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PostPosted: Tue Oct 26, 2010 8:18 pm 
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When you visit you doctor try to ask him about temgesic. We have them in denmark, i dont know if they are imported ( i think it is a british product) or if they have to be made on license. After reading http://en.wikipedia.org/wiki/Buprenorphine , it seems like temgesic have been fda approved. It cant hurt to ask at least:)
They come in 0.20 and 0.40 mg


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PostPosted: Wed Oct 27, 2010 3:26 am 
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Try not to get discouraged, as you've already traveled most of your tapering journey. Please let me know how the liquid taper methods works out for you as I've been seriously considering it. I'm only down to 3mg/day, but my doctor only prescribes me 8mg pills, so it's getting difficult to get my 1mg cuts of the pill.

filur, I don't believe we have temgesic here, or at least we didn't used to back when I checked. You say it's FDA approved though? That's interesting. If anyone has any info on temgesic in the USA, let me know, please. Thanks.

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PostPosted: Wed Oct 27, 2010 12:57 pm 
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Temgesic is not currently available in the United States. This is from drugs.com

[hr]

Temgesic is NOT known to be marketed in the USA. Temgesic may be available in the countries listed below.

Possible matches for Temgesic:
buprenorphine
Buprenorphine is reported as an ingredient of Temgesic in the following countries:

Australia
Austria
Belgium
Brazil
Czech Republic
Denmark
Ecuador
Finland
Germany
Hong Kong
Italy
Luxembourg
Mexico
Netherlands
New Zealand
Norway
Poland
South Africa
Sweden
Switzerland
Taiwan
Tunisia
United Kingdom


Read more: http://www.drugs.com/international/temg ... z13Zy76Lh7


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PostPosted: Wed Oct 27, 2010 1:52 pm 
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Arh thx for clearing that up Donh and Bubble- was curios about it tbh. I read the wiki and it seemed like it was approved as a anelgetica - wiki isnt always accurate though from what i hear.
The liquid method does sound like a really good alternative - i might actually had disolved my temgesic while tappering had i read about it, since it seems to be absorbed to the bloodbane faster.
The downside is prolly questioning yourself, when you reach a really low dosis - did i get enough? It dosnt seem to work? But i had that exact same feeling while taking my morning temgesic dosis - and i would first feel complete covered at evening when i had my third dose. The upside by splitting them up in 3 dayli dosis was the psykological feeling off having something to work towards to - a reward of a kind i guess.


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 Post subject: Kinda/Sorta Rapid Taper
PostPosted: Wed Oct 27, 2010 2:42 pm 
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So I guess it is now the time to acknowledge that my original 21-day rapid taper plan was a failure, or at least not a success. On the positive front, in 21 days I made it down to .5MG with pretty much complete comfort. However I definitely hit a little bit of a wall at .5mg and have been floundering my dose down and back up since with some fairly uncomfortable PAWS. I am now at day 29, I'm at .4MG and I feel OK, not great. About 80%. Fine to keep working. But pretty lousy concentration, and not comfortable (feel icky). At least my sleep is fine which counts for a lot.

I switched to the liquid taper, using a preparation that permits two, .2mg/1ml doses per day. This worked pretty well so I'll stick with it.

I am officially switching to a new plan. I am now going to schedule roughly 25% drops every 4 days and see how that goes. I'll aim to jump at .1mg or even .075mg if necessary. This would be either a 50 or 54 day taper if I'm successful.

I won't force anything. If after 4 days I am not feeling demonstrably better, I'll stay put or perhaps even raise back up 25%.

I have a clonodine prescription. I took .1mg prior to the start of my taper (induction) and found that all it did was make me want to sleep. Any views on whether it would help at this stage? I am thinking about taking half a tablet, but if it's not going to help with the concentration or icky feeling I won't bother.


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PostPosted: Wed Oct 27, 2010 3:21 pm 
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The clonidine, while it was a pretty low dose, may have made you sleepy because you were not in withdrawals at the time. Clonidine is a blood pressure medication that works by decreasing your heart rate and relaxing the blood vessels - thereby lowering your blood pressure. A slower pulse and lower blood pressure can certainly make you sluggish. In fact, this is a complaint of many patients who take medication for their high blood pressure - although many of them do get used to it and adjust. Anyhow, putting it in plain English, (non-medical) terms, when you go into withdrawals, your body gets "revved up" including an increase in your pulse rate which results in an increase in your blood pressure. If you take the clonidine when this is happening, it hopefully will return you to a more "normal" state. If you take it when not in significant withdrawal, you could certainly get tired. Make sense? The more you are feeling the withdrawal symptoms, the less likely you are to get sleepy from the clonidine. In fact, you may find that 0.1mg is not a high enough dose.

