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 Post subject: newbie
PostPosted: Mon Jun 14, 2010 1:49 pm 
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Hi I am new here and will be asking LOTS of questions...be talkin to ya soon!


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 Post subject: Newbies story
PostPosted: Mon Jun 14, 2010 9:56 pm 
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It began 4.5 yrs ago ...was developing weird pains in my low back, legs and feet. My fam doc put me on lortabs and all was well for a month or so then you know how it goes...the dr kept giving me more drugs as the pain grew worse and my tolerance grew...he finally sent me to a pain clinic ...put on dilaudid #4...THEY JUST MADE ME WANT MORE AND MORE AS DID MORPHINE,OXYS, etc the dr tried em all then he put me on 40mgs methadone daily (4 x 10 ) finally something worked and for 3.5 yrs I never had a need to increase dose. One year into this I started researching my pain. On my next dr visit I asked doc if I might be diabetic...he said he didn't think so but had a nurse do a blood glucose test and I knew something was wrong when she ran out of the room and yelled for doc...my blood sugar was so high it would not even register on the test! To get to the point doc had been treating me for a LOOONG time for everything BUT my real condition...diabetes! BAD DIABETES...it had gotten so bad I started laughing when a hosp nurse would come in and do the sugar test...invariably they would turn white and tell me I should be in a coma even tho I never felt bad at all at that point except for the pain. During this time the diabetes had destroyed the nerves in my feet and legs and it was slowly working up.While finally treating me for the diabetes I stayed on methadone and both doc and the pain doc said I would have to be on it for life...that was ok...it was cheap and easy to use and didn't make me want more than my reg dose. Then I was fired from the pain clinic for refusing a spinal block ( had 3 previously and they did not work...I am self pay so at $700 a pop no way!) Went to my fam dr and after begging he put me back on methadone ( after ending up in violent wds and being taken to the er.)So all was ok we....still could not regulate my blood sugar ( to this day it is still crazy high) then a month ago I got a certified letter from my fam dr saying he would no longer provide me with medical services at all and gave NO REASON....he would not answer my calls...his nurse finally told me that he did not want to deal with long term narcotics patients any longer because the DEA was messing with him...A lie...I have other friends and relatives who still get narcs from him regularly\
Well this is a small town and there was not one other dr who would prescribe any methadone...and we checked them ALL!
Tried the new methadone clinic and they said I had to have heroin or oxys in my blood or no acceptance...I was screwed and in a panic. I had just had a close friend who kicked a bad heroin habit with suboxone. He heard about my problem and showed up at my home with 58 subs 8.2s I was almost out of methadone but I really did my research on BUPE! I went into violent wds and gave up...I took the first suboxone...one whole pill...waited and hour w/ no effect so I took one more for a total of 16 mgs of sub...20 minutes later it was as if I had been reborn to a different world My withdrawals were 100% GONE!!!!! I felt like superman...not euphoria...not high...just a return to life! I had been at the point of eating the barrel of my .44mag...suboxone DID save my life!

Now I know I am gonna get beat up for doing the subs without a doctor, but I had no dr! There are only 2 sub drs in my area and they are both booked for 6 months plus! My doc refused to even give me a referral to them so what choice did I have ...It has been 5 days now and I have already started a taper ( due to one kind doc out of state who actually talked to me on the phone for over an HOUR!!! too bad he is 2,000 miles away!) He strongly suggested that I start tapering almost immediately after I start the subs and that is what I did...started at 2 8mgs a day in the am and one in the evening...2 days later I started 1.5 pills in the am and 1/2 pill in the early evening ( take it too late and I can't sleep ) in 2 days it will be one pill in the am...1/4 at night. I seem to be doing fine. I still have severe pin but its real pain not withdrawal pain...I have not had one second of wds and the kind doc said that with the amount of pills I posess I probably will have little or no sub wds but his concern is that this amonut of sub will not completely get me off the methadone. CAN I get some opinions> I feel good but I am terrified!
Thanks to Brian for suggesting this site...he found me on another (sub hater) site and that site SUCKED. Thanks in advance for all your help...Painted Angel


