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PostPosted: Sun May 09, 2010 12:16 pm 
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Diary of a Quitter- Please do not get me wrong- I am glad that you provided us with the log of your experience. How long have you been off of Suboxone? I have been a bit harsh with the Good Doctor, but he has decided to put himself in the forefront of the Suboxone issue. I will admit though- he is compassionate with regards to understanding that Suboxone is not an easy med to stop.

Ok,

So you mentioned to me:

Just FYI, Dr. Junig already addressed this issue on his blog, which is where I got the idea to mix a liquid solution to taper. He suggested decreasing your dose by 10% each month (once you get below 1-2 mgs).

So I looked to see what I could find and this was it: It is your own blog....
I got the impression from your FYI "the doc has addressed this issue" that it was a bit more than the following:

A while back, Dr. Junig brought up (on his blog) one of the problems with tapering off Suboxone - the fact that you can't get pills in low enough doses to taper comfortably. He suggested a way around this problem: dissolve the Suboxone pills in a small amount of water so that you can measure out smaller doses and taper in smaller increments.
A while back, Dr. Junig brought up (on his blog) one of the problems with tapering off Suboxone - the fact that you can't get pills in low enough doses to taper comfortably. He suggested a way around this problem: dissolve the Suboxone pills in a small amount of water so that you can measure out smaller doses and taper in smaller increments.

Since I'd been "stuck" at about 1mg of Sub/per day for a while, and every time I tried to start skipping days between doses I got sick, I thought I'd give it at try. This is what I did:

I crushed an 8mg pill and dissolved it in 10 ml of water, so every 1ml of water would contain .8 mg (800mcg) of Suboxone. This was a reduction of .2mgs (200mcg) of Suboxone from the dose I was taking at the time. I used an oral syringe that meaured in mls (available at pharmacies, used for measuring kid's cough syrup, etc.) to dose myself with a half a ml in the morning and half a ml at night. I know Dr. J is big on the one dose per day thing, but my doctor ok'd the 2 times a day because I have chronic pain issues and it works better for me that way. I keep the solution in an empty pill bottle in the fridge so it doesn't get funky.




I copied your post just to give Dr. Junig's response some context. This is what he had to contribute to the discussion on liquified tapering:

I haven't ever used the technique-- only read about it-- so I can't totally vouch for it. Thanks for trying it out in a 'public' way-- I wish you the best with your efforts!
Jeffrey T Junig MD Ph
D


This seems a bit contradictory since you said in the post that I copied above that: "He suggested a way around this problem: dissolve the Suboxone pills in a small amount of water so that you can measure out smaller doses and taper in smaller increments."


So what is it? Does the doctor recommend this tapering method or not. Can he vouch for it or not?

It is very clear that he cannot make any sort of recommendation. In fact he cannot even vouch for it.
Why? Simply CYA. Obviously a Dr. is not going to vouch for a High School Chemistry project where you make up varying solutions of a known substance- in order to get a "medically supervised taper and dosing schedule".
Do you see the problem? No, the Gov. is not the problem. They will gladly approve low dose bupe. It is simply not a profitable move for the company to apply for the lower dosage approval, then be forced to market this to doctors so that they can offer the patients with an exit strategy. In addition to this, it would be immediately available for generic. So why are they going to bother to apply for, then market a med that is going to contribute to the company loosing money?
Profit motive 101.
Do you think that in any other pharmaceutical situation that one would have to resort to acting like an alchemist in order to make ones own doses of a medicine?? If you know of any other I would like to know.
The reason that it comes so naturally for us to do such a thing is that we are experts at doing this kind of stuff.
We are junkies for chrissakes. We know about cutting and crushing OxyContin. Cutting dope. Cooking and mixing dope.
We are naturals for making up a "liquified dosing schedule" on our own.
Since we are addicts do you think it is proper for a company to make a situation such that an addict has to revert to his old ways of mixing and cutting and doing all this "dope behavior" in order to provide ourselves with smaller doses????

God I am getting pissed off about the thought of this and that I am even trying to show the obvious: That this is not at all a normal medical approach to any sort of medical and
standard operating proceedure. This is...weird.
The best word that I can come up with. Just plain bizarre.

In looking through your thread I came across this post:

happinessinsight wrote:
You know for me...I am now 2 weeks into it, the main problems I have are lack of sleep and feeling kind of depressed. I don't know if it's just because of quitting sub, I have a very grueling job which I don't really find much personal satisfaction at all and I'm just so overworked and my clients are always so unappreciative despite how hard I may work for them. I guess I am fortunate though to have a good job and make good money at 24 in this economy. I feel like I should be much happier though because I quit suboxone and I have a wonderful and beautiful girlfriend and all that good stuff but I feel a little bit empty and I don't sleep so well. Maybe it's just a harder night tonite...I should really look at going to an NA meeting, maybe that would give me some extra support. I just don't like where my head is at and I feel like I may act a little bit irrationally with my girlfriend. I dunno it's worth it though and I guess it's like breaking up with a girl...a few months down the road I will look back and forget all of this for this too shall pass.

I think the liquid taper method is truly the best way and I was having alot of trouble seeing a light at the end of the tunnel before this. I think it takes a little bit of will on your part because you need to really stick to your program but as long as you are making progress..you are heading in the right direction.

Good luck to all of you, if you really want it--it's something you too can achieve. Just look at us and don't focus solely on the negative reports. It takes some work and patience and perserverance on your part, but you can do it.

