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 Post subject: satisfying my craving
PostPosted: Sat Jan 08, 2011 6:18 am 
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ok been on suboxone for 1 month, and am liking me being fine and not withdrawling or spending money on oxycontin. i was on 150-250 milligrams of oxy daily for about 3 years. my doc is telling me to take 8 mg 2 times a day no matte what.
I have not had withdrrawals taking only 8 milligrams,but i was told to take a 8mg pill when i have mental cravings as well.
so i take one 8mg pill in the morning and feel good physically and mentally pretty much all day untill about 8 at night when i start having this mental craving to be high, or get high... suboxone doesnt get me high like oxy did but it does give me the feeling of relief, mentally and a calm well feeling, so i guess my question is, would taking another suboxone at night, even though i am not in physical withdrawal, be wrong to do? i feel like it is taking too much and im just taking it too make me feel better mentally,but i dont need it physically.. i dont no what to do, and if taking another suboxone a day is taking away my mental craving, or just me wanting more like i wanted with the bad pills. i dont no what to do, i feel guilty for taking 2 a day but thats what it takes for me to be completely free of the mental craving and other mental pill issues that i have but i dont want to abuse this med,even though my doc has told me to take this much, I just feel like its me just wanting more and more.
please help me out and give me some advice
thanks


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PostPosted: Sat Jan 08, 2011 10:14 am 
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Hello shane and welcome. Keep in mind you've only been on sub for a month. For now maybe you do need that second sub to address your cravings. You can always get stable on a lower dose later on. But you're right in that it might not be doing anything other than to help you mentally. This is why it's usually best to dose once a day and forget about it. Then you don't even have the option to take it just because you feel bad. You are the only one (with the help of your doctor) that can decide what you need. What you could do is continue to take that second 8 mg later in the day, but set a specific time to take it. That way you don't take it when you feel crappy, but at the same time everyday regardless of how you feel. Once you get comfortable at that, you can either then go to taking the full 16 mg all at once in the morning or drop to 8 mg.

I don't know if this is making sense - I feel like I'm not expressing myself well right now, so forgive me if I'm not crystal clear in expressing my thoughts. I guess my points are these: Give yourself time to stabilize and you've got options regarding how much and when to dose.

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PostPosted: Sat Jan 08, 2011 1:46 pm 
What hatmaker said is spot on, but I will just add that you in no way should feel that you are doing something wrong by taking that second 8mg tablet at night. If you feel that its helping you by all means take it but if you feel that you don't need it then just because your doctor is telling you to take it doesnt mean you have to. Doctors arent on it themselves so all they have to go by is what the info from reckitt and benckiser tells them and in they tell them that 16mgs is the target dose to address cravings so thats what they give to there patients.


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PostPosted: Sat Jan 08, 2011 11:25 pm 
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ya thanks for the advice. i think ill just take a second pill a day to start with and then maybe after awhile i can go down to 8 a day. im just nervous about getting in the habit of taking more and more. you guys have been a big help,siriously
thanks alot!!


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PostPosted: Sun Jan 09, 2011 4:29 pm 
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I think I have to disagree in this case. If you are doing fine on 8mg, and you are only having a temporary craving, I do not think it's a good idea to take extra Suboxone. I'm pretty sure that many Sub Docs would agree. For one thing, you may find that you have more side effects on 16mg than you do on 8mg. I have seen reports from many that claim this is the case. They report being more tired, increased bowel problems, etc., on higher doses. Then there is the cost. I have no idea your situation but without insurance it will cost you over $200 extra a month to be on 16mg versus 8mg. You seem to understand that it's just a temporary craving you are suffering. Dr. Junig has written that he works with his patients to push through those cravings and if they do, they will find that the cravings only last 15-30 minutes and after a week or two of working through them, they will subside and not return.

I think sometimes people suggest things based on their own situations or thoughts. After all, if others are doing it, well then it's okay for them to do it as well. This often happens with rationalizing taking extra Sub throughout the day "as needed", or taking benzos long-term to treat their "anxiety" - versus using a much safer and more prudent SSRI medication. Suboxone should not be an as needed drug - other than during induction. Once you find a dose that works for you, it is not a good idea to take your doses "as needed". It should be taken ONCE every 24-hours and that's it (unless it's taken for pain or you are on a low dose taper). Now, in your situation, you are only on Sub for about a month so you may not yet be stable - although you very well could be. If you were on for a couple of months I would emphatically suggest you stick with 8mg and not wavier, as it seems to be working for you. I can't tell you if you are stable at 8 mg or not. Only you and more so your doctor can do that. However, if you think and feel that you are stable at 8 mg, I would suggest you stick with that dose. Try pushing past your 8 PM cravings and see if they don't disappear for you. That would be my suggestion. I hope it helps. Please continue to let us know how you are doing.


