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PostPosted: Thu Apr 29, 2010 8:51 pm 
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Hello all,

I am the 34 year old mom to two beautiful babies. About a year ago I was prescribed oxycontin 20 mgs 3x a day for spinal stenosis pain. Before long I became badly addicted and went as far as to start snorting them. I now snort about 100 mgs or sometimes more a day. I have tried going cold turkey twice and relapsed both times about a month in. The physical wds were hell but it was the mental part - the severe anxiety and depression that kicked in after I quit oxys that led me to relapse. I tried tapering after that with no success. After doing a lot of research I've decided suboxone could be the answer for me. That and a lot of aftercare to get to the root of my addiction.

So I went ahead and made an appointment to start sub on March 11. Thing is the doctor asked me to not take oxys for two days before my induction. Isn't that a little extreme?? Most people I read about only stopped for 24 hours or not much more then that. I am thinking that if I did even 30 hours or so that would be enough. What do you think? I would appreciate any advice you have. I am really looking forward to starting subs but am really nervous at the same time. I'm just praying it works as well for me as it has for so many others. I'm glad I found this forum and hope you can help me.


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PostPosted: Thu Apr 29, 2010 9:47 pm 
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Hi freebird and welcome, we're glad you joined us.

About stopping before your induction, I've heard the the state of your withdrawals is more important than how many hours since your last dose. Look up the COWS scale online and it will help you to measure whether you're in mild, moderate, or severe withdrawals. I'm guessing the doc said 48 because with only 24 the person might not be in enough and the suboxone induction could bring forth precipitated withdrawals. The suboxone should relieve withdrawals. If that made any sense?
That said, I'm not a doctor nor a medical professional. I just learned alot from this forum and other research.

Now...congrats on your decision to start recovery. It's a huge step and you should be proud of yourself for having made it. Again, welcome and we hope you post often.

Let us know how you're doing.

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PostPosted: Fri Apr 30, 2010 12:25 am 
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First let me start off by saying great job on makeing that app its a reall big step and shows alot about u and you seem ready to start a new life or i like to say get your life back. any ways i was perscribed oxy contin for 4 years on a 160mg a day for a bad knee injury so i can relate to were you are and i went beyond snorting not injecting but popping long story not the site or time ill get into that. anyways my sub dr said 48 hours as well but bewteen u and the rest of the members i only went 24 hours with out oxy b4 my induction. and i was 100% honest with my sub dr about that. but i was luckily in enough wds to start. i think you should make this decsion based off how you fell and maybe try a slow taper to get ready for the 48 or how ever long u go with out it. just think 2 days of hell is worth a lifetime of freedom from the devil we all call oxycontin.

please keep us posted and welcome to the site youll find everyone hear is nice and willing to help you.


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PostPosted: Fri Apr 30, 2010 7:20 am 
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Welcome to the forum. I saw in another thread where you already took the time to help someone else out and I think that is awesome.

I agree with what has been said already. You probably know by now about how long it takes for you to be in moderate withdrawal. Since you mentioned 30 hours, I am thinking that is about how long you can go before you can't stand it and that is probably the right amount of time.

I also want to thank you for posting your experience about withdrawal from oxycontin. Often people will complain about suboxone having a drawn out withdrawal phase. What most people don't realize is that the drawn out withdrawal accompanies withdrawal from ANY opiate. A month is a long time to go without relapse and clearly you experienced first hand that PAWS lingers long after the physical withdrawal has subsided. I think that is a good reminder for people.

Cherie


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PostPosted: Fri Apr 30, 2010 8:08 am 
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I was crunching up about 180mg per day of Oxy at the end of my last "run" and I went about 36 hours without it before induction. I was experiencing moderate WD symptoms at the time, and my induction was quite successful, I was started off with 8mg twice per day.

I think everyone is different, but it sounds to me like your doctor is just playing it safe. You will feel like crap (as you already know) but within about 20 minutes of your first dose of suboxone, you should feel fine.

Good luck and congrats on making a decision to deal with your problem.


