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 Post subject: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 12:03 pm 
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Greetings from NC,

I joined this forum because I found Dr. Junig's contributions extremely enlightening, as well as feeling refreshed to see the advice coming from a source that knows firsthand how incredibly harrowing the addiction cycle and withdrawal itself can be. (Next paragraph skips personal history). I have recently been inducted with suboxone and am having an unusual experience from the majority of examples my various forum-lurking has found. I am your usual "suspect", I suppose... Although my DOC was alcohol until recently. I started heavy drinking at age 15, continued with a 12-20 drink a day habit from 19 until 27 when I entered a 30 day inpatient program - the last five years of that period I began to experience severe withdrawal symptoms within twelve hours of last consumption and would enter DT territory within a day or so. I had lost so much, including a wonderful girl who gave me far too many chances, and was truly ready to quit drinking. I have remained alcohol free since. I had experience with opiates and enjoyed them immensely when prescribed to me for various things, (no drug seeking, taken as prescribed and never developed tolerance). During my abstinence the past 2.5 years I was diagnosed with a benign pituitary tumor that was causing a moderate degree of discomfort as well as pituitary dysfunction. My doc addressed everything valiantly, even trusting me with pain meds despite my alcohol history. I took them as prescribed, but at the maximum dose - I was enjoying them. After two months my doc wisely decided that opiates weren't my way forward since we had by that time established that my tumor issue was stable and wasn't going to be removed. I had withdrawals and found opium through poppy seeds (of all things!), and self medicated the withdrawal and pain from there for a period of a year. During that time I developed a massive tolerance to opiates and lost the ability to function without dosing 3x daily, then lost the ability to function no matter what - the seeds have many alkaloids and I can't begin to speculate what caused the illness, but I was very sick and unable to get out of bed for months. I tried quitting, but the withdrawals were insurmountable and began within 8 hours of last dose.

Enter Suboxone. I had not used for 36 hours as the half life for ingested opium is quite long (plant's latex dissolving slowly?) I was instructed to self induct at home and did so, 4mg sublingual strip. Within minutes I was severely ill, sweating from every pore and literally lost control of bowels. I felt the worst I have ever felt, withdrawal x10! Ended up in the ER and received Clonidine and a finger wag (despite the suboxone induction) and made it home just in time to take the next dose of sub, 4mg. Immediately I returned to a nearly unbearable state, though not quite as bad as earlier that day, and suffered through an awful night. Continued to dose as prescribed, made it to 16mg by today, day 3, and refuse to go any higher since I've not noticed any more relief since 8mg (and plan to reduce back to 8mg tomorrow). Every time I dose I get sweaty, feel dysphoric and quite restless and feel perhaps 60% better than I would without the subs. I don't believe I'm a special snowflake, but I've only seen people praising whatever diety or pasta-being they choose by this point... What is going on? Dr. Junig wrote something like 5% or less may metabolize the antagonist agent slowly and experience issues and I am trying the "spit that crap out" method for my next dose. I take hydrocortisone 5mg 2x, testosterone 1cc biweekly, and venlafaxine (Effexor) 37.5mg 2x.

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-M


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 12:35 pm 
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I know that Godfrey will be coming along soon to post here. Because he went through the exact same thing! He was hooked on poppy seed tea and he had quite a bit of trouble transitioning to suboxone!

My educated guess is that you are having Precipitated Withdrawals. Even though you waited 36 hours, it was not enough time to rid yourself of all the opioids in your system.

I'm going to let Godfrey take it from here, but know this. You are not alone. You are having trouble transitioning, but you WILL get to the other side.

Amy

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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 12:42 pm 
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Hello Orion,
To echo Amy you experienced PW's. But, in my view that has passed and now you are in the phase of bringing down your tolerance to match the activation that Buprenorphine provides. Give it a few more days and you should match up. In general, I have people stay at 16 mg a day for awhile until we get that mismatch corrected. It doesn't always work and then methadone becomes the next option.
Hoping you make the transition, and like Amy said, Godfrey should be along with the 'been there, done that' nuts and bolts to help you.


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 12:58 pm 
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Thank you both for the assurances! It really means a lot, especially in a tough time. PST is hell - tolerance develops within a week and suddenly you're shaking five pounds of seeds a day and still never feel normal. Thanks for encouraging me not to jump my dose down since I was thinking that was the problem. I know this is completely subjective, but do you think I should stay at 16mg a day for a little while longer? I guess I need to occupy myself and let my brain adjust while the medicine works its magic... Thanks again and I look forward to hopefully posting some more positive results soon.

-M


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 1:30 pm 
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I agree with the other comments, and thanks for your kind comments. I may be off with the times, but it has been only about 24-36 hours so far? As Docm2 wrote, the tolerance 'mismatch' takes some time to resolve, i.e. your high tolerance coming down to match the limited opioid effect of buprenorphine. I don't think spitting would help, because the buprenorphine is the issue, not the naloxone. And as Amy mentioned, you are still likely reacting to the agonists in your bloodstream. There is a 'loop' with swallowed morphine, where morphine is absorbed from the intestine, and excreted from the liver in the bile, into the intestine, and then reabsorbed again. That pattern delays the elimination of the drug to some extent-- although a couple loose bowel movements will help the process!

