It is currently Wed Aug 23, 2017 12:35 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 40 posts ]  Go to page 1, 2  Next
Author Message
PostPosted: Thu Nov 12, 2015 9:46 am 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Hi everyone, at some point when I have time I will do an introduction but I'm scared and want to get right to the point. I'm a chronic pain patient who has been on opioids for about 5 years. For the past 3 I moved to Fentanyl patches due to needing around-the-clock relief. Instead of describing every single change and issue, I'll try make it simple.

My dose and tolerance has gotten higher and higher. The rate at which I absorb is very fast(at least that's what is believed); if not changed every 24hrs I go into minor to moderate W/Ds and severe pain. So, over the past year I've been needing anywhere from 100 to 300mcg/hr trandermally daily. I've tried tapering plans with the patch but I just can't do it. It has its hook on me; it works too damn well for pain and yet my quality of life isn't any better.

So, I made an appointment and will be switching to Suboxone come Monday(don't know the dose). I've moved down to 100mcg/hr daily this week and was told to take my patch of 36-48hrs before my appointment. I've done so much research and reading that I think I've scared myself silly about precipitated withdrawals.

Even though the doc says 36 to 48hrs before the appt, I've read plenty of people who have gone into PCWs even with 72hrs+ since their last dose. I need some of your advice and help on what I should do since I know people on here have experience. I also know everyone is different when it comes to absorption etc (especially me).

I'm thinking about taking my last patch off Saturday(48hrs), knowing by Sunday evening I'll already be very sick but that doesn't mean enough of the Fentanyl is out of my system. This is going to be a very tough experience for me and I'm scared. How much time is enough time?

I know no one can say definitively but any talk or suggestions would be helpful. Just posting has made me feel better. Thank you so much and sorry for the long post.


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 10:14 am 
Offline
Long Time Member
Long Time Member

Joined: Mon Sep 09, 2013 4:49 pm
Posts: 517
Painp
Welcome to the forum. I don't have fent experience but that would have been my next step

Everyone is different but I do know the longer you are off the easier the transition to sub. You can do a search within the forum using fentanyl as the key word. At least until someone else replays.

I am a chronic pain patient also. I wanted to share with you that the bupe has helped me with the pain. I take smaller doses 3-4 times a day. If I have a flare up I use aleive or Advil and I am fine.

If you feel you metabolized the fent faster than expected then hopefully it will leave your body faster.

IMO, you are doing the right thing by getting off the pain meds and onto sub. A couple of months after I was on sub, my daughter said "I don't know what you changed but your like my old mom again".


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 12:10 pm 
Offline
Moderator
Moderator
User avatar

Joined: Mon Sep 15, 2014 7:15 pm
Posts: 2317
Location: Tennessee
Hey PainP welcome,

Like Tiki said, if ur worried about fast metabolism or whatever it was, then it seems like it'd leave ur body quicker which is good news if ur worried about precipitated withdrawal. I know fentanyl is strong, I abused the patches for a little while during my active addiction. I remember when I ran out and went bk to my drug of choice oxycodone, I was still feeling withdrawal because of how strong and how much fentanyl I'd been taking and my oxy wasn't helping me from being sick very much. So I completely understand why ur worried about precipitated withdrawal. But I think ur going to be ok as long as u wait long enough before starting the suboxone. I wish I could tell u how long to wait, but I didn't switch from fentanyl to sub. I would listen to ur Dr. If he says that u only need to wait the normal amount of time, then I'd do that. Even though fentanyl is strong, it doesn't have a huge half life and the withdrawal from it kicks in pretty quick...that I remember well. There's ppl who switch from heroin to suboxone and their wait is about the same as the rest of us. So I think you'll be fine as long as u wait 36-48 hrs, that sounds like a good amount of time to me. Maybe someone with more fentanyl experience comes along or one of our doctors.

_________________
Jennifer


Top
 Profile  
 
Our Sponsors
PostPosted: Thu Nov 12, 2015 12:52 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Thank you both for replying. I guess the only and best thing I can do is take my patch off sometime between 36-48hrs before my appt and hope for the best.

