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PostPosted: Mon Aug 29, 2011 4:24 pm 
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I will try to make this quick...kids.LOL. Long story short,I have a long standing opiate addiction.6 yrs in total.Started out with vicoprofen for an injury then it escalated from there to roxicodone.I would take upwards of 150 a day or more.I have been trying on my own to quit and have gone thru withdrawals more times than i can count.Probably once a month at least.Its now affecting my marriage etc... and its time to stop.I always had a feeling sub would help me but lately that would mean admitting to my husband that I started using again.I have hid it on and off for a long time.My Q is...what is the avg maintenence dose? I read on bupepractice that its 12-16.It hard to find a Dr that takes ins as well.I found 1 and shes an hour away.I dont like her at all.She started me at 2mg twice a day and wanted me to take Clonidine and Ellavil at the same time.I just want to treat my addiction,the depression stems from that.I am a medical junkie and knew more about that med than the Dr.The 4 was not enough so I upped it to 6,then 8 over the course of a wk.I feel good at 8 so far and told her I would like the 8 mg films.She said 8 is too much and put me on 6.Didnt listen to a word I said and was actually raising her voice to me because I didnt take the other meds.Clonidine as we know is for withdrawal,the Sub is also.I am waiting until 9-7 to see my doctor of choice,much closer to home but I had to go with her since I couldnt wait that long.She didnt do induction in office,just gave me a script and off I went.I know 8 is working(and I shared this with her) because I got a call from a friend who offered me Roxi,30 mg.Normally that would put me in a frenzy and consume me until I got it.I said no and didnt think twice about it.It didnmt occur to me until later that night that I didnt think about it after that and to me thats progress! My Q is,what is the mg that most people are on.I know 8 is still low.I just dont want to set myself up to fail by not being prescribed enough.Also I still feel a bit "high".Not like when on pills but I have my energy back and feel good in general.Is that normal and will it subside? I really wanted the 8mg film,the pharm near me doesnt even stock 2mg because its hardly prescribed.I have enough to take 8 mg until I see the new Dr whom I hope is more knowledgable and not so demeaning.I cant afford to pay cash or I would have a whole array of Dr's to choose from.Any input I appreciate! Thanks.


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PostPosted: Mon Aug 29, 2011 5:28 pm 
Meli, welcome to the forum, you will find many friends and much great advice here. We are not here to judge.

If I were you I'd be honest with the hubs, he will find out eventually and you are making a very honest effort at getting sober. Really that should make him very happy.

8mg should be plenty, especially if you feel well. Lie to the doc and tell her you are using the elavil and clonidine. If you are not in withdrawal, it is a MOOT point. What a dumb doctor and especially to let you induce at home AND underprescribe. I would call the medical board in your state about her (unless she is your last resort) Maybe they can reeducate her!!

Explain what she did, to your new doctor. Stay on the 8mg if you aren't in withdrawal and craving. More usually doesn't make it better, if your receptors are already saturated. Don't let the addictive stuff rule your decisions!

Take care, I will look forward to your progress!
Robin


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PostPosted: Mon Aug 29, 2011 5:42 pm 
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Hi melijm,

It's my opinion that you should be taking as much Suboxone as you need to keep yourself out of wd and NOT craving. 8mg sounds like it fits the bill. 8mg is not a high dose for Opioid Replacement Therapy, not at all. I'm gonna say 8mg is about a normal dose, maybe even on the low side?? Bottom line, you take as much Suboxone as you need to stop the wd and the cravings.

After you've been on Suboxone for a while, you can certainly taper down to a dose that YOU feel maintains you. This cookie cutter approach that your doctor seems to be taking is not correct in my eyes.

Feeling kind of high at the beginning of Suboxone treatment is completely normal. Some of us experience it for a while, for some of us, it goes away pretty quickly.

