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 Post subject: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 9:38 am 
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Hello to all!
I am currently near the end of my Suboxone tapering and before posting on specifics, I thought I should introduce myself.

My story, briefly (brevity NOT being my strong suit)...

Roughly 25 year ago I had a heavy Percocet habit that ultimately had me taking about 30 per day. We're talking Elvis sized abuse. When I couldn't get Percocets, I'd grab Vicodin, Codiene, anything I could get my hands on.
Like many, I started out using "recreationally" but soon a single pill every few days turned into every day, to several a day and so on. I can clearly remember the exact day I realized I had become physically dependent... I had run out of the large prescription I had received after having four impacted wisdom teeth extracted and suddenly felt flu-like symptoms. I had no temp, and was baffled. It suddenly occurred to me that perhaps it was the fact that I hadn't taken a Percocet! What a stroke of genius!
When I think of this crucial moment in my life with the wisdom of hindsight, I longingly wonder how different my life's trajectory would have been had I just toughed it out and dealt with what surely would have been a relatively minor period of withdrawal, but instead, I asked my then girlfriend if she had any of my my pills left. She did and I grabbed it. From then, I began to cultivate sources to buy them on the street. My habit snowballed and my addiction took over my life. My career, personal relationships, finances, health, everything... all of it was derailed. After five years I went into rehab, relapsed after 8 months, did two more rehabs and and eventually reached 20 years of sobriety.

About 5 years ago I contracted a serious bone infection in my upper and lower jaws due to complications from an extensive tooth crowning. Teeth starting breaking off, pain, etc. In the end, my only recourse was a total and complete dental reconstruction resulting in permanent implant dentures. There were many complications, bone grafts, a sinus infection, two botched implant posts, etc. What was intended to be a year long process took 4 1/2 years. That's not a typo. The very first step was the extraction of what remained of 27 teeth in one sitting. There is only one way I can describe the experience - it was medieval.

Naturally, I informed both my dentist and oral surgeon that I was a recovering addict and they sat me down and explained that there was no way I would be able to go through this without opioid pain killers.
As I'm sure many of you know, we all have varying degrees of reaction to withdrawal from opioids and I am very sensitive.
I tried to take the absolute minimum number of pain meds after each oral surgery (of which there were 15) and right from the start I felt withdrawal symptoms as soon as I stopped the prescription. Luckily, I found the effects of the meds to be far different than in the bad old days. I felt nauseated, lethargic and foggy-headed. Nevertheless, as soon as I stopped the meds, the withdrawals started - sometimes even between doses. It seemed strange to me as so many years had passed since I had taken Percocets. The best way I can describe it is with an analogy I heard from and a doctor I met in my first rehab - opioids addiction is like the difference between a DVD and a VHS tape (I'm dating myself here). When you stop a DVD, take it out for a long while and then put it back in, in starts from the beginning. Pop in a VHS tape after a long period and it picks up right where you left off. More scientifically stated, the body "remembers" the levels of synthetic excitatory enzymes vs. the inhibitory ones from when one was using and when synthetic one are reintroduced, those old inhibitory enzymes "remember" where they were and kick in quickly.

Okay... I am not a doctor, and one may easily find holes in that analogy, but you get the idea.

So, I gave into the fact that there was no avoiding the dilemma and found a wonderful, compassionate addiction doctor who agreed to help me develop a game plan and manage my dental saga. He started me on Suboxone after the first, horrible surgery and when each successive surgery approached, he would switch me onto just Subutex for a few days before so I could be knocked out during the procedure and allow me to take pain meds for a few days and then switch me back onto Suboxone until they next. This allowed me to maintain my serenity and keep me from a real relapse. Now the dental reconstruction is over and I have tapered from 16mg a day down to less than 2mg a day. To be precise, I am taking each 8mg strip and cutting it into 12 small pieces, amounting to approximately 3/4mg. (For those curious as to why I'm not using the 2mg strips, it's because of the price - while you'd think the 2mg strips would be markedly lower than the 8mg, the cost is nearly the same.) I am currently taking two of these pieces a day and am now stretching out the time between doses. My comfort level has lowered. My nose runs constantly, I get chills, sweats, aches, etc. but these have all been manageable and nothing like the times I was forced to go cold turkey when my supply ra out when I was using. My doctor has me on Clonodine and that helps a lot. I am continuing to increase the time between taking the Suboxone as long as I can before more acute symptoms kick in.