The thing I'm most scared aside from PCWDs is the regular WDs I'm going to be going through this weekend before my appt monday. Since I usually start to feel sick 24hrs after applying a patch and I'm very sensitive, that means by Sunday I'll start feeling icky, by Sunday night/Monday morning I'll possibly be in moderate to severe W/Ds. Then I have to go to the appointment in full scary WDs, go the pharmacy, wait for a prior-auth and then hope I don't make it worse with PCWDs. Yeesh!

Thankfully I'll have some of my clonazepam, gaba, clonidine, Imodium etc. to help this weekend but I am so scared. I appreciate all your words. I just have to deal with it and realize I can't control what I can't control. :D


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 1:18 pm 
Offline
Moderator
Moderator
User avatar

Joined: Tue Mar 11, 2014 10:48 pm
Posts: 1317
Hello PPain,
Welcome.
Ive done some digging on dr Junigs Talkzone and will tell you what he said.
Once a person has been on something for a couple of months it doesn't matter if it is three months or three years, the tolerance and risk of PWs are more a function of dose and type of drug than time.
For example, high dose fentanyl have loug elimination half lives and therefore take Louger to leave the body before starting Suboxone., where as low dose fentanyl have short life and leaves the body more quickly. " Dr J owns this forum and is it s founder.

As soon as you start withdrawing ,your tolerance will start to fall. It falls fastest
initially and then slows down a bit after the first couple of days.
I understand you are scared, but it ll all work out for you if you begin lowering your fentanyl before taking off the patch on friday.
Also do you have any type of comfort meds? Clonidine can reduce simptoms, also have immodium on board as well. Body aches with Tylenol. .
To score yourself, use the COWS scale. This will give you a rating on how far you are or need to go.
Imo, three days of wd shohld keep out of the PW range..

Sounds like you have a good dr , good luck, you will make it!!!

Razor


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 2:18 pm 
Offline
Moderator
Moderator
User avatar

Joined: Mon Sep 15, 2014 7:15 pm
Posts: 2317
Location: Tennessee
PainP I completely understand that fear of the withdrawal while waiting to start ur sub. We all went through that and of course it's not fun at all. I remember dreading that and I'd worry myself to death about something going wrong and I'd get to my appointment and have to wait even longer. That's normal and my advice on that would be to just stop thinking of all the negative things and keep in mind why ur doing this. You will be ok and it is going to be so worth it I promise u that. Make sure that ur completely honest with ur Dr about how ur feeling during ur induction. Does ur Dr know about the clonazepam? The reason I'm asking is because some doctors don't allow benzodiazepines with suboxone. There's definitely some that has no problem with it, but there's also some like my Dr that doesn't allow it at all. So make sure ur Dr doesn't have a problem with it so there won't be any issues during ur induction. I've never been a benzo taker, but during my 32 hrs of withdrawal I took one klonapin to try to sleep, and when I got to my induction and that showed up in my drug screen, my Dr said if I'd taken more, then he wouldn't have inducted me that day. He's really strict though and by no means are all doctors that way about it. Just something I wanted to mention since ur going to be taking it.

In the end, ur going to be ok and I know it's hard to not worry about something like this. Stay away from the internet horror stories too, that'll just make u more nervous. I hope it all goes great and you'll be glad when it's done :)

_________________
Jennifer


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 2:35 pm 
Offline
Average Poster
Average Poster

Joined: Fri Nov 06, 2015 10:43 am
Posts: 12
A friend of mine recently went from Fent to subs. However, her dr had her switch from Fent to oxy for a week prior to induction. That week was rough but she had a great low dose sub induction.

I would not be able to do as she did as I am addicted. It's a guarantee I would have eaten all the oxy and not weaned properly.

Just sharing her experience for you. Good luck. I induced a week ago from huge oxy habit. I did get precip withdrawal but I survived and am doing well now. If I can do this I promise you can to. Really. You will feel so much better soon. I am also a pain patient and my pain is better too.

Good luck sweety. You have got this!


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 5:09 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Thank you all for the positive words and support. All I can do now is wait until Saturday when I take my patch off and whatever sickness comes will come. I do worry a little (since it is the weekend with no way to get a hold of anyone) what to do if the WDs get SO bad. I'm talking worst end of the spectrum, possible seizure bad. Since it is fentanyl and my dose was so high I just hope I'll be alright.

