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PostPosted: Thu Jan 14, 2010 4:07 pm 
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I have some random questions that I've always wanted answered about buprenorphine, that were never able to be answered on different Suboxone forums. I know the Subdoc can answer these questions but hopefully someone here will be able to instead, because I know the Subdoc is busy.

My first question is about dosing. Being that buprenorphines agonist effect peaks at 4mg, will there be a difference as far as well being is concerned if the patient maintains on 2mg VS. 4mg for the long term, and once tolerance has taken place?

This question also leads into an other question, that if endorphins are more potent and better than buprenorphine in being a better agonist to the mi receptor?
This is related to the first question because if endorphins are more potent, then the patient should feel better on 2mg, because they have more endorphins available in the synaptic cleft.

Also, shouldn't the patient feel better because the less suboxone you are on, the more testosterone you will be able to produce and your hormonal levels in general will probably function better, making the patient acheive homeostasis better.

So these are thoughts that I have about the whole less is more philosophy when it comes to sub. These thoughts make me ask the question that if less sub will make me happier, once of course I adjust to the smaller doses. If my mind and body are working better on smaller doses, shouldn't I technically be happier once I adjust?

So this leads to the ultimate question, that if we would be happier sober, if we could just adjust and heal and get through the WD.

I guess I want to know if I would be happier off of sub, if I could get through the PAWS and become my old self again. Maybe the sub is making me happier than I used to be but I can't remember, but I doubt it because I also went on bupropion to add a spring in my step early in my sub treatment. Bupropion is the drug in the popular antidepressant Wellbutrin. Great med btw, it has no side effects really.

I have more questions but I can't remember all of them right now. I always wanted definite answers for the questions above, but nobody was able to answer them. I left a small introduction about my self beneath these questions. I know I should of posted them in the introduction but I didn't plan on adding an intro and just typed it out in the moment I guess.








I didn't set out for this thread to be an introduction, but here is a little bit about me:
I consider myself a veteran to opiate addiction. I'm 25 and became addicted to opiates 3 months before I turned 19 to be exact. A rough timeline leaving out the complete trail of dust, smoke, and debris starting when I was 19 would be: 2003, started with hydrocodone, which led to oxycontin use by way of up my nose. I then met a "take home" methadone patient, who ruined my life basically; he had me doing his job for him for methadone and later would charge me one dollar per mg for liquid methadone (the pink shit).

After that, me and some friends started doing heroin. I never IV'ed any opiates thank God. After my parents had enough, I somehow quit cold turkey for 14 months with my fathers love and supervision. On the fateful Christmas of 2005 leading into 2006, I was drinking while depressed at a Christmas party (I was clean at this time for 14 months).

We were at my family's best friends home, which I new the lay out as well as my own home. I was best friends with the home owners children since pre-school. So I get drunk and depressed on Christmas and raid the home owners medicine cabinet in their master bath. I find hydrocodone ES 500, and consume 8 pills.
Finding this hydrocodone was by pure chance, as I never knew where the home owner kept it. But I just used junky intuition and guessed the best place it would be and was right of course.

After this I would use on and off until my induction to suboxone on July 7, 2007. Suboxone, like for most, saved the part of my life that meant something. It allowed me to be productive again. I went back to school to continue pursuing a degree in Biochemistry. The first few months on suboxone even allowed me to become a Realtor. So I got my real estate license very quickly in recovery.

So suboxone was God sent for me, as it allowed me to go back to school and start the long process to achieve what I always set out to do. I currently have a 3.9 GPA, and will be transferring to UIC here in Chicago within a semester or two. I may get into a growing field called biomedical engineering, or I may do pharmacy, or even medicine if things work out for me financially. School's expensive and I'm trying to avoid debt. I still live with my parents. Im sort of unhappy but somehow remain very ambitious with suboxones help. Opiate WD made me drop out of college twice during active addiction. Apparently opiate WD and school do not mix well for me.


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PostPosted: Thu Jan 14, 2010 5:46 pm 
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Hey Mike T -

There are a few people here who can probably specifically answer your questions. I think Shelwoy, setmefree, donh, Bigred...

I'll take a shot, but they are my opinions - and I may also learn from further answers here.

Q1: my rephrase - Long term will an addict feel better maintained on 2mg rather than 4mg because of their body restoring things such as testosterone, hormones, endorphins, etc.?

A:ME... Buprenorphine is a really strong drug at the receptor. REALLY STRONG. So from a medical/body standpoint - 2mg's will allow the body to adjust somewhat. I believe everyone's chemistry is different - that's why this is so hard to answer. I know some people who have NO SEX DRIVE on 4mg, and others that had SEX DRIVE (and Testosterone) at 16mg. There seems to be no "one size fits all" as to how our bodies adjust to doses. I may be doing OK with some endorphins (from exercise) and hormones at 8mg, and someone else have almost NONE at 2mg. My $.02.

