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 Post subject: Scared
PostPosted: Tue Sep 25, 2012 12:28 am 
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Hi,

I posted this in the introduction forum but maybe that wasn't the right place....so here's a history and how scared I am of the whole process:



I had a 2 part massive/dangerous spine surgery 4 years ago for Scoliosis. Today, I take 300 mg of MS Contin, 30 mg of valium, 300 mg of Lyrica and 300 mg of Wellbutrin.

Pain Mgmt doc says we are not progressing in my reducing meds. Says the meds I'm on are actually causing pain....a rebound effect of taking pain meds. (I believe that part).

He wants me to check into a regular rehab unit for at least 20 days and go into withdrawal, then use Suboxone to detox my system. Says I'll be all better after that.

I am crooked (tilt 30 degrees to the right, and slightly bent forward) and have pain in my back, pelvis, can't stand for more than 5 mins and can't walk far. It seems strange that I won't have any pain after this very uncomfortable detox process.

Plus...I'm just a little over-proud I guess and don't want to be in a rehab hospital and have drug counsellors beating me down and telling me how much I need to work 12 steps.

I'm dependent on prescription RX because of my surgery. I can't get high and don't want to be high. The only benefit is I sleep good! The rest sucks....memory loss, lack of motivation....I just feel like i'm not myself anymore at all.

I'm researching suboxone and it seems like I'm trading one for the other. I know I will suffer at first, then the sub kicks in and I guess I feel better but what about after?

What will I feel like in a week? A month? Will I have restless leg syndrome again? No sleep again? Pain? I'm already crippled and mis-shapen, what if I DO still have pain. Will I be anxious all the time?

I'm just terrified and tired and sick of crying. Anyone who can tell me what to REALLY expect, I would love them forever, LOL. :cry:

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PostPosted: Tue Sep 25, 2012 2:12 am 
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Suboxone might help your pain. It helps many with it to some extent, others not so much.

You should not have restless leg on suboxone. It helped me a lot with anxiety (also with depression).

Also why do you need to go in to a rehab for this?

Are they planning on putting you on suboxone long term? you shoud be able to induce on sub from that 300mg mscontin. You just need to go into mild to moderate withdrawal.

Welcome to the forum

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PostPosted: Tue Sep 25, 2012 5:41 am 
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[font=Comic Sans MS]Oh Wow, I am so so sorry to read this. I was just shaking my head the whole time I read that. No wonder you are crying all of the time. I really am sorry to hear this.

I do agree with what Glenbee says. I was wondering the same thing myself. Why can't you induce on suboxone at home? You would only have to stop taking the meds for about 24 hours or so. Give or take. Then start the suboxone. Is there a reason that you PM doc wants you in an inpatient rehab? I'm kinda with you on this one, that they are going to shove 12 steps and recovery down your throat. I think that you could accomplish all of this from the comfort of your own home.

I am one of the people that Glenbee mentioned that uses suboxone for pain. It works VERY well too. My conditions are not as severe as yours though. In fact, they are not even close. But their are people with worse conditions than mine, and suboxone works for them as well. I dose 3X per day. 8mg in the morning, 8mg in the afternoon, and 4mg in the evening, for a total of 20mg daily.

I hope that you are able to look at different routes besides the in patient method. Did your doctor say that you HAD to go inpatient?

Good Luck to you, and Welcome to the forum![/font]

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PostPosted: Tue Sep 25, 2012 6:00 pm 
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Hi TeeGee and welcome to the forum. You're asking a lot of good questions and I think you're very smart to research suboxone before inducing on it. I'll try to give you some information on it so perhaps you'll understand it a bit more and maybe that will relax you. Knowledge is power, after all.

"Regular" pain meds are what's called "full agonists", whereas Suboxone is a "partial agonist", so suboxone is also an opiate, but a bit different. As the others said, you can induce with the help of a suboxone doctor either in his/her office or in your home (depending on the doctor). You only need to be in mild-to-moderate withdrawals (it's not a matter of how long you're in withdrawals, but how bad they are), before inducing onto suboxone. Don't be surprised if you feel a bit "loopy" at first when you start sub, but that will subside within the first few days (several at the most) and once tolerant to the medication you should not feel any high when taking it.

