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PostPosted: Sun Oct 16, 2016 7:49 pm 
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I just read dr.Junig's answer to a question call hydrocodone( Vicodin) addiction and buprenorphine. Where he goes over the the issue of prescribing someone who is not on that high of a dose of hydrocodone if they should actually be started on subtext. I fall into what he stated would be a borderline amount that I'm taking to be put on subtext. I have been taking 60 milligrams to 70 milligrams of hydrocodone a day for the past 4 months. This includes taking Zohydro so I was not going to high on the acetaminophen. For about 5 months prior to that I was taking about 40 or 50 milligrams of regular 325/10 Norcos 1 Oxycodone 10 milligram per day. For about four months prior to that I was taking about 40 milligrams of hydrocodone per day. My pain doctor prescribed to me 8 milligrams of subtext 6 of them. And 6 2 milligram tablets. And he told me to take them over the course of eight days until I got down to one milligram a day . I waited 36 hours after my last hydrocodone dose and started feeling pretty crappy runny nose restless legs sneezing some nausea I just felt like I was going to jump out of my skin. Last night I took my first dose of 1 milligram subtext and the Restless legs subsided and I felt pretty good. This morning I took one miligram again and feel ok. I had tried tapering down several times unsuccessfully on the hydrocodone because I am also suffering from very high anxiety right now and have been for past couple years . In Prior years on multiple occasions I've taper down from Hydrocodone use up to about 40 milligrams a day several times successfully with very minimal withdrawal but that's before I suffered from this level of anxiety and also depression. that's why I thought going to subtex route might be better. Now after reading his very informative post I'm very apprehensive about continuing on subtext and raising my tolerance level making it even more difficult to get off subtext then. I talk to my psychiatrist and his opinion was to only take a very small amount of subtext just enough to not feel sick and to taper off from there for a short time . So now I think I need to talk to my doctor again about going this route. I am considering just going back to taking as little hydrocodone as I can to not feel sick and try tapering down from the hydrocodone. I really need to get off the opiates ASAP. I really value an opinion from an expert like dr. Junig. Would you advise revisiting how to get off this with my doctor. My other thought was to continue with the subtex at very low dosage. But also remember reading in the article dr junig stated that very low doses sbtex can actually act as an Agonist. Correct me if I'm wrong or was it Suboxone that can act as an Agonist at a very low dose . Thank you let me know your opinion on this I appreciate it


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PostPosted: Mon Oct 17, 2016 9:16 am 
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Hi PMU, Welcome! I do not have an answer for your question. However, I am sure someone will post soon with advice or they will share an experience that you maybe able to relate to. I just wanted to welcome you! This is a great forum and if you stick around,you will find lots of support and encouragement! Have a wonderful day!


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PostPosted: Mon Oct 17, 2016 9:48 am 
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Thanks


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PostPosted: Mon Oct 17, 2016 1:53 pm 
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Thanks again for your welcome reply Michael I'm new doing these type of forums do you know how I could get dr.junig to be able to see this post. Not sure how to post things so specific person sees it or where to put it thanks for any input I appreciate it


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PostPosted: Mon Oct 17, 2016 4:49 pm 
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Hello Proper,
First off Buprenorphine is Buprenorphine . All of these products have one active ingredient weather it is subutex or suboxone or Zubslov . All of these can act as a full agonst in the low dosages. 2mgs and under. If you are wanting to get off all opiates then tapering from Buprenorphine over all loug period of time may be your best bet. Going back to hydros could be a slippery slope. .

Dr Junig does pop in when he has the time. Certainly not every day.
You could go to the Q an A forum that is for Dr. Junig to see and read questions. Can't promise he will see it or answer.


Good Luck Proper,


Razor..


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PostPosted: Mon Oct 17, 2016 5:26 pm 
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Thanks for your reply razor. I was trying to understand how the partial Agonist vs. Agonist work with the buprenorphine. If understand the doctor's post correctly buprenorphine is only working as a partial Agonist when it is at the ceiling level. And if I go to the ceiling level that will actually increase my tolerance to opioids because of the strength of the subtex . And if I try using just enough subtext to not feel sick and and taperering that dose overtime it will be acting as a full Agonist and raise my tolerance also if I understand it correctly.


