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PostPosted: Wed Nov 14, 2012 2:56 pm 
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I feel so stupid being in this position, AGAIN! Facing withdrawal AGAIN! I started Suboxone 6 months ago from a 20 tab a day Tramadol habit and was afraid of withdrawal so thought Suboxone was the magical answer. Now I am stuck at 2x 8mg strips a day and when I try to taper, it just makes me want to take MORE! I have been able to do 8mg/ day all last week and now 4-6mg/ day for the past 5 days and am now starting to feel the sweating and anxiety coming on.

I figured that since I have only been on Suboxone for 6 months that it should be no big deal, my doctor even said he had someone stop at around the same dose and said it was "not that hard". The doctor is willing to give me Xanax and Clonidine to help with the symptoms. I even have an appt with my primary doc tomorrow to let her know the plan. My husband is supportive and willing to help with the kids. My dad has off all next week for the holiday, so he will pick the girls up from school and it is a short week, which means family will be around to distract me. So far all sounds pretty good.

Then the freak out happened. I researched opiate conversion rates online, they state that only 0.25mg of Suboxone is equal to 10mg of Morphine! Which means at 16mg/ day, I have a tolerance of 640mg of Morphine a day!!!????!!! It does state that Suboxone only has a 30-40% bioavailablility level, so that means at the least it's 192mg/ Morphine/ day. Is that really real!?!? How irresponsible of my doctor to put me in this position. He practically encouraged me to take "as much as you want".

So, now I am wondering how safe this is, should I just ask the doctor to give me more Suboxone and try my hardest to taper, or stick to the good set up I have and just grin and bear it.


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PostPosted: Wed Nov 14, 2012 4:27 pm 
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If I'm understanding correctly, you were on 16mg/day for about 6 months, 8mg/day for a week and now 4-6mg/day for 5 days and you're wanting to quit this Saturday, which would give you a total of about 7 days at 4-6mg.

I'm not gonna lie to you, personally, I don't remember hearing anyone jumping from that dose having an easy time with wd.

Suboxone wd is not as intense as pain pill wd, but it's still not fun at all.

Can you jump from 4-6mg and make it, sure you can. I was on Suboxone for almost 3 years and when I jumped, I did almost exactly what you did. I waited until a week or so before my quit date to start lowering my dose and I made it off of Suboxone. Was it easy....NOOOO, but I did it.

Ideally, I would ask you to get back on Suboxone and try a better taper, but if you're like me and you know you will bugger up a taper no matter what, then you might as well just jump.

The Xanax and the Clonidine will certainly help with your symptoms. Please, be VERY careful with the Xanax, you could easily wind up addicted to them and from what I've heard, they're even harder to quit than opiates. I used Xanax for a week or so during my wd then threw them away because I was so afraid of getting hooked on them. The Clonidine, however, is non-addictive. I stayed on it for months and months and had no issues at all stopping it.

As for the equivalency tables for Suboxone to Morphine, don't pay them too much attention. Those tables don't take into consideration Suboxone's ceiling and those tables don't predict how bad one's wd will be, they're designed around analgesic strength for the purposes of switching a patient from one opiate to another (I think).

I just have to say this one more time, ideally, you would get back on Suboxone and taper properly.

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PostPosted: Wed Nov 14, 2012 5:38 pm 
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Romeo- thanks so much for your honest and open response.

I think I am like you and I simply lack any self control when it comes to tapering. I tried it when I was on 40mg of Hydrocodone daily through pain mangement and the only time it worked was when I quit cold turkey and used things to help with the symptoms, sadly Tramadol was one of those things that helped me through the withdrawal. (althought THAT addiction started two years after coming off the Hydrocodones).

When I try to taper, I simply OBSESS about my dosage, when and how much, and I end up screwing up every time. It seems so much easier to just "rip the bandaid", I am really concerned about the safety of it.

My worst withdrawal symptom is anxiety. I get so terribly jittery and simply think and think and think about it. To what extent did the Xanax and especially the Clonidine help with that? I have really low blood pressure to start with (normal for me is 100/60), so I am nervous about taking a BP med. I have never liked the feeling of a benzo, so I'm not too worried about the habit there.

I am 32 years old and relatively healthy. I get regular exercise and have no medical condition, but I am still terrified. I have three beautiful children that I want to be here for and I need to be able to care for them during part of the day. They are old enough to care for their own basic needs, but young enough not to catch on to what is going on.

I am in a good place with therapy and I feel like I am working out a TON of emotional baggage that I ignored before. That is the only good thing that has come out of this Suboxone clinic.

