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PostPosted: Fri Sep 14, 2012 7:13 pm 
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Hello forum! I had a doctors visit on Wednesday and got a script for 30 Suboxone Film 8 mg. Since I don't have insurance, I spent all day yesterday shopping around for the best price to get it filled. Luckily I believe I found the cheapest place within a 20 mile radius from where I live. Anyways, I took 2 10/325 mg hydrocodone to get me up and about to go pick up my medication. I now have it and plan to start my treatment tomorrow. My question is, when would be a sufficient amount of time to wait till I take my first dose? I know that I have to wait until I'm feeling symptoms of withdrawal, and I thought that I should wait at least 24 hours to be safe. My doc said that like 8 to 13 hours would be fine before taking my first dose, but I've read too many stories about people taking it too early and going into precipitated wd (doesn't sound like fun). So yeah, that about sums it up. Oh, and I have been taking between 4-10 hydrocodone (same strength as previously mentioned) a day for roughly 2 years if that helps. Thanks


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PostPosted: Fri Sep 14, 2012 7:45 pm 
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hello,

your plan sounds good but i would add one thing.

take some small scissors or a razor and cut that film into smaller bits. i would start around 1mg and wait an hour to see how you feel. if you need more to feel good try another 1mg and wait an hour. try again if needed etc... your tolerance is not sky high now and i bet u that 8mg will make you feel nauseous and that will last quite a while if you overshoot your opiate tolerance.

I bet the most you need will be 4mg. but that is a guess going only on the 40-100mg of hydro/day like u said.

good luck.

gb


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PostPosted: Fri Sep 14, 2012 9:47 pm 
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Yeah, silly me forgot to ask about what dosage I should start with. Funny thing is, my doc told me to put the whole 8 under my tongue. Then he said that I might have to dose at least two or three more times that same day to start with!!! What is he trying to get me sick? I told him how much and how long I've been taking the hydro. That didn't seem to sway his decision. But I'd much rather take advice from people with experience with it rather than someone just able to prescribe it. I understand that in most cases when it comes to dosing "less is more", but just 1 mg to start with? That does seem pretty low.. Maybe considering that 40-100 mg of hydrocodone a day is all I have been taking, 1 mg of sub is plenty. But I would like to avoid re-dosing as much as possible. I want to get in the groove of taking just one dose a day for as long as I'm in maintenance. Maybe it's not that easy, especially starting out. But to me it seems like it would be easier finding my dose if I start high then go low. Or am I backwards here? Like, say tomorrow I take 4 mg, then I get nauseous and know that was too much. The next time I take 2 mg, and kinda gauge from there. Or on the other hand, say I do like you recommend.. Cut up the film into smaller doses, take 1 mg and wait an hour.. I still feel wd so I take another 1 mg. One hour later take another and seem to be feeling good. So when all that is said and done, it would seem 3 mg is enough to get the job done. Would I then be able to dose just 3 mg thereafter and not have to worry about any readjusting until it's needed? I'm not 100% educated about the stacking effect of sub, so the simple question on that aspect is... Is dosing say 3 mg throughout the day the same as taking the full 3 mg at the same time?


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PostPosted: Fri Sep 14, 2012 10:34 pm 
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The problem is that if you take enough to get nauseous, you will be that way for like 24 hours :/

You could do 2 mg at a time. It's safer to start low and build your way up. Most doctors do it that way that I've heard of although more are letting patients do it at home now I guess.

The advice to start at 1mg is just a suggestion but in my opinion I think it's the safest way to do it. If you take 4mg at first and it makes you sick, you will be that way for like 24 hours give or take. We have had people coming here thinking the sub isn't for them when in fact they are just overdosed. Also it tests the water to be sure you won't get precip w/d...