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 Post subject: Ummmm anybody here?
PostPosted: Mon Jun 14, 2010 11:10 pm 
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Is my post up? Nobody here or what? Slow night maybe...I will check back :cry:


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PostPosted: Tue Jun 15, 2010 3:27 am 
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I hate that you have been through so much with your diabetes pain and with your doctor. No one deserves to be treated like that!
I too wonder if you have enough sub to get you past the addiction of methadone. It sounds like you were more dependent on them than addicted but either way it can take a toll on our body and mind. Many people and doctors have different opinions on how long one should be on sub. I've heard some say at least 3 months due to the fact that is how long it takes our brain to get back to normal. That's why na/aa say 90 meetings in 90 days. I have also heard at least 6 months and also at least a year. But I have heard you should start tapering right away. I guess the relapse rate is quite a bit higher when it's tapered right away. This is just stuff I have read so can't say for sure. I do believe it comes down to the individual. Someone that took ten times the amount of opiates in the past that you did will probably need to be on it longer. And like me, I started off taking my pills as prescribed from my doctor for my back issues but as my tolerance grew I ended up buying pills off of friends. So I had more issues to work. I had to get past my addictive behaviors. I have been on sub for about two and a half months. I can tell I am just about back to my old self. I hardly ever even think about taking any pain meds. I do every now and then but the thoughts are getting further and further apart. I started off at 24mgs a day but over the last month have dropped down to 10 to 12mg of day. I plan on making another drop here soon. I have read that it is pretty easy to taper down but starts getting tough around 2 to 4mg. I think the reason it gets so much tougher is because it is hard to regulate the dose. When you take a crumb, how much of a crumb is it? That's where the "Liquid Taper Method" will come in to play. You can find that under "Stopping Suboxone". They have it stickied at the top. Just keep doing what you are doing. Read up on the best way to taper sub and what vitamins you should also be taking. Read about how much exercise and eating healthy will help. Every little bit of advice will make this journey a tad easier.
You are headed in the right direction!
Best of luck to you!

Brian


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 Post subject:
PostPosted: Tue Jun 15, 2010 8:36 am 
Hi and welcome. I don't have time to respond properly because I'm on my way out the door for an appointment. I just wanted to say that it is horrible the way the medical establishment has treated you, both for your diabetes and addiction. I would go ahead and get on one of those sub docs waiting lists. You might get lucky and get into a cancellation spot or something. If you do have to taper on your own, you will find a lot of good information and support here. Good luck and keep posting.
Lilly


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PostPosted: Tue Jun 15, 2010 9:05 am 
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Hi paintedangel and welcome to the forum. I'm so glad you found us. It really is appalling how the medical community treated you. I'm sorry you went through that. I, too, would suggest getting on a waiting list for a sub doctor. You just never know when an opening might become available and others on the waiting list can't go in on short notice. So it might be worth it.

When it comes to dosing, suboxone has a very long half-life (average 37 hours), so taking it once a day or even every other day is usually the norm. That is unless one is taking it for pain, then dosing is two or three times daily. So you might want to consider that if you do end up tapering off (going down to once a day might help your taper).

What will you do for your pain once you taper off? I've heard that suboxone does help neuropathic pain like you have. You might be surprised to notice your pain increasing once you're off it. Obviously I don't know for sure that will be the case, I just wanted to throw it out there so you aren't surprised.

Unfortunately I don't think anyone can say for sure if short term treatment with sub will help you with the methadone w/d's. It just depends on the individual. I would again stress trying to get in with a sub doctor. Have you extended your search? Maybe it's worth a short drive for you? There are 3 or 4 good sub doc locators online, maybe there are more sub docs in your area than you're aware of.

Good luck and again, welcome to the forum. Keep us posted.

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 Post subject: thanks guys and gals
PostPosted: Tue Jun 15, 2010 10:40 am 
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I have decided to go to a one a day plan thanks for the suggestion.

About the local sub drs...they are not even letting people be put on a wait list now! They are that busy! And unfortunately travelling is not an option at this time...Day 6 on suboxone and still not a twinge of withdrawals.


