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 Post subject: New Here & First Post
PostPosted: Mon Mar 24, 2014 9:17 am 
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Hi,

First I'd like to say that I am thrilled to have found this site. Secondly, I'm from a small, backwoods, Bible Belt area that doesn't believe in having Suboxone/Methadone clinics/doctors around, so, I know very little, to nothing on the topic. However, I have several Suboxone 8mg/2mg sublingual films, but not sure when I can safely take any of one.

My background - I'm 2 months shy of being on opiates for 6 years now, and more ready than ever to get my life back. I have been taking close to 150 mgs of hydrocodone daily, sometimes more. Usually 60 mgs as soon as I wake up, and the rest spaced out throughout the day. After many years, I recently got health insurance (I'm waiting on it to activate, and should be any day now), but was told with an approval, this insurance would help me with Suboxone. The closest doctor who can perscribe it is about 60 miles away, so I'm praying it turns out to be worth it.

My question(s) are this:

How long after last opiate use can I take part of the Suboxone, and given everyone's personal history (or someone who was taking around the same mgs of hydro as me) how much Sub should I take the first time? It is almost 8:30 A.M. where I am right now, with my last real dose of hydro being at 7:30 P.M. last night. So, it's been almost 13 hours. However, I woke up with symptoms starting already, and took 7.5 mgs of hydro, along with 1 mg of Xanax at 6:00 A.M. this morning. Yes, the addict in me and lack of willpower couldn't just wait.

I'm not wanting to stay on subs long term, but wanting to use them to get off everything completely. I was just wondering if anyone could tell me when I could safely take some of the film to feel better, and how much. Any and all help is appreciated! Thank you!


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PostPosted: Tue Mar 25, 2014 1:46 pm 
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I think that the reason you haven't heard from anyone is because there isn't much you can do with 'a few' doses of Suboxone. There is a way to use it for detox that I'll get into in a moment-- but the relapse rate after short-term detox is virtually 100%, so it is rarely used by doctors-- except for those motivated only by profit, who have no problem taking money from people for doing absolutely nothing.

The irony is that many of the 'anti-sub' crowd (see my last post on Suboxone talk zone) repeat the same old ignorance--- that doctors WANT to keep patients on Suboxone to make a buck. I make about 4 times more in fees from a new patient than from an established, stable patient--- and because I have 100 stable patients, I rarely have the new, profit-generating patients. But my 100 patients are all doing great; opioid dependence has become about as important to them as high blood pressure, and they are making gains in life that many of them never imagined--- a much more enjoyable way for me to practice, than seeing people in and out of the cycle of active using.

People don't realize that there are docs who LOVE the anti-sub crowd, for giving them cover for sleazy practices-- where all they do is start people on Suboxone, then force them off it, day after day. I always think of the machine in the Dr. Seuss book 'the sneetches', where they walk in one end, out the other, then loop back in again...

The method for detox varied from one place to the next, but the basic principle is the same in all of them-- you stop opioids for at least 24 hours (the longer the better-- 48 hours would be better than 24). Then on day one you take 4 mg of buprenorphine. Day two you take 8 mg. Day 3 you take 12 or 16, and you take that again for another day or two.... then you stop the buprenorphine and go through withdrawal, being sure to avoid ANY use of opioids.

The principle is twofold-- the buprenorphine pulls tolerance to a lower level when you first take it, and then the buprenorphine slowly leaves the body over a week or so--- lessening the severity of withdrawal. Studies have looked at the method and people do report less intense withdrawal, without a significant increase in length of withdrawal (it is going to take about 2 months to feel normal after stopping ANY opioid). The problem is that the addicted part of you-- that part you mentioned--- will be sitting there every single moment, watching for a moment of vulnerability-- not for 2 months, but for many years. My own 'inner addict' patiently waited 7 years, before taking me down. Most people will say that a recovery PROGRAM is necessary, to help you when your vigilance is down.


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PostPosted: Wed Mar 26, 2014 2:31 pm 
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There is not much I can add to the previous post. What got me smiling was your words on not wanting to stay on Suboxone long term. But you can't even wait 24 hours to induce w/o taking a little more, and a benzo to boot!

I'm not making fun of you. You and I are just the same. I smiled because it is the same behavior I would do.

Make the appt with the Suboxone doctor. There is no reason to dabble with it. You either want recovery or not. To answer your question about the timeline, I was taking roughly the same amount as you, maybe a little more. My doctor told me to take my last evening dose and made my appt. about 4 pm the next day. Was I miserable? Of course. But I knew it was temporary and relief was coming. My guess will be that you won't need more than one 8/2 mg film strip. Two at the most and weaning down to one a few months later maybe. I'm just guessing here, I surely am not a professional.

Do yourself and your liver a favor. Make that appointment and go through the program. Come back and post how it went.

Welcome to our forum!

rule

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

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

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