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PostPosted: Thu Nov 21, 2013 11:29 am 
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Hi All,

I've been reading this forum for awhile, but I have never posted before. I guess I am just looking for some support, as I feel the knowledge of suboxone tapering to be woefully inadequate from my Doctor and I don't have very many people I can talk to about this.

Background: Addicted to Oxycontin for 3 years, was put on 80 mg methadone maintenance, took me 5 years to finally get them to reduce my dose enough to switch to Suboxone. ( I harbor a lot of resentment towards this clinic but that's a rant for another time). I've been tapering slowly from 12 mg of Sub for the past 3 years and now I am down to 1 mg.

Everything was going great, I have been clean from any illicit drugs for a total of 8 years, building a quiet suburban middle class life, but being dependant on medication for so long is finally taking its toll on me. I want to get off of Sub more than anything in this world because my husband and I are ready to start a family and I just want to be as healthy as possible and free from any medications in order to have a healthy baby. In the past year and half I have even lost 125lbs since I have been eating right and exercising. Being the picture of health, I theoretically should have a relatively easy detox.

Since I've hit about 2mg things have been going south. Many days I am experiencing severe depression, uncontrollable emotions/crying, social anxiety, panic attacks. Frankly, I feel like I am losing my mind and I can no longer pretend everything is ok while at work and around family/friends. I am known as a very strong person for having lost all that weight and have kept up the appearance that I have everything together. Not many people know what I am going through and I don't want to tell them for fear of judgement and mistrust. I am getting to the point that I believe I will have to take off of work in order to completely get off of the suboxone. I just want to take this weight of pretending everything is fine off my shoulders.

I do not know how to go about securing time off of work without losing my jobs. I do not think my Dr will write me a medical leave, he seems to think I should be able to do this without missing a beat, I am desperately afraid that if I continue to reduce my dose I will end up breaking down at work (which I have come very close to on multiple occassions), or getting fired for attendance issues. I actually have 2 part time jobs which makes this even more complicated. After January I have 2 weeks unpaid vacation time. I am wondering if this will be enough? Or will I need to plan for several weeks or months of feeling crazy?

I guess I would like to ask all of you that have successfully gotten off this drug, where you able to continue working? How long did it take you before you felt like your brain was functioning normally again? I don't want to lose everything I worked so hard to build. My work and personal relationships are suffering right now and I just feel like I want to go hide until it is all over. I don't know how to go any farther without putting my life on hold. On the other hand, I am prepared to do whatever it takes to beat this. I just want to do it in the most responsible way possible.

I do not want to take anti-depressants or benzos to get me through, for it will just be another medication I will need to ween off of. Currently, I am taking Clonidine which helps the anxiety slightly, but it doesn't help the intense panic attacks I experience at work or social situations. I feel like I am becoming an agoraphobic. Just the thought of leaving the house causes me anxiety.

Thank you for listening, any advise you may have is greatly appreciated :D


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PostPosted: Thu Nov 21, 2013 1:40 pm 
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Hi Krista,

I am really impressed with your story. It sounds like you have fought your way back from your active addiction, and from an unhealthy lifestyle, and turned everything around for yourself. You are definitely not a weak person! You have shown that you have the will power to struggle through discomfort, and put your health and well being over doing what is "easy".

Unfortunately, I think most doctors don't understand how hard it is for us to actually get completely off this drug. Your story is pretty typical. It really starts getting tough when you get around 2mg or less. You are definitely at the beginning of the toughest part of it. How often have you been dropping your doses and by what amount? It is pretty important for you to start tapering slower after you get below 2mg if you want to do it in the most comfortable way. Ideally, you should drop by .25mg or less each week or two. You need to allow your body time to adjust to the lowered dose before you make your next drop. I know right now it doesn't feel like it's possible, but if you take it slow enough and are patient with yourself, you can actually do this without feeling awful all of the time.

