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PostPosted: Sat Dec 31, 2016 11:10 pm 
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I stopped taking my 5.7 mg zubsolv three weeks ago and relapsed taking 40mg opana er. I have been crushing them and snorting them and taking 3 to 4 of them a day. I wake up two hours earlier than needed for work every day because withdrawals are waking me up. I then proceed to snort another opana 40. I want to switch back to zubsolv and never take another opiate again. I am very scared that I will go into precipitated withdrawals because I can not wait very long considering I am withdrawing the moment I wake up. So my question is what is the best route to take to switch tomorrow morning? I took my last opana 40 at 830pm and want to take zubsolv as soon as possible tomorrow when I wake up from the withdrawals. What is the bare minimum amount of time I need to wait? How much should I take and how often? Also can I just take zubsolv when I wake up and go through the precipitated withdrawals and continue taking more and more zubsolv until it goes away? I ask because that seems better than withdrawing for 10 more hours after I wake up. I went through pw before because I took sub to soon probably 10 hours after opana and it lasted about an hour then went away and I was OK but I was only doing 2 or 3 opana 15 instant release then and now I am doing 3 opana er 40s a day. Any feedback would be extremely appreciated.


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PostPosted: Sat Dec 31, 2016 11:21 pm 
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Hi and welcome. First, I have no idea how to answer your questions :D . But it is recommended to guage your level of withdrawl rather than how long it has been since your last dose of opana. You can do this by obtaining a copy of the COWS list. Others will be along to better assist you. I'm happy that you are ready to take action on your road to recovery!


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PostPosted: Sat Dec 31, 2016 11:33 pm 
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Thank you for your quick response. My most important question really is can I get rid of the precipitated withdrawals with more sub for sure? I ask that because I know without a doubt I can not wait more than 12 hours. And yes I am going to try to use COWS but I do not think I can last long enough because the worst sypmtom for me is the creepy crawly skin and feeling like I am uncomfortable in my own body which seems to be the first sypmtom I experience. Do you think it is safe for me to take some NyQuil to see if it helps me go back to sleep so that I can sleep away as much time as possible before I take the zubsolv?


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PostPosted: Sun Jan 01, 2017 12:11 am 
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I'm not positive, but I don't think so. I think when you have PW you just have to deal with it- Don't quote me on that.


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PostPosted: Sun Jan 01, 2017 12:12 am 
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Not sure about the NYquil but I think it would be ok. Again, don't quote me on that either!!


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PostPosted: Sun Jan 01, 2017 7:12 am 
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I don't think NyQuil would bother ya if u decided to take it. I understand wanting to be knocked out so u can sleep through some of the withdrawals and worry. If ur anything like I was, I couldn't sleep for worrying about withdrawal lol.

Unfortunately there is a certain amount of withdrawal u have to go through in order to start. Once u do though, it'll be over with. I about worried myself to death during that time but it was very worth it. If u do get precipitated withdrawal, just keep dosing ur zubsolv until u reach ur prescribed dose and they will finally stop. Are u doing this under a doctors care?

It'll be over before u know it. Good luck!

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PostPosted: Sun Jan 01, 2017 9:52 am 
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Jennifer- so if you do get PW, they will stop if you keep dosing until you reach your prescribed dose?? Or will it stop after its run its course?


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PostPosted: Sun Jan 01, 2017 10:18 am 
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You need to understand the PW and the "fight" that's going on between full agonists and partial agonists to cause those PWs to happen.

To have PW, it means that you have a partial opiate agonist pushing the full opiate agonist - opana - off of your pain receptors. To have that battle ongoing is the PW part of it. Once the partial opiate agonist (Zubsolv) wins, the PW ends.

So, you want to wait as long as you possibly can for the opana to be as minimal as possible in your system...

I remember when I used to play games with my treatment. I would switch between norco 10/lortab 10 and Sub relatively quickly....I would always wait a full day before I took the first norcos. But switching from norco back to Sub, I would usually switch within 6-8 hours because of the short-acting period of norco. And when I did switch, I would usually take 2 or 2 1/2 Suboxone pills at once ...back when Subs were in pill form.

Since the film has been on market, I haven't done this...so I can't say much for it.
This was done only a couple of months into my initial start of treatment...I quit and got serious with getting clean on July 7, 2008 and haven't looked back since then.