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PostPosted: Mon Oct 17, 2016 5:37 pm 
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Thanks for the tip on the Q&A Forum razor but I'm having trouble finding it maybe I'm just dense but I don't see it is it the one called announcements maybe I'm just looking in the wrong place can you help me please nevermind I found it thank you though sorry to be such a pain


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PostPosted: Mon Oct 17, 2016 8:12 pm 
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I have used Suboxone for people who have relatively low tolerances. When? When they have had multiple attempts at detox, trying to taper on their own or under their doctors guidance and always return to using. Often there are other addictive behavior or substances involved. If you have tried tapering with hydrocodone, say by dropping your daily dose by 5 mg every week, and are unable to, then you have your answer and perhaps a course of treatment and Suboxone is in order.
Depending on family, work, legal circumstances a 70 mg a day hydrocodone habit can be every bit as devastating as other much higher tolerance habits can be.
If you have only been taking for 4 months then a taper would certainly be in order. You would find out as well if you were dependent vs 'addicted'.
Sorry, I went back and reread your OP. You have already tried the taper several times. A short taper and then no Suboxone is really no more likely to be successful. If you have a Substance Use Disorder then your chance of being sober at one year is 10%. You may be the 1 in 10 but be open to the possibility that you will need to be on it longer. You also have to address the 'why' you were taking hydrocodone in the first place.
PAX


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PostPosted: Tue Oct 18, 2016 12:00 pm 
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Thanx for all your replies. I was taking hydro for mulitiple pain isues but built up tolerance quickly. I had used multiple times in the past for pain but stayed on too long this time. At first I only took it on days that I absolutely had to have it for pain but then once I got depended on it took it on days that I didn't need it . I also found that it did help my anxiety and depression . I have severe anxiety & depression now and that has made i harder to taper off. I did in the past before i had such bad anxiety & deptession. I'm dealing with multiple problems now big time. I'm just afraid it'll be harder to come off the buprenorphine in the long run. My doctor wants me to do a quick taper using the buprenorphine. So far I have only taken it 3 days. And I'm not sure if I'm not taking enough or if I'm having adverse reactions to it. But I feel horrible. I also have been taking benzodiazepines for a long time. And cut down on those in order to make sure I don't end up with respiratory problems while taking the buprenorphine. My respiration was shallow yesterday even though I only took half the benzos I normally take which is about 2 to 2 and a half milligrams of Klonopin a day. I only took about .25 subtex yesterday and about .75 day before and about one milligram the first day. I barely slept the last 2 days I haven't taken any buprenorphine up this morning and my anxiety is through the roof.


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PostPosted: Tue Oct 18, 2016 12:13 pm 
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Actually the first day after I waited 36 hours after my last hydrocodone dose of 40 milligrams I took the one milligram of buprenorphine and actually felt a bit hi from it and felt ok. I wanted to know since I only took these three small doses. Yesterday's small dose was split up and I only took a small tiny piece that about 7 p.m. last night. How long would I have to wait without taking any more buprenorphine before I could go back and take a Norco dose again just temporarily until I can get in and discuss this whole situation with my doctor. I never took big enough doses of the Norco 2 experience any respiratory distress while taking both medications. I can't as you know just cold turkey the benzos. If I try and take a Norco dose today will I just end up going through withdrawals from the buprenorphine.


