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PostPosted: Fri Feb 12, 2010 8:12 am 
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Well, to bupe or not to bupe—this week that question was answered for me. I told a little of my background in an earlier post about starting Suboxone after finishing a taper. Turns out I never got to finish that taper.

I was taking 270 mg of oxycodone IR per day and went to my family physican for help in tapering off. I was self-medicating for pain, but also for psychological relief. The two sort of got rolled up into one, as I suppose they often do with people who have a lot of pain issues. My family physician was not the prescribing doctor; I got the meds legally from another doctor, but at a great price in so many ways—financially, healthwise, etc. I had been stubborn and cocky to think I could handle self-medicating, and I knew I had to stop.

My family physician put me on an initial taper of 180 mg/day for 2 weeks, which I followed with only one slip (kidney stone, I took one extra just to make the pain bearable). I began the taper with only the meds I had from my old script, and she said she would provide the rest when that ran out. The next step was to drop down to 90 mg for 2 weeks. I was close to running out (and yes, I did hoard a few because (1) I feared something would go wrong, either with the taper or with my migraines, which are viciously painful and very traumatic, and (2) I’m tired, tired TIRED of pain, and I guess the addict in me needed to know the meds were at least there) so I called the office and discovered my doc was on vacation. The doc covering for her wrote a script that would just barely get me through till she got back, which was fine. I didn’t expect to have any problems, but once I dropped down to 90 mg, by the end of the first day I was having significant withdrawal symptoms. (I did subsequently learn from an addiction specialist that this was too drastic a drop.) I was frightened, so I took two more tablets late that night and was stabilized. I called the office again the following morning and left a message about what was happening. This was on a Friday, and my doctor was to return the following Thursday (yesterday).

My doctor’s nurse called back and said she had consulted with the nurse practitioner, who said that because the meds were narcotics, they would not prescribe any further, nor could they or would they change the instructions; and besides, if I was having withdrawal symptoms, that was not something they would address. Instead of coming in to see whichever doc was covering so that we could adjust the dose, I was to drive 50 miles to our nearest big city (in a huge snowstorm) and present at the university hospital ER “for inpatient options”, which meant the university psychiatric ward. They do work with suboxone there, but I wasn’t ready for it, I didn’t see the necessity of being inpatient (let alone the expense), and at least at that point I had been compliant. All I wanted was to be seen by another doctor at the practice, explain what was going on, and get by until my doc returned and we could continue from there.

I wasn’t trying to cadge drugs off of them or see if I could con my way into getting by on another 180 mg week, but that’s how they treated me (at least that’s how I see it). I kind of hobbled through the weekend, found an outpatient suboxone treatment center, and called my doctor’s office again on Monday. I explained that I’d looked into outpatient suboxone options, was close to running out of meds, and was stable with no symptoms. The NP called back and gave me the same spiel, and told me that I WAS going to the ER, she was not going to consult with a doctor, neither was I, and that was that. I hung up on her.

I had just enough meds to last until this past Wednesday, so I made an appointment with the outpatient treatment center. I was a complete mess when I went in, confused, anxious, runny nose, burning skin, the whole spectrum. I could barely hold the pen to fill out forms, which looked like a 4-year-old had written them.

So, here I am, on my second day of suboxone, and it’s working well. I know I should be grateful that I have this opportunity, and deep down I am, but I’m also heartsick over what I’ve done to myself and how I’ve been treated (or at least how I perceive I’ve been treated). I am mourning what I’ve lost; my self-respect, my life the way it used to be. I feel a strange hollowness, something I imagine many of you have felt. I have many adjustments to make at this point, and I'll try to make every one of them.

I really wanted to make a go of the taper, I was motivated and proud of the way I was handling it. Maybe I was only kidding myself, I don’t know. Guess I’ll never know, now. And I guess, really, I would eventually have slipped again since one of my medical conditions requires pain meds on occasion (something I'm going to have to work out with people who know what they're doing).

My rehab center requires counseling, which I very much need, so that’s coming up next week. It’ll be good to talk to someone who can listen and help me. And my darling hubby couldn’t be more supportive; I thank God for him every day.

Sorry for going on, but I wanted to post this turn of events. I’ve been following many of the posts here and have already learned a lot. Thank you, everyone, for listening.