While I am hopeful I'm also a little worried as my time on Suboxone nears its finish. I a eager to read your stories and gain strength and optimism.

Thanks for reading.


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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 11:11 am 
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Hello and welcome Mr Taper.

I had all my wisdom teeth extracted yrs ago before my addiction started. They prescribed me hydro's, I had my gall bladder taken out and was prescribed hydro and I had awful tension headaches for yrs that I was prescribed hydro for but never got addicted to hydro's. But after reconnecting with my first love from highschool lol and he had an addiction to morphine and oxycodone 30's, I eventually tried em and almost instantly became addicted. It's weird how that it happened because I'd escaped it my whole life until then. But it happened and eventually I lost everything and everyone.

Once I found suboxone, I had a second chance and took full advantage of it. I'd tried rehab, detox after detox but nothing worked long term.

This is a great forum for support, if ur just starting or tapering off. It's the best pro suboxone forum around :)
We're very glad u found us!!

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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 12:55 pm 
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Welcome Mr. Taper,

We highly suggest that you ask for the 2 mg's films after you've tapered down low enough to warrant them. They are easier to get down to low numbers. Take your sweet time doing this, it is not a race. Once you get down as low as you can go on the 2 mg's films, ask for the Butran's Patch or Belbuca, which comes in micrograms vs milligrams. Both are for pain and not opiate addiction. The one for addiction is called Bunavail. Just Google Buprenorphine products and you'll find them all.

The tortoise wins the race on this one. Just make sure you give yourself permission to go back onto Suboxone before you end up back on the full agonist pain meds.

rule

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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 1:07 pm 
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rule62 wrote:
Welcome Mr. Taper,

We highly suggest that you ask for the 2 mg's films after you've tapered down low enough to warrant them. They are easier to get down to low numbers. Take your sweet time doing this, it is not a race. Once you get down as low as you can go on the 2 mg's films, ask for the Butran's Patch or Belbuca, which comes in micrograms vs milligrams. Both are for pain and not opiate addiction. The one for addiction is called Bunavail. Just Google Buprenorphine products and you'll find them all.

The tortoise wins the race on this one. Just make sure you give yourself permission to go back onto Suboxone before you end up back on the full agonist pain meds.

rule


Hi, Rule.
Thanks for the encouraging words and important info. I was unaware of the Butran patch or Belbuca. I shall look into these, and will heed your advice regarding moving to the 2mg strips. I agree whole heartedly that in this race it *is* the tortoise that wins. I have not set any time-tables for myself other than a successful end of treatment and continued sobriety.

Thanks very much!


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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 4:23 pm 
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Hey Mr. Taper,

Welcome here. Congrats for all your efforts. Well done. You've had a very difficult and tough dental saga after 20yrs of recovery! Hoping you now have a beautiful smile and functioning implant teeth. Can only imagine the $$ cost. Great story that you sought addiction help with buprenorphine and completely avoided restarting active addiction! I know the dental work was brutal but you've ended up a terrific outcome due to your hard efforts. Just great.
A side note, switching from suboxone to subutex is not needed. Per Dr. J., naloxone is barely absorbed when taking Suboxone, and whatever tiny amount makes it past the liver isn't enough to amount to anything significant so its not a blocker nor can it cause precipitated withdrawal.

Agree w Rule on the 2mg strips. They are the same size as the 8 mg strip, so the film cutting guide works for both. Cutting up the 2mg strip will enable you to taper to micro doses.

Suboxone film/dose sizes:

2 mg/.5 mg = 22.0 mm x 12.8 mm rectangle

4 mg/1 mg = 22.0 mm x 25.6 mm almost square as is 2 times as wide as the 2mg and 8mg strip. Some folks like these for tapering bc its easier to cut up due to the larger surface area.

8 mg/2 mg = 22.0 mm x 12.8 mm rectangle and is same size as 2mg film.

