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PostPosted: Fri Sep 04, 2009 4:16 pm 
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I have been poking around on this board for a while now unregistered, trying to get a grip on some sleeping issues I am struggling with while taking Suboxone 8/2 mg 2x daily. Let me start with my background...

"I go to bed in pain, I wake up in pain. Some days my pain levels are high, some days they are tolerable."

Dec 2007 - Went to PCP complaining of low back pain. - Percocet 5/325's for pain.
Feb 2008 - Referred to Pain Management - 20mg Oxycontin ER's for low back pain.
Mar 2008 - 1st MRI showed Disc Bulge at L5-S1.
May 2008 - Increased to 40mg Oxycontin ER's, 3 Epidural Steroid Injections in lower back over 6 weeks.
Jun 2008 - 2nd MRI showed Disc Bulges at T7-T8, T8-T9 and T9-10.
Aug 2008 - Increased to 60mg Oxycontin ER's. 4th Epidural Steroid Injection at T8-T9.

Oct 2008 - Mid March 2008 - Struggled every dose of Oxycontin 60mg ER's during the last 3-4 hours with "dope sickness" and breakthrough pain. Pain Management MD' refused to prescribe breakthrough pain medications.

Mar 22, 2009 - Finally had enough with the Oxycontin - - inpatient detox using Suboxone 8/2mg for 6 days.
Mar 31, 2009 - Begged Pain MD to prescribe a non-opiate for pain. Swore up and down that I would not take another Oxycontin (Opioids) again. Was prescribed 20mg Oxycontin ER's.

Apr 2009 - 20 days later, was referred to a Neurologist for an outpatient detox <sigh>.
Apr 21, 2009 - Took 1st dose of Suboxone 8/2mg in Neuro's office, began 2nd detox.

Apr 21 Jun 16, 2009 - 8/2mg Suboxone up to 3x daily for chronic pain management. Rarely used more than 16mg in a 24 hour period.

Jun 16, 2009 - 3rd MRI showed small disc herniations from T6-T11 with cord compression at T9-T10. Disc bulging at L2-L3, disc herniations at L4-L5 and L5-S1 with cord compression. Complained for months that pain levels were worse then they were a year prior and finally found an MD that would do a 3rd MRI.

Jun 18, 2009 - Off Suboxone and back on Percocet 10/325's every 8hrs. Began to struggle with this dose within 14 days.

Aug 20, 2009 - Present - Found myself going down the same frigging road as I was before with the opiates began detox for the 3rd time. Back on Suboxone 8/2mg 2x/Day max.

Every few months, it seems, there is another news release disclosing a new celebrity confessing to an addiction. The reports seem give the impression that the lure of these drugs is irresistible, that we're all just a few pills away from addiction.

This leaves people like myself with chronic back pain and my doctors stuck in the middle. On the one hand, my doctors are afraid of the risks of addiction that come with taking Opioids such as Oxycontin or Morphine. On the other, I am suffering from severe and debilitating pain and need some kind of help.

There's no doubt that prescription drug addiction can be devastating and destroy lives. As a severe chronic pain sufferer, I must say that Oxycontin is a great pain killer. In my opinion, when it comes to prescribing Opioid painkillers like Oxycontin and Percocet have risks, they're often outweighed by the benefits of controlling chronic pain if prescribed correctly.

It wasn't that I was showing up at my Pain Management office 2 weeks early for a refill on my pain medications. I was suffering in the last few hours of every dose with a runny nose, thighs cramping, nauseated, sweating, skin burning (in some instances) among other great discomforts and waiting to take my scheduled dose of Oxycontin and avoid self-medicating. As most of you are probably aware that the "quick fix" to "dope sickness" is to take more of the drug. I even tried to go with out pain medications at all during the first part of August 2009 and I spent 85% of my time in bed miserable.

There is no doubt that Suboxone is a very decent pain killer. My problem with it is that every time I goto sleep after taking this drug, its like being at a drive-in movie in HD and my eye-lids are the screen. Extremely vivid dreams, mostly the same dream repeats over and over and then waking up every 45 minutes to 1.5 hours gasping for air.

