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PostPosted: Sat Aug 06, 2011 9:12 am 
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My life recently crashed due to opioid addiction. As I try to put my life back together and seek various forms of help (outpatient rehab, na meetings, therapy), I have been prescribed Suboxone strips. My habit was about 3 years long and prior to that I was not on any drugs.

My Suboxone Dr. says that he subscribes to a concept of 90 days plus 10, for a total of 100 days on a steady dose. Then tappering can begin. My Subutex/Suboxone dose is around 10mg per day. I understand there are people on 24mg per day (3 8mg strips / day).

I read about people on longterm use of Suboxone and get a strong feeling that it may be worse then just detoxing from the Opioid. I am not trying to debate this point.

Really, for me I feel that I want to get to my life back in the correct direction ASAP. To do that I will give the NA (Narcotics Anonymous) path a true effort. Sobriety in NA begins when I am off the Suboxone. That is when I will speak for the first time and accept my 1st day keychain. Until then I remain quiet at the meetings and just listen.

So, the point of all this is to find out what it will be like to short-term use Suboxone. I am coming on week 4 and would like to start a tappering protocol.

I did review the forum sticky with the Tappering Chart. But I would be interested in real world stories. And basically I feel like I just need interactive contact during this very scary period in my life.

So I wonder as far as Suboxone theropy, is 30 days too short? How would I go about getting off of this? What method? What should I expect to feel and what should I be concerned about?

I am still fuzzy on the concept that my opioid receptors are "healing" while on Suboxone. If Suboxone is a partial Opioid, then how is it letting my receptors heal?

Anyway, if anyone can share their success (and/or failure) stories, that would be great. Looking for as much information as possible.

Thanks everyone!


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PostPosted: Sat Aug 06, 2011 10:10 am 
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Hi mensb1 and welcome. The first thing I want to say is that there's no evidence whatsoever that it's harder to come off long term maintenance of sub than short term. Dr. J's most recent blog post says the same thing.

You said you were in active addiction for 3 years, but plan on being on sub for only 100 days. It's my opinion that with your addiction history, this isn't long enough. You built up 3 years worth of bad, self-destructive habits that you need to change. While you're on sub, it will stifle your cravings, too. So you also need to prepare yourself on how to deal with the cravings that will come crashing back when you stop the sub. And you'll need to learn to deal with the triggers that you'll come across, too.

Also, studies presented to us by Dr. J indicate that short term use of suboxone (less than 6-12 months) has an extremely high rate of relapse, almost 100%. (Again, check Dr. J's posts.)

When it comes to tapering off, the best way to do that is to slowly lower your dose and get down to a very low dose (down into the micrograms) before stopping. The slower you go, the less w/d symptoms you should have. I'm sure others will come along and share their tapering experiences with you.

I hope this helps a bit. Good luck with your plan!

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PostPosted: Sat Aug 06, 2011 11:01 am 
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Don't let people at NA push you off of the medication any faster than you need to. They are not doctors. From what I understand, tapering off of Suboxone is much easier than full agonists. What I can tell you is that I am in the middle of a slow taper and have also tapered myself many many times off of full agonist opiates and the Suboxone is much more easier. I have felt mild WD effects for a few days each time I drop a milligram off.

When I was doing the 12 step thing, I would speak at meetings when on Suboxone. I never told anyone I was on it as I believed it was nobody's business but my own. If you feel that you must share, than perhaps try some other meetings? Also, take a look at SMART recovery.


