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PostPosted: Thu Mar 10, 2011 8:50 am 
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I was initially attracted to this website from the good doctors plug on youtube. I used Heroin for 2 years before going on the methadone program. I was on 36ml Methadone daily for 7 yrs before doing a 2 year slow taper to 1ml then jumped. After a year and a half of sobriety i finally managed to get a postition in the state funded Interferon program to get rid of Hep C. Half way through this mentally and physically challenging 6 month program I relapsed and began taking Oxycodone 40-120mg a day for 2 months. I quickly went on to the Buprenorphine program and finished the Interferon successfully. I took 8mg of Suboxone a day for the last 2 years until recently when i switched back to Subutex and began to taper. In the last 12 weeks I have reduced to 1 mg and have been on this dose for almost a month now with the intention of jumping in 10 days. Withdrawl from opiates can be so desperately lonely. S E Hinton once wrote something like: "Only people who have both been snake-bit can tell each other how it feels" so i am so grateful for this column as i live in rural Australia and dont have NA. I am glad to see so many positive reinforcements in this forum and congratulate your support for each other.


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PostPosted: Thu Mar 10, 2011 10:22 am 
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Hi crooltats (or G'day Mate),

Welcome to the forum. I really like that quote from SE Hinton, it's so true.

Congratulations on all the progress you have made, I know it wasn't easy.

Can I ask why you're wanting to quit sub?

I see you're at 1mg and would like to jump in 10 days. Is that quit date set in stone? The only reason I ask is because 1mg is a bit on the high side to be jumping from. You will most likely experience some wd. If you could continue tapering below .5mg....closer to .25mg you should have an easier time with the wd. Just some thoughts for you.

Can you get Clonidine in Australia? It's a blood pressure med that's prescribed 'off label' for opiate wd. If I were you, I would definitely go to my doctor and try to get some Clonidine. It helped me during my sub wd more than anything else.

Again, welcome and we look forward to hearing more from you.


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PostPosted: Thu Mar 10, 2011 10:55 am 
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Welcome to the forum crooltats (is your name related to tattoos?) - I have to agree with Romeo...You might want to extend your quit date and get even lower than 1 mg. People that seem to have the least amount of discomfort quitting subs taper as low as into the micrograms. Remember, the lower and slower you go, the easier it will be and the less withdrawals you should have. And yes, Clonidine will help you, too. Again, welcome. It's nice to have an Aussie on board - a dear friend of mine is in Perth. I know they're still having heat waves. If you're in that area - stay cool. 8)

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PostPosted: Thu Mar 10, 2011 1:01 pm 
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Hey and welcome. I also love that quote.

I'm tapering too. I can see why you'd want to jump at 1. The tapering certainly gets tedious, doesn't it? I'm at 1.25 and starting to wonder if I really feel like tapering down to .125, which is what I've been planning to do....but it's just such a long haul. Part of me just wants to get it over with, KWIM? I'll most likely keep tapering though, because I'm too afraid of that big jump.

Why did you switch back to Subutex? I've heard that this is the best thing to do before discontinuing Bupe altogether, but I really don't understand the scientific reason behind that. I'm on the films and that's all my doctor prescribes, so....I'm gonna have to taper on the Suboxone. If I could switch to the Subutex, I absolutely would. I wonder how much harder it really is to taper off the Suboxone verses the Subutex.

Good luck!! And congratulations on the Interferon. Man, that's a tough treatment. I haven't done it, but I've known lots of people who have and they struggled. I'm so happy for you that it's in the past.

laddertipper

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First you take a drink, then the drink takes a drink, then the drink takes you. ~F. Scott Fitzgerald


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PostPosted: Thu Mar 10, 2011 4:46 pm 
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I was surfing around the web yesterday looking at some other Suboxone websites and found some info regarding the difference between discontinuing Suboxone vs Subutex. The Naloxone is the difference. Technically, coming off of Suboxone you would be quitting 2 drugs at once. I know the Naloxone is not supposed to be able to enter the bloodsteam when taken sublingually, but then again I have read several reports on this forum of people who spit out their saliva after taking their Suboxone to avoid certain side effects they would get. Then I google searched "long term Naloxone use" and was surprised by some of what I read about Naloxone.