Thanks for all the information, it's really nice to see a doctor is actually compassionate about this. I was roped in by my doctor who seemed so compassionate but then I found out he's very cold and dismissive. I truly don't understand how there has not yet been a class action lawsuit regarding the way patients are perhaps mis informed about suboxone and how doctor's fail to recognize the seriousness of the withdrawal and addiction to suboxone. I'm rambling, anyways I feel better. I should really try to find a new hobby to fill my time--I think work has just been dragging me down lately and I haven't been as able to deal with the extreme stress as normal. Maybe I will get back to writing more. My knee is still a little messed up from a recent injury so I can't play basketball or take my dog running unfortunately, that would make a big difference!

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PostPosted: Sun May 09, 2010 12:27 pm 
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Joe- thank you for your posts. I borrowed this to emphasize my own dismay at the situation that we are in.

Joe McPlumber wrote:
Maybe an hour or so after i'm so impressed with you folks for your innovations and your humanity, i am P***ED OFF that you had to figure it out for yourselves. I mean, it's really great that you did, but i'm reading around the interwebs and coming on all sorts of people in all sorts of misery because the medical/pharmaceutical establishment has NO such options and people are jumping from 2mg cause that's the smallest you can get.

But OTOH if we didn't do for ourselves i suppose we'd be at the mercy of doctors who might think we should stick to a program that might not be right for us, individually. NTM, some folks have expressed fear, for God's sake, that their doctors might find out they've been doing something unauthorized. Sad...

Ok got that out my system.

Questions, if i may:

    *Where do i get a syringe for such micro-doses? I've got an oral syringe here but it's marked in... um... 1/5 milliliter gradations. So it won't work when, (see i said when), i get down to .25mg.
    *I suck at math. It's ways off from here, but but how i'm gonna reckon the solution at different levels on the taper? I think maybe this warrants a spreadsheet or formula or something, that people can reference for the tapering process. I'm not inclined to ask my doctor for anything less than my 8mg tablets, because i'd prefer to hoard them in case anything goes wrong and so i have all the time i might need. But that means i can accurately break the tablets, at very best, into quarters and even then at these dosages i can imagine it getting tricky. Am i gonna need, at some point, to ask for 2mg tablets?
    *What exactly is the process for dissolving the tablets and getting the solution into the syringe? For instance, my oral syringe has a nipple on the business end which appears to hold almost a milliliter of liquid. I was just now experimenting with it and found it difficult to load it with say, 4ml of water without filling that nipple, thus, having to squirt some out in order to get air where the water is. When i get to doing this with Sub i obviously don't want to be squirting any of it out. Maybe i'm just stupid right now.
    *What's the (rough) consensus as to how long the taper should be? Annmarie, for instance, was bummed that it would be "much longer" than a month for her to get to .25mg from her current .5mg. I'm told that it will take me ~6 months to get my new knee working properly, and i was sorta hoping to use that same timetable to get off the Sub. Is this realistic, at common rates of reduction?

Apologies if the answers to these questions are scattered about. And i obviously have no use for the answers right now because all i want in the whole world is back on to my Sub at whatever dose works. But i AM gonna do this, and it would be nice to have the whole process and all the maths and cigarette filter tricks etc. articulated in one place for those who might be stumbling around the interweb looking for help, now. I might could make my own answers if my brain worked, but meanwhile just seeing people actually doing these things is so very heartening i could almost cry.

Thanks again,
- joe

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PostPosted: Sun May 09, 2010 2:43 pm 
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gaulois -


I just can't shake the feeling that you are spoiling for a fight or at least trying to bait one of us into a debate. The fact of the matter is that NONE of us know the rationale behind the absence of lower-dose tablets of suboxone or subutex for tapering. My opinion is that the vast majority of people who take these drugs don't have such a hard time tapering off of them. I really do believe that the people who do have a hard time of it are simply a very vocal minority. And that is all I have to say about that.

Here is the relevant quote from Dr. Junig's blog - The Suboxone Talk Zone - which is where I got the idea for the liquid taper. Here on the forum he simply said he couldn't vouch for the method because he didn't know anyone who had tried it yet. But as you can see from this quote (which is easily found by googling Suboxone Talk Zone and Taper) he was the one who proposed the idea:

Quote:
OK.. Micrograms. This simply refers to the new info that was sent to me by a nice gentleman who I cannot mention by name… and a topic that I referred to a couple posts ago. I mentioned that in order to taper off Suboxone, you must think in terms of micrograms, not milligrams. When you take an 8 mg pill of Suboxone, you are taking a supra-maximal dose of buprenorphine– a dose that is off the scale. The ‘ceiling’ is way up high, far above the doses that are used clinically for treatment of acute pain. As I have said, 24 mg, or 4 mg, of Suboxone are both as potent as 30 mg of methadone! So your taper off Suboxone doesn’t really start until you get below 2000 micrograms per day– or 2 mg, which is a quarter of a pill. To do a proper taper, you want to think in terms of tapering down from 2000 micrograms to zero, in small steps.

