It is currently Wed Aug 16, 2017 11:29 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 7 posts ] 
Author Message
PostPosted: Thu Nov 29, 2012 1:38 am 
Offline
New Poster
New Poster

Joined: Tue Nov 13, 2012 3:12 am
Posts: 3
Hi all,
I've been on 8mgs of suboxone since September. The first week I felt like I didn't even need a half of a pill.it was so strong. Then after about a month, 8mgs seemed like the perfect dose. A couple months ago, someone told me that suboxone tolerance is different then other opiates. He said if you stick at one 8mg pill , then that's all your body/mind ever needs. While agree it's not like other opiates where you have to keep raising your dose just to feel normal, I somehow feel like it's not working as well as it did and I've been reading that the majority of people are on 16mgs, some all the way up to 32mgs a day! So I'm starting to feel like I need one dose in the morning and one at night not only because I think I've developed a tolerance psychologically but I work really long days and sometimes I get home really feeling like a second dose would be a good idea because I end up having cravings at night. (I take mine when I wake up). What's worse iis ever since I startedttreatment, my doctor has been adamant about me quitting smoking and I did. It's been over a month with no cigarettes but I've been chewing nicotine gum this whole time and I'm down to 2 a day and want to stop as soon as maybe in a few days. But now with out cigarettes and less nicotine in my system I've been having cravings. Do you think my doctor would put me on a second one at night? Next month is going to be one of the hoarders months of my life but I'm not quite sure if that's something I should say to my doctor as a reason to be knownthat a second one. How should I put it to my doctor so my doctor understands why it's important that I be on another without sounding like I'm using suboxone as a means of not dealing with life on life terms without nicotine and all the troubles in my life? I don't want to sound manipulative. I think I've been doing really good.

Any advice would be appreciated.


Top
 Profile  
 
 Post subject:
PostPosted: Thu Nov 29, 2012 8:43 am 
Offline
Power Poster
Power Poster

Joined: Wed Nov 28, 2012 12:45 am
Posts: 67
Hi there! Sorry, but I can't call you by the screen name you chose! You are not weak...powerless, maybe when it comes to your addiction, but you're working hard on that! Good for you!
My opinion on your situation: I tend to agree with what you were told about Sub being different...rarely does the dose need to go up once you've stabilized. You did acknowledge that at least part of your desire to up your dose was likely psychological. I think that shows a lot of insight & is probably the most likely issue. You're tired & you want a 'booster' dose later in the day.
The thing is though...taking something to change the way we feel is what got us in this mess to begin with, right?
You also said something about a lot of people being on 16 up to 32mg a day. In my opinion, that's ridiculous! I'm pretty sure the highest recommended dose is 16mg/day and I think it might actually have changed to 12mg/day...not at all sure about the 12, but I am sure about the 16. I think the doctors often Rx more if Sub is being used for chronic pain, but that's another story.
Sub has a dose level that once you 'hit' it (at around 4-8mg/day, usually, for most people) you get no further effect from upping the dose. Once you hit that dose, upping your dose will neither increase your effect nor increase your tolerance. It stays right where it is. The other thing that's different is the length of time it takes for Sub to leave your bloodstream...it's a long time (days not hours). Because of that, it "stacks" up on you...you take 8mg a day, but in reality your blood level is quite a bit higher once you've been on Sub for several days/weeks.

As to what you should say to your doctor: Tell him pretty much exactly what you told us. You did a fine job articulating your feelings and needs quite intelligently and insightfully here. Let him know your successes...you're off cigs, almost off nicotine gum, you're doing well on Sub, working, productive, etc. But youre finding yourself towards the end of the day having some cravings or feeling you need another dose. He may ask you if you're having actual w/d symptoms & just answer honestly. If I were you, I'd say something like, "I didn't know if it was possible that I might need another small dose later in the day, or if I should split my dose or what. I just don't want to do anything to mess up my recovery. What do you think I should do?"

Perhaps you do need another 2-4mg a day, maybe even another 8mg. But if I were you, I'd try splitting my dose first..Take 6mg at the usual time, then take your other 2mg in the evening. If that didnt help, I'd hope the doctor would up my dose, then try your usual 8mg in the morning and add 2mg in the evening. If still not better, up to an additional 4mg in the evening.
In my opinion, you don't want to be taking more of any med than is necessary. It can bring on more unpleasant side effects, increases cost, and just doesn't make good sense.
Above all, pat yourself on the back & protect your recovery. If you truly do need a dose increase...which you very well might..I hope your doctor gives it to you. Please let me know how it turns out.


Top
 Profile  
 
 Post subject:
PostPosted: Thu Nov 29, 2012 3:16 pm 
Offline
New Poster
New Poster

Joined: Tue Nov 13, 2012 3:12 am
Posts: 3
Thanks for the reply. The only reason I chose the user name is because it's one of my favorite songs by my favorite bands who did album about the recovery process but looking back you're right, probably wasn't a good idea.

Also, now that I'm not typing this on my phone, I wanted to correct this sentence from my previous post: "Next month is going to be one of the hoarders months of my life but I'm not quite sure if that's something I should say to my doctor as a reason to be knownthat a second one." I meant: Next month is going to be one of the hardest in months of my life but I'm not sure if that's something I should say to my doctor as a reason to of needing a second dose."