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PostPosted: Sat Aug 06, 2011 3:08 pm 
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I guess I'm just wondering if you still consider yourself to be in active addiction while on Suboxone. Are you "high" or impaired when you take it? Or did an NA hardliner tell you that your first day clean is the day you stop taking Suboxone? Back when I was in NA several years ago some folks felt you weren't clean if you were on antidepressants, but then people got educated, and i hope the same thing happens with Sub. Most doctors (including the one who runs this site) recommend a year or more of Sub treatment before going off of medication. (I know, I was surprised too when I first heard that). Some more conservative doctors will recommend something like twice the time of your active drug use on Sub for short term users. So if you were on drugs for 4 months you would go on Sub for 8 mos.
To be perfectly honest with you many times people come on this site saying they have a plan for a short term detox (like 90 days) and then we never hear from the, again. On the other hand we have people on this site who have been off Sub for 1-2 years, after they did their 1-2 years of recovery on Subs. You might be able to find info on short term detox by contacting a treatment center that uses that approach.
In re: the concept of receptors "healing"... I don't know if there is any scientific evidence for that, but I think the idea is that you use your time on Sub to heal your behaviors, without the constant pull of cravings, that little voice trying to tell you it's OK to use.
I wish you the best of luck, and please keep posting on your progress,
Lilly


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PostPosted: Sat Aug 06, 2011 3:23 pm 
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Hey dude, I agree with you using Suboxone doesn't qualify you as sober. It's the reason why I'm getting off myself. If you do actually follow a recovery program to the best of your ability you'll stay sober.

Look around for taper threads, you'll find plenty, but I'm sure your doctor will tell you how to do one.


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PostPosted: Sat Aug 06, 2011 5:10 pm 
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Hey Hat, you've mentioned a couple of times now about there being no evidence that suboxone is harder to discontinue with long term use, do you have any published studies to back up that claim?? I didn't think there were any long term clinical studies of Suboxone, certainly not any that measured the difficulty of wd after long term use.

It's been my experience that people who have been on Suboxone long term (longer than 2 or 3 years) DO have a longer, slower taper. It's my opinion that long term use of Suboxone, especailly at higher doses, does make it more difficult to discontinue Suboxone, but it certainly isn't impossible to do. I have no data to back up my claims, it's just my opinion from what I've seen.

mensb1, I think the bottom line is that you have to do what's right for you, even if it includes long term Suboxone use. Getting off of Suboxone, even after long term use, is going to be easier than trying to quit your drug of choice after long term use.

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PostPosted: Sun Aug 07, 2011 7:50 am 
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Romeo - You're asking me to prove a negative? Actually, the people who state that it IS harder to come off suboxone once they've been on it long term are the one's who need to provide a source/citation to back that up. That's how science works. What I've said is there is NO evidence to back that up, and that's what I mean.

And as I previously said, Dr. Junig has indicated the same thing. See his last post in the Suboxone TalkZone: http://suboxonetalkzone.com/2011/07/29/ ... -suboxone/

This is what he has stated:
Quote:
"There is no evidence or truth to the idea that ‘it is harder to stop buprenorphine the longer you take it’; tolerance does not increase after reaching a plateau, usually in a month or so, and I have found that patients are more successful at stopping buprenorphine the further they get from the period of active use."


I hope this response satisfies you.

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PostPosted: Sun Aug 07, 2011 9:15 am 
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Hey man--
The fact that you are wrestling with this is a good sign. You really have to be ready and committed to quit. I dont know how intense your WDs would be after only a month. I had been on 8mgs a day for two years and stopped cold turkey 12 days ago today. I am about 80% right now--but every day gets better. Yesterday I had a real appetite for the first time in days. Last night I managed to sleep through most of the night for the first time in many days. It has been hell (for me)--but totally worth it in exchange for getting my life back. I keep my kids and wife in view and keep slugging. You have to get mad at that monkey and be ready to go all out. Dont do it until you feel ready dude--but dont let fear of a few uncomfortable days out of your whole life keep you from liberating yourself and becoming the person the ones who love you most are hoping to see again. My best to you bro. Let me know if I can help. Feel free to email me. Later!