As for replacing one drug with another, it's not quite that way. Full opiate agonists come with their own set of problems. The nature of them is that there will always be tolerance building and therefore always the need for more and more in the way of dosage (or if you're in active addiction, more to get that high). And the danger of that is additional respiratory depression as well. With suboxone being a partial agonist, it reaches a certain point (the ceiling) and after that, there is no additional effect, no matter how much more medication is taken. There is no tolerance building either.

For us addicts, being on regular pain meds leads to a crazy cycle of negative, self-destructive behaviors, but on suboxone, we are in remission from that and are able to put our lives back together and work on our recovery, etc.

Lastly, you said your doctor mentioned that your pain is likely worse from taking more meds. That's called opiate-induced hyperalgesia. I experienced that as well when I was in active addiction and when I got off the pain meds and onto suboxone, eventually my pain leveled out. Now my pain is at a "regular" level and suboxone helps keep it manageable. Like Glen Bee said, it helps a lot of people with their pain, others not so much. It just depends on the person and the kind of pain they have.

I hope this helps. If you have any questions about suboxone or how it works, just ask away. Good luck and let us know how your induction goes. Again, welcome to the forum. :)

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PostPosted: Thu Sep 27, 2012 8:22 pm 
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First off dont be scared!!! Although I dont have the level of back problems you have but I have had 4 Fusions, starting a L1 and working up from there. It is thought that one or more of my proceedures were not even needed, but its water under the bridge. I was on Durgesic patches, Oxy's, morphine, the works, for 4 years then all the meds just seemed to stop to work. Adding more didnt help, and the constant ramping up and down off the meds was driving me to be mentally unbalanced. Not by choice but my workers comp insurance drops me, gives me 4 more office visits to get off everything I had been on for 4 years. Needless to say it didnt work, spoke with a workmans comp obudsman (sp?) and suggested going to a treatment center that deals in subs.

It has really been a God send, other than the out of pocket cash I have had to pay for 7 years but I have been able to function a pretty normal life. Built 2 really successful business's, just cant got out and play football and such with the kids. But for me it was worth it. Now Imgoing through detox to get off them, mentally Im ready, its time, this has gone on too long but only ave myself to blame.

Just step up and do it, think of it as a new start and use it as a motivation to acomplish some goals. Down the road when you get to a good place mentaly stat tappering off the subs and with professional help you should be able to get of them far easier than what your taking now...

Good luck!


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 Post subject: Re: Scared
PostPosted: Mon Oct 21, 2013 6:19 pm 
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Hello all, it's been awhile since I wrote that post!

I started sub therapy in January of this year. Had moderate withdrawal symptoms and went to docs office for a dose of 8mg sub. I was to take it 3X per day for a total of 24mgs. Within about an hour of taking the first dose, I went into massive withdrawal symptoms, legs twitching, sick to my stomach, the ride home was horrific. Called doc immediately and he said take another. I did, and it got mildly better. I was to take no more than one more tab that day (day one). Day two was a little better. Day three was a little better. By the time a week went by; I was pretty normal.

I was told that my speech was clear and not slurry - I sounded and reacted to conversation more quickly. All good comments from family. But I sure hate suboxone. It cost me so much money, I can't tell you - and medicare doesn't cover very much of it, I was in the 'donut hole' in April and in 'catastrophic' level of prescription medication in September according to my gap health ins.

I am now down to 4 mgs and made the cut to 3 mgs yesterday. Basically from 24 mgs to 3 and it took almost all year. Today I'm having mild muscle spasms and just feel blue I hope tomorrow is better. I want off by the end of the year but I think the end of January is closer to reality. The plan is to stay at 3mg, then go to 2mg in a month, then 1 mg, then off. Do-able?