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PostPosted: Sat May 01, 2010 12:54 pm 
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Maybe the doc figures you're taking the OxyContin as prescribed, meaning not crushed up, Time release coating still on, and orally. That's why he would give you a little bit longer of a time because he figures since it's time release, the half life will be longer. He just doesn't want to put you through precipitated withdrawals. You probably don't have to wait that long, but he's looking out for you so take pride in that.

But just to say, my very last opiate experience was about 120mg of snorted OxyContin. Completely crushed, no coating left. In my addiction days, I would use a hose clamp as a "grinder" to get the powder ultra fine. And it did that perfectly. From that last dose, I waited exactly 24 hours before my appointment. The suboxone was under my tongue 25 hours after I had touched the Oxy. I felt fine. Everything was positive. Seems like you are using it in the same fashion I was, so really, just try to wait 24 hours. If you can go a few hours over that, even better! It's hard for a lot of people to go 48 hours. Day 2 is the absolute worst, and it often fogs people's judgement and they end up relapsing before they can see a doctor.

I know when I was viscously sick the first time I tried to induct to suboxone(I ended up having to wait about 40 hours) I cracked in the middle of the night when I had been trying diligently to goto sleep for about 4.5 hours. For some reason my pill dealer was still up at that time of night, and I screwed up and got a pill. I wasn't thinking about suboxone being hours away. All I was thinking about was feeling better, and I didn't want to wait for suboxone. It's such a terrible experience, strength only goes so far in an opiate kick.


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PostPosted: Tue May 04, 2010 8:32 am 
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One more week.

One more week of trying to make my pills last (they never do) One more week of trying to not kill myself on these f'n things. One more week until I start subs!! I can't wait to put this addiction into remission. I want a life again. I want to be able to go through the day like a normal person and not be fixated on pills. It's become all consuming and I've come close to being consumed by this. One more week, just one more week. I'm really nervous too though, normal I suppose?


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PostPosted: Tue May 04, 2010 8:46 am 
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Cherie,

Yes PAWS is a very very real phenomenon and there were days I wanted to drive into a pole and end the misery of what I was feeling. I think PAWS hit me so bad because I have always suffered from depression and anxiety prior to getting hooked on opiates. While on oxy, my depression has been "cured" but take away the opiates and the depression and anxiety came back TENFOLD. During this time I sought out aftercare in the form of NA and I felt good while I was there for the couple hours but I'd leave and go home and be left with myself and the horrible depression. It got to be too much. I really really tried to quit the "old fashioned way" and was left and emotional basketcase. Actually I have always been one but opiate addiction really enhanced it apparently :roll:

I don't believe in a one size fits all approach to recovery. I think people have to do what works for them and although my hat goes off to anyone who can do total abstinance, I can't do it so if subs can be the next best thing and save my life. That's my goal - to save the life I feel slipping away from me - then so be it. So I know you guys have probably heard this question a thousand times but please answer anyways, how did you feel getting on subs? Was it like you expected or were there some surprises? I guess I'm trying to figure out how my transition will go. Thanks in advance :) I can't wait to be free from active oxy addiction. Only a week away now! *sigh of relief followed by nervous feeling in tummy*


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PostPosted: Tue May 04, 2010 9:26 am 
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So the 11th right?! That is so soon! You can do this! I remember the days leading up to my induction, I was so scared, nervous, excited....so many emotions. I felt like the day would never come. May 22 will be my one year anniversary of starting sub. Congrats on making such an important step in your life. I am also a mom and getting off pills is the best decision we can make for our kids. Suboxone has given me my life back. Thank god.
Anyway, as for your question, I would def. try to wait the 48 hrs your dr suggested if you don't think you can do that, def. try to do 36 hrs. And like the previous poster said within 20 mins of taking the sub you will feel so much better, so its worth it! Congrats on this and keep us posted! I'll be thinking of you on the 11th! You are giving your children an amazing gift by getting help!


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PostPosted: Tue May 04, 2010 9:39 am 
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Hi free bird,

I didn't have a normal induction, so my own experience wasn't really typical. I can tell you this, most people, for the first few days, experience a sort of loopiness (for lack of a better word). Some may call it a bit high - I call it feeling "oogely". (My own word LOL.)

