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PostPosted: Wed Aug 10, 2011 3:09 am 
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Hello, I started suboxone treatment on monday at noon. I have been addicted to opiates for about eight months. The first three of which were to oxycodone and the remainder to heroin iv. I did .4 g of good black tar heroin on sunday spread over two shots. The first was around 8 am and the second at noon. I met my doctor on monday for the first time for 45 min, went into a brief history then was given a prescription for 8mg suboxone twice daily for this week. I am meeting him again on monday of next week.

I was in pretty bad withdraw the night leading into the appointment and during the appointment. I filled only four of the pills right away due to financial constraints but am getting more tomorrow (Wednesday). My doctor told me I would be out of withdraw shortly after filling the prescription and taking my first dose which was a huge relief to hear at the time. Unfortunately I found that this was not the case at all! Throughout monday afternoon I was beginning to wonder whether I should take more, if it was held in my mouth properly and for the right amount of time, and whether I was experiencing some effect from heroin still being in my system and the suboxone ripping it out.

I had to be at work at 4pm on monday afternoon and was struggling. I basically told coworkers I was experiencing some sort of bug and they sympathized with me, as I was obvious I was hurting. I did very little work that shift due to my coworkers stepping up and it being slow. Throughout the shift I was feeling slightly better as time went on and was spared the debilitating physical withdraw symptoms, but felt very achey, cold, uncomfortable in my skin, and still suffered from most of the psychological withdraw.

I got home around 10:30 and smoked some very potent medical marijuana which helped alot with some of the depression, anxiety and headaches. The weed sort of smoothed everything over for a few hours which made me a bit more comfortable. I ate a few bowls of oatmeal monday night which provided some much needed nourishment. Before it, it felt like my stomach was trying to digest itself. I spent the time after work on monday until noon on tuesday in my bed on my laptop reading this forum and a few others. I was relieved to read stories of others on here who also weren't immediately relieved by the suboxone. It seems that most oxycodone addicts get pretty immediate relief from suboxone while those using iv heroin sometimes have trouble inducing especially if they have a good habit. This gave me hope for the day to come. I did not sleep at all monday night and unfortunately whenever I tried to sleep, things would only get worse. I had some pretty bad restless leg syndrome which was only relived by taking repeated hot showers. Tylenol PM did not do a thing for me, and I was miserable until about 6 am, but from 6 am on I was starting to feel an improvement.

With things starting to get better, I finally got out of bed around noon on tuesday and went on a bit of a jog/hike to try to get some natural endorphins flowing through those pathways that had for so long been soaked in heroin. I was also hoping this physical activity would help me sleep tonight which I am keeping my fingers crossed on (I will update tomorrow morning hopefully reporting a good nights rest). I live in the colorado front range and found a great path right by my house that leads up the foothills of the rockies. I found that jogging was too strenuous to maintain for some reason (harder than the few times I jogged while using H), but due to the elevation and the steep grade of the hike I got a great workout keeping up a moderate, steady pace.

Towards the top of the hill I sat down, did my best to clear my mind, enjoyed the view and took in an awesome sense of wellbeing from doing so. I then closed my eyes and started forcing myself to face the nitty gritty of my addiction and where it is bound to lead if it continues. I thought of all the things I was on the brink of losing and all those I had already lost. I thought of my girlfriend and for the first time in a long time was suddenly flooded with emotions about how I have not been engaged in our (currently long-distance) relationship. I cried and somehow it felt great. While what induced the crying was a rather sad predicament, simply feeling a strong emotion like that was somehow relieving. I kept thinking about these topics and let the tears flow. I was forcing myself to confront reality and to realize how badly I was fucking up. I kept this kindof train of thought going for the rest of the hike.

As I returned to my own neighborhood (around 2 pm, 24 hours after inducing) I definately noticed how much better I was feeling compared to the day before. I wore a smile on my face and got ready to go into work again. The bright sun I got on my hike made my gooseskin feel much better, and I feel that this physical activity helped to truly kick in the suboxone for me. I felt almost as good as how the doctor told me I would feel a full 24 hours before. Work tonight was so much more bearable than the night before. I was enthusiastic around customers, and despite feeling a bit crappy and exhausted, did not feel like I was in much physical withdraw at all.

