It is currently Wed Aug 16, 2017 4:08 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 31 posts ]  Go to page 1, 2  Next
Author Message
PostPosted: Mon Aug 15, 2011 7:50 pm 
I was asked to illiterate my process, past, present and future! Lol!!

Past: In 2005 I had the first of 3 surgeries that had horrific complications. I had a defibrillator, total L hip replacement and spine reconstruction and was diagnosed with HCV. This occurred between 05-07. My spine reconstruction failed and I became totally disabled, and non functional. I was a Trauma Nurse Specialist and had been in super shape. After the surgical complications, I had been on and off a ton of narcotics, benzodiazepines, antidepressants, nsaids, non narcotic pain meds since 05. I went into pain management in 07. I was fortunate to have a doctor that believed in narcotic rotation and was never on huge doses, but certainly was on every narcotic.

Since last year, I have developed tolerance after a few weeks to every narcotic and interdose withdrawal as well. I suffered withdrawal of some form, daily, for over a year. I went into a 10day detox in Feb. with a switch from OxyContin to Methadone and was going to stay on maintenance. I thought I needed something for pain..... The idiot Doctor knew that I have a lethal cardiac arrhythmia, hence the defibrillator, and that Methadone is COMpletely lethal with my syndrome. I had to get off the methadone pronto or risk dying....I went back on MsContin then OxyContin. Cold turkey off Methadone was the worst experience of my life and really, just plain evil. I wanted to die.

I was having horrific problems with the tolerance and interdose withdrawal. I have researched hyperalgesia and actually entered Sierra Tucsons, pain management program for 30 days. I had a ton of every kind of therapy and they advised I "may" have hyperalgesia and it might be worth being off narcs for 3-6 months. Weeelllll I tried to stop the oxycontin and I really could not tolerate the awful withdrawal symptoms. I was unable to last 2 days. The pain was unreal. They said to stay on the meds for pain and just continue rotating the narcotic. I thought you know what, I really can't do this anymore......I can't stand being in constant withdrawal from tolerance. My liver enzyme system was activated to the max. See Dr Js videos.....

I contacted a physician here in Phoenix and started a self tailored program using Suboxone. I talk with him every three days. The program involved induction with the doctor at 8mg per day. I dosed once a day although the doctor said I could dose twice daily when I got to 2mg a day. I was off oxycontin for 14 hours and had mild withdrawal symptoms. It went great and I stayed on the 8mg suboxone daily for three days, tapering every 4th day.
I went from 8, 6, 4, 2, 1mg with absolutely no symptoms or craving. When I got to 1 mg, I did have some anxiety, runny nose and leg cramps at 4 am. He advised I could use the Clonidine 1mg every 6 hours and Valium 5mg every six hours the First 3 days of suboxone use and advised I could use these meds when I got below 1-2mg and if I became symptomatic. And yeah, I have already done a benzo detox so I am fully aware of the risks of benzos.

I have used .5mg clonidine 2-3 times a day, especially at 4am when I have the most symptoms. I have not used the Valium but I have it when I am in that 1-2 week period. I am functional, not really depressed, have been able to sleep, eat and distract myself. Anxiety seems to be my most prevalent symptom.

I am currently on .125mg for one more day and may go down to .06 or just stop. So far this has been much easier than trying to taper full agonists or go cold turkey. Off oxycontin and methadone cold turkey was a nightmare. I am determined to do this. I will admit it has NOT been easy, but you know what, It is completely doable.
Suboxone and albeit a quick taper, has helped me so much. With my past experience, I know this time I can do this. And yes, I do have a ton of therapy lined up for the risk of relapse. Wish me luck, as I do YOU!
Thanks for listening.....Robin


Top
  
 
 Post subject:
PostPosted: Tue Aug 16, 2011 9:25 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Holy Crap Robin, my eyes were like :shock: while reading your story. You have been to hell and back. Dang it, I'm just speechless.....

You're an incredibly strong person and I think you're doing fantabulous with your taper!!

