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PostPosted: Tue Aug 06, 2013 3:33 am 
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Hi everybody, thanks for being here. Here's my not-so-different story:
I'm an almost-60 yr-old long-time addict who stayed clean and sober for 25 years in and out of the program. About 2 1/2 years ago I started taking Vicodin for dental and back-pain issues, one thing lead to another and now I'm a full-fledged oxy addict who snorts 180-300 mg of oxy (30 mg tabs) daily. Although I've not had an oxy habit for years and years, it's long enough for me. I have an appointment with a suboxone doctor in two days and was told by the head of the NA treatment center who got me the appt that I needed to taper down to four 30 mg tabs a day (120 mg total) so my body would be ready for the induction process. I got down to 5 1/2 for the past two days, but I'm such an addict...I did 8 pills - 240 mg - today. GODDAM IT!!! I really need to start the subs ASAP for a million reasons, but of course #1 is that I gotta GET OFF DRUGS again. How dangerous is it to start subs with a tolerance that high? And, if I can get back on track with my taper, how many days do I need to do only 120 mgs before that last day, where I know I have to take a couple days off of work, take NOTHING the last day and then (I guess?) start with the subs the morning after that last day with nothing? I'm terrified of withdrawals (which I've not yet fully experienced, having gone to great pains to avoid them at all costs as this habit really exploded over the past 6 months), and I'm DOUBLY terrified of precipitated withdrawal. Any advice/comments/etc are appreciated. All the best...


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PostPosted: Tue Aug 06, 2013 8:25 am 
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Hello and welcome to the forum. Wow, you had 25 years clean and need to do it again? Guess that goes to show this drug addiction business never gives up trying to get us back taking pills or whatever substance again. Certainly gives me something to think about as I go thru my own sub detox right now and attempt to get clean after about 18 years of addiction.

To answer your question, you really need to either wait for about 24-36 hours or more BEFORE taking that very first dose of sub, or use what my doctor did and that was called a Cows's Sheet. It measures your withdrawal symptoms and places a number score to them. Once you get into moderate to severe withdrawals you are ready to induct.

I have been on subs now for about 3 years. I was taking 24mgs for most of that time, and wanted off the sub in the worst way. I reduced my dose, without my doctor knowledge down to 2mg and tried to jump from there. Couldn't do it as the symptoms were too much for me to handle so now I'm reducing further to hopefully get off soon. I'm now down to 1.75mg and doing good.

But I wanted on the subs quickly in the beginning and lied to my sub doctor and told him I had waited 3 days going without any narcotics. I had not waited nearly that long, only waiting about 8 hours between my last Vicodin. He took my word for it that I had waited 3 days and had me take the sub in his office. I immediately went into those Precipated Withdrawals and wanted to die I was so sick. It's like regular withdrawals muliplied several times over. I was sicker than I have ever been in my entire life. I'm not trying to scare you, only telling what happened to me personally. Served me right for lying to him.

I stopped the subs at that point and the doctor then used that Cow's Sheet Score and all was well then. I think he inducted me when my score got to about 20, or maybe a 25 or so? You can use google and get that Cows Sheet I'm sure, or ask the doctor about it. I'm also quite sure if you wait maybe 24-36 hours AFTER your last dose of narcotic you will be ok too. Again, ask the doctor just to be safe.

I was also placed on way too high a dose of subs in the 24mgs. I found after reducing the dose myself that I felt the exact same on much lower dose than I did on the higher ones. For example I felt the same on 2mgs as I did on 24mgs!!! It's crazy I know, but that is true in my own case. Doses of 16mgs, 12mgs, 8mgs, 6mgs, and even 4mgs all felt the same to me. I'm just saying to take the least amount that gets you out of withdrawls and no more than that would be my suggestion. It seems I was wasting subs and money taking more than was needed. I'm also sure some people need a higher dose than I did too. Depends on their addiction levels and time they are addicted or abusing the drugs.

If I'm feeling just fine on 2mgs and below then I guess that proves I was right about the higher doses. At least to me it proves it. Might not be the same for everyone as we all are different of course. Something to think about anyway?

Just make sure you place some time between your last Oxy and the first dose of sub and you should be ok. Hopefully you have a good sub doctor that knows how to perform the induction correctly. I guess to be safe the longer you could wait to induct the better it would be. You have to go thru some withdrawals to get better if that makes sense?

Hope this helps. Please keep posting and let us know how it goes. I wish you the very best with your own induction.

