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PostPosted: Wed Jan 27, 2016 5:01 pm 
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Hello

I am approaching 3 weeks on sub. Started at 4, then moved to 8, then up to 10 mg for last ten days.

I am feeling confused about the whole thing. And I don't know if I am on the right dose. I will list the things I've been thinking in hopes I can get some advice from more experienced sub users.

Pros

-I have been off percocet for almost 3 weeks and I don't miss it at all. It is amazing.

-I generally feel happier on a daily basis, which I really notice in the morning. I am not so bummed in the morning when I wake up and realize I have to go to work. I am happy to face my day.

-I no longer feel caught in the pill chase cycle and am saving SO MUCH money. The suboxone is completely covered by my extended health, and being a Canadian I don't pay a thing to see the doctor.

Cons

-I sometimes feel cranky.

-I do feel like I am nodding off every now and then.

-My skin is very, very itchy, red and I even had a hive or two, which I have never had before.

-I am extremely worried about my next step. How long will I be on sub? How long should I be on it? What will happen if I want to get off? Will I face terrible withdrawal? I am terrified of that. Even when I'd run out of percs in the past, I could handle the withdrawal. It sucked, but it wasn't *that* bad. I was always still able to go to work if I just dosed myself with advil and Tylenol #1. I am afraid I will become dependent on sub, and when I try to quit and/or reduce, it will be worse than it ever was coming off percs.

-In my sleep, my arms and especially my hands are falling asleep. I wake up with them completely numb, pins and needles etc. That scares me. From what I've read, there is apparently no way that could be caused by sub, but I am convinced it is. Occasionally on percs the same thing would happen, but it was occasional and much more mild.

-I still see myself acting like an addict. Thinking about and looking forward to my next sub dose. Trying to save the smaller 2 mg. Pill and do it later, so I get two doses in a day. I don't know what to do about that.

Questions

-Am I on the right dose of sub? How would I know?

-Do I really need suboxone? Would I be normal if I stopped now?

I think probably not because on percs even though I was able to cope with the WD, it wasn't fun and I was so addicted. I could never stop myself from getting more the minute I could. And I don't want to go back to that.

-When is the right time to stop? How will I know?

-What do I do about these weird symptoms?

I told my sub Dr. and he said it sounded like a withdrawal symptom (the numb hands) and so prescribed my clonidine (sp?). I have never had it before and don't know if I really need it. I haven't taken it yet.

-Am I going to have a horrible withdrawal one day and regret taking this route?

-Why do I feel so confused?

II don't know what to do or think. I am trying to convince myself starting suboxone is the right choice, and when I realize that this is the first time I've gone almost 3 weeks with no percs, and I don't even want them, it feels like this is the right choice. Saving money, saving my liver, saving mood swings!

All the stories where people call sub evil, horrible etc are terrifying me.

Anybody have any advice or words of wisdom? I could really use it. I don't have anyone to talk to.

My husband didn't know I was on percs and also doesn't know about the sub. :-( the only person who does know is my dad, and he has his own serious problems. He became very addicted to percs also. His Dr. Prescribed for pain, but he always bought and did waaaay more. He went to his Dr. And admitted everything and asked for help, and his Dr. put him on a fentanyl Patch!! Now the Dr. wants him to switch to sub and I've heard that the switch from fentanyl to sub can be very hard. I am worried for him because he is 68. Going into WD before starting the sub will be hard on him. So I really don't have anyone to talk to. Anyway, that's my story. Please help!


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PostPosted: Wed Jan 27, 2016 8:17 pm 
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OK, so you've asked about a kabillion questions, so I will try to get to everything you asked.

First, let me tell you a little bit about opiate addiction. Opiate addiction is a chronic brain disorder characterized by relapse. The disorder in the brain comes from a change in the pleasure/reward circuits of the brain and an inhibited ability to control impulse. Certain parts of the brain also remember everything about your circumstances when you were receiving pleasure chemicals from the opiates. This is why opiate addicts are triggered so easily to relapse. These brain changes are permanent, meaning that you never stop being an addict. You will have to face addiction your entire life.

