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 Post subject: New Here, Need Advice
PostPosted: Sun Apr 17, 2011 12:22 pm 
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Hi, my name is Colleen and I am posting for the first time. I began taking Suboxone 19 days ago when I went Inpatient detox for 3 days. Upon discharge, I found a psychiatrist who accepts my Medicare insurance who will prescribes Suboxone for me; however, I am sorry to say that after my first appointment, I found him to be pretty useless. Hence, I have been online almost every day researching as much as I can. I read recently that MDs go in for one day of training to become certified. Is this correct? If so, I am deeply disappointed in the system as well as thinking I can find more helpful information online than from my doctor. Medicare psychiatric providers who will prescribe Suboxone are really hard to find, so I think I am stuck with this man. Also to mention is that my Medicare cost for a month's supply of 8 mg tablets is $6.30 if anyone else may find this info. useful.

I am having shoulder surgery in one month and I cannot seem to find any information on preparing for the surgery while on Suboxone. I have been told that I will be on opiate pain meds for 7-10 days following surgery and then back on the Suboxone. My question is, do I need to taper off the drug before the day of the surgery as I will be put on the pain meds immediately following the surgery?

I sincerely believe I am an addict because I ended up swallowing 20 Vicoprofen pills a day before going into detox. Yet, one of my main reasons for not previously stopping the opiate use is that I am always in a lot of pain, but now that I am taking the Suboxone I no longer have the severe shoulder pain I had previously been experiencing (pretty weird because before I couldn't even move my arm without shooting pain; hence the surgery). However the pain in my hands is more excruciating than before, and I still have pretty bad lower back pain.

In my online research concerning the posts I have read, it appears that many people stay on the Suboxone long term, like years. I also am facing two surgeries on my hands and one last surgery on my foot. My thinking is that after the last surgery for awhile I will need to be on the Suboxone and then I can slowly taper off the medication. Is this reasonable thinking? I know from the blogs I have been reading is that each individual is unique to their own needs, but I do not want to be taking this drug as a replacement for the opiates I used for six years, but I am seriously concerned about still having the cravings for opiates following the disuse of the Suboxone. Any advice here?

Last, the negative side effects I have been having since the third day of starting the drug, to me have been pretty scary. I know the medication has a sedative effect and I am always sleepy, sometimes I am not able to keep my eyes open if I am sitting reading or laying back on the couch. I also went without a bowel movement for five days of the first week being on Suboxone and now for seven days at the end of second week. Before the first bowel movement I had, my bowels were all backed up with really bad stomach cramps during the course of every day. My PCP put me on Zofran for the stomach pains and I started taking Muralex (a stool softner). I have stopped that for now, but am concerned about the long periods between bowel movements. I have read that others go through this, too. Will this continue or not? I am already considering it to be a problem. More serious, though, is that I have no appetite whatsoever on this drug. I am already way too thin at 118 lbs. being 5'5". Over the years of being on opiates, I lost a total of 68 lbs. So, eating needs to be an important part of my day, but I just don't want to eat. I am pretty much managing on one Ensure a day, a yogurt, and soft fruit like melons. If I try to eat solid foods, I gag and want to vomit and sometimes I do. During all my online research, I cannot find any info. regarding this. I realize that Suboxone is a synthetic opiate which can suppress appetite, but I was eating much more when I was taking the pain medication. I was also having pretty regular bowel movements.

Thanks for listening and any ideas and suggestions would be greatly appreciated.

Col


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PostPosted: Sun Apr 17, 2011 12:33 pm 
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Hi and welcome,

I'll try to answer as many questions as possible. With regard to surgery, I would say, yes, the best way is to taper down and stop your sub 2-3 days before the surgery. There are a couple of article in the "Links" section on the main index page of the forum that deal with treating acute pain in suboxone patients. Let me know if you can't find them and I'll post the link.

Constipation is a common side effect and is quite often related to the dose - as is the sleepiness. What dose are you on? It's possible if you can get down to a lower dose that you'll feel considerably better. It's definitely something I would discuss with my doctor.

As for not being on suboxone long term, if I were you I wouldn't even be considering that now. You have plenty of time to address that later. I don't consider it a replacement - I consider it a treatment for a disease. Anyway, let suboxone give yourself time to get your life and head together at the very least.

And lastly, about the appetite - actually some people report an increased appetite, so I'd say that it varies from person to person, just as side effects for any medications can vary from person to person. I'd say a drop in dosage might help that as well.

I think I covered everything - if I did not, please just let me know and I'll try to address it (or if you have more questions).