I'm wondering what will happen when I go to 2 mgs per day....a strip every 12 hours? I hear discussion of a "ceiling" in the forum. I'm wondering what will happen to my pain? It was very bearable at 4 mgs per day and now that I'm cutting to 3 (only day 2, remember) I will be on the lookout for pain increase. Also, I have to remember that I will NEVER be pain free in my life. The doctor says sub actually DOES help my pain, but I haven't noticed it - I've never gotten "high" off sub, ever (nor wanted to) and generally dislike the stuff so would like to go off. My doctor (he's a specialist in suboxone so I trust him) say many of his patients stay at 4mg a day for life. No thank you, I'd rather have the money!!

Anyway I just wanted to check in, say I was successful so far in getting off opiates thru suboxone but would like off it altogether. That scares me now! Will I have withdrawals when I get to zero?

Thank you everyone for being so kind here and for the wonderful responses I got - those gave me the courage to try suboxone (in the comfort of my own home, thank you).

Also, re-reading all this has given me a different perspective on my feeling "blue" today (day 2 of 3 mgs). OMG so many people are in a world of hurt way more than me - I hate sounding like a baby! I'm going to get up, do the dishes then take a shower and wash my hair! (always a chore with my back probs). I have been isolating myself lately, depressed (even before the 1mg reduction) and I need to remember there's always someone who has worse problems than me.

God bless you all.

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 Post subject: Re: Scared
PostPosted: Mon Oct 21, 2013 9:36 pm 
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Hey TeeGee and welcome back!

Okay, you want off the Suboxone, I get that. But what is your plan on pain control after that? And yes, you will have withdrawals from it. If you taper down as low as possible it will most likely lessen the symptoms.

Are you also off the Valium? If so, a big YEA for you.

Here is my 2¢. Instead of going off Suboxone completely, ask your doctor to prescribe you the Butrans Patch instead. It is just Buprenorphine w/o any other junk in it. You won't feel the patch like you do the Sub. I was on it for pain and I just felt normal. My Dr. gave me the most powerful one which is the 20 micro-gram patch. I did the math and it came out to roughly 2 mg's of Bupe delivered very slowly throughout the day and night. The patch lasts a week. My hope is that it won't be as expensive, but it may in fact be more depending how much Medicare will pay. You could work your way down to the 5 mcg one.

The fact is, you will still need pain control. You don't want to go back to all those drugs you were on before, do you? Buprenorphine in micro doses works well for pain. You can also use Ultram (Tramadol) with it. I take 2 Aleve with 2 Tramadols for pain control. Currently I am on 6 mg's of Sub right now.

All I'm saying is that you need a plan before trying to get off the Sub. Or do you already have a plan? If so, disregard all my typing.

Anyway, it's good to see you back here. Now we know how your situation turned out.

r

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 Post subject: Re: Scared
PostPosted: Mon Oct 21, 2013 10:30 pm 
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rule62 wrote:
Hey TeeGee and welcome back!

Okay, you want off the Suboxone, I get that. But what is your plan on pain control after that? And yes, you will have withdrawals from it. If you taper down as low as possible it will most likely lessen the symptoms.

Are you also off the Valium? If so, a big YEA for you.

Here is my 2¢. Instead of going off Suboxone completely, ask your doctor to prescribe you the Butrans Patch instead. It is just Buprenorphine w/o any other junk in it. You won't feel the patch like you do the Sub. I was on it for pain and I just felt normal. My Dr. gave me the most powerful one which is the 20 micro-gram patch. I did the math and it came out to roughly 2 mg's of Bupe delivered very slowly throughout the day and night. The patch lasts a week. My hope is that it won't be as expensive, but it may in fact be more depending how much Medicare will pay. You could work your way down to the 5 mcg one.

The fact is, you will still need pain control. You don't want to go back to all those drugs you were on before, do you? Buprenorphine in micro doses works well for pain. You can also use Ultram (Tramadol) with it. I take 2 Aleve with 2 Tramadols for pain control. Currently I am on 6 mg's of Sub right now.

All I'm saying is that you need a plan before trying to get off the Sub. Or do you already have a plan? If so, disregard all my typing.

