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PostPosted: Sun Jan 10, 2010 10:29 pm 
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I currently need about 240mg oc ocxycodone (120mg twice a day of oxycontin) to stay out of withdrawals. Is this too high a tolerance for Suboxone to treat at it's maximum dosage of 30mg? I can't quite tell from the information provided and the program I am starting hasn't even asked me how much I used. I talked to one last week and told them I needed 200mg and and he said "hmm, that equals about 20 pills a day" we'd probably start you out at 16mg of Suboxone. From that I'm assuming that I'll be alright, but in reading that methodone users have to taper to 30mg, that seems like I am over that quantity. I'm supposed to be starting tomorrow, but if I start and it doesn't go right, I will probably lose my job and have lots of problems.

Thanks for help,
John

I cross posted this to the Induction section, too. In reading this forum, it looks like I'm within what some other people are being treated successfully with. Just need some confirmation.


Last edited by subjohn on Mon Jan 11, 2010 6:12 pm, edited 1 time in total.

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PostPosted: Mon Jan 11, 2010 12:04 am 
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Hi John, do you have a Suboxone MD? I'm on my 6th day of Suboxone treatment and I feel awesome. I was only taking 100MG Oxy + 4 to 6 Norco per day - I went into withdrawal for about 34 hours then I started with 1 x 8mg Suboxone, the first couple of days I thought I might have to take second 8mg daily dose but I punched through it. The singly daily 8mg dose is working for me.

My MD didn't tell me anything about how or when to take Sub so make sure your MD is working with you. I wont even assume I have a solution for you other than to tell you you're on the right track. The Suboxone will reduce your WD symptoms so much you wont even notice it. There are a lot of experienced/intelligent people posting here so sit tight and wait for someone smarter than me. Hang in there.


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PostPosted: Mon Jan 11, 2010 12:24 am 
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Yes, I have a doctor, it's a Suboxone clinic, actually. But they didn't really tell me much except to stop using for 18 - 24 hours and show up. After reading some more it looks like I should be in the safe zone. All the places seem to be like this for some reason. It seems more logical to me that they would have you come in for an interview first, and then schedule your withdrawal and induction days. I'm really concerned about withdrawing for even 18 hours. The longest. I ever went was about 8 bours and I was feeling pretty sick then. I hope I've given it enough time. I took a large dose of oxycodone at 18 hours before my appt. I promise, if I make it through this I will never abuse opiates again. This has been hell.


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PostPosted: Mon Jan 11, 2010 1:04 am 
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So do you see your MD for your first Suboxone treatment tomorrow?


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PostPosted: Mon Jan 11, 2010 1:27 am 
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Yes, tomorrow I see the MD for the first time and hopefully start the suboxone.


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PostPosted: Mon Jan 11, 2010 1:43 am 
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In my case I wasn't throwing up but I did have diarrhea, severe hot and cold sweats, cramps, sneezing, runny nose, body aches... and the dark depression. But I was home in bed, I had made it through the night but I knew I either needed a dose of Oxy or the Suboxone - I put a 8mg tab under my tongue and closed my eyes, within 20 minutes I knew the Suboxone was going to work for me.

From what Ive read and from my experience try to keep it to one dose a day, it sounds like you will need a 16mg dose, maybe more but remember in this case less is more. I had made up my mind that I was going to make this work for me before my first dose but its been pretty easy. I feel stronger, more focused, I sleep 100% better.

It sounds like you're in the same boat I was, I'm really anxious to see if this works as well for you as it did for me. This is what I posted Tuesday, look at the other posts, its kind of a time-line of my progress. This time next week (or even tomorrow) you'll feel like a new man.


