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PostPosted: Sun May 24, 2009 4:48 am 
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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 kept the amount of water low so that the solution would be fairly concentrated, and it works really well. The dose does seem to hit me a lot faster than when waiting for a pill to dissolve though, which caught me off guard at first. As always, I am shocked at how strong a drug Suboxone is. Even at .4mgs per dose, I can definitely feel it when I take it.

So that was 10 days ago. I took my last dose of that solution today, and I will make up a new solution tomorrow. I'm thinking of using the same amount of water but only 6mgs of Suboxone, which will be a reduction of .2mgs again.

The drop from 1mg to.8mg produced only the mildest symptoms, some restlessness and a little irritability. Much better than what I was dealing with trying to go from 1mg a day to 1mg every other day.

Other things that have helped are hot baths, swimming, exercise generally and keeping myself distracted. The less I think about it the better off I am. I've noticed that when I read other people's withdrawal experiences I feel worse. Hmm...

So I'll keep this thread posted with my progress. If anyone else has tried this method I'd love to hear from you too. For the record, I started treatment with Sub in October of 2007, so I've been on it for a little over 1.5years. The last 6 months I've been on 2 mgs and then 1mg for the last 2 months or so. So far, this seems like the best taper method for a soft landing. Wish me luck.


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PostPosted: Sun May 24, 2009 11:28 am 
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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!


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PostPosted: Sun May 24, 2009 4:52 pm 
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Yeah, I know you didn't try it - but I think you had someone email you who had tried it, is that right?

Anyway, it seemed like a good idea. I think you suggested making a 10% reduction every two weeks or so. I'm running out of time, so I'm going a little faster than that. Still it's been much better than skipping days or trying to break a 2mg pill into quarters. I would put that little speck of pill in my mouth and it would vanish. The small doses dissolved in water work better.

The only thing is that I haven't told my doctor what I'm doing. He's pretty cool, but this situation might be a bit much for him to sign off on. I don't like keeping secrets, but he has limited experience in this area - he told me he hasn't had a patient successfully stop taking Sub. I'm hoping that I'll be able to do this, and then tell him after the fact so that maybe he'll let other patients know about it.

It sucks to still feel like I can't be open with my doctor after 18 months of perfect compliance. Bah.

You know what, I'm going to tell him. I have an appointment on Tuesday, and he's already written my prescription with refills for the rest of my insurance coverage, so there really isn't much he can do even if he fires me, which I don't think he would do. Hopefully he'll be able to respect my honesty.

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PostPosted: Tue May 26, 2009 4:39 pm 
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I am on my second day of .6mgs, down from the .8mgs that I was taking for the last 10 days. Yesterday was ok, I was just a little grumpy but I went for a long walk with my daughter and felt much better.

Today I woke up with chills and a runny nose and a little achy but that went away about 15 minutes after I dosed. I'm feeling kinda lethargic so I'm going to get off the computer and go for a swim. Swimming is the best - I have fibromyalgia and swimming doesn't hurt my body any more than it already hurts - exercise I have found for allievating the tapering symptoms. Motivating to do it is the only issue. I just have to remember there's a hot tub waiting for me after I work out. :lol:

I've now been doing this liquid taper for almost 2 weeks, and so far it's WAY better than my doctor's suggested method, which was to start dosing every other day. That put me on what felt like a roller coaster and the w/d symptoms were more pronounced, especially insomnia.

Since starting this new method I haven't even needed my Clonidine prescription, so I'm saving it for the end when things might be worse.

Just for the record, every reduction since I've gotten below 2mgs has had acute symptoms starting 2-3 days after the reduction and lasting up to 2 weeks. These are the achy legs, restlessness, irritablity, sleeplessness, runny nose, chills. Clonidine helped some of these - but the new taper method is gentler so these symptoms are less.

There are other aspects of the taper that are longer lasting - lethargy, apathy, the return of fibro symptoms, fatigue. It's hard for me to tell what of these is withdrawal and what is my fibro or my depression. I've had to make adjustments in my life to cope with these symptoms, and while they are a pain in the ass, they are not unbearable. Reminding myself that it's not forever, this is not the worst I've ever felt, and keeping a positive outlook helps me get through it. So has adjusting my expectations of what this period of my life is going to be like.