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PostPosted: Tue Jun 15, 2010 12:40 pm 
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Welcome Paintedangel :)
First off I'm always happy to see new people here and I'm continually encouraged by how many new people show up at our forum for help and support. I'd like to also say that while yes it would be best if you were under the care of a bupe doctor you obviously already know that so no I'm not going to "beat you up about it" lol. The more I've thought about it over the last few years I'm happy to see people on HDB (high dose bupe or Suboxone) whether they're with a doctor or not any time an addict takes even an 8mg tab that's at least a few days before they can get high and or potentially kill themselves. I'm obviously not encouraging people to engage in illegal activity I'm just saying that so many of our fellow addicts die annually that I'm happy to know that at least some of us have the ability/oppurtunity to go on bupe and if nothing else add days/months/years to our lives that would have otherwise been lost if there was not a medication like bupe or methadone available to make getting high pretty much impossible. Hatmaker already made several great suggestions I thought but I just wanted to say that if you're faced with dealing with chronic pain after you taper off the Suboxone then there still are many things that can be done to help. I had to have a spinal fusion several years back and I've had alot of success with using an SSRI to help with the pain as well as anti inflammatory medication and exercise. I've noticed exercise help so much in fact that after going a couple days without working out my back will really start aching pretty bad again. So hang in there and keep us up on how your taper is going and again we're happy to have you with us :)

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 Post subject:
PostPosted: Tue Jun 15, 2010 1:40 pm 
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WOW, that is one messed up story!

I'm going to be very honest with you though, I think you're taking a pretty big risk here. Not because you're getting on suboxone without a doctor, but because you're planning on tapering OFF suboxone so quickly after having been on Methadone for all that time. I know you have no legal access to suboxone, though, so you're kind of stuck, but what are you going to do about STAYING off drugs once you've tapered? Also, is your medical condition now controlled to the point where you'll be pain-free when you have no opiates of any kind in your system?

Stories like this one make me extremely grateful that I have access to dozens and dozens of doctors in my area that can prescribe suboxone.....


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PostPosted: Tue Jun 15, 2010 3:02 pm 
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Hi paintedangel, welcome to the forum.

You have already gotten some really good replies, but I wanted to add another thought. From reading your intro post about your history of opiate use, I didn't get the impression that you were abusing your medication - just that you have been taking it for a while and have a high tolerance.

It is my understanding that patients who take Suboxone for pain management do not count toward the doctor's 30 (or 100) patient limit. If the 2 Sub docs in your area are full up to their patient limit, that may be why they aren't taking new patients or putting them on the waiting list right now. The fact that you are a legit pain mgmt patient might work in your favor here. It couldn't hurt to call and ask if either of those doctors do pain mgmt and explain your situation.

You could also try calling local pain management doctors to find out if they ever use buprenorphine to treat chronic pain patients. As far as I know, any doctor can prescribe Suboxone/Subutex (buprenorphine) for pain...it's only if they want to use it to treat addiction that they have to have the special waiver.

I hope things work out for you. Keep us posted - we're here to help in any way we can.

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 Post subject: One a day!
PostPosted: Tue Jun 15, 2010 4:43 pm 
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Lilly, thanks so much for the tips...I am now only doing 1-8mg sub a day...in 3 days I am cutting that by 25%

DIARYof a quitter thanks for your reply...Yeah I tried that with the sub docs here ( only 2 of em! ) No go, so I have to make due. I am going to try alternative methods of pain mgmt tho! and no I have never had an addictive personality. I only started using because my PM insisted. you are right...I am not an abuser.

Junkie781...No I won't be pain free...as I said above I am researching alternate pain mgmt so who knows? All I can do is my best. ya know...I am gonna beat this thing one way or another and I am one stubborn SOB! I have it in my head that this will work .

aaathanks so much to allyou great people...I will keep posting and keep you apprised of my progress...T


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 Post subject: unbelievable
PostPosted: Wed Jun 16, 2010 5:22 am 
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I'm sorry, PaintedAngel, but your story makes me want to start firebombing :( Jeez, it's bad enough dealing with this sh!t when you're an addict, but an innocent person basically coerced into opiate dependency by his own doctor - an irresponsible, selfish and ignorant prick who almost kills a patient with wrong diagnoses and then kicks him out of treatment - knowing full well the patient is DEPENDENT on medicine that HE prescribed!!! I want to set his office on fire or smth :) and the pain clinic, literally blackmailing patients into dangerous expensive procedures and cutting them off life-sustaining medicines as punishment... is this sh!t real??? Maybe DEA wasn't such bad idea... maybe authorities should know about this. Or at least, someone should sue the sh!t out of this doctors and their practices. I don't know whether what they are doing is legal, but it is most certaintly unethical and immoral, hell, its inhuman!

