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PostPosted: Tue Jun 21, 2011 3:15 pm 
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Hi to all -

I thank everyone in advance for reading this posting and for any help that you might be able to contribute; I am really just quite ignorant when it comes to the chemical backgrounds of most of the drugs that are discussed on these forums and, really, particularly ignorant about Naltrexone in general. I'll discuss the study below, but first some details about me:

I've been on Suboxone for 3+ years (my dose is currently 1mg a day and has been for about 3 months - a 2mg or lower daily dose was actually one requisite of this study) and am ready to be off of opiates entirely, so when I saw the opportunity to participate in a study that would "have me off of suboxone/opiates in a week" for FREE, I jumped at the opportunity, despite the fact that I was not sure exactly what this Naltrexone is and why it would be involved. I just figured that if I'm ever going to get off of this stuff then why not do it in a hospital setting where there are nurses/doctors there to provide you with "medications to help ease withdrawal symptoms" and also to look over you in general - plus, of course, I'm much more likely to go through with the full jump-off of suboxone while in the hospital for one straight week, as opposed to attempting to do it on my own. And it's free!

However, the more I've read about Naltrexone over the past week or so the more I've grown quite wary of its potential effects (really I've read mostly horror stories!), and the more that I've read about Bupe withdrawal and detox have made my doctor's assertions that the intense withdrawal symptoms should only last about 2-3 days of the study from the 1mg of suboxone (that I've been on for 3+ years) now seem to me to be downright incorrect!

The details of the study, in brief, are that I'm to take my last dose of suboxone (been on it for 3+ years) on Friday (1mg) and then check into the hospital for a week, during which they monitor my vitals, give me medicine to keep me "comfortable" through the w/d of the bupe (they offer, if I'm not mistaken, clonodine, ambien and some sort of benzo in addition to the usual tylenol, etc.) and then three days after the suboxone is stopped (so Monday, I suppose) I will be started on a very low dose of Naltrexone, by which time my doctor has told me "withdrawal symptoms will have begun to subside or at the very least have plateaued."

I'm under the impression that the purpose of the naltrexone in this study (in addition to the fact that it blocks one's receptors from taking other opiates) is to moderate the severity of the withdrawal symptoms. My doctor has told me that the 2-3 days of withdrawal should not be at all too bad and that the final 4 days of my hospital stay (when I'll be on the Naltrexone) should be pretty much a breeze.
On my final day at the hospital I'll be given a shot of Vivitrol, which, I guess, lasts a month, and I'll have weekly check-ups to the hospital once I am discharged to check up on the effects of the Vivitrol/Nalrexone.

I am tired of having this crutch of opiates in my life and want them out of it ASAP. Although suboxone has been a godsend in my transition from opiate-abuse, it is still something I am addicted to and something I no longer want in my life. That being said, when I was presented this opportunity I thought that it was the best thing that could happen: the possibility to be off of EVERYTHING in one week's time (I start this Friday)! However, and this is probably partly my fault, I've been filling my time leading up to the study scouring the internet for testimonials of people who have done similar tapers to jump off of suboxone (not really much out there) and finding information about naltrexone that is downright scary! Most people say to stay away from it like the plague! I realize that I will be receiving a small dose of it, but it is just hard for me to imagine it helping these symptoms when people have so many bad things to say about how it can negatively impact someone's road to sobriety...and this is scaring the @#%# out of me! Add that to the fact that I really think my doctor is underestimating the length and severity of the withdrawal that I will be going through from the 1mg of suboxone, and, honestly, I'm currently doubting even checking in on Friday now, three days before this study that I was previously so excited for.

One thing I have yet to do, though, is reach out on a forum like this, or, really, anywhere for that matter, and just writing this all out has been a little cathartic for me. But, obviously, what I would love to hear (and truly, truly appreciate) would be people's experiences with anything similar to this study, what people may have heard about similar experiences or really just any comments or suggestions you might have for me, be they positive or negative, encouraging or discouraging with regards to the study. Essentially, I don't like the idea of going into this study completely blind, so I am seeking any sort of additional information anyone can provide me which might make what I will be going through more predictable.

I thank you once again for taking the time to read this whole thing, and I can't say how much I would appreciate any responses/comments you might have for me, be they in this forum or privately. I don't mind them being public, obviously, so please be honest and give it to me straight! Thanks again for your help, in advance, and the best of luck to you all as well.

Regards,
B

P.S. I found an e-mail from my doctor, which stated the actual "purpose" of the study:

"The study is meant to investigate whether naltrexone's antagonism of kappa opioid receptors leads to an amelioration of withdrawal symptoms. Kappa antagonism is believed to help with withdrawal symptoms."


