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PostPosted: Thu Mar 11, 2010 10:21 pm 
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Howdy gang,

Just hoping to get some advice and maybe some support because i'm not sure what i'm heading into here.

I'm about two weeks out of knee surgery and my surgeon says the worst of the pain should be done with, but i'm not really sure what that means. Anyway i'm less scared of the pain than i am of the withdrawals, and the two in combination. I've spent the past week in a sort of hell, flipping between too dmn many pills and low-level(?) withdrawals.

See my surgeon refused to deal with my post-op pain because of the suboxone and sent me home with 40 Norco 10's an told me i'd have to talk to my GP about anything else. Those seemed to work OK for a couple days, but now i think that was maybe because of the residual morphine, or maybe something they gave me in the hospital that i don't know about. Anyway on about the third day after my surgery i woke at about 3AM and couldn't get back to sleep. It's all gotten worse since then.

So i called my GP and he prescribed Percocet 5/325, one or two every six hours, and if anything i think that made matters worse. The stuff barely lasts me four hours and then i start getting uncomfortable. It actually took me another day or so to figure out that i was barely staying out of withdrawals. Unfortunately i was heading into the weekend, my doctor was gone, and i couldn't think of anything to do about it except to supplement with poppy tea, (my former DOC; i'd packed all the pods away years ago when i got on the Sub). I've tried to keep the tea to a minimum, maybe two cups/day made of 2tbsp powder. But i can't possibly take enough Percocet to keep me comfortable because i'd wreck my liver on the APAP.

I guess what scares me the most is the level of discomfort i've suffered this week, primarily in the morning. I've not gotten more than four hours of consecutive sleep all week, and i've only stayed in bed longer than that by taking a Perc and maybe a klonopin at 3 or 4am. When i get up it's because i can't stand to stay in bed sweating anymore and i go straight to the bottle and take four Percs to relieve the pain and misery and this is at most, six hours after my last dose. I don't know how i can possibly wait out the day, and put 24 hours between me and my last dose. Neither do i know exactly how i should induct; my doctor advised me to take half a pill initially or else i might get "nauseous".

I guess my questions boil down to...

1.) Has anyone figured out the half life of poppy straw? I mean, i know i'm dopesick in the morning but i've read some horror stories about bupe induction too soon with a poppy straw habit. So even if i'm sick, it's not near 24 hours sick and with my knee in this condition i don't know if i'd survive PWS. So i feel kinda in a pickle. But OTOH i don't recall any misery at all from inducting in the first place, from a really extreme tea habit. The main product i think is morphine which has a short half life but i know the tea lasts longer than the Percocets.

2.) Is the COWS test sufficient test for w/d, if i get myself to say, 15 or so? This is also somewhat confusing to me because previously, my first symptoms have been uncontrollable yawning and tearing. Now it's sinuses and running legs. So here i've got this objective measuring tool but subjectively my symptoms are all wrong.

Maybe i'm making things more complicated than necessary but like i said, given the level of pain and misery i'm already suffering at six hours, i don't know how to make it to 24. Excepting maybe by reminding myself of the possibility that the pain and misery could be exponentially worse... but i am frightened. I'm not a young guy, i've been through a lot of pain and misery, so i know what it is and what it isn't. This, is. I can't tell you, for instance, of the exquisite effect of a sneezing fit on a recently reconstructed ACL.

I do have an arsenal of meds to help. I've got clonodine, klonopin, mineral supplements, immodium, and five ambien the doctor gave me. I kinda wonder if i might be able to take the Ambien and maybe sleep until i'm sick enough? But OTOH given the merry-go-round of this past week and how tired, scared and confused i am, (and i get more confused the more distress i'm in), i worry about forgetting how much i've taken of what.

I hope that doesn't sound as confused as i feel. Any advice gratefully welcomed.

Thanks,
- joe


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PostPosted: Thu Mar 11, 2010 11:31 pm 
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I seriously wish I could help you but I haven't a clue what this tea thing is you are talking about. What I can say is I had a surgery once while on suboxone. I stopped the sub 3 days prior. They gave me percs for pain after, probably 60 of them or so which wasn't enough as I needed at least 4 just to get rid of the withdrawal. I was SO MAD because I was in pain. Well....I just said forget it and jumped right back on the suboxone and I was happy. The pain was livable but pain + withdrawal wasn't. You would be surprised how much pain you can tolerate if you know you are avoiding withdrawal. So.....if you are in withdrawal, i.e. large pupils, running legs, sniffly or sneezy, sweaty, if it was me, I would just take the suboxone. To be honest with you...I never waited that long and just took the suboxone. I was fine.


