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PostPosted: Tue Sep 27, 2016 12:56 pm 
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I am helping my daughter through withdrawal and the H in our area is cut with Fentanyl. Her last shot was 430 yesterday a very low amount. She took some colonapin last night to help her sleep. This morning at 8am she took 8 oz. Of the night time Elimidrol. We have been through this before, but she is very afraid of precipitated withdrawal and wants to wait as long as possible before induction to the bupe to avoid this pain. I am monitoring her blood pressure and heart rate, and they are both good right now. The COW is getting higher, but I think we are masking some symptoms with the other med and the Elimidrol.

Does anyone have induction experience with the Fentanyl laced H that can help us through this or help decide when we should start the bupe?


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PostPosted: Wed Sep 28, 2016 1:45 pm 
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Hey WeLoveDogs welcome.

I didn't answer yesterday because honestly I know very little about fentanyl laced heroin and I wouldn't begin to try to advise u about it in fear of telling u the wrong thing. I've never used heroin but I have used fentanyl and it's very strong as heroin is too I assume. Fentanyl stays in ur system longer than a lot of opiates, but I don't even know how heroin is laced with it... that's why I was waiting for someone else who possibly knew more to answer ya. I feel bad that nobody has answered and I'm hoping that ur daughter has figured it out by now.

Does she have a doctor that prescribes her the suboxone? If not she sure as heck needs one asap. Getting it off the street, continuing to see a dealer is just to risky. Plus what if it's inconsistent and sometimes she runs out because there's no suboxone.....then she'll be in withdrawal and buy whatever she can to stop it. It's just a recipe for complete disaster. Hopefully that's not the case and she has a dr. If so, then the Dr should have advised her exactly what to do in her induction. Precipitated withdrawal will happen if she takes her suboxone to soon. I don't know how to recommend a time from what she's used to taking.....I waited 32 hrs from a high oxycodone tolerance but not everyone waits that long. Also since fentanyl is in the mix, it stays in ur system longer, she'd probably need to wait longer than just a heroin user...but I'm not sure. Plus the COWS sheet is what a lot of ppl go by. If she does have precipitated withdrawal, just keep taking the precribed dose as directed. It will finally stop and she'll eventually feel better.

Hopefully Dr J or someone who's more experienced with heroin laced with fentanyl will be along. Please let us know how she's doing.

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PostPosted: Thu Sep 29, 2016 12:56 pm 
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We are heading into uncharted waters these days with the heroin not only being laced with Fentanyl, but also Carbfentanil, an elephant tranquilizer that is also an opiate. All these are being made either in China, Mexico, and possibly Russia from what I've read in the papers. The cartels seem to have a hand in it and who can tell just how strong these drugs are that are hitting the streets. The overdoses have skyrocketed in the last few months with the EMT's running out of Narcan.

A recent article stated that the supposed heroin being found on addicts is not heroin at all, but Fentanyl & or Carbfentanil. Very scary stuff.

Now we are going to have addicts whose tolerance is going to be through the roof if they can live long enough to seek treatment. With the 100 patient cap being in place that surely doesn't help any of them. Why the DEA and those in charge of handling our addiction crisis seem to know the least about the drugs out there I can't say. We seem to know more here and feel lucky to have found a Suboxone doctor to treat us. IMO, we are in the minority.

Personally, I can't give you an answer. Hopefully Dr. Junig or docm will chime in with their input. It is a very dangerous time to be an addict right now. The chances of getting a hot dose is very high. All I can recommend is to have your daughter come here to our forum for help and maybe she can find a doctor to treat her. Please tell her to be very careful of what she's taking. The drug dealers don't even know the potency of what they're selling.

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PostPosted: Thu Sep 29, 2016 12:57 pm 
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Many people who come for induction have used multiple opioids. The one that causes the most discomfort is methadone. Fentanyl can cause problems when used constantly at high doses, for example in people who are using or abusing fentanyl patches every day-- because in those cases the fat stores of the body get saturated with the drug, and elimination relies on metabolism by the liver, which is a slow process.

