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PostPosted: Sat Aug 01, 2015 10:26 pm 
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So, This is my first post on the forum. I signed up specifically to get some feedback on my problem while I am unable to contact my Doc over the weekend.

My situation is as follows: I have been on bupe maintenance for approx. 8 months (specifically zubsolv 1.4mg) and every thing has been going fine. I attend weekly alumni meetings at the rehab facility I attended when I got sober, and I see a therapist once every 2 weeks and my psychiatrist once every 3 months and I am loving life in recovery! :D I take one dose every morning sublingually and have been fantastic until the last month when I started working very early shifts at my job (4am) and on the long days which result from waking up so early, I find myself feeling slightly withdrawn/restless by the end of the day and I have had a lot of trouble sleeping if I dont take a half of another pill around 8 pm or so. I was on suboxone 2mg for the first two months and everything was fine when my insurance made the switch to zubzolv and I had to follow suit to not be destroyed by outrageous prices compared to the $2.50 I now pay monthly for my script. I was worried at the time about the technically lower dose of bupe leaving me withdrawn but It never was a problem as far as i could tell and even if it was i would figure that by now I would be adjusted to any variation of dose and i wouldn't have a problem. I have the impression that the zubsolve, which has no side effects like headaches or constipation like suboxone did, Is going through my body more quickly than the suboxone was. That might be in my head and I never got the chance to really think about how long my days were for the two months on suboxone to know if I wouldn't have felt the same problem regardless but it certainly seemed to stick with me longer such as well into the next morning to the point that I would sometimes forget to take it and not realize it until the middle of the afternoon. Anyway, I am really concerned because this months script is about 3 days short now as a result which is worrying me sick. The first thing that popped into my head was a higher dose but I am also not certain if jumping to the next possible dose up just because of 8 days a month of early shifts is viable or healthy. I really dont know what to do because I have been comfortable for 6 months with the zubsolv and the next dose up is the equivalent to 4x the strength as what I am on now. I think my doctor would entertain the idea if I was having a more serious problem or if I really wanted to pursue that but I dont really fancy having to cut up every pill in the morning into equal pieces to get my dose for the day or potentially raising my ceiling for tolerance which would make it more difficult to come off of the medication down the road. Just thinking about being more dependent on something even as helpful and constructive as zubsolv has been really makes me cringe and think about the old days of being a prisoner to my body. I know it's hard to ween off when the time comes and I dont want that to be worse if avoidable. also I am getting nervous about how I will stretch my remaining meds to last for the soon to be 4-day gap. I have considered taking my medication later in the day but within an hour of leaving my house without taking it I feel dizzy and withdrawn most times and that makes me nervous to drive. I am not sure if that is mental however because I can sit inside my house on a day off and not take the medication until 3pm without feeling bad at all. The other side of that is the prying eyes of coworkers which I know is minor when comparing to quality of life after recovering from opiate addiction but I hate the idea of having to hide medicine i am taking to try and maintain privacy about my recovery or really just about my past. :|

Does anyone have any suggestions or advice? I will be talking to my doctor this week hopefully if I can get an appointment on my off day. Any insights would be very appreciated, thank you in advance!

PS: I love my job and it happens to be a big "foot in the door" at my dream profession so I do not want to sacrifice performance or flexibility unless it is the very last thing I have to do. I will be promoted within a year at this rate to a steady 8-5pm shift which is going to be fantastic and helpful but until then this is the issue I am having.


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PostPosted: Sun Aug 02, 2015 5:01 am 
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If I were you I would talk to my doctor about the situation, but I might explain things in a couple different ways depending on what your doctor is like. For example, I could go to my doctor and tell him what you just said and he would up my prescription to 1.5 of the 1.4 mg pills, no problem. If my doctor was more sticky about things like this, I would add that I'm starting to feel cravings when I get home from work, and that feels dangerous to me because that's when I used to get high. I would tell him that I feel like going out and meeting old contacts and that it scares me. (That might even be part of what you're actually experiencing.) I don't like to advocate lying to you, but I do think that sub doctors really pay attention when relapse is a possibility.

Will it ruin your recovery if you don't get your prescription bumped up? Probably not. But there is no reason not to ask your doctor if you can try it and see how you feel. If it seems like too much to take every day, just take the extra half on those really long days. Definitely don't risk losing that awesome job over this! :)

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PostPosted: Sun Aug 02, 2015 3:07 pm 
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Hey 180,

I agree with what Amy said and if I were u I'd tell my Dr too. U only really have two choices. First choice is to just push through those long days without taking any extra at all. Yeah you'll feel bad but at least u won't run short at the end of the month. Second choice is to tell ur Dr and hopefully get ur dose upped just a little bit. Like Amy said, u don't even have to take any extra except for those long days. That's actually the choice I'd pick. Running short at the end of the month is honestly awful. I'm pretty sure we've all expirienced that at some point or another. I have and it made me worry my butt off. Not to mention you'll have to end up cutting urself bk and not even take all ur normal dose just to make up for the extra u had to take. It's a big vicious cycle.

I totally understand why u took more on those days, nobody wants to feel any withdrawal. I'd just talk to the Dr and get it taken care of. It won't damage ur recovery at all.

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PostPosted: Sun Aug 02, 2015 10:20 pm 
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Thank you both very much Amy and Jenn, it never occurred to me that he could up my dose but keep using the small 1.4mg pills! I dont know how all of that works, but if that is a possible solution than I am almost certain my doctor will do that and I wouldn't be uncomfortable at all. I thought it would be either 1.4mg a day or the 5.6 instead which would be insane now that I see that he could just write the script for something like 1 and a half pills a day or whatever. I will let you know when I talk to my doctor and update you on the situation, thank you both again!


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PostPosted: Thu Aug 06, 2015 4:02 pm 
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Okay so I have seen my doctor and he was understanding and agreed to increase my dosage! Now I have another question. I should have asked him this but I didn't think about it until I was driving back, but what I am wondering now is when to bring the new prescription to the pharmacy. Is it like a separate prescription since the qty per month is higher? I don't want to bring it too soon and get in trouble but I am short from what I was previously prescribed and I wondered if the increased qty per month would change how soon I could bring the new prescription to the pharmacy since my doctor essentially said I wasn't prescribed enough for the past month, or if I have to wait it out regardless. I have read different things, some saying it depends on my insurance which I think If you bring a new prescription it just has to be at least 23 days after you got your last refill and I think with refills you generally only get them 2 days early at most, but I really don't know all of the regulations and guidelines. I know the worst that can happen is someone tells me I have to wait a few days before they can fill it but it is sort of embarrassing I suppose even though everything is legitimate about why i'm short this month. Anyway, just thought I would ask here before heading in alone since this forum seems like a very helpful community!


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PostPosted: Fri Aug 07, 2015 1:26 am 
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I would call your doctor's office or your pharmacist, explain the situation and ask about this information, because it might vary between states and insurance companies.

Amy

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PostPosted: Fri Aug 07, 2015 7:24 am 
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180

With an increased dose it should be fine to fill now. The pharmacist may assume the doc had you increase during the previous month. If it has yesterday's date it should be fine.

Amy's suggestion is a good one. Call your pharmacy and make sure you tell them your dose has been increased.


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