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PostPosted: Sat Sep 25, 2010 8:19 pm 
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Hello everyone.... I just joined and im loving the amount of support and the wealth of information here.

Ive been a long time painpill addict. Around 7 years. Started with a surgery and exploded into a 150 to 200 mg lortab addiction a day.

I was going into work last week and was thinking to myself about some stuff and decided that it was time to seek help and kick this habit if at all possible. I located a doctor and made an appointment.

I went in friday and left feeling better about myself along with a prescription for 7 subutex 8mg. made an appointment for this coming thursday. The doctor talked to me about what to expect and how to take the medicine. Told me he would see me next thursday to see how everything was progressing.

Here is my question:

I have enough meds to take one 8mg a day. i was only instructed about the first day(yesterday). He said take half, then if your feeling okay 2 hours later take the other half. i did as i was instructed and felt pretty good.

Now, today is saturday. i awoke around 8am. took half a pill shortly after. about 3 hours later i felt asthough i needed another half. now, that was about 9 hours ago. im feeling like i need another half. what do i do?

On the way out of his office the receptionist said to call her monday and talk to them about how i was doing and said my dose may need to be adjusted.

Is 8 mg a day a normal starting amount? I need to take more but im scared that i will be short and not make it til my appointment on thursday. When i call monday ill tell her. Do they normally refill the first week or need to make adjustments? What do i do? what would you do? Thaks in advance everyone.


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PostPosted: Sat Sep 25, 2010 8:40 pm 
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I would have rather the Moderator reply to your post. But since I see he hasn't seen your message, I will talk to you & welcome you. I am on Subs too. My Dr. started me on 8mg. That does seem to be the norm. One thing I will tell you about Subs is that taking more does nothing and then you might be short before your next RX. Your doctor may not like that & you could feel sick which is what you don't want. I too, am addicted to painkillers. I know how you feel.Be patient, things will get better.

I learned here that Subutex Or Suboxone will not let you get sick, but no matter how much you take you won't get that "high" you used to get.

I live in N.Y.C. where do you live? You sound like you have a good Doctor. When you keep reading the posts here & get to know the people here, you will notice how difficult it is sometimes to find a good Sub Doctor.

I'm sure the others will start writing to you. They are the greatest. They are so willing to help. They are sincerely interested in your problems. I hope you stay. There are many friends here.

In the meantime, please write to me. don't ever give up & don't ever give in. Love & hope Queenie


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PostPosted: Sat Sep 25, 2010 8:55 pm 
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thanks for the reply.

Im 6'9" and 285lbs. Not sure if everyone take the same amount to stop craving and feel better. thought i may should have added that information. If its useless then please disregard.

I live in georgia.

Again, thank you for all the help in advance.


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 Post subject: Can't be.
PostPosted: Sat Sep 25, 2010 9:21 pm 
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Tell me that is a typo. You can't be 6'9"


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PostPosted: Sat Sep 25, 2010 9:26 pm 
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No typo. It runs in the family.


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PostPosted: Sat Sep 25, 2010 9:30 pm 
Welcome Downsouth! Glad you found us and glad you have gotten into recovery. We all know how difficult it is to make that decision and then go forward with the appointment and start the medication. But what a relief once you get started, right?! I know it was that way for me about 14 months ago when I started on Suboxone.
As to your question. I am not a doctor or any kind of expert, but I'll tell you what I can based on my own experiences and those I've heard from others. As far as the 'usual' starting dose, you will hear quite a bit of variation there. Some doctors like to start their patients on as much as 24mg/day (3 - 8mg tabs.) I believe that the 'official' recommendation of the drug manufacturer or the 'best practice' standard is for a maximum of 16mg/day (2 -8mg tabs.) I assume that when doctors do start patients out on greater than 16mg/day, it is just to get them stabilized and then bring the dose down to 16mg within a short period of time after induction. Another instance when higher dosing might be necessary is when patients are taking Suboxone for a pain condition as well as for opiate addiction. All that to say that 8mg/day to start out with is what I would call a fairly conservative dose. Is it enough? That's where it gets tricky. Everyone is different and you've got to work on getting the appropriate dose with your doctor, which is what it sounds like you're doing. If the doctor said 8mg/day period then I would stick to that until you talk to the office on Monday. If he gave you some latitude with dosing, you're certainly not going to hurt yourself by taking more. In fact, at this early in the process, you may indeed need more than 8mg/day to get w/d symptoms and cravings under control.
The other thing I would suggest is to look into what it is that is leading you to feel you need more. Are you having physical withdrawal symptoms or cravings or is it something else? Remember that our brains have been wired to need multiple doses of lots of pain pills for a long time. Those habits die hard! One of the great things about Suboxone, in fact, is that if you really don't need more and take more anyway, you won't feel any different.
Do all the reading here that you can. You'll learn so much about this medication and get such support here. There is information on the forum about maximizing absorption to make sure you're getting as much out of your doses as possible, and about how the 'ceiling effect' of Suboxone works. You can do a search on those topics and find complete explanations if you're interested.
Hope that helps a little bit. Again, glad to have you here. Let us know how you're doing!


