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PostPosted: Sat Sep 21, 2013 3:05 am 
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How long will the pw's last n wat should I do when I go into it bc it seem inevidable that when I take my first dose of sub's ima get sick but I'm determined to do it . I'm going to try again ima wait as long as I can then ima take a small piece of sub with out a doubt ima go into pw's so wat do I do next ? Should I take more sub ? How long will it take b4 I feel better


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PostPosted: Sat Sep 21, 2013 7:11 am 
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imsosick911 wrote:
How long will the pw's last n wat should I do when I go into it bc it seem inevidable that when I take my first dose of sub's ima get sick but I'm determined to do it . I'm going to try again ima wait as long as I can then ima take a small piece of sub with out a doubt ima go into pw's so wat do I do next ? Should I take more sub ? How long will it take b4 I feel better



Why do say that you know you will go into PW's? What are you taking & how much? You should be safe if you go by the COWS scale.

I was worried about that also. I did fine.


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PostPosted: Sat Sep 21, 2013 10:42 am 
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The severe part of PWs only last about 30-60 minutes, where you're stuck to a toilet cramping, heaving, etc. You might still feel crappy after that but you'll be able to handle it. Yes, take more sub. What that first dose does (if you get PWs..) is knocks the current opiates off your receptors. Once you go thru PWs, you need to take more sub to start filling those receptors. Take up to 24 mgs to get your receptors saturated.

Tiki- he's inducing onto sub from heroin, it's a bit more complicated than pharmaceuticals, for some reason. It's a more difficult switch.


Last edited by tinydancer on Sat Sep 21, 2013 3:18 pm, edited 1 time in total.

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PostPosted: Sat Sep 21, 2013 2:36 pm 
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I sure hope you have an easier time this go around. I have been following your story, but I don't have much to add. Tiny knows what she is talking about, and I would highly suggest you follow her advice.

I want to encourage you to stick with it. I can't imagine how hard it is to go through the WD and then get hit with PW's, not just once, but twice, after you tried so hard to get yourself ready for it. I can imagine the fear you feel to go after it again. Even though it is much more difficult to make the switch from heroin, I know it will be worth it for you! You can't even imagine how much better you will feel once you get your receptors filled with the suboxone. Please stick with it! You will be so happy once you get it done.

Do you have anyone in your life that you can share your problems with? I would be making sure that I had someone with me for your next attempt at induction. They can be there to help you through it, and then they can be there to celebrate with you once it's over. After all this mess you deserve to treat yourself to something special once you get the switch completed! You sound like a very brave and determined individual, I just know you are going to do well!

Please keep us updated on your progress ok?

Q

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PostPosted: Sat Sep 21, 2013 8:38 pm 
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The reason I said I'm no doubt gonna go thru pws is bc I've tried 2xs already to induce the 2nd time I waited 16 hrs n 15 mins after taking 2mg of sub I went into dripping cold sweat tremmors so my 3rd and final try is goin to b monday am I'm so scared but both times I went into pws I ran n got some H this time I'm going to struggle thru it . Yes I have family that is being very supportive n helping me thru this . So ima wait as long as I can take 2mg when pws kick in ill wait a half n take more sub this is the plan ... Wish me luck


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PostPosted: Sat Sep 21, 2013 8:41 pm 
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Ohh an for some reason I can't open the link for the cow scale whatever that is


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PostPosted: Sat Sep 21, 2013 10:11 pm 
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Google search.....naabt COWS.

Copy "naabt COWS", paste into google and search it, it will bring up a link to the COWS scale.

The COWS is a set of questions you answer that will help you determine how severe your wd is. It's best to get someone to score you as we tend to score ourselves too high.

IMO, you should reach a score of 18 or higher before you even think about inducing from heroin and this more than likely means you'll have to endure 24 hours of wd or longer.

It's up to you, you can wait until your wd is moderate to severe and induce without Precipitated Wd or you can induce too early and suffer Prec. Wd. (I'd opt for no PW, if it was me)

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PostPosted: Sat Sep 21, 2013 10:38 pm 
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Try clicking on this now and see if it works imsosick....

Cows Sheet

http://www.naabt.org/documents/cows_ind ... _sheet.pdf

If you click on this lonk it should open the Cows!


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PostPosted: Sat Sep 21, 2013 10:41 pm 
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It works every time I click on it!!

What I would suggest you do is to not take ANYTHING! And that means NOTHING that helps you to feel better. Get to where you are in moderate to SEVERE withdrawals. Score yourself on that Cows sheet and once you get to the 18 score or higher that Romeo suggested then it's safe to take the first dose of sub, not before!!!!

Karen


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PostPosted: Sat Sep 21, 2013 10:41 pm 
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Try to search it like Romeo told you. If you still can't open it and really want to use it (you really should) then I will try to type it out here in a way that will make sense.

I think the link is a PDF file if I remember right. Do you have adobe reader on your system? You can download it for free if not, that might fix your issues.

Q

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PostPosted: Sat Sep 21, 2013 10:49 pm 
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Here is a copy of the COWS. Answer each question and score yourself for each question then add up your score. Check your total score against the summary at the bottom to see how far into wd you are. (BTW, I was about a 23 on the COWS when I induced onto Suboxone.)