When you take that 1mg or 2mg to start with, you will feel better in 20-40 mins most likely, if you think you could feel better take a little more. Do what's best for you, you may need way more, but it's better to be safe than sorry. :)

Gb


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PostPosted: Fri Sep 14, 2012 10:55 pm 
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For the amount of Hydro's you were taking, I agree with glen bee that you would probably be best served by taking about 2mg of Suboxone to start with.

The thing with Suboxone is that it can raise your tolerance pretty quickly because it is a powerful medication. The numbers I'm about to give are bogus, they're just to illustrate my point. Say your tolerance to opiates is about 70mg a day, if you start taking too much Suboxone, you may increase your tolerance to an effective dose of 200mg of Hydro's per day? Do you see what I'm getting at?

The other side of that coin is that you want enough Suboxone on board to eliminate your cravings. 2mg of Suboxone may or may not be enough for you, you may need to go to 4mg or 6mg or wherever.

So, you're gonna kind of be balancing between not raising your tolerance too high, while having enough Suboxone in you to not have opiate cravings.

Starting out low and working up is the best way to go, in my opinion. Now, I'm not saying to sit there suffering through agonizing wd for two or three days to get your dose right. Within your first or second dose, your wd should disappear, then go from there.

As far as when to start, check out this link, it's called the Clinical Opiate Wd Scale. It'll help you to measure how bad your wd is and give you an idea when to start Suboxone. Also, like glen bee said, starting out with a low dose will help ensure you don't get prec wd.

Here's that link:

http://www.naabt.org/documents/cows_ind ... _sheet.pdf

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PostPosted: Sat Sep 15, 2012 12:56 am 
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Ah, okay. I guess I kind of underestimated how strong sub actually is. I will take y'all's advice and start low and work my way up. I will start with 2 mg and hopefully that will be enough to keep my wd at bay for the time being.

What baffles me is why my doc would start me at such a high dose and say that might not be enough? I guess even doctors don't know what the hell they're talking about at some times. But then again I guess he helped me out because I can stretch my sub much longer now no?

Oh one more thing that I asked about, is taking say 2 mg in the am and another 2 mg in the pm the same as taking 4 mg at one time once a day? Or like most other subjects, is it personal preference?

Thank you both Glen Bee and Romeo for your quick responses! I could tell you that this forum will quickly become one of the best tools in the shed when it comes to kicking this addiction in the ass. Thank you!!


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PostPosted: Sat Sep 15, 2012 7:35 am 
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[font=Comic Sans MS]Hi there! You have already gotten great advice from Glenbee and Romeo. Just do exactly what they are telling you to do and you will be fine. 2-4mg should be plenty for your habit. As far as dosing goes, you want to dose once a day for addiction. The idea is to get out o the habit of taking "pills" multiple times a day. Patients that dose for pain, like myself, dose three times a day. But if you are dosing for addiction only, then once a day is the protocol. In the morning preferably. Then you are done for the day and dont have to think about it again untl the next morning. Just be consistent in whatever time of day you do decide to take it. I do notice that sub gives me the slightest burst of energy about 30 minutes after I take it, so try not to take it too close to bedtime. (just my experience with it)

You sound like you are well on your way. Good Luck with your induction today! Let us know how ya make out![/font]

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PostPosted: Sun Oct 21, 2012 8:48 pm 
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Doctors def. have their own was to titrate paients. Fortunately for me since I had Roxies and Hydro in my initial UDT, my doctor gave me a 5 day supply of Subutek to use so the opies would have plenty of time to get out of my system.
Sould have already said, I just started the sub. the other day, and my prx'd dose is 4 mg @ 4-6 hours as needed for pain, I only took 1/4 a strip and waited +/-3 hours so I could see if I would get sick or not, then I did the other 1/4 strip. That is all the sub. I took the first day, then I started my prx'd dose the next day. As was earlier said, I def. agree that starting out on a low dose of Sub., especially when you already have any type of opiate in your system seems to make good sense that one would rather have minimal side effects, than to take a whole 8mg dose and perhaps be allergic to eirher the Bupr. or the Nx. which is of course in Subs.


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