I wanted to give you my experience with what I believe was hyperalgesia. In 1997, I fell out of a tree and ended up shattering both ankles, broke both legs and broke my left arm. Of course, I started on opiates. At first they worked great, but before too long I needed more and more for the same amount of pain relief. Long story short, when I quit Suboxone last year, within a month or two I noticed my ankle pain went away!! Once or twice a week, if I've been on my feet a lot at work, I'll take two advil and those two advil knock the hell out of the pain!!!

I'm glad you have a plan for when you get off of opiates. I had no such plan and ended up slipping up around 10 months off, it's SO easy to do. Luckily, I got control of it fairly quickly. I'll tell ya, slipping up was no fun, it was a painful experience.....the bitter disappointment you feel towards yourself is almost unbearable. Please, work your plan diligently!

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Tue Aug 16, 2011 10:28 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Robin, reading your post took me back to the last couple of months of using before I started suboxone. I was actually having full on withdrawals even though I was still taking my meds! It was awful, as you know! My doctor told me it was my tolerance growing and growing and my dose not being increased to match it. This happened with both my opiates AND the xanax I was on - at the same time! Talk about constant horrid withdrawals! Anyway, by the time the end of my active addiction neared, I was using but in w/d at the same bloody time! And, again like you, I also ended up with hyperalgesia.

I'm telling you all this to illustrate that I understand the struggles you've had (save the tapering - I'm not going off sub) and so you know you're not alone. But now you can look back and say, "I MADE IT. I survived and am moving forward as a better, stronger, healthier person." YOU can say that. And why, because YOU did that for yourself.

Lastly, this topic hasn't come up too much around here and when you spoke of those kind of withdrawals during your using...well, I thought I was alone in that. So thanks for showing me I wasn't the only one who went thru that. Since it's not a common topic, I honestly have no idea how common it is to have these "interdose withdrawals" - is that what you called them? (I'd never heard that phrase either.)

I'd be very interested in hearing how many other people had these "interdose withdrawals" (or whatever else they are called) WHILE they were still using. How common is this?

Sorry to digress so much. Keep up the excellent work you're doing and continued best wishes on that taper. Thanks for bringing this topic up - it's a good one and worth discussing more I think.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Tue Aug 16, 2011 10:27 pm 
Hi Hatmaker , You will have to tell me what your blog name means, Job? Passion?

I honestly believe that the tolerance and interdose withdrawal go hand in hand. We develop tolerance to the dose and if the dose is not raised, we experience withdrawal symptoms daily, sometimes all day, until the dose is increased. Then in a few days, weeks, or months the process starts all over again. The liver starts pumping out the enzymes to neutralize the opiate or whatever, like mad and the tolerance progresses through the roof.......It seems that everyone experiences this when on long term or even binge doses. I believe I have heard Dr. J say this is inevitable. *sucks*

I am having a pretty good day, long and hot here in Phoenix, 106 today! I am at .125mg today and I am not having symptoms or cravings, YAY!

It could be good!


Top
  
 
 Post subject:
PostPosted: Wed Aug 17, 2011 10:36 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Hi Fairrobin,

You made me :lol: :lol: , because after over two years here, I do believe you're the first to inquire about the origin of my screen name. Most people do think it's because I make hats, but alas, I do not. Actually, "Hatmaker" is the German translation of my maiden name. Believe it or not, way back when I actually considered legally changing my last name to Hatmaker. I was weird when I was younger. :lol:

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject:
PostPosted: Wed Aug 17, 2011 3:34 pm 
Haha Hat that is so cute, I love your avatar also.

Todays note is that I am still doing well. I am actually having less symptoms of w/d on the .125 ( for 3 days) I am fine at 4am now, only have the jiggies around 4pm until dark. Have no clue why. I have one more day on .125 then I go to .0625 for 3 days then maybe even .03125 ha ha who knows. I have the tablet dissolved in liquid and I am not having problems measuring with a TB syringe. I will probably skip at .0625 and see. I am sure it will be fine.

Hope you are all doing OK.


Last edited by Fairrobin on Wed Aug 17, 2011 5:29 pm, edited 1 time in total.

Top
  
 
 Post subject:
PostPosted: Wed Aug 17, 2011 3:51 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Dang it Robin, you're just zooming right along there!! Good for you!!

