It is currently Tue Aug 22, 2017 6:44 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 17 posts ] 
Author Message
PostPosted: Tue Nov 27, 2012 3:58 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Hi All,

I've been reading as much as possible on this forum to help support my fiancé tapering off suboxone. I've been supporting her, cutting her doses, but I need to understand some basics to best help advise and motivate her.

Firstly, she's on the sublingual films (says 8/2mg on the label). I understand this is the ratio of sub to naloxone (correct?), but I want to be fully certain of this. Does this mean that the full SL film counts as 8mg sub, or am I wrong( is it really only 2 mg?)? Currently she's taking 1/2 film a day, so does that equate to 4 mg sub? I want to be clear on this so I can communicate effectively on this forum.

Also, it seems somewhere along the lines of trying to taper (we tried going from 4mg to 3mg this past weekend, and it was rough....) she seems to be constantly behind on her dosing. I want to stabilize her at her dosage so she doesn't have to suffer wd symptoms, and taper as slow as possible. Currently she takes 1 1/2 mg at 6 am, another 1 at 12pm, and then another 1 1/2 at 6pm... Is this ideal? It seems like a bit of a roller coaster, as she nears her dosing time she gets edgy and starts to report wd symptoms. I believe I read somewhere on here that it's best to only dose twice a day, 12 hours apart - is this the case?

Any input is appreciated, please point me in the right direction, and show me (and in turn, her) the great resource and support group you guys have to offer.

Thanks in advance!


Top
 Profile  
 
 Post subject:
PostPosted: Tue Nov 27, 2012 4:10 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Oct 15, 2012 11:27 am
Posts: 1454
Yes, you are correct. What you have is an 8mg dose of suboxone and 2mg of nalaxone. I used to dose multiple times a day.. I got in a bad habit (while initially trying to taper) of taking smaller doses several times a day. I think I was up to 4-5 little doses per day. This actually helped me to lower my dose over all but it made it really hard towards the end. Once you get down to smaller 1mg/ 2mg doses, it really is better to not exceed 2 doses per day. She won't like it but trust me, she'll get used to it and it won't kill her. Nor are those wd symptoms she's experiencing all that bad. It is really in her head at this point (but don't tell her that because as far as she is concerned it's as real as real can be.)

I suggest finding a dose that works for her at this point and doing it no more than twice a day. Her body WILL adjust and it really isn't that bad as she thinks it is. If she gets past the initial yucky feeling when the sub -seems- to be wearing off, and just rides it out a bit, she'll realize that it isn't that bad. At least that's what happened with me and I was petrified of tapering/ jumping. Once you get to two even doses, take turns tapering each dose a tiny bit by altering.

For me, it was much easier to taper by using the 2mg strips after a certain point. It is tedious breaking up those 8mg pills & strips. It was worth it in my book.

Good luck!


Top
 Profile  
 
 Post subject:
PostPosted: Tue Nov 27, 2012 5:50 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Thanks for the quick reply!

Are you saying they make 2mg films? If so, I'll have her check into getting these from the doc instead. It's a tedious pain in the ass dividing up an 8mg into 8 even mgs, let alone get an exact .5 mg out of it...

Do you know if there is dramatic cost difference in the two dose sizes?


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Tue Nov 27, 2012 7:45 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Sat May 01, 2010 3:46 pm
Posts: 461
Location: South Florida
Hello,

There are 2mg sub films.  They cost almost as much as the 8mg films.  It's really stupid,  you may want to hold off until you get your fiance much lower.  It's roughly the same price for 1/4th the amount of meds.  

About dosing multiple times per day... Dr Junig, the creator of this web site has recommended multiple doses when tapering once you get to the low doses.  I started splitting my dose into three times per day I think when I got to about 1.5 or 2 mgs.  when you get below the ceiling level, sub wears off much faster.  Average about 6-8 hours.  This is because when you are below the ceiling level, you aren't saturated all day by once a day dosing anymore.  Dr. j even suggested up to 4 times per day.  But for me 3 has been fine.   

http://suboxonetalkzone.com/stopping-suboxone/ 

That's the full article, you should check it out and btw good job helping your fiance out with this. I totally endorse a long slow taper. I have been tapering almost a year now myself.. Been painless so far for the most part. If it feels bad try every other day or every 3rd day with a new, lower dose before committing to it.