At this point I absolutely do not regret going on Suboxone. Sub helped me save my life.

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 Post subject: Day Three - .6mgs
PostPosted: Thu May 28, 2009 3:14 am 
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Finally, today is over!

I had some w/d symptoms, but they were still pretty mild. I went to work, which actually helped by distracting me from myself.

My legs were achy this morning but a hot bath helped that tremendously. My stomach was upset so I got myself a tasty smoothie with extra protien and B vitamins. I drank tea and tons of water all day and just tried to pace myself.

The best thing is this growing sense of confidence that I Can Do This. Today, a lot of it was mind over matter: when I started feeling like this is too hard I was able to talk myself out of going there.

Another bonus to this tapering method is that even at this low of a dose, I can still split my dose and take half in the am and half at night. That was just not possible when I was taking a quarter of a 2mg pill. Even if I could cut it that small, it seemed like the pill/dust just washed away in my mouth before it had a chance to work. Being able to take a small dose at night cuts down on insomnia and the twitchy leg thing that likes to start up as soon as I get comfy in bed. And since I used the same amount of water to make the solution this time I don't feel like I'm taking less. Psychological, I know, but whatever works.

I know this is a really navel-gazy thread, but writing it out helps me in various ways, and hopefully my experience will also be able to help someone else through a taper as well.

Tonight I'm hoping that the next few days will be similar to today and then I'll start feeling better. Once I feel close to normal again it will be time to do this all again. I should be well practiced by the time I get to zero. :wink:

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PostPosted: Thu May 28, 2009 4:12 am 
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hi, im relly interested in this method...i been stuck on about 1 or 2 mg of sub for about 3 months and really have had trouble skipping days too and i cant really cut a 8mg pill into .5mg fragments.....so all you do is drop a sub into water measured the dose and then just swallow it?


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 Post subject: No, Don't Swallow!
PostPosted: Thu May 28, 2009 7:13 am 
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Hi Ralph - I know how you feel about being stuck aroung 1mg. Ugh.

To do what I'm doing you need a small container (I use an empty pill jar) and an oral syringe that measures in ML.

If you're at 1mg and want to go down to .8mgs, you can crush an 8mg pill and dissolve it in 10ml of water. Then each 1ml has .8mgs of Suboxone in it. Measure out your dose with they syringe and squirt it under your tongue. Hold it there for like 10 minutes or so, and don't drink or eat for 20 minutes after you swallow or spit it out. You're still taking it sublinqually, it's just liquified already.

I use 10ml of water because it makes the math easy and also becasue I like to split my dose and take half in the morning and half at night. So I take a half ml each time, which is only a few drops of liquid under the tongue and works quite well. I tried taking the whole 1ml dose at one time and thought it was a bit too much liquid - so if you're going with a once a day dose you might want to adjust accordingly.

I did 10 days at .8mgs and then went down to .6mgs. Same process, but I only used 3/4 of an 8mg pill in 10ml of water this time. Next drop will be to .5, then .4, .3, .2, .1...and then I guess I'll be done. Not sure if I'll try to space doses out or not, guess it depends on how I feel.

I don't know anyone else who's done this method, it was just a suggestion that I thought sounded good. I recommend trying it. I tried to go from 1mg to .5 by dosing 1mg one day and then .5 the next...and that was much harder.

The theory is, the longer and slower you do the taper, the softer the landing. Oh, and get down as low as possible before jumping off.

Hope you get unstuck!

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 Post subject: Taking Advice Also
PostPosted: Sat Jun 06, 2009 10:51 pm 
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[font=Verdana] [/font] Since the doc is cutting me down to 1mg this month, I know that half will be here before ya know it so it is nice reading this. Hope it is still working for you!! Thanks again! :)

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PostPosted: Sun Jun 07, 2009 11:41 am 
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Diary,

How are you doing? I hope all is going good and that you're close to succeeding. I have a question for you if you don't mind.