12 mg/3 mg = 22.0 mm X 19.2 mm almost square, but smaller than the 4 mg square as is 1.5 times wider than the 8mg and 2mg film.

Wishing you my best! Pelican

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Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 5:38 pm 
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I love your analogy of the DVD and the VHS tape. I was born in 71 and remember when my dad had to go on the roof to turn the antenna just so we could pick up CBS on the night of the Star Wars network broadcast. No cable in rural Vermont! I think we got a VHS player in 1983 (maybe?). So I'm dated with you and probably older than you. :)

I suggest that you give yourself plenty of time between buprenorphine reductions. There is no need to rush.

Welcome to the forum!

Amy

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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 10:19 pm 
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Mr. Taper

Wow.....that's an INCREDIBLE story!!

You've been through so much. I too have a very painful dental history....so, I can totally relate.
What really stands out to me in your post is how you took a very scary & intense situation (your dental reconstruction) and turned it into a total testiment for your recovery!

Dental pain is no joke. It honestly makes your entire body miserable. It took a LOT of courage and strength to find an addiction specialist and come up with an AWESOME game plan like you did. I hope you're very proud of yourself.....because you should be!!

I don't recall your mentioning how long you've been on Sub maintenance. It's fantastic how well you've done at tapering! Is there any other reason you're considering tapering completely off other than you're truly ready to do so? I ask because as others have said....slow & steady is the best policy. I would also highly encourage you to have a support system in place (private therapist, NA, group therapy) if/when you do taper completely off.

Just know, this medication is NOT a "one size fits all" approach. Some feel it's useful only for a very short period of time. Other people benefit from yrs of maintenance & then taper off. And, others feel it's important to remain on Sub indefinitely. I'm sure you've heard all this before, but I'm just reminding you that you always have the option to remain stable on Sub.

I've been on Suboxone/Subutex for almost 8yrs. While I'm very proud of my tapering progress and the ENORMOUS strides I've made in my recovery and life itself....I'm nowhere near ready to taper completely off. I might feel differently one day. But, right now I'm VERY happy feeling "normal" for the first time since I was a child.

Please continue to post. I thoroughly enjoyed reading your story. If you do decide that your goal is to taper completely off, there are many extremely helpful taper threads. I'm sure you'll find this community to be as helpful and as supportive as I have over the years!


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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jan 20, 2017 11:36 pm 
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I enjoy it so much when someone is a good storyteller like Mr. Taper and you, Marie. It's quite possible that I've seen some or all of your story, Marie. I am not very good at remembering which person goes with which story and I feel like that makes me a bad moderator. I wish my memory worked that way, but it doesn't. Anyway, I would love to hear the story of why you didn't feel like a normal person from childhood until you started on suboxone. I imagine it's a very interesting story!

Amy

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 Post subject: Re: Hello, Everyone.
PostPosted: Sat Jan 21, 2017 11:55 am 
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There are ppl that have that nack of telling a story, one that u can literally be in the moment with them. There's definitely a few here that have that talent. I also see the ppl that's probably really funny, the ppl that just have that funny bone.

I also remember VHS tapes, I was born in 76. I remember going from antenna to watching our first VHS movie, like Rambo or something lol and my mom saying..... look how clear that picture is! I am totally with ya on that Amy!!

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 Post subject: Re: Hello, Everyone.
PostPosted: Sun Jan 22, 2017 3:28 pm 
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Pelican wrote:
Hey Mr. Taper,

Welcome here. Congrats for all your efforts. Well done. You've had a very difficult and tough dental saga after 20yrs of recovery! Hoping you now have a beautiful smile and functioning implant teeth. Can only imagine the $$ cost. Great story that you sought addiction help with buprenorphine and completely avoided restarting active addiction! I know the dental work was brutal but you've ended up a terrific outcome due to your hard efforts. Just great.
A side note, switching from suboxone to subutex is not needed. Per Dr. J., naloxone is barely absorbed when taking Suboxone, and whatever tiny amount makes it past the liver isn't enough to amount to anything significant so its not a blocker nor can it cause precipitated withdrawal.

