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PostPosted: Sun Jul 26, 2009 6:33 pm 
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My Doctor told me during my last visit that if i ran out of suboxone, give her a call and she will adjust my dosing, and write me a new script. SHE WENT ON VACATION AND I DONT KNOW WHERE TO GO! SHOULD I GO TO THE HOSPITAL IF I GET REALLY BAD?
I have been taking 2 1/2 8mg. per day in the first month.
Im down to 1 1/2 8mg per day.
But this time im w/ding. i went down 4mg too fast, so i stayed at 2 per day.
She wrote enough for 1 1/2 a day, but since i have stayed at 2 per day, i ended up running out early!
Where else can i go for help?
Can her nurse write it for me?


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PostPosted: Sun Jul 26, 2009 10:45 pm 
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Hey there...

Suboxone is Schedule III, so it could be called in, I think. Try the nurse to see if they can get a hold of the doc, and then the doc could possibly call it in for you.

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PostPosted: Sun Jul 26, 2009 11:10 pm 
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Very important thing to keep in mind: take your Suboxone (or any medication) only as directed by your doctor (I'm not directing that at anyone just saying it's an important thing to keep in mind, at least in my own experience) If your doc just leaves for a vacation without making plans to have their patients taken care of while they're gone it's time to get a new doctor. My doc hasn't left me high and dry yet and that's why I keep going to him.

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PostPosted: Sun Jul 26, 2009 11:44 pm 
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Matt is right, you should take as directed. I don't know if you have insurance or not, but they may refuse to fill it early as well, or even the pharmacy may refuse to do it.

It sounds like you had some sort of agreement with the doctor about possibly needing to take more than prescribed.

I hope it works out for you. Do you have any left at all? Withdrawal usually sets in 72+ hours after your last dose, depending on your metabolism of buprenorphine.

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 Post subject: RAN OUT 6 DAYS EARLY
PostPosted: Mon Jul 27, 2009 8:54 am 
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Thank you for replying to my question.

I actually did make arrangements to make adjustments to my dose. My doctor said if i need to stay, or go up a little on my dose, to call and notify her. I did exactly that. I notified the on-call doctor, he said he could'nt prescribe me any more. Which is not why i called him, i just wanted to follow my doc's instructions.
The problem is this:
Im almost afraid to ask my doc or the nurse for an early prescription in fear that it may look "suspicious" to them. Although i have not been distributing my subs to anyone. Im just still trying to find the right dose. I just started this program in the last month or two...
I have 2 8mg pills left, i figured i have enough to take 2mg everyday until my next appointment. But im going from 16mg a day to 2mg a day!! I feel weird this morning already! yesterday i took only 2mg as well as this morning. But i feel like im not going to stick with just 2mg per day as i am feeling quite unconfortable right now. Nothing i cant handle, we have all "kicked it" in the past but how i feel now is nothing near what it could be. But then again like i said, this morning is the second day of only 2mg so im not too sure what tomorrow will bring.


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PostPosted: Mon Jul 27, 2009 10:05 am 
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It might sound cold and heartless but your only sure bet chance is to ration what you have and tough it out. I've had 2 occasions that I got shorted on my script, over the course of 2 and a half years I've been on Suboxone. I don't know how your Doctor's office works but mine wont give me anything with out an office visit and a pee test, even when it was their fault. My Doctor only filled out half of the prescription paper, He left out how many I took per day and the nurse finished writing it out and gave me 1/3 less then I normally took. No one could help me, not the pharmacy, or the Doctor's office with out paying for another visit, which I couldn't afford. The second time my medical coverage was dropped because My SSI Lawyer forgot to send them a letter. So I was stuck with 2 weeks worth of meds to last me 6 weeks, I was so far off my dose when I finally got back to the Doctor's that they had to re-dose me like they did when I 1st started. I hope you get something worked out, but it's not the end of the world. It happens to everyone at one time or another if your on it long enough, mistakes get made, and sadly most people will treat you like tough luck.


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PostPosted: Mon Jul 27, 2009 4:15 pm 
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Honestly, you will probably be fine on the 2mgs until you get your refill. You might feel crappy, like a mild(ish) flu, but 2mgs of Suboxone is still a strong dose. It's equivalent to 30mg of methadone - same as 16mgs.

Try not to freak out or obsess over any little feeling that something is wrong. I'm in the process of tapering (I'm down below a quarter of a mg now) and the best thing I can do is stay distracted. If you feel shitty, go for a walk or take a hot bath. Call a friend or log on here for support. If you have stomach/intestinal issues, immodium ad works. Drink lots of water.

I know it seems like a HUGE drop to go from 16mgs to 2mgs, so think of it this way. After about 4mgs of Suboxone, taking more doesn't really increase it's effectiveness. It just makes it last longer in your bloodstream. So you will have a few days before the level of Sub in your blood even drops below 16mgs, and you are still taking 2mgs a day on top of that. 2mgs a day is still a very effective dose of Suboxone, and many people use that as a maintanence dose and are totally fine.

