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PostPosted: Mon Jul 27, 2009 2:26 pm 
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Today is the day i tell myself, the day i will start my suboxone, the day i put the damn dope behind me and really start to work on me. I've been saing this for a week now and i haven't yet commited. First off, ive taken suboxonee before for vicodin and other pain killers, started MYSELF w/o a doctor on about 2mg max a day and after about 6 months i tapered to such a small dose it wasnt worth it and went through about a 3-5 day w/d. I came out of this and after about 2-3 weeks was using again. My problem progressed as it always does and i moved on to I.V heroin use. I visited my Doctor last week and was proscribed suboxone matience. Unfortunatly i haven't been givin an acurate dose, Hell the damn bottle says take 2-3 tabs p.o qd. I am a pharmacy technician and lost my licenece and job to excessive absence from work. So i do understand how bup works. Heres my deal, i dont want to use to much and i dont know where to even start, im so nervous to even start the medication that i have been using heroin this whole week and have a doctors appt. today where im sure he will expect some kind of insight as to where i think my dosing should be. I really don't know what to do. I really dont like suboxone to be completley honest, but its better then withdrawl. I dont know anymore and i have lost hope for myself many, many times. Any advice is appreciated, thank you


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PostPosted: Mon Jul 27, 2009 3:44 pm 
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Hey Brain - welcome to the forum. Look, I know that it's hard (and sometimes scary) to make a change - even one we know will be good for us. It's easier to stay with the shit we do know, which is what keeps so many people stuck in bad situations. But if you are still dicking around with heroin when you have a full bottle of Suboxone on hand, the time has come for you to take the plunge.

What exactly are you nervous about? Are you afraid of precipitated w/d? You said you don't want to take too much - but you already know from your past experience that you can adjust your dose and taper down or titrate up if you need.

Your doctor should have done an induction with you in his/her office to avoid all of this anyway. I find it kinda whack that your doc sent you home to induct yourself - did he give you any instructions on what to do if you got sick?

The common wisdom around here is that the best dose of Suboxone is the smallest dose that supressed your withdrawals and your cravings. An easy way to find that dose is to start your induction with a small(ish) dose and work up from there. My doc gave me 4mgs, we waited 30 minutes to see how I would react, then he have me the other 4mgs and that was it for the day. The next day I went up to 12mgs, and then to 14mgs. I only stayed on that high of a dose for a few weeks, then I started tapering till I got down to 4mgs where I stayed for a long time. That's what worked for me. We all have to find what works for our personal body chemistry and needs.

How much heroin have you been using this past week? I'm not personally familiar with H (dilaudid was my DOC) but I have heard that it's a good idea to get your tolerance down somewhat before starting suboxone. No matter how much Sub you take, it's not going to have more effect than about 30mgs of methadone and if your opiate tolerance is much higher than that then you run the risk of getting sick when you start the medication. This would be a good issue to discuss with your doctor - hopefully he has some experience with that.

The other issue, as you probably know, is that you need to be in mild-to-moderate withdrawal when you take your first dose of Sub.

Hopefully you'll be able to get started soon, and that with the right dose you'll find that Sub is way better than "just better than withdrawals." Some people really just don't like it, but many of us (me included) found a lot of freedom and clarity with this medication. It's not perfect, but it's one of the best tools we have right now to fight opiate addiction.

Let us know how it goes.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


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PostPosted: Mon Jul 27, 2009 3:55 pm 
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Thank you for your reply. Yea i found it odd that he would send me home with 15, 8mg suboxone then basically said, wait 24 hrs before your first use, and see me in a week. i have experinced the w/d of taking the medication to early, it was prolly the worst experince of my life. Well a week has gone by and i used last night around 6-7 and i tried about 4mg of sub 30 minutes ago, and will probly take another 4mg after 30min if needed. Its scary because I am no professional, I meen i know my share of drugs and all being in the pharmacy field but i have no idea about physical and mental health. I guess im just more scared to commit than anything else. Everyone including me wants the help but i guess i have to start somewhere. Thanks


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PostPosted: Mon Jul 27, 2009 3:57 pm 
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6-7 o clock*** first 4mg was at 12:30 this afternoon


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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