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PostPosted: Thu Jan 07, 2010 10:58 pm 
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In fact, there is a reason that the manufacturer recommends twice daily dosing - following scientific trials and FDA approval.


Donh, do you have a link or something that supports this statement?

I'm asking because I was in a clinical trial and they made a big deal about only dosing once per day.

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PostPosted: Thu Jan 07, 2010 11:09 pm 
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This info is from Suboxone.com - the dosing guide for Suboxone maintainance in the section of the website for treatment providers. The only reference I could find to twice a day dosing was in the guidlines for an impatient rapid-taper detox in which the person would only be on suboxone for 3-7 days. The following info is for longer-term suboxone treatment. Here's the link: http://www.suboxone.com/hcp/opioiddepen ... erapy.aspx


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3. Dose adjustment/stabilization following induction

You should aim to have reached a suitable maintenance dose of SUBOXONE or SUBUTEX within 1 to 2 weeks.
It takes from 3 to 7 days for steady-state blood levels to be achieved.
After the patient is stabilized (2-3 days), once-a-day dosing should be possible. Doses should be titrated according to regular review of the following clinical signs/symptoms:
Intoxication, withdrawal, and cravings over the past 24 hours
Additional drug use and the patient's reason for use of illicit street drugs or prescription opioids
Side effects or other adverse events
Adherence to dosing regimen
Patient's expressed satisfaction
Adjustments to the SUBOXONE or SUBUTEX dose of sublingual tablets should be made:

At 3- to 7-day intervals
In 2- to 4-mg increases or 2-mg decreases if the patient experiences intoxication (not withdrawal effects)
It is believed that most patients can be stabilized on a dose between 12 mg and 16 mg; however, due to patient variability, each patient should be dosed to clinical effect. There is no maximum recommended dose; however, doses greater than 32 mg are not generally needed.
It is important to warn patients of the dangers of misusing benzodiazepines when taking SUBOXONE or SUBUTEX. Overdose deaths have occurred when buprenorphine and benzodiazepines were concomitantly abused via the parenteral route.1-6 On at least one occasion, a buprenorphine overdose has been associated with oral benzodiazepine ingestion.7 Only 2 buprenorphine alone overdose deaths have been reported; in both cases, death was due to Mendelson's syndrome (ie, asphyxiation due to aspirating vomitus).

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PostPosted: Fri Jan 08, 2010 12:06 am 
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I was referring more to those new to the drug (although I may not have made that as clear as I could have) I also may be working from outdated information, but let me see what I can find. I must admit that I'm recalling this from memory. Also those at a low dose may not keep their levels high enough to be effective over a 24 hour period and need the extra dosing to stay at or above their threshold. Doses that are way above their threshold are not likely to fall below over 24 hours where those who are dancing real close to the threshold either need a higher dose one time each day or the lower dose twice a day. That one came from my personal doc. I'll do some additional digging.


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PostPosted: Fri Jan 08, 2010 12:11 am 
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Foremost, thanks to everyone for everything - I didn't do a PM dose (yet) I'm feeling a little better now. I'm going to just try to get through another night on the single dose. I know my body (and mind) are probably in a minor state of flux right now. If I can minimize everything as much as possible Ill probably be better off in the long haul.

I'm used to dosing 3 to 5 times a day on the Oxy/Norco combo but its usually when I feel the withdraw symptoms more so than the cravings. Going to a single dose of one medication is an adjustment but I know there will be times where I will just need to get over the hump w/o any medications at all.


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PostPosted: Fri Jan 08, 2010 1:06 am 
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I'm curious, what would happen if I didn't take any more Suboxone? How bad would the rest of the withdrawal symptoms be? Am I being unrealistic?


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 Post subject: DAY 4
PostPosted: Fri Jan 08, 2010 2:44 pm 
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I made it another night and I'm still at 1 x 8MG every 24 hours. I slept good but damn Ive got the shakes bad this morning. I feel much better in a lot of ways but I still kind of feel like I'm waiting for the bottom to drop out, probably just residual anxiety.