Now, about Suboxone. It's too bad you cannot go on a stready Bupe regimen for both pain control and maintenance - for someone who needs live with chronic pain, and still be functional with minimal side effects, i think Bupe is the best option. It really helps with the pain, while keeping other symptoms like sleepiness, numbness etc. at bay. By the way, if you're on day 6 using only Sub and no methadone, you probably won't get into WD as long as you continue taking your Sub - most of the Methadone is out of your system by now. usually patients with high tolerance, after being inducted (given the first dose) on Sub feel like crap on day 1, a little better on day 2, almost good day 3, and totally fine on day 4, at least at doses higher than 4 mgs. You've gone almost a week w/out symptoms, so it's safe to assume you won't get them at all as long as you're taking your Bupe. it's too bad you have to do a taper in such a hurry - having chronic pain and all, it might get tough for you at low doses. Maybe, like some ppl here suggested, you should try to contact some pain clinics - they can, in fact,m prescribe buprenorphine for pain control without having to have a special license, since you're not an addict and never had a history of addictive behavior. But you say your town is small, so maybe everyone in medical community is in cahoots... otherwise i can't possibly understand how they can treat patients like that. It's just so outrageous and mind-boggling. i'm actually screaming at my boyfriend right now cause he is not pissed off enough about your story lol....

Anyways, maybe some tips... knowledge Is power, after all :) First - suboxone stays in your system for 2-3 days, but its opiate (painkilling) effects last only about 6 hours or so. Thus, for chronic pain, most doctors advise taking small doses of your daily amount every 6-7 hours. To avoid dull headaches and nausea (side effects of Naloxone, especially if your liver is not doing so well) spit out the saliva instead of swallowing while dissolving a tab under your tongue. Don't worry - you won't be wasting any of the precious Bupe that way, it's only effective when absorbed by mucous membranes. Naloxone, however, is not - it only works when injected directly into bloodstream. It dissolves in saliva and when swallowed, is supposed to be destroyed by the liver, but when liver is weak or damaged, some of it might still end up in your blood - therefore the side effects. So its better to spit it out.

Well, sorry, I obviousely didn't have anything new to say.. just needed to vent... it's just... maybe those things keep happening because we, patients, let them get away with it? I understand when addicts get an attitude from med. personnel, but innocent sick people misdiagnosed by their doctors? Hell, had he beencompetent, maybe you wouldn't have had to deal with chronic pain at all! Maybe you should give a shout out, find other victims of malpractice and blatant blackmail... get together, I donno, at least hold someone accountable... patients should be protected against that kind of crap, and I'm pretty sure they are, they just don't know it and too sick/embarrassed/afraid to ask...

I hope you find a solution you're comfortable with, both physically and financially. i just wish I could help you more and not just huff and puff and misspell angry words :) Maybe another state?... i donno... travel once every two or three months, for instance, if you decide to go on Bupe, - i know prescription amounts and refills are not limited since Bupe has a low abuse potential or whatever its called... or is traveling out of the question? And then go badass on those jerks :) Karma my ass, people should not be punished for having diabetes!...

ugm... i'm sorry... i should probably shut up before I break my laptop :) gotta go... Good luck... really reallly hope it works out for you....

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 Post subject: day 7
PostPosted: Wed Jun 16, 2010 2:58 pm 
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Day 7 my friends...might have been a mistake but I only took 1/2 of a sub today....its now 2pm and I feel no different than I did when I was taking 3 whole pills a day. If I am doing this wrong it sure feels right. I hate to contradict the status quo but I firmly believe that the quicker I get off the subs the easier and better its gonna be. my friend who was a heroin addict for a long time did the same...methadone for 1 day, subs for 10 days then stop...she never had any withdrawals either except for a runny nose and has been clean for 17 months. I may crash and burn, but I have to follow my instincs here...they tell me to get off the subs as fast as possible...Give me your opinions guys.


