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 Post subject: Re: Hello.Need advice.
PostPosted: Thu Dec 22, 2016 9:04 pm 
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Hi Geoff,

I can see you are loaded with questions. I certainly don't dictate whether or not one of the doctors here responds back to you, but I can suggest that you give them a break. The fact is, your questions could all be answered with a little bit of diligence on your part. There is a tab up top that says, "Search". I think that you should consider using it before unleashing another barrage of questions on the doctors here.

The truth is that no one can predict with utter certainly how long you need to wait from your last dose of hydro to fully avoid precipitated withdrawals. The best we can do here is to make educated guesses. From what I've learned here, waiting 24 hours could very well work just fine for you.

What we suggest to people inducting on buprenorphine is to take enough of it to cover all of your opiate receptors. Usually, this means being on 8 to 24mg a day. Once all of your withdrawal symptoms are gone and once you're not craving/obsessing over your drug of choice, you can wean down to a lower daily amount.

The scientific research to date has been showing that it's necessary to be on buprenorphine for at least over a year. Any shorter period of time results in relapse as soon as the addict goes off the medication. I know that this is not what you want to hear, but it's necessary that we give you the most accurate information that we have. Buprenorphine is only effective while the addict is taking it, unless you take it long enough to completely turn your life around, or at least around 2 years.

I hope that since we got you started by answering a lot of your questions, that you can take the bull by the horns and search for some of your own answers. Especially since you are in a hurry to get them answered.

I hope you know that I'm not trying to be a jerk. I'm a moderator here and I feel some obligation to make sure that the doctors' time is not monopolized by one person. They do not typically answer so many questions from the same person. We have to spread them around a bit more thinly! Lol. They are here to help, but we don't want to burn them out by each person asking for an individual treatment plan. Does that make sense?

If you've already searched for an answer that you can't find, then go ahead and ask away. One of us will try to get on it. But it helps us if you can do some preliminary searching on your own.

We wish you the best and we hope that you will take our advice to heart.

Amy

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 Post subject: Re: Hello.Need advice.
PostPosted: Fri Dec 23, 2016 1:49 am 
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Just to clear up some possible confusion. Dr. Junig owns this site and is a very busy man, relying on us mods and members to run this forum. We run it the way he wants and we try to stay within his line of thinking. Most every question has already been answered in the TalkZone. If not, post it and we'll do everything in our power to help you. Just please look first. If Dr. Junig does answer you here, he does it pro bono. IMO, he should be paid for every question he answers. But he doesn't so that shows a great deal of altruism and empathy for us addicts who still suffer.

We do have another Suboxone doctor here (docm2) who is a member only and comes here when he has some spare time, which is rare. We feel very blessed to have two doctors giving expert advice, albeit only several times per month. Other doctors have logged in over the years but like all physicians, they are just too busy to return to give free advice.

Amy is only saying that your recovery is up to you. You will have a better chance of success if you put in the work to stay clean. Thank You Amy for that very informative post explaining our forum research base.

rule

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 Post subject: Re: Hello.Need advice.
PostPosted: Fri Dec 23, 2016 1:57 am 
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HI Geoff,

I'd only add to Amy's and Rule's comprehensive answers...and it's possible i just missed it... that most agree that time isn't the most reliable measure as to when it's safe to take your Sub, The only reliable measure is how sick you are, That's where the COWS comes in. IN my case, I waited 31 hours....7 hours more than the 24 suggested to me....and it wasn't enough.

looking back, I know I wasn't sick enough. I recall standing in the bathroom and watching my hand reach out for my first half tape. It was as if my hand had made the decision for me. I paid for that mistake with 2 or 3 hours of PW, plus another couple of days of being sicker than I needed to be. It's all in the rear view mirror now and I couldn't be happier. But I could have had a much better induction experience had i had a bit more discipline.

I was much like you, full of questions. But looking back, all I had to do was avail myself of the information readily available here and on other easily found parts of the Internet. It's not complicated, honest to Pete.
Stop your opiate of choice, get to at least 16 or so on the COWS, then start dosing with SUBS. I'm a new guy here, and don't know that much, but truthfully you don't have to.