Q2: Shouldn't I be happier or more content with things after I am off sub and adjusted BACK TO MY OLD SELF.

A2: I believe, as hard as this is to admit to even myself, that I will NEVER return to my OLD SELF. Shooting for that imaginary target is not realistic. I have taken opiates long enough that my brain has changed, my personality has changed, and so on and so on...

I believe there is a good chance that we will feel happy, sad, and all the emotions on doses of sub, or 100% free. It's also important, though, to acknowledge that OUR OLD SELVES wanted something more... We hit opiates - and it met that something more...

Ain't no going back to the OLD me...gotta make a NEW me that is able to handle things differently.

Don't know if this makes sense... and others may be able to articulate it better.


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PostPosted: Thu Jan 14, 2010 6:55 pm 
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LatheDude,
I just wanted to state that you did a wonderful job answering the questions. I couldn't have said it better myself!!!

Mike T congratulations on the accomplishments you have gained with the assistance of suboxone! The questions that you asked were really good ones.. I wish you all the best in the future.


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PostPosted: Thu Jan 14, 2010 11:55 pm 
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Thanks for the replies so far. LatheDude, youre right about how we can never be our old selves, I should of dug deeper, but I still wonder if I can acheive the same level of well being I felt sober before opiates then after opiates. I know I will never have that ignorant happy feeling I did being high on sobriety as a kid not knowing how drugs felt. I really miss being high on life but I question how happy I really was sober, because when I first did opiates I thought I found what happiness really was, but it was a big lie. Feeling happy when your not is wrong.

I still really want to know what are more potent on receptors, natural endorphins or bupe, and how they both work compared to each other on the receptor level. I really want to know everything about it. Would endorphins stimulate the mi receptor more than a partial agonist, such as bupe?

Also, why when I drink alcohol on rare occasions do I feel miserable? Is the bupe blocking receptors that alcohol is supposed to fill. I know I shouldn't drink on sub and I really don't, but the few times that I did were lousy experiences.


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PostPosted: Fri Jan 22, 2010 11:38 pm 
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Mike, I'd love to know the answer to your alcohol questions...doesn't seem like anyone knows. I HATE drinking alcohol on sub. I get kind of forced into it at work stuff sometimes. If I get completely drunk I feel good...but 2 or 3 beers sucks.


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PostPosted: Sat Jan 23, 2010 2:29 am 
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Mike - I think you might be seriously oversimplifying the mechanism of endorphins and their relationship to buperenorphine use. For example, PAWS has more to do with overactivity at the Kappa receptor than with the mu receptor. It's also hard to know if you would be happier off of Suboxone, because it's difficult to determine the amount of damage caused by your opiate abuse and how quickly and to what extent your particular brain will recover.

I'm not a doctor and I've only had one pharmacology class so far, so I'm really not qualified to answer your questions. I would venture a guess that most doctors don't even really understand exactly how this all works. It seems to me that your main question is whether your brain will eventually adjust to being off Suboxone and whether you can once again feel well without opiates or Suboxone.

I don't know, and I don't think there really is any way to know. Our understanding of the human brain is constantly evolving, and current research into neuroplasticity is really encouraging. There very well might be ways for our brains to heal. From my experience, certain practices brought me to a place where I felt comfortable tapering off of Suboxone. Other people feel that they will never get to that place. I think it really depends on the individual.

I hope Dr. Junig does chime in with some insight on your questions because I think they are very interesting. In the meantime, welcome to the forum. I'm glad to hear that Suboxone has worked so well for you and that you've made so much progress in your life since you've been in recovery. What a wonderful thing, to turn your life around like that.

One last thing - I would think that a simple experiment to see if your natural endorphins still have some effect on your mood in spite of the Suboxone you're taking would be to get some strenuous exercise and see if you are able to get a feeling of euphoria from that. If you do, then you know that you're still getting some benefit from your endogenous endorphins, which should be reassuring, right? Good luck.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


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PostPosted: Sat Jan 23, 2010 9:49 am 
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Hawker1 , I will tell you I have pretty much stopped everything 3 yrs ago when my brain became addicted to opiates... I stay away from things that dont let me feel good, even on sub things like alcohol and smoking dope ( only got high once or twice a month ) are a thing of the past, they dont make me feel good!!!! Shit, even Viarga works different, I'm holding at 1.75mg for 1 more week, I'm thinking theres NOT enough room on the receptors, Someone out there knows more about this than us, Mike


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Dr. Jeffrey Junig, M.D., Ph.D.

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