Anyway, it's good to see you back here. Now we know how your situation turned out.

r


Wow - The plan (which isn't really one) is to just determine my pain level, then go from there. No, I can't go back to anything narcotic, because I would end up in the same place. I am down to 10 mg of valium right now instead of 30, plus 300mg Lyrica provides great pain control but I take it at night because it makes me sleepy if I take it in the day. I'm also taking 2mg of clonazepam, a muscle relaxer called tizanidine and 800 mg prescription ibuprofen works well during the day.

I had thought the Lyrica, muscle relaxer, and ibuprofen would work for pain control but I will ask the doc about that patch. The clonazepam and valium (especially valium) can go - I think the clonazepam will help with the end of suboxone. My daughter is terrified I'll end up with Altzheimers if I continue with valium, so I want to ease her stress, but it's also a nasty withdrawal process in and of itself.

I don't know - I can live with 4mg of suboxone physically I believe. This next week will show if I can deal with 3. I will give it a week and if the pain and depression continue I will go back to 4 and discuss with doctor next visit. He's a fan of me staying on 4mg pretty much forever. I'm writing down this patch name so I can discuss it with him too.

Thanks so much for the response - I know narcotics will never work for me UNLESS I have a second surgery which may or may not be a possibility. I would explore that next year and would only use the premier surgeon in the country for spine surgery (Dr. Lenke) and he's only 4 hrs from me in St. Louis. I would love to have a straight body again! If that happened I would need meds after surgery but I would discuss my problems with him in advance - plus if the surgery works I wouldn't need them!

I'm only 56 so I could have a lot of years left with a straight spine if he can help me. Otherwise? I'm just going to have to live like this and eventually be in a wheelchair I think. That makes me want to throw up. 12 years ago I was attractive, dating, working and had a mildly sore back. Now I'm a mess - its been hard. I get jealous of people who have straight bodies......funny, huh? People take it for granted (I did) and used to be so proud of my posture and confidence. I guess God or providence gave me a whack in the pride arena. So all of you who can stand up straight be grateful :)

Thank you again for the advice about that patch. I have an appt. with doc in about 3 weeks so will talk it over with him. You all have been so helpful - I'm grateful :D

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 Post subject: Re: Scared
PostPosted: Tue Oct 29, 2013 10:19 pm 
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How have you been doing this past week? Were you able to stay at 3 mg? If not, maybe try to go down by .5 mg to 3.5 instead and see how that works?

I'm sure it must be very hard to live with a disability, especially if it causes constant pain.

You've done a great job this past year using suboxone to help with your opiate dependence. Do you think you are addicted to opiates, or just dependent. To me you sound like you aren't addicted and that should make tapering off sub somewhat easier. At least, for example, you won't have to deal with drug cravings when you taper off!

How does your doctor have you dosing? The best way to take advantage of suboxone's analgesic properties is to take a dose every 6 hours. Are you doing that? Also, I know that sub is expensive, but they did just start making generic suboxone. It's not going to be cheap right away, but the price is trending down. I don't know why your doctor doesn't prescribe the generic subutex to you anyway. The only difference is that suboxone has naloxone in it to allegedly prevent people from shooting it up. But a lot of doctors only prescribe suboxone except for pregnant women.

I hope you're feeling better this week!

Amy

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 Post subject: Re: Scared
PostPosted: Sun Nov 17, 2013 6:32 am 
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Thank you Amy! Here's the latest:

First, thank you for all the positive support - I have learned so much through this forum. Once committed, I was successful at 3 mg per day for the past month. I have experienced facial sweating, increased pain in the beginning and some depression/isolation. I take the 2mg strips, cut them in half and take the "half's" 3 X per day; or the equivalent of 3 mg. per day (1 about 8 am; 1 about 3pm; 1 about 11 pm).

Ok - now I want to go to 2mg per day. Dr. said he admired me for my dedication to get off the suboxone (he thinks I should take it for life for pain control, but I just don't agree). I am to cut the 2 mg. strips in half again and take each half 12 hours apart.