I had an idea of how to do this at about the same time I received the message from the nameless contributor who had done his own tapering studies. He did what I had finally figured out; take an 8 mg tablet and dissolve it in a small amount of liquid– water would probably be fine. You want a small enough volume so that when you put it in your mouth it is concentrated enough to cause absorption of the drug through mucous membranes, but a large enough volume so that it can be measured accurately. I suggest using a vial that childrens’ medicine comes in– one with a measured eye dropper. calculate out the concentration of buprenorphine, and then use the dropper to take a measured dose of the liquid each day. At some point– if you start getting withdrawal by the end of the 24 hour period– you might want to change to dosing every 12 hours (cut each dose in half, of course). I recommend making a reduction in dose every one or two weeks– if you are still feeling sick from the step a week earlier, don’t make another change until you feel better. In general, each drop in dose should be a drop of about 10%. Be sure to keep the mixture refrigerated, and toss it if it develops a foul odor!

If you taper very slowly, you should be able to avoid the vast majority of the withdrawal. It will take a long time though, so be prepared to keep at it for months. If, on the other hand, you need clean urine very quickly…. you have little choice but to simply stop, and tell everyone that you have mono again. (gee… seems like you are ALWAYS getting mono!),




I hope you agree that this ends the debate about whether he actually recommended this idea or not.

And to answer your last question, I have been off Suboxone for 9 months and I'm doing great, thanks for asking.

Here is the link to the quoted blog post: http://suboxonetalkzone.com/?p=1297

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PostPosted: Sun May 09, 2010 8:00 pm 
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Gaulois,

I don’t want this post to further the debate, but I do want to comment on a few statements, then I will get into the real point of my post.

“Once they loose the Patent on Buprenorphine/Naloxone ie " Suboxone trademark"- you can be sure that the smaller doses will be available. Who knows- maybe they will take advantage of that market, and create some special formulation that requires us, again, to use a "Suboxone" brand name to taper. "Suboxone SR", "Suboxone Patch", Suboxone 100mcg tab"”

If you will go to my earlier post from yesterday, you will see an article that I copied into the body of the text that states that the patent has already expired (as of Oct. 2009). So, according to your logic, we should see a great number of new, innovative products in the market soon. However, according to that article, R-B doesn’t seem as interested in Suboxone as we would all think….the article says they are not even going to market the generic because they are more focused on the other products they make (household products…like my Veet spray on hair removal).
I really think that, if they wanted to keep all us addicts hooked for life to increase their profits, they would definitely be working on manufacturing the generic version of the drug….once that is approved, the brand sales will go WAY down.

“Here is a challenge if you think that Drs are not either 1) being intimidated not to prescribe gen bupe or 2) the Marketing is such that...lets say it is in the good Drs best interest to only prescribe brand name Suboxone- even to committed recovering addicts. Why do good behavior ex junkies at Meth clinics get take homes (of a deadly OD substance)- Methadone, and we Suboxone Patients that have shown to be serious are not offered the same as in being able to be prescribed generic Bupe so we can save quite a bit of money.”

First off, about the doctors being “scared” by the drug companies…..BS!!!!! I am so SICK and TIRED of the asinine argument. It makes no sense at all. I grew up in a family full of doctors, I worked for doctors in college, I managed medical practices after college….I NEVER saw a doctor intimidated by a drug company. In fact, I usually saw the opposite….doctors who were set in their ways and prescribed the older (less expensive medications) and doctors who would go out of their way to save money for their patients (by writing for generic if medications aren’t covered or substituting their original scripts for something on the insurance formulary). How exactly do drug companies intimidate and scare doctors? In your world, the doctors are evil, the drug companies are evil…..who do you trust?
I frankly didn’t even understand the last part of that paragraph. Sub patients ARE allowed large quantities of lake home meds….months at a time….usually pretty early on in treatment….and, again, I and MANY others are on the generic bupe (I don’t have some maverick doctor who is “going out on a limb”).

But, and my response above may contradict this, I genuinely am not very concerned about ANY of this….slightly annoyed, but it is ultimately irrelevant. Here is my question for you…..what do you want? What are you trying to accomplish? When I first read you posts, my heart went out to you. You seemed like you were having an unusually bad response to sub, and you wanted taper suggestions. When taper alternatives were suggested, you began to debate drug company ethics. Which is it? Do you want to taper off or do you want to debate? Both are ok, but people need to know, so we know how to help you.

You are so focused on blaming the drug companies for your inability to taper off suboxone, but many people on this site and all over have successfully tapered. You insist that the liquid taper method involves some sort of chemistry degree, but it is only mixing water and powder (my nephew can do that when he makes Kool-Aid…he’s 9). I just see all this anger as a diversion…..yes, the situation sucks (and it does), but it is what it is. So, what can we do about it? As an active addict, I wanted to talk about anything other than my problem…and I see some of this in your responses.

Honestly, if I were having the problems that you are having from sub, and I came upon a source of information like this site that provided a plan to stop taking sub (along with comments from people who had been successful using it), I would at least TRY IT OUT! You seem so much more interested in the debate than in the solution, and, based on this, I wonder if you really are ready to taper.

The other thing is, I went back and read some of your older posts from September, as well as some of your current posts on other topics. From what I understand, you have gone off sub in the past, and have relapsed rather quickly. What has changed? How is this time going to be different? What have you done for relapse prevention? What is your recovery plan after you are off sub? What I am getting at is, are you really afraid of the physical withdrawal (which, I’m sure is a part of it) or are you more worried about what comes after? I came off sub in October (jumped from 1mg), and I relapsed in December. Getting off wasn’t fun (about 5-10 days of flu-like symptoms), but being off opiates was impossible because I hadn’t done the work. I wasn’t ready to live sober.

