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PostPosted: Tue Nov 01, 2016 4:28 pm 
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Wondering if anyone can help me with this question. I was planning to jump to bupe tomorrow, but after reading a few posts about PW it occurs to me I might benefit by lowering my tolerance first.
Is splitting dose useful at all? I normally take x amount of opium in evening so I can sleep at night.
If I take half that dose a little earlier than norma,l and then the other half before bed some 7 or so hours later, is that accomplishing anything useful? Or do I need to cut down on total amount taken over a 24 hour period?

I have already cut my morning dose in half, but it's the nighttime dose and the sleep issues associated with it that makes cutting that dose more difficult.

Hope that makes sense...

Gratefully,
Godfrey


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PostPosted: Tue Nov 01, 2016 7:09 pm 
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You should be okay if you take your nightime dose and then induce onto Suboxone around 3-5 PM the next day. You will probably sleep alright because your brain will think it's getting the same thing, which it is. Your MU receptors will be saturated enough for sleep.

How much Buprenorphine are you planning on inducing? Are you seeing a doctor or is this off the street?

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PostPosted: Tue Nov 01, 2016 10:17 pm 
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So, your talking about maybe putting off induction for a few more days and getting your tolerance down a bit before jumping into induction? Hhmmm?


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PostPosted: Tue Nov 01, 2016 10:19 pm 
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Hey rule....

Doctor prescribed 8 mg 3 times a day if necessary. I plan on cutting the film into quarters and go at it more slowly than that,

I was going to make the jump tomorrow but have decided to spend few days bringing down my tolerance a bit.

My question...poorly framed I'm afraid....had to with with whether splitting up my usual doses of narcotic (opium in this case) will indeed bring down my tolerance in a useful way (by which I mean make PW less likely.

Hey bama....yes, exactly right :-)


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PostPosted: Tue Nov 01, 2016 10:23 pm 
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If you can pull it off, and not get into any trouble while using your drug of choice, I say go for it. It might pay off in the long run! Just my opinion. Not sure how many will agree with me on this but I definitely see where your going with this... Good luck :D


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PostPosted: Tue Nov 01, 2016 10:35 pm 
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Hi godfrey, I was just going to write something to you about the cows sheet in the induction section, and I just read where you posted on there earlier today. So I guess the rest is up to you. You have a lot to take into consideration. Good luck with your choice though.


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PostPosted: Tue Nov 01, 2016 11:41 pm 
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Godfrey,

You would just be delaying the process by adding more opiate. The facts are a person must be in at least moderate wd for a better and smoother induction. The louger you wait the better the Buprenorphine is going to work for you.
Its good your going to take the film slowly, no dought.

In theory useing a little of your doc could help you get though the night but this will lead to a louger wait for wd and induction. I understand its hard but the wd is necessary.
Just my 2 cents.

Razor


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PostPosted: Wed Nov 02, 2016 9:24 am 
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Hi Razor...

I think it's likely you misunderstand me. I'm sorry I wasn't clear. My question is would just splitting a fixed daily dose lower tolerance? Say I'm taking x amount once a day. Instead I now take half of x twice a day. Same amount over a 24 hour period, but lower doses.


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PostPosted: Wed Nov 02, 2016 2:32 pm 
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How much is X amount of opium? What and how are you taking it? How do you get a consistent 'dose' to know whether you are lowering your tolerance? I don't ask to be provocative but 'opium' is not available by prescription and any illicit source will not have any quality control measures in place. (Unless you found someone willing to prescribe tincture of opium or Laudanum but I am not aware if it is even available anymore.)
Depending on your intake you may not need to lower your tolerance at all. The COWS is the go to guide, moderate to severe withdrawal is necessary, unless you are taking methadone or fentanyl then you really should be having that discussion with your doctor and inducing in the office.


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PostPosted: Wed Nov 02, 2016 2:37 pm 
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I understood you Bud, and your plan can work as loug as you are indeed taking less of your doc. So you want to stretch the doses out over a louger period of time before induction?. Ok.