I am now home from work and smoked some marijuana again. I really enjoyed smoking tonight; I know many on this board are against using any substances while in recovery but I have always had a positive relationship with this plant and felt that tonight I could once again appreciate it and its power without it just being a nice add-on to a heroin high. Its 12:30 am where I live and I am really hoping I will get some good sleep tonight as tomorrow I have a hectic day of moving in front of me. On thursday I have to move out of my place for a week and my next lease doesn't start for a week after that. This means I get to couch surf for a week. This is probably not ideal for someone just getting acclimated to suboxone and experiencing insomnia, but I have no choice. I am hoping to convince some friends to go camping for at least a night or two during my week in limbo.

I dont really know why I bothered you all with the information in the previous paragraph, but I guess I am curious what you think about me being basically homeless and without a base for a week while still adjusting to suboxone. One of the reasons I decided to write this post was to help reassure others whose symptoms are not immediately relieved in the first 24 hours of suboxone. I want those people to know that things WILL get better. I got the itch that first night to go cop heroin at 5 am to try and breakthrough the sub and get relief, but luckily did not listen to that little bastard of a thought. I really am convinced of the benefit of some physical activity in helping the suboxone to kick in and am curious if others have been helped by this. Another really thereputic thing that helped me realize that I am absolutely doing the right thing was talking to two old childhood friends over the phone who have experience with the ins and outs of addiction. These friends did not know I was addicted as I never told them and now live in a different state, but I cant tell you how much of a relief it was just to say "hey dude, uhhh, Ive been addicted to heroin for about eight months." As those words left my mouth, the weight on my mind and the feeling of carrying this all on my own left me. Both friends agreed to be a part of my recovery in the form of phone therapy.

I am going to sign off now, but I will update frequently over the next month letting you all know how everything is going. I cant thank this community enough for helping console me that first sleepless night before starting suboxone and the next night which was also sleepless. From the knowledge of this board I was able to convince myself over those two nights not to go score dope and stick it out. WOOHOO! ADDICTION REMISSION!


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PostPosted: Wed Aug 10, 2011 10:08 am 
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Hi dizzle and welcome to the forum. It's my opinion that you didn't feel well right away because the dose you took was simply too low. People switching from heroin to suboxone should feel fine right away just like prescription opiates. In your case - from the sounds of it - you just didn't take enough suboxone.

As for your use of medical marijuana - I personally have no issues with that whatsoever. But as you mentioned, there are lots of people who believe in total abstinence. I just believe to each his/her own. No one else can judge YOUR recovery/remission and in my opinion, no one should.

I hope you continue to feel better. Are you now doing fine on the 16 mg per day?

Thanks for sharing and again, welcome!

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PostPosted: Wed Aug 10, 2011 10:51 am 
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Hi Dizzle, glad you are feeling better now. I'm REALLY glad you decided to smoke some pot instead of copping heroin.. It seems like lately I've seen more people say they didn't get relief after coming off heroin and some of them didn't stick it out like you did. There seems to be a push to have docs limit their prescriptions to 16 mg/day. IMO they should allow addicts with large habits to at least start at the full 32 mg, and then taper down to a maintenance dose. It sounds like that would have helped you.
Good for you going hiking in the mountains rather than using. If we all did that I think we would have fewer relapses! And i think a lot of us can identify with your emotions coming flooding back like that, too. Anyway, you didn't say anything about your dosing after the first dose. I hope you are still taking the 16mg/day. As far as being homeless for a week, just keep taking your medicine, and don't crash anywhere where people are using (the campout sounds like a good idea). Also, be careful with the pot, if you used to use it as an adjunct to heroin it might be a trigger.
Good luck, and keep us posted on how things are going.
Lilly


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PostPosted: Wed Aug 10, 2011 1:59 pm 
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I think part of my issue that first day was that I got prescribed the orange tabs because I spoke with some pharmacies and they are unwilling to sell less than a whole box of the tabs which I cant afford all at once. When I put that first sub under my tongue i immediately started salivating like crazy and it was dissolved in about 3 min leaving me with a mouthfull of fluid that I wasn't (and still am not) sure of how to deal with. I swished it around about an additional 3 min and then couldn't handle it anymore and just swallowed it. My doctor said that this was the proper way to do it and the pharmacist I spoke with today reiterated this. I am worried I did not get the full absorption. The same pharmacist today said that her pharmacy can split the boxes if need be so on monday I will just have my doctor write me a script for the films which should help with any absorption issues.