I never had this problem when I was taking Oxycontin or Percocet's. This problem arose every time I started taking Suboxone. I am also taking Celexa 20mg / 1x daily for depression and have read that vivid dreams are a side effect.

I participated in a sleep study on July 12, 2009. I was taking Percocet at the time. Results from the sleep study included Severe Obstructive Breathing Disorder which a CPAP machine was prescribed. No relief whatsoever from the machine. I do plan to do a follow up study with the machine and on Suboxone in the near future. Will post the results then.

I also had a skin reaction when I started taking the Suboxone all three times. Painful lumps deep under the skin in the flank and breast areas. All three times they were gone within 10 days after starting the Suboxone 8/2mg doses.

I am planning to stay on the Suboxone this time to manage pain for good. I dread the thought of going through any type of withdrawal symptoms again. Hopefully I can get the information that I need to help me deal with my sleeping issues in this forum.

Thanks in advance for your responses.

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An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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PostPosted: Fri Sep 04, 2009 8:29 pm 
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Hi Megamp3n, welcome to the forum.

I would recommend that you PM or email Dr. Junig (the site admin) you questions. He hasn't been around a lot lately because he's working on a book, but I know that he tries to answer email questions like yours if he can.

Were you on Celexa the other times you had these intense dreams? Maybe it's some kind of interaction between the two medications? I know that when I switched from full-agonist opiates to Suboxone I had to adjust my antidepressant dose because I started experiencing side effects. Once I lowered the dose I was fine. Suboxone potentially has antidepressant effects, possibly because of its action at the kappa receptor, but not a lot is known about it.

I wish I had something more helpful to tell you, but really all I can do is speculate from my experience as a patient. Does your doctor have any ideas about this?

I hope you're able to find some relief from this issue soon. Not sleeping is not good. Keep us posted.

One last thing - I have read that chronic pain patients sometimes fare better when they take smaller doses of Suboxone throughout the day - like 2mgs every 4 hours. I know that taking a large dose of Suboxone later in the day can interfere with sleep. Maybe changing the way you space out your 16mgs would help?

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PostPosted: Fri Sep 04, 2009 10:44 pm 
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I have been taking Celexa for over a year which was at least 6-8 months before my initial dose of Suboxone in March of 2009. When I consulted with my Neurologist about the vivid dreams and the exhaustion that I was facing from the lack of sleep, he ordered the July 12, 2009 Sleep Study. He did not have many answers for me either.

I have always took my Suboxone doses at 2-4 milligrams and never more than 4mg in a 9hr period even though I am prescribed up to 16mg per day. I agree that spreading them out over the day has a much more reliable effect on the chronic pain issues. In fact, I even try not to take a dose after 1pm or 2pm in the afternoon as an attempt to try to get some sleep in the evening.

I have scoured the web trying to find an answer why I am struggling to stay asleep and the vivid dreams while on Suboxone. If I could figure that out this would be the perfect drug to manage my pain.

Therapy to deal with the depression, anxiety and insomnia as they all contribute to my pain levels would probably benefit me. I wonder if Dr. Junig could refer me to somebody in Phoenix, Arizona that is familiar with addiction / chronic pain issues.

Ill keep waiting to see if others may have had the same issues. Thanks for responding..

_________________
An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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 Post subject: xanax
PostPosted: Sun Sep 06, 2009 1:12 am 
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Location: fort lauderdale
Most DRS,perscribe xans wth subx,,,,
Major.FT Laud


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PostPosted: Sun Sep 06, 2009 2:50 pm 
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Seriously, major, what the heck are you talking about? How can you possibly know what "most" doctors do or do not prescribe? I'm pretty certain that benzos are contraindicated for people taking Suboxone.

Look, I know you are trying to help, but please consider what you are writing here.