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PostPosted: Sat Sep 25, 2010 9:50 pm 
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HELLO Down South,

Welcome to this forum and welcome to addiction remission!! :) Congratulations on taking your life back!!

As far as the the dosing, I would have to somewhat agree with setmefree. If what you are feeling is w/d's or if you are having bad cravings I would ABSOLUTLY take another 4mgs or even 8mgs if need be. It really depends on how you are feeling. I don't think there is 1 set normal dose as we are all different. I was inducted at 8mgs and within the first few days went up to 24mgs. Overall you should in no way be feeling w/ds or bad uncontrolable cravings and if you are take more. Suboxone is here to eliminate that part and that part only of addiction.

Again welcome and feel free to PM me and all the others here with any questions, concerns, or just to vent thats why we are here. There are online meetings on Mondays at 9pm or if you ever need to talk any other times a few of us meet a few times a week to chat just write a time and well be there!! Wish you the best of luck :)


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PostPosted: Sat Sep 25, 2010 10:22 pm 
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thanks hancal.

i was just worried about using up my "weeks worth". I know the lady in the office said to call her monday morning to see how i was doing and to see if the medication needs to be adjusted.

im guessing they can give me more if i run out within my first week. lots of worries. im loving my new life though.

And thanks to all who have replyed so far.

I would like more information on these online meeting as i see that it would be yet another helpful tool for me to use in this battle.


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PostPosted: Sat Sep 25, 2010 10:37 pm 
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Hello Down South,

Hatmaker runs the Monday 9pm online meetings they are listed in the 4th topic down and she will post a reminder the day before. There is usually a topic but we will always discuss any problems first! I am not sure where you live so the time might be different but click it and it will direct you to the correct time!

I would think that is what your Dr. would mean by call me on Monday and let me know how your doing. It might be best to wait to talk to your Dr. first but if I would hate to see you suffering :( Is there a way you could call him and explain how your feeling?

I wish you the best and hope you are feeling better :)


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PostPosted: Sun Sep 26, 2010 7:54 am 
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I agree that we are all a little different so dosing is different. With that being said, I also think 8mg isn't really the norm. It seems to me that most people are started on about 16mg per day. First thing is to make sure you are taking the medication properly and keeping it in your mouth long enough to get maximum absorbtion. In terms of taking more, it really depends on if what you are feeling is true withdrawal or just typical anxiety most people feel when they stop taking the full agonists. I think this is why most people are started on a higher dose and then brought down because at a higher dose, you ENSURE you really fill up those receptors which takes a week or so to do. You don't want someone new in recovery left hanging with half their receptors open and craving. So it does make sense to me that on day two you are feeling like you need a little more. But I am always quite cautious about taking more or recommending such without Dr.'s permission. Weekends are rough because you can't really call. I have always had weekend access to my sub docs but since you don't, my recommendation would be to at least leave a voice message if you are going to take more and let him know what you are doing and just tell him you don't know what else to do. This way he doesn't feel like you were being your own doctor and disrespecting him or anything. Depending on the doctor, they could still be mad about it.

Good luck! Welcome to the forum!