My demon is pain. I have terrible neck and back pain that I have tried everything short of surgery to fix, now I just have to live with it. I have never gotten meds illegally, it's all been through well meaning doctors. Now that they are all on board, I feel safer. I have been out of work since starting Suboxone and am desperate to get back to work for financial reasons- we are hurting really bad, like daily medical-bill collectors calling bad. But I want to be off of it, so I don't have to explain it to a new employer, before starting a new job.

I'm very ready, but TERRIFIED!!


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PostPosted: Wed Nov 14, 2012 5:41 pm 
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Oh, one other question. My doctor doesn't let any of his patients stay on Suboxone for more than 1 year, he says it is easier to get off of it that way.

Am I better off that I've only been on it for 6 months? Or do you think it makes no difference?

Thanks so much,
JByrd


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 Post subject: breathe
PostPosted: Wed Nov 14, 2012 6:15 pm 
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Hey JB98 .... Ok you are in a rough spot right now .... BREATHE .... you're gonna be ok ... you have made decisions and listened to Drs and like Jon Kabit Zinn says "wherever you go there you are" ... panic is not a good thing right now and neither is jumping ... in my humble opinion ... You need to be strong and calm to jump ... you have to be confident about what your body is gonna go thru ... You have flooded your receptors and at 4-5 mg still feeding your ceiling level .... I agree with Romeo in suggesting you go back on and taper properly .... also agree there is no super easy way off any opiates but jumping that fast in panic mode after 6 mos is NOT what I would suggest .... seriously.
People have been on for years then gradually tapered and jumped ... NOBODY claims it's easy to do even from >.25 mg day
!!!!
calm down if possible ...
keep asking questions
get a plan and work it .... confidently


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PostPosted: Wed Nov 14, 2012 8:29 pm 
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No, 16 mg of Suboxone does not equal 640mg of morphine. Because Suboxone has a ceiling effect the conversion is not linear. Suboxone maintenance is equal to about 60 mg oxycodone or 80mg hydrocodone a day. But I do understand your feeling that being put on 16mg for a Tramadol habit is overkill - I went through a similar situation. The only consolation I can give you is that IMO Suboxone WD isn't as painful as Tramadol WD. But if you can even do a very short taper, it will be to your benefit.

The question is, are you sure you want to go off of it? It may be helping your pain - and you might find yourself turning to painkillers again when you go off. Many employers do not screen for Suboxone on their urine tests (it doesn't show up on a standard opiate panel).


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PostPosted: Thu Nov 15, 2012 1:05 pm 
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Hey Jbyrd,

The Clonidine helped me quite a bit with anxiety. Clonidine calms the Sympathetic Nervous System (the SNS is one of the things that goes nutty during wd....it did for me anyway!). The Xanax really didn't do much for me, then again, I barely took any. I was deathly afraid of it. I'm like you, I never had a thing for Xanax or any other benzo's, but I was still petrified of them.

I see your blood pressure is already low, the only consolation is that opiate wd is well known for raising blood pressure, so you may be able to get on Clonidine after all? Either that or you should start eating the hell outta some salt right now to raise your blood pressure!! LOL.

Whatever you do, you MUST check with your doctor before starting on Clonidine. My doctor prescribed me .1mg twice daily.

The fact that you're still young works in your favor, the fact that you already get good exercise and you're in good shape also works in your favor. I was 43 and not in the best shape of my life when I quit.

I'm going to try to answer your question about how long you were on Suboxone and how difficult it may be to come off, but it's really just gonna be my opinion, I have nothing to back these statements up with. I'd say if you were only on Suboxone for a matter of a few weeks, you would have a relatively easy time stopping it. You've been on it 6 months, it's already built up in your system, your body is quite used to and dependent on having it around, so I don't think there would be much difference between 6 months or a year or 5 years? Just my opinion.

Have you decided whether you're gonna jump or not. Whatever you decide, to taper or jump, we'll be here to help ya along.

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PostPosted: Thu Nov 15, 2012 3:39 pm 
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Thanks for your responses. I guess I overstated my anxiety over quitting. I really was in a good place until I researched the coversion table!
Lillyval- THANKS for the information, I failed to consider the ceiling effect- duh! I do agree about the pain relief, my pain has been worse while cutting down.

I still plan on going cold turkey on Saturday. I will have 7x 8mg strips of Suboxone at my disposal if needed as well as 1mg Xanax tablets.

I made an emergency tool kit which is full of vitamins (which I started loading up on this week), teas, hard candy, Melatonin, Immodium, Robitussen, ibuprofen, Tylenol PM, Energy Drinks, Scripture readings, insirational quotes, meditation exercises, as well as a list of things to do such as: Hot Bath, Mantra, list of projects, etc.

