfort drugs like clonidine and Ativan if needed?

Finally, I experienced a weird dream. It was like I was stuck and couldn't breathe or move. I didn't stop breathing bc I didn't wake up gasping like my dad did when he had sleep apnea. I never had dreams when taking methadone. Or at least none that I remember. My
mind has been clearer this past week or two and I've started having dreams again so it may not be from
Sub. Idk.

Thank you for your help!
Mark


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PostPosted: Fri May 08, 2015 9:43 am 
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Mark,

I will try to answer a few of your questions based on my experiences. One question, though, is your primary objective to wean off of opioids, or is it to change to Suboxone for pain management? The way you dose is different...once a day if you're trying to eventually wean, and approx. every 4 hours if used for pain.

You haven't blown anything by taking the 5 mg once, so don't worry about that. Now, concerning headaches from the Naloxone, some people have had success with waiting for the strip to dissolve and be absorbed sublingually and then spitting out the saliva rather than swallowing it so that the naloxone isn't swallowed.

You should be able to discontinue the comfort meds once you've started Suboxone, and in fact, you should be very careful taking any benzo (such as Klonopin) in combination with Suboxone.

I believe you will find that you feel much, much better once you stabilize on Suboxone. I certainly did. My mind was much clearer, I began experiencing emotions again instead of being numb, and my cognitive abilities returned. Physically, it was so nice to not have the ups-and-downs of constantly dosing the morphine.

Keep us posted and ask any questions you have.


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PostPosted: Fri May 08, 2015 12:03 pm 
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I'm glad my info was helpful to you last night, even if you ended up taking 5 mg. Like morphing said, that is not a big deal. To be honest, I was expecting to keep taking pieces until you felt comfortable, so I wouldn't have been surprised if you had taken 8 mg by this morning.

The thing you want to focus on right now is to take enough sub to make you feel "normal", not sleepy and not withdrawing. The fact is that sleepiness can be a side effect when you first begin sub, so don't be worried about that, but the end goal is to be at a dose that is comfortable without many side effects. Some people are definitely sensitive to the naloxone in sub, and in your situation your doctor should not have any problem prescribing bupe without naloxone. The naloxone is specifically to keep addicts from shooting up their medication. (The irony is that it doesn't work well at that and we have heard of people shooting up their sub.)

The other thing I want to bring up is that your doctor most likely has very good intentions starting your dose at 8mg. He wants to make sure that you will not be in withdrawal, but he doesn't have to worry about you craving your drug of choice because you don't have one (lucky you!) That is why we are suggesting that you find a dose that keeps you from withdrawal, but is not higher than you need. If you find that 4 or 5 mgs keep you from withdrawing and make you feel pretty normal, there's no need to go up to 8mg.

Like morphing, I can't tell whether or not you're planning to use sub to taper off. If you are planning to taper off, I can recommend a cutting guide made specifically for sub films. The member who came up with it is called RXFCG and here is a link to one of his threads:

post97253.html#p97253

You can PM him and ask for a link to his guide, or you can look at his profile and he may have a link there. I also just urged him to provide a link specifically for you in his topic so you don't have to search for it.

Please ask any other questions you may have and someone should be along to answer soon. :)

Amy

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PostPosted: Fri May 08, 2015 1:44 pm 
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I only have a minute but i wanted to tell you I am a chronic pain patient and usually very sensitive to medications. Since starting sub (first sub films, then zubsolv, now subutex) I have had very good pain control. I never got headaches from the sub films and i didn't spit at the end.

Oddly, i did find by accident that the films very causing my arthritis to flare up. My insurance would no longer pay for films so i went to zubsolv and that's how i found out. After being on zubsolv for 2 months i asked the doctor to switch me to subutex to see if i had even less pain. He finally did last month & I find no difference. Next week when i go back i will ask for the zubsolv. My point being, we are all different so just because one person gets headaches doesn't mean you will.

In NY they don't like writing for subutex unless you are pregnant so don't be surprised if your doctor doesn't agree right away.

It's been my experience that bupe covers all my pain and i haven't ever wanted to use oxy etc.

Good Luck


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PostPosted: Fri May 08, 2015 2:41 pm 
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Hi everyone,

Thank you for your additional posts and help,

To answer Amy and Morphings questions, I plan to taper. I want to see how my headaches are controlled without anything long term. I recently tried a muscle relaxant for my headaches - after 30 years of them - and it might be the key to the most common ones I get.

So this morning at 8 I took my 2.5 mg, I noticed I was sweating a lot after my shower. I didn't feel bad like wd and thought it could be because I stopped the clonodine which I was taking for excessive sweating.

Around noon I started getting the runny nose again....so,I took another .5mg. And then around 2 it started again - (either yawning or the runny nose is the first symptom I ever get when I start to wd)...and started to,feel,the fatigue that had gone away last night. So I ended up,taking another 1mg for a total of 4mg today. So Amy your prediction was correct, only for whatever reasons I'm needing more today. I suspect this is bc that methadone is still in my system.

Is having to take this much going to destroy my chance at a successful taper? Or will I just have to do it more slowly?

I have another question. It was either here or another thread that someone told me that chronic pain patients on subs should take it multiple times a day, but people wanting to taper off completely should take it once a day? Is this correct?

