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PostPosted: Wed Jul 09, 2014 12:07 am 
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Hello, and thank you for the wealth of info that is provided through this forum.

First I want to make it clear that I am not here to bash Suboxone. I know it has helped many, many people all over the world. I am simply searching for answers. Also, this is about my father, not me.

My father has degenerative disc disease, and has been on narcotics for 15 years because of it. He was most recently on oxycodone and morphine, but then switched to just morphine about 4 months ago. He and his doctors decided to get him off of the morphine by way of Suboxone, mainly to assess his true pain level.

He had his last dose of morphine yesterday at 4pm, and went to his doctor this morning at 7:30am for his first dose of Suboxone. Within 20 minutes, he began to show severe withdrawal symptoms, and became enraged. The doctor kept giving him more doses, thinking the withdrawal symptoms would eventually lift. The problem is, it got worse. The doctor eventually gave him the most he could possibly give him, (not sure on the dosage amount, thats just what he said). For lack of a better term, he basically went king kong on the doctors office. He ripped out the curtains, was throwing chairs and tables around, kicked and punched holes in the walls. He is a farmer, so he always has a knife on him. He pulled it out and tried to stab himself. He kept on begging everyone to kill him. The doctor panicked and didn't know what to do. We were across the street from the hospital so we rushed him there.

At the hospital they gave him large amounts of sedatives, (not sure on the exact drugs or amounts) and it took him several hours to calm down. They had to strap him to the table to keep him from hurting other people or himself. At this point, (10pm) he is still in severe pain, and is having severe withdrawals, and is still enraged, although with the sedatives he isn't able to do much. He hasn't had Suboxone or any other drugs, other than the sedatives, since around 12pm today. His red blood cell count is extremely high as well. The doctors said they have never seen a reaction to Suboxone like this.

I will add that my father is one of the most calm people I have ever met. He is very gentle hearted, kind spirited, has an excellent marriage of 35 years, and has always been a phenominal father. He has never had a single issue with suicide, or any anger problems. No one in my family has ever seen him even remotely like this, ever.

Have any of you seen this happen? If so, what steps followed? How long should these symptoms last? At this point, there is absolutely no way he can leave the hospital because his symptoms are so severe.

Thank you, and your help is greatly appreciated!

Jason


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PostPosted: Wed Jul 09, 2014 3:38 am 
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Yes, I saw something like this once. A friend needed to get off methadone fast before starting a new job, and a clueless doctor prescribed naltroxone (the component of Suboxone that causes precipitated withdrawal, which is what your father experienced).

After taking it, I watched my friend get insanely ill instantly. I called an ambulance within about 15 min. One of the worst things I've ever seen.

She came around by the next day. S'ry to hear about what your dad went thru.

-- ji

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PostPosted: Wed Jul 09, 2014 8:42 am 
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You are a very loving person to come here & ask for help! It sounds like he took the suboxone way to early & is having precipitated withdrawals, both emotionally & physically.

I am also a chronic pain patient & at the time of induction I was on massive amounts of both oxycontin & oxycodone & i had to wait 24 hours to be assesed.

Hopefully your dad is feeling much better by now. Please keep us posted on how he is doing.

Tiki


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PostPosted: Wed Jul 09, 2014 11:17 am 
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Thank you for your replies!

So basically, precipitated withdrawals occur when the Suboxone was taken too close to his last dose of morphine, is that correct? My mother said she was certain his last dose of Morphine was at 4pm the day before, and he was completely out of it at that point. So 15 hours must not have been enough for him. How long do precipitated withdrawals typically last?


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PostPosted: Wed Jul 09, 2014 2:05 pm 
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Unbelievable. ..So so sorry this has happened
Ive heard of bad outcomes before.
There is a thing called the cows scale. It is used
to measure wd simptoms before sub is given.
Wish I could tall you more on how and when your father
will feel better.. only that time will heal him from this PW..
I have to say when I got to the part that he wanted to e killed,
I just dropped my head...damn....

Hope things are better today..


Razor....


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PostPosted: Wed Jul 09, 2014 4:32 pm 
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With a massive amount of Suboxone in his system, precipitated wd's may last many hours. Suboxone has a very long half life.

PW's from Suboxone happens because Buprenorphine (the active ingredient in Suboxone) has a MUCH higher affinity for the mu receptor than his morphine, but Suboxone doesn't stimulate those receptors anywhere near as much as morphine does. So, the Suboxone knocked all the morphine off his receptors, but doesn't stimulate those receptors with much strength which plummeted his mood straight to hell.

I've been through PW before and it's an absolute horror. I sure hope your dad gets better soon.

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PostPosted: Wed Jul 09, 2014 6:16 pm 
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When PW happened to my friend (who was prescribed Naltrexone alone to end a 30 mg/day Methadone dose), she was given a large dose of Methadone the next evening, about 36 hours after the PW.