Agree w Rule on the 2mg strips. They are the same size as the 8 mg strip, so the film cutting guide works for both. Cutting up the 2mg strip will enable you to taper to micro doses.

Suboxone film/dose sizes:

2 mg/.5 mg = 22.0 mm x 12.8 mm rectangle

4 mg/1 mg = 22.0 mm x 25.6 mm almost square as is 2 times as wide as the 2mg and 8mg strip. Some folks like these for tapering bc its easier to cut up due to the larger surface area.

8 mg/2 mg = 22.0 mm x 12.8 mm rectangle and is same size as 2mg film.

12 mg/3 mg = 22.0 mm X 19.2 mm almost square, but smaller than the 4 mg square as is 1.5 times wider than the 8mg and 2mg film.

Wishing you my best! Pelican



Thanks for the kind welcome and sage advice, Pelican.
I wan't even aware there were 4mg strips. I shall ask my doctor about these at my next visit. If, for any reason, my pharmacy can't get these, I'll switch to the 2mg strips so I can continue to lower my dosage in a consistent taper.

As for my dental situation, as horrible the experience was, I'm pleased to say that I do, indeed, now have a full set of straight, white teeth! For the duration of my reconstruction, I couldn't eat any solid food. My entire diet consisted of varied frozen dinners that I would cook and then place in a blender. During this time of eating goop, I assemled a long list of foods I intended to eat once I had teeth and I have ravenously gone through that list. Let no one take for granted the joy of biting into a steak, or turkey melt sandwich, or a slice of apple! It's wonderful to eat whatever I want again and not be terrified to smile.


Thanks again and I'm glad to make so many new friends here.


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 Post subject: Re: Hello, Everyone.
PostPosted: Sun Jan 22, 2017 3:29 pm 
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Amy-Work In Progress wrote:
I love your analogy of the DVD and the VHS tape. I was born in 71 and remember when my dad had to go on the roof to turn the antenna just so we could pick up CBS on the night of the Star Wars network broadcast. No cable in rural Vermont! I think we got a VHS player in 1983 (maybe?). So I'm dated with you and probably older than you. :)

I suggest that you give yourself plenty of time between buprenorphine reductions. There is no need to rush.

Welcome to the forum!

Amy


Thanks, Amy!


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 Post subject: Re: Hello, Everyone.
PostPosted: Sun Jan 22, 2017 3:44 pm 
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jennjenn wrote:
There are ppl that have that nack of telling a story, one that u can literally be in the moment with them. There's definitely a few here that have that talent. I also see the ppl that's probably really funny, the ppl that just have that funny bone.

I also remember VHS tapes, I was born in 76. I remember going from antenna to watching our first VHS movie, like Rambo or something lol and my mom saying..... look how clear that picture is! I am totally with ya on that Amy!!


I was born in the late '60's and vividly remember our family getting our first VCR. It was one of those enormous clunky models that featured a cassette loader that was similar to the eject seat on a fighter jet. As a matter of fact, I used to put objects on top of the machine and press the eject button and watch these things shoot upward and hit the ceiling.
What was also funny is that in those early days of the VCR, there were no Blockbuster stores, so our only recourse to get movies was from "independent" sources. If memory serves, the first movie we got was a poor quality bootleg of The Rocky Horror Picture Show. :-)


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 Post subject: Re: Hello, Everyone.
PostPosted: Tue Jan 24, 2017 1:46 am 
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So funny!

Amy

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 Post subject: Re: Hello, Everyone.
PostPosted: Tue Jan 24, 2017 2:01 am 
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My suggestion is to ask for the 2 mg films and your doctor can prescribe the amount you need as you go down.

Years ago I decided 6 mg's was my perfect dose, and it was for a long time. My doctor prescribed 3 boxes of the 2 mg films to equal 90. ( 90 divided by three 2 mg films is 30 days) Now that I'm on only 2 mg's now I am going to ask for the 4 mg ones so he'll only write the script for one box. That will still allow me to stockpile 50% of them. Then later on I'll switch back down to one box of the 2 mg films. By then I should be down to 1 mg again and still won't worry about running out. Plus, that way I only have to go in every 2-3 months instead of monthly. Much easier on my budget.