Here is my main concern. I hear a lot of pain in some of your posts…even comments about not caring if you live. What will a relapse do to you in this state of mind? Are you ready to live sober…you know how hard that is. I just want to ask you to spend as much time working on your recovery as you have researching and writing posts about R-B. A friend of mine in NA once told me to evaluate every action as, “Does this move me closer to sobriety or take me further away?”. Please ask yourself what this debate is doing for your long-term recovery and if this is the best use of your energy. Only you know the answer to this.

Elizabeth

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PostPosted: Sun May 09, 2010 10:34 pm 
Great post ene579. You brought up some great points for gaulois to think about.

I have to disagree with you, Gaulois about these comments....You said:

"Do you think that in any other pharmaceutical situation that one would have to resort to acting like an alchemist in order to make ones own doses of a medicine?? If you know of any other I would like to know.
The reason that it comes so naturally for us to do such a thing is that we are experts at doing this kind of stuff.
We are junkies for chrissakes. We know about cutting and crushing OxyContin. Cutting dope. Cooking and mixing dope.
We are naturals for making up a "liquified dosing schedule" on our own.
Since we are addicts do you think it is proper for a company to make a situation such that an addict has to revert to his old ways of mixing and cutting and doing all this "dope behavior" in order to provide ourselves with smaller doses????"

"God I am getting pissed off about the thought of this and that I am even trying to show the obvious: That this is not at all a normal medical approach to any sort of medical and
standard operating proceedure. This is...weird.
The best word that I can come up with. Just plain bizarre."

There are in fact many drugs that are not forumulated in the exact dose that is prescribed for a particular patient. There are a variety of circumstances in which a medication must be halved or even quartered to make the correct dose. That is why pharmacies sell pill cutters. There are also liquid formulations of medications sold in multi-dose bottles in which the proper dose must be measured accurately by the patient before it is administered. There are actually injectible meds which must be drawn up accurately and self-administered as well, such as insulin. There are even a few meds in powder form that are not to be reconstituted until right before administration, in which case, the patient must actually mix and dissolve the drug into solution himself before taking the medication. What I'm suggesting is that Suboxone certainly isn't alone in being a drug whose 'standard' doses are 'easy' to use, but whose doses, when deviating from that 'standard', take a little extra time and attention to titrate down. It certainly doesn't take a chemisty degree nor does it take "acting like an alchemist" to figure out how to take a known quantity of drug, turn it into powder form and dissolve it in a little water to make a solution. Measuring isn't a difficult task at all if one has a simple syringe or marked eye dropper. I'm not a math-whiz at all, but I'm thinking I can handle this.
Moreover, I'm thinking I can handle this even though I am not an expert at this. I am not a "junkie" who has ever "cut, cooked or mixed dope." Nor do I feel that by taking my legitimately prescribed medication and mixing it with water to achieve an easier way of tapering is "dope behavior." If it even comes to that for me as I finish my taper. So far I've done fine by dividing my 8mg tablets into 4 (relatively) equal pieces and then cutting those pieces into 2, leaving me with a 1mg dose. Now when I am ready to go under 1mg, I may indeed need to move to the liquid method to finish the final stages. Doesn't seem like a big deal to me. I'm certainly not staying up late and spending hours studying it. It's been done here. Several people were kind enough to share that it worked well....that's good enough for me.
Frankly I could care less about who, why, why not......it's the Reckitt....it's the DEA....it's the FDA....it's the doctors.....it's the drug reps.....What does that have to do with me and my goals? Seriously. It's not going to get in the way of my goals. Could there/Should there be an easier way? Most probably so. But it's not here yet. I'm not going to spend a lot of time worrying about that stuff. I'm instead going to spend my final time on Suboxone making sure I'm stable in my recovery, that I've got a good relapse prevention plan in place, that my support system is in place, that my body and mind and spirit are where they need to be in order for me to have an easy final taper and a soft landing. That's what I'm focusing on. There is no room in there for me to be angry at a drug company, especially the one who put this drug out there that saved me from certain doom. But then again, I've never been one to buy into conspiracy theories anyway!
It seems like there is a common thread among opiate addicts. That being that they are really just looking for an easy way out. They're looking for a 'reset' button or a 'rewind' button or maybe even a 'fast forward" button, so that they don't have to experience any degree of hardship or pain or discomfort or aggravation in order to get out of this mess. We've all looked and some of us have tried......but that is not gonna happen, my friends. We just have to do the work, exercise the patience and perseverance and walk through, just walk through, for that is the only way to the other side!! Personally, my prayer is for peace, above all else.....that as I do my final taper over the coming weeks or months, that I will have peace. In knowing that this is where I want to go next, trying life without buprenorphine. Peace although I may experience some level of discomfort along the final taper. Peace in knowing that whatever difficulties may arise, they may be dealt with and they too shall pass. Peace that I will come out on the other side feeling good and feeling free to continue to work on my recovery, only after that, it will no longer include bupe.
Gaulois, I hope you are finding what you are looking for. I'm concerned that you're making it way harder than it has to be. Maybe if like me, you could just relax about it a little bit. Find a method that you think might work well for you and then start going for it. Take your time and settle in to your plan and then take a deep breath.....and begin your taper. It really doesn't have to be like approaching the mystery of the ages. They're just orange tablets that break quite easily. I'm not sure how much you're on now, but I just started dropping pretty fast from doses anywhere higher than 4mg/day. Most of us find that we can go from 16mg/day or 12mg/day down to 8mg/day in one step because of the ceiling effect of the drug. I went from 8mg to 4mg with one step.....painless. At that level I had to start slowing it down a bit. Now I'm at ~1.5mg/day and doing pretty good so far. I'm not using the liquid method yet, but I might after I get down to 1mg. We'll see. I have no set-in-stone plan. I'm just taking it as it comes in hopes of being finished this summer. We'll see.
All that to say once again, as we all have said......If you want off the drug in the easiest way possible.....just get started. Put a basic plan in place and go for it! We're here to help and support in any way we can. But I think there's been enough of the side tracking off on the drug company conspiracy theories and so forth. Let's just stick to what you want to do, how you want to do it (with the methods we know of) and when you want to do it. Doesn't that make more sense than anything else. This should be 100% about getting you to your goal. So drop other side-talk and let's get you working on your goal!