Anyway, I wanted to point that out to you so you're not surprised by it. Usually it goes away within a matter of days. As for the induction itself, many people describe slowly getting back to feeling "normal" within an hour or two of taking their first dose(s). Different doctors have their own way, but my understanding is that they often will give you one dose and have you stay in the office and see how you respond and then give you another dose while tracking your withdrawal symptoms. But like you said, everyone is different and that includes doctors.

I think it's completely normal to be nervous or even scared. It's a huge change...a really big step. But I have a feeling you'll be very happy you made this decision.

Keep us posted on how you're doing.

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PostPosted: Tue May 04, 2010 11:25 am 
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Hi free_bird,
Welcome to the Forum and Congrats on deciding to get your Life back... :) ! As far as the time between your last dose and start of Induction goes . Be careful not to cut it to close and have the Dr. send you away because you are not ready for the Suboxone induction.... That would suck after all the work you have done to prepare yourself! I just wanted to throw that out there.
I was Inducted on 2-02-2009 and it went great. I was definitely in moderate W/D's when I arrived to claim my life BACK and I started to feel better within an Hour :) I have been on 16mgs. per day since then and I feel great!!!!
Soon you WILL BE Free as a Bird to take care of those beautiful daughters of yours......
It sounds like you are determined to get into Recovery and I hope you get as much out of this Forum as I do... It's a great place to come for info or to share your story in hopes that it might help others... We look forward to you coming back and posting your progress. I'm sure you will be a great addition to the Forum... :D Take Care.

God Bless
TW

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PostPosted: Tue May 04, 2010 3:14 pm 
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I'm new here too but not new to subs or addiction. How you feel after induction will be determined by where you came from. If transitioning from methadone or f-patch; probably not good. But coming from street will usually bring comfort, relief and peace of mind, at least for the short term. A 24 hr induction from a short acting opiate will probably be ok but we got to follow the dr's orders. At least on the surface. Try testing yourself in advance to see how bad you feel at 24-36hrs and use that as a guide. Most all docs will want to see some physical wd's before induction. How much they want to see depends on the doc himself. There are a few insensitive ones out there and look to see some real significant pain, so hopefully yours isn't one of them.

Good luck!


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PostPosted: Tue May 04, 2010 3:50 pm 
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hatmaker510 wrote:
Hi free bird,

I didn't have a normal induction, so my own experience wasn't really typical. I can tell you this, most people, for the first few days, experience a sort of loopiness (for lack of a better word). Some may call it a bit high - I call it feeling "oogely". (My own word LOL.)



I felt like I was high as a kite for about my first week on suboxone. In fact, I was a bit concerned at first because I have been on Methadone before and it felt somewhat similar to that, and I was never very successful with Methadone because of the fact that you can get high from it.[i]

But after the fist week, I settled in to my dose of Suboxone and started feeling quite normal, not high, not "oogely" :lol: and for the first time in a LONG, LONG time I actually started to have some hope again that I could live a normal, productive life.


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PostPosted: Tue May 04, 2010 5:03 pm 
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It really seems like many people like to focus on the amount of hours that have passed since the last opiate intake rather than the condition the patient is in prior to taking the first Suboxone. The amount of time really does not mean all that much. A blanket statement like having someone wait 24 hours or 48 hours really does not mean nearly as much as having the person obtain a certain level of opiate withdrawal. Different opiates take longer to wear off. Different people will metabolize and clear medications in different amounts of time. The amount of opiate taken, together with the level of tolerance the person has, will factor into the amount of time needed.

There are a lot of variables that go along with trying to induct using time alone. The amount of time is always going to be variable. That is why many physicians use the COWS scale in order to determine when it is safe to induct a new patient on Suboxone. A minimal score of at least 5 is recommended while some physicians refer scores of 15 or higher. I have seen several recommendations as 10 or greater being the level to shoot for. Google "COWS scale" to find out more about this tool. Once the patient hits, for example, 10 on the COWS scale, he is ready to take the Suboxone. It really does not matter if it takes 6 hours of 60 hours to get to 10 on the scale. Mild to moderate withdrawal is mild to moderate withdrawal - regardless of how long it takes the patient to get there. Hopefully you can see why the time really does not matter nearly as much as the level of withdrawal. That's why making a statement like waiting 36 hours is of much less use than a statement like being at a 10 of the COWS scale. There is also danger on both sides when using time rather than symptoms. If 24 hours is not long enough to put the patient into withdrawals he risks even greater discomfort with the potential of precipitated withdrawal brought on by the Suboxone. On the other hand, someone may be in some really painful withdrawals after 48 hours and has endured a level of discomfort that was not at all necessary. It's easy for us to say "wait 48 hours" when we are not the ones going through the agony. Imagine being "ready" at 24 hours and having to survive another 24 hours while each minutes passes like an hour and it seems like this will never end. That's the danger of using time rather than COWS scale.

