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PostPosted: Thu Nov 25, 2010 9:16 pm 
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Just getting acquainted with the site and i see a place to post our stories, so I apologize for putting it here.
And i made a typo about receptors....doesn't matter but just wanting to know if the partial antagonist effect of subutex (without naloxone) will cause precipitated withdrawal if I don't wait long enough going off methadone...my plan is to be off it about 110 hours or so to start subutex...but is it more important to wait for moderate withdrawals to start it since I am going off methadone at dose of 75mg. Thanks again


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PostPosted: Fri Nov 26, 2010 9:21 am 
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If I understand your question correctly, then yes, you could have precipitated withdrawals from subutex if you start too early. If that wasn't your question, I apologize for misunderstanding you.

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PostPosted: Fri Nov 26, 2010 11:01 am 
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Thanks for responding. Yes that was part of my question....I am wondering if I need to figure out my tolerance before starting subutex or just wait until I have moderate withdrawals before starting it. I am taking 2-5mg vic's 2-3 times a day to help with w/d but need to stop those today. I took 2 this am due to symptoms altho my plan was to stop yesterday....the fact that 2-5mg vic abate some of my symptoms could mean my tolerance is lowering? Just a bit confused on when exactly I should start subutex. Thanks


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PostPosted: Fri Nov 26, 2010 6:23 pm 
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Are you doing this on your own or do you have a doctor? Your doctor will be the one to best determine what you need, dose-wise. We're just a bunch of online, recovering addicts who happen to know a lot about bupe. But honestly, you should be in communication with your doctor. Good luck and let us know what happens.

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 Post subject: Yep...have dr.
PostPosted: Fri Nov 26, 2010 6:53 pm 
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Hi Hat,

Def have dr. I wouldn't want to revert to my old addict behavior and continue to treat myself. Being in medicine makes it even easier and I know that is something for me to be very careful of.

I am only asking the questions because of fear of pwd's. I've been reading all day and night here in order to make sure I take care of myself well.
Also, my methadone use was a replacement therapy for 2.5 years. I think I might have confused the issue by just saying I had been on it. It was through a clinic with a dr and counselor...who were awesome. Methadone worked. My recovery was solid. My complaint now being off the methadone has been blunted emotions...I'm more awake now. I'm going on bupe because of weight gain on methadone, drugged feeling and apathy, and custody issues.

My dr. said to wait until moderate withdrawals (Im a 7 on COWS MAYBE now) and start at 4mg. and not to exeed 16mg. I think I will actually try 2mg first altho that is doing it again....changing my dose myself. So I am going to call him and I see him again Monday to make sure he is aware and ok's it. I really try to stay in recovery and not let myself get too crazy but hey, I'm an addict in remission. My thinking sometimes is quite skewed!

I'll let you know how the induction goes. A tad nervous about it I must say. Some moments I think I'll just stay on methadone but I want to try this. I am thinking I'll feel better on sub.


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PostPosted: Fri Nov 26, 2010 7:05 pm 
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You're not alone in your thinking. We've all been there. It's perfectly normal to be a bit scared going through this transition. It's not always an easy one and precipitated withdrawals is a legitimate fear. I wish more doctors would do the induction in their office rather than leave people like you to figure this out on their own. I know s/he gave you directives, but it's their responsibility to gauge the state of their patient's withdrawals. You shouldn't have to be playing this guessing game. Shame on him/her.

Rant over...Hang in there and be sure to check your pupils. That's another good way to keep track of your withdrawals.

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PostPosted: Fri Nov 26, 2010 8:58 pm 
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I really understand your sentiment...I don't like the idea of any of us having to figure it out despite whatever medical background we might have. we are the patient now. It's a little bit like encouraging old behavior in a sense.

That said, I know my dr. was really going to bat for me, getting me in before he really had an available appt, understanding my anesthesia background and my current work treating addiction myself as a psychologist. He was really helping me out yet I don't think he inducts anyone in his office if I remember correctly, so it can be difficult. But he keeps costs down, too, that way. I am self employed and don't have insurance yet so that was huge for me. One clinic here wanted $450 for first appt, then to induce they wanted $1800.00 for a few hours there. Then I would have had to get an alcohol and drug assessment elsewhere despite the fact I had one a year ago when I changed methadone clinics. That was an exorbitant amt of money to pay to be inducted at an office. So, this guy charged me 200$ for first visit, talked me through my induction plan and did say he realized how different and how difficult my case was coming off the methadone clinic and jumping at 75mg etc. The pharmacy I brought the subutex to said they didn't make a generic....DUH! I had to tell her that yes they do....she looked it up and said, oh you're right. But they didn't have it so I had to pay huge to get my subutex. Next time I'll call and have them order it or take it elsewhere obviously.

So I am probably over reacting by asking so many questions out of fear of methadone w/d and the potential of pwd's if I don't do it correctly. I have a COWS scale and still am only 7 or 8 and I know its way too early yet. My only question after reading all the posts the past 2 days was do I try to figure out my tolerance or go by my withdrawl symptoms and what I am hearing is just wait until my w/d are moderate.

thanks again. I'll let you know how it goes.


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PostPosted: Sat Nov 27, 2010 9:18 pm 
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I WOULD NOT BE TOO WORRIED ABOUT Parcipitted withdrawl which in my own opinion doesnt happen when i made my transition from methadone to subutex i did it the very next day and had no problems whatsoever did it with suboxone too the amt os naloxone in ther subs isnt enough to send some1 into blood curdling withdrawl so id say ur good to go but always consult with doc even tho they dont always seem to know as much about this kinda stuff as ppl who have experienced it them saelves good luck the percipitated withdrawl term i believe is a term used to scare people outta not using opiated with sub nothing more but thats my opinion


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PostPosted: Sat Nov 27, 2010 9:25 pm 
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I'm sorry Byron but I must respectfully disagree with you. Precipitated withdrawals during induction has nothing whatsoever to do with the naloxone in it! It happens because the suboxone knocks whatever full agonist is on the receptors right off. I've know plenty of people who started way too soon and did suffer precipitated withdrawals. The naloxone is there to prevent people from shooting it up.

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PostPosted: Sat Nov 27, 2010 9:54 pm 
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Bryon, I appreciate your experience very much. I do have to agree with Hat, however.
the naloxone is so people don't shoot it. there is no bioavailability when taken SL from what I read.
The buprenorphine is a partial agonist at mu receptors but a partial antagonist at kappa receptors so that is why precipitated withdrawals occur.
I'm really happy for your transition. I took 2 vic today due to seeing my daughter and not wanting to be too sick and feeling restless so I will have to wait now for sure until sunday at noon or so. that will be 24+ hours post last vic dose. 5 days post methadone today, 6 tomorrow...I hope i will be inducting but I think I'll wait for w/d to get worse in case.
thanks for your help


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