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PostPosted: Sun Jan 09, 2011 7:30 pm 
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Your doc said to take 8mg 2X per day no matter what. So why not follow his/her orders especailly if you're having cravings? You're still pretty new to Sub. You can work on reducing your dose as you become more stable.
Good luck,
Lilly


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PostPosted: Sun Jan 09, 2011 8:29 pm 
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Maybe instead of taking the whole 8mg at night, break it in half and take 4mg. I would much rather see you 'protected' from those craving feelings than not to be, especially seeing as you're still kind of new to suboxone.


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PostPosted: Sun Jan 09, 2011 8:54 pm 
Whats up Shane!! Here is my opinion and its based on my first hand experience. When i started out, i was prescribed 24mg's. Pretty high up their, in my opinion. Anyways, i would say for the wrong reasons i took the whole 24mg's because my mind was not capable of making very good decisions. Now, im not saying that taking 24mg's is a bad decision, but if i had it to do all over again i would have stayed much lower. I ended up dropping down to 16 over time due to unwanted side effects. Im now in my 20th month and im down to 10mg's also due to more unwanted side effects. However, my advice would be to stay as low as you can and if you think you can fight those cravings without taking more, then i believe you should. Im not gonna say it was bad or even hard but, when i dropped from 16mg's to 10mg's in 2mg increments, it was not very pleasant. It was not horrible, but it just made me wish i had never stayed at that higher dose. This is only "my" experience so take it for what it is worth to you. I dont fully disagree with hatmaker and the others who said opposite of what im saying. I definitely get where they are coming from also. When a person is just starting out treatment, they should take whatever dose they need to curve the cravings and become stable. I just know personally, i would not have taken that higher dose if i had it to do all over again. I did it for stupid reasons and i really didnt necessarily need as much as i took in the beginning but the addict in me told me i did. Im sure you get what im saying. Now that my mind has cleared and im deep into recovery, i see things completely opposite of how i saw them in the beginning. Hope this helps!!


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PostPosted: Sun Jan 09, 2011 9:40 pm 
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IMO you are fine. You've only been on it a month, don't give yourself a hard time. You have lots of time to adjust the dose, decide your dosing schedule, etc. I think part of the beauty of this medicine is that you DON'T have to take it at a set time every day. I take one dose a day, sometimes in the morning, sometimes at night, or after lunch - OR sometimes I forget to take it at all! That is the miracle: we are not slaves to Suboxone for our feelings. I encourage you to also partake in some form of recovery, be it meetings, a therapist, or just a weekly group. Suboxone will not fix everything, you have to take some action to better yourself as well. Working through feelings is possible, it's just that sometimes we don't feel like it. A psychological craving is a feeling that will pass. Like Donh said, once a day dosing is better because you can take it and forget about it. When a feeling comes up you can deal with it directly.

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 Post subject: Dr.'s Orders
PostPosted: Mon Jan 10, 2011 12:19 am 
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I agree that your doctor has prescribed two per day for now so go along with that if it makes you feel better mentally. Then on your next appt. discuss it with him.

With me, I tend to end up with some left over at the end of the month because even at 12 mgs I feel it's still too much. He started me out on 24 which I think is really high unless you're on heroin or a lot of Oxy's.

But with my addictive brain, having an extra one satisfied my addictive habit of taking something when I got home from work. Normally, Sub is supposed to be taken once a day preferably in the morning. But a lot of doctors have no problem splitting the dose up so it's more of an even feeling and not a large peak.

Now I take my 8mg film in the morning and the other 4mgs when I get home. Is it prolonging my recovery? Yes, I believe it is, but Sub makes me terribly sleepy and taking all 12mgs at once and trying to work is hard. I still get really sleepy on 8 so I am looking forward to getting down low enough that I feel normal and not so tired.

Only you will know later on if taking the extra one is addictive behavior or not. I do agree that it sure helps with the cravings. I just want off eventually and I'm not in any hurry.

Good luck and welcome aboard.

Tom


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PostPosted: Mon Jan 10, 2011 8:05 pm 
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Looks like you got some pretty good advice here so I will just address what I feel is most important and then share a little of my experience. The most important part of your treatment right now is to find a dose that not only keeps you comfortable but suppresses the cravings. You are still very early in your treatment. I was started on 12mg daily in August of 2009 and didn't make my first drop in dosage until August of 2010 when I went down to 8mg daily. As of my December 2010 appointment I am trying 6mg daily. So far so good, I had some minor discomfort but nothing worth typing. I also had the problem of the Suboxone making me extremely tired and was one of my main reasons for cutting down. It sounds to me that taking the 4mg at night might be your best option right now until you determine if you really need it or if its just the "addict" in you wanting it. One thing I must share with you that my doctor stressed to me is that you will get minor flashes of withdrawal ie; watery eyes , runny nose, aches, sweats, yawning, etc. but they are not the real thing and they will pass almost immediately. The trick is finding something to distract your mind, read a book, go for a walk, eat, anything to take your mind off it. THIS WORKS! Well thats it for now, dont want to overwhelm you. GOOD LUCK AND KEEP US POSTED!