Last night my mind was just far too awake and alert to sleep. So as of right now (wednesday at noon) I haven't slept since saturday night when I was high last. I do feel as if I have energy to get through the day however, even enough to do some strenuous and painstaking moving-out tasks. Last night I felt a resurgence of interest in things I haven't been paying attention to much over the last couple months. I spent the night reading online about what is going on in the world, getting into some new music, and playing guitar. It felt good although I would have preferred to sleep.

My dosing has been 16mg a day, on monday I took an 8mg sub twice about 10 hours apart. Tuesday it was 8 mg in the morning then 4 mg about 6 hrs later and the other 4 a few hours after that. Today I have taken 4 mg and am about to take another 4 after this post. I split the tabs into 4mg to try to eliminate some of my concerns about wasting the tablets as is discussed in the first paragraph of this post. Im not completely sure I will need 16mg daily over the next few days and thereafter. I feel that 4 mg twice daily just might work for me and will split the roughly 400$ a month cost of the medicine in half allowing me to actually pay my doctor. I feel that 4 mg might be ok because of how long the halflife of bupe is. I dont feel like plugging in the half life formula to figure out just how much bupe is in my system right now but i suspect it is around the 35 mg mark. If I were to take 16mg every day I would finally level off with such a high amount in my system that I am worried about side-effects. Elsewhere on the internet I have frequently read that 16mg is a very high dose and not necessary for people with my duration and amount of use.

Thanks for your replies!!


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PostPosted: Wed Aug 10, 2011 2:25 pm 
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16 mg isn't really that high of a dose, especially for a starting dose. I'd suggest you give yourself time to stabilize before dropping your dose down a bit - maybe a week or so. Once your stable, try dropping by like 4 mg at a time. And watch that your cravings don't come crashing back when you drop your dose. That's the one thing that's pretty much individualized, so try not to compare your dose to anyone else's.

I hope you stabilize soon and get some sleep. As a matter of fact, since you're not sleeping yet, it almost sounds like you could still be in withdrawals. I'm curious, what do your pupils look like (what size are they)?

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


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PostPosted: Wed Aug 10, 2011 4:47 pm 
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I have a suggestion if your worried your are not getting max absorbtion.. Try breaking the pill in half it prob wont make your mouth as watery. Dont drink anything about 20 min before or after you dose, and dont talk while its in your mouth. Swishing is helpful also. ( I love the taste so I always do this ) I have been on sub for 4 years and Im on the film now. It disolves much quicker so you get alot better of a dose. Been on film for about a year, personally I like it much better but to each his own. Also 15 min after my very first dose I felt better.. ( iv heroin user for years ) Dont make yourself needlessly suffer if you dont feel better right away you should just tell your doc so you can get a higher dosage. Hope things go well for you!


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PostPosted: Wed Aug 10, 2011 10:06 pm 
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I agree that you are probably still in withdrawls and may need more. I have been on sub for 2 months, I also take 16mg and my doc was oxy. I definitely wouldn't try to lower your dose yet. The whole point of sub is to be comfortable and feel normal so you can have time to heal and fix your life. I have not tapered yet but from what I read it is very easy to taper from higher doses and does not get tricky until 4 and lower. I do not think staying at 16 instead of 8 will make much difference. Just relax, take your time and enjoy feeling normal. Congrats on starting sub and getting your life back!


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PostPosted: Thu Aug 11, 2011 3:47 pm 
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If you find that you are not in withdrawal(by pupil size) I would suggest that you don't take a dose too late in the day. It makes some people wakeful. You might want to dose in the a.m and then again in the early afternoon. Also, I agree with the other replies, don't think about lowering your dose until you stabilize ( at least 3 weeks to a month, minimum).
Hope you continue to feel better,
Lilly


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PostPosted: Fri Aug 12, 2011 1:35 am 
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Dizzle wrote:
I feel that 4 mg twice daily just might work for me and will split the roughly 400$ a month cost of the medicine in half allowing me to actually pay my doctor. I feel that 4 mg might be ok because of how long the halflife of bupe is. I dont feel like plugging in the half life formula to figure out just how much bupe is in my system right now but i suspect it is around the 35 mg mark. If I were to take 16mg every day I would finally level off with such a high amount in my system that I am worried about side-effects. Elsewhere on the internet I have frequently read that 16mg is a very high dose and not necessary for people with my duration and amount of use.