You will likely feel much better each day.

I generally favor staying on 16 mg in new patients, providing the medication is covered by insurance. You could certainly get by on less, but then you might have to wonder whether you are fully covered against withdrawal. Part of the positive process includes developing confidence in buprenorphine, knowing that you will be protected against withdrawal, and allowing your mind to move away from the focus on 'all things opioid'.


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 1:44 pm 
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Dr. Junig, himself! Kind words aren't enough, you have an immense resource here and I'm very appreciative - promise I'm no sycophant, haha. It's now day 3 for me. I forgot to mention that I have felt better each day, I would say around 20% improvement. My concern was based around the initial and somewhat still present discomfort at dosage and the lack of a "wow, this surely is an improvement" experience I've seen others have from day one. I see now that perhaps between my DOC and other factors I need to give it more time. I appreciate the feedback and will stick it out at 16mg for a little while longer since the issue is likely my tolerance and not the sub.

Where do I address the co-pay? :)
Thankfully,
-M


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 2:49 pm 
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Hey there Orion,

Amy was kind enough to PM me about your situation. I'm late to the party so I kind of skipped through some of what you wrote on the theory that you're needing reassurance more than anything right now.

I did have some PW....about 5 hours worth before it got suddenly about 50 percent better. Were you using the seeds themselves? I was buying poppy pods...and sometimes growing my own...though I have heard the seeds can be used as well.

As I understand it, the main opiate in this stuff is morphine, which is short acting I do believe. It was actually Dr. Junig who advised me on that, and it helped me tremendously in terms of allaying my fears about how long I'd have to wait before taking my first dose of bupe. I'll always be grateful to him.

I waited about 32 hours before sticking that first film under my tongue, but in hindsight I wasn't sick enough. I was probably in the middle of the "moderate" range on the COWS. Had I to do it over again I"d wait longer.

The good news is the PW didn't last all that long. Then it become a matter of waiting until my tolerance came down enough to be covered sufficiently by the buprenorphine. Each day got substantially better. By day 3 I was perhaps 70 percent better. By day 4 100 percent.

I waited far too long to make the jump that I'm convinced saved my life. Most of that was
the fear and uncertainty around the poppy tea, which isn't commonly used by addicts and the dosage
impossible to quantify in a meaningful way.

Feel free to PM me anytime. I'll be very glad to give you the benefit of my experience.

It's great to welcome a fellow poppy tea addict!!!

I can assure you that things will only get better from here.

Best wishes Godfrey


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 3:16 pm 
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Thanks Amy, and Godfrey!

I mainly used the seeds due to their availability, pods when I could get them (quite rarely). The fact you essentially had the exact same experience I just had these past three days makes me very relieved! (But I am so, so sorry you had to go through that, too.) I agree that in hindsight I probably wasn't sick enough before I inducted - I was around a 15 on COWs but I knew within another day I'd be much higher. As I'm sure you remember, those withdrawals start early and by 30+ hours I was close to giving in. I don't know how rare a breed us tea addicts are but I wonder if there is a general difference in our induction to suboxone? ...Well, I sound like a snowflake again. Thank you for the encouragement, Godfrey. I followed Dr. Junig's advice and went from 12 to 16mg since his post, and I am feeling around 75% normal now. I do want to assure everyone that I'm in no danger of either relapse or harm, so if time is better spent addressing more urgent issues don't worry about this guy. I will post an update soon and can't thank you all enough for the assurances to stick with the meds and let it work.

-M


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 3:21 pm 
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You heard from all of the experts! Both of our doctors, including "the man himself" (don't worry, we're big fans too!), and Godfrey.

I'm not great at remembering details, so I didn't remember exactly what Godfrey went through. Now I'm remembering the tolerance differential that he experienced. What I do know is that Godfrey came out the other side and is doing well, and that he is a valued member of our community.

I encourage you to remain part of our community too!

Amy

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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 3:54 pm 
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Great thread orion and all! Orion, welcome to your new good life on bup!
Godfrey has amazing posts I suggest you read, At the top of this site menu is a Search box, click and in the author field type godfrey and all his will come up, Worth a read. Best, P

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 Post subject: Re: Stabalizaton Issues?
PostPosted: Fri Apr 14, 2017 4:07 pm 
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Orion87 wrote:
Thanks Amy, and Godfrey!