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PostPosted: Wed Jun 16, 2010 4:19 pm 
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I have seen this over and over again, Painted Angel, and your story pretty much follows along like all of the others. Pretty much everyone that I read posts from has little to no trouble with dropping their dose to around the 4 mg a day range. Their reports and their stories read pretty much like yours. It is all pretty easy and pretty simple until getting to around 4mg. While I'm not down to 4 mg yet I have just arrived at half of the dose that I originally started at (16mg) and I too feel no different on 8 than I did on 16. The problem is, once you get to the 4mg area, everything starts to change. Without a doubt, once you get to the 2mg/day range, you will start to feel it. That just is how it seems to go with the majority of people. You can do pretty much whatever you want to get to 3 or 4mg but from that point on, long and slow with small dose reductions is the way to go. If you don't do it that way, you very likely will no longer "feel no different than I did when I was taking 3 whole pills a day." If you are somehow able to get to 1mg or ever off of Sub without any of these symptoms, you truly are going to be the exception and not the rule. Unfortunately, it seems like us addicts always want to feel like we are difference, we are special. Everyone else may need to do this or that but not us. We will be the exception. And, while I guess someone always has to make up the 5% (or whatever it is) there is 95% saying it won't be you.

Now, having said that, I think that what you are doing is fine. If there is any rule that you should follow it is "pay attention to what your body is telling you". If you are feeling great (no cravings, no withdrawal, etc.) at whatever dose you are at, hell, why question it? If it works, keep doing it. Just be aware that it could change and if or when it does, you may then have to readjust your approach. The dangerous part is a relapse back to regular opiates. I personally don't see much of a problem with returning to your previous dose of Sub if you need to. To me, that is not a relapse. To me, having to take a couple Norco or an Oxy is a relapse.

So that covers the whole taper thing. The bigger deal here is not going to be getting through withdrawals and off of Suboxone. The bigger deal is going to be in staying off of all drugs in the future. That is where the challenge comes in. Again, from all I have read and from the many people that have posted, those who have tapered quickly and then stopped their Sub completely are often able to get through the acute or early phase of it all. It's then two, four, eight or more weeks later that they are still struggling with PAWS (Post Acute Withdrawal Syndrome) and that is when they are in the greatest danger of relapse. Those who go long and slow seem to do better over the long term and suffer less "painful" withdrawal. Those that do it quickly, like I said, can often get through the withdrawal but they really, really struggle with being tired, depressed, sluggish, withdrawn, etc. and that is the PAWS at work. I am told it is because their brain is having to readjust to not having any opiates (and Suboxone MOST CERTAINLY IS an opiate). If you do a very gradual taper over a long time, it is a far smaller shock to your system and your brain is able to adapt much better. I don't know if that means your brain is healing or what. It just seems very clear that over the long term, the slow taper is the most successful.

I understand your situation and how is is factoring into your decisions and actions. I just really worry when addicts want to follow their feelings or follow their instincts. After all, it was our feelings and instincts that got us in this mess in the first place. Again, you may not squarely fit into that slot based on what you have told us. I'm not qualified to determine whether or not you are an addict, and even if I was, I could not do so through an Internet board. If addiction is not part of what is going on with you, dependence will be your only issue. However, if there is some addiction component in there, you'll be just like the rest of us.

Good luck with your taper. Keep paying attention to what your body is telling you. It will tell you when you have gone too low in your dose.


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 Post subject: Donh
PostPosted: Wed Jun 16, 2010 5:05 pm 
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Don thanks for your post...let me clarify a few things...I don't think I am "special" by any stretch of the imagination. After 3 plus years of methadone use there is no way I would not be "dependant" However as I said I just don't have an addictive personality...I have NEVER used more than prescribed. I HAVE done my homework and talked to many people on forums and blogs, in person on the phone...doctors and addicts etc, etc,etc...the people who agree with your assumption are those who take suboxone LONG TERM...99% of the people I have talked to who used subs only SHORT TERM and I mean VERY short seem to have much better results than those who use subs longterm. Even a few weeks can make a BIG difference in how easy or hard it is to discontinue the use of suboxone. As I also said ...if I crash and burn, then lesson learned....I will take other steps...but I started with a very limited supply of subs (58) so I have no choice I HAVE to stop sooner rather than later. To be clear I am not stopping my methadone use because of addiction...Methadone worked wonders for me...didn't get me high at all...I never craved more than I was prescribed...no appreciable side effects ...I had to stop because it very suddenly became unavailable...I refuse to buy methadone on the streets so this is the only viable method left to me. I don't have blinders on....I know about PAWS and the other negative situations that can and do happen but at this point I am on the only viable path I see.