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

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PostPosted: Sun Sep 06, 2009 3:10 pm 
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Location: fort lauderdale
Maybe because i live in the capitol of opiates ,Broward cty,Fl,,ill send DOQ a personal message,no need for all his political views ,Zanax positively helps just take small dose maybe Valuum,MY Doctor is # 1 detox Doctor in Broward cty,,again i hope we all get better..
Major FT Laud


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 Post subject: vivid dreams
PostPosted: Mon Sep 07, 2009 4:18 pm 
Hey Megamp3n - Yeah, I have had some bizarre dream issues since starting Suboxone too! I haven't ever posted about it because unlike you, they haven't been bad enough or frequent enough to significantly interfere with my rest/sleep.
I've also noticed that the longer I'm on Sub, the less they are happening (I've been on Sub 2 months now), but at first they were pretty disturbing.
I also try not to dose past about 4pm and that helps too. I have had real vivid dreams - even what I would call auditory hallucinations when I would first fall asleep. To the point that I would wake up and wake my husband, and say "what was that? Did you hear that?" And he never did!! It's hard to remember though exactly what the dream was about or what sound I had "heard" because I typically just fall back asleep and sleep through the rest of the night okay. But, yeah, if you're having that type of thing every night or multiple times a night - that would be rough!
As far as the poster who said something about Xanax - 'what the heck' is right. Most of us addicts don't need benzos to add to our list of problems. Nor do I think most Subox prescribers are handing out scripts for them like it's no big deal. Of course there are situations when it is in the patient's best interest for their well-trained, conscientious physician to write them a script for a few Xanax. However, having spent many years in the medical field, I know that benzos are not usually the medication of choice for sleep disturbances. How about Ambien or Lunesta, something like that? Has your doctor ever tried you on those? I worked 12-hour nights for ~10 years and would have trouble switching back and forth and Ambien worked great. I know there are lots of stories out there about it, but if you just take it and go to bed and don't fight sleep with it, you're probably way less likely to do any of the crazy stuff you hear about!
Anyway sorry I don't really have the answer to your problem, but I can relate. Actually, kinda glad to hear I'm not the only one who has done that. I sure do hope it gets better for you though because it sounds like the Suboxone is helping you a lot. I am so glad. I know it's done so much to help me too!
Let us know how you proceed.


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 Post subject: Yes me too..
PostPosted: Fri Sep 11, 2009 9:15 pm 
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Ive only been on the Suboxone for about 3 weeks this round but I too have noticed it getting a bit better than it was during week one. Man, it was like trying to sleep with someone holding a brick up against the side of my head and would not let me up. I would dream about things that I never even knew that were in the back corners of my mind. 45 minutes is all I could get at a time and never would get into stage 3 sleep.

Would wake gasping for air, all that. Dealing with chronic pain is no fun much less on no sleep. No sleep also = higher depression and anxiety. My Neurologist pulled me off Lorazepam when I started Suboxone. It was a nice compliment to the 20mg of Celexia I take daily. Oh well.

_________________
An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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PostPosted: Sat Sep 12, 2009 12:04 am 
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I also have trouble sleeping and have sleep apnea. I have been using a bi-pap (similar to CPAP). I encourage you to keep trying to get use to your CPAP. I had to try several different masks before I found one that worked for me. My sleep was so bad before my sleep apnea was treated that I was loopy, I don't know how else to describe it, kind of was out of it for a few seconds at a time, was vocalizing and my hands were moving kind of miming what I was thinking about. There are good web sites out there about sleep apnea. I also have a book "SLEEP The Mysteries, The Problems, and the Solutions" written by Carlos Schenck, M.D. On the medication for sleep while on suboxone I might as well give you my two cents worth. My current doctor will prescribe ambien or Lunesta. My previous sub doctor would not allow any of his patients to take benzos or hypnotics like Lunesta. Hypnotics can show up as benzos in drug tests also. I have rambled enough. Jean


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PostPosted: Mon Sep 21, 2009 6:52 pm 
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I had an appointment with a Neurosurgeon today (for a second opinion) and was offered a Spinal Cord Stimulator Implant on a 5 day trial and a permanent implant if there is success in reduction of chronic pain.

After all of the Physicians that I have seen over the last 18 months, this is the first that I have heard of this. Has anyone else had one of these " installed " or have any advice on weather or not I should take a shot at using one?

_________________
An addict in pain suffers thrice:

Once from his disease,
Once from his addiction,
Once from his physician’s ignorance.

Karen Miotto, M.D. - Integrated Substance Abuse Program, UCLA


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