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PostPosted: Mon Jan 10, 2011 8:40 pm 
donh wrote:
I think sometimes people suggest things based on their own situations or thoughts. After all, if others are doing it, well then it's okay for them to do it as well. This often happens with rationalizing taking extra Sub throughout the day "as needed", or taking benzos long-term to treat their "anxiety" - versus using a much safer and more prudent SSRI medication. .
I love how you put anxiety in quotes like people with an anxiety disorder are just making it up. Ive had social anxiety, agoraphobia, and just general anxiety and panic attacks before I ever became an addict and its what caused me to love opiates so much and become addicted. If you had an anxiety disorder which it sounds like you dont you would know that SSRI's are complete bullshit as a treatment for anxiety and are only used by doctors who are to afraid to Rx a benzo when it is actualy needed. And calling SSRI's "safe" is off base to, they can cause people to become suicidal, they have a very uncomfortable withdrawal period despite doctors telling you they are "non addictive" and cause no withdrawal. So I guess my sub doctor is putting his liscense at risk to treat my anxiety by Rx'ing lorazepam just for the hell of it huh? Ive been on plenty of ssri's for anxiety and they all end up the same doing absolutely shit and having to take a benzo on top of them. Sorry but acting as if people are faking having panic attacks and anxiety and shouldnt be treated with a benzo if its neccessary is BS. And also WTF is wrong with me suggesting that he should take that second tablet a day if he needs it? His doctor said he should take 2 a day and if he needs it there is nothing wrong with it, but I guess you know more than the doctor. Id be willing to bet you took 16mgs a day or probably more and hell maybe you still do and you are telling someone else they are wrong if they feel the need to take that much.


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PostPosted: Tue Jan 11, 2011 3:27 am 
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Good Lord. This is not about you Suboxowned. I'm sorry that you are taking this so personally, as that was not the point of my comments. I'm actually not even sure where to start. I guess the easiest might be with the quotes around the word anxiety. Why did I do that? Do you want the honest answer? LOL, I can't for the life of me remember. No good reason actually. I don't want to say it was a mistake but I as I re-read it over and over again, I can't think of any good reason and really can only say it was a mistake. I didn't mean to imply that people with anxiety really don't have it. That was not at all my point. So I have to apologize on this one and honestly I don't know how or why I put the quotes there.

Unfortunately, that's not going to change most of the rest of what I wrote. While I most certainly understand that people suffer from the very things that you do, I don't at all think that benzos are either a good or a safe way to treat this. No, I am not a doctor, but I tell you what, I have heard a lot of doctors that say the exact same thing. In fact, Dr. Junig is one of them. Take a look at some of what he has written and you will find that he does not at all think benzos long term are a good treatment for anxiety. There are many other docs that agree with him.

It sounds like, unfortunately, SSRIs have not helped you. That is unfortunate. I again, don't doubt what you are saying. However, just because you have not found one that works for you does not mean that is the case for others. In fact, for many people, they are helped by these medications. Others do meditation with great success. Some have to keep trying different "brands" or "flavors" (and I really did mean to use quotes there) of SSRIs and sometimes combinations until they find something that works. Some have had great success with Welbutrin. Others have had success with Zoloft.

Then the item about SSRIs being safe. They most certainly are very safe. Now, that stated, any drug does have side effects, etc. The thing is, when compared to just about any other treatment for depression or anxiety, SSRIs are about as safe as it gets. Yes, a very small percentage of people have reactions like suicide ideation, but they are the great minority. As for withdrawal symptoms, that is also not common with SSRIs. Although, perhaps, are you thinking of SSNRIs? These are meds like Cymbalta, Effexor, and Pristiq which tend to give people a harder time when they stop them so perhaps you are confusing the two. I have heard that Cymbalta (an SSNRI) is hard to stop. I have never heard that something like Prozac, Celexa or Lexopro (SSRI) is hard to stop.

Either way, hands down, there is no comparison with SSRIs and their level of withdrawal and their level of danger and that of Benzos. Ask anyone who has stopped both of these medications and I'm certain they will tell you that SSRIs are much, much easier to come off of than are benzos. That again is just fact. Benzos are rarely a good idea long-term and rarely a good idea to treat anxiety. You may not like to hear that, but it is a very widely held belief - again including by the doc that happens to own this little piece of the Internet that we post on. You are right, many doctors are afriad to prescribe benzos - and with very good reason - that goes double when opiates are also involved in the mix. I don't say this to hurt you, make you feel bad, or anything of the sort. In fact, it's not about you. It's just what I believe to be the truth and is what many healthcare professionals believe to be the truth.