Thanks for your replies!!


Congrats Dizzle on making a step in the right direction, and it's good to see you're still picking yourself up and going to work in times of real sickness. 8 months of addiction is definitely long enough to know that it's not a life you want, and hopefully it'll be easier to recover than those who've been stuck in for 8+ years.

Suboxone's half life really doesn't mean much when put up against your individual tolerance. ie a person with a massive tolerance to opiates could take 4mg of suboxone and find it only gives relief from withdrawals for 4 hours, because they need high levels of buprenorphine remaining in their blood to get relief - while another person with a tiny tolerance could get relief for 24 hours. Half life does not equal relief. If it did, we'd all be on the same dose regardless of tolerance.

You might be onto something about the whole salivating thing. When in withdrawals, we salivate like dogs over dinner. You say you're feeling better now? Give yourself some time to stabilise. Don't make any drastic decisions about dosing yet. In the early days, it's better to be on too high a dose than too low. You can always adjust a dose down if you need to, but you might not come back from a relapse if you crave too much from a low dose. Try to do what you can to afford your current dose. Surely it must be cheaper than your habit?


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PostPosted: Fri Aug 12, 2011 9:24 am 
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Hi Dizzle,
I'm glad you shared your experience. I think it will not only help you get thru this difficult time, but also help others.

I have a few thoughts that may or may not help you. I had a MASSIVE roxy addiction. I took 50 or more 30 mg pills a day. I would take 5 at a time, every hour throughout the day. I was living in South Florida where there is no heroin, but pills are cheap. When I quit, I tried to go to cold turkey. I was also detoxing from alcohol at the time. i don't know how I thought I was going to do this on my own. Although they say you can take subs 12-24 hours after oxy, I would go 2 or more days before real withdrawal started.

I went to a clinic and was in bad shape. The suboxone did give me instant relief, but remember I was in SEVERE withdrawal by that time. I recently switched doctors, and he told me that if I would have come to him with that habit of roxy, he would have sent me to a methadone clinic. Thank God my first doctor didn't. But my new doctor told me the only reason subs worked for me was because I waited so long before I took them.

The doctor also gave me clonidine, and I didn't have to work at the time. I wasn't feeling 100% for at least the first couple of days. It will get better. Did you get a script for clonidine? I think that would have helped you, especially with sleep. I only took it for 3-4 days, but it was a big help.

It sounds like your doctor didn't give you the subs in the office, and have you take them while being monitored. I know that although the recommended way of inducing is to take your first sub in the office, that not all doctors do it that way. I really think that doctors are not doing a thorough job by giving you a script and sending you on your way. While the last thing I wanted to do when I was in horrible withdrawal was to spend an hour on a doctor's table waiting for the pill to work, I am glad my doctor did it this way. Not only is it better for the patient, I think it's better for the doctor to see that subs do not affect everyone the same way. They could then see cases of precipitated withdrawal, or incomplete relief from suboxone. I know I felt better at 8 mg, but the doctor told me that I could take another 8 in an hour if I felt I needed it. I did, and that made me feel even better.

Other than that, it sounds to me like you are working on your recovery in other ways. Thinking about your addiction, and exercising! They say that exercise is one o the best things you can do for your recovery.

Hang in there, and please keep us posted! I promise it will get better. I feel totally normal after 16 months on subs, never have withdrawal or cravings.


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PostPosted: Sun Apr 27, 2014 4:18 pm 
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I go throught this all the time becuase I switch back and forth between suboxone and heroin all the time.. It's not that your not taking enough or to much it just the what happens to some people when you I.V heroin. But if you only snort suboxone will be a miracle for you. Whenever I switch from heroin to subs I just take a small dose of sub about 1-2mg and then I will immeadiatley start to feel crappy, so after I few hours of taking more sub I do 2 bags i.v. On top of the subs which will take away all the pain your experiencing and will cover the receptors that the sub couldn't becuase it's only a partial agonist ( also this won't make you sick like some people think) ..So now after you have done the two bags go to sleep and then 8 hours later take another small dose about 2 mg of sub and you will be fine and you won't have to go throught those hellish three days when you shock your recpetors from heroin to straight suboxone.


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