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PostPosted: Thu Nov 14, 2013 5:09 pm 
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Just wanted people to know what worked for me. Results are probably not typical so this is not a recommendation but it did work great for me!

I had a 3 year 40mg/day IV Dilaudid addiction. Could not stop on my own as the withdraws were too great to handle.

First 3 days: Stopped Dilaudid, used Xanax to help me sleep through the withdraws.
Day 4: Felt like I was going to die, took 8MG suboxone - quickly back to normal.
Day 5-8: 4MG suboxone daily.
Day 9-10: 2MG suboxone daily.
Day 11-12: 1MG suboxone daily.
Day 13: Applied 50mcg/hr Fentanyl Patch.
Day 13-16: Mild discomfort, used Xanax these nights only to assist with sleep.
Day 17: Removed Patch.

Today is Day 30 with no signs of withdraw or cravings since patch was removed. Urine drug screens are negative for opiates/bupe/benzo.

I am sure many people will have input why this is not a good idea and maybe its not, but so far has worked great for me! Only used a total of 4 8MG suboxone films. Ending the suboxone with a fent patch was my own idea based on unprofessional ideas and at home research. :)

I could not be more thrilled to be off the Dilly and the Bupe so quickly without the withdraw or cravings.


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PostPosted: Sun Nov 17, 2013 3:28 pm 
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Hey falken,

You're right, most would not consider that to be the ideal way to stop narcotics. Now that you are clean and have some time under your belt, is there any recovery plan you intend to use? An addiction therapist, NA, etc..

The main problem you will face is the temptation to use again. Some are able to do it on their own but most aren't. I truly wish you are one of the few who will pull it off.

With due respect, Congratulations on having 30 days opiate free! Stay the course.

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PostPosted: Mon Nov 18, 2013 1:28 am 
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My theory was that the Fentanyl would be strong enough to knock some of the bupe off the receptors. Fent is not a drug I normally abuse and do not care for the effects of. I was hoping this would cause for a quicker and cleaner comedown off the bupe. I just felt the need to share my story as I am amazed at how well it seemed to work for me personally.

I am hoping to be able to stay clean on my own. My advantage is that my supply came from one person and I have cut that person from my life. I honestly have no idea where to buy any from any other source and I have never bought from the street. The Suboxone was rx'ed to me however I obviously did not follow their protocol. They actually have a good program if something happens and I do fall back in to my old ways my plan is to enroll and follow the program as intended.

However, so far so good. I have no urge to go back and the only drug I even have in my possession is the Suboxone. No more counting out pills every day, trying to make sure I have enough, trying to figure how what to do if I run out, etc. My ever increasing tolerance made the some amount per month never enough.


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PostPosted: Mon Nov 25, 2013 12:45 am 
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Well, I didn't make it. Back on my DOC. The funny part is I do not get the same euphoric feeling I remember, however something is driving me to keep taking it, at even higher dosages than before.

While my plan worked for me short term it is obvious I need more support to stay clean. My problem is I have social anxiety as well, group settings and even one-on-one doctor visits are very difficult for me. I often avoid doctor appointments of any kind. The only thing that got me in to a bupe doctor to start with was the withdraw was so painful I would have done anything to make it stop, now that I am feeling well I have a hard time getting myself to go back.

My tolerance has gotten so high that I can not obtain enough DOC to make it to the next round so I am in withdraw each month. It started out a day or two which I could handle, I am now out 2-3 weeks early and I can not handle that. Unfortunately that is my sole reason wanting to get clean, to avoid the withdraw when I run out. I do WANT to stay clean however to avoid that, always worried if I have enough, etc. I do not want to use bupe as a band aid until my next fix but I fear that is what I will end up doing if I can not convince myself to continue to seek treatment when I feel well. Get sick, see dr, use bupe, obtain DOC, repeat. I do want to end up doing that pattern each month.

I need to treat my social anxiety then treat my addiction problem but when I am feeling well I can't bring myself to see a doctor about my anxiety. Doctors are one of my largest anxiety triggers.

Any suggestions? "Get over it" is the best I can think of but that is easier said than done. :(


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PostPosted: Mon Nov 25, 2013 4:07 pm 
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What happened with you is pretty normal. The reason your tolerance is so high is because of the Suboxone. It is a stronger drug and holds on to your mu receptors like a pair of vice grips. The only solution is to go back on to the Suboxone. Stop trying to get buzzed off your DOC! You may die trying!

It takes a very long time for your tolerance to go back to normal so what choice do you have? Give yourself a break and go back on maintenance. It isn't all that bad.

Then you can start a recovery program to prepare yourself for tapering and stopping Sub, if that is what you want.

Go to a NA meeting and just sit in the back and listen. It will take time but the program will help by just listening. After awhile, maybe your anxiety will go down enough to make some friends. It doesn't have to be NA. There are other programs out there. Say the word and I'll do a search for the thread that listed all of them. One or two are secular I think, so there is something for everyone.

PLEASE, stop taking your DOC! Get back onto Suboxone ASAP. You might die otherwise.

Keep us/me posted,

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PostPosted: Mon Dec 02, 2013 12:52 pm 
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rule62 wrote:
PLEASE, stop taking your DOC! Get back onto Suboxone ASAP. You might die otherwise.

Keep us/me posted,

rule


I do agree with you, however I can not find a doctor that will see me. Every call has been a dead end or a 2 week+ waiting list. I went through 1000MG in 2 weeks, I can not stop without feeling so sick it makes me want to die. My supply is going to run out in 2 days, I do not know what I am going to do at that point.

