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PostPosted: Mon Aug 01, 2011 9:03 am 
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Long story short, My Dr has had me on opiates for herniated discs and compressed nerves for a little over a year now.
Ive gone through the relief options (vic, perc, oxy, opana..etc).

Few epidurals and piles of money later, im still in pain but sick of being on the drugs.

we tried with 15mg roxys (which did work with the pain) but i would keep taking them as soon as the pain would start coming back and I was eventually taking up 200+mg in a 24 hour period.
I was waking up in the middle of the night to take pills because the W/D would wake me up.

long story short, it started turning in to the opiate nightmare that im sure you all are familiar with.

I mentioned to my Dr for a very long time that I wanted off the meds and a few months ago he finally agreed that my only option at this point would prob be surgery and agreed to taper me off the pills.

We tried tapering with what i was already taking (roxy 15mg) but my habit and my now dependence got the best of me and i was back to old habits again.

Now he has me tapering down using fentynl patches. (started at 50mcg/hr and now at 37mcg/hr. he tried to drop me from 50 to 25 and i went in to very bad withdrawal so i was given some 12mcg pathches to use with the 25)

Ive asked him about suboxone bc i know someone who was a addict that recently got clean using subs.
My Dr says he cant write for the suboxone bc i would have to see a addiction specialist but he could get me just the plain bup without the opiate blocking agent. since i was dependent and not an addict (did not show drug seeking behavior or failed any screenings).

He tells me that im on such a high dose of opiates right now that the bups wouldnt be able to help me til i tapered some more...
is this true?

I hear of hardcore heroin addicts getting on bups with no problems.
I cant figure out how my 37mcg/hr fentyl dose is too high..

- would there be another reason why he wont give me the bups?
Ive never shown any signs of abuse. the only thing i would considering addict behavior is finishing my Pills early but hes been fully aware that was due to the amount of pain i was in and the level of tolerance.

He knows i want to get off this junk as soon as possible.
Im just hoping hes not keeping me on a longer plan to make more money off me....
hes been a great Dr to me so i would really hate to believe that...

- Also, Is getting off opiates with bups as easy as everyone here makes it seem?

Ive read that you cant start taking bup until youre in withdrawl.
- how bad does it have to get before you can start taking it?

I can deal with the stomach/sweating..etc issues but the one thing i cannt stand is the creepy crawlies and the RLS. :cry:
Im not sure that i could deal with that much more than a few hours even with all the xanax i have (i take .5mg at bed time to help me sleep).

- how long would i have to deal with that before i could start the induction?


Sorry for the long post,
Any help would be greatly appreciated.

Thanks


Last edited by BC12 on Mon Aug 01, 2011 9:07 am, edited 1 time in total.

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PostPosted: Mon Aug 01, 2011 9:04 am 
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p.s i hope i posted this in the right place.. Feel free to move if i did not.

oh and can someone give me an idea on how much the generic buprenorphine would cost for a months supply?


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PostPosted: Mon Aug 01, 2011 10:36 am 
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Hi BC and welcome. I've NEVER heard of someone being on too high a dose of full agonist ("regular") opiates to start suboxone. All that would affect is your starting dose of sub - it would likely just be higher than that of some people.

You also asked, "Is getting off opiates with bups as easy as everyone here makes it seem?". That depends on what you mean by "easy" and how you use the sub/bupe to get off the opiates. Some people choose maintenance with sub (longer term) and others just use it as a detox tool. What I mean by that is you'd use it in order to wean off opiates and use it for maybe a couple of weeks or so, again, depending on the dose you start at.

Yes, you do have to be in withdrawals before you can start sub. If you don't wait long enough, you risk going into precipitated withdrawals, which is so much worse than any "regular" opiate withdrawals you'd ever feel. Google the COWS scale and that is what can be used to determine how bad one's withdrawals have to be before starting sub. You can go over that and it will help you to see how bad they w/d need to be. One only has to be in mild-to-moderate withdrawals. That said, the fentanyl patch is extended release and is LONG-acting as compared to other full agonists like oxy or vics. Some doctors will switch people on that type of opiate to a short acting one for a week or so before one's induction onto sub, just to be on the safe side.

Finally, you asked how long you'd have to deal with the w/d before starting sub. As I sort of alluded to above, it's not about how LONG you're in withdrawal, but HOW BAD the withdrawals are.

I hope this helps answer some of your questions. If not, or if you have more questions, feel free to ask away!