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PostPosted: Tue Oct 18, 2016 2:29 pm 
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No, you will not go through W/D if you take a dose of Norco today. You would not go through W/D if you took a dose of Norco right after you took a dose of Suboxone or medication of the type. Suboxone interferes with Norco by not being able to "feel" the Norco but I don't think you took enough Suboxone to interfere with that. I myself was on Norco up until the end of my addiction. I used it for breakthrough pain, 10 pills a day until I lost my Dr. and soon after got on Suboxones. Norco addiction is very real and very dangerous. The Tylenol itself can damage the liver beyond repair. I really hope you get help from your Dr. and may be consider finding a Suboxone Dr. that allows you to Stay on Suboxone long enough that you don't feel pressured for time and can make some really good decisions regarding getting off and staying off Opiate pain medication altogether. The best of luck to you as you begin you journey into freedom. There is another way. We are here for you 100%. Bamagirl


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PostPosted: Tue Oct 18, 2016 3:42 pm 
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Thanks a lot of mine was so Hydro so hydrocodone wasn't the issue meant to say excessive acetaminophen isn't wasn't an issue. Even when I was taking regular Norco 10 325 I never went over 2500 or 3000 milligrams of acetaminophen and a day. I know that's still borderline a lot. But my liver tests were okay 2 months ago


Last edited by Proper med user on Wed Oct 19, 2016 6:29 pm, edited 1 time in total.

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PostPosted: Tue Oct 18, 2016 8:02 pm 
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Thanks for your reply my anxiety was so bad this morning that I actually ended up going to the emergency room I barely slept in 4 days was the first night I had to wait for the withdrawals to kick in I waited 37 hours after my last opiate dose for I took one milligram all subtex. My theory and problem right now is that the hydrocodone actually greatly reduced and help my anxiety. And that although the subtex is keeping me from going into opiate withdrawals but it's not helping with my anxiety like the hydrocodone did. Year-and-a-half ago actually needed very little clonazepam to help with the anxiety and only needed the third of the pain medicine I take now for my pain issues back then as you know tolerance build up. The doctor did prescribe me subtext wouldn't even call me back in the hospital today had his nurse call me back and say if I didn't want to take the medicine the way he prescribed it to come and see him in the office tomorrow and bring the medicine with me and talk about it. I believe he prescribed me way too high of a dose 8 milligrams twice a day to start with to come off of 70 milligrams of hydro for everything I read is extremely high and I probably would get sick taking that much. My other option is to try to work through my psychiatrist who was also got an x DEA license to prescribe subtext and work with opioid addiction. He actually gave me some advice and told me to stop taking clonazepam and to take gabapentin to prevent any possible withdrawals and to take clonidine for the anxiety. After coming back from the hospital I'm afraid to even take buprenorphine again as it also did keep me from sleeping when I took it later in the day and disrupted my sleep for two days. The first day at help because my 37 hours was at 1:30 in the morning and I was trying to sleep and had restless legs like crazy Sneezy runny nose runny eyes felt like I was going to jump out of my skin and figured I wouldn't risk precipitated withdrawals at that point. I had already been up almost the whole night before and was extremely tired and about 15 minutes after I took the subtext the restless legs stopped and I was able to fall asleep but it was a very light sleep as it actually got me quite buzzed. This should be an indicator that 1 milligram was plenty at one time. I looked it up in equivalency chart then I think it equals about 25 milligrams of hydrocodone if not more. Someone else posted a conversion for me but I forgot where it was. So now I'm not sure what to do about tonight still if I should try taking subtext I know I'm going through opiate withdrawals soon as I haven't taken any all day and only took about a little less than half a milligram yesterday. I'm still very tempted to go back on a hydro dose for tonight but I know it will help with my anxiety but that will put me back to square one and I'll have to wait again to go into withdrawals in order to take the buprenorphine again. Having a high anxiety level makes it very difficult me to figure out what the hell to do right now


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PostPosted: Tue Oct 18, 2016 8:03 pm 
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I did also read that anxiety is a side effect possibly buprenorphine. And my pain doctor wouldn't even answer that question for me as he wouldn't even talk to me today. I call my psychiatrist on his emergency line but he says why are you calling me I didn't prescribe it you need to call the prescribing doctor.