Again thank you for your post.


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 Post subject: 58
PostPosted: Wed Jun 16, 2010 5:06 pm 
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That was supposed to read 58 subs...don't know how I screwed that up...sorry!


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 Post subject: Don H...
PostPosted: Wed Jun 16, 2010 7:38 pm 
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Don, one more thing, just to be very clear...I did NOT get myself into this mess , as you said in your post, my DOCTOR got me into this mess...the dr who started me on methadone, the dr who in one letter abandoned me for NO reason knowing full well that getting a scrip for methadone in this area is IMPOSSIBLE...he knew what he was doing. So no , I did NOT "get myself into this mess"...I was following a trusted drs orders ( which I will NEVER do again)


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PostPosted: Wed Jun 16, 2010 9:16 pm 
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I guess I'm not sure why you are getting so defensive here. I never said that you got yourself in any mess. Here is what I said:

"After all, it was our feelings and instincts that got us in this mess in the first place."

By saying "our feelings" and "us" I mean those of us addicted to opiate drugs. To even separate you further from that I followed it up by saying:

"you may not squarely fit into that slot based on what you have told us. I'm not qualified to determine whether or not you are an addict,"

In other words, my statement of "our" and "us" may not apply to you at all. I was trying to take into account that unlike those of us addicted to opiates, you may just be dependant. I just have no ability to make that determination.

Please keep in mind, that it was you that said:

"Give me your opinions guys."

That is all I was trying to do - is give you my opinion. I thought that's what you wanted.

Yours is a more complex and difficult situation than many others here due to all of the different things that have gone on and continue to go on. I was not blaming you for it. I was not claiming it is your fault. I was just trying to help you out based on the information I have gathered as an addict for many years. I'm sorry if I wasn't very clear in what I tried to say.


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 Post subject: Donh
PostPosted: Wed Jun 16, 2010 11:33 pm 
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Don...WHOOOAAAA there Hoss....I was NOT being defensive at all...as stated I was simply CLARIFYING. And no, you made things perfectly clear. Please don't assume I was being defensive...not my style friend. I appreciate the opinions of every poster here even when and especially IF they are not in accordance with my own opinions. I learned many years ago that a person will invariably and inevitably learn more from people who DISAGREE than with those who blindly agree. If I had a magic mirror I would know and be able to say exactly how this thing will turn out for me...its a coin toss at this point Don. However I am one of those people who posesses a terminally positive outlook all the while remaining with feet firmly on the ground. My method may very well not work as I hope. I will deal with that when I get to that point...and adjust plans accordingly. AND whatever happens it will be a learning experience not only for me , but also ( hopefully ) to other readers here...so its a win either way. Again I thank you for your posts I appreciate ALL opinions.[align=right]


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PostPosted: Thu Jun 17, 2010 12:11 am 
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Location: Wisconsin
That's all great to hear. Sorry if I misread where you were coming from. Evidently there was a good reason why I didn't understand why you were being defensive - it's because you weren't! Sounds like you have a refreshingly healthy attitude.

I also did think of one additional point and that is from all I have read, hands down, Methadone seems to be the most difficult opiate to induct onto Suboxone from. It sounds like you have actually made that transformation rather well. Hopefully that is a sign that the rest of it will go smoothly for you as well. Also, if you indeed don't have the psychological component of addiction in place (only the physical) that will also make things significantly easier for you as well.

I'm not trying to candy coat any of this for you. Like I said, I think the 4mg range is going to tell you a lot. But since you are good about looking at the positives, I thought you might appreciate a few more of them.

Please continue to let us know how it all goes.


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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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