But even in those cases, people will do OK if they are in significant withdrawal before induction-- which usually means waiting about 24 hours.

The fentanyl-laced heroin doesn't have a consistent amount of fentanyl. That's actually the reason it is so deadly; one dose will be 'hotter' than another. But if she waits a good 24 hours, she should be fine with induction.

I'm going to write somethings in response to your question that are intended as general comments to other moms and dads. I don't know you at all, so I am not criticising you personally. I always worry a bit when a parent is helping their daughter or son with treatment. In my practice, I always had a standard policy that I wouldn't take a new patient whose mother or father called for the appointment-- because those patients never did well. This plays into the withdrawal thing a bit... people who have become addicted to 'fentanyl laced heroin' have experienced withdrawal many times. It is impossible to avoid withdrawal as a heroin addict; it comes every 8 hours, and NO addict is covered all the time. So it is unreasonable for a patient to accept withdrawal symptoms over and over, as a using addict, and then expect to never experience discomfort as a recovering addict.

To do well on buprenorphine, patients have to be ready for it. Many times, parents are 'ready' for treatment months or years before their children are. So I encourage you to have your daughter run the show with treatment-- make her own appointments, etc-- so that she knows where the responsibility lies.

If your daughter does experience precipitated withdrawal, she would do well to understand that using heroin is a deadly problem that has killed a lot of people, and she has put herself in a situation that will be very difficult to get out from. She WILL have days, while on Suboxone, when she is anxious and really wants to use. She will have headaches, and maybe even minor surgery, and she is to stay clean she will need to tolerate a bit more pain than other people. I'm not saying she doesn't deserve pain relief-- but she should know that people with addictions usually struggle, at least initially tolerating 'life on life's terms'. The ones who do well learn to tolerate discomfort; the ones who end up using again are usually the ones who think every bit of discomfort or anxiety needs to be fixed or medicated.

Precipitated withdrawal never lasts very long, even when it does occur. If she has any, her quickest way to comfort is to stick with the plan, and stay on buprenorphine. The people who try to bail on buprenorphine and take heroin or other opioids only end up sicker far longer.


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PostPosted: Thu Sep 29, 2016 6:47 pm 
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Thanks everyone for the feedback. Yes my daughter makes her own appointmentsite and was totally in charge of her induction. She just asked for my help to be sure she stayed on track. Her doctor prescribed the 1.4 dose (1 pill) of Subzolv and we started with 1 every hour for 3 hours, then 2 more the next hour, then 4 more the final hour on day 1. Day 2 she took 4 pills 12 hours after the last day 1 dose and has maintained that every 12 hours. Day 3 she went back to the doc to discuss progress and inquire about the 5.7 MG dosage pill and or Bunavail, as she had just discovered it was available. Doc called in the Bunavail for her and now she is freaking out about switching!

This is not our first rodeo by any means. She is 30 years old and has been an addict since 19 and been through 9 rehabs and a prison stint already. She managed nearly 3 years clean before this relapse began and has a tried a few times unsuccessfully to get clean without the doctor's help. She finally accepted she needed the Bupe to get through. Now the doc says she will need to stay on Bupe for life and she only wanted a 30 to 60 day taper plan.

I'm leaving the big decision to her. I understand I'm not in control of this AT ALL. We are just trying to keep open communication and be 100% honest so she can be successful.

I told her I posted on this board, and she asked several times if there was any responses. So thank you all for the feedback. Since she is stabilizing I will ask if she wants to take over and post on the board any of her concerns.

Her main complaint at day 3 is muscle pain in her back and legs. I appreciate the honest feedback that she will just need to understand there will be pain.

She is tough, she can do this.