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PostPosted: Mon Aug 01, 2011 10:44 am 
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Thanks!

ill take a look at the COWS scale...

I wonder why my Dr is so apprehensive about putting me on Bups...

I know when i first asked for them, the reason was because it wouldnt do much for my pain so he preferred to keep me out of pain and try not to get too heavy in to WD..

ill have to bring this up again when i go back in a few weeks.
while the fentynl is relatively cheap, it seems like the bup detox is a lot faster and seems to be smoother than what ive been going through.

with the patches, im pretty much in WD every other day when its time to change out the patch. it just slowly creeps up about 30 hours in and i change every 48hrs.
i would prefer not to deal with it at all if the bups would possibly give me that relief.


what i meant by easy is,
ive read a lot of suboxone stories where people were just miserable til they finally got on a sub treatment.
ive read and heard that it was pretty much a piece of cake.
you take your doses, decreasing and pretty much have no WD during the decrease.

a buddy of mine managed to completely detox in 3-4months just on sub program and he mentioned that he felt no WD through the whole process.

i just wondered if other experiences were smiliar since what im going through now (heavy WD every 30 or so hours) is no fun at all.


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PostPosted: Mon Aug 01, 2011 10:48 am 
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BTW, this is a GREAT forum you guys have here.

full of such great info!
glad i found it


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PostPosted: Mon Aug 01, 2011 10:56 am 
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If you plan to do about a 30 day detox, any comfort/discomfort you feel will be very individualized, based on your unique addiction history, your dose, and the way you do your taper. If done right, yes, it can be painless. I agree that since you show no signs of addiction, then using sub short term for detox would probably be a good idea for you.

Normally, suboxone doctors must have a waiver to prescribe suboxone for addiction purposes (it's called a DATA 2000 waiver). I remember recently reading (and I can't find the source right now), that if a doctor is using suboxone to wean a person off opiates and they are NOT an addict and sub won't be used for maintenance, that the doc does NOT need the special bupe DEA waiver to prescribe it. Does anyone else know what I'm talking about?

Suboxone does have pain relief properties. Take me for example, I also take suboxone for pain in addition to for addiction. It helps my pain enough so that I can deal with it. I'm still disabled, but I'm able to keep my pain under a "5" on the pain scale most of the time. That said, it doesn't help everyone's pain...it just depends on the person, what type of pain they have, and how bad their pain is. When you are on sub, you'll have a chance to see if it helps your pain. Normally when someone takes it for pain, we dose a bit differently because when using it for pain, sub only lasts about 4-6 hours. If you find out it helps, then you can think about staying on it to treat your pain. Wouldn't it be nice to take something that helps your pain that doesn't get you high or fog you out or even have to keep increasing your dose? All of those things are what sub is all about.

Now who's long-winded? LOL. Hope this clears up some things a bit better.

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Mon Aug 01, 2011 11:05 am 
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I understand what youre saying about the license.
My Dr (spine and pain specialist) said that he couldnt write me the suboxone with the naloxone bc he was not a certified addictionologist but could write for the buprenorphine and said he would be ok with doing that since im not a drug addict or whatever... just cant figure out why he wont do it..

i guess ill mention it again. :lol:



as for the pricing...
i think my pharmacy told me it would be around $200 or so for a 30 days supply...
is that a normal price?
is there anywhere cheaper i could get it from?


thank you so much for your replies!
:D


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PostPosted: Mon Aug 01, 2011 11:11 am 
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Sorry, I guess I missed a couple of questions. I also wanted to say that when it comes to the waiver/special license, suboxone/subutex are no different. If either of them are used for addiction treatment, the doc needs the waiver. For example, if say you decide later on that it helps your pain enough to stay on it for that alone, your doctor would also not need the waiver.

As for prices, my suboxone is covered by insurance, so I can't give you a quote. I do know that subutex - name brand - is very costly. But it does come in a generic (suboxone does not) and that can save you money. I also know that prices do vary from pharmacy to pharmacy, so be sure to call around for the best price. And the more pills your doc prescribes, obviously the more it will cost you. So for you, the lowest dose that keeps you out of withdrawals will be best for you (it's always best, but in your case - for financial reasons AND for a short taper - it definitely is best for you).

Does that cover everything? I hope your doctor comes around.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Mon Aug 01, 2011 11:24 am 
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Thanks for all your help!

its impossible to explain to someone what Im going through without them judging you.

The info on this site has been a life saver!


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