The other point I'd like to make is dropping 25% every four days is still a pretty darn aggressive taper. I don't remember at the moment your motivation for wanting or having to do this so fast but just wanted you to realize that even your scaled back taper plan is still pretty aggressive. A lot of people have done 10% every two weeks. Others do 10% every week and even that can be a bit uncomfortable. At 25% every four days your body is not likely to be used to the new dose and you'll already be reducing again.

Hope all that helps.


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PostPosted: Wed Oct 27, 2010 4:18 pm 
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I have a question about clonedine - I am already on Atenolol and Norvasc for "hi blood pressure" ( :wink: ) So, if I were to eventually taper off suboxone (no plans to do anything of the kind at this time) can I assume that given the fact that I am already taking fairly high doses of two hypertension-reduction medications that I would not be a good candidate for clonedine?

I don't mean to derail the thread here, but my guess is I am not the only person taking suboxone who also takes medication for blood pressure, so I'm guessing this is useful information int he context of this thread.


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PostPosted: Wed Oct 27, 2010 5:14 pm 
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Matt, don't give your 'failure' a second thought. Look what you have been able to accomplish in such a short time. Please remember that recovery can not be rushed. It takes time for the brain and body to adjust to the new lower levels of opiate, so I would say, especially at the low dose you're at to not rush. You are right around the dose where a lot of people find their body is pushing back on them to use more...just stabilize your dose, then move forward. Recovery is not a race, and if you treat it as such you probably won't be happy with the results. There is NO getting around the fact that it takes time to get better. Some people get better quicker, some slower. You have to find a pace that works for you.

It is great that you are excited about getting off these meds altogether, that will help you greatly, it did for me anyway. Keep up the positive attitude, even though it must be very hard at times.

As far as the pain goes, check this out...I fell out of a tree (25ft fall) and crushed both my ankles and broke my left arm. That was in 1997, my opiate use steadily escalated while my pain did not go away. Got on Sub in 2007, abused the hell out of it and still had regular pain. I quit Sub 5 months ago and my ankles don't bother me near as much as they did when I was using/abusing opiates? Go figure? Now, the pain didn't subside the day I quit, it was several weeks before I realized my ankles weren't bothering me as much as they did?? Copious amounts of pain meds = regular pain, no narcotic pain meds = big improvement. I mentioned narcotic pain med because I now only take advil. Once or twice a week, whenever I have had to spend a lot of time on my feet. The advil eliminates the pain within 1/2 hour.

This is what worked for me, it may not work for anyone else? I just wanted to let you know about it.

Keep up the good work Matt. Keep hanging on!

As far as the Clonidine goes, I take .1mg twice daily. I didn't start the clonidine until day 30 of detox(blood pressure went pretty high even though I had never previously had high blood pressure. Apparently, detox causes a blood pressure rise for a lot of people in recovery), it seemed to help calm my nervous system down and helped some with sleep. I just don't know how it would affect you while still on Sub?? No experience in that arena buddy, sorry.


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PostPosted: Wed Oct 27, 2010 6:13 pm 
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Junkie: I'm not sure I'm qualified to answer your question but I'll provide what I can. Perhaps there is a doctor on the board that could do better than I will. :)

Both of the drugs that you are on work in different ways to lower the blood pressure. The good news is, they actually work in different ways and on different mechanisms than clonidine does.

Atenalol is a classic B/P med. It is very, very common. I remember having oodles of patients that were on it. It is a beta-blocker, which essentially means it blocks the beta-receptors in the body, which slows down your heart rate. Slow down the pulse and you can often lower the blood pressure.

Norvasc is actually a calcium channel blocker. What this does is relax the blood vessels so the heart does not have to pump as hard. It is not as "heavy duty" as the Atenalol and in fact is typically used in conjunction with another drug, like atenalol, as the two of them together often do the trick. My guess is they tried Atenalol and when that didn't do enough for you the Norvasc was added - although there could be other reasons for the Norvasc as well including a cardiac history.

