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 Post subject: new to suboxone
PostPosted: Tue Dec 29, 2009 9:44 pm 
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I have been taking suboxone for 10 days I started at 16 milligrams per day and am now down to 12 mg. I noticed no differance when dropping the dose. I have been getting really bad anxiety while on suboxone and the physician wants to switch me to subutex. Does anyone have any experience with subutex. Also I want to get off the sub as qucikly as possible and be opiate free. Does anyone know if there are any withdrawals if I get down to 4mg a day would I have any withdrawals if I stopped after this dosage?


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PostPosted: Wed Dec 30, 2009 10:54 am 
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You either need suboxone or you don't.. Mike


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PostPosted: Wed Dec 30, 2009 12:05 pm 
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Hi mikemac -

I'll give this question a crack. I am no doctor - and that's my first advice - TEAM up with your doctor on this. Anything I type here is from what I have learned on the web, my doc, and this site.

1- Suboxone/Subutex only different in one medication to avoid abuse - that medication is naloxone. Naloxone appears to be in suboxone so that people would not make it into an IV and shoot it. The main medication to block the opiate receptors and give us relief is Buprenorphine. That is the same medication is subutex (only bupe) and suboxone.

2- Bupe has a 'ceiling' effect in our bodies. There is some discussion - but it appears if you have 'optimal' absorbtion under the tongue/in mouth - that is around 4 mg maybe as low as 2mg. Therefore you 'should' be able to drop to 4mg or maybe even 2mg with little wd's. Dr. Junig does a good youtube - search there on suboxdoc and you'll find it.

3- Anxiety. We all have it. If you have never had any anxiety and had been on heroin/opiates before and suddenly simple replacement of your drug of choice, and suboxone caused the anxiety - then perhaps it's the target. If you have had anxiety (like i have), perhaps it's part of you getting off your drug of choice and facing the normal stressful world. Your doctor should be directing you to group help, or therapy. It is important.

**The theme remains the same** It's always good to use the smallest dose of medicine that will provide you relief.

4- In MY OPINION - if you are using bupe (subutex, or suboxone) to treat dependence, and want to TAPER off... 4mg's will leave you with cold-turkey symptoms for an extended time. You can look through the forum - there is a great taper discussion, including a crumb method, and a water method.

LASTLY- Some folks get in their mind that suboxone / subutex is a cure for opiate dependence. It is, but not my making the effect of years of opiate abuse disappear overnight. It simply replaces the drug receptors with bupe - and is stronger at holding on to them than your typical drug of choice.

EVERYONE has to deal with getting off their drug of choice, or sub. Sub is only a 'partial agonist' opiate - and appears to allow many of us to taper, and maintain jobs, a life, etc. Most of us will take a LONG time tapering off. Some of us will never taper to zero - but stay on a lifetime dose. This is about LIFE. If it takes suboxone to keep someone clean and active in life - great! If someone else has learned other behaviors and TAPERS off - GREAT! Please hear me... you can not cheat getting off opiates completely. Suboxone / Subutex is a great tool for us to get clean over time - but not a take this for 2 weeks, taper to a certain dose in a few days and - WHAMO.... you walk away from opiates.

That sounds good - but not reality. And again - 4mg is at the ceiling range... if you 'just stopped' at 4mg of bupe/sub you would be stopping at a high dose and have opiate cold-turkey withdrawals.

Hope this helps! Learn, team up with your doc, be involved in the forum, get a group, or a therapist, it all will help! Please keep on a posting.


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PostPosted: Wed Dec 30, 2009 7:25 pm 
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Well mikemac, I couldn't have said it better myself than what lathedude wrote. Bravo lathe!! And Thanks!! Great info, and you saved me a bunch of typing....lol!!!

Really though, if that info wasn't listed, I would have wrote somthing very similar, but in my own 'slang'. Also gonna add a couple things quick:

The ~4mg ceiling dose is as lathe said for those of us who get the optimal absorbtion. MANY, including myself, are on a higher dose to ensure that we stay ABOVE that ceiling dose for the 24 hours. This makes sure there is no w/d in the morning before dose. I have also read that in the higher doses, bupe (suboxone) acts more of an antagonist than a partial agonist. This is important because if you are on say a high dose, 32mg per day, and need say surgery and pain control medication....the bupe will be much stronger at blocking the meds. At lower doses, 2mg per day, there is less of a blocking effect, but it is still there. By the way... I am not a doctor, or expert....just an addict trying to spread good information as much as possible.

IF you do want to taper that quickly (I suggest against that quick of a taper, but whatever you need!), I do not know the best way to do it. I would imagine the smallest dose possible is KEY! In reality, a L-O-N-G taper is what needs to be done for success.

Please, if you have ANY questions just ask and someone will help you out. I wish you the best with whatever you end up doing, and please keep us posted! GOOD LUCK!

Links:

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Wed Dec 30, 2009 11:06 pm 
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Whats happenin, since you replied to me I will return the favor. I tried a quick taper about 4 yrs ago with minimal sucess. I was preoccupied with being opiate free and after getting down to 4 mg I was struck with a serious bout of cravings and general fear of using. I went back up to 12 mg and stayed there untill recently. I'm now on 10 mg and like I said before if I have to stay on my current dosage and stay off the junk and oxy so be it. Just concentrate on how much progress you have made in other aspects of your recovery and dont sweat the numbers. Keep on keeping on.