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PostPosted: Fri Mar 12, 2010 12:50 am 
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Hello!....I wish I could help you out, but I will post a quote from erowid.org. I AM GOING TO EDIT THE QUOTE AND WILL LABEL MY EDIT WITH THE WORD " *****EDIT***** "! Also, I am not going to post the exact link rather just the partial quote, but if you want to find the exact page it is not hard. If anyone would like it please PM me but I do not want to post the actual page for certain reasons. I would explain in a PM. I just don't think it should be posted here for anyone to see. Hope this gives some info on 'Poppy Tea':



Erowid wrote:
Poppy Tea
by Zort
Edited & Published by Erowid, Feb 2003
Introduction #
Poppy tea has been used for thousands of years and is still used as a home remedy around the world today. It is occasionally used as part of a home method for 'detoxing' off of other opiate / heroin addictions. Poppy tea is used as a pain reliever, as a sleep aid, as a cough suppressant, as an intoxicant, and as a mild relaxant. The flavor of crude poppy teas is quite bitter and strong and many people find the taste completely unpalatable (nasty). Poppy tea can have effects varying from very light relaxation and sleepiness to overpowering sedation. Nausea is common.



An Overview of Poppy Tea #
Opium poppies (most commonly Papaver somniferum) contain a number of opiates, including Morphine, Codeine, Papaverine, and Thebaine.

Dried Papaver somniferum heads are sold around the world, despite Prohibitionist drug laws. In the United States and Canada, the dried pods are sold as flower arrangement art pieces and in craft stores. Opium poppies are also commonly grown around the United States as ornamentals, although in the last 10 years, the DEA has begun to harass flower vendors. In the late 1990s, stores in large cities in the United States would often sell 10-20 dried poppy pods for 10-20 USD.

Opium poppy heads can vary in size, from marble size to larger than a golf ball, or about 2cm to 10cm in diameter. The average is about the size of a walnut, about 4cm across. Although the botanical names are sometimes mixed and confused, names of opium-containing poppies include: Papaver somniferum, Papaver setigerum, Papaver giganthemum and Papaver paeoniflorum. Some of these may actually simply be other names for sub-varieties of Papaver somniferum. Papaver giganthemums can have heads that are, well, gigantic.

NOTE: Potency of poppy pods varies dramatically from one variety to another, and from one crop to the next. Although experienced poppy drinkers learn to titrate their dose as they drink the tea, it takes time to get to know the material you're working with. Start low, work up.

Choosing a dose is difficult the first time out. When working with a new batch, starting with 1-3 medium sized pods per person is probably right. Regular opiate users and those with high tolerance often use 5-15 poppy pods. However, at the higher end of dosages, those who are not tolerated to the effects are likely to experience significant, unpleasant nausea and could overdose themselves. Opium is not nice to OD on and it is certainly possible to die if enough is taken.

*****EDIT*****














*****END EDIT*****


The taste is bitter and often considered foul. Many people mix other flavored teas into their poppy teas, such as licorice or other strong spicy flavor. A second steeping of the same crushed poppy mash can be done and the second extraction will be weaker, but still have some effect. Using less water for the second steep works well.

The stems can also be used in this process, but they are less potent than the heads. Many poppy tea drinkers don't separate the heads and just use the whole stem and head together for their tea making. If you have access to leaves, sometimes these are used, but are not as well liked as the heads.



Addiction #
Although this article will not cover the topic in any detail, I thought I'd include a note about opiate addiction. Although the effects of poppy tea are not as compulsion-inducing as smoked, snorted, or injected opiates, it is certainly possible to become both physically addicted and habituated to the use of opium poppy tea. Opiates are the classic psychoactive drug addiction. If you take in opiates for several days in a row, your body acclimates to the presence of the opiates and when you stop taking them, your body will take time to adjust. Unfortunately this readjustment can be extremely unpleasant and often leads people to take more of the opiates in order to avoid these sensations, allow them to sleep, etc. There are published case reports of individuals who found themselves with difficult opiate addictions after using only poppy tea. An even more troublesome issue is not just the physical addiction, but the emotional and intellectual habits that can form around using a daily psychoactive. Please be careful.