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PostPosted: Mon Aug 29, 2011 6:06 pm 
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Melijm......Simple and to the point......."THE TRUTH WILL SET YOU FREE".......As Opiate Junkies we are inate liars, and one of the the things we change when we get CLEAN is TELL THE TRUTH. It may not seem like it in the beginning but in the long run it is ALOT easier. We will tell a dozen lies to coverup for the one. So the lies compound exponentially. Myself speaking, I was one that would steal your wallet and lie to you and help you look for it. Those are behaviors that we are suppossed to change. They say in NA you only have to change one thing...and that is EVERYTHING !
Sounds like you need a NEW doctor....one that knows MORE than you about about the compound that they are prescribing.
You are in a GOOD place here. I am new here also and new to Suboxone but an EXPERT ON DOPE and the insidious disease that accompanies it. The people in these room for the most part are Good people and and this site was created to help us understand SUBOXONE and its effects on individuals which seem to be as differant as we people are differant from one another. Except for one thing...IT WORKS. I consider it a GODSEND ! And coming for an addict with 16+ years of OXY abuse, that is saying alot !
Again, you are in a good place with good people...Please dont be afraid to ask questions. There seems to be several differant schools of thought about how long and how much your dosage should be, but I look at it this way....Find what works for you and RUN WITH IT. Again...DOnt be afraid to ask. That is the way we learn If you are still feeling sick, if you are still having cravings you are not taking enough..but give it a little time to adjust. I hear people talking about it making them feel high..well to me...feeling NORMAL makes me feel high. I didnt come here to learn how to get High..As stated I am an expert at that...I came her to learn how to feel NORMAL and still learning what that is....normal....!!!!!!

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PostPosted: Mon Aug 29, 2011 6:12 pm 
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Thanks for a quick reply.I remembered one thing the quack said to me today.She was angry at me for not taking the Elavil because perhaps I would need less Suboxone.So her method is to put me on an MAOI,which I dont need,so I dont possibly have to take the correct amount of Sub.She said perhaps if I had followed her direction,I would have had to up it to 6mg but truthfully I feel better at 8.I tried once in am doseing but by the time afternoon rolls around I feel it wear off and in the evening I am sleepy like when I was in withdrawal.She said to take second dose by noon because what Im feeling is withdrawal from the Sub but I thought it had a long half life.I think wd is creeping back in from what I was on before the Sub.So many q's,not enough answers.All I know is she was mean and it was basically her way or she wont prescribe.I also thought it would cost less to get 30 8mg films and cut them as opposed to 60 2mg which were 227.00 I will be honest with the new Dr and I pray hes good and nice because hes my only other option.I was honest with the one I see now about not taking the MAOI and she flipped.Im new to this so she freaked me out.I asked her also why I need to take Clonidine now when I am just starting and not tapering yet.She told me not to question her!


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PostPosted: Mon Aug 29, 2011 6:38 pm 
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OK,2 more questions.Sorry.I know about the 4mg ceiling affect.Is that 4mg total for the day or per dose? I took 4 this morning and 4 this afternoon and again,about this time I get really sleepy.I dont know if its too much or not enough? Confused.Sleepy as in the narcotic withdraw sleepy,like you dose off and dont know it.Cant stay awake.


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PostPosted: Mon Aug 29, 2011 7:12 pm 
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How long have you been taking Suboxone?? It does take some time to build up in your system and it sometimes takes time for the individual to "get used" to it.

I honestly can't tell for sure, but it does sound like you're on too low a dose? It's kind of hard to say though.

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PostPosted: Mon Aug 29, 2011 7:30 pm 
Meli, I had extreme fatigue the first 3 days ion 8mg. That dose is actually equivalent to a HUGE dose of oxycodone.


Read Dr Junigs stuff.......that is really important, OK? It takes a few days to get used to it. Be careful, don't drive, and promise me you are not taking any benzos. Benzos and Suboxone can possibly cause respiratory arrest.

Have some coffee, stay active, it should only last a few hours. If it persists, drop to 6mg. If you are an addict take the entire dose once a day. If you are a pain patient, you can dose every 12 hours or so........just keep us posted and notify your doctor.
robin


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PostPosted: Mon Aug 29, 2011 10:07 pm 
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Romeo...been on for 8 days and Fairrobin I am an addict.The sub energizes me but at night,like 5-6 hrs after afternoon dose I crash.Like just want to sleep.Dont know if thats withdrawal creeping in or from the Sub but I feel real good after I take it.Its almost as though I can feel it wearing off.I will hang at the 8 until I stabilize.I tried once in am dosing but then felt I "needed" something in the afternoon.I had cravings so now I am trying dosing 4 hours after am dose to see if it helps.