This is a reduction of 1/3 of what I have been taking; the largest reduction to date. I haven't done it yet but plan on sometime this week.

I am wondering if it is too soon to do another reduction. I am also wondering how bad the withdrawal symptoms will be with a 1/3 reduction. The dr. prescribed Clonodine for withdrawal symptoms - I have started taking it now with the intent of beginning the reduction in a day or two.

Also, I really, really, REALLY HATE the facial sweating!!! It is embarrassing and happens at all the wrong times!

Any thoughts from those who have been there/done that are so appreciated!

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 Post subject: Re: Scared
PostPosted: Tue Jun 17, 2014 6:17 am 
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So....it's been a year and a half. I'm now down to .50 of the strips per day; .25 in the am and .25 in the pm. It is SO hard to cut those strips in EXACTLY the same shape!

Anyway, I'm cutting them to slightly smaller .25 doess (1 strip = (8) .25 "doses" (or "quarters" I call them).

I have been on the medicine 18 months. My plan is to go CT on July 1 at approximately .25 to .35 per day but here is the problem (in my mind): because the doctor has been prescribing clonodine for all this time (withdrawal symptoms for every reduction I've had per month) I believe I'm getting used to the clonodine and it's not working.

Facial sweating is terrible. Even with a dose of clonodine. When I go CT he is going to give me Xtra valium (yes, I will go off that next and I DO know it's a bitch) and sleep medication. I also take a muscle relaxer and clonazepan and Lyrica.

You would think I have enough medication to drop a bear in it's tracks but I used to be on 400 mg of morphine a day - I am "tolerant" to the point of ridiculous because of my scoliosis and all the surgery and meds I've been prescribed over the years. I do have a real medically deformed spine that causes pain and it's highly likely I need another surgery - my right leg is getting completely useless at times, but that is a whole other story (I just want off the suboxone).....

So - going CT on July 1. I will post and I hope to God the meds work because I feel I've grown tolerant. I know dr won't prescribed any higher doses of anything I'm on (well, I am going to ask for a decent sleep aid for one month).

I've been told I can expect to feel shitty for a few weeks; then just generally miserable or just not feeling good for 30 to 60 days.

I don't know what to believe. Everything the dr. told me was a lie when I started this medication (it was effing hell for over two weeks) so I don't believe him when I quit.

Any thoughts or comments? Am I being realistic? I'm on .5 now per day and July 1 is only two weeks away. Thank you all.

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 Post subject: Re: Scared
PostPosted: Tue Jun 17, 2014 6:24 am 
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Amy-Work In Progress wrote:
How have you been doing this past week? Were you able to stay at 3 mg? If not, maybe try to go down by .5 mg to 3.5 instead and see how that works?

I'm sure it must be very hard to live with a disability, especially if it causes constant pain.

You've done a great job this past year using suboxone to help with your opiate dependence. Do you think you are addicted to opiates, or just dependent. To me you sound like you aren't addicted and that should make tapering off sub somewhat easier. At least, for example, you won't have to deal with drug cravings when you taper off!

How does your doctor have you dosing? The best way to take advantage of suboxone's analgesic properties is to take a dose every 6 hours. Are you doing that? Also, I know that sub is expensive, but they did just start making generic suboxone. It's not going to be cheap right away, but the price is trending down. I don't know why your doctor doesn't prescribe the generic subutex to you anyway. The only difference is that suboxone has naloxone in it to allegedly prevent people from shooting it up. But a lot of doctors only prescribe suboxone except for pregnant women.

I hope you're feeling better this week!

Amy

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Thanks Amy, as you can see by my post a few minutes ago, I am taking 2 doses 12 hrs apart, but want to make the jump in 2 weeks - I just want to get to 0.25 or 0.35 by then so I'm cutting smaller strips.

I have no clue why he prescribes suboxone other than he has a huge practice and I'm about a 3 minute visit "how are you" "I'm down to XX amount" "Great -you're doing great" "Thank you, I have these concerns" "OK, here are your scripts". That's how the conversation ususally goes.