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PostPosted: Sun May 09, 2010 11:30 pm 
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Wow gaulois you are one very lucky guy! You just got three great posts providing you with some significant help. Both ene579 and SetMeFree gave you some awesome information and DOQ gave you the tools and information to carry it all out. Now, will you please listen to them? Great advice like this doesn't come along everyday - and for free on top of it. They have all really hit on the necessary information for you. They are all right on target. I won't even try to add to what they have already said - if I even could!

So, please - please - please, don't try to argue, debate, fight, justify, twist, turn... Just take to heart what they have said and accept the wonderful gift that they have just given you. It may have been mother's day but it looks like the mothers just handed you the most awesome gift. I truly hope you will make the most of it.


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PostPosted: Mon May 10, 2010 10:38 am 
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I have been reading since I joined this forum(only a couple days agao) amd I want to thank all of you for the wealth of information you have posted!! I still have much reading to do.
I have weaned down to 1 mg doses(just started this morning). Not using the water taper method, yet, but I am sure I will.
I have some occasional chills, some fatugue, and sleeplessness(which causes mental fogginess during the day) and my constipation issues have completely been resolved!(what a perk..lol) Some muscle aches and joint pain, but all tolerable.
I just want to be off sub as soon as I can(and that may not be very soon)
Again. thanks for all who post and share their info so I can take it and make my own decision.


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 Post subject: 4 Weeks Post-Jump
PostPosted: Fri May 14, 2010 4:19 pm 
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Hi Kids!!

On Monday, it'll be four weeks since I took my last dose. Honestly, by the second week, I had quit counting the days. That's how great and normal I've felt! I'm trying to remember exactly how the WD faded out:

It seems like I had a few days of slight depression around Days 10-13, but I think I posted earlier about that. During this time, I was out riding bikes, shopping, working, and going to shows, restaurants, parties, etc. I was in a great mood, smiling and happy.

Week 2: No more night sweats, and I didn't have those "odd sneezes" anymore. I was still waking up just before sunrise, but I am not taking anything for sleep, so...

Week 3: Still fantastic! Have TONS of energy! No cravings or using dreams. Still waking up very early (5-6am), but I haven't felt this normal in years!

Week 4: A few days ago, I started feeling tired. I felt some chills and had some weird sweating on the palms of my hands and feet. The muscles in my legs twitched a couple of times during the day. I also had night sweats one night. Could this be the PAWS?? Anyway, It was very short lived, requiring only a sweater and a few naps.

So that's about it. No horror stories, just better and better every day. I wish I knew it was going to be this easy BEFORE I entered detox panic-mode. I spent so much time worrying about how terrible it MIGHT be. I am very grateful that it went so smoothly. Remember: You don't need luck, you just need a slow, low taper.

I'll keep posting with my progress.
AM

BronzeB, Glad to read you are doing just as well!! I can't believe it's been a month! Time flies when you've done an easy detox, huh?? I'll PM you soon so we can catch up.

Cat, Great frickin job getting to 1mg!! That was quick! Typically, I only felt 1 or 2 days of WD after each decrease, too. If you time it right, you can use the weekend to go through any WD. I had to slow things down quite a bit when I got under 1mg. Keep chugging along patiently. I promise it will be completely worth it to jump from a tiny dose.


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 Post subject: You made my day!
PostPosted: Fri May 14, 2010 7:26 pm 
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<b>annmarie</b> - Hey there, my friend... it's wonderful to hear that you're doing so well.

It really is hard to believe that it's already been a month now without any sub - all that worry for nothing is right. One of my biggest concerns when I was tapering was that I thought I might hit a point where I was unable to level off, but that didn't occur. A couple of times it did take a little longer, although on those few occasions, exercising helped enormously.

Looking forward to your PM!

Bill


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 Post subject: The Dreaded Exercise...
PostPosted: Fri May 14, 2010 7:53 pm 
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Hey Bronze! God, how I miss our neurotic PMs!! :lol:

I received an alert that you posted, so I logged in really quickly to respond. You are spot on with the exercise comment. I had read that it helps with the WD but I never felt like doing it. While i was tapering, I never felt bad enough to lie around. I was restless at times, but also tired. Then one day my legs were twitching, and I got really annoyed. I jumped up and started doing some simple exercises (squats with a weight bar). I could only complete 20 or so, and had to lie down afterward. Then an amazing thing happened: the WD disappeared. No more chills or sweats!!

From then on, I was a believer. The first few days after I jumped, I went completely hardcore, riding my bike several miles every day, lifting weights, and walking all over the city. It made me feel great, and I slept like a log. I'm thinking that's a big part of why I never had to take sleep meds. I have unfortunately done 30-40 detoxes (rough guess) in my lifetime, and have ALWAYS needed sleep meds. Period. To this day, I am baffled by how easy the Sub detox was from the slow, low taper.