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PostPosted: Tue Oct 18, 2016 9:17 pm 
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Thanks again Bama girl for your reply. The withdrawals I meant would be to go through withdrawals from the buprenorphine. If I took the Norco oday instead. Because at this posint I'm not sure what went wrong with trying to be fhydrocodone( Vicodin) addiction and buprenorphine. Where he goes over the the issue of prescribing someone who is not on that high of a dose of hydrocodone if they should actually be started on subtext. I fall into what he stated would be a borderline amount that I'm taking to be put on subtext. I have been taking 60 milligrams to 70 milligrams of hydrocodone a day for the past 4 months. This includes taking Zohydro so I was not going to high on the acetaminophen. For about 5 months prior to that I was taking about 40 or 50 milligrams of regular 325/10 Norcos 1 Oxycodone 10 milligram per day. For about four months prior to that I was taking about 40 milligrams of hydrocodone per day. My pain doctor prescribed to me 8 milligrams of subtext 6 of them. And 6 2 milligram tablets. And he told me to take them over the course of eight days until I got down to one milligram a day . I waited 36 hours after my last hydrocodone dose and started feeling pretty crappy runny nose restless legs sneezing some nausea I just felt like I was going to jump out of my skin. Last night I took my first dose of 1 milligram subtext and the Restless legs subsided and I felt pretty good. This morning I took one miligram again and feel ok. I had tried tapering down several times unsuccessfully on the hydrocodone because I am also suffering from very high anxiety right now and have been for past couple years . In Prior years on multiple occasions I've taper down from Hydrocodone use up to about 40 milligrams a day several times successfully with very minimal withdrawal but that's before I suffered from this level of anxiety and also depression. that's why I thought going to subtex route might be better. Now after reading his very informative post I'm very apprehensive about continuing on subtext and raising my tolerance level making it even more difficult to get off subtext then. I talk to my psychiatrist and his opinion was to only take a very small amount of subtext just enough to not feel sick and to taper off from there for a short time . So now I think I need to talk to my doctor again about going this route. I am considering just going back to taking as little hydrocodone as I can to not feel sick and try tapering down from the hydrocodone. I really need to get off the opiates ASAP. I really value an opinion from an expert like dr. Junig. Would you advise revisiting how to get off this with my doctor. My other thought was to continue with the subtex at very low dosage. But also remember reading in the article dr junig stated that very low doses sbtex can actually act as an Agonist. Correct me if I'm wrong or was it Suboxone that can act as an Agonist at a very low dose . Thank you let me know your opinion on this I appreciate it
or 3 days. I think part of it is that I noticed that the Norco specifically really help with my anxiety more than other opiates that I have actually taken for my multiple pain conditions over the past 15 months. So it actually had that added benefit at least until I build up a big tolerance to it. It still does help a little bit when I take it butt I really don't need to take it as often anymore and that's why I wanted to try to get off of it. I'm also on clonazepam and my psych won't prescribe me anymore clonazepam if I stay on opioids as he says there's a new black box warning that makes it practically illegal to prescribe benzodiazepines and opioid narcotics. Sorry if I'm being repetitive but I'm still wrestling the idea of at least taking Norco this evening to keep my withdrawals away and to help with the anxiety and revisit the buprenorphine again potentially with my psychiatrist or are different doctor. Problem with that is I have to go back to square one and suffer through the withdrawals again from the norco before going back onto the buprenorphine. My other possibility is to work with the psychiatrist to control my anxiety and try to taper down slowly from the Norco again like I have done in the past. My psyc is also has an x licensing is an opioid withdrawal doctor 2 . I was able to do that quite easily but that was before I suffered from such high anxiety and depression. So I'm battling multiple fronts here. My pain doctor also specifically stated through his nurse because he wouldn't talk to me today even while I was in the hospital that there should be no interaction between the buprenorphine and clonazepam however on drugs.com there was a major warning about respiratory issues with benzos and buprenorphine. Unless somebody hears know something different I think drugs.com is usually pretty accurate. As far as I know all opioids can interact with benzodiazepines in effect the respiratory system. Fact that the pain doctor also prescribed me an exorbitant high dose for my level of use also is deterring me from even seeing him again. All the forms and everything I looked on only had people starting on 8 milligrams twice a day that AR on a of very large habit. I had suggestions from a couple people but for my dosage one milligram would be sufficient. And actually the first day I took one milligram I actually got quite buzzed. My 37th hour after not taking the last opioid was at 1:30 in the morning so that's when I took the one milligram and was able to fall asleep but it was a very unrestful sleep. The next day I seem to have a little trouble breathing and thought it might be an interaction from the buprenorphine and clonazepam so I cut down a little on both. Felt OK physically but still had breathing problems and couldn't sleep. Seems that the buprenorphine is also disrupting my sleep. Actually I've always had quite a bit of difficulty sleeping while I know. I was in the hospital a number of times for surgeries and it was difficult for me to fall asleep believe it or not after being given Dilaudid or morphine. The only thing that actually made me sleep was the first time I was in the hospital with my pancreatitis problem over thirty years ago they gave me Demerol and I was usually asleep half hour after I got the shot. Sorry for rambling on but I really have no one else to talk to about these things right now. Thanks again