Regardless, I'm done. I'm just looking for someone who's been on the meds for 18 months to tell me what to expect when going CT from a .35 to a .25 dose..... I don't think my withdrawals meds are really working as well anymore - I'm as tolerant to medicine as a bath sponge, lol!!

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 Post subject: Re: Scared
PostPosted: Tue Jun 17, 2014 10:11 am 
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I've got a great addiction doctor, but it turns out she's utterly clueless about what it's like coming off long term Suboxone use, her other Suboxone patients were relatively short-term opiate users. So I'm having to figure out stuff for myself.

I just went down to .25 mg/day today, and I hope to be on my final dose level -- .125 mg/day -- by the end of this coming weekend.

Reading about the experience of people who went CT even from higher dose levels, 2 mg or higher, I don't think there will necessarily be a month or two of consistently feeling crappy ahead. I'm just trying to pay attention to today, and to not worry about how things might go tomorrow. I'm definitely feeling fear on and off, but I also get periods of happiness and serenity during the day, and I've got no reason to think that all this happiness and serenity will disappear with my last Suboxone dose.

Like me, you're doing something you've decided you need to go, try not to lose sight of the fact that you're moving forward in a big way.

-- JI

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 Post subject: Re: Scared
PostPosted: Sun Jul 27, 2014 8:33 am 
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johnny_ikon wrote:
I've got a great addiction doctor, but it turns out she's utterly clueless about what it's like coming off long term Suboxone use, her other Suboxone patients were relatively short-term opiate users. So I'm having to figure out stuff for myself.

I just went down to .25 mg/day today, and I hope to be on my final dose level -- .125 mg/day -- by the end of this coming weekend.

Reading about the experience of people who went CT even from higher dose levels, 2 mg or higher, I don't think there will necessarily be a month or two of consistently feeling crappy ahead. I'm just trying to pay attention to today, and to not worry about how things might go tomorrow. I'm definitely feeling fear on and off, but I also get periods of happiness and serenity during the day, and I've got no reason to think that all this happiness and serenity will disappear with my last Suboxone dose.

Like me, you're doing something you've decided you need to go, try not to lose sight of the fact that you're moving forward in a big way.

-- JI


Thanks you're very kind. I started 2 threads about my jump off suboxone so I apologise for that. The other one is "Truth Please....." or something like that. There I describe my 5 day stay in the hospital for this "easy" CT jump off suboxone. Yeah, right.

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Last edited by TeeGee on Sun Jul 27, 2014 8:57 am, edited 1 time in total.

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 Post subject: Re: Scared
PostPosted: Sun Jul 27, 2014 8:35 am 
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Amy-Work In Progress wrote:
How have you been doing this past week? Were you able to stay at 3 mg? If not, maybe try to go down by .5 mg to 3.5 instead and see how that works?

I'm sure it must be very hard to live with a disability, especially if it causes constant pain.

You've done a great job this past year using suboxone to help with your opiate dependence. Do you think you are addicted to opiates, or just dependent. To me you sound like you aren't addicted and that should make tapering off sub somewhat easier. At least, for example, you won't have to deal with drug cravings when you taper off!

How does your doctor have you dosing? The best way to take advantage of suboxone's analgesic properties is to take a dose every 6 hours. Are you doing that? Also, I know that sub is expensive, but they did just start making generic suboxone. It's not going to be cheap right away, but the price is trending down. I don't know why your doctor doesn't prescribe the generic subutex to you anyway. The only difference is that suboxone has naloxone in it to allegedly prevent people from shooting it up. But a lot of doctors only prescribe suboxone except for pregnant women.

I hope you're feeling better this week!

Amy

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Thanks Amy - I ADORE your avatar!!! Where did you find something like that?

I mistakenly started 2 threads about my jump off suboxone. The other one is entitled "stopping suboxone" or something like that. There I describe my 5 day hospital stay and the hell I've been through and still going through. Perhaps you could take a look at that thread and comment?

Again, thank you for your kind post.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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