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PostPosted: Mon Nov 28, 2016 8:02 am 
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So after a rather hellish induction I find myself free and clear and feeling well this am, which is the morning
of my 4th day of sobriety. I was prescribed 24 mg's to cover a large habit and the large tolerance that goes with that. Turns out I went to 32 mg's on my own, but I can't really be sure if the extra 8 helped me. I was just so miserable I didn't think it would hurt.

Yesterday I was able to cut that down to the prescribed 24 with no trouble, which is to say no return of the terrible restless legs or any other major WD symptoms. So my question is how does one find what's really needed after the induction process is over. I can see no benefit at all of taking a higher dose than needed, though it took me a while to wrap my addict mind around the novel notion that more is not always better.

OTOH I obviously don't want to rush anything. I very well might need the 24 mgs. I just don't want to addict myself to a higher dose than needed.

Any ideas on a safe approach? I do understand it's dangerous to get too aggressive in cutting down at this point.


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PostPosted: Mon Nov 28, 2016 8:51 am 
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From what we can all gather here, personal knowledge about short-acting opioids, you should stay where you are for about 2 weeks (at 24mg). That will give you enough time to make sure the short-acting are out of your system completely. Once that time has passed, you can then probably cut to 16 or even 12 without much effort at all.

The less is more effect will be more prevalent after this 2-week period...your body needs time to adjust and get all that poison out...so doing it that way would insure no feeling bad if you drop your dose.

Once you're ready to try this, I'd say try it doing 8 in the am, and 8 at bedtime. Or try 4mg, 4 times.

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PostPosted: Mon Nov 28, 2016 9:28 am 
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Thanks very much for such a good answer Jonathan. I appreciate the clarity. I'll go ahead and
follow that advice. I mistakenly wrote it was my 5th day, but it's actually only my 4th.
As I said I feel fine WRT any WD symptoms. But I feel like I got run over by a truck at the same time.
I also can feel the lack of my DOC. For the first time I've got some cravings, though they're minor.

I think Dr. Junig has written that it's best to take all your medication at once over the first few days anyway.
But for established patients it seems to be common for people to split their doses over the day, as per your recommendation. I don't suppose it really matters once you've got a decent blood level established, considering the long half life.

Thanks again for this.

G.


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PostPosted: Mon Nov 28, 2016 10:17 am 
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Good morning Godfrey, I got hooked on tramadol that I was taking for osteoarthritis. I also was experiencing some depression as a result of menopause. So, dosing twice per day really works for me. Suboxone, in my case, is treating the addiction, the pain, and the depression. Of course, here in the US it is only prescribed "legally " for addiction although pain management docs are starting to realize the benefits of suboxone to treat pain. It is being used in other countries for pain as well as depression. I can tell you that I dropped from 24mgs to 16mgs within a few weeks. I do agree with Jonathan, give yourself a few weeks to stabilize. Then you can begin to think about decreasing... and go slow! Just start with 2mgs and give it a week. If that works, try another 2mgs and see how you feel. You will find the dosage that is best for you. Have a wonderful day!


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PostPosted: Mon Nov 28, 2016 11:08 am 
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Good morning back Michelle. I gave you a shout out on the induction thread if interested.

That would be good news if there's some pain relief. I've been reading there's no analgesic effect
for those previously addicted to full on opiates. Perhaps Tramadol is a partial? Or if not then it looks like
I may have that wrong.

OTOH I have read that if you're used to a regular smallish dose, say 4 mg a day, that adding some on an occasional basis will give pain relief. I hope so as I have a chronic pain issue myself that's worse some days than others.


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PostPosted: Mon Nov 28, 2016 12:59 pm 
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Another thing Godfrey, once ppl get through their induction process, they start to realize that they have a big gap in their day to fill since they are no longer chasing their drug of choice....in ur case preparing ur tea. A lot of us were like....well now what?? That's where u need to get urself into something new or a hobby, something to fill ur time. It truly is a big adjustment. I got a treadmill, started going out to eat or more dates with my fiance and also I started shopping....a lot lol so u gotta know what's healthy and what isn't. I changed a lot of things also, I did anything different that reminded me of my routine when I was using. I even stopped eating a certain type of candy that I'd always get when I'd be high. It reminded me of using so I just stopped eating it period.