It took away the withdrawals.

-- ji

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"Past and future veil God from our sight; burn both of them with fire."
-- Rumi, Sufi poet and teacher


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PostPosted: Wed Jul 09, 2014 9:35 pm 
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That is one terrible induction his doctor did. All the physicians who go through the Suboxone training are instructed not to give it too early or all hell will break loose, like what happened with your father. In a word, it was stupidity on his doctors part. He should have been off the morphine for 48 hours, just to be safe. 24 might be enough but I'd error on the side of caution.

Everyone before me who posted gave you good info. This would be a fitting question for our Dr. Junig to answer. I don't think any one of us knows for sure what to recommend. I'm hesitant to say he should be back on the morphine because he'd have to go through another withdrawal period before induction again. And who knows if the Suboxone will work in a few days.

Go up top the page to the Talk Zone button and see if you can ask our resident Dr. Junig to give his opinion. We members are not doctors. (except for a few) You need answers by someone who really knows how this induction stuff works.

I hope your Dad is starting to feel better. They will probably give him morphine again and postpone the Sub induction 'till later. A very hard lesson learned.

Welcome to the forum!

rule

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PostPosted: Mon Jul 14, 2014 8:29 pm 
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jasonlewis1986 wrote:
Hello, and thank you for the wealth of info that is provided through this forum.

First I want to make it clear that I am not here to bash Suboxone. I know it has helped many, many people all over the world. I am simply searching for answers. Also, this is about my father, not me.

My father has degenerative disc disease, and has been on narcotics for 15 years because of it. He was most recently on oxycodone and morphine, but then switched to just morphine about 4 months ago. He and his doctors decided to get him off of the morphine by way of Suboxone, mainly to assess his true pain level.

He had his last dose of morphine yesterday at 4pm, and went to his doctor this morning at 7:30am for his first dose of Suboxone. Within 20 minutes, he began to show severe withdrawal symptoms, and became enraged. The doctor kept giving him more doses, thinking the withdrawal symptoms would eventually lift. The problem is, it got worse. The doctor eventually gave him the most he could possibly give him, (not sure on the dosage amount, thats just what he said). For lack of a better term, he basically went king kong on the doctors office. He ripped out the curtains, was throwing chairs and tables around, kicked and punched holes in the walls. He is a farmer, so he always has a knife on him. He pulled it out and tried to stab himself. He kept on begging everyone to kill him. The doctor panicked and didn't know what to do. We were across the street from the hospital so we rushed him there.

At the hospital they gave him large amounts of sedatives, (not sure on the exact drugs or amounts) and it took him several hours to calm down. They had to strap him to the table to keep him from hurting other people or himself. At this point, (10pm) he is still in severe pain, and is having severe withdrawals, and is still enraged, although with the sedatives he isn't able to do much. He hasn't had Suboxone or any other drugs, other than the sedatives, since around 12pm today. His red blood cell count is extremely high as well. The doctors said they have never seen a reaction to Suboxone like this.

I will add that my father is one of the most calm people I have ever met. He is very gentle hearted, kind spirited, has an excellent marriage of 35 years, and has always been a phenominal father. He has never had a single issue with suicide, or any anger problems. No one in my family has ever seen him even remotely like this, ever.

Have any of you seen this happen? If so, what steps followed? How long should these symptoms last? At this point, there is absolutely no way he can leave the hospital because his symptoms are so severe.

Thank you, and your help is greatly appreciated!

Jason


WHAT AN IDIOT DOCTOR!!!!! Any decent doctor should know: if you take suboxone and get withdrawal symptoms, more suboxone will make it worse. he should have been immediately been injected with ativan and given clonidine. that doctor should lose his license. I am "inducting" myself. I think I am on my 8th day without methadone, and I feel better without suboxone than on, bc everytime I take suboxone I feel worse. I get this frontal lobe headache and just feel magnified detox symptoms. my doctor tells me i will be fine, so i am hoping it will gradually make me feel normal, but i dont know how much longer i can go on and am thinking about just going back on methadone. it is quite a hassle!!! as for your dad, sounds like he was much more seriously addicted to his pain meds, and for a much longer time, than i was. Why couldnt he go home with a bottle of xanax? was it that bad? is he still in the hospital?


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PostPosted: Tue Jul 15, 2014 5:40 am 
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Sounds like negligence on the doctors part. My doctor wouldn't even see me until I was clean for a week and in a withdrawal period from the methadone even though I begged and pleaded with him he insisted on waiting until he was sure I was sick in withdrawal. I'm sorry your father had to go through that it's sad... hopefully he is working on becoming stable very quickly I feel for him.


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Fond Du Lac Psychiatry
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