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 Post subject: Just not myself
PostPosted: Sun Feb 26, 2017 4:25 pm 
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Question...I'm a middle-aged male and am having the same unfortunate health issue on suboxone as when I was on tramadol. I am wondering if this is a known side effect for opioids. Before I started on the tramadol, I was a beginning runner. Although I'd only run about two half marathons and wasn't the best at it, I was still always improving and had a ton of energy. Once I was hooked on the tramadol, I was sluggish and out of breath all the time when I ran... and I gained weight, like 20 lbs. The same is going on with the suboxone. When I'm working out, it's just such a struggle with the breathing and energy level. Plus my joints ache almost 24/7. It's a paradox, because the continued lethargy is leading to more weight gain, sore joints, harder to work out...a vicious cycle. In full disclosure, I'm 49 and 3/4, so not getting any younger. And...I absolutely hate my job and am miserable every day (I am actively looking), which is leading to binge comfort eating. I have these issues working against me. But still...I know I can feel better than this!

J


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 Post subject: Re: Just not myself
PostPosted: Sun Feb 26, 2017 5:47 pm 
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Hello Hager,,

I might consider getting your testosterone levels checks. I'm under the impression that opiates can lower testosterone levels (I'm not a doctor and only telling you what I've heard anecdotally) and you're reaching "that age" anyway. . If your level is low, it can be treated, if somewhat controversially.

The other thing to ask yourself is if you're depressed. I'd see a psychiatrist to get an expert opinion. BInge eating, no energy, achy this, sore that, a generous side dish of anxiety perhaps. Depression can be treated as well.

I'm a long time opiate addict and remained a jogger and biker throughout. I still do these things at age 65, along with long walks .on a regular basis. I take 8 mg's of suboxone a day, and notice no problems along the lines you mention.

I'm betting with a little perseverance you'll be losing weight and running up a storm in no time.

Best wishes

Godfrey


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 Post subject: Re: Just not myself
PostPosted: Sun Feb 26, 2017 8:41 pm 
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Hi Hagerj1, Welcome! I too was hooked on tramadol but the reason I got there was because it made my knees feel better, it lifted the depression that I was experiencing related to menopause, and it gave me that boost I was looking for. Suboxone has done the same only without the boost. It works for me because I really was not looking to get high, I just wanted to be normal again. I take 2mgs in the am and 2mgs in the pm and it is working very well for me. I think Godfrey gave you really good advice. I wish you lots of luck. Please keep us updated!


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 Post subject: Re: Just not myself
PostPosted: Mon Feb 27, 2017 10:15 am 
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Hey Hager.

Back when I was using, I remember thinking to myself 'gosh I miss my natural energy that I used to have before opiates'. After I started using opiates, it felt like I never had any energy unless I had taken enough opiates that day. When I went to rehab, I had zero energy. But I will also say that now that I'm on buprenorphine, I feel pretty normal, energy wise, every day.

I am not horribly upset with my weight right now but I have gained a few pounds too. Since gaining that weight, I do feel a little fatigued sometimes. I think the fatigue is from gaining the weight not suboxone. And I gained weight from stopping my treadmill routine. Plus when u stop exercising u start feeling low energy from that too. But as far as suboxone goes, it doesn't give me low energy and I'm thankful because I cannot take feeling like that. I hope u figure out what it is and feel better soon!!

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 Post subject: Re: Just not myself
PostPosted: Mon Feb 27, 2017 11:37 pm 
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You don't share much of your history, so it is hard to comment. You were on Tramadol, and now you are on buprenorphine.... how long were you on each of those medications, and what preceded them? Are you on buprenorphine just because of the Tramadol use, or were you using more potent opioid agonists? (it would be a bit irregular to go from Tramadol to buprenorphine, so either you have a doctor with an unusual approach to pain treatment, or you were on some stronger opioid in the past). The sequence of medications is also important, because if you took tramadol at some point and took opioid agonists at another point, I would have less confidence in what your mind remembers from each experience. As a psychiatrist I regularly hear long-term patients describe feeling one way on this medication and another way on that medication-- but when we go back an look at the chart, where I wrote in real-time what the patient said about those medications, the written information never correlates with the memories.

Beyond the details of your history, you are convinced that one variable is the reason for a host of other things. The narrative you believe is that tramadol and/or buprenorphine caused the lack of drive, which then caused over-eating and weight gain, which then hurt your knees. Maybe you gained weight (like many people do in their 40's), became less enthused with running (which happens when people gain weight), and had more knee pain because of the extra 20 pounds (and the history of running, which increases the wear and tear on the knees). Or maybe the constant pain when you ran reduced your interest in running, which led to lethargy and weight gain?