That's the bad news, along with the fact that you could die if you overdose on opiates (especially when mixed with alcohol and benzos). The better news is that we have ways of addressing our addiction with medications that take away both the withdrawals and the cravings. How amazing does it feel to go from being a withdrawing mess of cravings to feel like a normal person?

So now that you're feeling so much better you are second guessing your decision. It's like you're waiting for the other shoe to drop. Let's separate myth from fact.

1. Most people who go on suboxone/buprenorphine do best when they stay on it for at least several years. Dr. Junig, who started this forum has noticed some patterns among his sub patients. The first pattern is that his patients who turn around and get off their medication, especially because they're being pressured by someone to get off, relapse quickly. Sometimes he sees their names in the local obituaries. The second pattern is that his patients who take bupe for several years will sometimes notice that they don't feel like they need to be on their medication anymore. These are patients that have completely turned their lives around since active addiction. They have steady jobs, stable relationships, good finances, are cut off from any old using acquaintances. They have worked on their recoveries by seeing an addiction therapist, doing exercises from SMART Recovery, or attending other support meetings. They know what their triggers are and how to avoid them. Then they slowly taper off the medication with the support of their doctor.

2. Buprenorphine, the active ingredient in Suboxone, is a partial agonist on the opiate receptors of the the brain. The drugs you've been taking are full agonists, and it is extremely difficult to taper off a full agonist. That's why you couldn't get off your drug of choice, even though you tried. Tapering off a partial agonist like buprenorphine is not easy, but for plenty of people it's not hard either. But you don't read comments from people who have had a relatively easy taper off bupe because they don't have anything to complain about! What I've noticed about people who tend to complain and say that bupe is evil is that they haven't taken much responsibility for their addiction and they haven't worked hard on a recovery program. Suboxone is just a tool! It's not a miracle and it's not the devil. When taken properly it will put your addiction into remission. You are responsible for what you do during that time.

3. Yes, you will be dependent on suboxone because it has an opiate component. But unlike full agonists, it can be tapered slowly and relatively comfortably. Because buprenorphine is a long acting drug, it tends to stack up in your system so that you have a steady dose, instead of the highs and lows of your drug of choice.

4. You should take your entire dose at once! Unless you're dosing for chronic pain, which you're not. It's not unusual to try to play with or up your dose when you are first on it to see if you can get some kind of high. Let those of us with experience assure you that you can't. Your addiction is making you wonder and wants to make you mess with your dose. You have to take advantage of the fact that you are not having any physical cravings right now and deal with the psychological ones. One of the best ways to do that is to get busy with other things. Start a new hobby, an exercise program, a volunteer position. Don't find yourself a destructive habit! I've known people who have become sex addicts, shopping addicts, and food addicts to replace the opiates. Stay away from the things that could get you into trouble.

5. It is completely normal to feel like you have nothing to look forward to or nothing to think about. There is something of a hole where our obsession over drugs used to be. Fill it with good things! See #4.

6. There will always be naysayers and people that disagree with your form of recovery. Just let that go. If you are doing well you don't have to worry what others think. Using buprenorphine to treat your addiction is a scientifically proven, evidence-based treatment.

So to recap...

1. Plan to stay on for the time being and don't worry about when you will get off. The addicts who manage to stay in recovery are often on bupe for years.
2. Suboxone is a recovery tool. Use it well. Follow directions.
3. When it's time to taper, do it slowly and deliberately.
4. Take your entire dose at once. Do not take more than prescribed.
5. Find a positive activity to fill the hole left by obsessing over opiates.
6. Don't worry about people who are negative about your medication.

And lastly, remember that you are doing the best you can with a difficult and complicated disorder. The point is not to live drug free, although that can be a worthy, eventual goal. The point is to stay alive and live well even with this insidious addiction. It can be done!