Slow and steady is the key to a successful taper! As for your plan on not missing much work, I think that is completely do-able, but you might have to push it out a little farther than you were thinking. You said you had two weeks vacation after January, can you take that whenever you want to or does it have to be in January? If it were me, I would try to slow your taper down just a bit and give yourself more time to adjust to these lower doses before you continue tapering. I can't stress enough how important it is to do that. If you give it enough time your body will start to function almost normally on the smaller amounts, and once you start to feel good you can stay at that lower dose for a week or so in between drops to kind of rest.

Keep the clonodine on hand, most people who have used it say it is the most helpful drug to use during WD. It's not going to take away all of the symptoms, but it definitely helps. The anxiety you are having is probably pretty normal. Your body has been used to having something given to it for 8 years. When you take that away, even in small amounts, it is going to start freaking out a little bit. I'm sure your normal fears of how it will be afterwards, and the worry about your job situation aren't helping it either. I don't blame you for wanting to stay away from other drugs to combat this issue, but you need to find some way of releasing your anxieties. Deep breathing excersizes are helpful to me when I get into that borderline anxiety attack mode. I have generalized anxiety disorder as well, and any stressfull situations can trigger it. You just have to find ways of coping with it that are helpful to you. Have you ever tried any kind of counseling? There are many doctors out there with many different methods of getting you through these types of things. Some you will like, some you won't, but if you look hard enough you are bound to find one that is helpful to you.

I would suggest you look around on the stopping suboxone forum. There are tons of posts there about things people have done to help them with their tapers. If you read those and still have any questions, just get back to us and someone will be around to give you advice.

I know how hard it is to do this while still trying to hold everything else together and not look like you are struggling. You need some place that you can go and just let it out. Some place that you don't have to be brave all of the time and can just talk about your fears. That is what this forum is here for! I'm so glad you found us, and I hope that we can help you, or just be here to listen to how you are feeling and understand you.

Hope to hear from you soon.

Q

_________________
No one can make you feel inferior without your consent. ~ Eleanor Roosevelt


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PostPosted: Fri Nov 22, 2013 8:43 am 
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Thank you so much for your response! Sometimes it feels as if there is no one out there who understands what I am going through. I’m very happy I found this forum and it’s so inspiring to read all the success stories. You are so right about needing to be patient and giving myself more time. I think I really needed to hear that.

As far as how I have been reducing, I am terribly inconsistent. I have tried to come up with a comprehensive taper schedule, but it has honestly just come down to how I brave I feel that day as to how much I have reduced. It seems to be about 25%-50% reduction at a time. I went straight from 2mg to 1mg and I think that was probably too fast of a jump. My husband has been telling me I am needlessly causing myself to suffer and that I need to slow it down. I am more than mentally ready for this, but my brain and body are not quite as enthusiastic. I have been on 1mg for about 3 weeks now, and with all my other reductions, I have felt stable within 1-2 weeks. I tried to reduce to .75 last week and on about the 3rd day I had a complete mental breakdown. I ended up taking a total of 2mg that day just to get my head together. I will definitely be giving it some more time before attempting that reduction again.

I can take my vacation time anytime after January, so there is really no hurry. I originally set myself a goal of being off of Sub by the end of the year, and I am just having a hard time admitting that is not going to be possible at this point unless I was to stop working temporarily. Spring or even Summer might be a more realistic goal. I am realizing that I need a more stable plan and support. I actually made an appointment with a therapist for next week, something I have been putting off for awhile. I tend to be very prideful and it’s hard for me to admit that I cannot do this alone. Shutting myself in is probably making it worse than better. I think the breathing exercises you recommended are a great idea too. I am going to research those and ways to better cope with my anxiety. Exercise tends to help me tremendously so I am going to switch my workout times from after work to before to see if that helps me get through the day better.

I am feeling a little more hopeful today. I will not hesitate to post or reach out for support. I have made it pretty far and if I just practice a little patience I am sure I will succeed too. Thank you again for your support!