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PostPosted: Thu Mar 10, 2011 5:47 pm 
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Romeo wrote:
I was surfing around the web yesterday looking at some other Suboxone websites and found some info regarding the difference between discontinuing Suboxone vs Subutex. The Naloxone is the difference. Technically, coming off of Suboxone you would be quitting 2 drugs at once. I know the Naloxone is not supposed to be able to enter the bloodsteam when taken sublingually, but then again I have read several reports on this forum of people who spit out their saliva after taking their Suboxone to avoid certain side effects they would get. Then I google searched "long term Naloxone use" and was surprised by some of what I read about Naloxone.


Well, I do understand that the reason is the Naloxone, only because that's the difference between the two meds. What confuses me is that I've been told consistently by my Sub doctors that Naloxone shouldn't make any difference unless injected. Then, I also know some people cannot tolerate Naloxone at all and need to take Subutex and other people tolerate it as long as they spit. Well, what's the deal? I know when I had to switch to Subutex when pregnant, I 'felt' it. It was not the same as taking Suboxone, for me anyway. I didn't get loaded by any means, but I could feel something rather than nothing. So, the Naloxone seems to make some sort of difference, in my experience, but does the Naloxone make tapering harder and if it does why? Is it because it interacts with the bupe in some way or is it because the Naloxone itself causes w/d symptoms when stopped? I really just don't get it, and the answer to this question may determine whether I start pushing really hard to switch meds.

laddertipper

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First you take a drink, then the drink takes a drink, then the drink takes you. ~F. Scott Fitzgerald


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PostPosted: Fri Mar 11, 2011 1:39 am 
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Thankyou for your replies and encouragement. I saw my doctor today and asked about a smaller dose. Apparently there is only 3 tablet sizes available in Australia and the chemist is only willing to split the tablet in half. The tablet sizes are: 8mg, 2mg and .04mg swords. I have been taking half of 2mg (1mg) daily. The reason why I switched from suboxone to subutex was due to the naloxone content. I may be wrong but i understand that it may interfere with the natural production of dopamine, therefore taking longer for the body to start efficiently producing it again? I also switched becuase suboxone was a takeaway medication whereas subutex was a supervised dose and i thought i might benefit from a protocol which did not allow me to procrastinate in my reduction. My quit date still is valid due to reasons of accomodation and sickness benefits.


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PostPosted: Fri Mar 11, 2011 11:49 am 
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crooltats wrote:
Thankyou for your replies and encouragement. I saw my doctor today and asked about a smaller dose. Apparently there is only 3 tablet sizes available in Australia and the chemist is only willing to split the tablet in half. The tablet sizes are: 8mg, 2mg and .04mg swords. I have been taking half of 2mg (1mg) daily. The reason why I switched from suboxone to subutex was due to the naloxone content. I may be wrong but i understand that it may interfere with the natural production of dopamine, therefore taking longer for the body to start efficiently producing it again? I also switched becuase suboxone was a takeaway medication whereas subutex was a supervised dose and i thought i might benefit from a protocol which did not allow me to procrastinate in my reduction. My quit date still is valid due to reasons of accomodation and sickness benefits.


You were really smart to switch. I read up a bit on Naloxone and I'm quite concerned, having been on Suboxone so long. Yikes.....I'll switch too if my doc will let me. I wish I'd known to switch earlier!!!

laddertipper

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First you take a drink, then the drink takes a drink, then the drink takes you. ~F. Scott Fitzgerald