Any questions please just ask....

Good Luck!!!

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"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Fri Mar 12, 2010 1:28 am 
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Jackcrack wrote:
The pain was livable but pain + withdrawal wasn't. You would be surprised how much pain you can tolerate if you know you are avoiding withdrawal.

You don't need to know anything about poppy tea to help me, what you said right there helps me a lot because that's about what i been thinking all along. It's just scary considering the level of pain i suffer in the morning when presumably i have the least opiates in me. But like you say, it's proably better to have pain than to have pain and w/d's.

Also helpful to know you needed 4 Percocets just to be right, that's same as me. How long did you wait then?

I guess my question is... well... i just don't know how bad the w/d's can be, or should be before i take my Sub again. I had no idea all this time how powerful the stuff is and how high my tolerance was as relates to pain pills. Even so, when the usual timetable is 24 hours and i'm sick after only six, it's hard to reckon how sick i should have to suffer before i take the sub because the last thing i need is to get exponentially sicker.

Knowatimean?

The poppy tea *might* be a complication, i was only asking in case someone here had experience with it. Like i said, i packed it away years ago, i think it may have lost a lot of potency else i shouldn't be so sick so soon.

Thanks,
- joe


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PostPosted: Fri Mar 12, 2010 8:54 am 
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You can take a small dose of sub - like 2mgs or maybe even less - to help with your withdrawals and then just take the percoset for breakthru pain. When your knee is healed then just go back on your regular suboxone dose.

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PostPosted: Fri Mar 12, 2010 9:05 am 
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I must say I literally didn't really wait long. It was a couple years ago but I didn't worry about it. I think I took the percs at night and when I woke up I just too my subs and was fine. Had I woken in the middle of the night and didn't feel right I would have taken them then. Just take em already... in my opinion.


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PostPosted: Fri Mar 12, 2010 11:27 am 
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Diary of a Quitter wrote:
You can take a small dose of sub - like 2mgs or maybe even less - to help with your withdrawals and then just take the percoset for breakthru pain. When your knee is healed then just go back on your regular suboxone dose.

Wow... so says a Moderator, which makes it seem legit.

How is 2mg sub not gonna put me in withdrawals? Is that small dosage not enough to boot the Percocets? Is it an additive effect? Not that it matters, the percs are nearly gone, but that's the strangest advice i ever seen in reference to Sub.

What do you mean "just go back"? You mean i don't have to suffer?

I don't mean nothing personal that was just a weird post and contrary to everything i've learned. I did mention how terrified i am of PWS, didn't i? And how by inference it might damage my new knee to have it kicking around, or send me to the hospital because i can't deal? Not to say you're wrong either, that's just weird. Very pleasant thought if true, but weird.

Thanks,
- joe


Last edited by Joe McPlumber on Fri Mar 12, 2010 12:22 pm, edited 1 time in total.

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PostPosted: Fri Mar 12, 2010 11:32 am 
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AND, if it's so, and i can take a small dose of bupe right in the middle of taking full agonists, then theoretically i don't have to suffer AT ALL because, so long as i don't take any more Percs and my symptoms are controlled, i can simply up the dosage after a safe time?

Weird...

- joe


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PostPosted: Fri Mar 12, 2010 4:30 pm 
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Hi Joe -

I think you'll need to come to some conclusions yourself about how to balance suboxone with full agonist opiates.

Here's my (I'm no doctor) -

At roughly 4mg (given full absorption) - your opiate receptors are flooded by buprenorphine. Those attachments are stronger than full agonist opiates like percocet - so if you are on a consistent suboxone dose of 4mg or higher - you probably will have almost no help from percocet, or other pills like Norco, etc.

It's all about the opiate receptor.

If you are taking less than 4mg - say 2mg (By the way I'm well above 4mg) - then you have a little wiggle room on the opiate receptor for attachment. If you use percocet, or other full agonist opiate - you have in effect some attachment by bupe, and some by the full agonist - like a percocet.