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PostPosted: Mon Jan 11, 2010 11:09 am 
Hi Subjohn! I may be replying too late for you to see this before your doctor appointment. But I wanted to tell you not to worry too much about what your prior dose or opiate tolerance was. I don't think it matters all that much. It does matter, however, what your prior drug of choice was in terms of whether long or short acting. You said you'd been taking Oxycontin which is a longer acting opiate as opposed to just regular old oxycodone (like Percocet or Tylox or Roxicet, stuff like that). Oxycontin is released into your system more slowly giving it a longer half life and a longer time to be eliminated from the body. Therefore, it is generally recommended that you be off those a little longer than the short acting. You mentioned Methadone - comparing methadone to most any other opiate is apples to oranges. You certainly don't want to compare yourself on oxycodone to Sub, to someone going from methadone to Sub. Further, Suboxone dosages/dosing needs are altogether different and separate from anything you were taking before. So try not to worry about not being given "enough" Suboxone to meet your previous tolerance levels.
Your clinic should evaluate your withdrawal symptoms to determine if you are at the appropriate time point to be given your first dose of Sub. It is fairly straightforward - there is a withdrawal scale they use and you will have told them exactly when and what your last dose of opiate medication was - then they'll dose you with Sub until you feel better. It should turn out awesome!! I know I left my doctor's office after induction feeling more hopeful than I had in a long, long time.
Please let us know how it goes. I am so happy for you. Hopefully, you'll be feeling so much better over the next few weeks that you'll be able to really get to work on your recovery so that you never have to live this way again!!


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PostPosted: Mon Jan 11, 2010 5:01 pm 
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Ive got my fingers crossed for you buddy.


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 Post subject: Good Luck! (re-post)
PostPosted: Mon Jan 11, 2010 5:40 pm 
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Hi SubJohn,
I posted this under your post in induction. I wanted to make sure you saw it. It sounds like we were at the same starting point when we started Suboxone.... Best of luck with your appt.
TW


Hi Subjohn,
I can only tell you my experience. I was also on a high dose of oxycodone.. Mine was over 300mgs. per day when I got into Suboxone treatment! I am on 16 mgs. of Suboxone a day and have been for 11 months. Like LatheDude said the toughest part at least for me was that I had to be in mild to moderate withdrawals . That is not fun.... It was the hardest thing I ever had to do, But the best thing I could have done!!! For me everything is going great. I take my meds and go to counseling twice a month. So far it has worked. No cravings for opiates at all. I would find a Suboxone Dr. before you try to quit on your own.. There are some very good Subox Docs out there. Best of luck and keep us posted on your recovery.

God Bless!
TW


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PostPosted: Mon Jan 11, 2010 6:11 pm 
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oxycontin and oxycodone are the same drug. Oxycontin just has time release, so it doesn't really have a longer half life, but you have to measure that half life from the end of the time release period (10 hours) rather than when you take the pill. At any rate, I was extracting the oxycodone from the pills and shooting it, so there was no time release factor. However I had planned to take a time released one at the cut of time to lessen my suffering. But I got too worried about not being in enough withdrawals and cancelled that idea. I just took a 200mg shot of oxy, which is normal for me. And did nothing after that. Well, I woke about 5 am in withdrawals which escalated the next couple of ours and the rest is misery. So I am positive I could have taken my less dose several hours later. Like 12 hours before the sobxone. I have read in one place that you must take the suboxone after the half life period of your drug. Which is 2 hours for suboxone. Most every where else it says a 24 hours or more depending on the drug. It's a shame the docs don't interview you and get you more to a minimum. I was feeling so bad at 8am I started rigging up a shot, but in the end decided to push on through and not risk not being able to start. Of course, my 12:30 apt at the doc ended up me actually getting the suboxone about 2pm. I was given 8mg to take immediately and 8 to take in about 4 hours. After a 1/2 an hour on the 8. I was feeling better but still somewhat crapppy, I went ahead and took the second 8mg without waiting. About 1/2 hour after that I begin to feel almost OK, but not quite. A assume they will increase my dose slightly tomorrow and that should settle me out.

So gee, now I'm addicted to a new drug. Hopefully I can reduce down pretty quickly. The doc wasn't real enthusiastic about me reducing quickly. He said I would be at risk of cravings. But I've been addicted before. Actually in the last 16 years I've been clean more than I've used. Being clean is my natural state. I just got into trouble with pain meds a few months ago after a really bad accident. I'm very involved in NA and have even been going during my relapse. So hopefully I can tolerate quick reduction and I can talk my doc into it.


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PostPosted: Mon Jan 11, 2010 6:23 pm 
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Give the Suboxone some time. It take 3 to 7 days to stabilize in your blood stream but you should be feeling "normal" very soon.


