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 Post subject: Precipitated Withdrawal
PostPosted: Thu Jun 29, 2017 8:04 am 
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My fear of PW has made my induction very difficult.I have tapered down from H, my DOC to 1 bag daily of very weak quality of which I am glad. I waited 18 hours this time, had three of the symptoms, diarrhea, yawning and tears, and took an extremely small crumb of sub, and a short time latter it started. This is about the 3rd time. Can such a small dose of sub do that?


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PostPosted: Thu Jun 29, 2017 8:51 am 
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Hey JD,

I think I remember your situation, at least some of it. I don't know the answer to your question. Did you chart intensity of WD using the COWS. That's really the more reliable approach. You want to be at least squarely in moderate. Of course some get away with less intense symptoms but given your fears you want to err on the side of caution. It takes the guesswork out of this to a very large extent.

So when you say "it started", can you be more specific about your symptoms.

But here's a key point, if you follow the protocol and do end up with PW anyway, it veery likely won't be that bad. I had about 4 hours worth....and while intensely unpleasant it was far from the worst thing that's ever happened to me.

Bupe saved my life. The difference between being a bupe user and a heroin addict is s profound a difference as can be imagined.

If you do have symptoms of PW, do not go back to heroin! Stay the course. It will get better, and likely soon.
Just keep dosing your bupe as directed. The fact that you're on a very low dose of H is very, very positive. It's all about tolerance and yours is very low relatively speaking.

I'm seriously wondering if your symptoms were psychosomatic.Waiting 18 hours with a very low tolerance would it seems to me be sufficient. Of course I'm not doctor. Just giving you my best (somewhat) educated guesses.


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PostPosted: Thu Jun 29, 2017 9:04 am 
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Hey G
I do remember you. Thanks for getting back.
"It started' The diarrhea and the RLS which I mean I could not stop my legs from moving.
And I took such a small little piece.
I want badly to get off this H bandwagon.
If I have to knock myself out with benxos to get past the 24 hours I will.

On COWs I had the diarrhea, Sneezing, Yawning and tearing. I thought that would do it.

Will try again for sure. Thanks for your support. Any advice is definitely welcome


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PostPosted: Thu Jun 29, 2017 10:41 am 
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Well you need to score yourself. It's about intensity of the symptoms you have, not just the symptom itself.

I've no doubt whatsoever you can do this. Just about everyone here has. And we're a bunch of pain fearing, cowardly addicts. :)

I can absolutely understand your fear of PW because I shared it, but what you should really fear is continued use of heroin. The very last thing you want to do is take more heroin after taking bupe. Stick with it! Do it right! Set yourself free! :D

If you got relief from the heroin I'm assuming you used after encountering trouble, then I think you didn't have enough bupe in you to create the opiate block. That being the case, I'm not at all sure you could have had PW. Again, not a doc. Not even all that bright. But I try...


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PostPosted: Thu Jun 29, 2017 12:17 pm 
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I agree with Godfrey and I was going to say too that maybe u don't have enough buprenorphine in ur system. How can u be sure u are having pw? If ur not taking a big enough dose of bupe then ur possibly still having withdrawal not pw.

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PostPosted: Thu Jun 29, 2017 1:04 pm 
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Hi Jenn and G,

Jenn because the intensity right after I took that very little piece. I could not believe something that small. Maybe it was my fear. OMG I find everything you all tell me to be correct. I just have to stop being such a wuss and tough it out.
Saturday, round 4. Will let you know.

I want to be free. I swear i do


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PostPosted: Thu Jun 29, 2017 4:33 pm 
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We know you do jd. We've all been there, believe me. I agree that it was very likely fear. Dr. J talks a lot about how expectations play into our WD symptoms. If you're expecting the worst, our bodies and minds tend to comply with that.

A tiny crumb of bupe is very likely not enough to cause PW. You need enough to fill all or most of your opiate receptors (as I understand it) which in the process....by reason of their greater affinity....displace the remaining heroin from those receptors. Actually it wouldn't be the heroin that's displaced per se, but the full opiate agonist molecules (again to my no doubt incomplete understanding). If there are too many of those molecules occupying your receptors, such a sudden elimination plunges the brain and body into WD.

But if you wait until you're in moderate WD, this should not happen. If it does since there are no guarantees, just live with it. Take your bupe as directed. You'll be fine. Believe me, a few hours of PW is absolutely worth it.

You are taking very little heroin. You should be fine. In fact you were very likely fine this last time!!

Next time however, score yourself. Wait until you're in moderate withdrawal, then take your first dose.