How's your pain level?? Are you dosing once per day?

BTW, what the heck are the jiggies?? :lol:

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Wed Aug 17, 2011 5:27 pm 
JIGGIES CAN BE FUN actually it is anxiousness...... :arrow:

Pain is pretty good on tylenol or ibuprofen :wink: :arrow:

I take it once at 0500 and I am using a liquid :wink: :wink: :wink: :wink: :wink: :wink:


Top
  
 
 Post subject:
PostPosted: Sun Aug 21, 2011 4:39 pm 
Hello and happy Sunday to ALL. I am down to .03125mg and I am having absolutely no withdrawal symptoms what so ever.
Sleep is fitful at times but I have found the key is to stay active and distracted and eat well. I am hoping this continues to be the pattern.

Take care all of you.

Robin


Top
  
 
   
 Post subject:
PostPosted: Sun Aug 21, 2011 5:40 pm 
Offline
Moderator
Moderator
User avatar

Joined: Sun Jan 02, 2011 12:35 am
Posts: 2801
Location: Southwest
Fairrobin,

Reading your story certainly proves just how well Suboxone works and w/o it we'd all be in so much worse circumstance. People can say what they want about Sub but try tapering down from Oxy's or Morphine, ha!

With all the pain meds your were taking and now to be down to such a low dose of Bup, it gives me hope for many a pain patient and addicts out there trying to find some way to stop the madness.

Congrats on your success.


Top
 Profile  
 
 Post subject:
PostPosted: Sun Aug 21, 2011 5:48 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Hey Robin,

Thanks for the update, you are doing fantabulous!!!

Rule62, I hear ya on trying to taper off Oxy and the like, the only kind of taper I could do while on OC's was a reverse taper......my usage went up and up and up!!

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Sun Aug 21, 2011 10:12 pm 
62 and Romeo thanks for the drive by. Ya know tapering fast is not a breeze, but I am like you, I think( and have done) the cold turkey thing off of the morphine and oxycontin and THAT, really was hell. This has been so much easier. My biggest problem I believe, is a little depression. Other than that, I really have to keep pushing!

Thanks so much, Robin


Last edited by Fairrobin on Sun Aug 21, 2011 11:46 pm, edited 1 time in total.

Top
  
 
 Post subject:
PostPosted: Sun Aug 21, 2011 11:07 pm 
Offline
Power Poster
Power Poster

Joined: Sun Dec 06, 2009 4:12 pm
Posts: 78
Thanks for sharing your story, Robin! I am glad to hear another voice telling me that it won't be so bad when/if I decide to go off of suboxone.
Although, from your story, it is clear that you are a very strong person. I really hope that you get off the suboxone and feel well. I'm so glad that the OTC meds are working for your pain! Fancy that, I forgot how effective a simple tylenol could be when I was using so much oxy!
Good luck and KUP


Top
 Profile  
 
   
 Post subject:
PostPosted: Thu Aug 25, 2011 6:37 pm 
YaY, doing well today, minimal symptoms. I am on the liquid buprenex at the dose of (don't laugh) 0.0156mg for 3 days. Yeah, pretty low and should just jump. The PTSD thing freaks me out. You cannot believe what I went through on a cold turkey benzo withdrawal 2 years ago.

I had a traumatic injury with complications and was put on 8mg of Ativan a day. When I finally got home, I couldn't function at all. I even paid 2k to see Paul McCartney in concert and don't remember a thing...nada..... I called my doctor and said I am stopping this drug today, he said OK, even after I reminded him, the dose I was on. Needless to say on day 8 I had a grand mal seizure. Not good, very scary. Will scar me for the rest of my life.

I do have some laziness, but I am doing what I need to do, keep me and the house up. Care for the pets, walk the dog, when it isn't 117 outside and call people on the phone. I never thought that getting off of the OxyContin was possible, but suboxone certainly has changed my mind about that. Yes, I know the real work is ahead and the bad stuff is about to begin with craving and possible relapse. I am going to try my best. As far as the pain, I just want to say that it has been mostly controllable on tylenol and ibuprofen.