Good luck on your taper,

rule

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 Post subject: Re: Hello, Everyone.
PostPosted: Sat Jun 10, 2017 1:44 am 
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Hi, Everyone.
I wanted to post an update, if for no other reason, than to let any members who may be having trouble getting proper help know that there *are* truly compassionate doctors out there to be found.

When I last posted, I was in a quandary regarding finding agreement with my doctor about what I felt to be a proper dose of Suboxone. He was, in my opinion, pushing for too fast a taper. He reduced my dosage down to 1/8 of a 4mg film, twice daily. Even with Clonodine, this left me feeling nasty withdrawals symptoms throughout the day and feeling sleepy an weak. No matter how I tired to explain this t my doctor, he sinister that it was up to me to exert "mind over matter" by (literally) placing signs around my apartment with positive sayings to aid me in finding the strength to get through any periods of discomfort.

Out of desperation, I contacted a woman who runs a clinic in another state and, after explaining my situation, she said something that resonated with me in a big way...

"If I had a patient with diabetes, I would never tell them to skip their meds or lower their dose, and then blame them for getting sick because they were somehow weak. You need a another doctor."

With that wind in my sails, I searched my health care provider network for substance abuse doctors and found a clinic less than a mile from my apartment. I made an appointment and upon arriving, I was a little nervous, as the place was a bit off-putting. All my concerns were dissipated instantly when I was escorted into the doctor's office. He was compassionate, understanding, was willing to listen and get to know me and my unique situation and then asked me what I thought was a proper dosage. What a shock. When I told him what my current doctor proposed and what I felt was needed, he chimed in by saying that he felt I should be talking more. He felt that 1mg, four times daily was the safest bet. I was thrilled. Moreover, he said, "I'm not going to write on the script that you should cut the 4mg film into quarters as it's my experience that some pharmacists like to insert themselves into the equation, so I'm just going to prescribe 1 4mg film per day and you take it however you see fit."
WOW! A physician who gets it!
I told him that I had a few films left over and he needn't write for any that moment, and he said, "Good. keep them for a rainy day or a vacation. I'm your doctor now and I'm not letting you leave here without a script. Now take what will help you, tater off the Clonodone for now, enjoy the extra energy and get back to enjoying your life! Now get outa here and come back in a week!"

What can I say? I'm I love with this guy!

I feel a sense of relief and a weight lifted from my shoulders that is tough to explain. I feel like I'm finally in the competent hands of someone who not only cares about my individual recovery but views this as a two-way partnership with my health's best interest at the heart of the matter.

I hope everyone is doing well and can find such a relationship with their physician.


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 Post subject: Re: Hello, Everyone.
PostPosted: Sat Jun 10, 2017 11:45 am 
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Welcome back Mr. Taper! So refreshing to read your update and thanks for taking the time to post it. Yes, finally a doctor who gets it. Being an optimist, it's my belief that the longer we go with Suboxone treatment the more educated the medical field will get just from reading the medical journals, memo's, patient feedback, etc. A lot are still in the dark ages but that doesn't mean they won't get up to par in the future.

Glad to hear you took the tortoise position regarding tapering off. We surely didn't want to know you were back using again.

rule

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 Post subject: Re: Hello, Everyone.
PostPosted: Thu Jun 22, 2017 10:59 pm 
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that's awesome Mr. Taper, i'm glad you found the dr. you needed.

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 Post subject: Re: Hello, Everyone.
PostPosted: Fri Jun 23, 2017 12:41 am 
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I would like to stress the importance of someone coming back and posting an incredible update like this. As patients, I think it's important that we hear these stories of victory as much (if not more) as the stories of defeat. It's such an emotional roller coaster. And winning a battle with "the system" is worth bragging about!!

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 Post subject: Re: Hello, Everyone.
PostPosted: Thu Jul 13, 2017 5:38 pm 
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Oh, Mr. Taper!! I am just thrilled for you!

You were really very smart to seek another doctor and what a great result!! I don't know where you live, but if you could give info on your doctor for others in the area, please consider making a post in "Taking New Patients". Perhaps there are others near you who are having similar problems to what you had.

Thanks for the update!

Amy

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