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PostPosted: Fri Feb 26, 2010 11:48 am 
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Hey guys!

All is going pretty well... tomorrow will be 1 month I am on the subutex, and I am overall very happy with my choice. I understand on a cognitive, biological level that the sub has a long half life, binds tightly to the receptors etc... but I am having a hard time not wanting to dose every few hours. surprisigly, the morning and late afternoon are the toughest times, but if I take my last dose at 3 or 4 PM, I am fine and good to go. I am prescribed 8 miligrams and he gave me 1 extra "just in case", but over the course of the week, there were times I needed to take another 2 mgs so that safety net is gone. I know I can be find on 8 mgs, but I feel like I need to take another quarter, another quarter just to feel a bit better... Does anyone have any input or solutions that worked for you? Have any of you had this struggle too? Any feedback or suggestions are very welcome!

Thanks!

MW


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PostPosted: Fri Feb 26, 2010 12:22 pm 
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Just try and remember that bupe is a potent drug and in europe they prescribe as little as .40 for analgesic pain. So when we take 4+mg that is usually more than enough to cover our physical needs. The mental part is another story which is what you are dealing with. Try to get yourself in some kind of social sporting activity for 2-3 evenings a week. Consider volleyball, tennis, bowling...etc. This will get your mind off taking extra. As long as you are sleeping ok everything else will take care of itself over time.

Just FYI... I was on a high dose methadone for 15+ yrs and was switched to 14mg subs. Over the last yr I've tapered to .50mg and feel essentially the same as when i was on the higher dose. The point is... you are likely getting all the bupe your body needs... you just need to wrap your mind around that fact. If you absolutely can't adjust... tell your dr and go on a higher dose.


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PostPosted: Fri Feb 26, 2010 12:45 pm 
Hi MW! I remember that feeling too during my first month or so on Sub. I had more leeway with my dose though because my doc had actually written me for 3 - 8mg/day. I never needed that much so have always had plenty of tablets to spare for when I felt I needed an extra small dose in the p.m. Yes, the thing is we know we don't truly need that extra dose if we're already on a good 8mg or so/day, but still.....the feeling is there whether it's a psych thing or a physical thing, doesn't matter that much in my opinion.....the feeling or need or craving or habit or whatever you want to call it is still there! So what to do with it is the question. My doctor's advice to me has always been to go ahead and dose with another 2mg and see if that takes care of it. The thing is....it's worked out pretty well for me, his loose methodology with dosing. I know I'm okay to take more and I did/do at times, but the fact remains that after a couple months on Sub I was quite stable and able to reduce my dose down to 8mg/day and then reduce further to 4mg/day within a few additional months. I guess just knowing that I was okay to take more if needed made the 'need' lessen pretty quickly if that makes sense.
I think a lot of it is a mental thing and I think distraction can help tremendously. When you hit that point in your day when the 'feeling' comes, go and take a brisk walk or make a phone call to a friend and talk about something totally unrelated to recovery, go get a cup of coffee or tea....just whatever, something to take your mind off for a few minutes. I know that has worked for me several times. If I'll just wait it out for a little bit, I'll find that I didn't really need that extra dose after all. But again, I think it's less about how many milligrams you're taking and more about how you're feeling. I don't see how there would be any harm done to speak with your doctor about bumping up to 10 or 12mg/day for a few weeks....that's not an uncommonly high dose at all and it may be all you need in order to get real stabilized, dose once per day and forget about it for the rest of the day, thereby breaking that habit of multiple doses.
Those were just a few thoughts for you. Know that you're not at all in an unusual place right now. You're still early enough in this to need a bit more time to get lined out. I think it's just all part of the process and it takes time to really get where we want to be, dose-wise, recovery wise and other wise!! lol! You're a good judge of what your needs are, so don't hesitate to call your doctor and ask for a dose adjustment if needed for little while. Your recovery and stability is paramount right now!
Hope that helps a little!


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PostPosted: Fri Feb 26, 2010 12:49 pm 
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yeah good call Suboxfreedom about importance of getting hobbies but I'd also suggest that you have someone you can trust but that isn't afraid to say no to you hold on to the medication for a predetermined amount of time. After not being able to reinforce the behavior in any way it will go away pretty quickly. I've even heard some people say it only took 3-4 days of not taking any extra before they had things back under control. Also you may want to be sure that you're getting really good absorbtion of the medication because if you're not then taking more could prove to be physically enforcing. If you can manage to get decent absorbtion then taking more will not lead to any increased "opiate effect". I take 8mg per day as well and the way I've found works well is put the tab under my tongue and while trying to keep the amount of salive down I move the tablet all over the area under my tongue. You can even break down a tablet with your teeth if you're in a hurry and you need it to absorb more quickly. The main thing I've found though is 1. Keep amount of saliva down to a minimum if you can 2. Don't swallow at all until after 30-40mins and the tablet is well dissolved 3. Don't eat or drink anything after for another 20-30mins.

Welp gotta get ready class take care mwflorida and I'm still so excited you came back to join us again :)

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 Post subject: thanks guys!
PostPosted: Fri Feb 26, 2010 3:37 pm 
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Thanks for the quick responses, I really appreciate it! Funny enough, the night is not my "craving" time. First thing in the morning and mid afternoon is. Today I took 4 mg first thing in the morning (about 6 AM), then the other 4 mg at 1 PM. I hope I can go the rest of the day without any, but around 4 PM is when I usually want another little bit. I am fearful that I will run short before my next appointment which is next Saturday. The center is really great and they told me numerous times to call if i need anything - and I could tell they meant it. Do you think i should call and ask for a few "safety ones", or just cut my dose right away. thanks set me free for validating that this is a normal part of the intro phase. last time, I was only on it for 18 days, this time its almost a month so its like I am starting all over again from scratch! I have identified that its not that I am trying to avoid withdrawals, or feel that I am starting to withdraw (other than chills), I still honestly miss the buzz. thats the truth. I still have that mentality that if I take a little more i will feel opiate good, not just "Im not withdrawing good". Does that make sense? Its hard to admit that out loud, but again, I am accountable to me and I feel the people on this forum are good, non-judgmental people who actually get it and have more experience than i do with suboxone success. I am having a hard time imagining reducing my dose voluntarily, though I know that is the goal, to be on a low amount long term... thanks for your stories, it helps to hear what the first month was like for you too!

have a great one!
mw


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PostPosted: Fri Feb 26, 2010 8:04 pm 
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Been there! I am glad you posted this. First, call your doc and tell him what is going on. Hopefully he will have an answer. For me, I have learned that anxiety telling me I need just a little bit more is exactly what I have to work on in therapy. Those are the feelings you need to further examine in my opinion. Those are the ones that make you feel so much more comfortable when you are on opiates because you are uncomfortable off of them. In my opinion, this takes something more than a chemical dependency counselor or NA. I think this takes a skills and qualified therapist. Anyhow....that could just be me. But this is my 2 cents on the topic.

You aren't crazy by the way :)


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