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PostPosted: Sun Apr 17, 2011 2:37 pm 
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Hi Colleen,

Sorry for my late response, I had to go get busy on the "Honey do" list before my wife came home! :lol:

I see where you ask about people being on Suboxone long term. Some people make the decision to take it long term, it is effective at keep active addcition at bay. Some people start taking it and really have no quit date in mind....this is where I was. I worked with an addiction counselor and learned a lot about myself and my addiction over the few years I took Suboxone. I woke up one morning and I KNEW it was my time to quit and I quit. I jumped from a high dose and went through a fairly intense wd. I could have minimized the wd greatly had I tapered. Some people start Suboxone with the intention of only being on it long enough to get through the withdraw of their drug of choice.

Like Hat said, constipation is common with any opiate, Suboxone is no exception. You may need to talk to your doctor again if this side effect continues to be so troublesome.

The loss of apetite is a new one on me. Maybe as you adjust to Suboxone you will get your appetite back?

It would be helpful to know what dose your on. I'm thinking if your dose is really high, that might interfere with your appetite.

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 Post subject: Hi Hatmaker
PostPosted: Tue Apr 19, 2011 8:53 pm 
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I think I want to thank you for what I consider to be the most important thing you reminded of and that is to be patient, not run ahead of myself, and not try to take on everything all at once. I just have been so nervous, rapidly scanning and reading everything I can about this medication because from the start I knew absolutely nothing. I guess I can kind of admit that I am a somewhat of a researcher, myself.

I found some info. about the surgery and tapering off seems like the right thing to do, but some of the research indicated that for pain relief post-op, I will need a stronger pain med. - narcotic than others because the suboxone has a half life. Anyway, I have mailed three articles to my orthopedic surgeon today, spoke to his PA on the phone letting her know they were in the mail as well as giving her the name of the psychiatrist prescribing suboxone to me and asked her to tell the surgeon that he needs to talk to the psychiatrist before the surgery. I want everyone on board including the anesthesiologist, PA, doctor, and nurses at the hospital. (I will be staying overnight). I also scheduled one more appt. with the doctor before the May 18th date of surgery.

I can deal with the bowel movement problem with Muralex and Zofran for stomach cramping. I can only hope this gets better with time. I take the no appetite events very seriously. I asked my PCP to refer me to a dietitian. She said my Medicare insurance will not cover that and just an initial consultation would be $150 which is out of my league right now. So, I am still struggling with that issue.

Up until yesterday I was on 8 mg of suboxone a day, but the last three nights I felt symptoms like withdrawl. My psychiatrist told me I could increase or decrease the dose. I was confounded that he was leaving that decision up to me, but last night I took another 4 mg and felt much better. So, for awhile, I think I am going to stick with 12 mg.

I have four surgeries ahead of me and after reading your post, please trust me that I am forgetting for now thinking about getting off the stuff. I will deal with that way down the road.

Thanks again Hatmaker.

P.S. I just love your name!


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 Post subject: Dear Romeo
PostPosted: Tue Apr 19, 2011 9:12 pm 
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Thank you so much Ron, for getting me started. I am pretty sure that I now understand what I need to know within this forum. Actually, how can I say that? I am sure there is more for me to learn. It was so comforting for me to hear that this is the place I need to be not only for questions and answers but also not to feel that I am all alone out here in the big world where my few friends know absolutely nothing about suboxone or opiate addiction for that matter. Like I indicated, I have an intake appt. on Thurs. for a substance abuse counselor, in which the clinic also has groups. I am hoping that maybe, just maybe there will be a dietitian or nutritionist on board that can help me with my eating habits. I have always been pretty thin and even when I was clean for four months in 2008, I never regained my appetite. So, maybe it is me or my metabolism and nothing to do with the suboxone. I just wish I could get hungry. How ironic, when there are so many people in this country struggling with being overweight and here I am complaining. I think being to skinny is just as bad. It is a real struggle.

I am going to continue on the 12 mg until the next time I see my psychiatrist on 4/29 and even though I do not think much of him, maybe together we can work on a dosage that I will feel balanced on both physically and mentally.

Like I mentioned to Hatmaker, I am not going to obsess about having to replace one addiction to what I think may be another. I do not feel the euphoria now that I used to feel. Other than the few negative side effects, overall, I am feeling good, and I don't even want to think right now about going through another withdrawl period. I am hoping those days are over.

Col


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PostPosted: Tue Apr 19, 2011 10:45 pm 
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Good for you Colleen on making up your mind not to obsess over how long you're going to stay on Suboxone. You're 3 weeks in and you have some serious work to do before you should even consider quitting Suboxone.

I am SO happy to know that you are going to be seeing a substance abuse counselor. My substance abuse counselor helped me so, so much to able to handle life without opiates. One huge way he has helped me is just by knowing his story, he was a major heroin addict, but he is now currently 27 years clean!! 27 years....Holy Smokes....that's the kind of story that inspires me!! He also helped me to understand the nature of addiction and some of the tricks it's going to play on me as I continue my journey opiate free. Knowing ahead of time what my brain may do to sabotage my recovery AND using the tools and techniques he taught me to combat those urges are priceless.