Good luck,

-Gb

Quote from Dr Junig article: 

"As the dose is lowered, the effects of buprenorphine become shorter in duration. So the person tapering buprenorphine need to not only take smaller amounts each day, but must also divide that daily amount into two, then three, then maybe even four doses to avoid withdrawal symptoms at the end of the dosing interval."


Top
 Profile  
 
 Post subject:
PostPosted: Tue Nov 27, 2012 9:17 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Tiny, Glen

Thanks so much for the advice and the link to the blog. I've only stumbled on this site for two days, and sadly I've learned infinitely more online than I have by doctors visits with my fiancé.

I've had pharmacists and doctors tell us that she's been on the program for too long (its been about 20 months) and it's doing harm - hearing things like this are demoralizing and counter productive. Hearing other people's words and encounters is cathartic, and much more beneficial than waiting for hours to see an ill informed doctor.

I'm going to try dosing her tomorrow 2x, 2mg in the AM and 2 in the PM. Hopefully this will put her at ceiling level and allow her to feel a bit more stabilized, and not constantly 'behind the eight ball'. This last 'rapid' taper attempt this past weekend has caused more distress and insomnia, which in turn affects her work performance.

Another question regarding supplemental drugs for wd symptoms... Her current doctor prescribes klonopins, which from what she tells me help rather minimally. Doc wont write Valium for one reason or another. Someone on this board mentioned clonodine - is that another benzo? Can anyone comment regarding what's helped best to supplement wd symptoms?

Thanks so much,

Chris


Top
 Profile  
 
 Post subject:
PostPosted: Tue Nov 27, 2012 9:57 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Oct 15, 2012 11:27 am
Posts: 1454
I used klonopin during the very first part of jumping off suboxone and then my doc switched it to Valium for whatever reason. It does help during the acute wd phase but it a whole other beast. I used Klonopin for a year of tapering and then stopped all benzos about 3 weeks after stopping sub. It wasn't that bad for me and I truly believed it helped with the anxiety/ restlessness of quitting subs. I was happy that I didn't continue to take the benzos though. I believe it was almost easier to deal with it all together after getting thru acute wd syptoms.

Another one that helped was neurontin (brand name for gabapentin) although between the klonopin & nuerontin, it's hard to really tell what helped more. The two combined did the trick and I believe I had less side effects from the nuerontin.

Clonodine is a blood pressure medicine and not a benzo. Clonodine can help too.


Top
 Profile  
 
 Post subject:
PostPosted: Wed Nov 28, 2012 1:00 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Hey BabyLove,

Welcome to the forum!!

I wanted to mention that Buprenorphine is the active ingredient in Suboxone. Buprenorphine has been around for a long time, but it was mostly used in small doses (.2mg) in Europe for pain relief. High Dose Buprenorphine, aka-Suboxone, does come in 2mg/.5mg and 8mg/2mg (the bolded numbers represent the Naloxone content). I mention all of this to give you an idea of how much Buprenorphine your fiancee is ingesting and to maybe give you a little bit better idea of how to taper her off. Think of Suboxone in MicroGrams instead of MilliGrams.

You're going to give her 4000mcg tomorrow, which is perfectly fine. When it comes time to taper, instead of thinking, "I'll cut her down by 1mg or 2mg" think instead in MicroGram doses.....you would be cutting her dose by 1000mcg or 2000mcg....that's a LOT!!

After reading NUMEROUS taper threads on this site and following those folks over the 2 years I've been here, I've found the most successful taperers cut their dose (once below the ceiling of 4mg) by about 10% or so and a lot of those people wait a MINIMUM of a week or two at the new dose before they attempt their next taper.

Suboxone is a powerful drug, especially at the levels we addicts have to take. You want to remove that drug from her system slowly, this is the best way to minimize wd, in my opinion.