I mainly used the seeds due to their availability, pods when I could get them (quite rarely). The fact you essentially had the exact same experience I just had these past three days makes me very relieved! (But I am so, so sorry you had to go through that, too.) I agree that in hindsight I probably wasn't sick enough before I inducted - I was around a 15 on COWs but I knew within another day I'd be much higher. As I'm sure you remember, those withdrawals start early and by 30+ hours I was close to giving in. I don't know how rare a breed us tea addicts are but I wonder if there is a general difference in our induction to suboxone? ...Well, I sound like a snowflake again. Thank you for the encouragement, Godfrey. I followed Dr. Junig's advice and went from 12 to 16mg since his post, and I am feeling around 75% normal now. I do want to assure everyone that I'm in no danger of either relapse or harm, so if time is better spent addressing more urgent issues don't worry about this guy. I will post an update soon and can't thank you all enough for the assurances to stick with the meds and let it work.

-M


Hey, you snowflake! My suboxone doctor wanted me to withdraw for 72 hours just for percocet! Instead I withdrew for 60 hours before I got to his office for induction. He had given me scripts for clonidine, Hyoscyamine, xanax, and skelaxan as comfort meds. The con was that it was a fairly miserable experience. The pro was that I left his office feeling on top of the world. I felt normal, not high. The withdrawals and cravings were gone! But, yup, 60 hours. I went over to my cousin's house and she took care of me during the withdrawals.

Hey, there aren't many of us who aren't scared of withdrawals, so you fit in here. We're all snowflakes!

Amy

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 Post subject: Re: Stabalizaton Issues?
PostPosted: Sat Apr 15, 2017 8:59 am 
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I'm so glad we have Godfrey here to really put a personal experience with poppy tea! Knowing someone that has physically and mentally went through the exact same thing as u is priceless. Now u get to see how well this person is doing (insert Godfrey). Godfrey is the only real personal information I've had on poppy seed tea so it's great to have another member in that category of experience with him. The more we learn the better we can help others! So glad u posted! And so glad ur feeling better!

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 Post subject: Re: Stabalizaton Issues?
PostPosted: Sat Apr 15, 2017 9:23 am 
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Hahaha, Amy! The fact that even made me laugh is testimony to the fact I'm around 90% this morning. I took everyone's advice to heart yesterday and kicked my own ass a bit - called my mother who lives across town to ask if she needed any errands run since she's caring for my Grandmother's recent stroke (miraculous case where there was no obvious lasting damage!). I actually went out and bought ingredients for Easter dinner, something I wouldn't have considered possible the past few months when I was "seed sick". I want to encourage anyone who was in my position to try suboxone, and I hope any interested persons read this far to see that indeed the suffering is short term and improvement is rapid. I've read so many posts on various forums of people saying that eventually the seed tea makes them physically ill, and I believe whatever agent/alkaloid in the seeds causes that illness (much more than usual opiate symptoms) is now cleared from my body by today, day 4. Godfrey used the poppy pods, not seeds, but I'm curious if he experienced that illness as well? The seeds are much more processed, so perhaps not. I'm extremely grateful for the advice and encouragement as again I likely would have either stopped dosing or reduced dosing yesterday without it. I also want to thank Dr. Junig, his quote about "looking a gift horse in the mouth" has reminded me that without subs I'd likely this moment be violently shaking pounds of seeds in lemon water, praying that this time would be different.

I'm glad to add a little more perspective to another source of addiction, Jenn! Hopefully I can pass this experience on and pay it forward.

-M


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Sat Apr 15, 2017 11:26 pm 
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Hey orion,

Very glad to hear you're doing so well. No seed sickness here thankfully. The main trouble
was that I was spending a fortune and could no longer accept that, and that I was living in fear of
losing my supply. I don't even like writing about it. It's all too fresh in my mind.

Now there's no more waking up at 3 am already edging into withdrawal, and having of course to drag myself downstairs to begin the tedious task of making tea. Now I wake up after a decent night's sleep and
sometimes even forget to take my suboxone. Sometimes, having gone through detox and drug rehab and years of AA earlier in my life, I feel guilty at how easy this has been by comparison. A few days of discomfort in exchange for a whole new life. It almost doesn't feel earned.

But it is earned. You've earned it. I've earned it. Almost everyone here's earned it by years of pain and suffering.

Keep hanging out here and keep posting. Sooner or later another poppy tea guy will be along and you'll be here to help him along. Pretty cool, how it all works!


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 Post subject: Re: Stabalizaton Issues?
PostPosted: Sun Apr 16, 2017 9:25 am 
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I agree that this has been so much easier than my alcohol "reprogramming". I went all out with that, told everyone I knew, Facebook posts, inpatient rehab.. Months of PAWs and depression. This morning I woke up and just felt... Normal? 5 days, that's all it took. The only issue now is I don't know how to respond to all these emotions flooding me - that S.O.B.E.R. saying is definitely directed at opiate recovery lol. Thanks everyone, again, for the support to get to this point. I'm almost grateful that I had the issues I did with the seeds, otherwise I'd have continued using them until I found that overdose.

Since it's no longer an induction issue I will move on to hopefully helping others. I do intend to stick around because besides suffering from addiction it is also a hobby of mine to research.

Happy Easter and recovery,
-M


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