Then, finally (I think) taking extra Suboxone "as needed" is again just simply not a good idea nor is it supported by the majority of Sub docs - again, including Dr. J. Once the patient is stable, they need to break the habit of reaching for a pill in response to how they feel. That is what addiction is all about. Taking extra Suboxone "as needed" is just simply not a good idea, nor is it suggested by most of the experts.

Again, this was not about you Suboxowened nor was it about me. Whether or not I took 16mg or more really doesn't have much to do with anything. If you are interested, I actually was started on 16mg and not knowing any better, just took it as instructed by the original doctor. Through learning from my new Sub doc, as well as reading boatloads and talking with many other Sub patients, I have come to learn that many, perhaps most, people don't need 16mg. In hindsight, I clearly did not as I actually feel better or at "worst" the same on 8mg as I did on 16. Again, it's not about me. There are all sorts of things that I used to do that I would never suggest anyone else do and hope I never go back to doing. I'm not interested in defending what I did in the past by trying to perpetuate it or suggest it to others. I'd rather they learn from my mistakes, not make the same mistakes I did just so I am not alone in having made them. For me, 16mg was a mistake. Now, it didn't really hurt anything. Didn't set me back - other than financially. So really not a lot of harm was done by my doc starting me on 16mg. I just have come to figure out that I would have done just as well if not better on 12 or 8mg - and I would have saved some money too!

Hope that clears it up. I was only trying to respond to and help Shane. Sorry again for the "anxiety". I still can't figure out why I did that. Must have been a side effect of having been on too much Suboxone. LOL. KIDDING!!! I don't doubt for one minute that an anxiety disorder is every bit as real and can suck just as much as my opiate addiction does. Unfortunately, taking Benzos for anxiety is not nearly as good of an idea as taking Suboxone for opiate addiction.


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PostPosted: Tue Jan 11, 2011 8:19 am 
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I've gone through quite a few SSRI's and SSNRI's over the years and have never had any problems going off them. In fact I've never had many problems with them at all. But I was on xanax for several years and had to go off that with the help of phenobarbital in order to keep me from having seizures. Being on a benzo, for me, actually made what anxiety I did have worse. After stopping the xanax and opiates and going on suboxone, it became clear to me that I had nothing more then everyday, normal anxiety, rather than any kind of anxiety disorder. Now that doesn't mean other people don't have anxiety disorders - obviously some do. I'm just saying I didn't, and probably should have never been put on a benzo in the first place. This is only MY experience and is not intended toward anyone else. I just wanted to share my experience with benzos and anxiety.

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PostPosted: Tue Jan 11, 2011 8:58 am 
Oh man i am gonna have to go with suboxowned on the fact that you do get withdrawal from SSRI's. I have taken everyone in the book and the one that gave me the most problems was celexa. I took it for 2 years every single day and it made me feel like a damn zombie. I was completely emotionally numb and just blah. I stopped taking them and for 2 weeks straight my brain felt like it was pulsating. It was the worst headache i've ever had in my life for 2 weeks straight maybe more. It was freakin horrible. I felt dizzy, i couldnt hardly walk from how dizzy i felt and the headache was so bad i almost went to the hospital. Although i didnt go, i still suffered major hell from the withdrawal from celexa. Those type medications, "for me" are complete shit. I have taken effexor, zoloft, celex, etc. etc. etc. etc. etc. because they wanted to try everything they could before putting me on a benzo. The only thing that ever honestly worked was klonopin. I know their will be withdrawal from that if i stopped but that is not my point of this post. My point is, SSRI's most definitely cause complete hell if you stop them, for me anyways.


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PostPosted: Tue Jan 11, 2011 9:04 am 
And the nausea was unimaginable!! Im not looking for argument or debate. Just simply giving my experience.


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PostPosted: Tue Jan 11, 2011 10:12 am 
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Antidepressants should be tapered. Not a slow arduous taper like with Sub, but a reduction over about 3 weeks or so. When I tapered off of Celexa I took half a tab of the lowest dose every other day for the last week - never had any adverse effects at all doing it this way. I think SNRI's can be a little more difficult to get off than SSRI's.
I agree with what others have said, SSRI's are a safer treatment for anxiety than benzo's for those who don't have adverse effects from them. Sometimes you have to try a few different ones because there's no definative way of matching the right SSRI with the right patient. There's often a lot of trial and error.


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PostPosted: Tue Jan 11, 2011 10:15 am 
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I don't dispute the idea of tapering off antidepressants. But for me, I've never tapered off any of those that I'd been on and never experienced any withdrawals symptoms. I guess it really does depend on the person.

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