I will keep you all updated and I'm just going to try and not think about it and keep myself busy(easier said than done haha :wink: )


Top
 Profile  
 
PostPosted: Thu Nov 12, 2015 9:11 pm 
Offline
Long Time Member
Long Time Member

Joined: Tue Nov 24, 2009 7:36 pm
Posts: 879
Location: Wisconsin
There is a lot of info here. Also a lot of things not adding up. For one, why would you have to change a 72 hour patch in 24 hours? That doesn't make sense to me and here is why. The patch "dispenses" fentanyl at a predictable rate. How fast your body uses it has nothing to do with this. It's not as if the patch speeds up or increases the flow of fentanyl based on your body's use. Your body may well use up the drug faster than average but that won't increase the flow from the patch. It's only going to flow 100 mics per hour no matter the use by your body. Therefore the patch should not "run out" early. It's not like a demand pump. If I'm missing something here I'd love for dr. J or someone to explain this.

Switching to a short acting opiate is a proven strategy here. Can that happen? Sure, you would not induct early next week but it might be safer to wait a week on short acting meds.

Finally, time is going to be the same for everyone. What you really should consider here is not taking the patch off for X hours but rather using the COWS scale to objectively determine your leval of withdrawals. Some people will hit 15 on the COWS scale after 25 hours. Others may take 75 hours. You're ready when you're ready. This will be a much better tool to decide when to take your sub dose. If you've never heard of it, Google COWS scale. This will help you decide when to take that first dose

I lied, this is my final comment. My doctor gave me a "brilliant" and obvious statement yesterday. I nearly said "well duh" as it was so obvious yet I never thought of it. In medical terms, withdrawal in many ways is an adrenergic response. It's like getting a shot of adrenalin or epinephrine. And what happens when we fear something - that too is an adrenalin response. So this feeds on itself. The more we fear the Withdrawals, the more worked up we get, the faster our heart beats and higher our blood pressure goes. This is exactly the opposite of what we want to happen! I know it's hard but the calmer you are, the better this will go. The more afraid or keyed up, the worse this will be. I know it's easier said than done but do all you can to relax and it will help you.

Best of luck on your induction. Let us know how it goes!


Top
 Profile  
 
   
PostPosted: Thu Nov 12, 2015 11:45 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Lots of good comments. Yes-- withdrawal fires up central adrenaline and noradrenaline pathways-- which is why clonidine is helpful.

I see two problems in people on fentanyl switching to buprenorphine. The first is the tolerance issue. Buprenorphine 'pulls' tolerance down to a lower level than the tolerance of most people using agonists-- and people on fentanyl can get to very high tolerance levels. That mismatch between the patient's tolerance, and the maximal effect of buprenorphine, is one source of precipitated withdrawal.

The other issue is the remaining fentanyl bound to mu receptors at the time of induction. Buprenorphine binds very tightly to mu receptors-- with 'high affinity'. So when you replace morphine or oxycodone with buprenorphine, the buprenorphine rapidly displaces those agonists, allowing for a new stable condition to develop fairly quickly. But fentanyl also has very high affinity for mu receptors, so those two drugs compete with each other for as long as the fentanyl stays around. I've never seen molecular studies about this situation, but from my old days learning about actions at receptors, I would think that there would be a period of confusion at the synapse, where receptors fire at one rate, then stop firing, then fire again, etc-- as one molecule replaces the other over and over.

Maybe the actual situation looks nothing like that-- but the clinical situation does give that impression. There tends to be a long stretch (several hours) of discomfort when changing from fentanyl to buprenorphine, where the person starts to feel relief, then feels sick again, then relief, then sick again. The symptoms are minimized if the fentanyl is mostly-gone-- which is why some docs change to oxycodone for a week.

Fentanyl is metabolized slowly at the liver. When giving a small IV dose, the drug level increases in the blood and brain very quickly-- and then decreases very quickly as the drug soaks into fatty tissue. But when taken for days, fentanyl builds up in those fat stores, just as THC does over time. When people get high doses of fentanyl for cardiac surgery, they typically are on a ventilator for 12-24 hours, waiting for the drug to wear off so patients breathe again.

I agree with the comments about using a patch on a daily basis. You would waste a lot of fentanyl by taking them off after only 24 hours, as the patch is designed to release the drug over time (as donh already said).