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PostPosted: Fri Sep 30, 2016 11:52 am 
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That sounds like good news and all is not without hope. If she can stabilize on the Suboxone (Buprenorphine), get at least a year or two under her belt, change the behaviors that brought on the addiction, deal with the deep emotional issues via a 12 step program or one similar w/o the god part, then she will have a normal lifestyle and be used to it. Then after that she can consider whether she is ready to taper down or not. I've been on it since 2010 and am in the process of weaning down very slowly once again. The last time I got down to 1 mg, had surgery, then went back on to 6 mg's because that dose felt right. Yes, I may be lifer but don't like to think so. Many members here who thought they'd be on it for life have stopped. They just knew deep down when the time was right. That is what I'm waiting for. If it comes, it comes. If it doesn't, then I'm on it for life. My wife has said this is the best me she's ever seen since I've been on it. And don't believe for a second that it dulls emotions. I just watched a DVD replay of a Paul McCartney concert I went to years ago and an over abundance of feelings came to the surface. Totally overwhelmed with gratitude and love. It was hard to keep the tears in check. So no, my feelings are not dulled one bit.

Your daughter is on the right track. But please have her come here and join us. We'd love to meet her and this too is a recovery tool.

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PostPosted: Fri Sep 30, 2016 2:40 pm 
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Hello everyone,

I am said daughter of the experienced worried mother who has been through hell and back with me throughout the years. I appreciate those of you who answered our concerns as I wasn't exactly physically up to visiting a forum or even picking up a laptop for that matter at the time, so I asked my mother if she would post on my behalf seeking answers for my questions. As she explained, this is not my first rodeo and I have had a lot of experience with suboxone in the past, both long time use and short detox plans (mostly done while in an inpatient treatment facility). So, I am pretty familiar with the induction process.

The only difference is since the last time I had to deal with this a lot has changed. My mom got my clean time wrong as I was clean for nearly 6 not 3 years I believe she was referring to the clean time i spent in AA. I spent the first 3 years in the program and maintained the last 3 just living my life. The "prison stint" I did was a 9 month program called SAFP, I’m sure many of you are familiar with it. That was the treatment that actually stuck, I believe in most part because of the full year it kept me away from the people places and things I had grown so accustomed to and gave me the opportunity to learn to think, feel and experience life on life’s terms with no numbing agents.
I remained clean after that treatment program for another 5 years just about.

What caught me up was becoming a mother. I know that may sound confusing but let me explain why. I have dreamed of being a mother for as long as I can remember, most girls grow up dreaming of their wedding day or prom but I dreamed of the day I could bring a life into this world and show that life all of the beauty and guide it through the pain. I have had a strong maternal instinct as far back as I can remember. So when the day came to deliver my daughter I was filled with joy and had spent the past 9 months preparing everything to be perfect for her.

As luck would have it the doctor I had been seeing every two weeks for my entire pregnancy (due to a high risk pregnancy because of having been diagnosed with endocarditis at the age of 22 my heart was stressed heavily by the pregnancy). I had been completely honest with my doctor about my history of drug abuse and she decided to test me at each appointment for back up in the event social services got involved because of my record of past drug use. I was squeaky clean the entire time due to being in recovery and didn’t even want to take so much as an antacid for fear of harming my unborn child. But as often happens in pregnancy I had hellish heartburn and it became a necessity to keep food down to help my baby grow.

Now back to the day of delivery, I had a resident Doctor doing my delivery since my Ob had the flu. She tested my urine from the catheter bag and returned to tell me that I had tested positive for methamphetamine. I literally laughed at her and said that’s just not possible you should do another test. The second came back the same and I was terrified wondering how that could be possible. Not only had I not done any meth while pregnant, but even in my days of active drug use I didn’t use meth. So this was ridiculous.

They said not to worry that they would send it off to the lab for further testing and test my daughter’s urine and meconium once she arrived. What they did not tell me is the inexperienced resident immediately informed social services before awaiting these further test results. So the second my daughter came into this world she was whisked away by a gang of nurses into the nicu. I sobbed uncontrollably. The pediatrician informed the delivering doctor that she was in no way shape or form experiencing withdrawals and was a healthy 9 lb baby! Now call me crazy but I wouldn’t expect a mother who had been using meth to gain 50 lbs during pregnancy and deliver a 9lb baby.