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PostPosted: Fri Jun 30, 2017 11:15 am 
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I can see how bad u want this! I've watched u try so hard but ur fear is holding u bk. I think ur amazing just being able to cut urself down from the H, not many of us can do that! I couldn't have done that at all. See, u are strong and u don't even see it :) but we see it.

Trust me, Godfrey is the absolute best person to talk about this with imo because he went through what ur going through too. Actually u cut bk ur tolerance before starting suboxone too right Godfrey?

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PostPosted: Sat Jul 01, 2017 8:23 am 
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Thanks Jenn.
I appreciate the encouragement. Last use 1:00pm yesterday Friday.
Feel pretty decent this morning inspite. Connect called and I told him I am through. I am wondering if I will even need the sub. Time will tell. I am holding out as long as I can.

You guys are the best


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PostPosted: Sat Jul 01, 2017 8:31 am 
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Keep us posted jd! U can do this. However u decide, u will know what to do.

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PostPosted: Sat Jul 01, 2017 3:36 pm 
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:D Hi Jenn and G--
First, I want to say how incredibly safe I feel baring my soul to you. i was on chat with a woman named Jackie and I remember telling her how S-Zone is a Judgment Free Zone and she said she picked that up right off the bat. Means something. Trust me it does.
So Jenn and G, from 1:00pm yesterday afternoon was my last shot. I dont feel terrific but I dont feel like the world is coming down.
I also took the work (we call is that here) and flushed. Even the set I was hiding for an emergency. I decided there will be no more 'emergencies'.

So I am loading up on high doses of Magnesium for the Restless Legs which were bad last evening. I have some Clonidine and Gabapentin, and some benzos if the situation is bad.

Jen, nothing on the GI distress at all. No symptoms which would justify me starting induction. You stressed to me forget the time and focus on the symptom as the COWS outlines, so that is what U and
G have mad perfectly clear.

Do perhaps the Last dose I took was pretty high powered OR I am not as addicted as I thought. I am just doing to continue waiting and see if the feelings change at all. Thank you guys.

Jenn can I run something by you for some feed back. If it is not something you would like to respond to I understand.

Jenn, my guilt is kicking my butt really hard.

I am and have been in the field for well over 12 years; well known and highly regarded. I feel like such a hypocrite. I have worked primarily with teens and when I would get certificates, acknowledgements, thank yous for doing what you did for me and my son/daughter, I felt like crap inside. How hypocritical. Then the people I have been working with all have their past issues and I find myself getting angry at them for not seeing me, and calling me on it. Somehow my twisted mind feels they are supposed to see my pain and they are supposed to reach out and understand what I am going thru inside. I hide it well Jenn. I mean, no one has an inkling. I function and hide my pain quite well inside which really sucks.

Someone once told me that others are not responsible for my recovery; I am and i should not put that on others. My recovery is my responsibility and no one else s. Makes sense.

So Jenn and G, If I go along and feel I can get by without the use of the Subs, should I give it a go, or should I induct just to be on the safe side?

You guys are awesome and I appreciate you so much. Your encouragement is a source of strength for me as I have been a silent sufferer for so many years.

God bless and be well. JD


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PostPosted: Sat Jul 01, 2017 7:15 pm 
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I am pretty new here so I will defer to those that have been around longer (and to the directions of your doctor).

That said, I generally advise people to wait as long as they can before induction. Almost certainly you will need to take the Suboxone as opposed to getting off the H without ever starting the Subs (if I read your question correctly).

So, continue to hold off on induction if you can so long as you are determined regardless you will not go back to H. If things get really bad, once you start the Suboxone it should not take more than 30 minutes for you to feel better. You can also dose again after 60 minutes or so depending on what your doctor told you.

Ultimately, you and I should defer to your doctor. If you are able to or when you get back in with your doctor, be sure to ask specific questions and even ask about hypothetical situations so that you have instructions for various scenarios.

If you can tolerate it also try to stay active or busy, stay hydrated, and get a hold of some highly recommended self help books or check out some motivational videos on youtube.

Lastly, I see this group is an invaluable support; once you are good on the Suboxone pay much of your attention to relapse prevention.

It's not easy but you will get there.