Amy

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PostPosted: Wed Jan 27, 2016 8:42 pm 
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Amy I'm so glad that u answered that first because there were so many questions I would have confused myself and forgotten about my point lol...so thank u and u covered it well!

Freshstartmama ur thinking way to much instead of just letting urself enjoy this happy time of finally being free of the horrible cravings. Plus ur just three weeks in, ur body is still adjusting to sub. The symptoms u described with the numbness and rash doesn't sound like it's coming from suboxone and doesn't sound like withdrawal to me at all, so I'm not so sure u need clonadine (sp?).

Stop reading horror stories on the internet, it's only going to scare u and u have no reason to be scared. Ur an addict who can't stop using on ur own, ur the exact type of person this medication is for...like the rest of us. U shouldn't be worrying about coming off already, u just started. And do u know how lucky u are that u pay nothing for this treatment?? U have been given a huge opportunity and u don't even realize it because ur worried about everything else. U did the right thing by getting on sub. Now start working on ur recovery and living a normal life again. This is ur chance, take it and run with it! Read positive stories instead of crazy stuff ppl who haven't taken advantage of this medication. I really hope u relax, I can tell how stressed out u are about this.

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PostPosted: Wed Jan 27, 2016 8:49 pm 
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Awwww. Thank you Amy for your effort in giving me your best thoughts and insight.

A bit about me.

I teach high school full time, practice yoga, have 2 children whose lives I am very active in, have many friends (none of them do drugs or know I do), and have a wonderful husband for the last 18 years. I am just about to start skiing lessons with my kids this weekend. My life is FULL. And I am very grateful for it.

I do understand what addiction is, how it works in the brain, and that it is a disease I will battle for life.

I don't have any access to extra bupe, so doing more isn't even on my radar. And not something I want either.

But, I have been prescribed 10 mg. They give me an 8 mg pill and a 2 mg pill. My question with this is do I really need 10? My gut is telling me I probably only need 8. A couple times I have saved the 2 mg and taken it later in the day or the next morning to see if that is useful for me. Upon doing that I've noticed, no difference, so that is likely the ceiling effect.

I have discussed these questions with my doctor. His response was: once I get the carries, I can spread out my daily dosage however I want. But I do recognize what I've read on here about only doing once a day to learn to overcome my old habit of taking pills many times throughout the day. And that is something I am working on really getting, practicing, internalizing.

The other thing my doctor said about dosage, when I asked him how I will know if I need more or less, is only I will know. He didn't seem interested in "telling" me what to do. So that is probably where some of my confusion has come from.

Hearing about Dr. Junig's advice and experience about people getting off of sub right away and relapsing is a message that speaks to me through my confusion. It is telling me not to second guess and doubt this plan l have undertaken.

I also think there is a lot of wisdom in your point about people who say tapering off sub is hell being people not ready yet to accept responsibility. The ones who are successfull at it, are probably not sharing their stories as much. That helps ease my mind a lot. Thank you!

The biggest area for me to focus now is learning more about my addiction. Why do I have it? What do I need to learn from it?

Also, is it possible that some of the side effects I am experiencing, the itchy skin and numb hands, may be due to the fact that I am perhaps taking too much? Maybe I really should lower back to 8?

Ok, again lots of words, but I do think you have helped me sort out some of my confusion and questions!! Thank you so much.


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PostPosted: Wed Jan 27, 2016 8:54 pm 
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Lmao..JennJenn

OMG you're so right! I need to stop worrying and over thinking and recognize this as a blessing.
I am an over thinker by nature. Not having anyone to talk it out with in real life doesn't help that.

I really appreciate the support from both if you ladies!!! It helps!

Thank you.


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PostPosted: Wed Jan 27, 2016 11:01 pm 
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I know the US does it differently than Canada, but it doesn't hurt to have extra on hand for emergencies. So if you're not having to take your dose in front of the pharmacist, it may behoove you to hold onto the extra 2mg pills. If, however, this triggers you to want to use the extra in an unhealthy way, you might want to just tell the doctor that 8mg holds you fine (if it does.)