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PostPosted: Fri Mar 11, 2011 6:40 pm 
Hello Crool and welcome! I'm glad to see you posting here and look forward to hearing how the rest of your taper and subsequent cessation of buprenorphine goes! It sounds like you've been through a good bit with your health and treatment. I'm glad you're doing okay!
I'm impressed with your level of committment to get this done with the Sub too. It's interesting to hear how things are done in other countries.....specifically that you are not allowed to take Subutex home. I think what you did in switching to Subutex in order to control your taper was smart! I did a long taper to ~1mg/day several months ago and I had a hard time sticking to my dose. I actually considered having my husband dole out my dose each morning so I wouldn't "double-dip" so to speak! Anyway...that's all beside the point, as I wound up aborting my taper and going back up on my dose because that's what I needed, for me. I certainly don't want to imply that your plan or anyone else's plan to taper and quit Sub will end like mine! Plus, I still plan to try again, just not today!
I will suggest to you that I believe if it were at all possible for you to extend your quit date, even by another 2 weeks or so, it would be much more optimal for you. Say you were able to go on down to 0.75mg for a week, followed by 0.5mg for another week, then 0.25mg for a week or so before your final quit date.....I think your withdrawal symptoms would be significantly diminished from quitting at 1mg/day. Even doing it the way I just suggested is a fairly rapid taper compared to what some folks have done. It just seems that the best reports we get here are from those who have reduced to a very low dosage over a fairly long time period. There just doesn't seem to be any getting around that fact. So maybe, just maybe you could find a way to buy yourself just a little more time.
If that cannot be done, perhaps you could go ahead and drop down from that 1mg/day you're taking now. It stinks that the chemist won't at least quarter your tablet for you! If I read you correctly, the only other option is a 0.04mg dose? That's too low from where you're at now to drop to all at once even you were to take as many as 4 at a time. I don't know, that makes it tough. I just wish you could somehow get that dose well under the 1mg/day mark before quitting.
I'm also interested in the discussion that you've opened about the naloxone portion of Suboxone and whether that has an impact on the withdrawal process. While I'm certainly not going to dispute that there is a possibility of that being true, at the same time I've got to wonder. Here is why......The amount of naloxone in Suboxone is so small and the naloxone isn't even thought to be absorbed to an appreciable degree when taken sublingually. The amount of it even taken up by the body should be so low as to have no real effect on us. Let me back up a minute and give a disclaimer.....I am no expert on this subject and my knowledge is pretty limited. Hopefully donh or junkie or someone else who knows more will come along and set the record straight if I've got this all wrong. Anyway, as I understand it, when we look at 'studies' about the long term effects of naloxone use, they're looking at way more in terms of dosage than what we're getting in Suboxone.....like 20 times more. If that's the case, I don't think there is much to worry about. Again, I haven't studied this at any length and I could be wrong.
On the other hand....I was recently switched to Subutex (generic) at my request. I requested it primarily for $$ reasons. When I first started the generic Subutex I almost wished I hadn't asked! I think it tastes terrible and it seems to take longer to dissolve and it leaves my tongue feeling sort of numb! Other than that, I see no difference its effectiveness or anything else. However, after reading through this thread, I have to say that I'm glad I am on plain buprenorphine now! Even if there isn't any scientific rationale for it being preferred for tapering/quitting, I'd rather taper and stop it than bupe with naloxone, on the outside chance that it does make a difference. Plus, believe it or not (being that I wound up an opioid addict,) I have always felt it best to ingest only the minimum number/amount of any chemical that must be ingested to get by. So why take the naloxone if the truth is that it isn't necessary to treat my addiction? That substance was never intended to be a part of the treatment. The addition of that drug was purely an attempt to satisfy the minds of the powers that be that Suboxone could be safely prescribed in an outpatient setting and that maybe it would deter IV use of the drug. In any case, I look forward to hearing from others on this subject.
Anyway, Crool.....I sure hope things go well with the rest of your taper! Please stay around here....you'll get so much support!


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PostPosted: Sat Mar 12, 2011 9:52 am 
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Thanks for your post setmefree, you all make such interesting and valid points. When i came off the methadone and was down to 12ml a day i found the only rehabilitation unit which handled methadone and buprenorphine reductions in Australia to help me. The reduction protocol for Buprenorphine at a dose under 8mg was to reduce by 2mg per fortnight and jump off at 2mg. In rare cases they would allow people the option of going to 1mg for a week. So, can you imagine it-everyone in a state of severe detox...it was terrifying. There were hardened convicts paroled out through drug court with the possibility of release if they got straight, and they were breaking. I think the hardest thing for any addict is to see the time it takes to recover stretched out before them. I witnessed one guy jump off the bupe at 2mg and practically go without sleep for 21 days! oh, and did i mention it was an unmedicated unit? lmao. Anyways i hear a lot about cost and insurance from you American brothers and sisters. Every region in NSW has a health department with a D+A worker that will find you a slot with a prescribing doctor. In the city and larger towns there are free clinics but in rural areas you may have to pay for the administration at a pharmacy, $4 a dose for me. Everything else is covered by medicare (free) I would like to open a forum and ask "what is the most you have ever had to pay for an administered dose?"


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