How much to take isn't an exact science. Bupe is a very safe drug. If you've got a big habit, take at least 8 ...up to about 24. I took 32 because I got so sick. Because of the ceiling effect which starts at 4 mg or so, anything over say 16 to 24 won't do much additional good. Talk to your qualified personal physician to settle on an amount to take

After that, stay on subs for at least a year or two. You'll be fine if you all that. I can practically guarantee it.

Best
Godfrey




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 Post subject: Re: Hello.Need advice.
PostPosted: Fri Dec 23, 2016 3:06 am 
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Amy,

I can see that your intentions are good.Your tone is pretty hard for me to understand.

"There is a tab up top that says, "Search". I think that you should consider using it before unleashing another barrage of questions on the doctors here."

Whatever your intentions. that was a mean ass thing to say to someone. Yes I may have come here asking questions (to the site called suboxone talk zone..on a free forum)In my desperate attempt for answers after a short relapse,I am trying to recover from .and yes I missed the "search" button. My sincerest of apologies.
coming here asking questions is my diligence. You could have mentioned much much earlier in the thread I could search for things so easily if you wanted to convey that and i bothered you.

"What we suggest to people inducting on buprenorphine is to take enough of it to cover all of your opiate receptors. Usually, this means being on 8 to 24mg a day. Once all of your withdrawal symptoms are gone and once you're not craving/obsessing over your drug of choice, you can wean down to a lower daily amount.

The scientific research to date has been showing that it's necessary to be on buprenorphine for at least over a year. Any shorter period of time results in relapse as soon as the addict goes off the medication. I know that this is not what you want to hear, but it's necessary that we give you the most accurate information that we have. Buprenorphine is only effective while the addict is taking it, unless you take it long enough to completely turn your life around, or at least around 2 years.


I already mentioned I was on bupenorphine for many years.I have a program and a sponsor. I dont "want" to hear anything. The Dr. said to take .2mg or less not 8-24.

"I hope you know that I'm not trying to be a jerk. I'm a moderator here and I feel some obligation to make sure that the doctors' time is not monopolized by one person. They do not typically answer so many questions from the same person. We have to spread them around a bit more thinly!
I had no idea I was monopolizing the Dr's time and causing problems for them and you. If they felt that way I wish they would have just said so.Obviously my asking questions is creating some kind of friction. That wasn't my intention. I apologize.


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 Post subject: Re: Hello.Need advice.
PostPosted: Fri Dec 23, 2016 6:13 pm 
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Hey Geoff,

You're right. There are parts of my post that were downright bitchy. First, let me tell you that I have been dealing with really sucky dental pain for over a week now and it is making me short tempered.

Secondly, I'd like to say that I highly respect our military members and veterans, including you. My post did not reflect the respect I hold you in and for that I apologize.

My place here on the forum can be strange. While I like to help people, if I think someone is taking advantage of our doctors, knowingly or not, or my fellow mods, I will jump in. I don't concern myself with how most members view me. Anyone who has been here for a length of time knows that I advocate for all addicts, I protect the underdogs, and I truly care for most of the people here. But I would rather be the bad guy than have any of my mods or the doctors feel uncomfortable.

Your questions aren't a problem per se. It's just that you seemed to have an expectation of information being handed to you, without effort on your own. If you look at other threads that the doctors comment on, you will notice that your amount of questions is definitely on the high side. If you reread this thread, maybe you could understand where I'm coming from. It's kind of like you're getting medical advice for free, and I don't think that is fair to the doctors. You even asked Docm2 to create an individual timeline for you.

I didn't comment earlier in the thread because it hadn't, in my opinion, built up to the level of egregiousness. But when you asked questions about subjects which had already been covered, I finally commented. I thought you could have extrapolated your own answers from what had already been posted. What you seem to be asking for is a little bit of hand-holding while you are stressed over what is happening in your life. I don't think there's anything wrong with that, but this is not an appropriate place to receive that kind of attention. That's what sponsors are for. :)

I am sorry that I came across so harshly. I hope you have a Merry Christmas and a Happy New Year.

Amy

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

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