Or maybe something else happened in your life besides buprenorphine. Maybe you got tired of your job. Maybe your relationship faced a challenge. Maybe your mood just drifted downward over time, as happens with many men, as part of the 'mid-life crisis' most of us experience? If you do have a history of opioid dependence (i.e. addiction), you probably have all sorts of 'issues' under the surface, including shame, resentments, and fears left over from addiction itself?

Most runners, over time, become ex-runners; that is a normal trend. I'm sure all of those ex-runners have reasons in their heads for why they stopped. Some would say they stopped because their knees hurt. Some would say 'I don't know- maybe I got lazy'. Maybe in your case it was the buprenorphine. I don't think that is likely, but maybe I'm wrong... but I can guarantee you that buprenorphine doesn't make it impossible to exercise-- so you may just have to work a bit harder at it.

Sometimes we find excuses for things; sometimes the excuses are valid, and sometimes they are just... excuses. But the problem with having an excuse is that the excuse maintains the behavior that you are trying to change. In other words, if you are convinced buprenorphine keeps you from exercising, then it WILL keep you from exercising. You will be much better off if you push that excuse out of your mind, and act 'as if'-- as if your exercise is NOT affected by buprenorphine. That is, if you truly want to get exercising again.

The other option is to keep believing buprenorphine is the problem, and use that thought as motivation to stop taking buprenorphine. But of all the options, the one that makes no sense at all is to keep the attitude that buprenorphine is to blame-- and then do nothing about it.


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 Post subject: Re: Just not myself
PostPosted: Fri Mar 03, 2017 7:40 pm 
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I'm really not okay with you saying I'm using excuses. I was just sharing that I feel like shit and asking if anyone had any idea from a side effects perspective. I won't be open anymore about my situation on here. You have no idea how hard I work on my career or other things in my life to minimize my struggles to a lazy fat middle aged guy making excuses. I'm actually very successful and am just going through a rough patch. I thought this would be a supportive blog...guess not.


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 Post subject: Re: Just not myself
PostPosted: Fri Mar 03, 2017 10:50 pm 
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One of our goals on this forum is to help addicts become more responsible for their own behavior, not because we are ogres, but because it aids the recovery of addicts.

You put your post under "Side Effects" implying that you think your troubles are side effects from taking buprenorphine. Dr. Junig (suboxdoc) is a psychiatrist with a thriving practice, plus he is an addict himself. He is not judging you or anyone else from on high. He is trying to help you become more introspective about where you troubles are coming from.

I am sorry that you are struggling.

Amy

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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 10:01 am 
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hager,

My default approach is to see things from the struggling newbie's point of view when someone feels insulted, probably because I was one just a few months ago. But I think you're misreading doc's post. Try to reread what he wrote objectively. He's genuinely trying to help you. It's easy to blame bupe or something else for some problem or set of problems that arise....or seem to arise after this or that, but there can often be a kind of faulty logic about that assumption. He's asking you to look at other possibilities. That's not to say you're wrong. I do believe opiates tend to lower testosterone levels. That might be something you could look at.


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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 3:27 pm 
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Thanks Godfrey. I just re-read it myself. I can see where the tone could be taken as sarcasm-- and I'm sorry if I used too much of that.

Understand that people often write here about problems they attribute to buprenorphine. The comments mirror something that happens in the 'real world', where doctors tend to blame symptoms that are vague or that they can't figure out, on the medication that they know the least about. So I regularly have patients who see their primary care doc and describe pains, fever, dizziness, double vision, shortness of breath, or a range of other symptoms, only to be told that 'it must be the buprenorphine.'

That is a very annoying phenomenon. I'm placed in the position where my patient doesn't know who to believe. In the worst cases, the patient stops buprenorphine and returns to heroin. I've also had a number of young patients-- 6 or 7 at least-- who were pushed off buprenorphine by parents or other relatives, and then DIED. Honest. I have had many, many young patients forced or encouraged to stop buprenorphine-- dozens if not hundreds. But I have read at least 6-7 obituaries on patients from that group. It is possible that many more than those 6-7 patients died, because I don't regularly read the obituaries.

So those of us who are 'pro-buprenorphine'; i.e. who see that this medication could have saved a quarter-million lives in the US over the past 15 years, sometimes react harshly when people blame buprenorphine for vague symptoms.

