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 Post subject: ER for suboxone?
PostPosted: Sat Dec 26, 2015 7:12 am 
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Three weeks ago I went to detox where they began subutex induction. Two weeks ago I went to a PCP who started me on suboxone. Last week I went back to the PCP and told her that although i was taking as prescribed, the sub dosage was causing severe nausea. The taste/smell/look of anything orange flavored/scented/colored would make me violently ill. Even thinking or talking about it would make me vomit.

I called the office and reported this effect and they said to continue my regular dosage, regardless of the nausea, and assured me I still was absorbing the sub even if I became sick afterward. The doc thought maybe it could just be my body getting used to the medication. I didn't get used to it. At my appointment last week she came in and began discussing suboxone treatment etc etc and I threw up in a bag right in front of her :( not my proudest moment.

After witnessing the degree to which I was affected she ordered a shot of zolfran. When we discussed dosage I suggested to cut down the mg in hopes of curbing the nausea. Right after that she told me she would be prescribing more zolfran to take home.

So now I'm here. With a bit of a problem.... the zolfran worked. I have no more issues with sickness or vomiting as a result of sub. When I was taking the original dose without zolfran I was experiencing very little relief because I was literally throwing up all day. Now that it's gone I am benefiting from suboxone.... but I'm used to the higher dosage. The lower mg we switched to is not cutting it at all. I (hesitantly!) tried to take what I was originally dosed at to see if that would be better for the wd maintenance. It ended up working wonderfully! :)

That's great and all, but now I'm short. I'll run out before my next weeks appt. And it's barely even the weekend!!

Can I go to an ER with my original script from 12/16 and explain this all to them? Can they even help me? Or should I call my PCP and see if they can call in the rest until my appt?

I'm new to suboxone, and very new to sobriety and recovery. I don't know how this works. Has anyone experienced or heard of a situation like this? The subs are my life line at the moment. I'm really scared to be without it. :/

**sorry for all the details! I thought it better to lay it all out there and get answers to MY questions, instead of having to reply to with answers to YOUR questions. Lol. :) **


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 Post subject: Re: ER for suboxone?
PostPosted: Sat Dec 26, 2015 8:33 am 
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Personally I would be calling your prescribing Dr and explaining to them what's happening, he or she sounds understanding. I know if it was my dr he would be straight onto it for me and has in the past. It could be different where you are but only drs with specific training can prescribe suboxone (and in my experience with a couple of unrelated hospital stays, a lot of health professionals haven't even heard of it.....) so l personally would not go to a hospital, stick with your dr who knows what they are doing and who you won't have to explain your story to again and I am sure they will sort it out for you.

I pick up weekly but I've had to call to get extra if we are going away or change days and once even had my meds stolen (my valium not my suboxone) and my dr sorted it straight out for me.
Good luck.


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 Post subject: Re: ER for suboxone?
PostPosted: Tue Dec 29, 2015 9:39 pm 
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Your prescriber will be pissed(!) if you go somewhere else for more medication. Your best option is to divide up what you have left, make it last, and then explain what happened to your doc at your appointment. SOME docs are understanding; others seem to look for reasons to discharge people.

Your second-best option is to call your doc and explain you are short, that you understand that you took too much, and that you will make your best effort to follow the doc's instructions going forward.

Again-- your best bet is to divide what you have left and THEN talk with your doc. If you ask here, people will tell you how to absorb the most of your dose (people typically absorb only 25% of a dose). But any misery you have now, in the short term, will favor you down the line-- by showing your doc that you are serious about treatment.

Docs don't fully understand why addicts choose to take whatever med they think they need-- whereas other patients take what is ordered. Realize that most patients do as the doc prescribes, and go into the discussion with that understanding-- so that you appear to be appropriately serious about what happened.

Finally-- zofran is a serotonin med that appears to be safe for long-term use.... but you may want to consider other options. See if your insurer will cover another form of buprenorphine, like Bunavail, Zubsolv, or generic bupe/naloxone. They may even cover buprenorphine, but many docs will not prescribe buprenorphine (mostly because of ignorance about abuse potential).


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 Post subject: Re: ER for suboxone?
PostPosted: Wed Dec 30, 2015 9:44 pm 
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Thank you for your advice. I decided to suck it up, divvy up what up had left, and push through those few days until my appointment. You both mentioned the possibility of jeopardizing the relationship with my PCP. After consider that the choice was easy. I am serious about recovery and I wouldn't want my prescriber to have any suspicions about me. .... plus, no one ever said withdrawal would be easy!! There will be bad days like I had last week and I'm sure there will be plenty more. But I've learned my lesson:Take only as prescribed!!

Thanks again :)


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 Post subject: Re: ER for suboxone?
PostPosted: Thu Dec 31, 2015 6:14 am 
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suboxdoc wrote:
Docs don't fully understand why addicts choose to take whatever med they think they need-- whereas other patients take what is ordered. Realize that most patients do as the doc prescribes, and go into the discussion with that understanding-- so that you appear to be appropriately serious about what happened.


This is very interesting and useful information. It's something that I'm obviously aware of, but not quite conscious of. I guess I've just never really thought about it. Before detox I would take whatever I wanted whenever I wanted-- and not even reserved for strictly controlled substances. They'd give me allergy pills, it'd say one and I'd take two. Or OTC meds, whatever the dosage I'd double.

I think I felt that doctors and OTC dosing directions always erred to the side of caution, prescribing the lowest dose of medication that still would provide an effect. I thought i needed more than that and they were just trying to avoid a lawsuit by saying on paper it was actually alright to take more.... this mentality, I know, is wrong. And it's surprising to me that you say this is 'addict' behavior. I th ought it was just me because I am kind of a know-it-all sometimes. Lol. Kind of nice to know km not the only one :)

As far as sticking to a schedule with medication, I benefited quite a bit by going through the detox program. I learned how to wait. And how to feel when something is wearing off. I honestly can't remember the last time I actually waited a complete four hours for the next dose!! Lol.

But thank you for sharing that insight. Something to think about, for sure.


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