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PostPosted: Sun Jan 01, 2017 11:19 am 
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Htown, Dr. Junig recommends to just keep dosing as prescribed and the bup will eventually take over ur receptors if ur experiencing pw. It doesn't immediately take over and I'm sure depends on how much opiates u have in ur system and how long u waited. But the best and pretty much only thing u can do for pw is to just dose as normal until it finally stops :)

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PostPosted: Sun Jan 01, 2017 11:48 am 
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" I wake up two hours earlier than needed for work every day because withdrawals are waking me up"

Boy can I identify with this! I don't believe I had a decent night's sleep in 5 years when I was using.

t-man, I think you're going to be fine.It's not time that's the key criterion as t whether you're ready to jump, but how sick you are. If you're waking up dope sick, you're already half way home. Go as long as you can from there. Get a COWS chart online (just a quick google search), and once you're in moderate WD territory
you should be good to go. 12 hours after your last dose of short acting opiate....as long as you're in moderate WD should be fine. I"m not familiar with the opiate you're taking, so just make sure it's short acting, It very likely is if you're sick after 12 hours.

If you do get some PW....I did....it likely will not be bad as long as your COWS was sufficient. My PW lasted about two hours...then I suddenly got about 50 percent better. It was definitely bearable, and I'm as
big a baby as there is when it comes to pain tolerance..

Just keep dosing as per your doctor's instructions.


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PostPosted: Sun Jan 01, 2017 9:14 pm 
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Thank you for all of the responses. I pushed it back a day because I woke up in the morning in withdrawal again but it had only been ten hours and I knew pw would make it worse and I was scared. Tomorrow I have to do it. My big issue is that my tolerance is through the roof. I think these opanas are long acting not short acting but I am crushing them and snorting them to break the time release. Hopefully that makes it more like short acting. I will probably wake up around 6am again and this time take a couple ambient then try to sleep as long as possible until I have to wake up. At that point I will try to wait it out but I know it is unlikely so I will go through PWs. I will start with half a 5.7 mg zubsolv then wait thirty minutes and take the other half. If, well actually when I am still feeling the PWs because I am sure I will with me taking 120 MGS a day of opana I will take another half continually every half hour until the PWs are gone. Wish me luck and if there is anymore advice I am open to hearing it. Thank you


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PostPosted: Sun Jan 01, 2017 9:27 pm 
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Thanks Johnathanm and Jennifer for the explanation. So they play king of the mountain until the Buprenorphine wins. Got it


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PostPosted: Sun Jan 01, 2017 9:31 pm 
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Good luck and let us know how it goes!!


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PostPosted: Mon Jan 02, 2017 8:56 am 
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"My big issue is that my tolerance is through the roof. I think these opanas are long acting not short acting but I am crushing them and snorting them to break the time release. Hopefully that makes it more like short acting."


I did a quick google search and opana....oxymorphone...is in its quick release formula a short acting opiate.
They say that extended release is long acting...I guess by definition... but if you're crushing them I'm pretty sure you're ok. But understand I'm far from an expert.

You mentioned a very high tolerance. That's an important issue which argues you should go as long as you can without your DOC, since your tolerance drops as you wait. Do you have a doctor?

If your tolerance is still too high when you start your buprenorphine, you might not get sufficient coverage from the drug....which would result in your remaining somewhat sick for a few days. This was my issue. As I mentioned above, I had a couple hours of PW, followed by several days during which I was mildly dope sick. By day 3 I was much better But day 4 I was 100 percent except for being tired.

Again though, I think how sick you are covers your from all angles. If you're sufficiently sick...at least well into moderate on COWS...I think you should be fine. We're all tougher than we think. We have to be to live
the life of an addict. You can make it.

Just to add I was terrified of WD, and even more of PW. Neither was as bad as I'd imagined. And I'm an old guy in my 60's. It wasn't a day at the fair, but I"ve had many worse experiences in my life as an addict.


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PostPosted: Mon Jan 02, 2017 10:12 am 
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Please let us know how it goes. Opana's are strong, they tend to last a bit longer when I abused them, but I think they're still short acting opiates....not positive because I haven't researched it but I went through a period of abusing them until they started making them like oxy 80's and 40's, supposedly unabusable. Regardless I think ur induction will go ok as long as u don't panic and take ur suboxone to soon. Just try to wait it out, I know withdrawal is absolutely awful but u gotta do it.

Good luck!

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

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