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PostPosted: Mon Jan 11, 2010 11:26 pm 
Subjohn - Yeah, I know oxycodone and oxycontin are "the same thing" in terms of the active ingredient. I made the distinction and wrote about half-life because of concerns regarding the timed release nature of Oxycontin, which I felt could be important in preparing for your Suboxone induction. I made the assumption that you were taking it orally - my mistake.
As far as you now being "addicted to a new drug" - not really. You are addicted to OPIATES. It sounds like you've been an addict for a long time. Most schools of thought agree that you always will be an addict. An addict either living in active addiction or living in recovery.
It probably won't take long to get your Suboxone dose figured out. Continue working with your doctor on that. As far as how long it'll take to taper and wean off - everyone is different. Some feel strongly that lifetime maintenance is the way to go while others are able to succussfully wean off. You say you've been down this road before and have gotten and stayed clean for long periods with NA and that's great. Perhaps you'll be able to be on Sub for a few months to a year and be done with it. On the other hand you may find that remaining on Sub for longer than that is best. You need to do what keeps you safe and alive most importantly!
If you should decide to do a quick taper off Sub, please don't blame the Sub if it is difficult. It won't be Sub's fault. It will be the fault of the addiction to opiates that was in place long before you started Suboxone.
I'm glad you're feeling better! Keep posting on your progress.


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PostPosted: Tue Jan 12, 2010 12:27 am 
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I tried the Oxycodone, I hated it. It didn't work nearly as well as the Oxycontin. I used to take Methadose, my MD switched me to Methadaone he said "its the same thing" nope... not for me. Maybe its all in my head... maybe not.


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PostPosted: Wed Jan 13, 2010 12:34 am 
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Hey brothers and sisters. I guess I'll continue chronicling my personal experience here, in case it may be of use to someone else in the future. So I obviously was experiencing still some withdrawal symptoms at my initial dose of 16mg of suboxone. I wasn't totally sure my dependency was exactly at 240mg of oxycodone per day. Truth was at the end there I was shooting 200mg more than once a day, so it was probably actually higher than that. At any rate they gave me 24mg of suboxone today at the doc when I told them I was still experiencing withdrawal. Even so, I only took 16 initially, then around 4 hours later I took 4 more mg and that just about fixed me. But I just now took that last 4mg as I am still experiencing some chills and sniffles and restlessness. I have been feeling mostly better since lunch, but I guess I still have a ways to go. I may in fact need even a little more 24 to 100% out of withdrawals. I feel no sense of euphoria, whatsoever.

I'm thrilled at finally getting away from those damn pills and the cost was rapidly draining my bank account. the additional 8mg per day of Sub is costing me 36$ per week. The nurse said this to as if that extra cost may deter from getting it. Hello, I was spending at least 1500$ per week using. But, I'm not real thrilled at still being dependent on Suboxone. The place I am using is extremely strict and only give out a weeks worth of time. If something should happen like I lose some or whatever I fucked. I'm going to try not to worry about that, but I'm going to start attempting to taper down as soon as I'm stablized.

Oh, I went to my first NA meeting since starting tonight. I've been going pretty regularly for the last 3 years, even some since I got on the oxy. So there were probably surprised to see me pick up a white keytag tonight. but everyone was supportive. going to try to do 90 in 90. that should help my head get right.

Ok, wishing you all the best,
Subjohn


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PostPosted: Wed Jan 13, 2010 11:38 am 
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Wow that was a lot of Oxy's... I'm glad to hear you are getting stabilized.

Yes keep us posted on your progress.


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PostPosted: Wed Jan 13, 2010 2:29 pm 
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subjohn, If you are dead set on tapering yourself off Sub as soon as you get stabilized, please just make sure you taper correctly.

What I mean by that is that you allow yourself to stabilize for a week to 10 days after each decrease in dose. That means at least a whole week free of any withdrawal symptoms between each drop. At the higher doses you shouldn't have as much trouble with w/d symptoms, but as you get lower you feel it more. Once you get down to around 1 or 2mgs per day, then start decreasing in mcgs instead of mgs.

Take your time and listen to what your body and your brain tell you. The idea is to let your brain regulate and adjust to producing its own endorphins as to avoid really bad acute withdrawals as well as PAWS.

I can not tell you how many people I've seen completely fuck themselves and their recovery by tapering too fast and jumping off Suboxone at too high of a dose. It's sad really, because instead of using this time as an opportunity to create good habits, put some substantial time between you and your last relapse, and create a good after-care plan & support system, people tend to view their time on Sub as something to get behind them asap.