Your doctor's office sounds kinda dysfunctional. I hope you'll be able to talk this over with your doc so this doesn't happen again. It's really not a good idea to increase/decrease your dose on your own like that. The best thing would be to take your dose as prescribed, once per day, as that breaks the addict habit of taking more drugs when we feel crappy. Most of those "evening withdrawal symptoms" are mental and will pass if you just wait them out anyway. The only reason to dose more than once per day is if you are using the Sub to treat pain.

Best of luck to you and remember: You Are Going To Be Fine.

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PostPosted: Mon Jul 27, 2009 9:01 pm 
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I do not want to sound cold, but I wanted to point a couple things out to you so you can own up to putting your recovery in your own hands, which is exactly what you did by not informing your doctor immediately about staying at 16mg per day. Taking Suboxone is not just about getting relief, it is about recovery from opiate addiction, and not telling your doctor about staying on a specific dose right away defeats the purpose of taking it! We need to stop thinking for ourselves when it comes to medication. You probably do not realize this, but the fact that you say you are feeling the effects of taking only 2mg after one day is close to impossible.Much of this is your addictive thinking taking over.Suboxone builds up in the body, it has a long half life which means, if you take 16mg on day one, it takes about 37.5 hours for half of the dose to leave your system.Image

This image shows how the medication builds up in your body-it takes 5 days for that first 16mg dose to become 2mg in your body.Hopefully you understand.
Honesty is so very important in your recovery, mainly honesty with yourself! I hope that you are getting some kind of support such as meetings or counseling along with the Suboxone.We do have online meetings here in CHAT on Monday and Wednesday night, 7:30pm EST! Please join us!

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PostPosted: Wed Mar 31, 2010 5:09 pm 
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Help
I have done the same thing, and have 10 days left of my full dose of 16 mg before I can get my rx refilled in 16 days. I have been on 16 (occaisionally 20) mg. per day (reason for the shortage, since the script is written for 16 mg. per day) I have parsed them all out and if I use 12 mg per day, interspersed with one or two 16 mg days I will make it untl pharmacy will fill. How will I do? Big lesson learned....I will take my suboxone as directed once I get the new rx. It is the usual addict behavior...I think I know everything! My question is... What will I experience by decreasing by 4 mg /day over the next two weeks or so?? Will I experience withdrawal? It sounds like, due to the long half life, I should be fine. I was starting to get too sleepy on the 16 to 20 mg dose anyway. Just don't want to crash and burn.
Please help!
ladydi


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PostPosted: Thu Apr 01, 2010 1:27 pm 
You're not gonna crash and burn. You understand the graph that Shelwoy so kindly posted right.....Because this medication has such as long half-life and because of its ceiling effect, you should feel absolutely nothing in the way of withdrawals. Anything you do "feel" will be almost certainly psychological. You're on a high enough dose at the 16mg/day that you really should do just fine. In fact, I'll go a step further and say you might actually find that you feel better on 12mg/day!
I'm not a doctor or an expert, just another opiate addict on Suboxone. My experiences and the experience of most everyone else you'll ask will tell you the drop from 16mg to 12mg is no problem.
I will add, however, I think the bigger thing you might need to look into is why you're upping your prescribed dose from time to time. No Judgment....I've made those types of adjustments too. Part of getting better is learning to stop the self-medicating and that includes tweaking our Sub doses based on how we're feeling from one day to or one minute to the next. Just something I need reminded of from time to time and I figure might be good for you to think about too!


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PostPosted: Sat Apr 10, 2010 7:56 pm 
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Hi Everyone!!

So last year I posted this because i think it was the first month I was taking it. Since the beginning of this year, I switched to Subutex 8mg and I have been feeling alot better. No constipation and I have been sleeping ALOT better. So about the whole "going down 4mg" thing...
I can now speak from personal experience that I have pretty much done what you are doing almost every month. I start out taking 2 8mg a day and 2-3 weeks later, down to 8mg or even 4 or 2mg. I have to say, chart or no chart, I don't feel a difference at all. I took 16mg.+ per day for 3 weeks and the next day went down to 2 or 4mg and did not feel ANY difference at all. And this is almost a year into it. I meesed up a few times but it was when I ran out. The only time I felt crappy is when I didn't take Subutex at all for 24 hours and over.
IT DOESN'T MATTER IF A TAKE 32MG FOR 3 WEEKS STRAIGHT. IF I DON'T TAKE IT THE NEXT DAY, I FEEL WEIRD. THE DAY AFTER THAT, WITHDRAWLS. ACCORDING TO THE ALL MIGHTY CHART, I SHOULD FEEL FINE, BUT NO.