I have my family available to me all next week, which is a big motivation factor to do this NOW. I also am trying to apply for a job, so I want this to be done, and not have to lie to a potential employer prior to starting.

I am working closely with my doctors and therapist and have weekly appts scheduled. I feel like I have everything in place, just that I am jumping at a high dose. It is too hard to taper and if I try to just hand them over to my husband, I know that lying and sneaking with just start again, and it will become a game of, where to find the meds.

I am going to do this, but knowing that if it gets too hard, I have options and maybe it will be a wake up call to go slower.

Thanks so much for all of your advice, it helps knowing that you all know what I am going through. I'll keep you updated.


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 Post subject: go for it
PostPosted: Thu Nov 15, 2012 6:45 pm 
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Hey JB98 .... sounds like you have a plan and are prepared to face the jump ... please keep us posted and keep a log ...
It would be very valuable to many in this forum. Proud of your courage !
prayers are in for ya. Remember days 1-4 are hard but days 5 -10 are the "will this never end" period. It does end ...
Just takes time and determination.


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PostPosted: Fri Nov 16, 2012 2:28 am 
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I developed a tramadol dependency a few years ago. I was taking between 500 and 700mg per day. It was prescribed by my doctor and I was told it was non addictive which is very untrue. This drug may not bind to your opiod receptors in the same way that hydrocodone or oxycodone does however when I tried to quit cold turkey I found out first hand what withdrawls were. I actually worked through this on my own and tapered myself off of the tramadol. I tapered myself down at 100mg intervals every 3 days until I was down to 25 mg for the final 3 days and then stopped taking it and didn't feel any withdrawls. I was on this drug for almost a year and was so happy that I got off of it.

Is there any chance you can maybe get back on the tramadol and taper yourself off that? I'm not sure how much tram you would need to take to replace your suboxone treatment at this point. I can't believe your doctor put you on that much suboxone for a tramadol dependency though. That was very ignorant of your doctor to do and I would question their understanding of drug dependency altogether.

I have found I have had the best luck when I have done things on my own. Most doctors are idiots and just want your money anyways. Luckily there are forums like this where you can get better information from other people that have been there and done that.


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PostPosted: Fri Nov 16, 2012 3:22 am 
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hi jbyrd98". i hope you taper or jump in the most help full way and the best comfort. i like romeo's say on this. but it all ways say's trying to taper off a less strong or addictive drug can be the hardest way for some reason. i think the reason is being cot up on the less addictive and less w/d drug can make a addict think it's not all that bad and in time abuse the simple less addictive and less w/d drug not saying they all are :? i no i'might jump some day and don't see me putting up with it, i had to much pain in the past 50 years and i no my self enough and hope i'm wrong. i am on 22mg for 3 years now at 54 years. pain patient

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 Post subject: Feeling Peaceful
PostPosted: Fri Nov 16, 2012 6:57 pm 
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Just wanted to give a quick update and thanks to you all.

First of all Macboy- thanks so much for the encouragment, I need all I can get right now!!
Shaz- I have thought about trying Tramadol for withdrawal, but I have decided that would be feeding the demon and if I don't have the will power to taper Suboxone, there is no hope for stopping Tramadol at this point!!

Today is my daughter's 8th birthday, so I have to run out to dinner in a minute. Nice distration on a day like today.

I took 4mg of Sub today. I tried to get by with 2mg, but I think I got caught up in the nervousness and was trying to not be in w/d tonight for my daughter's birthday.

I had therapy yesterday that really helped, she thinks I am ready! I felt so confident today I found myself giving advice to my mother who is massive depressive mode right now. I am desperately trying to get her to see my therapist. My mom is not an addict- yet. She has bad behaviors towards medications, like taking hydrocodone with alcohol to "make it stronger". :roll:
She is the one thing that I am worried will blow my efforts, but I won't let her.

I think I might take a 2mg dose tomorrow afternoon, just to taper a little smidge more before cold turkey. So Sunday Nov 18th is looking like my official jump date and I am feeling really good about it at this point. I have been through hydrocodone withdrawal with much less help/ support/ and no Xanax, so in comparison this should be OK, of course I am not being unrealistic. I know I will not get much sleep or get much done in the next couple of weeks, but I am prepared.

I will keep a journal and maybe pass some of the things I have learned in therapy to you all tomorrow. Until then, THANKS so much!!


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PostPosted: Sun Nov 18, 2012 4:55 pm 
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Hey JByrd hope you're doing good. How is the withdrawal going? I could totally use things you learned with your therapist, if you still can post them.