Since you've been on this taper, are you of the opinon that it's better to go through withdrawals slowly, having them last longer but being less intense, as opposed to doing it cold turkey: tapering down to 1mg and stopping it abruptly? Using the latter method, withdrawals still last a (relatively) long time, so I'm assuming that with the taper method you'll be in mild withdrawals for the duration of the taper, and then you'll go through an additional withdrawal period while your body slowly fixes itself and gets used to being on no medication. Thus, wouldn't it be harder to go through a prolonged, albeit milder, withdrawal period rather than a shorter one?

The reason I'm asking this is because I've always toughed out the worst part of the wd's (3 attempts at quitting so far - each time trying harder than the last). My last attempt at stopping Suboxone lasted a month and a half. Then, although the wd symptoms were much milder than they had ever been, I gave up because I couldn't face another day at work in that state. I mean that general feeling of mild pain and uncomfortableness that lingers on after any withdrawal. I just couldn't give work all my attention if I was not comfortable in my own skin. One day I just gave up and took 0.5mg of Suboxone in the morning to help me get through the day. My junkie self rationalised that I'll only be taking it when really needed. But as we all know, that ends up being everyday.

Thus, from experience I'd say that it's not the intensity that causes me to relapse, but rather the duration of Suboxone withdrawals.


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PostPosted: Sun Jun 07, 2009 1:30 pm 
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I think it's really great that your taking the time to share your success with the rest of us Diary. If I decide to taper off I'll definately use your technique. Will definately be hoping for your continued success in tapering off completely. Hang in there :wink:

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PostPosted: Sun Jun 07, 2009 3:36 pm 
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Hi stregol - Thanks for your comment.

I tried to stop Sub from 2mgs and 1mg before and it wasn't happening. I also tried going from 1mg to 1mg every other day and that didn't work either. When I tried breaking the 2mg pills into .5mg bits, it seemed like the Sub washed away in my mouth before it ever got into my bloodstream. Trying to do all of the above made me feel worse than I wanted to feel - I can't really take much time off to just deal because I have a job and a kid.

The way I'm doing the taper now, I don't feel sick all the time. I drop my dose about every 10 days or so. For the first 2-3 days after the drop I'm fine, then comes about 3 days of very mild irritability and achyness, then I'm fine again for the next 4 or 5 days depending. So I'm usually only feeling slightly bad for a few days with at least a week of feeling normal in between. I've also noticed that if I work out consistently, even when I really don't want to, I feel my withdrawal a lot less.

I'm hoping that doing it this way, going down incrementally and very slowly, giving my brain time to recover and adjust between each reduction will help my natural endorphin system recover a bit before I totally stop. It seems to me this is the best chance of avoiding or at least reducing paws.

Believe me, if I just felt protractedly sick during this whole process, I'd probably just jump from here. But I feel pretty good so it seems to be working.

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PostPosted: Sun Jun 07, 2009 3:50 pm 
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Thanks for the support Matt, I appreciate it.

I haven't posted over here for a few days because I'm still holding at .6mgs - I decided to stay there for another 10 days - and I've been feeling pretty well. I try not to dwell on every little thing that's wrong with me - I've noticed that when I read really detailed accounts of other people's withdrawals I start to feel that way. So suggestable, huh?

I'm doing good though. I had a couple of days that I forgot to take my night dose of Suboxone and I was fine, then I went back to the dose I was taking because I don't want to get all silly and rush things and screw up a good plan.

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PostPosted: Sun Jun 07, 2009 4:39 pm 
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I really do wish you all success, my friend.

I hear you on the job, it makes things that much difficult. I mean, it's not like you can fake a month long illness or something.

The 1mg every other day is the worst idea ever. Some people suggested it to me, and said that since bupe has such a long half-life I shouldn't feel a thing. Yeah, right. That lasted around a day.

I'm really going to try this taper method out. The only difference is that I don't have much time available. I took as much time off as I could justify during August, and that's when it needs to happen. I've got until the 1st of August to go down to 0.2mg . Then after that I'll just jump. I hope it's possible. If not 0.2mg then at the very least 0.5. I'd assume that the detox would be much easier jumping off of 0.5 than it would be off 1mg.


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PostPosted: Wed Jul 08, 2009 8:38 pm 
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Its now july 8th what happened?