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PostPosted: Tue Oct 18, 2016 9:19 pm 
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I am so sorry your dealing with multiple problems right now; depression, anxiety and deciding what to do about weather or not to take the Subutex. It really sucks that your Dr. wouldn't talk to you and/or the psychiatrist. Good luck. Hopefully you'll get some advice from someone who knows more about this matter. May be take as little as it takes to get by since you just have enough to wean off the Hydro. I'm not sure if I quite understand your situation. If the Subutex is causing this much anxiety then don't take it. Take what you know works. This is probably not the best advice since I've not had much dealings with severe depression/anxiety. Sorry I couldn't be better help. Bamagirl


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PostPosted: Tue Oct 18, 2016 9:29 pm 
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Why is the Dr. only giving you enough for 8 days!?!?! And then wants you to wean down to 1 mg all by your self with out him giving you any better directions than that! Shame on him!! Honey, it gets harder and harder to wean yourself off of pain pills the longer you take them. I am sure you know this already. I am just shocked at your Dr. kind a leaving you to wonder about all of this. I am sorry I can't be of more help. This forum is full of people with these kind of issues, the depression and anxiety. No wonder your having anxiety having to make these decisions all by your self though. Bless your heart.


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PostPosted: Tue Oct 18, 2016 9:39 pm 
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OK, after going back an rereading your post several times, we were actually writing 1 at the same time, I would follow the directions the psychiatrist gave you. I am by no means a Dr. But your right about the buprenorphine keeping you awake at night. If you can get some sleep tonight, do so and take a little bup in the morning. I am still shocked he left you to fend for yourself during this horrible time. I mean weaning off opiates is a hell of it's own. Best of luck tonight. If thing get too rough, take a little buprenorphine, like if the rls gets out of hand and you can't sleep anyway.


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PostPosted: Tue Oct 18, 2016 9:42 pm 
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Thanks again for replying you're very sweet. In years past I had been on Norcos for up to 7 months. And was able to taper down from about 40 milligrams a day successfully five or six times. Sometimes only keeping myself on them for 2 months or a month just to not build up a big addiction. And then just suffer with the pain problem after that for a while. Then fortunately I didn't need them for quite a number of years. Took them on and off three and a half years ago. And went back on 15 months ago. It was the only way I could work at the time I have been on medical leave for 10 months prior to that. Wasn't that difficult to taper off when I didn't have such high anxiety and depression. Right now my anxiety is extra high because I haven't been back to work in 3 months. But I've suffered from anxiety for over 2 years now.


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PostPosted: Tue Oct 18, 2016 9:44 pm 
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Yes I guess we were writing at the same time and that is kind of my plan for tonight too try to get some sleep and if I have to take a little bit during the night from RLS then I will. I just took a clonazepam so my anxiety is so so right now. Thanks I think I'm going to try to go to bed soon


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

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