Check out the Clinical Opiate Withdrawal Scale (COWS) to see the various symptoms that are rated in order to obtain a total COWS scale. When you score 10 or more, you are ready (according to literature from the National Alliance of Advocates for Buprenorphine Treatment). If less than 10 you may want to wait a little bit longer. Throw away the clock and instead pay attention to the symptoms and level of withdrawal.


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 Post subject: doctor appointment??
PostPosted: Fri May 07, 2010 10:29 am 
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[font=Arial] [/font]

Hi there,
I just thought I would send you a quick note to see how you made out at your doctor. I have been thinking about you and hope everything went okay, and that he can prescribe sub for you.

So, let us know!

Also, donh's meesage was very important, it's not really a time thing for induction, but the amount of withdrawals you are in. Have you found the COWS scale? and taken a look at it? let me know if you haven't and I will find it for you.

Hope you are okay, let us know how your doctor's appointment went when you get a minute,

Ginger :D [code]


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PostPosted: Fri May 07, 2010 11:44 am 
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I was sure I posted about my doc visit yesterday, maybe it got lost..

Well I saw my family doc and asked him to prescribe me sub. He has never even HEARD of sub before!! needless to say he wouldn't prescribe it so I'm going in on Tuesday to see the sub doc and get started. I also made sure there are pharmacys near me who have it.

On Monday I will take one dose in the morning and thats it. i know from experience it doesnt take long for bad withdrawls to hit and by Tuesday morning I will be VERY sick. I'm nervous about the appointment and excited to finally have an end to active addiction in sight. I HATE what I've become. The pills used to give me energy - now I have ZERO motivation to do anything. The pills used to make me feel euphoric - I don't even catch a buzz now despite the high number of pills I take. the pills used to ease my depression - did I mention I hate myself? yeah everything the pills did for me they no longer do and sub is my last hope to get my life back and start really living again.

So fast was the downward spiral on these things. In just a year i have taken a freefall all over a stupid pill. I can't wait to feel normal again and stop having pills run my life and dominate my thoughts every day. Just a few more days....


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 Post subject: sub
PostPosted: Fri May 07, 2010 12:08 pm 
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Hi again,

I have lost several posts, too. Actually I have a lot of difficulty posting, I keep getting a message that there is no post mode specified and I have no idea what that is. So, I try a lot of things, and then my posts get these weird code things applied to them

I am sorry to hear that your doc appointment didn't turn out well, but I am not surprised at all. For some reason Sub is not something doctors even know about. I know sub has only been in Canada a couple of years, but usually when something new comes out, the big sales guys are at all the docs promoting it, but now SUB.
my doctor had not heard about it either, but at the time was prescribing hydromorphone contin, and alot of it, so he was really happy to try sub, and I am kind of his guinea pig. I sometimes worry that someone is going to find out that he is prescribing it, and will tell him that he can't, but so far, all is okay.

So, what did your doctor say when you told him that you were addicted to your opiates?? Was he surprised? Did you tell him about your appointment with the sub doctor?

The good thing is, you do have an appointment with your Sub doctor. I know exactly how you feel right now, nervous buyt excited!!

Opiates almost killed me. Like you, at first they were like a dream come true. i had no pain, no depression, and a ton of energy, and was always in a great mood. When it changed, it happened fast, and i was a mess, and scared to death. i tried to detox so many times, tried tapers, even tried methadone, but I could not stop. In the end, I went through all my savings, have no friends from isolating so much, almost destroyed my marriage, my kids were really worried about me, but most importantly I was worried about me, i honestly thought I was going to eventually overdose and die! Really, I thought there was no way oout for me. i al so grateful that i have found sub, it has really changed so many things.