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PostPosted: Sun Jul 02, 2017 12:25 am 
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juniorsdad3 wrote:
I am and have been in the field for well over 12 years; well known and highly regarded. I feel like such a hypocrite. I have worked primarily with teens and when I would get certificates, acknowledgements, thank yous for doing what you did for me and my son/daughter, I felt like crap inside. How hypocritical. Then the people I have been working with all have their past issues and I find myself getting angry at them for not seeing me, and calling me on it. Somehow my twisted mind feels they are supposed to see my pain and they are supposed to reach out and understand what I am going thru inside. I hide it well Jenn. I mean, no one has an inkling. I function and hide my pain quite well inside which really sucks.

don't feel like a hypocrite. addiction can suck anyone in. my first dr. asked me why I was even there. he said i didn't fit in with the rest of the clients. but i do. i'm an addict. i may dress like a school teacher and drive a station wagon, but heroin knows no bounds. i was diagnosed as a severe opiate addict. mostly since i have decades of use behind me. that NO ONE knew about.
anyway even while in active addiction I was helping other people to get clean. and yes, i did feel guilty when one friend kept telling me he didn't know how i did it and i was the strongest person he knew etc. (i quit h and cigs the same day cold turkey the first time!) i didn't have the heart to tell him i had relapsed. but he's clean now and back with his wife after a separation. you understand the addiction part, so you can help people with theirs!
good luck!

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PostPosted: Mon Jul 03, 2017 4:20 pm 
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Hey Juniorsdad! Sorry I'm just seeing ur post, it's been a busy weekend with the 4th coming up and everyone on vacation.

It's awesome that u made it this long so far! Doing great! Are u still going with nothing since Friday?

This is ur decision 100%. If ur not having any cravings and not sick and want to wait until u see what may or may not happen, that's definitely ur decision. My only worry with that is if u do start cravings and u turn to heroin before suboxone. So please be very careful. If it were me (and I'm going by how I was in active addiction) I would take the suboxone after I'd waited long enough. But I'd also been to rehab and detox so I knew I couldn't stop on my own. I also wasn't a functioning addict, it sounds like u are possibly a functioning addict. A functional addict can hold down a job and still function in society somewhat. I was the complete opposite. I couldn't hold down a job and I stayed in and out of jail. I knew if I was without my drug of choice, I'd use 100%. I think it's risky to wait too long, on the other hand, I know u may want to prove to urself if u can stop by urself or not. I think it's safer to start buprenorphine but it's ultimately ur decision, just don't ruin ur chance to finally induce by relapsing on heroin and possibly dying. The stakes are extremely high my friend. Please be careful.

Don't think of urself as a hypocrite. We're sick, that's just the way it is. The guilt I went through in my early recovery days was very intense. I had to face losing custody of my kids..... It doesn't get any worse than something like that. It happened because I couldn't control my using. If u can get some counseling, it'll help all those feelings ur going to have. But it is SO worth it.

Please keep us updated!

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PostPosted: Mon Jul 03, 2017 10:06 pm 
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Hey JD,

I really think jennjenn said it so well. And as to judging yourself so harshly, part of recovery work is self forgiveness which happens later. Given how powerful self bashing is, adding it in now is incredibly destructive. We all know what you're taking about and have all done it ourselves, many still are tho it never helps. it never helps. In no way is it beneficial or profitable or healthy. I wonder if this specific shame stems from your training and environment where I assume abstinence is the only way? Maybe your environment believes addiction is a weakness or character defect (which is a bunch of hooey) and you're getting negative messages there everyday. I think you'd be surprised at the addiction professionals that are in active addiction or in recovery. Your profession is no more immune to addiction than any other. Why? Because addiction is an equal opportunist.

My hope is that you start bup, and w work on your part, it'll break your active addiction cycle and you get your life back. best always, Pel

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PostPosted: Sun Jul 09, 2017 12:17 am 
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Hi all! So far so good. Still trying to regulate proper dose. No H since last post. I think this will be the time I finally call it quits. Love you all.


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PostPosted: Sun Jul 09, 2017 12:30 am 
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Hey JD,

I prolly missed it bc I can do that so help me out here. thinking your last H was 8 day ago.

so what does this mean? 'Still trying to regulate proper dose. No H since last post."

regulate dose of what?

so many here pulling for you! - including me, Pel

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PostPosted: Sun Jul 09, 2017 11:02 am 
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I'm hoping u mean regulate ur dose of buprenorphine. If that's what u meant then that's great! Give us a little more info next post because we're truly pulling for u!! U have been trying to do this for months and I'm so happy ur not doing H so far. Find a dose that covers ur cravings and just stick with it, when u jump around on doses it's hard to stabilize. I can't remember, are u under the care of a bupe doctor?

Good luck JD! Please keep us updated :)

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PostPosted: Sun Jul 09, 2017 9:12 pm 
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Congrats juniordad glad you got over the initial bump. It should be relatively smooth sailing from now as long as there's no regressions from poor choices. Suboxone makes it easier to stay off heroin, but it's no panacea. I find having other supports useful as well.


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PostPosted: Wed Jul 12, 2017 11:35 pm 
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Any update JD? We are all pulling for you! I wish we could help you go through the induction up close and personal! Part of your fear is probably doing this on your own. But you can do it!

Amy

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