So the good thing is, clonidine is actually a third class of medication called an alpha-agonist. As the name implies, it deals with the alpha-receptors. So we have a beta-blocker, a calcium channel blocker and an alpha agonist. If your blood pressure was not controlled by the first two meds, it could be possable that this third med could be added. The million-dollar question is would a physician be concerned of your pressure getting too low? Well, it's not like clonidine can plummet your pressure. There are drugs that can really drop your blood pressure. For example, nitroglycerine. However, it would be rare for 0.1mg or 0.2mg of clonidine to do this. Besides, you would not take it when your blood pressure was "normal". You would take it when in withdrawals, when your pulse and pressure are likely to be elevated. My sense is that your doc would caution you, as would your pharmacist, but he/she would still allow you to give it a try. You certainly would want to alert them to the fact that you are already on the other two agents. It would not surprise me at all that you would get five different opinions about this from five different docs or pharmacists. At the end of the day, all that matters is that you don't get dizzy and pass out because your pressure gets too low. It's not going to be life threatening. At worst, you might have to lay down, elevate your feet and drink some fluids until the clonidine wore off. I would be very surprised, however, if they would not allow you to at least give it a try - based on your vitals. The other option would be to discontinue the Norvasc while you were on the clonidine. I really do think they would come up with a plan for you.

I hope that helps and again, someone else might be able to provide a better answer for you than I have. I am certainly not a physician and have never claimed to be.


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PostPosted: Wed Oct 27, 2010 6:57 pm 
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Don and Romeo - thanks for the feedback. I appreciate it. I can see that I have to slow it down. No real motivation to get to done other than when you make a decision to make a big life change, it's human nature to want that change to start ASAP. But I realize, even from my own past experience with full agonist taper, there are no silver bullets and no rushing things.

So I think I will extend to a week now at each drop and see how that goes. I will say that I am scratching my head on how the heck one is supposed to accurately measure the liquid taper when you're dropping by 10% at this low dose. I guess I can eyeball approximations. But that's all it's going to be. If I drop in .05mg increments the measurement becomes straightforward and accurate. And I don't get past a 25% drop until I am dropping from .15mg to .1mg.

On that note, how do you know when it's time to jump? I don't think it's possible to go below .05mg which would require .25mg to prepare the 10ml solution. I assumed that once you are able to drop your dose at least once and get through at least 5 days
without any additional discomfort, then it's probably time. Any thoughts?


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PostPosted: Wed Oct 27, 2010 6:58 pm 
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matt - Don't be hard on yourself about your taper, it seems to me that you've actually been pretty successful.

Regarding clonidine - I took it at the tail-end of my taper and I found that it did help with some of the physical symptoms of withdrawal and it also helped with anxiety. On the flip side, I didn't like the way it made me feel (tired, grumpy) and when it wore off I could literally feel my pulse all over my body which was freaky.

So I ended up just taking it a few times when the benefit seemed greater than the negative side effects. I remember at one point I was so achy and grumpy and anxious and irritable and I took it, took a nap, and woke up feeling like a new woman. I don't know if it was the med, the sleep, or the combination but just that one little break from feeling shitty got me through the next few days.

When I started having problems with insomnia, I got ambien from my doctor and that really helped too. I only took it a few times, but it worked great.

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PostPosted: Wed Oct 27, 2010 7:21 pm 
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Thanks DOAQ. Appreciate the kind words. yeah I'm thinking I'll give the clonidine a shot this weekend. When I don't have work to do and if I get sleepy all it means is that I can take a nap rather than shuffle my little ones to their sports games. :o


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PostPosted: Wed Oct 27, 2010 7:35 pm 
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Matt, you asked the $64,000 question, how do I know when to jump? I assume you meant quit completely? From the little bit I know you by reading your posts, I would say you are getting pretty close to being there. Just asking the question shows you are getting close. It's up to you whether you want to continue tapering and feeling minor wd symptoms for a given length of time, say another few weeks or you can jump and feel stronger wd for a shorter length of time...I guess I'm saying that either way you are going to have to pay the piper. I jumped at 2mg and would never ever do that again. Hindsight being 20/20 I would have tried taking more time tapering.

No matter what I or anyone else says, you and only you will be the best judge of when to jump. Know this, you are not alone. Others have done it and you can too.


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PostPosted: Thu Oct 28, 2010 8:14 pm 
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Clonidine helped me greatly when I detoxed off methadone, it was a "life-saver" of sorts.

For dropping below .5mg couldn't you use more water to dilute the dose more? Instead of taking less of the same solution?

I'm not sure about knowing when your ready to jump. I would think you get to the point where you feel that the does you are currently taking isn't "doing" all that much for you, and you feel like you don't really *need* it. Then you try going a day without, and if you need it after 24, then you could try dosing every other day, or if you don't get that feeling that you need to dose, you continue without it. But, again, I don't know from experience, only from what I've read from others experiences and what I suppose would be the case.