As far as supplements to help ease wd, I would wait until she was a lot closer to jumping. I've seen people start taking Clonidine weeks and weeks before jumping and it didn't do that much to help them. I took Clonidine after I got off Suboxone and it helped me a lot. Clonidine is non-habit forming, so no worries there, but she does need to get her blood pressure checked first because, like tinydancer said, it is a blood pressure medication. I've heard good things about Neurontin too, but I never used it myself.

Best of luck to both of you!

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Thu Nov 29, 2012 8:10 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Thanks all for the wisdom and replies!

Its been a rough few days adjusting to the different schedule, but seems to be doing better with the dosing times than the first day. Once she's stabilized, we can start to talk about the taper plan as described. Thanks for the suggestions so much Romeo.

All the best.


Top
 Profile  
 
 Post subject:
PostPosted: Fri Nov 30, 2012 11:11 am 
Offline
Power Poster
Power Poster
User avatar

Joined: Wed Aug 08, 2012 9:44 pm
Posts: 43
Romeo's reply is very well informed, and completely correct.

I've tapered from 32mg (but quickly down to 8mg after a month) to .75 mg over the past 11 months and have done it by being vigilant about my taper and dropping around 10-20% every 2-5 weeks. I coasted to 1mg, but the drop to .75 was hard and I'm getting ready to go to .625. I live in a Hurricane Sandy affected region, so the past month was no time to drop.

Anyway, yeah, think in MICROgrams and drop her slow. It gives the brain and body time to adjust. I've always dosed twice a day. 9am and 9pm. You can drop her comfortably and really minimize the withdrawals substantially when it comes time to jump if you can get her lower than 100 micrograms. Whenever I jump, i do an A/B/A/B/A/B/B/A/B/B/A/B/B/A/B/B/B/B type thing. So I stagger the new dose between the old dose by one day to start, then 2, then 3 occasionally, until I feel mostly comfortable at the new dose. With suboxone's long half life, this works really well. Sometimes I'd be ready for a drop after 2 weeks. Sometimes it felt like I needed 5 weeks at a new dose. I just listened to my body. Whenever I felt TOTALLY 100%, I dropped again. When I would initially drop, I'd feel 85-90% though, it's not unbearable at all, but there's going to be some minor discomfort of course. Melatonin and Benadryl help with sleep when adjusting, for me. I also take tons of vitamins, eat healthy, and exercise, which I think are under-appreciated factors.

Anyway, best of luck. This is a great place for information, and I'm sure you and your fiancé will be able to beat this thing. It's just going to take some time.


Top
 Profile  
 
   
 Post subject:
PostPosted: Fri Nov 30, 2012 4:17 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Pardon my ignorance...

I know it says not to mix suboxone with alcohol, but would one casual drink cause great harm?

Reason I ask is she went to a work related function last night, had one cocktail, and today she's reporting inflammation and joint pain. Is this a known side effect? Do we need to cut alcohol out of our lives?


Top
 Profile  
 
 Post subject:
PostPosted: Fri Nov 30, 2012 11:09 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Sat May 01, 2010 3:46 pm
Posts: 461
Location: South Florida
I started suboxone about 6 months before I gave up drinking and became completely drug and alcohol free (beside sub). I would drink a lot. Of course I was accustomed to drinking day and night. Alcohol is a respiratory depressant and that is why it is contra indicated with suboxone., just like benzos. This doesn't mean taking suboxone and a benzo as prescribed will kill you but mixing all three may be a bad idea depending on tolerance to each drug. Not to mention the risk of cross addiction trade off...

One drink shouldn't kill her but for me I would be carefully and tend to stay away from it... IMO


Top
 Profile  
 
 Post subject:
PostPosted: Wed Dec 05, 2012 11:29 am 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
Still working on getting her completely adjusted to the new dosing schedule.

What's the best way to divide these films? I never fully realized how mere micrograms could make such a significant difference.

Are people using a ruler and razor blade to surgically divide out doses?