The key word here is SLOW. Bronze is correct. Near the end (doses under 1mg or so) the decreasing becomes slower, and the progress occurs in baby steps. But if you want an easy jump, and if you want to bounce back quickly, I do think it is absolutely necessary.

AM


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PostPosted: Wed May 19, 2010 7:14 pm 
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Hey Everyone!!
It's been 5 days or so since I've posted. I'm at 4 weeks and 2 days post-jump. For the past few days I have had some WD or PAWS symptoms. I felt tired for 2 days, needing a nap here and there. Then, my hands and feet would get sweaty for 30 mins to an hour a few times a day. Two nights I had pretty significant nightsweats, waking up super-early and soaked. Gross. There was a day where I felt mentally "weird" and had trouble maintaining any functional pattern of thought. I felt like I wanted to get high on SOMETHING, ANYTHING, but no drug specifically. You know that feeling: crawling the walls...?? During this time I slept pretty well, surprisingly.

Today, I feel back to normal again. I am assuming it was PAWS. It was crazy-mild, but having any type of WD just reminds me of drugs and being on Sub, when frankly, I am just ready to move on. So the annoyance factor was the only problem I really had with it. If you keep your day full of activity and your mind occupied (or plan to hit a meeting), it should be a piece of cake.

When I jumped from 2 mgs a few years ago, I went through complete hell, and then had very significant WD symptoms (or PAWS?) for 13 1/2 weeks post-jump. This time, I tapered. And there is simply a WORLD of difference!!!! I wish I could adequately explain in words how much milder and easier the tapering method is. On a scale of 1 to 10: My jump from 2mgs? An 11. My taper? Barely a 1. Barely. It was dramatically shorter, and the post-jump bounce-back happens within days--not weeks. It was SSSOOOO worth it!!

AM


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 Post subject:
PostPosted: Wed May 19, 2010 9:28 pm 
Thanks for the update annmarie! I'm sorry you had a tough couple of days, but glad that it was nothing debilitating....just more a nuisance it sounds like. Kind of one of those "what the heck was that about?" type moments, huh? As you said, it passed and you feel better now. You've done great and it's looking like your meticulous work on the taper is paying off all told. I don't expect the final stages of the taper or the final jump to completely without problems, but manageable with a little exercise of the body and mind, so to speak! Seems that's the way you've approached it as well.
Good for you. Thanks again for the update.....sure is nice to have others to look to in order to prepare for what may be in store!


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PostPosted: Tue May 25, 2010 7:12 pm 
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I just wanted to check in to give an update on how everything was going for me post taper.

It's been exactly six weeks since my last dose of Suboxone and so far I don't seem to be experiencing any PAWS. I have continued to workout - a one hour walk everyday and some strength training every other day - and have been maintaining a good diet, so that, coupled with the long slow taper may be why I'm feeling so good.

I've been reading some more articles about the effects of exercise on the brain and it's all very encouraging. From what I can gather, it not only helps to stimulate the opiate receptors that have atrophied due to abuse, but it also speeds up the neural rewiring that occurs when we stop abusing drugs. This rewiring actually starts to happen when we begin taking Suboxone in place of our drug of choice. Below are a few snippets I found that I thought might be interest some of you.
---------------------------------------------------------------------------------------------------------------------------------------------

"When one ceases taking opiates, the opiate receptors are going to be less stimulated, but given time, they upregulate. But the short answer is that while opiates will cause some short term changes in neurochemistry, they will not cause any serious long term changes. This is not to say that long-term opiate use doesn't have negative health effects, just that brain damage does not appear to be one of them."

"Now, it is possible to rearange the connections between neurons, of course, your brain does it all the time: it's called learning."

"Exercise (running) has been shown to increase cell proliferation and neurogenesis (proliferation, migration and differentiation of neurons) in the dentate gyrus of the adult mouse."

----------------------------------------------------------------------------------------------------------------------------------------------

I thought this information was very encouraging because it confirmed what I had already suspected - that we can be much more proactive in our recovery than most people think is possible. Many of us have heard the statistics relating what percentage of individuals succeed in maintaining their sobriety over a given period of time. Depending on the source, it's anywhere from 3 to 10%. I think of it as a throw of the dice, except with every tool in place we can load those dice so that the odds are even greater for our long term recovery.

For those interested in using the liquid taper method... I've done the math so you can accurately decrease your dose by whatever amount you would like down to .150mgs per 1ml of water. I hope someone finds this information helpful.