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 Post subject: Failed ???
PostPosted: Fri Feb 12, 2010 9:16 am 
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Oh my GOD, I failed so many times at stopping .. Your in the right place, find a good Dr. who can prescribe Suboxone , get youself adjusted to the lowest amount of sub needed, it is the WONDER drug, Good Luck, Mike


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 Post subject: You are on your way!!
PostPosted: Fri Feb 12, 2010 10:39 am 
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Good Morning Morningglory,
Congrats on starting your way back!!! I have been where you are.... I didn't taper though. I was using 300 - 350mgs. of Oxcodone a day when I got into treatment... Some of my meds. had come from my Dr. and the rest where off the street! Anyway's I went from 300 + mgs. of Oxycodone a day to 16mgs. of Suboxone a day in a 24 - 48 hour period. I will NEVER forget the awful feeling I had when I was in moderate / severe withdrawals just before my Suboxone started!!! My treatment started a little over a year ago and I am still on 16 mgs. a day and all is going well. My Suboxone Dr. strongly recommended( insisted ) on counseling Also and I am glad he did as I find it helps me very much especially at the begining of my treatment... I was sorry to read of your troubles with your Drs. office. It is terrible when we addicts get treated like second class citizens. Its just not right. I have a great team of Drs. & therapist' so I didn't have that problem But, It seams when we are at our most vulnerable state some people treat us the worst.... :cry: Well now that you are in Recovery I wish the best for you. Please keep posting so we can watch your progress! Take care for now.....

God Bless
TW


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PostPosted: Fri Feb 12, 2010 1:59 pm 
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Thanks Morningglory -

Your story, while horrid, surely makes us thankful we have suboxone as an option. I agree with one of your last paragraphs, though, that says you'll need to find a way to deal with your ongoing pain issues.

I also get pretty severe migraines. Naturally, in the olden days - it was opiates for that pain and other non-opiate meds for the migraines. I find now, that while I can't get relief from, say a percocet, I get relief from the buprenorphine, and my other vaso-type med's.

I can't recall if you have chronic pain issues - (I think you do?). If you do, then it's good to be honest with your suboxone doctor about that. Also, there are many here who are in chronic pain - which are commonly treated with methadone, or other full agonist routine. Some members of our forum with Chronic Pain have figured out how to maximize what pain control buprenorphine provides with other medications and techniques. I feel certain you will find ways to address the other issues you mention.

As for the feelings you mentioned:

Quote:
but I’m also heartsick over what I’ve done to myself and how I’ve been treated (or at least how I perceive I’ve been treated). I am mourning what I’ve lost; my self-respect, my life the way it used to be. I feel a strange hollowness, something I imagine many of you have felt.


You are right about me. I felt the same way. I thought for a very long time, I was Mr. In Control - still part of my personality I'm dealing with. It hurts to realize that indeed we are not in control. We can not 'just stop.' We can't just taper without issues, etc.

I'm so glad you are in counseling. I'm working on (my words here) - the SHAME TRAP. Yes, we all have done things to feel ashamed about. Yes, there are damages done to feel shame. But, my doctor and others - feel VERY STRONG - that feeling that way - not learning to forgive ourselves, make remedy where possible, is a HUGE CATALYST for future failure. My doctor is excellent at catching me with that. If indeed we have a disease (and can accept that) - where we are susceptible to opiate's, we are indeed in need of treatment. The best analogy I can think of is someone who is a little older and is diagnosed with Type 2 diabetes. Many people figure it out after some event in their life caused by the symptoms. Many, test their blood, and take insulin (analogous to our using suboxone) - while they determine if they can keep their blood sugars in line with diet and exercise (our analogy is therapy, group support, and exercise).

Most all of us know people with TYPE 2 (sometimes called old-age onset) diabetes. It's a disease. Nobody would say 'boo' if a TYPE2 person needed insulin short term, mid term, or for the rest of their life. If they acted out 'horribly' as part of their symptoms (often time happens if blood sugars go too low), people understand.

We as people with this disease need to remember these analogies - if for nothing else - to reduce our own feelings of SHAME. For me (and the doctor says for all his patients) - it's a beginning step in the negative direction toward relapse. Most of us want to feel numb to the SHAME - and our Drug of Choice typically gave us numb.

Please keep us posted. I am personally interested in how your migraines get covered now that you are in a doctors care. I'm glad you can express your feelings here, in your therapy, or wherever - then move on to a new you! Regardless of the total BS you were put through - there is really only today and tomorrow. You are feeling OK on suboxone TODAY. Terrific.

All the Best!