Top
 Profile  
 
 Post subject: YOU ROCK!!!!!!
PostPosted: Wed Dec 05, 2012 12:59 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Sun Jun 10, 2012 10:12 am
Posts: 565
Location: in front of my laptop
http://www.suboxforum.com/viewtopic.php?t=296

[font=Comic Sans MS]Hello there babylove, and welcome to the forum!!! YOU are really getting some great advice on here.
I hope that your fiance is feeling better and better. I posted a link for you. It's about a Liquified
Taper Plan. I am really surprised that noone mentioned this to you yet. It is a terrific thread, and it
is FULL of detailed information, about how Diaryofaquitter, successfully tapered off of suboxone.
She had to dissolve the mediation in 5ml of water( I think), in order to measure it accurately.

Those films and pills are near impossible to start cutting up into such tiny increments. Especially when you REALLY
get into the lower end of the tapering process. It's just easier to do it the way that Diary explains in this
thread.

I also wanted to touch on the fact that someone said that the withdrawal is all in her head at this point.
Completely NOT TRUE. Telling her that would be counterproductive, and probably have her feeling hurt, and
a little resentful with you. This is a VERY VERY individual process for every single addict. While all of our
experiences are similar, they are not the same. I've had side effects that others have not, and vice versa.
I also can "feel" when I don't get my refill in time. If I am without it for 2 days, I'm in withdrawal. I do not
care who says that it isn't happening. I am not imagining diarrhea, goosebumps, and sneezing, watery eyes.
You can see that with your own two eyes.

Anyway, you are doing such a terrific job of taking care of her! I almost feel as though I want to thank you
myself! LOL! I am so glad that you came here for help and guidance. The fact that you looked into it THIS
much, speaks volumes for how you feel for her. You truly are a great guy for doing this WITH HER. Not FOR
her. Kudos to you!!!!

If you have any questions about that Liquified taper thread, let us know and we will definitely help!!

Best Wishes to you both, and Good Luck~Kelly[/font]

_________________
"All great changes are preceded by chaos."
~Deepak Chopra


Top
 Profile  
 
   
 Post subject:
PostPosted: Wed Dec 05, 2012 4:48 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Hey babylove,

We've had people on here who have divided their 2mg film dose up into 32 parts (.0625mg or 62.5 micrograms each), they used a razor blade to do it. Once the pieces get that small, they would use tweezers to pick up the pieces and put it in their mouth. You could try cutting the films with a razor blade or you could do what Goinstrong said by going the liquid taper route.

_________________
Be kind to yourself. Our character defects do NOT define who we are!


Top
 Profile  
 
 Post subject:
PostPosted: Wed Dec 05, 2012 4:56 pm 
Offline
Power Poster
Power Poster
User avatar

Joined: Wed Aug 08, 2012 9:44 pm
Posts: 43
http://www.artsupply.com/alvin/cuttingmats.htm

one of those self healing cutting mats with 1/8 inch hash marks and an x-acto knife work best


Top
 Profile  
 
 Post subject:
PostPosted: Wed Dec 05, 2012 5:02 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Sat Jan 01, 2011 12:59 pm
Posts: 1039
Maybe I missed something here, but why are you "dosing her". Why are you cutting up her films, planning her taper, etc? I don't mean to be a jerk, but part of addiction recovery is taking personal responsibility for one's own recovery. I think it's great that you support her, and it's always helpful to have a partner keep us honest or hold our meds if we tend to take to much. But she really needs to take charge. Just my humble opinion, and I truly am saying it with kindness.


Top
 Profile  
 
 Post subject:
PostPosted: Wed Dec 05, 2012 6:07 pm 
Offline
Average Poster
Average Poster

Joined: Tue Nov 27, 2012 3:42 pm
Posts: 7
I'm here of my own accord.

I volunteered to cut her doses, because she's literally bad with math and fractions. Telling her to take 1/8 a film at X o'clock doesn't work for her.

Regarding the taper, shes tried countless times in the past to taper aggressively, and pushes herself too much to maintain a functional lifestyle in the mean time. The end result is counter productive, frustrating, and demoralizing. I came here on my own to help find a more gradual route to advise her about. I also came here to enlighten myself, and to help better support her through this process.

I track her dosage at end of day, cut her films, and remind her how far she's come along, and how important she is to me. Everything else is on her.

I understand your stance, but please don't take my efforts to further my own knowledge as enabling her to be ignorant. In my humble opinion, your post irked me slightly.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 17 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: MovingOn and 2 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group