8 milligrams of Suboxone to 8 millileters of water - 1ml = 1mg
8mg/9ml ---- 1ml = .888mg
8mg/10ml --- 1ml = .800mg
8mg/11ml --- 1ml = .727mg
8mg/12ml --- 1ml = .666mg
8mg/13ml --- 1ml = .615mg
8mg/14ml --- 1ml = .571mg
8mg/15ml --- 1ml = .533mg
8mg/16ml --- 1ml = .500mg
8mg/17ml --- 1ml = .470mg
8mg/18ml --- 1ml = .444mg
8mg/19ml --- 1ml = .421mg
8mg/20ml --- 1ml = .400mg
8mg/21ml --- 1ml = .380mg
8mg/22ml --- 1ml = .363mg
8mg/23ml --- 1ml = .347mg
8mg/24ml --- 1ml = .337mg
8mg/25ml --- 1ml = .320mg
8mg/26ml --- 1ml = .307mg
8mg/27ml --- 1ml = .297mg
8mg/28ml --- 1ml = .285mg
8mg/29ml --- 1ml = .275mg
8mg/30ml --- 1ml = .266mg
8mg/31ml --- 1ml = .258mg
8mg/32ml --- 1ml = .253mg
8mg/33ml --- 1ml = .242mg
8mg/34ml --- 1ml = .235mg
8mg/35ml --- 1ml = .228mg
8mg/36ml --- 1ml = .222mg
8mg/37ml --- 1ml = .216mg
8mg/38ml --- 1ml = .210mg
8mg/39ml --- 1ml = .205mg
8mg/40ml --- 1ml = .200mg
8mg/41ml --- 1ml = .195mg
8mg/42ml --- 1ml = .190mg
8mg/43ml --- 1ml = .186mg
8mg/44ml --- 1ml = .181mg
8mg/45ml --- 1ml = .177mg
8mg/46ml --- 1ml = .173mg
8mg/47ml --- 1ml = .170mg
8mg/48ml --- 1ml = .167mg
8mg/49ml --- 1ml = .163mg
8mg/50ml --- 1ml = .160mg
8mg/51ml --- 1ml = .156mg
8mg/52ml --- 1ml = .153mg
8mg/53ml --- 1ml = .150mg
8mg/54ml --- 1ml = .148mg
8mg/55ml --- 1ml = .145mg
8mg/56ml --- 1ml = .142mg
8mg/57ml --- 1ml = .140mg
8mg/58ml --- 1ml = .137mg
8mg/59ml --- 1ml = .135mg
8mg/60ml --- 1ml = .133mg


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PostPosted: Wed May 26, 2010 5:52 am 
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Location: I live in GA but my roots are in WI
thanks for that! I am a distance runner and have been for MANY years. I knew that running was good for me in many ways but never truley felt it could actually help aleviate some of the W/Ds while I taper..but it does!
I also needed that info for the liquid taper method and appreciate the work you did to post it!
Congrats on your sobriety!
See you on the running trail!
G44


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 Post subject:
PostPosted: Wed May 26, 2010 10:39 am 
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Hello everyone :)

I made my first liquid taper cut yesterday after finally stabilizing (and inducting) on .8mgs of suboxone. I had a very small habit of 22.5mgs of oxycodone a day before starting the suboxone. It took me about 5 days to figure out what my starting point should be. I finally felt normal on .8mgs last Monday and held that dose for a week. I tapered to .72mgs yesterday morning and am starting to feel some symptoms today.

Everything I am experiencing so far is very mild compared to my WD on the oxy. I made the mistake of cutting my oxy dose by 50% (45mgs to 22.5mgs) 5 weeks before starting suboxone and the WD I feel now after making a suboxone cut is minimal in comparison. Let's hope it stays that way throughout my taper. :D

At hours 23-24 I had some mild GI upset, slight fatigue (heaviness in limbs) and a runny nose. After taking my morning dose (Hours 24-26) I have only mild GI upset and I'm cold. I also have some brain fog, dizziness and a tightness in my head. These "head" symptoms may be from the very warm weather we are having here today and didn't occur until after I dosed.

I'm a bit confused because I thought most people went through WD at the 36-48 hour mark but it seems I'm metabolizing quicker. I had 4 great days before I cut so I am confident that I was stable before I started. Anyone else experience early WD's? I didn't think this would happen until tomorrow and I have 2 appointments I need to get to today. I sort of planned on being uncomfortable tomorrow when I had nothing to do LOL!

Anyhoo....I have an exercise routine and will get to that in an hour or so. I honestly don't feel like it, I'd much rather just lie around and rest until I absolutely have to do anything, but I know my brain and body can use the boost and the distraction.

I'll check in and let you all know how my symptoms subside (hopefully) or increase. I'll tell you this though, this is NOTHING compared to how sick I was after 24 hours post cutting my oxy.


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 Post subject: dosing adjustments
PostPosted: Wed May 26, 2010 12:48 pm 
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<b>Samantha</b> - If you are having some difficulties with a 10%+ decrease you may want to slow things down a bit and cut back by approximately 5% instead. Here's some additional information that you may find useful:

8mg/8.5ml --- 1ml = .941mgs

8mg/9.5ml --- 1ml = .842mgs

8mg/10.5ml -- 1ml = .761mgs

8mg/11.5ml -- 1ml = .695mgs

Good luck! Let me know how things work out.

<b>Ginger</b> - Glad to be of some help. For me personally, while exercising did help to get me through the daily withdrawals, the biggest benifits seemed to occur over weeks and months.

That's great that you're a long distance runner... it should help you a lot with your taper. Correct me if I'm wrong, but didn't you mention in one of your posts that you ran seventeen miles a few weeks back? I've jogged ten miles on a track on two separate occasions (quite some time ago) and both times I remember I had absolutely nothing left at the end. I give you a lot of credit.

I wish you luck with your taper. If I can be of any help at all, please feel free to contact me.