I'm very glad for you that you have a great, full life and stable relationships. That helps so much! My situation is similar to yours except that I don't have a full time job. Right now I'm working on my Masters in Addiction Studies. In a couple years I should be working full time! I look through addiction counseling jobs every now and then and there always seem to be plenty in my area. I've never had a real career before, so I feel both excited and somewhat daunted by the prospect. :)

Just know that we're here for you, to answer your questions and provide support. Jenn always has great advice!

Amy

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PostPosted: Thu Jan 28, 2016 2:44 am 
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Hello Freshstartmama!
Good on you for taking the steps to begin your recovery!
I just wanted to respond to the neuropathy your experiencing. I have found something that has almost eliminated all my symptoms. My symptoms of pain, numbness and tingling reached a peak last year where it became impossible to sleep without being woken numerous times in one night. It was actually quite painful and the only way to get some relief was to get out of bed and remain vertical for about ten minutes.
Close to my wits end, my pharmacist pointed me to magnesium powder. She seemed very confident this would work for me. After two weeks I had no symptoms. I have noticed if I stop taking the powder for a few weeks, the symptoms return but are minimal in comparison. My sleep is amazing now! It has helped me so much!
If you do decide to try it, you should see a huge difference after a few weeks and of course I would love to hear if it has helped you, it's good for RLS too as I was encouraged to take this by my addiction therapist when in WD from methadone. At the time I didn't but I wish I had of.
Of course I would talk to your DR about both issues and make the rash a priority.
I hear your concerns about your dad transitioning to subs, DR j and Docm would be able to offer some good advice on this, so I hope they see this!
Take care and be kind to yourself,


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PostPosted: Thu Jan 28, 2016 7:14 am 
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I wish I could convince my husband to try this!!!

Amy

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PostPosted: Thu Jan 28, 2016 10:47 am 
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FreshStartMama I'm a major over thinker also, omg I freak myself out a lot over different things. Honestly though, I never did over think the suboxone process though. I've been amazed and grateful for sub since the second I started. Hopefully u can just focus on the positive from now on. I know it's hard to control the thinking and worry but u can. Those awful cravings being gone is worth celebrating :)

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PostPosted: Thu Jan 28, 2016 6:12 pm 
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Yeah I agree. Just getting the opinion and support if you and others on here has helped put things in perspective for me. :-)


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PostPosted: Fri Jan 29, 2016 10:43 am 
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Hey Mama (lol),

Congrats on getting on subs! People's advice on here is awesome. Just wanted to say that since you just got on them, maybe just give yourself a break for a month and return to your concerns then? You've been through so much (we addicts give ourselves so much less credit than we deserve, sometimes what our biochemistry and our desperation puts us through is borderline traumatic) I'd focus on stabilizing on the dose (finding a dose which is most comfortable for you) and then confront those questions again once you're all back on the ground.

Also, the hand numbing thing I believe is indeed a sypmtom of opiates. When I was using (a natural form-opium) I would wake up in the mornings with my hands entirely numb. Not painful or anything, just weird and kinda alarming. I connected the two because obviously this didn't happen on days when I hadn't taken any opiates. But this is only 1 person's experience! So take it with a grain of salt you know :)


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PostPosted: Wed Feb 03, 2016 7:30 am 
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If you're "on the nod", I'd be inclined to say you're taking more than you need. Go with your gut. That being said, I'm not a doctor and am just a random from the other side of the planet. Good luck!


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PostPosted: Wed Feb 03, 2016 10:04 am 
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The nodding thing seems to have gone away. Could it have been just an adjustment phase? Not sure actually. In any case it did feel quite strong at first. Thanks!


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PostPosted: Wed Feb 03, 2016 6:21 pm 
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You've likely grown tolerant to the higher dose.


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