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PostPosted: Tue Aug 30, 2011 12:13 am 
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You're coming off a pretty heavy dose of Oxycodone, you may not have enough Suboxone in your system to manage the wd of the Oxycodone. Suboxone is supposed to block the wd from our drug of choice by occupying all those opiate receptors, instead of just letting those opiate receptors go empty all of a sudden. When we first get on Suboxone, we are actually detoxing off of our drug of choice. I suspect that your Suboxone dose is just not high enough at the moment.

The totally crappy thing is that you really can't do much about that, you're kinda stuck right now. I believe that you will continue to feel better or more normal as the Oxycodone and its after effects subside.

It looks like you're just gonna have to ride it out until Sept. 7th.

I wish I had some better advice for you. Maybe someone else will come along and be of more help.

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PostPosted: Tue Aug 30, 2011 8:21 am 
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Hi melijm and welcome. If you feel you're still having midday withdrawals even at 8 mg (which some would consider a low to medium dose), then like Romeo said, you may still need a higher dose. Let's hope you can get in with that new doc soon!

Now you said your current doctor wants you taking Elavil, correct? Then you said she also wants you on an MAOI. Are you thinking that Elavil is an MAOI? It's not. It's an older, tricyclic antidepressant that's used very often for pain. Although I have NO freakin' clue why your doc would prescribe it for you, so I don't blame you one bit for not taking it. It's funny, it almost sounds like she is treating you for withdrawals - knowing full well that she put you on too low a dose. Again, I don't know what she's thinking.

Good luck to you!

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PostPosted: Tue Aug 30, 2011 9:25 am 
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Hatmaker,my mistake.I know Elavil is a tricyclic,I thought it was in the MAOI category.Regardless,Im not taking it.I have tried Pristiq and Wellbutrin (several times) thinking they would help me to not use.Pristiq was a nightmare coming off of and Wellbutrin made my hair fall out,ears ring loudly and it just plain didnt work.It made me compulse over certain things.I told this Dr that and she said there will come a time when I will have to go back on it.I said "why would I have to take a med that didnt help me?" again I was told to not question it.This quack is a neurologist.She has bad reviews and her office is in her house,its also a mess.I felt like I was going into a crack house.No joke.Slim pickin here in NJ for Drs that take insurance.Im banking on the new guy.I took 6 this morning and I will take the other 2 in the afternoon or more.I just dont know.I guess it takes a while tinkering to establish the right dose.I dont have cravings but I feel withdrawal creeping back in later in the day.I also went to NA last night.I really liked the group.I dont know if its for me and I am considered to them "not clean"...I think.I may go again and see if i think it will help.Its just so cookie cutter and I would like to be in a group where you can comment and speak freely.Its kinda robotic.


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PostPosted: Tue Aug 30, 2011 11:06 am 
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Oh I completely understand you not wanting to take the antidepressant, especially right now and with the history you mentioned. That doc sounds just....off to me. I hope you can find one that takes your insurance. I guess I'm lucky that I did find one.

NA meetings differ from group to group and some groups do accept people on sub more than others. Maybe you'll find one that fits you better. I hope so.

And I also hope you can find the right dose very soon. Keep us updated on how you're feeling. :)

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PostPosted: Tue Aug 30, 2011 1:41 pm 
Hang in honey, my thoughts are with you today!


Robin


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PostPosted: Sat Sep 03, 2011 8:40 pm 
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Finally after 12 days found "my dose".Started at 2mg twice a day,not enough.Went up to 6 mg then tried once in am dose.Still not enough.Went up to 8 and 8 was good but I dont want to be eating films in the middle of the day and 4 was not enough to get my day started.Took 8 in am as 1 dose and I could feel it leave my body 6 hours later.Got real sleepy,like withdrawal sleey and dosed another 2 at 1pm and i was fine till bed.This morning I took 10 mg at 7 am and didn't get that sleepy feeling in afternoon so the med lasted all day and I know with the fluctuations I am above the ceiling.My question is,If I stay at 10 will I get 8 and 2mg films? My Dr (changing) only gave me 2mg so its a PITA letting 5 films dissolve in my mouth.2 then waiting,then another 2 then 1.Takes too long.I guess you just know when the dose is right and finally I found it.Had I been induced in office I may not have had this problem.I prefer once in AM so if I have to dose higher than so be it. :lol:

