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PostPosted: Thu Dec 08, 2011 2:57 pm 
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Hi, I am new to the forum and having trouble finding a "reliable" answer. (I hope my identity is protected..) I've been doing opiates for many years and heavy brown use in the last 1.5 years. I would use subs every now and then when I wanted to switch, but did not commit seriously until recently. After so many relapses and a crucial turning point from college to the real world in the near future, I can assure relapse is not my route - I am sick of the tired, cloudy feeling during use of drugs. I've been on an 8mg strip once a day (except I cut it in half - 1 in morning, 1 in evening - or sometimes quarters 4 times a day). It has been a month on suboxone. Here is the question:

Should I stop subs now? As time continues, will I become more dependent on the subs and it will be harder to quit? If I decide to taper over a weeks' time, what will happen afterwards? Will I be back to "normal"? Or will I have withdrawal?

(I don't have a doctor) Also, I am a lightweight female.

Thanks


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PostPosted: Thu Dec 08, 2011 5:29 pm 
invisiblemovement wrote:
Hi, I am new to the forum and having trouble finding a "reliable" answer. (I hope my identity is protected..) I've been doing opiates for many years and heavy brown use in the last 1.5 years. I would use subs every now and then when I wanted to switch, but did not commit seriously until recently. After so many relapses and a crucial turning point from college to the real world in the near future, I can assure relapse is not my route - I am sick of the tired, cloudy feeling during use of drugs. I've been on an 8mg strip once a day (except I cut it in half - 1 in morning, 1 in evening - or sometimes quarters 4 times a day). It has been a month on suboxone. Here is the question:

Should I stop subs now? As time continues, will I become more dependent on the subs and it will be harder to quit? If I decide to taper over a weeks' time, what will happen afterwards? Will I be back to "normal"? Or will I have withdrawal?

(I don't have a doctor) Also, I am a lightweight female.

Thanks


Taking 8 mg of Sub every day for a month, yes you will definitely have w/d..and yes, the longer you are on it, the worse the w/d will be.

Remember that you are not just w/ding from Subs. If you took Sub to stop using heroin, you never detoxed from the initial heroin, and you have been continuously using opiates since you started using heroin daily (from what I understand).

Tapering from 8 mg to no Sub in a week would be very difficult and painful, I imagine. It isn't something I would do.

This is a good reason why people shouldn't illegally use Sub. I am sorry that you didn't realize you were addicted to the Sub.


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PostPosted: Thu Dec 08, 2011 5:40 pm 
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Hey Invisible, Welcome to the forum, and yes, as long as you don't post any pertinent info about yourself, your identity is protected.

The best advice I can give you would be to find a good Doctor to help you with this. Sub is a powerful drug and you need to be inducted to it properly. If done right you should feel "normal" with no hi. From my first day on this stuff it was like I'd never been on drugs. There's no doubt in my mind that this drug saved my life. It gives you time to get your life straight and work on the issues that got you into this situation in the first place. Based on your post, I don't think you're there yet, I don't mean to sound mean or condescending in any way, but I'd rather you here it straight from someone who's been there, there's no easy fix to addiction, your most likely only setting yourself up for another relapse.

Sub is what's called a partial agonist opiate, simply put it has a ceiling effect that stops you from getting loaded like a full agonist opiate does. If you stay with it, as time continues you will become dependent on the Sub, but it will give time to get a handle on things. Withdrawal from Sub isn't as bad as with other opiates, but it can be drawn out much longer if jumping at a high rate. The best way is with a slow taper over several months. It worked for me, I was able to jump at .25mg with very mild withdrawal symptoms.

Based on your previous use, plus the sub you're using now, even if you taper for a week, your probably going to be in for some serious withdrawals. Whatever path you choose there are people here who will support you, myself included. Remember recovery from addiction is a journey, not a race. I wish you the best

Blessings,
Mike


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PostPosted: Thu Dec 08, 2011 5:42 pm 
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There's no evidence that the longer one is on suboxone the harder it is to come off of it. And once DEPENDENT on suboxone (rarely are we ADDICTED to it), it's not harder to do a long taper for someone who's been on it for a year than for someone who has been on it for 5 years. Now obviously if someone has only been on it for a few weeks, then the taper can be shorter, so in that sense, it could be said that it's "easier" to come off suboxone. But once someone is one it for maintenance, the longer they are on it, there is no evidence that it's any harder to come off of it. I just needed to make that clear.

Now, depending on how long you've been taking suboxone, you will definitely need more than a week to taper off your DOC. See, you're using sub to taper off the H. It sounds like you're trying to use sub as a short term detox tool, is that correct? Maybe you can be more specific. When did you start taking sub and for how long?

You said you've been using for 1.5 years. Why not think about saying on suboxone for a little while to get your life and head together. Spend some time not chasing the high with suboxone on board so you don't have to struggle with cravings. You can use that time to get ready to live suboxone free, should that be your goal (and it sounds like it is). But give yourself time to prepare for it. We have a lot of bad, self-destructive habits to change and that takes time.