Cherie

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PostPosted: Sun Sep 26, 2010 8:45 am 
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Based on what you told us you were taking, I would say that dose is a bit low. Call your doctor and tell him you are still having strong cravings for drugs. He'll probably have you come back in to the office to check your vitals, then up your prescription to something a little more realistic.

I haven't seen this all that often, more often I see folks started on a dose that is way too high, not too low, but it appears your dose may be a little bit low.


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PostPosted: Sun Sep 26, 2010 11:25 am 
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Hello and welcome. I, too, get the sense that perhaps your dosage IS too low. It's not at all unusual to need a higher dose initially. If it were me I'd call the doctor, his or her service or voicemail and let them know you feel you need to take more and that you hope you're doing the right thing. It's also common in the beginning of treatment to dose more than once daily. Once stabilized most people get to the lowest dose possible and dose once in the morning and then forget about it. Like Jackcrack said, the induction is a time to get those opiate receptors saturated so there are ZERO withdrawals and cravings. I would just keep in close contact with the doctor. Good luck, welcome, and let us know how you're doing.

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PostPosted: Sun Sep 26, 2010 2:40 pm 
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Thanks to everyone who has replied. its nice to have some cyber shoulders to lean on. Its also nice to get some advice. i ended up taking another half last night. doing well today. my wife gave me a list of stuff to do. keeps my mind occupied and im sure shes loving all the help. its different now. i used to complain all the time and try to get out of it but now im trying to be different. trying to do better and trying to help more. things are coming along. its a long road ahead and im only on day three. im excited about the future.

still worried about my meds running out. my doc office does not have a voicemail or an after hours number. has anyone here gone thru this in the first week? do you think ill have a problem getting more meds? the receptionist said to call monday because my meds may need adjusted. im guessing i shouldnt have a problem. i lucked out and got a super nice doctor and his entire staff is awesome. very helpful.

let me know. thanks again for the help and advice. you guys are a blessing. ~Down South.


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PostPosted: Mon Sep 27, 2010 7:46 am 
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It really depends on the doctor but if they said to call Monday because the meds may need to be adjusted then it sounds to me that they anticipate this and you aren't likely to be in trouble. Just be very honest about what was going on for you and I think you will be fine.

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 Post subject: update
PostPosted: Mon Sep 27, 2010 3:39 pm 
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hey all, i wanted to update the situation. called the office this morning. the lady that answered the phone was very helpful. she said this happens alot the first couple of weeks. she was going to touch base with the doctor and call me back. about an hour later they called and wanted to know which pharmacy to call it in to.

went to walgreens. 7 of the 8mg generic subutex ran me 34 dollars. i asked last week about getting a generic and they looked it up and said they could order it and have it waiting on me. thought i would share that info. the scrip i got last week was for namebrand subutex. 7 of the 8mg tablets were 78 dollars. ask your pharmacy about the generic, its worth it.

Thanks for all the help from everyone here. ~Down South


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PostPosted: Mon Sep 27, 2010 4:46 pm 
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Hey Down South,

I'm so glad the Dr. said it was fine! Some Dr.'s can be idiots, but it sounds like you got a good one :)

How are you feeling other wise? Are you taking 16mgs? Wish you the best!

Jenn

Oh ya there is a online meeting tonight at 9pm if you want to stop by? Hatmaker runs them, I alwas enjoy going!


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PostPosted: Mon Sep 27, 2010 5:55 pm 
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hey, that's great news! Thanks for updating us. And yeah, how are you feeling now? Better?


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PostPosted: Mon Sep 27, 2010 5:59 pm 
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YAY you! I'm so glad you were able to explain the situation and it all worked out well. That's terrific.

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PostPosted: Mon Sep 27, 2010 6:44 pm 
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All is well. I am now on day 4. Now at 16mg/day. with the price of the generic i cant complain. my meds seem to be doing thier job. no cravings to speak of. i did wake up hurting this morning. weird kind of pain coming from my hips and radiating down to my knees. was very uncomfortable. took my morning dose and it went away. we will just see if it comes back to greet me in the morning tomorrow.

my wife and i have noticed that my appetite has come back. with a vengance! I cant stop eating. lol.

I could stand to add about 30 pounds so we will see how that goes. im a big boy(6' 9") so im not too concerned about getting fat. yet.

more to follow.


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