But the wd has to come. One way or another for induction. Thats what I was saying. Its the best way to stay out of PW s.

We are pulling for you . You ll make it.

Razor


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PostPosted: Wed Nov 02, 2016 3:07 pm 
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Hey Doc,

i carefully weigh what I take, so that I can be sure I'm using a consistent dose. I'm hesitant to explain procurement methods as I don't want to give any curious young addicts any more ways to harm themselves than they already have, I'm not putting you in that category. IN fact I'm assuming your a physician. It's just that it's a public forum. i just don't want to feel responsible for causing any harm.The information is ready available however. I've also posted a bit more info on this forum in the last few days, then immediately felt guilty

After twelve years I can safely say my tolerance is quite high. I was told by a bupe physician I respect that the lower my tolerance the safer in terms of avoiding PW. Seems to me perfectly reasonable to try and lower it as much as I can before making the switch. Reading some of the stories of people going into PW has motivated me to try.

Insofar as inducing in doctors office, that doesn't seem to be done around here. I've been to several clinics in the area and they all tell you you're on your own pretty much. I've never seen a "moderate to severe," instruction, more familiar with "mild to moderate" ....with most people erring on the moderate side to be safer.


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PostPosted: Wed Nov 02, 2016 7:02 pm 
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The problem with inducing with a very high tolerance is not PW. The buprenorphine does not provide enough coverage until the tolerance drops to match the buprenorphine. Still miserable and perhaps splitting hairs. I try to get folks to the high moderate, to severe spectrum on the COWS or SOWS. Usually 18-30 hours for those on short acting opiates. I have only seen PW once, maybe that is why.
Regardless of what happens, if you stick with the buprenorphine a couple of days you come out the other end in a better spot (well, usually)
PAX


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PostPosted: Wed Nov 02, 2016 8:29 pm 
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Thanks for that clarification doc. It looks like I'm in for a little slice of hell no matter what I do...unless I make a bigger effort at say halving my tolerance. But that would likely take months. I was given a prescription for up to 24 mg per day. at first I thought it was a lot but I'm slowly realizing it's probably needed. If my tolerance is as large as I suspect I assume i'll continue to feel crappy and use all 24 mg's no problem...

Suppose I stretch this out over two days,,,,,whereby I devote the first day to maybe half rations which will leave me pretty miserable....but presumably it would also work to lower my tolerance a bit. The second day I'd take none at all. It would also cut down on the predicted 24 hours or so of torture I think as I'd likely go into full blown WD much more quickly...suppose that makes any sense?

If you're still interested in the opium situation, feel free to message me....

Many thanks...


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PostPosted: Thu Nov 03, 2016 9:48 am 
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Try not to worry so much Godfrey, I know it's scary because we all fear withdrawal so much. But most of us had to go through this phase, and it wasn't fun, but once it's over u can start recovery and the next chapter of ur life. I waited 32 hrs, knowing what I know now, I'd waited about 24 and saved myself longer suffering. I know it sucks but if I were u, I'd just start the process because no matter what u do, imo, ur gonna worry and question urself no matter what or how u do it. That's how us that worry all the time do....we never stop lol, I'm absolutely like that. But in the end, withdrawal is necessary, so why not just go for it and get it over with?

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PostPosted: Thu Nov 03, 2016 12:02 pm 
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Quote:
That's how us that worry all the time do....we never stop lol,



"Takes one to know one," as the saying goes. :D You're no doubt right, Jennifer. I won't spend more than a couple of weeks trying to lower my tolerance a bit. Of course I get tempted to cheat while doing so and sometimes even give in, but over the last few months I've managed to cut my customary morning dose in half, which is pretty substantial. I can't do that much with my evening dose if I want to sleep at night. Even with what for me is a nice full dose I don't ever get more than 6 hours...and more often 4-5. But I've had some success in the last few days just splitting the dose over 5 hours or so....half of what's usually my full dose in late afternoon and half a couple hours before bed. I don't get much of a high at all, but my sleep isn't too disrupted that way.