I have done only a couple inductions to buprenorphine straight from fentanyl, and it is a difficult process. I prefer to use oxycodone in between if possible. My concern with waiting 36 hours is that there is a high concentration of fentanyl in skin tissue under a patch-- so there is a delay, after removing a patch, before the level of fentanyl in the body actually starts to fall. The longer you wait, the better. But before I get you too worried, I want to stress that the patients who made the change would definitely say it was worth it. One of them has inflammatory arthritis that causes severe pain, and she is on 4 mg of buprenorphine per day, and uses oxycodone for bad flares of pain-- an approach I've described on the blog as recently as a couple posts ago. She gets much better pain relief than she did on fentanyl, as the buprenorphine holds her tolerance at a lower level.

One last thing-- once you start the induction process you MUST see it through. There is no going back once you take buprenorphine, as anything you do will only prolong the process. Ask for 'comfort meds' and use them. Within 12-24 hours, and PW will be mostly gone. Within 48 hours you'll be fine. And despite all the talk about PW, in the end it is just withdrawal. The worst part of withdrawal is that it seems to last forever... and that is NOT the case with PW. If you can curl up in bed, or take a warm bath, you will be fine-- and that's the WORST case scenario.


Top
 Profile  
 
PostPosted: Fri Nov 13, 2015 5:20 am 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Thank you SO much for the posts and information.

Just thought I'd post an update and try and answer some of your questions. As I said previously, before just this week I was using up to 300mcg/day but dropped down to 100mcg for this week until my induction. Thankfully just doing that drop hasn't provided any real WDs aside from my inability to get much sleep and slightly more pain. So that might be a good sign!

As for why I was Rx'd to change my patch every 24hrs, there are a few things that have been presented as reasons. It started with the fact that about after 24hrs after applying the patch I'd start to experience minor/moderate WDs as well as a severe increase in pain. As to why this was happening is left to only some data me and my doctors could gather. I tend to sweat and run very hot and as you know this will increase the blood levels and absorption to be increased. Also, we had a genetic test done in regards to CYP450 variants and how I metabolize certain opiates/opioids. It was found that for some I was an "ultra-rapid metabolizer" and some a "poor-metabolizer". For example, none of the standard breakthrough meds(oxycodone etc) would work due to certain variants in my genetics and thus unless the dose was extremely high I could not receive a therapeutic dose(so it was unreasonable to Rx). The same result turned up for Fentanyl. And while it was the only good medication for my around-the-clock pain with minimal side effects, I needed a higher dose and it was being absorbed too quickly, thus it needed to be changed more often.

I'm not a geneticist nor a doctor and I'm sure I did not explain that exactly right but that's what I was told as to why I experienced WDs just 24hrs after applying a patch. I understand why most would think of it being a waste but for me it was necessary.

Of course these issues are part of the reason why I I've just reached my limit on pain medication and am switching to suboxone. Not to mention that Fentanyl worked so well for my pain but my quality of life purely revolved around Doc appt's, changing my patch, finding the right dose, and avoiding WDs.

I'd like to thank you guys again as I've now removed my fear of PCWDs... if it happens, it happens. I'm still very scared of how I'm going to feel this weekend but too bad, I have to deal with it. I'll be taking my patch of 48hrs before induction and just hoping all works out.

I will continue to keep you updated and again your information and words have been more valuable than you can imagine.


Top
 Profile  
 
PostPosted: Fri Nov 13, 2015 7:03 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Oh man this is bad. I put my last patch on yesterday around noon and am scheduled to take it off tomorrow, 48hrs b4 my appt but I'm already starting to WD. As I've said this is normal for me when it comes to how my body reacts.

I don't know how I'm going to make it until Monday when I haven't even removed my patch and I'm already in minor WDs. :cry:


Top
 Profile  
 
PostPosted: Fri Nov 13, 2015 11:30 pm 
Offline
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4140
Hang in there! I was going to suggest that you are tested for a genetic variant of CYP450 so I'm glad you did. It's a good thing for you and your doctor to know that. You may have to dose on sub more often, but the doses don't have to be very large to have the proper analgesic effect and your tolerance shouldn't increase past a certain point. Good luck! You'll feel so much better when you are on a stable dose of sub.