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PostPosted: Sun Aug 07, 2011 10:11 am 
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Well, nobody is really listening to those of us who have been on Suboxone a long time, and as we are the only ones who can provide any 'evidence', being ourselves the guinea pigs, I don't know how we can ever 'scientifically' back it up. Please, Hatmaker, if I can report how tough it has been for me to get off after 5.5 years, please let me know who will take this information. I've already tried R&B's numbers and spoken with them.

Don't get me wrong, though, because even though I think it's tougher to stop Sub after long-term use, that doesn't negate the benefits in my mind of taking Suboxone until one has had time to overhaul their lives. However long that period of time is depends on the person. I just have an sick feeling sometimes that because this or that has not been proven scientifically, a whole lot of people may be pretty blown out of the water down the line when they get there. Most drugs get more and more difficult to stop the longer you are on them. Suboxone is a drug and a strong drug at that. There's no comprehensive long-term studies that follow people who have been on Sub for years and years. I tend to believe that we always have to pay the piper in the end. I don't believe there's any drug that is such a miracle that we never run into any trouble down the line from taking it and then trying to stop taking it. Anyway, that's been my experience, but I'm just a guinea pig. :D

To the original poster, mensb1, your concerns are valid and the way you are wanting to go about this is actually in following with the way Suboxone was originally intended to be used. Of course, it will be significantly harder for you to stay sober once you are off, compared to someone who is on Suboxone. It is still possible, of course. Dr. Junig himself is in recovery for opiate addiction and has stayed sober without the use of Suboxone. I'm very happy to hear that you are wiling to work an NA program. I understand you not taking a chip until off Suboxone, but I don't think Suboxone qualifies as active use. You gotta admit, there's something drastically different about being on Sub and chasing your drug of choice around and around all the time. I guess I'm just hoping you are giving yourself enough credit for getting yourself onto a completely different path, because you've already come a long way.

As far as your dose goes, this is where it gets weird. I used to take 32 mg a day, so to me 10 mg would have seemed like a 'low' dose. The trouble is that Suboxone is very strong and has a long half life. I'm on .25 mg/day and I've got a ways to go to get down to jumping. It's been a big surprise to me to discover how strong this stuff really is and I know you won't believe me until you are there yourself. So, give yourself time to taper. 10 mg is actually quite a bit of Sub when you are looking at it from the perspective of wanting to be at zero. Don't get too hung up on when you will be off, because you need to focus on responsibly tapering and taking care of yourself every day, and there is no magic number of days to heal the brain or taper without symptoms. It would be a bad idea to blaze through tapering and then jump and make yourself sick. Chances are, you would go out again. I don't want to psych you out, but that's the way it seems to work, unfortunately. You have to be real with yourself about where you are at in your head, because you don't want to burn all the progress you've already made. Take it easy on yourself and drop carefully and slowly. Listen to your own body and be proud of the progress you've made. Don't push yourself beyond what your body is clearly telling you it can handle. I started tapering from 8 mg in Oct. '10, and I'm not done yet, just to give you an idea of how long it can take to taper. Now, I'm pretty sure it won't take you as long, since you've been on so briefly compared to me. Of course, that's not the case if it doesn't get any tougher the longer you are on....but I don't buy that. :D

I wish you all the best and encourage you to just stay very honest with yourself. I believe you can taper and stop Suboxone and stay sober. I also think you can taper and stop Suboxone and then relapse. The second is the worse thing that can happen. Obviously, it's better to be on Sub than to be on full agonist opiates. I completely get not wanting to stay on Sub a long time. I wish there was a magic answer, but you just have to do the best you can with what you've got and with what comes your way. I promise it won't be the end of the world if it takes you a bit longer than you'd like.

Good luck :D I'm glad you found this forum.

laddertipper

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PostPosted: Sun Aug 07, 2011 11:01 am 
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i have a friend who's been on suboxone for 2 years from 34 to 16 and jump at 2. he went through bad w/d's for 1 month. with no paws. he's been sober now for 14 months, and i see and talk with him about twice a week,and he's working hard and not going through any paws. that is what he say's ". but that's bill! hope this help's!! :)


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PostPosted: Sun Aug 07, 2011 11:01 am 
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Hat, now I see what you're saying. I thought you were referring to some clinical study that had been done with regards to discontinuing Suboxone after long term use.