Bill


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 Post subject: WD After Decreases
PostPosted: Wed May 26, 2010 1:53 pm 
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Hey Smat!. You posted:

"I'm a bit confused because I thought most people went through WD at the 36-48 hour mark but it seems I'm metabolizing quicker. I had 4 great days before I cut so I am confident that I was stable before I started. Anyone else experience early WD's? "

The answer is YES! I dosed twice a day when I got down to .8mgs, and my WD came on and left much faster than other people reported. Specifically:

Decreases from .8 mgs to .6
0 hrs last dose
24-41 hrs WD become noticeable
42-50 hrs WD increase to moderate
51-55 hrs WD peak
56-60 hrs WD decrease rapidly
60 hrs Over
Total: 53 hrs


Decreases from .6 mgs to .4
0 hrs last dose
17-28 hrs WD start, increase to moderate
28-40 hrs WD very light, feeling better
41-47 hrs WD light breakthrough
48 hrs Over
Total: 30 hrs


Decreases from .4 mgs to .1
0 hrs last dose
18-30 hrs WD start, light
30-37 hrs WD only chills, feeling better
38 hrs Over
Total: 19 hrs

My Subjective Definitions:
Light WD = A slight feeling, as if you've just realized you forgot to take your dose/or are late taking your dose. A feeling that "something's going on." Sweaty palms of hands, and sweaty feet, occasional headache.

Moderate WD = Chills, sometimes yawning or sneezing, a leg twitch here and there.

Peak WD = Feverish, tired, sometimes a rapid heartbeat, twice I had to lie down for a few hours, twice my skin felt hot.

It seemed the lower I got, the faster the stablization became. I was able to decrease every 2-3 days, but I do recommend taking a break every now and then by staying with one dose for 5 days. The subsequent decreases will be easier if you do.

When I jumped (well, more like an uneventful "hop") my worst symptoms happened in the first 24 hours, then I felt better and better everyday. Almost high. I know, weird, right?? Let me say again, that even my worst WD symptoms felt roughly equal to a detox from 10-20mgs of hydrocodone. Very, very mild. Too mild to even take anything.

The Brain Fog comes and goes, but gets much better/lighter at lower doses. After I got under .5mgs, I only felt "a little out of it/a little flaky" every now and then. In fact, it made me laugh. I'm not sure why, I just thought it was funny to feel like I had 30 IQ points disappear overnight. It never lasted more than a day each time. The depression gets very light, too. Not really depression, just sort of a blah feeling sometimes, scattered between days of happiness.

I am so glad you are tapering. You will be amazed at how much easier it is!! I think it took me 6-7 weeks to go from .8 to .1ish, so just be patient. You are already doing great!!


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PostPosted: Thu May 27, 2010 1:28 am 
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Down to .8 mg now. If I forget to take my dose I feel what Anne describes as moderate withdrawal (yawning, stretching, teary eyes, lethargy etc...) I have never experienced a leg twitch or restless legs from withdrawal, thankfully. Even from severe withdrawal. My symptoms during severe-moderate withdrawal are: diarrhea, muscle pain mostly in the calf muscles, severe dysphoria (the worst part), anxiety, restlessness, sleeplessness and anorexia. The dysphoria being the worst followed by diarrhea. The actual physical pain is the most tolerable.

Sorry for the tangent. Everything seems to be going well. This isn't harder or easier than I expected. So far it's been predictable.

The liquid method is great!


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PostPosted: Thu May 27, 2010 6:43 am 
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Bill..
yes..I did do a 17 miler and am training to run the R & R Mari in Chicago on Augusta 1st. I have run several marathons (and other races)while trying to taper (and several while on my DOC) but seem to do alright as far as during and toward the end of my runs..it's getting started that I have trouble with. I dose with sub just before I run. Not sure that's the greatest idea tho bc I am tapering off and hope my brain doesn't trick me into thinking that I NEED it in order to run. If my taper goes well..I will be off when I run the marathon in August.
reat reading all the info ppl are sharing!
So glad I found you all!
G44


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PostPosted: Thu May 27, 2010 10:47 am 
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Hello everyone :D

I just wanted to update as I am almost at hour 50 during my first cut in the liquid taper. After my post yesterday my D went from mild to moderate w/ increasing nausea, dizziness, muscle twitching, anxiety, brain fog and sleepiness. I forced myself to exercise (some gentle yoga followed by 15 minutes on a NordicTrack ski machine) and I felt better almost immediately. I can only describe my level of WD post exercise as "uncomfortable". I did have some very mild mood changes and slight muscle twitches but the worst of it was over. I slept a full 7 hours and woke up feeling pretty well all things considered.

My symptoms today are slight muscle tightness/stiffness, very mild muscle twitches, brain fog and I'm tired. Not fatigued, I just feel like I could use some more coffee. I have only done my yoga so far and that helped considerably w/ the tightness. I wouldn't say I've stabilized just yet, I feel like something is off but I am much better than yesterday. I expect I'll feel even better when I do some aerobic activity.

So good news ey? I thought I would have to up-dose another 5% but I can tolerate and function w/ no difficulty so I'll forge ahead! :P

Bill- Thanks again for the up-dose information. I would be lost w/out you :D

Annmarie- Thanks for sharing your experience w/ me :D I'm happy to know that we are both exceptions to the WD peak rule. I know that everyone is different but it really helped me to know that you had a similar experience. I'm glad to hear you are doing well. I followed your taper w/ Bill and I found it to be extremely informative. I'm so grateful for you all blazing the trail and giving hope to a newbie like me.

Schrodinger's Cat- Glad things are going well for you on your taper. Thanks for taking the time to provide the spreadsheets,your ideas and experience throughout this whole thing.


ginger44- Good luck on your taper! Keep us posted.

Ok I'm off to exercise and get on w/ my day. Hope you all have a great one!!!!!!!! 8)


Samantha


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