I am close enough to the end of my career (gosh that sound morbid!) that I do not plan to dominate the world by prescribing buprenorphine. If there are problems related to buprenorphine, I will 'go there'. My opinion right now is that buprenorphine is a very safe medication compared to things that people take without hesitation. I have not seen evidence that it rots teeth; I recently learned that it has NOT been shown to lower testosterone levels in men; and I know that it does not 'get in your bones' to any extent greater than any other drug such as aspirin or tylenol.

With all of this, I'm trying to explain where my attitude comes from. I'm sorry if I wasn't supportive. I do not agree with your self-diagnosis, but I do SUPPORT you. Understand that the easiest way to 'show support' is to simply agree... but while that may FEEL like support, it doesn't really do what would help you the most-- which is to provide an honest opinion from someone who has a good chance at being right about this issue.

I also know that I drone on too long... understand that the value of this forum is that you will hear honest opinions. I wrote in a way that I hoped would change your opinion-- or maybe help change an incorrect opinion of someone else who reads your post. I don't know YOU personally, so I am certainly not making judgements about you.

I hope you'll continue to speak openly.


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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 4:21 pm 
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Dr Junig wrote...
"So those of us who are 'pro-buprenorphine'; i.e. who see that this medication could have saved a quarter-million lives in the US over the past 15 years, sometimes react harshly when people blame buprenorphine for vague symptoms."

Absolutely Dr J!!!! U explained that exactly the way I feel too. I do think I can be harsh when I see someone I think is being negative about buprenorphine. Sometimes those ppl deserve it and others I may be too sensitive in defending this medication. But my actions are always in defense of this medicine because it's such a life saver for us opiate addicts. I see some blaming suboxone for everything and it drives me crazy. I can only speak for myself, but even if suboxone had all these side effects, I'd still take that over the alternative of when I was in active addiction.

Sorry hager, I just wanted to respond to doctor Junig's comment about defending suboxone. Didn't mean to hijack ur thread :)

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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 6:36 pm 
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Jennifer writes: "Sometimes those ppl deserve it and others I may be too sensitive in defending this medication. But my actions are always in defense of this medicine because it's such a life saver for us opiate addicts."


I absolutely understand this Jenn. To a large degree I even endorse it. I will only add that the written word in in itself can be a rather cold medium. It takes a special effort to inject a kindly tone when telling someone something he or she likely doesn't want to hear. That's why we sometimes resort to those silly emoticons. That's at least partly why they're there. It doesn't take any great effort to use one or two, along with a couple of kind words.

People suffering high degrees of stress, which likely describes the majority of newbies here, will almost always interpret things in the most negative way possible. I didn't see anything in Dr. junig's response to hager that was insulting when I first read it, but hager took it that way anyway. It's too bad. Of course it's his loss if he doesn't come back. Just as it is for every struggling addict who abandons an effort to sort out his problems. Who knows what happens from there. Likely in most cases, not anything very good.

Sometimes we're the last, best hope for an addict. Thinking about it that way, it's a pretty big responsibility.


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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 8:53 pm 
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Thanks for all of your feedback. Some background. My emotions are getting better, and I've slowly been able to see that I was completely irrational and on mood swings like a roller coaster going up and down, constant withdrawal symptoms on tramadol (I was afraid to go much higher than 400 mg a day because I heard you could have seizures, so instead I was constantly craving and in withdrawal due to my tolerance), trying like hell to taper on my own, only to be jonesing, on a chair looking around in the cabinets for any possible loose pills, and then begging the people in India to send my next shipment ASAP. Of course, like a good addict I had a small cushion that was rapidly running out.

That's why I sought treatment at the clinic prescribing the buprenorphine. I just could not taper off of the tramadol on my own without going almost insane and getting more. I felt guilty and paranoid for obtaining the pills the way I was. The risks I took. And I was doing all of this while being new at this super corporate job. I'm in AA too for alcohol. It was a big secret from everyone. I'm VERY thankful for the doctor I have. Too bad he doesn't take insurance. This has all be very expensive..but worth it...and I'm fortunate enough to be able to afford it.

Anyway, I think I started having energy and weight issues while on the tramadol and it has continued with the bupe. That's the basis of my question...purely physiological...do opioids do this. But...I think the real answer is, while going through this for the last 3+ years, I was in my late 40s and maybe it's all just part of the normal aging process and that's all it is.

Thanks everyone for listening.