When people have surgery, they typically do a couple of things:

Before surgery, taper relatively fast off suboxone - and replace that with percocet or equivalent. Then have the surgery and stay on percocet (no suboxone) - until they are ready to re - induct - and they follow the same waiting period of 24 hours - or moderate wd's.

Some can stay on a lower dose of sub (but you have to be there for like 3-4 days) - like 2mg then supplement with perc - like diary did.

They key to the last - is that your body is OK with the 2mg dose or lower than 4mg. You can't jump around due to the 37 hour half life of suboxone.

Hope this helps. Caution is advised in any mix. Diary was just relating an experience that worked at lower dose. Results may vary per individual.


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PostPosted: Fri Mar 12, 2010 7:50 pm 
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Just wanted to throw in my two cents. When I had a procedure in December I spoke to my subox doc about taking pain meds and going back on the subs. He told me to just wait up to 12 hours, that I didn't have to be in withdrawals to go back on the suboxone. I ended up not needing any take-home pain meds, but I did get heavy doses at the hospital. When I got home I went right back on the subs without any problems.

Not quite the same situation, but I wanted to share it with you anyway.

Good luck and let us know how you're doing!

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PostPosted: Fri Mar 12, 2010 7:54 pm 
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Precipitated withdrawal only happens if your opiate tolerance is higher than the maximum opiate-effect that you get from your dose of Suboxone. If that's the case, then when you take a dose of suboxone, the buperenorphine "knocks" the other opiates off your receptors but fails to fully stimulate them, thus sending you into withdrawal.

So, if your normal dose of full-agonist opiates is equivalent to 300mg of OC or 120mg of methadone or basically anything more than about 30mg of methadone, and you take Suboxone while you have that level of opiates circulating in your system, then you get PWD.

If you are taking percoset now, 4 at a time, and are still in withdrawals & not getting any pain relief, a small dose of Sub is not going to put you into withdrawals. That amount of bupe will just fill up some of the empty receptors, eliminating or at least decreasing your w/d but still leaving some receptors open to the full-agonist opiates for pain relief.

When you go to switch back from a minimal amount of full-agonists, like a few percs a day after surgery, you don't have to really worry about pwd. If your normal dose of Sub is 4mg or more then that would be stronger than the amount of opiates you're taking. If you're really worried about it, you could just wait like 4-6 hours from your last dose of percoset or something.

This all comes out of my personal experience with passing a kidney stone while I was on Suboxone. I was on about 4-6mg a day at the time, went to the ER, got 2 shots of dilaudid, which worked great even though I'd taken my Sub that same day. I didn't tell the ER docs about the Suboxone. They gave me percoset to take home, but when I took it by itself I just felt like I was in WD and it didn't help the pain. So I did some figuring and worked it out that I could take a small, 2mg or under, dose of Sub and then take my pain meds. I did not wait to go into wd before I went back to my full dose of sub and I was totally fine.

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PostPosted: Fri Mar 12, 2010 8:25 pm 
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By golly this is the smartest damn group of drug addicts I have ever been around :)

Take the bupe!


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PostPosted: Fri Mar 12, 2010 11:01 pm 
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Thank you guys so very much.

Yes, i been very worried about PWS, mostly because of the horror stories i've read, and i can't imagine how i'd deal given that i barely deal when i wake in the morning.

But i appreciate all your comments, and at least i'm less scared now. I took my last four percs at 5pm and i'm gonna take one more before bed with a klonopin, and see how i feel in the morning. If i got the runs and sweats and sneezes and busy legs like usual then i reckon a bit of Sub would only help.

I guess what this proves more than anything else is how fear and drama can make a bad situation seem worse.

Thanks again, hopefully i'll see y'all tomorrow afternoon, my 'normal' self.

- joe


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PostPosted: Sat Mar 13, 2010 11:08 am 
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I took 1/4 sub this morning becuase i thought i was plenty misery. Either it didnt work or it made me feel worse in any case i feel worse an hour later. Should i take more bupe or wait longer? Help please?

EDIT: nm, i took a clonidine and it knocked me for a loop, still sick but i'm not nearly as upset about it lol ;) So that and maybe an Ambien will get me to 24hrs or near it, then i wont be so scared and can just take my full dose.

- joe


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