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 Post subject: Daily Hiccups
PostPosted: Wed Nov 02, 2011 1:09 pm 
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I started subutex a couple weeks ago and I've been taking 1.6 mg a day. About 4-5 hours after I take my dose I get the hiccups for a few hours. This is consistently every day. I notice drinking coffee helps a little bit but not all the time. I understand this is a fairly common side effect of opiate medications but not that common. Do you think I am taking too large of dose? I do feel pretty damn sedated a lot of the time but thats why I started drinking coffee again. Anyone else experience hiccups on subs? What did you do to mitigate the problem?

Thanks.
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PostPosted: Wed Nov 02, 2011 1:55 pm 
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Hi, I have never experienced that symptom but if you feel it is a side effect of sub and you feel sedated then it certainly couldn't hurt to try a lower dose. If it doesn't help or you do not feel as good after dropping you could always go back to your previous dose. Once getting below the 4mg mark it is common to feel your dose more, at lower doses bup acts more like a full agonist. Many people have reported feeling their dose as they get lower in their taper. I hope dropping your dose helps because hiccups are extremely annoying!


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PostPosted: Wed Nov 02, 2011 2:35 pm 
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I'd never heard of this, so I did a quick, cursory Google search and sure enough, there are others who've experienced what you are. I have no explanation for this, nor do I have the time to look it up (sorry). For me, the only thing that gets rid of hiccups is drinking water upside down. I know, sounds weird, but it works.

So you just started a couple weeks ago and are only on 1.6 mg? May I ask why such a low dose? Are you doing a really short detox only? Or were you planning on doing sub maintenance for a bit longer? I'm just curious because that's a really, REALLY low starting dose. Again, I was just curious. No need to respond if you're not comfortable doing so.

I hope you get some relief from those damn hiccups soon! Good luck.

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PostPosted: Wed Nov 02, 2011 3:10 pm 
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The reason I am on such a low dose is that I'm afraid of suboxone creating a greater dependence then what I had before. The past 6 months before sub I was taking 180-240mg of codeine a day. Several months before that I was taking 30mg oxycodone every day and a year ago I tried heroin (and hydromorphone) about a total of 10 times (1-2 weeks between uses). I've also used an herb called kratom for a period of 6 months which exhibits a relatively strong mu-receptor agonist effect considering its a legal herb. Acute withdrawals have never been that much of a problem for me but the PAWS is the main reason I got on sub. My goal is to use a minimal dose to take away the symptoms of paws and help with the depression/anxiety/motivation issues that go along with it.

My worst fear is that after I am on sub for 6 months, that when I try to taper the PAWS will be even worse that what I experienced before.

What makes this so much more complicated are the agonist/antagonist effects of sub. Its almost like OPPOSITE tolerance. The more I raise my dose the more side effects I experience but I don't necessarily feel better. I am attempting to slowly drop to 1mg and see how I feel for a week or so. I am going down by .2 mg every couple days.

I would love someone's input that has a lot of experience with using sub for PAWS from a habit similar to mine. Thank you.


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PostPosted: Wed Nov 02, 2011 3:21 pm 
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Well, it does sound like you have a fairly low tolerance, although I'm not the best person to judge that based on how much you were taking. But be aware that you're under the about 4mg ceiling and below that, you're going to "feel" your dose as at those low doses, sub "acts" more like a full agonist. You'll have ups and downs instead of a steady supply of bupe in your system.

I'm not saying this can't work for you the way you're doing it, but it is different than the usual sub maintenance or even a rapid detox, in a way.

Your best way to reduce PAWS as well as acute w/d is to do a very long, slow, drawn out taper. The slower you remove the opiates your brain got used to, the less shock your brain will feel and therefore, the less PAWS you should experience. I describe it as very slowly pulling a band-aid off - so slowly that you don't even notice it. That's how slowly you need to remove the opiates from your system. The less you feel it as you taper down, the less acute and post-acute w/d you should have.

If I were you, I wouldn't drop my dose every couple of days. I'd give myself more time that that to adjust to a dosage drop. You need to listen to your body and what it wants. You could also drop your dose even slower by dropping only every other day and do that for several days and soon you'll be down, but you'll have done it in very small increments and hopefully hardly felt a thing. It will take longer to taper though.

Oh and yes, as you up your dose you will increase your side effects - that's to be expected with any medication.

I hope this helps.