I ask because when I took methadone I always took it 3x a day. If I tried to,take it just in the morning I woild get withdrawal in the early afternoon. And when I tried to take it twice a day, I woild get wd symptoms by bedtime....mild stuff like yawning over and over and over or,a runny nose. So I'm a little worried because if methadone didn't last me 24 hours there's no way this will. Like I said I,want off,of,the subs asap. I also know that I'm not even stabilized yet so,there's a way to go.

So just to make sure I have this right, I take what I need to keep out of wd but not too much to make me sleepy. So do what I need to do but at the minimum dose. And not,worry about what that dose is for now because I can taper later?

Ok thanks again and Amy I'm going to track down that guide you mentioned. You guys are all awesome and idk what I'd do wo this place. ;)

Mark


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PostPosted: Sat May 09, 2015 9:26 am 
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Hi everyone,

Kind of have some issues here. I'm sorry I'm being such a baby. This is all,so new to me....I,,very anxious and I'm not an anxious person.

I had to take 8mg - split in 2 - 12 hours apart yesterday. That was my first full day.

I also had a headache, and since I rarely get them anymore I put a call In to my doctor. I also wanted to ask him about whether a week and a half of twice a day clonazapams could have put me in wd for that too. So he calls, and when I tell him about the headaches he says "well then maybe u are ready to be off suboxone." I called him just one other time since he prescribed the subs, he knew how anxious I was. It was several hours before I took first suboxone dose. He was nice that first time and said to call him whenever because this is a scary process and I can see how,anxious you are. So now he's threatening to take,me off of suboxone and let me take the ride as he said. I got myself into this but I knew that he was willing to,help because I've discussed this with him during 5 or 6 previous appointments is we had talked suboxone. It's almost like he now,doesn't want to deal with this. Does he know,the implications of abandoning me off of this because I had a couple of questions? I could turn to street drugs. Really wreck my life. I have never felt so hurt and mad in my life.

So what do I do? I'm already freaking because I have such a high induction amount - 4mg 2x a day. Now,I've got this. Unreal I had a great great rapport with this guy for a year and a half. I'm dumbfounded. He's angry at me for doing this, doctoring myself, but he's not my pain doctor and my pain doctor literally gave me a hug and said get yourself on suboxone.

So now I have to go call my primary care and see if she can somehow,be reached today. Grrrr.

The 8mg a day yesterday worked for wd control.

From my reading proper induction is crucial. Is that both for addicts and non addicts or just for addicts? What I mean is, if someone isn't properly inducted does that make relapse and use of drug of choice more likely or,something? I don't want to sit around on mild wd symptoms like runny nose but I can do it. I'm going to take the 8mg today in two equal doses. Tomorrow will be day 3 and I'll try to start reducing very slightly.

Last question. I don't want to goto a treatment center for this. I don't want it on my records etc. I feel like crying almost except I'm too mad.

Ok thank you for your help,and listening to my problems.

Marcus


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PostPosted: Sat May 09, 2015 1:12 pm 
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Mtrem,

It's pretty common to be anxious during the induction phase. A lot of unknown things are going on. If 4mg twice a day is what it takes to suppress the withdrawals and cravings, then that's what it is. Right now you just need to focus on stabilizing at that dose. Try to spit the saliva after the buprenorphine has been absorbed to avoid swallowing the naloxone, so that you don't get a headache from that. Although, if you do swallow it you will eventually get used to it and the headaches will go away. It just takes a couple of months for that to happen.

I'm sorry your doctor reacted that way. Maybe he was overloaded and trying to get started on his weekend...who knows? My situation was very similar to yours. I was prescribed morphing and oxycodone for headaches for almost 11 years. So my doctor classified me as opioid-dependent rather than opioid-addicted. But, I think that's just word games. I liked the way it made me feel, and I would often take more that prescribed in order to feel good. I would get panicky if something looked like it might interfere with my refills, and in the end I was just trying to avoid the withdrawal pain.

So, regardless of which category I belong to, the end results are the same. I am currently at 10mg, with so many things having improved, like my sleep, emotions (not a constant dull, numb feeling), thinking ability, etc.

Just focus on stabilizing for now, and they when you are ready you can work on a plan for your taper.

Thanks,
Morphing


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PostPosted: Sat May 09, 2015 1:19 pm 
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You need to stabilize on the right amount of sub for you, whether that's 8mg, 12mg, or 16mg. You were on high doses of methadone for quite a while. You may need a dose of suboxone that is on the higher side.

This shouldn't cause panic, however. But you also need to know that tapering from the amount of opiate medication you were on is not going to happen overnight, or in two weeks, or maybe not even two months. If you want to handle the withdrawal on your own, without a rehab that isn't necessary, you will have to have patience. Do you think you can be patient while tapering off this med? It should be easier for you than for us addicts because you don't have to deal with the compulsion that we do. You can taper very comfortably if you take your time.

We can guide you through a rather painless taper after you get stable on the sub. Keep spitting out the remainder of the sub instead of swallowing, and if that doesn't work ask your doctor for plain buprenorphine without the naloxone. Since you're not an addict the doctor should have any problem doing that.

Don't panic! We are here for you!

Amy

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