Resting Pulse Rate: Record Beats per Minute
Measured after patient is sitting or lying for one minute


0 = pulse rate 80 or below • 2 = pulse rate 101-120
1 = pulse rate 81-100 • 4 = pulse rate greater than 120


Sweating: Over Past 1/2 Hour not Accounted for by Room Temperature or Patient Activity

0 = no report of chills or flushing • 3 = beads of sweat on brow or face
1 = subjective report of chills or flushing • 4 = sweat streaming off face
2 = flushed or observable moistness on face


Restlessness Observation During Assessment

0 = able to sit still • 3 = frequent shifting or extraneous movements of legs/arms
1 = reports difficulty sitting still, but is able to do so • 5 = Unable to sit still for more than a few seconds


Pupil Size

0 = pupils pinned or normal size for room light • 2 = pupils moderately dilated
1 = pupils possibly larger than normal for room light • 5 = pupils so dilated that only the rim of the iris is visible


Bone or Joint Aches if Patient was Having Pain Previously,
only the Additional Component Attributed to Opiate Withdrawal is Scored


0 = not present • 2 = patient reports severe diffuse aching of joints/muscles
1 = mild diffuse discomfort • 4 = patient is rubbing joints or muscles and is unable to sit still because of discomfort


Runny Nose or Tearing Not Accounted for by Cold Symptoms or Allergies

0 = not present • 2 = nose running or tearing
1 = nasal stuffiness or unusually moist eyes • 4 = nose constantly running or tears streaming down cheeks


GI Upset: Over Last 1/2 Hour

0 = no GI symptoms • 3 = vomiting or diarrhea
1 = stomach cramps • 5 = multiple episodes of diarrhea or vomiting
2 = nausea or loose stool


Tremor Observation of Outstretched Hands
0 = no tremor • 2 = slight tremor observable
1 = tremor can be felt, but not observed • 4 = gross tremor or muscle twitching


Yawning Observation During Assessment

0 = no yawning • 2 = yawning three or more times during assessment
1 = yawning once or twice during assessment • 4 = yawning several times/minute


Anxiety or Irritability

0 = none • 2 = patient obviously irritable/anxious
1 = patient reports increasing irritability or anxiousness • 4 = patient so irritable or anxious that participation in the assessment is difficult


Gooseflesh Skin

0 = skin is smooth • 5 = prominent piloerection
3 = piloerection of skin can be felt or hairs standing up on arms


Total score _____

Score: 5-12 = Mild
13-24 = Moderate
25-36 = Moderately Severe
More than 36 = Severe Withdrawal

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PostPosted: Sun Sep 22, 2013 9:10 am 
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[
Tiki- he's inducing onto sub from heroin, it's a bit more complicated than pharmaceuticals, for some reason. It's a more difficult switch.[/quote]



Tiny

Thanks...I didn't know he was switching from heroin. I do have 2nd hand experience with dope & sub as my son is/was a recovery IV heroin addict. This is his 3rd time on suboxone & finally he is sticking with it. He has almost one year without using. He is also the one that's gonna be a daddy.

Anyway, my experience with dope & sub is that the person needs someone else to hold the sub & be super supportive. No matter that my son waited 26 hours...most of that time pacing & begging me for the sub, he still didn't feel "ok" after 2mg then 2mg 90 minutes later. He didn't have full blown PW's but he was feeling really sick, pupils still large etc. I used the COWS scale with him. Over a about 16 hours he took 18 mg & a comfort med. He was able to sleep & the next day he felt a bit better.


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PostPosted: Sun Sep 22, 2013 9:26 am 
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I hope you make the switch tomorrow & do well. The only suggestion i have is to have someone else score you & to stick with the sub no matter what. Give it a full 7 days & i bet you will be ok.

My switch from roxy to sub was also difficult. I stuck with it & finally at 3 weeks i am ok. The w/d i had that stuck around were those deep thigh/leg aches & bathroom issues, also low energy. To be fair i also had other health problems, which really made me want to say F it but i stayed with the sub.

If my son can do it I know you can. His entire life turned around. He has a live in GF, car, his own place, a good job & now a baby boy on the way.....just overall he has a "normal" life. This after living on the streets/shelters over the 10 + years he has been addicted.

One last thing, yesterday my son ran into a friend he had ripped off 10 years ago (got arrested & did jail time), ya know he needed money for that next fix, anyway...this friend actually gave my son his phone # again & they will be in touch again. My son felt so happy & that was when he realized how far he had come.

Please give the sub a chance. I will be thinking of you tomorrow....

Hugs
Tiki


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PostPosted: Sun Sep 22, 2013 10:16 am 
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^ Exactly, Tiki. I had the same issues, although I would have been topping the COWS chart after 16 hours. Thats why with H, I don't know how well it works. In theory yes, but in the moment everything goes out the window. It's the worst kind of dope sick I've ever experienced, I don't know why that is. I've been addicted to it all but ask me to go 16 hours or more off dope and I would have been willing to do anything for relief. And I mean anything.

Yeah, sticking it out is key, no matter what induction is like. It's nice to hear how well it's worked for your Son! It's pretty amazing, isn't it?


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PostPosted: Sun Sep 22, 2013 10:39 am 
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Tiny & Iamsick911

Yes sub can be an amazing tool in getting your life back. Sticking with the sub NO Matter What is really important because you will feel better...it's different for everyone but given enough time it is a wonderful thing to not be dope sick or crave your DOC.

This time my Son is working on Recovery. He see's an addiction counselor who is an ex-addict. I am so very Happy at where my Son is today.


iamsick-You can do it & please believe me it is worth it. Just stick with the sub & it may be a day or 3 days or 3 weeks but you will adjust & feel "normal" & that will give you the chance to change your life.

Tiki


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