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PostPosted: Wed Nov 02, 2011 3:44 pm 
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thanks, that helps a lot. I'm reluctant to raise my dose to 4mg because it just seems like way too much. I'm already getting side effects such as sweating, sedation, and a dull mood in the afternoons. Maybe if I raise my dose the antagonistic effects will counteract the lethargy and sweating (idk of this is a withdrawal symptom or a symptom of too much opiates...?). I do wake up around 6am with cold sweats so my dose ALMOST covers me for a full 24 hours. It just feels so damn strong, and I'm having trouble getting past that.


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PostPosted: Wed Nov 02, 2011 4:26 pm 
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I used to get hiccups ALL the time, but it didn't just happen while I was on Suboxone, it started long before that. I finally realized that it was my anxiety/nervousness that was the cause of my hiccups. Some people experience anxiety as a side effect of Suboxone, I wonder if this may be causing your hiccups??

Once I finally started addressing my anxiety/nervousness issues, the frequency with which I get hiccups has decreased drastically.....thank God!!! :D

As far as your dose is concerned, you said, "It just feels so damn strong" referring to your 1.6mg dose. I'm gonna say that you don't need to increase your dose, especially if you're trying to keep your dependence low with the goal of eventually tapering off in the not the too distant future. Going up now is only going to cause you to have to come back down through this level again.

If I were you, I'd stick it out. Stabilize at each new dose, taper slowly (10% or so) and keep moving forward.

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PostPosted: Wed Nov 02, 2011 4:51 pm 
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I've had a lot of issues with anxiety in the past but bupe has taken away most of the issue. I think my chronic anxiety was actually from being in opiate withdrawal all the time (even only slightly). I can see that everyday that I have been on sub, my anxiety has gotten lower and lower since I am not having to take anti-anxiety meds anymore. Although when I am really sedated on the sub I feel very unresponsive and "dopey" and that gives me anxiety a little because I am in a university environment and its not entirely socially acceptable to be sitting there borderline drooling, in class.


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PostPosted: Wed Nov 02, 2011 11:28 pm 
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I get the hiccups ALL THE TIME,,,,,,,,and i cant get rid of them by drinking water, not even upside down. holding my breath doesnt' work either.
the only thing ive found to work is to take 3 gulps of water as fast as I can and eat something sticky right after without taking a breath between the water and eating. like a chunk of cheese, or peanut butter crackers. I know it sounds wierd, I work in a door shop, and sometimes I RUN to my car holding my abdomen tog o get crackers.
becuase for some reason i hiccup harder than normal people, its been an issue my whole life, I got the hiccups at the dr. office one time, and even he mentioned something. It HURTS when I get them.
anyway, just wanted to let you know your not the only one.
and that's what works for me..................i was a very heavy opiate user, about ten yrs straight. the only time i stopped was for 3 days when I had my son by csection. and I got morphine rite after.
anyway Im on 24mg a day........so I get them a lot...
thanks for listening,,,reading
Hang in there


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PostPosted: Thu Nov 03, 2011 12:25 am 
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Hey all-seeing-eye!

I could relate to your experience with everything but the hiccups.

The first time I went on Subutex, I was only using heroin maybe 3 times a week, and I still had quite a low tolerance. I was quite young too (19). My then doc had reservations about buprenorphine treatment, believing my use was sporadic enough that I could stop without medication, and she thought the bupe may increase my overall tolerance, creating more dependence. In the end she agreed because I was an overdose risk, using mainly alone with a low tolerance.

So I started on 4mg, and I too was quite sedated, my eyes were pinned and droopy. The next week she saw all floaty and ... stoned ... and she dropped me down to 2mg. I was a bit disappointed, but in the long run, it was a smart move.

I gradually tapered off the bupe over 6 months, but relapsed in the months after. I realise now that this first time on buprenorphine may have increased my dependence on opiates, as my cravings were stronger after treatment. But I also realise that if I wasn't on it, I would have continued using, and my tolerance would have grown anyway.

So I'd strongly recommend talking to your doctor about how sedated you are. He/she may recommend dropping your dose. It may be necessary to book an appointment sooner rather than later, because it doesn't take long for our tolerance to catch-up. As with all things, it's best to tell your doctor how you feel, and go with their decision.

Tolerances to opiates vary so much. By the sounds of it you didn't allow yourself to become too tolerant to your drug of choice, which is smart. Try your best to keep it that way with all opiates, buprenorphine included. I'm glad you're cautious about becoming more dependent. IMO it's a smart move, as long as you don't take it too far and put yourself at risk of relapse.


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