A hospital wouldn't give you that much if you had all your limbs hacked off with a dull knife.


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PostPosted: Tue Dec 03, 2013 2:07 am 
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Thank you for your honest, and for sticking around.

I won't worry about discouraging the people intent on getting off buprenorphine, because we have the numbers from several large studies-- so I'm sharing study results, not trying to discourage anyone.

After at least a year on buprenorphine or Suboxone, over 94% relapse within the first year of stopping the medication. That is in one year-- I always point out that my own relapse-- the one that took the most from me-- waited for me to enjoy great recovery for 7 years before coming out of nowhere. No 'using friends'-- just a tablet of codeine on a shelf in the Bahamas. Relapse is really like the line about terrorism--- we have to get it right every single time, whereas the addiction just has to find one tiny moment of weakness, or distraction, or overconfidence.

My experience as a doc reflects those studies. I have about 60 long-term buprenorphine patients who have done better in life than they ever thought they could, just from staying on buprenorphine year after year and getting on with life. Then I have 40 spots where hundreds of people have come and gone, many with the intent to 'get off everything'. Almost all of the 500 or so people in that group are using their DOC. A few are alcoholics. A few are benzo addicts. Many are dead. I live in a small town, so I tend to hear what happens to people; I bet out of the 500 who 'stopped everything', the people who stayed 'off everything' can be counted on one hand (not counting those who died). At every sub-taper site or forum you'll see names of people boasting over 3 or 6 or 9 months clean... then the person never writes anything again. I know what happened to them-- when I think that some people assume they are out there doing great, I'm reminded of the old movie 'logan's run', about the people who get revitalized when they turn 30......

The shortage of bupe docs is only getting worse with the silly stories in the press, and the increase regulation at state levels. I hope you find help. I have seen non-medicated recovery work, in cases where the patient becomes immersed in a recovery group like AA or NA. I prefer AA, just because of the anti-sub attitude at NA meetings, and the very short-term nature of recovery at most NA groups. I urge you to consider it; the more desperate you are, the better shot it has of working. The goal is CHANGE-- not a 'learning process.' In other words, for it to work, it has to feel uncomfortable, and feel WRONG. If meetings feel good, like they fit, then they are unlikely to do much for you. The whole point is to become different-- to become someone else.

That's my problem, by the way, with distinctions about who is 'clean' and who isn't. To be sober, a person must be changed from who they were as an addict. That change can happen through a lot of meetings, for the rest of the person's life-- or through a medication that tricks brain chemistry. In both cases, the person is different; I think that the person who uses the steps successfully changes a lot more than the person taking buprenorphine. Some of that change is good, some not as good-- but the idea that people on buprenorphine are somehow 'on something', and people on the steps are 'off everything' is nuts. People on step sobriety (like me, actually), are 'on something'. And I know I have a very high risk of relapse if I stop MY maintenance of step work.

I wish you success-- and please, consider meetings if you can't find a doc. Expect the meetings to suck. That's what 'change' feels like. Or find Suboxone. Those who think one is better than the other are missing the point of what recovery is all about.


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PostPosted: Tue Dec 03, 2013 6:32 pm 
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Excellent post Dr. J. We need a "Best Of" category to put great posts like this one in there.

falken, you're doing the best you can for now. Keep trying to find a Suboxone doctor and widen your search area. You may have to drive quite far away if that's the closest one. What needs to be addressed is the 100 patient cap on doctors. Too many addicts like yourself who are asking for help aren't receiving it.

Just be careful with your drug until you can find a Sub doctor. If you don't mind me asking, what IS your DOC?

r

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PostPosted: Thu Dec 05, 2013 10:25 pm 
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Excellent post and a lot to think about.

I have never been able to wrap my head around "the steps". My main problem is I am not religious, have not really hurt anyone with my addiction (no one knows actually), am a highly paid professional(only pointing that out to show I have a job and money), stable family, own my own home/cars. Heck, my DOC cost is less than the doctor and suboxone rx). The only "harm" is the past several months where I have been sick as a dog because my addiction is greater than my supply.

Sitting in my office, mixing up Dilaudid for injection has finally started to make me feel like a looser. The fact I run out of Dilaudid faster and faster every month pisses me off when every month I tell myself I won't do it. I ran out 20 days early this month!

I am on suboxone right now (not rx'ed) while trying to find a doctor. Hopefully they won't hold it against me that I am already taking it when I come in. Silly me though I could switch from high dose Dilaudid to Bupe with only 12 hours wait - doesn't work like that - I ended up taking 32MG on day one to stop precipitated withdraw(had to get enough free bupe in my system to attach to the receptors it was kicking the dilly off of if I understand it correctly) it was then several more days (just now) that I started feeling somewhat back to normal. I am going to try to go down to 4MG/day for now to make it until I can get in to a doctor as I am not able to obtain any further supply.

I felt I had to come back and post my failure - if nothing else so people knew how wrong a "success story" can go.

I will post an update of how I do on the Bupe this time, I have no intention of jumping off any time soon. While on the bupe my cravings for my DOC are 95% gone, I don't spend the day mixing up vials for injection and thinking about my next hit.

FYI for harm reduction: Never inject pills. I know exactly what is in my pills, use a sterile area, universal precautions, sterile bacteriostatic water for injection, clean syringes for mixing/injecting, 0.45 PES filter followed by a 0.1 PVDF micron filter, sterile vials, etc. Even this doesn't make pill injection safe and unless you do the above at minimum you are asking for quick death (as opposed to the slower death I was requesting).


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