Be prepared to start feeling again. Do you have a therapist?

Anyway, we will deal with all of that later! For now concentrate on what you have to do for now. have you taken a look at the COWS scale??

let us know if you have any more questions. This is such an awesome forum, and everyone here will behere to help you get through your induction,

all the best,
Ginger


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PostPosted: Fri May 07, 2010 1:47 pm 
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Hi Ginger,

Yeah I guess I shouldn't have been too shocked that he wasn't willing to prescribe it. I really downplayed the addiction to be honest with you. I told him I wanted to try sub because of my ever increasing tolerance to oxys. I told him that instead of upping my dose I wanted to try sub and he seemed really happy that I did not want to up my dose anymore. I was afraid to tell him the real truth because of my kids but I'm sure he could read between the lines, especially when I asked him for enough oxy to get me through until Monday. I waited for him to blast me for going through 21 pills in 4 days but he instead wrote me out a script for 12 more oxys. Sad part is it's not even enough. i'm on my way to go buy a couple 80's to get me through until Monday. I'm a mess financially, for the first time I even went as far as to write myself a post dated cheque yesterday so I could get some money. My cheque goes in on the 20th and I'm praying the bank just takes their money and doesn't flip out and cancel my machine privelges. Ahh what a mess I've created for myself. I am deep in debt and I've dug myself in pretty deep. My consolation is knowing once I'm off these damned oxys I will save a pile of money. I have no savings and my bills have piled up because instead of paying the bills when I get them I buy pills instead and I owe big bucks out. I just got a referral to a therapist and should start seeing her next week. I'm just waiting for a call back. I was supposed to see her for the first time yesterday but cancelled because of the appt with the doctor. She hasn't phoned me back so I'm going to try her again. I hope she's not pissed off I missed the appointment. I gave her advance notice and hope she is good. If not I'll keep looking until I find a therapist I'm comfortable with. I also want to start going to NA again. I went to several meetings but stopped going when I relapsed after going cold turkey in January. PAWS really came on badly and I was a mess. I think thats why most people relapse, the feeling of depression and anxiety is so overwhelming and to try and stay away from pills yet feel so abnormal without them makes staying clean almost impossible. I really think aftercare is a big must in order to truly recover. I have a lot of work to do on myself and I'm hopeful sub will help me feel normal enough to work on the stuff I need to and stay free from active addiction.

I will be posting a lot here and am grateful for the support I've gotten. It's great to talk with people who know what this is like.


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 Post subject: sub
PostPosted: Fri May 07, 2010 3:12 pm 
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hi again,

I know exactly how you feel spending the last of your money on oxy's. I hated it so much, but had to or i would be so sick. I don't know what 80's cost where you are but I just heard that they are now selling them for $50 each. that is insane, I'm so glad that I'm not spending all my money on them any more.

I have not heard you mention a husband. Is he in the picture? Is he supportive? Aare you working right now?

I have gone through two therapists already. My first one really wanted to dwell on my sexual abuse and kept talking about it and wating to know the details, it was really weird. The more I told her I didn't want to talk about it, the ore she insisted that we should. I hated going to see her, and it was not at all helpful. My second therapist is a man and i've really like him, but the last two times I've seen him all he wanted to talk about was me getting of the sub, so I'm going to have to get another therapist. I'm not sure I'm even going to tell the next one that I'm on sub. they just don't know anything about it, and can only compare it to methadone, which it is not even close to.

Anyway, I"m on bus duty so have to run. I'll check back in when I get home.
keep writing, keep asking questions. The more you know, the better you will feel about all of this.

Ginger[code]


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PostPosted: Fri May 07, 2010 4:26 pm 
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Hey free_bird:

One thing I have learned over the years is if you really want to give yourself a fighting chance at staying clean for the long-haul, it's a good idea to come completely 100% clean with your doctors.

For many years I avoided doing this and it ended up as a pretty significant enabling factor in my relapses.

Just trying to help. :)


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