I have an appointment with bupe doc the 16th of this month. I will likely jump then.

All that said, I certainly hear you. I could put this off forever left to my own addict devices. I just want to give myself every chance at a relatively smooth induction. I believe I...and my body... can handle the 24 hours. But several days of relentless anxiety whether due to PW or the fact that my tolerance is greater than the bupe can handle right away....would be a different matter. I've been through some pretty hellish experiences as a much younger addict and came through ok. But I'm in my 60's now. As much as I fight that with running and working out etc, I'm not nearly as strong as I once was. We never really fully accept deep down that we'll get old some day, but time is relentless. I think it might have been Tolstoy who said "The greatest surprise in a man's life is old age." Presumable a woman's too. :D


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PostPosted: Thu Nov 03, 2016 1:26 pm 
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Hi Godfrey, Welcome! Please, before I start, understand that my questions and comments are from a place of concern. Why are you torturing yourself with all of this craziness? Stop the opium.....wait 24 to 32 hours and start the suboxone. You will have just a few hours of being uncomfortable but you also will know that relief is coming! You will have it in your hand, ready to go! I know I was very lucky in how smoothly it went for me but I also followed my doctor's instruction to the letter! I just think you maybe over thinking this. We will be here for you every step of the way! Good luck and keep posting!


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PostPosted: Thu Nov 03, 2016 3:31 pm 
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HI Michelle...

No worries at all. I understand and appreciate you're wanting to help. Refer to doc's reply 2 or 3 messages upstream, concerning the difficulties of induction for people with a very high tolerance. I'm just lowering mine as much as I can before jumping. I really don't want to have several days of misery if I can avoid it.
I'm taking a drug...opium....in a form that can't be usefully quantified. I"ve been taking it for 12 years in ever increasing doses. I'm just making the assumption....out of an excess of caution of you like.....that I might well be in the very high tolerance category. There's no way for me....or the several bupe doctors I've seen....to know for sure.


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PostPosted: Sat Nov 05, 2016 12:30 pm 
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Buprenorphine is such a weird drug. The less you take, the more powerful it feels. But that is after you've stabilized on it first.

Don't worry about your tolerance. Take the high dose of Suboxone and then taper down from that. It is incredibly easy to do. Trying to lower your tolerance seems like you're suffering for nothing. You don't even need to be in severe withdrawals, just moderate. You can go 18 hours w/o the opiate. Just a little uncomfortable for only a part of a day.....no big deal. Just do it and be done with it.

Then take at least a year to taper and get off the Suboxone if you want. Or just stay on it like a lot of us here.

Just like an addict...you're thinking too much. Action speaks louder than words.

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PostPosted: Sat Nov 05, 2016 1:40 pm 
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rule,

I hope I'm not boring people with this thread. But it's hard not to respond to someone who's clearly well meaning, which has been the case with everyone's who's weighed in. And although I'm surprised at the reaction I'm getting, it's still appreciated.

I'll just say that I've heard from 2 bupe physicians now, one of them Dr. J., that going in with a high tolerance can lead to difficulties. I love the way you described the induction process...making it sound fairly easy, with just a few hours of real discomfort. I found it deeply encouraging, and i appreciate it. As I've said, I'm pretty sure I can get through it. But a couple of days of PW...or something similar as described upstream by doc, would be a different matter. My health isn't great and I'm not a young guy any longer.

I'm not trying to be a hero with the tolerance reduction. I know from bitter experience it can't be rushed. When I do too much in too much of hurry, I end up just taking more to feel better, which of course is only increasing my tolerance. So just a few baby steps. Though I think I mentioned I've managed to cut my morning dose in half over the last couple of months. That's pretty significant I just want to chip away at the evening dose as much as I can within the next couple weeks.


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