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PostPosted: Tue Jun 21, 2011 5:32 pm 
Hello B, and welcome! I am quite interested in this study you are about to participate in! My doctor actually mentioned almost exactly this type of "plan" in assising patients with their Suboxone cessation. I've been on Sub for almost two years and until my appointment last month, he's never suggested anything like this. What he told me was that a collegue of his who is also a Suboxone prescriber, has begun to offer his patients something quite similar to what you described, minus the hospitalization. He basically said that he plans to try this with patients who are struggling with getting off that last one or two milligrams of Sub. What he said he would do is have the patient stop their 1-2 mg/day dosing, wait about 3-4 days and then give them a shot of Vivitrol.
Now, when my doctor suggested this, I have to admit that I thought and actually said, "I'm sorry, but that doesn't make a whole lot of sense to me." I guess I just don't see how taking a full antagonist is going to help with withdrawal. My doctor wasn't able to give me a satisfactory explanation, although he did try. So I'm thinking that I'll just wait until I've seen some results from others before I'll jump on that bandwagon!
Here's the thing, though. Although you're the first person I recall here asking about this particular type of protocal, you're not the first person I've heard who has tried or thought about trying low dose Naltrexone after getting of Sub. In fact, a friend of mine has tried it twice now. Shorty after both attempts, this friend has chosen to go back on Sub due to lingering w/d and PAWS symptoms. That, of course, leaves me wondering if there is any promise to this type of protocal or not.
Then again, we are all so different. I don't honestly believe that my friend was truly, truly in the right place to be completely off the Sub in the first place. You and others, however, may well be. It certainly sounds like you are. For instance, if you've not had any slip-ups, relapses, etc for a very long time and if you have done the necessary work and have a good relapse-prevention plan in place, that makes a HUGE difference.....ALL the difference in my opinion.
I will ask you this, though.....Have you attempted to just keep tapering on down from the 1mg/day? What has kept you from doing that, if anything? Of course, you don't have to answer if you don't care to. I'm just curious.
I think a lot of us, myself included, are certainly looking for a softer landing in this thing. If there is any chance that your doctor's theory could help us, then God bless you for being willing to try it! I also believe that attitude plays a large role in it, too.....You need to go into it believing that it will work, you know? The other thing that comes to mind with your situation in particular is that you have been on a real low dose for a real good while. I think that will work in your favor as well.
I wish I could offer you more information, but that's all I personally have. I would love, love, love to know how it works out for you! Thanks for signing up and sharing with us. Hopefully you will get some more replies!


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 Post subject: naltrexone study
PostPosted: Tue Jun 21, 2011 6:18 pm 
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Hi Masemase,

Thanks much for posting about this. Many (maybe most) people on this site will be interested in the results of this study. I don't blame you for being nervous about participating in the study. I too would have some doubts about it, I think most of us would....for one thing, as you say, from what I understand of suboxone...it can take 3 days off it before withdrawal even starts! Although, I think (not sure) that maybe withdrawal tends to start sooner when one is on a low dose like 1 mg. But most of the reports on this site from people describing their experiences....withdrawal does NOT usually seem to peak around the third day, low dose or not. So....I don't know what to think about that, but is certainly is one area of concern. If I were you I think I would make a list of all my questions and concerns and try to get the doctor to address them all in advance of starting this study. I also can understand why it sounds like naltrexone would be the opposite of what you would take to help withdrawal symptoms but I too have heard of using Low Dose Naltrexone (LDN) and apparently at low doses it has some different effects than at higher doses. I can also say that from all the different stories I've read of people getting off sub on their own--people swear by clonidine, and most people do want medication to make them more comfortable. So, being in this study , sounds like they will provide that. Anyway, I want to wish you luck, and I too hope you will let us know how this turns out.


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PostPosted: Thu Jun 23, 2011 3:07 am 
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I thought that as well setmefree.

I remember I was in the throws of methadone withdrawal. I was on about day 20, so it was still pretty bad, but starting to subside a little bit. Anyway, I started naltrexone pills, and my withdrawals improved considerably. I was able to function again. I still don't understand it, but I can't deny what happened.

That being said, the high doses of naltrexone you get while taking the Revia pills have unpleasant side effects. My neck felt stiff constantly, I had weird headaches isolated to my temples, and a jittery anxiety that followed me around whever I went. I've heard that it's heaps better when you have the implant or the depot injection however.

Mase, the only thing that doesn't sit 100% right with me is the "by 3 days you will be at least plateu'd". Like autonononymous said, sub detox usually starts to kick in end day 2 and peaks around day 7 or 8?

Also, is it a double-blind study? Will there be a control group? If so, there may be a chance you will get a placebo instead of naltrexone. Regardless, you will still be in an assisted detox, so you'll come out a winner anyway (as long as you stay clean) :D


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PostPosted: Thu Jun 23, 2011 9:23 am 
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I've been hearing more and more about Naltrexone being used to help with opiate withdrawal, at first I was like WTF?? I couldn't wrap my brain around how in the world Naltrexone would make things better, maybe after it made things 10 times worse, it would make them better, but apparently this isn't the case??

I'm curious about seeing the results of this study as well, especially after reading what Tearjerker wrote about his experience.

BTW Tear, I got the same jittery/hyper/anxiety for the short time I took Naltrexone, it was so bothersome that I discontinued them. I believe I was taking a 50mg pill. I also tried cutting my dose to 25mg, same side effects, so I just said f*ck it and tossed 'em.

masemase, thanks for posting and sharing on this subject.

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PostPosted: Thu Jun 23, 2011 11:34 pm 
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Thanks so much to everyone for responding...truly. I am going for it tomorrow and will report back in one week. Please wish me the best of luck, and thanks again so much for all your suggestions, comments, concerns, etc. I think I have to go for it, so...we'll see what happens. Here goes nothin...

B


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