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PostPosted: Fri Jul 10, 2009 4:25 am 
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Good lord, I am too lazy to keep my own taper thread updated. :lol:

I had this realization today that I have only 12mgs of Suboxone left, and then I am done. To be totally honest, I'm a little scared, but my insurance and my financial situation are a good incentive to at least give this my best shot. My doctor thinks I'm ready, and most of the time I agree.

I've been on .4mgs (400mcg) for the past 2 weeks. I feel the worst at night - I get a lot of headaches and I'm restless. I think this is because I now dose only in the morning, where before I was dosing twice a day. Also, I had chronic migraines before I was on Sub, and when I got on Sub my headaches were decreased quite a bit, so now that I'm on such a low dose maybe they're just back. Who knows. Still, I'm able to fall asleep without taking anything, so that's good. I have a scrip for clonidine that I haven't even filled yet.

I just try not to dwell on it. I work really hard on keeping perspective. This is what I've been working toward all these months. Suboxone was a useful tool, and a sturdy crutch to lean on while I learned other ways to cope with physical and emotional pain. When I don't use those other tools, I pay the price in feeling shitty and out of control. That's a really good motivation to use them.

Tomorrow I'm going to drop to .3mgs. I'll keep you posted.

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PostPosted: Fri Jul 10, 2009 5:11 pm 
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Thanks I think you should do what ever your comfortable with.


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PostPosted: Fri Jul 10, 2009 11:53 pm 
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Hey this thread is awesome...please keep keeping us updated! I am at 1 mg and trying to figure out the next step. I'll give this a shot.

Can anyone tell me more about clonodine? Does your suboxone doc prescribe it?

Also, am I the only one that feels like the docs don't know much about this drug really....? Mine just blows off every concern or thought I have and says it's psychological. He's kind of a jack ass but I don't feel like changing docs at this point.


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PostPosted: Sat Jul 11, 2009 12:48 am 
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Thanks for the replies and support, yo.

My sub doc does prescribe clonidine to me. It's a blood pressure medication, also used off-label for anxiety and opiate withdrawal. My doctor said that it calms the sympathetic nervous system, which controls blood pressure. The sympathetic nervous system is also responsible for some opiate withdrawal symtoms, which is why clonidine helps with withdrawal.

For me, it helps with insomnia, chills, hot flashes, sweating, anxiety, constant yawning and restlessness (also that feeling like you're going to crawl out of your own skin.) I've only taken it a few times. The down side is it makes me groggy. Not the most fun feeling, but better than the alternative.

I'll probably take it after I stop taking Sub completely. I was using it when I did reductions, but since I started the liquid method I haven't needed it.

It sucks that your doctor just blows you off like that. I think there is a problem with the training that docs get for prescribing Suboxone, since so many people say their doctors are misinformed, uninformed or generally clueless and dismissive. I've lucked out I guess. My doctor is honest about his relative lack of experience but he is open and listens to what I have to say and if he disagrees he tells me why.

On the other hand, a lot of our issues as addicts are psychological. Sometimes you just have to try to figure it out. If you disagree, tell your doctor. If it's something that's seriously bothering you, you might have to switch docs.

I will keep posted. Nothing new to report today.

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PostPosted: Sat Jul 11, 2009 4:38 am 
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Hi Diary,

Do you have a target date for when your taper will be finished? What dose do you plan to end with?


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PostPosted: Sat Jul 11, 2009 2:05 pm 
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Thanks for the quick reply! I've been on Sub for a year and this is the first time I've every posted on a site like this. Usually the blogs and stuff I find are old. It's cool that this one seems new and updated and people are still checking. It's good to hear from people going through the same thing...i just helps to know that what i"m experiencing is normal.

My favorite quote from my doc is when he says, "the suboxone rep says....." . I'm a medical device rep and of course the suboxone rep says stuff like tapering is easy, it's all psychological, it doesn't effect sex drive, etc. That's why the pharmaceutical industry is crumbling.

Anyway, love the liquid idea. I am taking a quarter in the AM and a quarter in the PM of a 2 mg pill and was starting to wonder what's next.

Keep up the taper man, you can do it.


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Dr. Jeffrey Junig, M.D., Ph.D.

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