Everyone's body is different. In a perfect world, i guess I shouldn't withdraw even the 3rd day without Sub's. But as w all know, the world is far from perfect and my body doesn't care what the chart thinks. LOL.

But no, you will not fell a difference if you drop the dosage. MOST doctor's do not know what taking Sub's feel like so they often prescribe WAY to many to any one person. If you don't take sub's, you will feel different (not good).


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 Post subject: Going from 16 to 8 mg
PostPosted: Fri Apr 30, 2010 10:01 pm 
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You guy were so right! Nothing at all happened, except in my mind. Here's what happened. I rean out early, tppk 8 mg for a few days instead of 16 mg. (not much else to do when you don't have 'em!!!! If anything, I felt more awake. Sometimes, on 16 mg., I get "the nod". Perhaps that is because it is too big a dose for me I'll be talking to the doc about it. I tan't say enough how helpful the comments "you're not going to crash and burn:", and the chart were. I am trully appreciative.
One sub user to another.


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PostPosted: Fri Apr 30, 2010 10:12 pm 
Ladydi, That is awesome! Glad we helped!
Thank you very much for the PM and for replying on this thread as to what your outcome was. It is like a little "prize" for us who take a moment to respond when someone actually comes back and says "thanks" or even comes back to say things didn't go as we thought they would. Either way....it's nice to hear back. And, to me anyway, it speaks to one's character and to one's progress in recovery when they are willing to check back in. By doing so, you're helping the next guy or gal who has the same question or concern that you once had.
So again.....thanks. Come back and share more about yourself when or if you are comfortable.


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 Post subject: why the higher dose??
PostPosted: Sat May 01, 2010 7:26 am 
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Since there is a ceiling effect and since it does not seem to matter what dose you take...why do doctors prescribe different mgs. for diff. people?? I still do not understand that.

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 Post subject: screwed
PostPosted: Thu Aug 09, 2012 11:43 pm 
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hey guys.. ive read most of ur posts and i get everyone.. but ive kinda screwed myself this time.. im withrawling as i write this.. this is my second day with no meds... i figured i would cut down bcuz my doc and i dnt have verry good comunication and my mom figured we could lower me on our own.. but boy were we wrong.. i started off at 4 8mg pills every day and gradualy lowered down to a pill a day but that was when everything was going good for me.. now my last visit i told my dr sumtimes i take 4mgs a day and sumtimes i can do 2, bcuz thats how my mom and i were going to lower it.. he prescribed me 15 pills with 1 refill for 2 months.. and when i was trying to cut down i couldnt.. at times i felt i needed more so i was takeing 4mgs to 6 mgs. i tryed going down to 2 but couldnt stay there bcuz i ended up sick so i ended up takeing another 2mgs - 4mgs... its been a month and a week and ive used all my meds even the refill.. and on top of that my pill cutter was shaddering my pills so i lost sum of the pill and i didnt have complete 2 mg peaces... and now i found out my dr wont be back till monday and i feel like im dead.. my back hurts, along with everything else but my back is the worst... now for the depressing and fustrating part... my mom wants me to deal with this and my grandmother thinks i should be on my meds... once i mentioned to my mom about getting more meds she flipped... but my gma says she will help me out if i need her to.. so anybody have any advise for this mess? plz reply and i hope for the best for everyone... i wish this feeling on nobody... its torture..


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PostPosted: Fri Aug 10, 2012 6:00 am 
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Hi lilemc123 & welcome to the forum, although I'm sorry for the situation that brought you here. I'm also sorry you're feeling so horribly. As you know now, you did too fast of a taper. You do have one option....and that's to go to an Emergency Room. The law says that they can prescribe up to 3 days of suboxone. The problem with that is that many ER's don't know the law and may not help you this way. But it IS the law, so maybe you can do a Google search and find that law and take a copy with you to he ER. The other idea is to go to your primary care doctor...any doctor can prescribe suboxone off-label for pain purposes. Perhaps s/he would help you out in this one circumstance by writing a script for pain for you.

As for trying to quit this way...many of us here have learned through many people's experiences that the most successful way to taper off suboxone is when you do it for yourself when YOU are ready and not when other people - even family - push you to do it. I'm glad you g'ma is willing to help you though, but perhaps when you do go back on the two of you can sit down and try to educate your mom about suboxone and how it works and why you still need to be on it. At least for long enough to taper off it properly, that is if YOU are ready to taper off it.

I hope this helps.

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PostPosted: Wed Nov 28, 2012 8:02 pm 
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Roby wrote:
Since there is a ceiling effect and since it does not seem to matter what dose you take...why do doctors prescribe different mgs. for diff. people?? I still do not understand that.