So, I guess I could say that there is no evidence whatsoever that Suboxone is easy to come off of after long term use. It would be up to the people who had an easy time getting off of Suboxone to prove it to us scientifically.

I guess I could also say, there is no evidence whatsoever that little green aliens aren't using their evil mind probes to influence the folks at the White House causing the current administration to lose their ever loving minds. I could say that, right?

As long as I preface my comments with "there is no evidence", I can say pretty much anything without having to provide proof........COOL!!! I gotta remember that the next time my boss asks me if I came back from lunch late again, I'll just say, "Boss, there is no evidence to support your claim that I came back late from lunch again." :lol:

BTW, you asked if your response satisfied me......you ALWAYS satisfy me!! :D

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PostPosted: Sun Aug 07, 2011 1:21 pm 
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You are correct, there are no little green men. When/if you say there are little green men, the burden of proof is on you. It's just like many other things that people claim to exist, yet have no proof of. It's always up to the person making the claim to provide evidence of such.

Now, when I say that there's no evidence that it's harder to come off of long term use of sub, I'm repeating what Dr. Junig has said and keeping the information on this forum accurate. I'm by no means saying that anyone who has been on it long term isn't having a hard time. But there's no way to prove that it's harder than if the person had only been on it short term. Oh and this is not personal in any way.

Lastly, everyone has a right to their own opinions, but not to their own facts. And the fact is, there is no evidence that it's harder to come off of long term sub treatment. It's that simple.

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Sun Aug 07, 2011 1:37 pm 
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I am now SO satisfied with your response that I'm gonna go outside and have a cigarette!!

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PostPosted: Sun Aug 07, 2011 2:02 pm 
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My theory on "opiod receptors healing" is this: It's impossible to take less and less normal opioids. I tried tapering off tramadol and vicodan but you really can't. It is very possible to taper off suboxone. In fact it's almost hard not to if you want to. So the less suboxone you take the more receptors are left open or your receptors are less stimulated and they start healing. I"m no scientist but thats what always made sense to me. And for me it worked.


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PostPosted: Sun Aug 07, 2011 2:21 pm 
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Hawker--
I'm no scientist either. I arranged it in my mind that receptors are like oves burning hot--and they crave increasing temperature--i.e. ever-increasing dosage of Vicodin, etc to keep them burning. As you t=start tapering or withdrawing the ovens are shutting down and screaming for more heat--until they finally go out. That's how it worked for me anyway.


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PostPosted: Sun Aug 07, 2011 9:07 pm 
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Logically I think it makes sense that the longer your on sub the harder it is to get off. Unfortunately science has repeatedly proven that the logical conclusion is not always the correct one. My personal opinion is that it is harder to get off sub the longer your on it. Both physically and mentally. But again I'm not a doctor or scientist, just another addict.


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PostPosted: Mon Aug 08, 2011 2:31 am 
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MensB, I did NA for a long time, and the two previous times I was on Suboxone I did NA. As a result of the guilt I felt, and the exclusion from being 'clean', I jumped off relatively high doses (8+ mg). I tell you, jumping off doses that high is harder than getting off heroin. Unfortunately, I didn't stay clean.

Honestly MensB, given we don't know you personally, we can't gauge whether or not you will be successful with a short taper. If you find that you're well supported, and have established close friendships in NA who will look after you, you may very well be successful! If you taper wisely, take your time and don't jump off a high dose, your withdrawal should be much easier than your drug of choice.

What I will suggest is, no matter what path you choose, if it doesn't work, don't be afraid to try something else next time. Different things work for different people. Don't let any recovery method convince you that theirs is "the only way" because there is no such thing.

Good luck!


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