Karen
xoxo


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PostPosted: Tue Aug 06, 2013 10:44 am 
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Hi Sqanjaili,

I understand your fears. It is a scary thing when you make such a huge change and induce onto subs for the first time. As for the advice you received to taper your dose for a few days before induction...I'm not sure if that is completely necessary. The only reason I can see for doing that is to make the 24 hours before induction a bit easier on you. I would imagine that lowering your tolerance a little bit for a few days would make the wd a little bit less severe...but as far as having to do it for induction, I don't think it will make any difference.

As Karen said above, the most important thing is to be in moderate wd before beginning your sub treatment. Whatever you do, don't give in to the desire to take anything the day before. I know it will be tough, but it is so worth it in the long run. Alot of people, including me, when they are waiting for their appointment day, are concerned that the subs won't take their WD away completely. I know you didn't mention that in your post, but just in case it is floating around in the back of your mind...don't worry about that. You will feel 100% better when you get that first sub under your tongue.

Let us know if you have any more questions or if you just need some support when you are going through that WD day.

Q

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PostPosted: Tue Aug 06, 2013 12:09 pm 
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Here's a link to the COWS (Clinical Opiate Wd Scale) worksheet that Karen was talking about.

http://www.naabt.org/documents/cows_ind ... _sheet.pdf

Ideally, you would have someone else score you, we addicts in wd tend to score ourselves too high.

Like Qhorse said, tapering down your oxy use is not paramount, waiting until you're in moderate wd before starting Suboxone is very important or else you could get Precip. Wd.

The bottom of the COWS explains Precip. Wd.

Good luck and let us know how things go!!

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PostPosted: Thu Aug 15, 2013 9:32 pm 
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Hi,
What you need to understand is the way that Buprenorphine works is that it will essentially attach to the opioid receptors in your brain and strip off any other opioids like oxy etc ( to put it simply). If you haven't started to WD of they Oxy, when you take Bupe/Sub it will cause you to go into withdrawals but not the slow withdrawals, but a more rapid one.
24hrs off OXY may seem like forever, but honestly once you get the Buprenorphine into you it will make you feel good in a very short period of time.
If you don't cease from using before being inducted, you will get sick.
Unfortunately that is how it is, no real way around it.


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PostPosted: Fri Aug 16, 2013 10:03 pm 
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Squanjailli,
How are you doing? Romeo gave you some good advice on using the COWS scale. I just induced today and I am A O.K. !!!! I had an 120mg oxycodone habit, sometimes more, some times less. Got down to 50 mg, stopped for a little over 24 hrs(33hrs for me) induced on a small dose and I am doing well.
You can do this!!! You will be o.k. Please check in, want to know how you are doing.


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PostPosted: Fri Aug 16, 2013 10:25 pm 
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Justdoit4u wrote:
Squanjailli,
How are you doing? Romeo gave you some good advice on using the COWS scale. I just induced today and I am A O.K. !!!! I had an 120mg oxycodone habit, sometimes more, some times less. Got down to 50 mg, stopped for a little over 24 hrs(33hrs for me) induced on a small dose and I am doing well.
You can do this!!! You will be o.k. Please check in, want to know how you are doing.



I'm inducing tomorrow after a currently 45mg/day oxy habit. Can I ask what your dosage was today, if this is your first time on subs, and how exactly you're feeling (tired, energized, moody, dopey, etc)? You sound well overall of course. I'm afraid of the sub side effects, especially at first.


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PostPosted: Sat Aug 17, 2013 8:59 pm 
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spditup, I am doing well. I was on suboxone before for about 6 months. I weened down to .125mg-.25mg, stopped for about a week, then had foot surgery and got on straight oxcycodone for the last 8.5 months. From 60mg a day to 120mg or more a day. Recently tapered back to about 50mg. I was going to try to ween off the oxy, but found I was just sick of taking the s**t. Induced on sub on Friday. I have gained a lot of knowledge about the suboxone, and I was not scared to go back to it, to get off the pills. I will eventually ween off the sub and be totally clean. I will do it when and how its right for me. ciao


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PostPosted: Sat Aug 17, 2013 9:10 pm 
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Sorry, I induced on .4mg on friday 300pm, felt fine, slept good. Got up took .25mg, felt good at work, normal, good mood, normal energy. Took a .125mg sliver at 200pm. I am now home and do not plan to take anymore sub until tmrw, when I feel I need to. I have chronic pain, so I have to be careful how I use the suboxone. If I use it for pain control, I could easily take more, but Im trying to just take the withdrawal symptoms away, on the least amount possible. A great side effect of that is that it does help with some of my pain. For me, inducing on the lowest effective dose was critical, so that when I begin to ween off, I believe is in my best interest.


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