This is a very good question. To be honest, I think a lot of it comes down to sublingual absorption. Some people absorb it better under the tongue. Someone taking 8mg could be absorbing the same amount as someone taking 16mg. Therefore the second person would not feel good on 8 even though they both get the same amount in there bloodstream.

Also the ceiling effect has been debated a lot. I think people used to say 2mg, now there saying its 4mg or even 8mg. Heck i've heard other people say its 32mg.


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PostPosted: Wed Feb 06, 2013 10:55 pm 
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If you run out of meds 3+ times even in a year then maybe its time to start questioning what the problem is.. you cant nonchalantly say "I messed up a few times but it was only when I ran out".. after a few months or more in recovery, in my opinion if you're still running out early or taking too many meds then there is a problem somewhere. The doctor prescribes you a certain amount, you are supposed to take a certain dose, the same dose, daily. If you are taking more than you are supposed to for the first 2-3wks then rationing what you have left to make it the rest of the month then its clear that you are abusing your meds, which is what you do in active addiction. If you've been on sub for over a year and thats what you're doing monthly then maybe sub isnt for you, Im sure its only a matter of time before your doctor would find out anyway and then you might just get removed from the program. Theres many of us that do what we are supposed to, we need this med to stay clean, for many its saved our lives.. People that abuse it are ruining it for the rest of us. Also, the half life and the build up of sub in your body really isnt too much different for everybody.. most people dont feel withdrawals until after a couple days without meds.. heres a couple quotes from a previous post in this thread (which is the same post I have been directing this whole post to)

"IF I DON'T TAKE IT THE NEXT DAY, I FEEL WEIRD. THE DAY AFTER THAT, WITHDRAWLS. ACCORDING TO THE ALL MIGHTY CHART, I SHOULD FEEL FINE, BUT NO."

"Everyone's body is different. In a perfect world, i guess I shouldn't withdraw even the 3rd day without Sub's. But as w all know, the world is far from perfect and my body doesn't care what the chart thinks. LOL."

The reason this person is feeling withdrawals very quickly is in my opinion because they are using sub just like their DOC.. taking it whenever they feel like it, running out early, going back to using when they run out til they get a new script.. Of course you would feel withdrawals using it like that. Really the withdrawals this person is feeling are physiological.. Your mind is a very strong thing and can make you feel like its really physical.
Another thing I wanted to point out is your recovery is YOURS, no one, not even your mother should be in charge of your recovery. Family is good for support but thats it. Your mother was not the one with a drug addiction so how could she possibly know when you are ready to taper or get off sub? You should set boundries and take control of your recovery.. the only thing she is setting you up for is a relapse. I think you need to get back on sub, take a dose that you are comfortable on, if thats 8mg or 16mg then so be it. Do everything at your own pace, explain to your doctor just like you did to us, that its your mother pushing you to take less and get off and then tell him/her where youre at because of that. Be honest with your doctor and im sure you will get the help you need. Make sure you take as prescribed and dont let anyone dictate whats best for you, not even your mother.. im sure she means well but look where you're at now.. I wish everyone the best of luck and im sorry if I offended anyone with this post.. im just very opinionated and I dont like when people ruin things for others.


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PostPosted: Sat Feb 23, 2013 11:49 pm 
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Hi guys! I've been reading this forum for the whole 3 months that I've been on subutex. I feel like i already know some of you! I would love to share my story but i will save that for another time, as it is a long one! Plus this is the first time I've ever posted anything (don't know if im doin it right)?!? My question is, I've been on subutex since Dec 14. Started on 6mg a day 1st week but had major pain issues. Went up to 16mg a day shortly after that, so I've been taking that almost the whole time. It literally SAVED MY LIFE and everything in it. But recently i have been unusually tired, like need 16 hrs sleep tired. There are a couple other issues i have that could explain this but i have a feeling the sub has something to do with it. I've stopped taking the second dose so only on 8mgs for 2 weeks now. No difference at all which is good cuz i still feel sober and great but still sleeping aLOT. Im very newly sober and scared to take less, actually I've tried and can't. Any questions, comments, or answers????


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PostPosted: Sun Feb 24, 2013 12:10 am 
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Welcome to our forum! I'm glad you've decided to start posting! It would be awesome if you could tell us your story in the Introductions section.

Sleep disturbances are not uncommon for people on sub. Some folks have trouble going to sleep and some sleep too much. It's great that you were able to reduce your sub dose to 8 mg without it affecting you, but it hasn't made any difference in your sleep habits? Also, this may be a sensitive issue and I don't want to pry, but are you pregnant? I only ask that because usually doctors will only prescribe subutex (as opposed to suboxone) to pregnant women. If you are, that would definitely shed some light on the fatigue.

If the fatigue is from the subutex, it may subside as time passes and your body is more used to the sub. Or it may end up being an on-going side effect.

I'm so glad to hear that you turned your life around! That is wonderful.

Amy

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