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 Post subject: I agree
PostPosted: Sun Nov 18, 2012 6:34 pm 
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Shaz ... i agree with what you said ... Tramadol to suboxone ??? ... amazing a Dr did that !
Warm oven to a sizzling frying pan ... my prayers are in as before.
Let us know how you are doing


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PostPosted: Tue Nov 20, 2012 12:36 am 
I'm on two mgs of subs aswell. Even though im prescribed 12mg a day. Just to be safe. Plus i am on the patient assistance program so i get em for free. The last two doctors i know taper people off of subs and put patients on tramadol for 9 days. I CANNOT believe your doctor put you on 16 mg's of suboxone for tramadol. That is so WRONG!!! I don't wanna seem discouraging. But i used to buy tramadol online and was taking 200mg to 300mg a day for 2 months straight and cold turkey it without feeling anything wrong.
Now getting off subs compared to tramadol in my opinion is like a alcholic switching from beer to whiskey. i am really hoping for the best my friend. I would welcome tramadol w/d 3 times back to back then sub w/d once. : /
Please let me know how your doing any report any side effects. Keep strong man, it's all temporary!


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 Post subject: Taper
PostPosted: Tue Nov 20, 2012 1:23 pm 
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JByrd98,

I was looking at your post, I am currently tapering off of Sub, was at a max dose of 32mg for eight years. It was wrong and is a long story, regardless to say I have a new physician. I had tried several times to stop the sub rather quickly which provdied me with too heavy of a withdrawal process, but we are all different. I am currently at 3.5 to 4 and going down very slowly in .5mg incriments.

Right now I am not having anything acute just a bit of muscle aches and the depression of coure has been the worse for me. I have spent the last two years researching the issue of suboxone and am actually writing my dissertation for school on the withdrawal process.

It does seem that you are taping a bit fast, in no way do I want to dicourage you, no one has ever died opioid withdrawal alone, but most people have a tough time. The one time I switched to Duragesic from bup, I was still in withdrawal.

Any way I did want to see if I could offer you any tips, talk etc....I have loaded up on suppleents and am doing just about anything I can to help ease this process. I would say for you if your last dose is tommorrow the hard withdrawal should hit Thurs or Fri, it is usually 48 to 74 hours due to the half life.

If you would like to chate etc... feel free to sent me an private message. I have been struggling through my taper too, but am being positive and knowing I will beat this.

Good Luck and chin up


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 Post subject: A few bumps in the road
PostPosted: Wed Nov 21, 2012 6:08 pm 
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I foolishly decided to use my weekend, and almost what's left of my Suboxone, to get things done around the house, instead of starting my detox. I took a 4mg dose on Monday and now it's been 48 hours since my last dose.

I am mostly just irritable and anxious, I think over the anticipation of what's coming. I am also hot/ cold and lack any focus.

I took half of a Xanax last night and I slept beautifully, but I was not really functional.

I could use some advice about two important events coming up. I have Thanksgiving with some family that doesn't know what I am going through, and I also have my daughter's birthday party this weekend. I was contemplating either taking a small dose of Suboxone or a couple of Tramadol those days to help with the symptoms.

That's all I am up to at this point.


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 Post subject: gonna be rough
PostPosted: Wed Nov 21, 2012 7:09 pm 
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Hey JB98 .... i think all of us who "know" and are reading your thread do so with baited breath.... 4 mg jump is not a good situation ... there are no "i feel good moments" for perhaps weeks !!!! Please if you have some sub left .... enjoy the weekend and seriously consider a long term taper. OR .... hang on and don't pretend to be normal because what you are doing is not normal and as far as I'm concerned "super human"
prayers are in .... there are ways to increase BA if you are short on subs.
All three options not good things tho


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PostPosted: Wed Nov 21, 2012 8:17 pm 
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Macboy- thanks. Truth is, I've never been good at a taper. What does increase BA mean? I guess I am not hip with the lingo yet.


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 Post subject: bioavailability
PostPosted: Wed Nov 21, 2012 9:07 pm 
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Not sure it is prudent to go into it with you at this stage of jumping. You can google it but basically its different ways to ingest sub more efficiently than under the tongue. I really don't wanna be anything less than totally supportive in your jumping off sub and getting as far away from it as possible. I don't believe but KNOW that when a person says 'I WANT OFF' ... they are ready to be off .... problem is there are no more magic pills .... there is only one way this is gonna end ... and it is not a feel good story. I don't know you but am sooo impressed with your courage ... that courage is about to be tested. I know all the chemicals that people take to ease the fall .. all the good ones that work are illegal... so hang in there ... tell me how your feeling and I'll let you know what I can.
GOD BLESS YA and a brand new BETTER road


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