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 Post subject: Thank you, All
PostPosted: Fri Feb 12, 2010 2:36 pm 
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Thanks, everyone, for your understanding and tremendous kindness--something I badly need at this point. I only hope I'll be able to, as they say, "pay it forward" someday.

Lathedude, I am going to cut and paste your reply so I can keep it on my computer (I should probably put it on my iPhone, too!) for reference when I start to beat myself up, something I excel in. You're right, ongoing shame gets nobody anywhere. I made an appointment for counseling today, and I'm looking forward to meeting my therapist next week and getting to the root of this. It's a physical and psychological malady, for sure. I know I need to learn some other ways to cope with the fear and dread that migraines put into me (it's been that way for 44 years). I started on opioids in the fall of '08, due to a triptan-induced mild heart attack (that's how frequent they can be); the odds of that happening are, according to studies, less than one in a million. I thought I'd found an ideal way to cope because of the physical and emotional relief oxycodone brought me when I got a migraine. I never thought I'd lose control, but I think looking back, I was ripe for the picking.

Anyway, I did ask my cardiologist if I could go back to triptans, and he agreed, so at least I have that going in my favor. I'm supposed to alternate those with painkillers if I have a spell of several in a row (as you probably know, that's standard protocol), so I don't know how my doctors will handle that. But I have an appointment with a new family physician who prescribes suboxone and is very experienced with it--I guess I mentioned that in my first, earlier post--but it's not till March 29. She probably handles many patients who have ongoing pain issues along with addiction. I'll just be glad to get away from the judgemental clowns at my current family practice. I'll definitely let you know how things go, and I'll keep reading and posting. Thank you again, so much.


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PostPosted: Fri Feb 12, 2010 3:21 pm 
Morningglory, I don't have too much to add to the wonderful replies you've already received. Thank you for coming back and giving us an update. I wish I could say I'm surprised at how all this went down, but I'm not. We've all been there and done that.....tried to taper and failed. The reasons why don't matter all that much. The sad truth is that we are addicts...whether we got here through legitimate pain conditions or by just dabbling with opiates recreationally. The bottom line is still the same....we need help to get our lives back in control. Many of us find that once we've gotten stabilized on Suboxone, our chronic pain issues seem to improve. I truly believe that the cycle of pain - opiates - more pain - more opiates is just a perpetual cycle that must be broken. As a nurse, I quickly learned that there is a thing called "rebound" pain.....you treat your pain with opiates, the opiates wear off and the pain returns worse than it was before. The phenomenon seemed to be especially true with headaches. I'm not saying this is scientific and I know of no studies to back me up, so don't quote me on it....but it just seemed to happen a lot in my experience. So hopefully now that you're breaking that cycle of medicating with opiates continually, you'll find that your pain issues subside a bit. I'm not a doctor and I could be totally off on this...but no harm in hoping for the best!!
Congratulations for getting help despite the shameful way you've been treated. Try not to let it get you down. You've done the best you can and you can't change the past, so keep up the good work and keep working on everything.
Keep coming and sharing with us! We're glad you are here!


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PostPosted: Fri Feb 12, 2010 6:06 pm 
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Just remember, in the 12 step way of thinking, your already a veteran to the person still using pills, Think about it !!!


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PostPosted: Fri Feb 12, 2010 8:50 pm 
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Sullimi, that IS a positive way to look at it. I really want to do what's right for my poor assaulted body and brain...hard as it's been, I know I've taken the right path this time.

Setmefree, thank you, and yes, that phenomenon is especially true with head pain. Tension-type, migraine, and other headaches often morph into chronic daily headache with excessive use of painkillers, whether OTC or prescription. In my case, oxy was the only med that didn't cause rebound...drat...but as you said, that's neither here nor there; the main thing is to deal constructively with life as it is now. And I wonder, maybe the interstitial cystitis will calm down now that I'm out of that cycle. Maybe the sub might (although I'm not counting on anything and won't be doing any experimenting) even provide a slight analgesia, as some people say it does for them. But if not, so be it. Anything's better than what I was doing!


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PostPosted: Sat Feb 13, 2010 1:45 am 
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I know that I've been beating this drum for months, but I'm gonna keep doing it anyway! Check this out:

http://www.triggerpointbook.com/headache.htm

This book, which covers all kinds of chronic pain, not just headaches, has seriously saved me. I was able to resolve most of my headaches and fibro pain using this book. I can't recommend it highly enough. Best 20 bucks I ever spent.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


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