Have a wonderful symptom free evening everyone, you are in my thoughts.

Robin


Top
  
 
 Post subject:
PostPosted: Thu Aug 25, 2011 10:17 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Thanks for the update dude!!

2K to see Paul McCartney......wow, you were on a lot of drugs. Now, if it were Pearl Jam or Tool or something cool like that, I could understand, but Paul McCartney??? LOL!!

I'm glad to hear your pain is being controlled with Tylenol/Ibuprofen. I know I had some very real worries about pain control when I quit Suboxone and was AMAZED how effective a couple Ibuprofen were once I got all the Suboxone out of my system.

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Fri Aug 26, 2011 12:32 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
Yeah Romeo I am with you, I have been to Tool 5 times. They put on an amazing show and are my favorite band to see live. Wow Robin you are doing so great! I am so happy you aren't suffering and that you are getting pain relief from the otc meds. I stopped taking Tramadol with my Sub about 2 weeks ago so my Dr. gave me a script for Naproxen and it is working better than tram was. I didn't have much hope since its otc but it is actually helping. You are sooooo close, Congrats! Quick question, what is liquid Buprenex? Is just bup that you can get in smaller doses?


Top
 Profile  
 
 Post subject:
PostPosted: Fri Aug 26, 2011 12:22 pm 
Yeah, I needed to see Paul McCartney once before he dies. I missed the Beatles. He put on a great show, 3 hours. I'll send you some pics, Romeo, I know you'll die for those!!! I have seen Tool twice, Pearl Jam, well pretty much everyone........ I am the daughter of a musician.


Breezy Ann, The Liquid is basically buprenex. I am a pain patient, so my doctor is able to prescribe it for me. Also, the low dose Butrans patch is available for pain patients.

Good luck wobbie


Top
  
 
 Post subject:
PostPosted: Fri Aug 26, 2011 3:11 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
WTF??

Fairrobin, YOU have seen Tool in concert.....I thought the age cut-off to see a Tool concert was 50 years old.....how'd you get in?? BAH HA HA!!!

Breezy_Ann, I didn't want to hi-jack Robin's thread so I sent you a PM talking about some bands.....had I known Robin was so cool, I would have just replied right here.

Lastly, y'all are two of the only ladies I know who like Tool. I am honestly stunned, but pleasantly surprised!! Rock On ladies!!

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
PostPosted: Fri Aug 26, 2011 9:37 pm 
JUST FOR ME; TRYING TO UNDERSTAND THIS CHIT



7
JUL
Tolerance and Hyperalgesia: Complications of Opioid Use
Posted July 7, 2011 by janaburson in Hyperalgesia, Tolerance.


Both tolerance and hyperalgesia are difficulties encountered by patients who are prescribed opioids. Both conditions can be seen in pain patients and in people with addiction.
Drug tolerance means the body requires a higher dose of drug to achieve the same effect. In the case of a pain patient, that means it takes more opioid to achieve the same amount of pain control. In an opioid addict, it means the addict requires more of the drug to achieve a “high,” or euphoria. However, as the addiction progresses, many addicts are no longer able to get high, but use opioids to prevent painful withdrawal. Tolerance occurs due to changes that the body makes in response to the presence of the drug.

Scientists think that the presence of opioids results in decreased activation of the mu receptors. One theory is the cell actually “swallows” the opioid receptor so that it’s no longer available, on the outside of the cell, to be stimulated by an opioid.

Hyperalgesia isn’t the same as tolerance, but somewhat similar. Hyperalgesia is an increased sensitivity to pain. In other words, little pains feel like big pains. Allodynia, a related condition, means feeling pain in response to things that aren’t usually painful. For example, a touch on the arm may become painful to someone with allodynia.
Hyperalgesia doesn’t only occur with long-term opioid use. Nerve damage of any kind can cause both hyperalgesia and allodynia. In these cases, anti-convulsant medications are used in an effort to stabilize the nerves that transmit pain messages.