Off topic but did anyone see Celebrity Rehab last night? If anyone needs an incentive to get off dope, that's the ticket right there. :roll:


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 Post subject: DAY 6
PostPosted: Sun Jan 10, 2010 8:27 pm 
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I have so much more energy and I have been sleeping 100% better. I just feel very optimistic about everything, hell I may even go back to work. I still have a little bit of an upset stomach but I am stunned at how much better I feel everyday. For anyone that just stumbled across this thread, I am not high or even slightly buzzed, Suboxone (for me anyway) only relieves the opiate withdrawal symptoms and for right now that's enough. I feel like I'm alive, physically and emotionally stronger.

I don't know what else to say... I feel like I just got my life back.


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 Post subject: yeah...
PostPosted: Sun Jan 10, 2010 9:28 pm 
That's the beauty of Suboxone, that you're normal, you're not high, and you can just go about living your life. :D


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PostPosted: Sun Jan 10, 2010 9:46 pm 
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It always amazes me when something works as advertised especially something this important - dude you have no idea what Ive been through the past few years. I keep thinking something this good must have something bad behind it... are my teeth going to fall out? :roll: I wish I had known about this 5 years ago.


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PostPosted: Sun Jan 10, 2010 10:02 pm 
Hey Mitch! I'm so glad things are getting so much better for you! I agree with you - Suboxone does work as advertised! I'm with you, too, in wishing I had known about it sooner!! I could've avoided a world of hurt and troubles!!
Keep posting!


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PostPosted: Sun Jan 10, 2010 10:10 pm 
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Thanks setmefree, I look back at my posts and I sound like some kind of shill for the product. What is the next step, is tapering hard? I just cant see tapering 1 daily dose being that bad. I don't want to do it too fast but I don't want to be taking Suboxone forever either.


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 Post subject: hey, now!
PostPosted: Sun Jan 10, 2010 10:44 pm 
Mitch! Let yourself just stop and enjoy your newfound freedom. You have all the time in the world to worry about eventually going off the Suboxone. Just for now, try and relax and be good to yourself. You have been through the hell that all of us addicts put ourselves through, both physically and mentally. I like to look at the Suboxone as buying me the time to learn to deal with myself and my problems and issues. Some people stay on Suboxone for a year, most stay on it for multiple years. When the time comes to wean off of it, you and your doctor will decide. Right now, try to focus on today. Just a little advice, if it doesn't apply, let it fly.
JD


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 Post subject: Cabin fever!
PostPosted: Sun Jan 10, 2010 11:20 pm 
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I really feel like a road trip or camping trip or... dare I say... Vegas! Something outside, I should enjoy the weather, I'm in CA, everything east of Nevada is freezing but CA is having freakishly warm weather. What can I take for pain now, Ive been using cold/hot packs. I'm guessing topical treatments are going to give the most pain relief.

BTW this is about 65% of my problems (below) - Ive also got 3 herniated disks, a bad shoulder, lots of nerve damage and blah blah...

[align=center]Image[/align]

I'm just an old dog that bumped into a lot of things :wink:


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 Post subject: word of warning
PostPosted: Mon Jan 11, 2010 12:16 am 
It's perfectly OK to take Tylenol, advil, naproxen and all of that stuff, but don't ever take anything with a narcotic/opiate in it like Vicodin or Norco for pain. It may be tempting, but with the Suboxone it either won't work at all, or will cause a very uncomfortable state called "precipitated withdrawal". I'll let you look that term up on your own. I just wanted to tell you this in case your doctor didn't tell you.

The buprenorphine component of the Suboxone, which is actually the active ingredient that works for us, is actually a pretty decent analgesic in it's own right. But actually, I've been researching buprenorphine and found out that its analgesic properties only last about 6 hours, even though buprenorphine engages the mu recepter much longer. Therefore, you may want to reconsider twice daily dosing. This may help with your pain level. Hope that helps!!

I found this great site about Suboxone and buprenorphine, and the history of opioid abuse, laws, and what to expect with Suboxone treatment, along with all sorts of other stuff for "newbies" and anyone else at:

http://www.suboxoneassistedtreatment.org

JD


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PostPosted: Mon Jan 11, 2010 12:48 am 
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Ive got a pretty good surplus of Methadone and Norco - which are headed for the toilet very shortly. Actually I think its better to take them to a pharmacy to be destroyed. At this point I cant imagine taking another opiate ever. Its just too much of a hell.