After her urine test came back clean they sent off the meconium and returned my daughter to me in our private room. I thought all was fine until I got a visit from two CPS caseworkers the following day. By this time the tests had come back confirming my UA was a false positive due to my asthma inhaler and the antacid I was on. CPS did not seem to care - with the threat of taking my newborn daughter away they sent me for a hair follicle test and their own UA. I was in complete shock and panic that them taking her away was even a possibility.

I called My Husband who was at work and he rushed to the hospital to support me. They sent us both to the testing facility. So here I am the day after delivering my daughter all stitched up, not even released from the hospital making my way downtown to have chunks of hair cut out of the back of my head and painfully trying to urinate in front of a woman who was treating me like a disgusting criminal.

My husband went through the same process and once we returned to the hospital the caseworkers informed us that we would have to sign over temporary custody to my in-laws until the results came back. I was breastfeeding so I begged them to allow me to stay with them at their house and they agreed. They assured me that once the results came back clean all would return to normal and the case would be closed.

So for the next two weeks we waited to hear back from them with the results. By this time my daughter’s meconium results were back from the lab proving there were never any drugs present in her system during the entire pregnancy. We got a visit from the caseworker who informed me just as I knew that all of my results came back negative.

BUT..... and here's the kicker. My husband tested positive for THC. Upon hearing that we were quickly reminded of our baby-moon to Colorado where he had visited the dispensaries which are perfectly legal there and treated as if someone had gone to the bar and had a beer.
It was pure curiosity on both our parts since it was something so brand new and a wild concept to us we wanted to go see it for ourselves. I, of course, didn't partake but they gave my husband free samples and he thought what the hell we are on vacation and this is perfectly legal. Having no idea this could possibly ever be an issue and certainly not one with such devastating consequences.

Regardless, CPS kept the case open moving it to a different department and my "crime" was "abuse of a child" by allowing her to be near her father. I guess at the time of birth? Because we hadn't exactly had any time alone with our daughter what so ever. My entire birthing experience was ruined and before I even became a mother I was robbed of that experience as well.

This began the long drawn out process of battling with CPS and having them put more and more restrictions on our life and contact with our daughter. We were told this would take 6 months at the longest, when a year came rolling around with no end in sight and watching my daughter turn 1 without truly even getting to be MY daughter I lost it. I had been through so much pain and humiliation for something I hadn't even done and I snapped.

I began using pain pills for a back problem I was prescribed knowing good and well I had no business taking them and it was only a matter of months before I found my way back to heroin. Only 6 years later the drug I was so familiar with had changed. It was now in powder form and MUCH stronger. I was physically dependent instantly.

It was only a matter of time before I had a dirty drug screen and gave CPS what they wanted all along. They then completely removed her from us and placed her with his parents placing strict visitation only twice a week for an hour and a half. the more restrictions they put on me the more pain I had to numb. The case is in court now deciding whether or not to terminate my parental rights.

So I am now once again finding the strength to fight this battle, only things are different this time. The stakes are higher, the drugs were much harder to come off of and do the induction to the Bupe which was also very confusing because back when I had used bupe before there was only suboxone and subutex, now there are a variety of options and confusing dosages and charts to figure out the ratio of bupe from one drug to another.

And that is how I ended up on this forum... in a moment of extreme sickness asked my mother to post for me. I am now on day 4 of the zubsolve and am feeling more and more stable each day, yes I'm still achy and somewhat lethargic, but it is improving along with my hope for this to work for me this time around.

PS – Sorry for the life story, I’m sure there is somewhere better to post this. But once I started typing, it just started flowing, so I went with it. Thanks for listening and helping answer mine and my mother’s questions. I will be monitoring the board regularly and learning my way around here.


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