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PostPosted: Sat Nov 30, 2013 2:22 am 
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I suspect I won't change your mind.... but I've shared many emails with the 'successful' people from the 'stopping Suboxone' sites-- people who are finally happy, on Suboxone-- or miserable and using.

As the founder of this forum, I find it hard to watch people define 'success' as 'getting off Suboxone'. If that is success, then the 10 or 12 dead people who I used to prescribe to, who stopped Suboxone and relapsed a year or two later, were REALLY successful.

Anyone can stay clean for a month or a year. Actually, I'll take that back-- it would be very rare for a person with depression and panic attacks to stay clean for a year. People forget, though, that addiction lasts a lifetime. My own relapse came after 7 years of working with potent narcotics in the OR every day-- never a slip. But then one day, out of the country, with my mood at an unpredictable place... and I'm back in it.

You are torturing yourself. Your 'struggle' is completely unnecessary, and it has your entire life revolving around a drug. My advice to my patient who want to stop? Give it a run. do a slow taper-- from 8 mg plus 8 mg, to 8 mg plus 6 mg, to 6 mg plus 6 mg, to 6 mg plus 4 mg, to 4 mg plus 4 mg.

Make a change each week. There is no physical withdrawal with that schedule-- only psychological-- and if a person cannot stick to that taper, they just are not ready to stop. Get back to life; get back to dosing once per day, and work on forgetting you take Suboxone. Or work on gratitude for being able to avoid a fatal illness by taking one or two tabs each morning-- that's a pretty good deal.

After 6 months or a year, try again. But don't keep torturing yourself like you are-- up and down, on and off.... of COURSE you will have panic attacks and depression, living that way!

You didn't deserve addiction to opioids. You do deserve a treatment that will work, if you let it work-- take a sufficient dose, etc. Anyone who lists 'long-term risks' is lying; ten times as many people die from Tylenol each year as from buprenorphine medications.

Benzos ALWAYS make panic attacks worse. An SSRI like fluoxetine has a long half life--- i.e. NO discontinuation symptoms-- and it would simply eliminate panic attacks. Are you going to treat a heart attack if you have one? Why? Why would you do THAT, given your attitude toward pills? You know, once you start med for your heart, you'll probably be on a heart med for life.... is that a good reason to risk a fatal heart attack?

In my opinion, you are WAY to nuts over the buprenorphine right now---- you are the same way you would be if you were trying to stop any other opioid. You need some maintenance treatment until your life is in order-- no anxiety or panic, a good job with benefits, good daycare.... and when that is set up, the taper will not be a big deal

'It gets' harder to stop the longer you take it'-- Bull. I gets easier, as the med becomes less important to you-- UNLESS you screw it up by spending your whole maintenance time OBSESSING over it.

'we don't know the long-term effects'-- BULL. Over 30 years of info on buprenorphine; 15 years on the regular use of Suboxone- size doses.

'It is easier to stop OTHER opioids'-- BULL. the people on Suboxone are taking it because they all failed to stop other opioids.

When I was the 'expert on addiction' at medhelp.org, before starting my own forum, the 'non-expert addiction group' would trash me constantly for 'wanting to keep people on Suboxone'. People there would boast-- I've been clean 18 months and never felt better! After I left that position, over the next few years I received e-mail after email from the people who had been so proud to have 'stopped Suboxone'. They were writing because they were back on OC or heroin-- but now the couldn't find a doctor. I would have had no pleasure from saying 'I told you so'-- but I do wish they would have looked at the research, and realized that the 97% relapse rates in people who stop opioids applies to them TOO.


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PostPosted: Sat Nov 30, 2013 12:07 pm 
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Hi Suboxdoc,

I am wondering if you have an opinion on the vivitrol shot? When I got off suboxone I struggled for about a month with terrible cravings. After the shot the cravings went away and the thought of using left my mind completely, until the shot wore off. If I stay on the shot I know I can stay clean. I also know I cannot stay on it forever. Do you have any information on long term vivitrol success rates?

thanks


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