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 Post subject: Surpluse Meds.
PostPosted: Mon Jan 11, 2010 9:54 am 
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Hi Mitch ,
First off Congrats on your progress. It sounds like things are going well! Keep up the hard work...
As far as the excess pills go. I have read that the old down the toilet method is NOT the best?? They say it can end up in the water supply?? Not sure if this is true or not???? I think think the best bet is like you said, Bring them back to the pharmacy. I'm sure they have a protocol on destroying old meds.!!

Best of luck on your continued RECOVERY!!!
TW


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PostPosted: Mon Jan 11, 2010 11:45 am 
Hey Mitch! Ouch on the photos! I find it particularly unfortunate when a person (such as yourself) becomes addicted to opiates, gets into recovery and then has to find ways of dealing with chronic pain. You are certainly not alone. I hope you will find that you can get by with the good ole NSAIDS for pain and of course there's hot/cold therapy, physical therapy, acupuncture, massage and so many other alternatives that deal with pain management. If I were you, I'd start researching alternatives before you find yourself in a bad flare up of your pain. DOQ swears by a book about trigger point therapy. I'm embarassed to say I never did go get it like I said I would because I've not had any more pain problems lately. But I think it was called The Trigger Point Therapy Workbook. Anyhow, you might want to check that one out. JD is right about some of the chronic pain patients taking their Sub in divided doses for pain management. Might be worth asking your doctor about.
As for your surpluss drugs - don't flush them. Call your poison control number and ask what the latest recommendations are, but I think it's probably to take them to the pharmacy. I will say that with my history (being an addicted RN) I wouldn't just hand them over to the pharmacy tech. I'd ask for the pharmacist and I'd make sure there was another person around to hear that you are giving them controlled substances to be destroyed. That way, hopefully, the drugs will not be diverted and hurt someone else....just a thought.
As far as your tapering and weaning off Sub. Slow yourself down there! is my best advice. Yeah it seems like one 8mg tablet a day isn't much to try and quit. However.....it is! That little tablet is doing a whole lot of business in your body and if you were to stop it (unless you're super super unique) you'll be in a world of trouble. I'm not a doctor and have no special knowledge here but it seems like most of us need to settle in at our dose for several months before trying to reduce. You are already on a reasonably low dose for just starting out anyway. So just take it easy, enjoy feeling good and free, and start working on every possible aspect of your recovery from this dreadful disease of opiate addiction!


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PostPosted: Mon Jan 11, 2010 5:11 pm 
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Setmefree, I have to say that feeling REAL physical pain is almost welcome. All the opiates ever really did was take the bite or sting out of the initial pain issue. Its weird, I feel like I'm cheating by getting the results of a detox without the suffering (no I'm not a masochist but I play one on TV :shock: ).

I'm still in shock at how quickly my whole life has turned around.


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PostPosted: Tue Jan 12, 2010 10:09 pm 
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Every day just gets better. My energy level has increased dramatically. Sometimes I feel like I'm on a Starbucks caffeine high waiting to crash but the crash never comes. Come bed time I'm ready to fall asleep, no problems. Its a freaking Christmas Miracle!

Seriously, I'm going to just shut up now. :lol:


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PostPosted: Fri Mar 25, 2011 4:03 pm 
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Lets see, I quit last Friday, by Sunday I wasn't doing to hot so I took 1/8 of a 2mg Film. I did the same thing Monday. Tuesday I went to my doctor got some Xanax and Clonidine. My heart and pulse was racing so bad my chest hurt. After checking my BP was a little high but safe, my pulse is always high but not dangerously so.

So today is day 4, I sleep when it comes and it hasn't been too bad thanks to the Xanax which I only take in the evening. I take the Clonidine 2 x per day. I am constantly exhausted and restless at the same time.... Ive sneezed more in the past week than I have in the past 3 years.

Ive pushed myself to stay physically active. The caffeine I used to love only because it was the only thing that would get me off my butt is not recommended during wd, by me anyway. Ive updated my signature, I made it work, you can, anyone can if you want it. You have to want it, you have to need sobriety and health.

Thanks to everyone here, I really feel like I'm over the hump, I'm feeling better. It took me 15 months, I actually forced the tapering process a little faster towards the end but I have no regrets, I wanted it over with - I know Ive still got work ahead of me but I'm very optimistic.

Again, thanks to everybody, I'm a little tired right now but Ill be back to promote, enforce, encourage and help anyway I can. Its the least I can do.

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