You certainly won't feel alone here, we are all addicts or recovering addicts and we can relate to how you feel. As you get more familiar with the forum and as you start to read more of other people's experiences, you'll feel less and less alone. Many of us on this site have more issues going on than addiction alone. For instance, I'm OCD (Obsessive Compulsive Disorder). There are many who suffer from depression. Many who suffer from anxiety. I know you have one of those issues I mentioned and I again encourage you to read as many different stories on this forum as you can, you will find so many similarities between your story and that of others and that alone is comforting.

I hope you are able to completely stabilize on your dose very shortly too.

Best wishes to you.

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 Post subject: Hi
PostPosted: Wed Apr 20, 2011 4:15 am 
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Hey Colleenjm,

My name is Queenie. Nice to meet you. First of all welcome. I want you to know you have made a good decision by going on Suboxone to treat your addiction. I am currently in the hospital where I underwent my 2nd. leg amputation in 1 1/2 yrs. I got off Subs 8 days before surgery but was put on Percocet for pain & withdrawal. When I am healed and my pain is gone I plan to go back on Subs right away. I like life better on Suboxone but this was necessary.

I read your posts and I too have appetite & constipation issues. As for the constpation, Fleet suppositories take care of the problem in 20 min. for me.

Now the eating.I have always had a poor appetite. A long time ago My doctor of 21 years prescribed something called Cyproheptadine.. (Periactin). It is a non-narcotic pill, an antihistamine but the side effect is that you get crazy hungry. It works wonders for me & my dr. assures me it is harmless.

I wish you the best of luck with everything. Let us know how you are and how things are working out for you.

Love, Queenie


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PostPosted: Wed Apr 20, 2011 4:03 pm 
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[font=Century Gothic]Hi Collen, I am so sorry you are experiencing these side effects from the Suboxone you are taking, Im not sure what dosage you are on, I may have missed it if you did post it but that would be helpful info if you wouldnt mind sharing. Unfortunately the constipation is a pretty common side effect that quite a few of our family of posters have experienced including myself, however as a healthcare professional (im a certified NJ state Paramedic) might i make a suggestion, you said that your doc put you on Zofran? correct? well Zofran is an anti-emetic (anti-throw up med) primarily used to stop nausea/vomiting however it can in reverse cause constipation in patients including myself. I have Crohns disease so i have spent the past 6yrs living on Zofran because with my disease it causes constant severe nausea/vomiting, so i would sometimes vomit up to 12times in a day whether i would eat or not. So unless you are truly nauseated the Zofran may actually be adding to the constpation that you are getting from the Suboxone, And the reason that the Sub is giving us Constipation is because it is still an opiate be it only a partial one however opiates almost always cause constipation or some form of GI upset. What i used to off set the side effects of the Suboxone for the first few weeks until my body got used to it was (senkot) it is a vegetable laxative) it doesnt cause cramping like alot of the others do) however the mirilax is also a good one. But the Zofran really isnt going to help with stomach cramping thats not what its used for. You should really never let yourself go more than 4-5days without having a BM unless that is the norm for your body. As far as the lack of appetie, I too had the same feeling of not wanting to eat anything, having to force myself to eat really having zero interest in any food at all, and then one day right around my one month mark i woke up and was so hungry i almost ate my husbands arm. lol So im not saying that it is absolutely normal or abnormal but i have gone through ALL of the same symptoms that you have posted and all of mine have subsided or disappeared right around my one month mark and alot of people on this site have had alot of these same side effects. As far as your shoulder pain subsiding I know exactly how you feel, i just cancelled my neck surgery that was scheduled for neck week and i have 2 herniated discs in my neck and a c1 subluxation from being hit by a drunk driver. My surgery was scheduled 2months ago to do a discectomy and the suboxone has subsided my neck pain so much that i felt no need for the surgery right now. And before i began treatment which i began primarily because i am that 1 in 10,000 people that has hyper-analgesia syndrome ie the more pain meds i took the worse the pain would become until one day my doctor put me on a morphine pump to control the pain, and the medicine sent me into such excruciating pain and spasms that my spinal cord swelled up and i started seizing!!!! BAD BAD BAD yes believe it or not that can actually happen, i had to take the pain meds to not begin to withdraw but when i took the pain meds they immediately and intensely made the pain much more severe within minutes. Aint that a bitch! yeah my surgeon said i was the second case he had had in 26yrs now dont i just feel special, lol. So anywho now that im rambling hope that helped some! [/font]

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