A recent study compared the pain thresholds of four groups of people: normal controls, chronic pain patients medicated with methadone, chronic pain patients medicated with morphine, and patients on methadone for opioid addiction. All three groups were studied with the cold pressor test. In this test, a subject is asked to submerge a hand in ice water, and record the length of time until the subject feels such bad pain that he must remove his hand from the ice water. Normal controls, not taking any opioids, averaged around 31 seconds. Chronic pain patients on methadone tolerated the pain for 20 seconds. Chronic pain patients on morphine were able to endure the pain about the same length of time at 19 seconds. Methadone-maintained patients with addiction were also able to tolerate an average of 19 seconds. (1) This study seems to indicate that patients on opioids for either pain or addiction treatment both develop hyperalgesia.
So what’s the difference between hyperalgesia and tolerance? In hyperalgesia, there’s increased sensitivity to pain, but with tolerance, there’s decreased sensitivity to opioids. (2) This difference is important, because if the opioid dose is raised in a patient with hyperalgesia, the patient’s pain may actually worsen. But a patient with tolerance would likely improve with a dose increase.

How many patients on opioids develop hyperalgesia? We don’t know, as there are no controlled studies of this problem as yet. We do know that tolerance often occurs in pain patients. For patients on methadone to treat addiction, tolerance does not seem to develop to the blocking effect of methadone, meaning once a patient is at a dose of methadone sufficient to treat all withdrawal symptoms, he usually doesn’t have to keep increasing the dose over time. Of course, other changes, like new medications, weight fluctuations, and changes in physical activity may change methadone blocking dose requirement in these patients, but this is different from tolerance.
Why does this occur in some people but not others? This may be genetically determined, at least in part. There are three basic opioid receptor types, mu kappa, and delta. To complicate things further, within each of these groups, there are subtypes. Our genes determine which subtype of mu receptor predominates in one person as opposed to another. One opioid may stimulate one sort of mu receptor more than another. (This may be why when switching from one opioid to another, the patient isn’t completely tolerant to the new opioid.) Some scientists believe some configurations of subtypes of opioid receptors make a person more likely to develop hyperalgesia.

What can be done to prevent or treat hyperalgesia? Many patients actually have improved pain control after they are gradually tapered from opioids.
Because the body isn’t completely cross tolerant to different opioids, switching opioids helps some patients. Of course for patients being treated for addiction, there are only two medications that can be legally used: methadone and buprenorphine.

Some pain medicine doctors advocate using low-dose opioid blockers along with a full opioid. The blockers may have effects at opioid receptors besides just the mu receptor, and these other receptors, like the kappa receptor, may play an important role in hyperalgesia and tolerance since some research shows this improves pain outcomes.
Other types of brain receptors may also play a role in pain and hyperalgesia. For example, there’s evidence that the NMDA receptor is involved in development of tolerance and hyperalgesia.

Some doctors add non-opioid medications like anticonvulsants to opioids in an effort to minimize opioid doses needed. At present there’s a lack of strong evidence to support this practice, though it’s a reasonable method to try.
This is a relatively new area of study, and hopefully in the future we’ll have a better idea of why hyperalgesia, tolerance, and allodynia occur, how to treat them, and even how to prevent them.




Hay JL, White JM, et. al., “Hyperalgesia in opioid-managed chronic pain and opioid-dependent patients.” Journal of Pain, 2009, Mar;10(3):316-22.
DuPen, Anna, Shen, Danny, Ersek, Mary; “Mechanisms of Opioid-Induced Tolerance,” Pain Management Nursing 2007; 8(3):113-121.
Eco World Content From Across The Internet.


Top
  
 
 Post subject:
PostPosted: Sat Aug 27, 2011 8:22 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Fairrobin - Thanks for pasting this, it's an extremely interesting article. Could you do us a favor though, and include the link to the full article so that we know from where it originated?

Also, articles like this can also go into the "Links" section of the forum so that people can more easily find such things (or in it's own thread). When it's part of a thread in the "Stopping suboxone" thread, an article such as this can easily be missed by people that I think will really want to read it. So maybe you can copy and paste it into a new thread as well? That would be great - thanks. :) And thanks again for posting it. It really is a great article that happens to apply to many of us.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 31 posts ]  Go to page 1, 2  Next

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 2 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group