As far as you being addicted to a new drug - well, you were basically addicted before you even started Suboxone. That's how cross-tolerance and cross-dependence/addiction work. If you weren't already "addicted" to Suboxone, then you would have been barfing your guts out on the dose that you took. Addiction happens in the brain, and those changes have already taken place in yours. It's not like being on Suboxone is going to make that worse. Maybe you don't like being dependent on a medication, but it's better than the alternative.

Give yourself some time to get well. I spent a long time on my taper and it was totally worth it. I'm five months off Sub now after 2 years of treatment and I'm doing great. You can do it too if you're just patient.

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PostPosted: Wed Jan 13, 2010 6:34 pm 
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This sucks. even 24mg isn't giving me a full 24 hours of relieve from withdrawals. At around 10 am I am getting withdrawal symptoms again. I am not scheduled to see the doc again for checkup until tomorrow. I guess I will need to go up another step. I wonder how many days it would take to just tough it out at this level to get to a stable point where I know longer experience any symptoms like chills, nausea, runny nose, general discomfort? Suboxone seems to only last full effect in me about 21 hours, not 24.

In reply to the previous post. I understand your point of view. I guess one thing that strikes is that I've only actually been using opiates for about 4 months. It doesn't seem reasonable to be on Suboxone for some great period of time in comparison to that. I've been clean for the better part of the last 15 years, so not using is more of a natural state for me, I just had a horrible accident that was causing me a great deal of pain for several weeks that predisposition-ed me for relapsing on the opiates. I've healed enough from that that I no longer need opiates to treat pain. I hope I don't regret going the rapid detox method this time. That's what I did a few years ago, and that worked pretty well. 5 days, and I was essentially free. Not sure if it would have worked out the same way this time, though. You never really know.


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 Post subject: Time to get honest
PostPosted: Wed Jan 13, 2010 7:03 pm 
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Subjohn, as I re-read through your post, it really seems like its time to get honest. Not only honest with us, but honest with yourself. Even your post tells a bunch of different stories. On 200 mg/day then it's 200/mg at a time multiple times in a day. Then clean for "the better part of" 15 years, then just needing medication for pain from an accident - for which you were shooting up 400+ mg day or at least spending $1000s on oxy. Yet you want to get off right away, want to taper. Don't really have a problem with drugs - it's just the accident and pain you were in. At induction the doctor tells you to take an additional 4mg four hours later and you take it 30 minutes later because everything wasn't working fast enough for you.

I'm still learning a lot about all of this but if this doesn't sound like addict behavior and addict talk, I'm not sure what does. And by now I'm sure you are hating my guts for pointing these things out - just like I wasn't happy when I had things put to me this way. But here's the deal, if you really want to get better, you need to stop making up your own rules and start playing by the rules your doctor is giving you. Shooting 200mg of oxy a day is a very serious problem. It's not one you are going to fix with a five day rapid detox or by getting off of Suboxone as fast as you can. This is going to be a long, long road. And you may be saying that you know that but in the next breath you want it all done like yesterday.

Go back and re-read what you have written Subjohn. Read it for yourself. This is not going to move nearly as quickly as you want it to. Even getting stabilized on the Suboxone isn't going as fast as you want, but it really only has been a few days. All of this is just reality. Just like Diary and others here, I want to see this all work for you. And getting honest and real with yourself is going to be another key to making that happen.

Please keep posting and hanging in there. It's a long road but you'll make it and have all sorts of support here and other places, but it's going to take some time to happen.


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 Post subject: Re: Time to get honest
PostPosted: Wed Jan 13, 2010 7:15 pm 
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donh wrote:
Subjohn, as I re-read through your post...


You've misinterpreted me somewhat. I make no claim that I have not been whole heartedly lost in addiction for the last 4 months. I came here for help getting on Subxone. I'm not going to justify myself to you. If you have any information about specific questions regarding Suboxone, I appreciate your input.


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PostPosted: Thu Jan 14, 2010 3:11 pm 
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Latest status: day 4, and I have to say Suboxone seems to be a wonder drug. I feel nearly normal and 1000% better than just a few days ago when I was chasing oxy. I'm very greatful. Hardly any discomfort. I notice some alight dizziness and fogginess shortly after taking Suboxone, but I bet that will smooth out, and there as I mentioned before sometime before a full 24 hours I will experience some withdrawal but it's very manageable. I managed to only take 20mg yesterday so I think I can stablize at that.


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