Your doctor knows that you will probably need to dose with sub every 4 hours or so, right? Sub's analgesic effect fades every 4 to 6 hours. I don't know the specific metabolism of buprenorphine, so I am not sure that the CYP450 gene comes into play or not with this formulation.

Amy

_________________
Done is better than perfect!


Top
 Profile  
 
   
PostPosted: Sat Nov 14, 2015 4:18 am 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Well that's the thing, I've never met this doctor before. For the past 2 weeks I've been calling and trying to find a doctor because I knew it was time to make a change. Finally I got through to one that was somewhat close/taking new patients and made an appointment. The nursing staff told me what he wanted me to do before my appointment. I really want this so I did and here we are.

I did talk extensively with the nurse about my medical history and concerns. I would have preferred to have met him before going through WD and having our first appointment but it wasn't possible. Obviously when I go in there I'll make sure he gets a full run down of everything but in the state I'll be in, it seems a little crazy.

As an update, I took a nap for three hours yesterday and just slept from 7pm to midnight. I'm feeling alright except for severe chills/sweats, runny nose/eyes, pain, and anxiety. Thankfully those symptoms go off and on and aren't constant yet. I'm going to do a COWS score right when I take my patch off later this morning just to gauge how bad I'll be on Monday when I see him.

I really hope I can make it. My only temptation if things get so bad this weekend is to take some methadone but I know that will only prolong the induction.

EDIT: It's about 4:00am, I haven't even taken my patch off and I'm already a 17 on the COWS with observation from family. How do I make it 2 more days? Ugh.

Edit2: 8-9am, 26+ on COWS. Again this was just 2 days after putting on a patch and 4hrs after taking it off. Clearly I go into severe WD very quickly, my genetics are fucked, or I don't know. But I couldn't take it anymore and was about to go to the ER. So, I just put on an old 75mcg patch :( . There was no way I could make it until Monday at the rate I was going(even with loads of clonazepam, gaba, etc already in me).

This patch will somewhat get me through tomorrow I hope and then I'll take it off. I'll have to tell the doc what happened and that his plan for ME didn't work and hopefully he thinks 24hrs instead of 48 will be okay or let me induct on my own. I feel like a failure and weak but I was dying.


Top
 Profile  
 
PostPosted: Sat Nov 14, 2015 3:06 pm 
Offline
Average Poster
Average Poster

Joined: Fri Nov 06, 2015 10:43 am
Posts: 12
Please don't feel badly. Have you thought about inpatient? I can tell you - my tolerance is sky high as well. I had a brutal home induction - took last dose on a Thursday at noon. By Saturday am I was getting better. But not really able to function or get up until Monday. Wish I had done inpatient.

As I had no meds but Bupe in the house my induction was successful - but other opiates in my home would have resulted in a delay and a more painful one. I should have been given comfort meds but wasn't.

I guess what I am saying is you can do this. Either go inpatient OR get comfort meds and remove all opiates from your home and do it. If I can I promise you can. Please be totally honest with your dr and demand they help you get this right.

As a pain patient as well (but I abused) my pain is already better. And I had moved UP from Fent :)

You got this sweety!!


Top
 Profile  
 
PostPosted: Sat Nov 14, 2015 3:30 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Yes I've thought about it. I actually called the local detox before I made my appointment with this doctor. They said they don't like to take chronic pain patients and prefer they taper off their current meds with their PM Doc. I couldn't believe I was hearing this because of course I've tried tapering of my Fent but failed every time. It worked too well for my pain but I all I cared about was my fentanyl.

For the first time in my life I had found something that took away my pain, helped anxiety, and let me sleep. That's NOT a quality life. So I told the head of the detox this and they said they might accept me if my prescribing doctor thought it was the best thing. And then they said something weird. The main doctor at the detox thought he would first need to switch me to methadone before my induction to suboxone while I was there.

Now from everything I know, that seems a little weird considering I'd only be there for 3-7 days. High doses of Fentanyl to methadone to suboxone? Hmm. That scared me off and I really wanted to do Suboxone therapy from home. Plus I have all the comfort meds they would give me at the hospital anyways. So I made my appointment with the only doctor I could find.