Everything you said was really helpful and I've thought about splitting dose but the thing is, I've been use to taking a full one in the beginning of my day for months now and I think I would most likely spend most of the day feeling like I should've taken more though its worth a try.

I will take your advice into consideration and ask for at least 2mgs at night to start with if not more. Luckily, insurance covers everything so I needn't worry about costs.

Thanks and I will let you know how it goes soon!


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Sat Dec 01, 2012 1:14 pm 
Offline
Power Poster
Power Poster

Joined: Wed Nov 28, 2012 12:45 am
Posts: 67
Glad you got my reply and posted again. I get your username now...I'm not 'up' on music unless we're talking 80s!
I really do encourage you to be careful about increasing your dose by much. I know how tempting it is to take more...that's addiction, after all. As I referred to before, with bupe, dosing appropriately mostly comes down to that ceiling effect...staying at or over it, and that dose varies a bit from one person to another.
Determining whether or not you're on the "right" dose should be a matter of a couple things. One being that you're not having withdrawal symptoms. By "withdrawal" I mean the real deal...sweats, chill bumps, runny nose, loose stools, insomnia, etc. When experiencing opiate w/d, the pupils of the eyes will be dilated (big) and if not the pupils will appear normal in size. When we're high on opiates or when we're appropriately dosed on bupe, our pupils will be constricted, oftentimes pinpoint tiny. I have found pupil dilatation to be a pretty good indicator for my own status, and medical personnel use this as part of their assessment when evaluating patients.
The other thing about finding the right dose has to do with how well your cravings are managed. For most people, once the ceiling dose is reached, the cravings for opiates is either completely eliminated or it's so low as to not be a big deal to overcome. And you're the only one who can know how you're doing in that regard. Most likely, without bupe, you'd be nearly completely obsessed with finding drugs. So you know what that feels like. So think about how you're feeling currently. Are you having serious cravings? Have you been thinking often about using, etc? Or is it more that you're concerned about making it through this upcoming difficult time without being high?
Anyway, it's all about your recovery and a huge part of that is discovering that you actually can handle things without medicating yourself. So weigh that all out and you'll come up with what is best for you.
I'm not a doctor or anything. Just trying to help you based on my own experiences and research.
Please keep participating here whichever way it goes. Keep us posted.


Top
 Profile  
 
 Post subject: constricted pupils
PostPosted: Sat Dec 01, 2012 10:12 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Jun 08, 2009 4:04 pm
Posts: 391
One of the side effects I have by taking bupe is pin point pupils.........I mean seriously consricted. It has bothered me so much that I went back to glasses instead of contacts. My docotor says No Worries most people don't notice that pin point pupils mean your on something...........but the fact that I know it makes me beleive everyone knows it. I really wish this was not one of the effects of this medicine but it not that big of a deal I guess as long as people don't make judgements and really the only one's that seem to notce are those that are in AA and when they get close to me I find myself not looking them in the eye....and we all know that is not a good thing......

Jim


Top
 Profile  
 
 Post subject:
PostPosted: Sat Dec 15, 2012 12:29 pm 
Offline
One Month or More
One Month or More
User avatar

Joined: Tue Dec 11, 2012 12:20 am
Posts: 35
I'm up at 2 a day now and think that's the right dose. After quitting smoking, cravings were high at night but once they start to subside, I may start taking both dosages in the morning. I do think 16 mgs a day is right for me.

And Jim, I definitely know what you're talking about but I only got pin point pupils for the first few days. I'd come to worm and people would say "dude you look so fucked up right now." How much are you taking?


Top
 Profile  
 
 Post subject:
PostPosted: Sat Dec 15, 2012 4:52 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Tue Nov 01, 2011 11:48 pm
Posts: 1346
Location: oregon coast
healingwaters wrote:
I do think 16 mgs a day is right for me.



You know,,, YOU KNOW yourself better than ANYONE else, only you know how bad/isolated
your addiction was,

I just wanted to say, don't let anyone tell YOU what YOUR dose should be....

Just thought I'd take this opportunity to let everyone else know that too, Im not trying
to pick on you or anything like that....

It just sucks the stigma, around this drug, and how some ignorant people think EVERYONE on suboxone
is high , all the time,, whatever......
I don't experience any kind of a buzz,,,, never have,,, and believe me, in the begining, I TRIED for it....
LOL
we are addicts afterall,, I mean, hell, at least we are consistant, right???
:wink:

anyways,,,
if you think 16 is right for YOU right now, then I'd just stay there, and NOT worry about it,
until YOU FEEL ready to change it......

and GOOD JOB on the quiting smoking!!!
JEESH,, it's HARD,,,
Ive tried SO MANY TIMES,,,,,
I have WHOLE HEARTEDLY tried to quit, at least five times in the last year,,

ALWAYS cave,,,, always,,,,,,,, It just sucks,,,,, I want to quit so very badly.......

Anyways,
[marq=right]~~~GREAT JOB~~~[/marq]

I bow to you*******

_________________
anyone can give up,
its the easiest thing in the world to do, but to
hold it together, when everyone would understand if you fell apart
That's TRUE STRENGTH
http://almostoneyearclean.blogspot.com/


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 7 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group