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 Post subject: FYI- Feeling Sleepy
PostPosted: Sat Sep 03, 2011 9:05 pm 
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The entire time I've been on Sub I've felt sleep around 1 or 2 in the afternoon. It's okay if I keep physically busy but if I'm reading or on the computer I have to take a nap.

I felt sleepy on 24mgs, 16mgs, 8, 6, 4, 2, and even 1mg so it's just one of those side effects that don't affect many people. My doctor says I'm the only patient complaining of it. I even felt sleepy when feeling depressed from tapering too fast. It won't go away for me until I'm off.

But you got some advice earlier. Have some coffee, Red Bull, whatever wakes you up. Going for a walk worked best for me after a good large glass of ice coffee.

Hope things are getting better for ya.


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PostPosted: Sat Sep 03, 2011 9:38 pm 
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Hey melijm,

It sounds like you found your dose. 10mg/day for the amount of Oxycodone you came off of is great. If I were you, I'd go ahead and tell my doctor that 10mg is working great and ask the doctor if they'll prescribe you some of the 8mg films and some of the 2mg films. The worst they can do is say no.

Glad you found your dose and I'm glad you're doing well.

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PostPosted: Sun Sep 04, 2011 9:34 am 
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Rule66,the kind of "sleepy" I had was that withdrawal type sleepy.Ive put myself through wd so many times over the last 6 yrs I am so sensitive to even the earliest sihns.I watched Dr Junigs video on youtube about the ceiling effect.Also around that time I was craving more and I dont want to do that.The 2mg increase made all the difference.I went all day and had no feelings of extreme grogginess.Now I am above the ceiling so when the levels dip in my blood I will not feel withdrawal or cravings because I took enough to keep me above the ceiling until my next dose.If I go a few days on 10 and it levels out and I get that feeling again,I will go up to 12 which seems to be the "average" maintenence dose.So far I am so happy with this med and happy when Im on it.I feel really good,no depression,anger,obsessive thoughts etc and my motivation is coming back.Cant wait for kids to go back to school so I can go back to the gym and tear my house apart to clean it.Before I couldnt even do laundry without a pill,no pills-all I did was lay around and sleep all day,had a fever for days,hot- cold,goosebumps,insomnia,wicked cravings,diarrhea and the list goes on.Just feel so relieved theres no more pill counting,checking calender to see if I will have enough for certain things I had to do,falling asleep at work,having obsessive thoughts about how,where,when to get next fix and drumming up elaborate stories to tell the Dr etc...What a relief! :D

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 Post subject: Re: New
PostPosted: Sun Sep 04, 2011 3:05 pm 
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Mel,
As you should know..ewveryone is differant...I to had a longstanding (16) year opiate habit..
Personally I take 8mg. each morning and feel GREAT...no high, NO negative effects at all....No cravings etc.My doc perscribed me 16mg. I had taken some from the street and found 8 was great...lol...Find what works for you...again...I have suffered no opiate BS(withdrawals, cravings etc)...and No negative Suboxone effects either(tired, depressed etc).
Guess I am lucky that my perfect dose is 8 mg. @ day...have even gone as long as 36 hours between doses(just to see what happened) without any ill effects. Sub has changed my life...energy, happy, eat like a horse..well, I STILL only sleep about 4 hours if that much per night. Other than maybe sleep deprevition..lol...(and that seems to be NO problem) Suboxone is a gift from GOD it seems to me. Hitting on 8 mg. per day was perfect....BUT again..everyone is differant...
Good Luck to you guy...Stay Strong..if ya go back to the opiate crap...IT IS STILL THE SAME OLE SHIT!!!!! And who wants to go back to that, being sick if ya dont dose yourself. AS I am sure you know...that is NO LIFE !...I tuely have a life today..a true blessing !!!!!

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