Goodluck with this final taper. You've come so, so far. And your on the last leg of your journey. Be sure to remind yourself of how far you've come and where you are headed. Remember your goals and try to get yourself pumped up about. Reward yourself for successful reductions, even if it means just a pat on the back. Every tiny drop is a step in the right direction. It's one more inch towards the bright light at the end of the tunnel. Keep your eye on that light... it's getting bigger.

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PostPosted: Sat Oct 30, 2010 11:42 am 
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Hi all. I felt pretty good yesterday so today I've moved to .3mg. Roughly anyway. Very tough to measure at this point. Big drop I know (25%). I saw my Doctor yesterday who told me that I am taking such a tiny dose that any perceived benefit is psychological. I told him I completely disagree. I know that that these low doses have a physical effect and make a big difference. So I think that explains my earlier question about why they don't make doses below 2MG. Actually to be fair to my doc, he said that use of Sub for opiate dependence is so new (relatively) that when they started all this they may very well have believed that 1MG was all you needed to taper down to before stopping. He seemed to acknowledge that there are many like me who perceive a benefit below 1MG. But he also implied that "the powers that be" haven't acknowledged that to be the case. But regardless he was very supportive and told me I should do whatever I want to do if it makes me comfortable. He's a good guy.

So we'll see how I feel in a couple of days (all's well for now). Although I do have this annoying leg pain that's brand new. It's almost like a precursor to RLS. As though my muscles might start twitching even though they're not. I'm assuming it's minor withdrawal symptoms. It seems to relieve a bit with Motrin.


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PostPosted: Sat Oct 30, 2010 12:14 pm 
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Hot baths and some kind of exercise (if you're able to do it) really helped me with the withdrawal leg-pain. Put plenty of epsom salts in the bath for extra goodness. If you have a heating pad you can use that too.

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PostPosted: Mon Nov 01, 2010 1:05 pm 
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As predicted, given my large drop from .4 to .3, I had a pretty rough day yesterday. Left leg pain is gone (interestingly) but now I am prone to sneezing fits (couple per day) and I feel very edgy. Snapped at my wife over what typically would have been merely an eye roll. Haha. Also that general icky feeling.

Today I was not feeling much better so I tried the Clonodine. You know what - helpful. The doctor gave it to me for my induction while I was awaiting my first Sub dose. I found it useless at the time (but only took .1mg). But now that I getting down to the end of my taper, I think it's a different story. I've taken .15mg and I am feeling OK. Not great, but plenty functional. I'll go for a run after work and hopefully that will due for the evening.

Thinking about jumping off at .25mg - next week if all goes as planned.


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PostPosted: Mon Nov 01, 2010 4:06 pm 
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You're doing really, really good Matt. Hang in there.

Thinking about jumping next week, as far as I can tell you are about as ready as you will ever be. You're at a pretty low dose so you should have minimized any serious withdrawal.

Let us know when you pull the trigger. You're in our thoughts and prayers man.


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 Post subject: The real test begins
PostPosted: Fri Nov 05, 2010 8:30 am 
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So I took my last dose (.15mg) yesterday at 4PM (.3mg total for the day). Today I am attempting to stop and now is where the real test begins.

To summarize - I have tapered off 5 years of pain medication in 37 days. Starting with an induction of 6mg, working down to .5 mg in 20 days. And then taking another 17 days to work from .5 to .3.

I was reluctant to even make this post because I am not 100% confident that I am ready for this. But I am going to give it a shot, partially because my Doctor suggested I should try. Partially because I am emotionally (if not 100% physically) ready to be off opiates. If it doesn't work I'll go back to .3mg and probably stay there a while.

BTW - pain is definitely worse, but not killing me....yet.

Wish me luck. I'll post my progress.


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PostPosted: Fri Nov 05, 2010 11:20 am 
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Don't be scared man. Take it a day at a time and remember the discomfort is mostly mental. This is not going to be the easiest thing you have done in your life, but you have to keep your eye on the prize.

Try to keep busy if at all possible, it helps pass the time quicker and passing time is what this is all about.

Music helped me immensely, Rock and Roll with the volume at 11! It helped me pass the time while doing something I enjoyed.

If it gets completely ridiculous, you have a good plan to go back to your low dose and that's a comfort you can keep in your back pocket if the need arises.

Stay strong and keep us updated.


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