Joe


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 Post subject: Re: Just not myself
PostPosted: Sat Mar 04, 2017 10:18 pm 
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Hey Hager (Joe)

So glad you're back. I think you might be on the right track. Doc cleared up the issue of bupe and testosterone. So that helps. One very good thing you can do for yourself is to continue participating in the forum. There's nothing you can be going through I don't believe that somebody else hasn't gone through
too.

YOu've got a lot going on. And you've been through an awful lot. Important to remind yourself...and you seem to be doing some of that....of the good things. You're in AA, you're taking a safe medication in the buprenorphine which means for all intents and purposes that you're sober. And you've also got a great doctor.

The life of an active drug addict is tremendously stressful, even without the stress of an important corporate job. It's really little wonder just from that standpoint that it took a toll in the form of less energy and maybe some depression. You mentioned a mood swings and I'm thinking plenty of anxiety in the bargain.

I don't have specific advice really, but I can promise lots of support from the forum.

Keep coming, keep sharing, and keep asking questions. It's all good.

Best wishes,
Godfrey.


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 Post subject: Re: Just not myself
PostPosted: Sun Mar 05, 2017 3:06 am 
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I'm so glad you came back around, Joe! We are not perfect around here, but we do care about people we don't even know, just for the fact that we are all in this addiction boat together.

It's funny, because some people come here asking if f suboxone causes you to LOSE weight. (I would love that problem!!) I tend to think it's coincidental, but I don't know for sure.

In any case, thanks for giving us another try and take care!

Amy

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 Post subject: Re: Just not myself
PostPosted: Sun Mar 05, 2017 10:43 am 
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Hager I don't think buprenorphine can cause u to gain weight and I don't think opiates necessarily make u gain weight either. I think that once ur taking buprenorphine, after we've finally settled and not worrying about getting our drug of choice anymore, I think we tend to eat more and maybe not as health conscious. I think I finally had peace of mind and I was just enjoying that in every way possible. I could go out and eat, I could go shopping and I could enjoy my family again (and they could enjoy me again too).

I think once on buprenorphine, dust settles and life resumes like it usually did before pills. Life on life's terms is probably what ur experiencing Joe. That's my opinion and I hope u have a great Sunday :)

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 Post subject: Re: Just not myself
PostPosted: Sun Mar 05, 2017 11:13 pm 
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hagerj1 wrote:
Question...I'm a middle-aged male and am having the same unfortunate health issue on suboxone as when I was on tramadol. I am wondering if this is a known side effect for opioids. Before I started on the tramadol, I was a beginning runner. Although I'd only run about two half marathons and wasn't the best at it, I was still always improving and had a ton of energy. Once I was hooked on the tramadol, I was sluggish and out of breath all the time when I ran... and I gained weight, like 20 lbs. The same is going on with the suboxone. When I'm working out, it's just such a struggle with the breathing and energy level. Plus my joints ache almost 24/7. It's a paradox, because the continued lethargy is leading to more weight gain, sore joints, harder to work out...a vicious cycle. In full disclosure, I'm 49 and 3/4, so not getting any younger. And...I absolutely hate my job and am miserable every day (I am actively looking), which is leading to binge comfort eating. I have these issues working against me. But still...I know I can feel better than this!

J

lol at 49 and 3/4. you're really not looking forward to turning 50 are you!!
i've also had weight gain and tons of joint pain. the pain was so bad I got the name of a rhematoid (sp?) arthritis dr (it runs in my family bad family members had hips and knees replaced!) but now after almost 6 months on subs the pain is going away. i was taking 4 advil multiple times a day. i now just take 3-4 in the a.m. 8 years ago i went cold turkey (and was clean for 5 years!) and also experienced the same pain then.
how long have you been on the subs?

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 Post subject: Re: Just not myself
PostPosted: Mon Mar 06, 2017 1:25 am 
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Hi Joe and welcome to the forum. So glad to see you gave us a second chance. To answer your questions about opiates and the sluggishness feeling, it was just the opposite for me. The opiates always seemed to give me more energy. Suboxone made me feel like my old self again wich I had not felt in years and the shear joy of being myself again motivated me so that I had energy all along. I am 45 and coming off, weening off the Suboxone and when I got down to 2 mg, I felt I had no energy but I know that has to do with the dropping my dose. I hope I helped answer any questions you had and I hope you stick around. This forum is a gem and a great support which is wonderful for helping with anxieties of all kind. If your having a bad day at work, come here and tell us about it. You would be surprised just how much it helps. We are here for you. Sincerely, Bama girl


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