Good luck and I hope this helps.

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PostPosted: Fri Dec 09, 2011 2:02 am 
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Ironic wrote:
Remember that you are not just w/ding from Subs. If you took Sub to stop using heroin, you never detoxed from the initial heroin, and you have been continuously using opiates since you started using heroin daily (from what I understand).


I never understood this. I know Dr. J says it often, but it doesn't match my experiences at all. I did maybe 3 heroin detoxes assisted by buprenorphine in a clinic. I was put on buprenorphine in there for 6 days. The doctor gave me just enough bupe to relieve my symptoms - 3-6-8-6-2-1 or something like that. I certainly didn't suffer any heroin withdrawal after they tapered me down off the bupe, and I had massive heroin habits. Both times I was shocked at how little withdrawal I had after I left.

For me, PAWS was when I had to pay for my past drug-abuse.


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PostPosted: Fri Dec 09, 2011 2:49 am 
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well I suppose I will try the taper and let everyone knows what happens so if other people are in the same position as me they will know what works for at least one other person. thanks for replying, everyone. i just want the satisfaction of not relying on anything to "live". I will report back on what happens with the taper.


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PostPosted: Fri Dec 09, 2011 3:16 am 
tearj3rker wrote:
Ironic wrote:
Remember that you are not just w/ding from Subs. If you took Sub to stop using heroin, you never detoxed from the initial heroin, and you have been continuously using opiates since you started using heroin daily (from what I understand).


I never understood this. I know Dr. J says it often, but it doesn't match my experiences at all. I did maybe 3 heroin detoxes assisted by buprenorphine in a clinic. I was put on buprenorphine in there for 6 days. The doctor gave me just enough bupe to relieve my symptoms - 3-6-8-6-2-1 or something like that. I certainly didn't suffer any heroin withdrawal after they tapered me down off the bupe, and I had massive heroin habits. Both times I was shocked at how little withdrawal I had after I left.

For me, PAWS was when I had to pay for my past drug-abuse.


I can explain. When using Sub to detox, you don't use it for long enough to become addicted to it. It gets you off the dope without getting you hooked on the Sub. Plus, you are tapering the amount of opiates you are using.

If you stay on Sub long enough to become addicted, it means your body has been continually addicted to opiates since you started using your DOC. instead of tapering, people who stay on Sub for maintenance maintain (or even exceed) the amount of opiates they were using before. Even if you eventually taper, until you start getting down below 4 mg, you are still saturating your receptors (no chance for tolerance reduction. Bupe is very strong mg for mg compared to something like oxy or hydro), so you are maintaining your tolerance and therefore, level of dependence.


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PostPosted: Fri Dec 09, 2011 4:56 am 
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Why if someone tapers off Subox after 1 months, are they also withdrawing off their drug-of-choice they used beforehand?

I didn't withdraw off heroin when I tapered over a week.


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PostPosted: Fri Dec 09, 2011 7:58 am 
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When we withdraw, we are withdrawing off of OPIATES. PERIOD. The brain doesn't know the difference between any of them. When we're hooked on H or perc or vics or whatever then replace it with suboxone, it's all opiates. That's what we're addicted to - OPIATES. And that's what we're tapering off of...OPIATES.

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PostPosted: Fri Dec 09, 2011 9:46 am 
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So you're saying that if someone was on methadone, then switched to heroin for a few months. They'd still have to endure the 30+ day methadone withdrawal? Or would their withdrawal be a week long heroin detox?

Duration of withdrawal is related to a drug's half life, how long it stays in the body after the last dose. Withdrawal usually peaks at the point when our brain has no more opiates floating around in them, which is why methadone & buprenorphine detox peaks much later than the heroins/morphines/oxys. If I've been on buprenorphine for 5 months, there's no more heroin left in my body. So by this stage the length of my withdrawal is only related to buprenorphine's half life.

That was my experience when I switched between opioids with different half lives.


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PostPosted: Fri Dec 09, 2011 12:50 pm 
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Obviously, the half life of the drug last taken still applies, but its because it's the last one taken. If you stopped methadone and switched to bupe, eventually the half life of methadone would "wear off" and you'd have the half life of bupe going on. If you then switched to vicodin, you'd eventually lose the half life of bupe and have the short half life of vicodin, but you'd still be addicted to OPIATES!

An opiate is an opiate is an opiate. The brain cannot tell the difference between different kinds. This is why bupe stifles our cravings for other opiates.

I hope this helps explain it better. Sometimes I have trouble putting what's clear in my head into words so it can be clear to someone else. Let me know if I'm leaving something out or confusing something or whatever...