I would NEVER say my withdrawals are stronger or worse than anyone else but there is something weird going on when it comes to my Fentanyl and the quick onset of withdrawals and the strength of them.

Honestly, I think the way the appointment was set up really hurt me. Withdrawal on my own from Fent for an entire weekend (knowing that it happens within 20-24hrs with the patch still on), and then see him for the first time. Like many have said it maybe would have been better to switch me to a short-acting for maybe a week. Or at least have him know how quickly I actually go into withdrawals so I don't have to wait 48+ hrs of WD before induction.

I think it would have worked perfectly if say I stopped my patch last Wed and saw him on Thurs/Fri morning. Or if I had to, do the induction at home using a COWS after I got an Rx. I know I'm a complicated case so that makes things more difficult.

I still fully plan on seeing him Monday and starting induction even if it means some PCW. I hope he is open to me starting slowly.. .5-2mg to test the waters to see if I enter PCW. We will find out.

Anyways, I'm doing the the best I can. The severity of my WDs so quickly does scare me.

Thank you all so much for the help. Sometimes there just aren't any answers for why one person experiences something differently.


Top
 Profile  
 
PostPosted: Sat Nov 14, 2015 4:17 pm 
Offline
Average Poster
Average Poster

Joined: Fri Nov 06, 2015 10:43 am
Posts: 12
Hang in there. You sound really determined and that is so great. Do you think you could do a week on oxy from Fent then subs? If yes maybe bring up with doc? I can't believe the inpatient doc suggested methadone. Sounds crazy to me but I am not a dr.....

Btw, I also got push back on going inpatient when I asked, also because I am a pain patient. And that is after I told them I was heavily abusing. They want us off the meds so bad, but can make help really hard to get. I did at home but it was hard and my husband is traumatized. I think more so than me ;) It was a hard weekend.

With your determination you will figure it out, I am sure :)


Top
 Profile  
 
PostPosted: Sat Nov 14, 2015 4:52 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
Switching to Oxycodone might not work for me due to a genetic variant. I'd need extremely high doses compared to someone who doesn't have it just to get to a 'normal' therapeutic level. Then you add the extremely high dose of Fentanyl on top of that. Oxymorphone would work though since it is unaffected by the CYP450 and uses glucuronidation for metabolism instead (sorry about the science talk but I had to learn it due to my condition). Plus I used it as a breakthrough for a while and it worked quite well.

The problem is this is my first time meeting this doctor and explaining all this is quite the feat. But if he won't help me I'll have to find another doctor, I suppose.

I have to make this work. I was on methadone for chronic pain many times as well and despite the fact that I could never get the right pain relief and it caused insomnia, I almost wish I had just kept with it. But I never felt right.

I'm rambling now because I'm scared but again thank you and hopefully come Monday I'll have a great Suboxone plan started.


Top
 Profile  
 
PostPosted: Mon Nov 16, 2015 5:24 pm 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
:D :D :D :D :D :D :D :D
Just met with the most amazing doc for the first time. Usually he wont take on chronic pain patients but het set up a plan for me.

I'm starting my induction right now(mind you I only just took off a 100mcg patch 9hrs ago but he visibly saw I was in moderate WDs)

My normal dose will be 4mgs up to 4 times a day but for right now I get to test if I'll go into PCW:

3:15pm - 1mg Subxone

4:00pm - 1mg Suboxone (still feel about a shitty as I was before, will wait for 45min to take another 1mg)
If i were to go into PCW, would it have happened yet or is this still too low of dose to know?


Top
 Profile  
 
PostPosted: Tue Nov 17, 2015 7:37 am 
Offline
Average Poster
Average Poster

Joined: Thu Nov 12, 2015 9:19 am
Posts: 23
After about 4:00pm, I added another 1mg 45min later. I don't know if I went into PCWs but things did seem to get worse UNTIL in a fog I said fuck it and took my dose of 4mg. Then I dazed off for a couple hours and woke up feeling better but in great pain.

I fell back asleep from 9pm to 3am and woke up weak and just sloppy. Lots of pain but no real symptoms of moderate to severe WD. I just took my first 4mg dose of the day and we'll see how it goes. :D

Also... THE HEADACHES, my lord! I was warned of this but man haha.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 40 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 1 guest


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