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PostPosted: Mon Nov 28, 2016 1:05 pm 
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Ditto on what jonathanm1978 said. That is probably true for every one of us. Most of us started very high and in less than a month we started reducing slowly not even noticing the difference. Then we realize that to take more than the ceiling it is wasting the medication.

I started at 24 mgs and in a year was down to 1 mg with absolutely no withdrawal effects. Amazing drug!

Welcome to the club. If you haven't guessed yet, we truly want you as a contributing member of this forum. Your experience is quite unique and will help others in the future.

Please stay,

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PostPosted: Mon Nov 28, 2016 1:34 pm 
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Rule.that's all very flattering and deeply appreciated. Of course I'll stay I owe this place a huge debt of gratitude...

Jennifer, you're so right. You know, I'm also a recovering alcoholic and xanax addict, also cocaine. But except for the tea, that was all years ago. I lived the addicts life back then naturally, lonely, low end, settling for less than nothing on just about every level.

I got sober in AA for what I was sure was for good back in the mid-80's. My life predictably did a 180. Suddenly friends, attractive, decent women, a satisfying career. Eventually I got married for the second in my fifties. I was a drunk during my first.

These days we have a good life, with enough money not to have to worry much and grandkids (courtesy my sweet wife). All the things I never thought I'd have during my 20's and 30's. Things I thought were permanently out of reach.

But I also got sick and was in a lot of pain and finally made the decision....with my wife's approval...to try opiates after I'd tried just about everything else. And it worked so well. I had my life back. For a good long while I couldn't have been happier. 5 or 6 years. But it's also true that I'm an addict. I began using too much, built up my tolerance. That can never end well.

It's only now that I'm realizing how much of my time and attention my habit consumed. You're so right about needing to find things to fill in the gaps. You sound like you've got it nailed though! Shopping, exercise, more dates, more restaurants! All good Jennifer. You're a good and caring woman. I wish you all happiness...


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PostPosted: Mon Nov 28, 2016 3:45 pm 
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My god, you just told my story almost to the tee. Sober because of AA back in April of '87 and haven't had a drink since. But I too let the little vampire out by enjoying the feeling of pain medication. Like you, it took years before my daily dose of 3 increased. By then it was too late and the vampire was up on top again. If not for Suboxone I shudder to think what the outcome would have been. My family said I looked ghastly sick just before giving up again.

Even though my sobriety was comprimised by pain medication I still am pleased by the fact of not taking a drink for just under 30 years.

We have a lot in common.

r

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PostPosted: Mon Nov 28, 2016 4:23 pm 
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Hah! No such thing as a unique story! 1 mg is impressive. Are you able to go a little higher on days you are in need of pain relief. Or wouldn't that work? Or maybe pain's not a chronic issue for you.


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PostPosted: Tue Nov 29, 2016 1:49 am 
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Pain was an issue but not anymore. If I take more it is strickly to "feel it", so I don't do it. I just take one day at a time.

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PostPosted: Tue Nov 29, 2016 10:08 am 
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Rule,

I had not realized that you'd be able to feel it, which is to say catch a buzz, by increasing your dose if your baseline is low enough....but it makes sense now that I think about it.

I think you mentioned something about feeling regretful about ruining your AA sobriety after such a long time, which of course is understandable. Just let me say that you sound very solid now, bearing in mind of course the one day at a time thing.


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PostPosted: Tue Nov 29, 2016 3:23 pm 
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Godfrey, when your baseline is as low as Rule's the level of buprenorphine in your blood plasma is often no longer stable. Not all of your opiate receptors are occupied by the medication, so if you took more, you might feel the difference. In some ways, buprenorphine acts more like a full agonist opioid when you are taking a lower dose.

You've gotten great advice from every single person here!

Amy

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