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PostPosted: Fri Dec 09, 2011 1:42 pm 
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I am not sure if this is what tear means but something I've wondered. If one uses sub for a week to detox off heroin (like tear) and they do not experience sub withdrawl after they stop then there must be a difference? I have seen it stated on here and other places many times about people just using sub to detox and take care of their withdrawl period. Yes they taper but very quickly, someone on sub for 6 months couldn't do that same taper and get off with little to no withdrawl, therefore it takes time for the body and/or brain to become dependant on sub. So there must be a difference. If there were no difference you wouldn't be able to use sub for detox because you would still be left in withdrawl. I am not saying this conclusion is correct but it's what I've come up with, thoughts are welcome.


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PostPosted: Fri Dec 09, 2011 1:54 pm 
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Let me think on this.

THIS IS AN AWESOME DISCUSSION. You've given me much to think about, both of you. I love being challenged. :mrgreen: Give me some time.

Tear, your thoughts?

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PostPosted: Fri Dec 09, 2011 5:20 pm 
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i know there is some sort of difference between subs and other opiates but i don't know why it is that way. i know that when you take opiates and then take sub before 24 hours (or just 12 if u only do 1 mg - for some people) i get a major migraine, restlessness, and constant vomiting. but when i take sub and then a couple hours later take something else, that does not happen. sometimes i can even feel the other thing even though you aren't supposed to (but of course not to full effect). i read that as time goes on, you get more feeling of the other thing as the sub wears off. I have noticed that myself too. There is something different about buprenorphine but i don't know what it is. maybe it is related to the comedown of subs and why it is not as severe as other opiates. but what about if you are on it for years? is it same as brown detox? i can't imagine that.


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PostPosted: Fri Dec 09, 2011 6:48 pm 
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The reason you feel like that if you take sub prior to being in withdrawl from the full agonist you were taking is precipitated withdrawl. Buprenorphine (the active ingredient in sub) has a higher binding affinity to your opiate receptor. So if you take it prior to withdrawl it will rip the other opiates off your receptors and cause precip. withdrawl.


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PostPosted: Sat Dec 10, 2011 12:46 am 
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When I was in addiction, I did lots of inpatient detoxes. It was called the detox shuffle. People like the Salvos, and certain hospitals, ran free detox clinics. Everyone would go in there determined that "this would be the time I'm going to get off". Ultimately, I went into them many times, and looking back, they were more like "breaks" from the hecticness of using.

Initially they used Clonidine & Brufen & Valium and all those stuffs. Then I rocked up for another admit, and they were using buprenorphine. At first I was sceptical, because I had been on it before and knew it was an opioid. I was afraid it would just delay my heroin detox.

The end result surprised me. The buprenorphine dose covered my withdrawal symptoms while I was there really well, yet for some reason I didn't have to withdrawal too badly off the buprenorphine once I left. Mind you, I did have some mild withdrawals after I left, but it was as if I was just cruising down to land. I was easily functional. 3 days after I left I felt like it was completely over.

So something clearly happened. I've yet to make sense of it myself. It wasn't just me either because I bounced it off NA people and they had similar experiences.

When it doesn't work, was when I was using buprenorphine previously, whether it was intermittently and using heroin between or all the time. Clinics weren't familiar with detoxing people off buprenorphine as much, so they just did the standard 6 day detox with bupe they'd use for heroin. What happened for me was, 2 days after they gave me my last taper dose, BAM the withdrawal hit me. I spent another 2 weeks really quite ill. They dragged me to groups and I just lay on the ground in cold sweats. They kept me in for 3 weeks! The doctor was scratching his head wondering what went wrong.

Anyway, it's interesting. I still thinking buprenorphine is the gold standard detox med for shorter acting agonists. Instead of taking 6+ medications for all the symptoms, it's just one medication, and it works much better. However, long acting opioids still need a slow low taper I've found.

Quote:
Obviously, the half life of the drug last taken still applies, but its because it's the last one taken. If you stopped methadone and switched to bupe, eventually the half life of methadone would "wear off" and you'd have the half life of bupe going on. If you then switched to vicodin, you'd eventually lose the half life of bupe and have the short half life of vicodin, but you'd still be addicted to OPIATES!


totally with ya there.


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PostPosted: Sat Dec 10, 2011 12:52 am 
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I don't think it's that complicated. If you stop your drug of choice and start taking sub, the sub does not change the amount of time it takes for your drug of choice to get out of your system. Hydro withdrawal, for example is usually around 5-7 days. So after the 5-7 days the hydro is gone, and the sub masked the hydro wd. If you quit the sub a week after that, and have withdrawal, it is sub withdrawal.

In other words, sub does not delay the withdrawal from the other opiate, it masks it. This is why so many people see sub as a great detox tool. Of course it is easier to quit sub after only a couple weeks vs a couple years.

Back when I was switching back and forth from oxy to sub, although the sub did a great job of wiping out the oxy withdrawal, I always had a sense of when the oxy was out of my system. After a week or so on sub I would notice I had a little more energy, better mental attitude, etc. It wasn't the sub starting to work better, it was the oxy withdrawals going away, even though I had never really felt them.

That's my take.
Jimmy


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