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PostPosted: Wed Dec 30, 2009 11:27 pm 
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I guess the reason I feel like I should try to go as quickly as possible is because when I first started on the sub I had no problem dropping the dose, a couple days later I felt like I could drop it again to 8mg per day. I feel like I have gone backwards. When I started I had no problem "willing" myself into taking a smaller amount but today for the first time I went back up to 16mg per day. My doctor said it was ok if I took this much if I felt like I needed it but I just feel like I am slipping back. I think one reason I am doing this is because of the anxiety I get while on suboxone, I still havent changed to the subutex yet and am hoping this will help with the anxiety.

Years ago before I new I was hooked and couldnt get off the pills myself I would dabble in painkillers for a couple months each year. I was a collegiate athlete and consciously I could talk myself into "bucking up" and gettin off the pills before the start of the season. I did this for a few years. After I quit athletics I remember consciously telling myself that I had gone over that hurdle where I could pull myself back. This is what is so frustrating how do I get that will power back? Is it possible? Would I be better off just having someone lock me in a room for a week and get the withdrawals over with? I guess I feel like I dont have the willpower to go through this long process. More than anything I am scared ! When I am on the pills I feel I think "this sucks" I dont even Like the pills any more but when I'm on the sub i feel like my life was easier on the pills, but I know if I keep taking them eventually something terrible will happen to me. I'm trying to get off before this happens.

I'm sorry if I'm rambling I'm just writing the 1st thing that comes to mind. I am finding it difficult to even explain how I really feel


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 Post subject: thanks BblunderbusS
PostPosted: Wed Dec 30, 2009 11:36 pm 
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BblunderbusS when you got off the sub did you have withdrawals. I am so anxious to see what it is like to be actually sober. I have been on the painkillers for so long i honestly have know idea what its like to be sober. I feel like i dont know who I am, I feel like there is me and the rest of the world revolving around me and I'm not part of it. The pills have turned me into a hermit and all I do is work and watch tv. I literally havent had a social life in years. I am so excited to actually go out and hang out with friends and actually do something fun. Unfortunetly on the subs I still simply dont feel like going out and socializing, I dont feel at least what I think feeling sober should be like


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 Post subject: Body Changes
PostPosted: Fri Jan 01, 2010 3:04 pm 
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Hey Mike -

I don't know how long you have been on pain meds (before you started sub ). If it's anywhere like me, 8+ years with earlier dabbles here and there... I forgot what I should feel like 'sober.'

It's only logical (although it stinks) that the drugs we put into our body have changed our bodies. Our brains will be changed permanently. Our entire body systems are different due to this disease. Does this make sense? I guess I'm trying to say if you or I had never had a pill - and could somehow compare our bodies today to the body we 'would have had (sober)' we would be quite different.

So, I have decided to give myself permission (with help of therapy) - to just let things 'be what they are.' I'm where I am at. You are where you are at. If you were somehow able to drop suboxone and all other opiates today - have some instant cleanse, leaving you without any trace of opiates or cravings, I suspect you would not feel much different than you do now.

That's a generalization, and may be way off base. Most of us - find that suboxone gives us the ability to feel 'normal' again. It's validated by others in our lives. Many people feel they get their spouses back, mom/dad back, etc... They are on suboxone but normal.

Sorry for the ramble... I get the feeling you, like most of us, have a preconceived notion of how you will be sober. Truth be told, none of us know exactly (we simply are not there).

My dad drank a lot as a younger man. He had the willpower I don't have. He quit one day - never took another drink. I heard him say once 'nobody knew I was drunk, until they saw me sober.'

I understand that now - in SPADES! I lived a life on pain killers that was not me sober. I was functional enough, but still - not me. I remember the anxiety of the pain pills, the lies, the manipulation, etc. For me, suboxone was a HUGE relief. No more of the opiate rat race. I pray you give yourself the permission internally - to let suboxone be the treatment - one step for you - without anxiety or worry. You can look people in the eye.

Lastly, we all want off of opiates. Some of us will potentially taper off slowly (to reduce relapse, and minimize withdrawals). Some of us will require a maintenance dose. Who cares! Without this path - destruction would follow surely. Hang in there. Please try and think long term. You didn't get here in one day - and you can't get out of it in one day.

I want to ensure you feel encouraged! Stabilize on whatever dose you need. Stay there for a while, and relax. Then let the changes affect your life! Maybe go to a movie with friends, or something you probably really don't want to do, but you will be surprised if you do. Maybe start walking (that's my new big deal - exercise) - around the blocks, a gym, whatever your preference. Give yourself permission to feel sober HOWEVER you feel sober on suboxone. Then take your time - look at the big picture and look at a plan on taper. I recommend you decide to stabilize first, then decide later how to taper. It's like make only one decision now - adjust/learn/change then make another after you are satisfied.

I am glad you are part of this forum and look forward to more in the future!


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Dr. Jeffrey Junig, M.D., Ph.D.

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