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PostPosted: Wed Aug 29, 2012 9:04 pm 
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Hello I'm not new here I had an old account but I cannot log in for some reason it will not work.
So I made a new one. So here's the deal. Abused perks ocs viks whatever I could for a few years.
Went onto suboxone about a year and a half ago and started at 24 mg a day.
So the plan with my doctor has always been taper down slow and steady and then when I'm ready jump off
I'm currently at 6mg a day. So a few days ago I go Into. My appointment like usual and my doctor comes in and congratulates me for being under one 8mg pill a day finally and then talks to me about the usual stuff. He then out of nowhere tells me that next month when I come in he will be taking me off of sub and putting me on naltrexone injections once a month.
I ask what it is and he tells me it's like the same thing as sub and now that the drug habbit is gone" he wants to break the taking a pill everyday habit"
I am on the film btw. I have never failed a UA or lied to him, always tapered when he asked me too.
Have basically been a model patient. I do not feel okay with this sudden shock after a year and a half.
I am so scared as I feel I am not ready to be off at all. I just got good insurance and a good job and was planning on finnally seeing an addiction therapist.
I am so scared I am going to be forced off before I am ready and my life will go back to hell.
I am taking this program sirious and am wanting to solve my root issues before I come off.
We have never in almost 2 years talked about what he wants to do or anything close.
The plan has alWays been the same to taper low as possible and jump. I'm only 23 years old btw.
So the fact that I've been a good patient and have followed all rules why is he all of a sudden trying to get me out the door quick? I am soo lost.
He has to have some kind of motive like too many patients or something but I have payed thousands of dollars to this place and I deserve to be allowed the time to taper down and jump at a reasonable dose. Any advice would be greatly appreciated.


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PostPosted: Wed Aug 29, 2012 9:39 pm 
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First of all, your doctor is an idiot.

Second, 6mg is a huge dose to jump off of.

Third, Naltrexone is NOT like Suboxone. Naltrexone is a pure opiod antagonist!! Naltrexone is an opiate blocker only, it has no activity at the mu opiate receptor, other than to occupy it and block other opiates from getting in. Suboxone is a partial agonist, it binds to the opiate recpetor and partially activates it, thus, no cravings for opiates. OC's, Vic's are full agonists, they go to the mu receptor and hit those baby's with 1000 volts and excite the hell out of them.

Fourth, your doctor is an idiot.....ooooops, I think I said that one already! :D

You should tell your doctor exactly what you told us. Tell him you don't think you're ready yet. Tell him you're afraid of a relapse. Tell him you just got your things together to where you can see an addiction therapist. You can maybe ask him how many other patients he's detoxed off of 6mg of Suboxone.....nah, don't do that, he'll probably just lie to you.

Between now and your next appointment, I'd be looking for another Suboxone doctor, just in case he does force you to jump.

Lastly, your doctor is an idiot!!!

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 Post subject: Thanks romeo
PostPosted: Wed Aug 29, 2012 9:57 pm 
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Yes I no the difference between the two now after doing some research. I just don't understand how a doctor could be so stupid and negligent.
I've always kinda known that he knows nothing about suboxone from other stupid comments he has made in the past but have just dealt with it and done as much research myself to no what I actually need to be doing. I have been in panic since yesterday when he told me. I have had trouble while tapering down in between doses at times so I no jumping off would maximize my chances of relapsing. I just hate how a doctor can have so much control over my life. Furthermore, he also mentioned how before I could go onto this "shot" that I would have to be off sub for at least 8-9 days. He also said right after that I had two choices I could do a rapid detox at a clinic, or I can do it myself and he could give me cocktails to make it more comfortable. I just jumped a few weeks ago down to 6 from 8 and everything was fine untill my appointment. I am going to look for a new doc I just hope that I can find one that will understand my situation. This just leaves me feeling anxious as hell at all times and very insecure. If I can't find a doc In time and he makes me come off I will get fired from my job because I cannot take time off. This could really screw me up. It's just not fair, and I want to no what his intentions are since this was as random and unpredictable as could be. Any guesses? Thanks you Romeo for taking the time to talk you don't no how much I appreciate it


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PostPosted: Thu Aug 30, 2012 12:46 am 
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WOW.................

I am soooooooooo sorry this is happening to you.
yes, #1 priority I think is to find a NEW doctor!!!
obviously you're doing that. I hope you can find one, a GOOD one. At least you have a LITTLE time to get in, and insurance now too, thats GREAT.

Geez, I wish I had some magical answer, but I just dont.
heres a couple links, if you dont know these ones for doctors.

www.naabt.org
https://www.suboxone.com/patients/opioi ... octor.aspx

[marq=right]GOOD LUCK[/marq]

Please keep us posted :wink:

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PostPosted: Thu Aug 30, 2012 10:33 am 
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Hmmm, it's really hard to figure out what his intentions are. From what you said in your first post, about the plan has always been to taper down slow and steady and when you're ready, you'll jump off.....that makes me think your doctor is just pushing you? He may have no real intentions of starting you on Naltrexone yet? It's really hard to say, though.

He may be dead serious about putting you on Naltrexone because he believe that's the best course of action for you? Again, it's very hard to say.

What you have to do is convince him that getting off of Suboxone is not the best course of action for you. I would talk to him about the progress you've made, but I'd also mention that you're just not ready for the jump yet. If he insists on getting you off of Suboxone, I would plead with him to let you continue lowering your dose because jumping from anywhere near where you are isn't gonna be pretty. Ideally, you should taper well below 1mg. Getting well under 1mg before you jump will minimize your wd greatly. Honestly, if I were you, I'd shoot for getting to .25mg. We've had several people jump from around .25mg and their wd has been very mild.

I don't know how you get your doctor to understand that 6mg or anything near that dose is too high to jump off of. If you tell him you heard it on the internet, he'll just scoff at you.

You could try to look up some of Dr. J's articles about tapering, print them out and maybe your doctor would be willing to read what another doctor has wrote?

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PostPosted: Thu Sep 06, 2012 1:42 am 
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Ditto what Romeo said about your doctor being an idiot. Only Romeo didn't say it enough!

Are you in an area where there is more than one sub doctor? I wish you were in Colorado so I could hook you up with my doc, who is NOT an idiot!

I'm sure you're looking hard for a new doctor, and I sincerely hope you find one. I'm trying to think of what I would say to a doctor in this situation. Something like:

"I understand why it's important for me to get off suboxone, and I'm totally on board with that as my goal. I'm very concerned, though, that stopping sub so abruptly at 6 mg is going to incapacitate me for a few weeks. It's so important for me to be at my best for my new job, and now that I have gotten my life back together, I don't want to derail the progress you've helped me make. Would you please consider letting me taper to 2 mg before I have to totally quit? I'm sure that some people can go off suboxone at 6 mg (yah right!), and be successful, but with the stress of my job and being a single dad, I believe I will not be able to make it without serious consequences."

Plus, if you have an alternative taper schedule like Dr. Junig's printed out to hand to him, that might help.

It's crappy doctors like this that make people feel like they have to hoard sub "just in case". What a butthead!

Amy

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PostPosted: Thu Sep 06, 2012 7:35 am 
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[font=Comic Sans MS]I don't understand what the hell is wrong with some of these doctors. My addiction counselor just tried to tell me yesterday that the FDA has only approved suboxone for maintenance up to 24 months. Then I smacked him upside the head with the facts, and he quite frankly looked a little stunned that I was as informed as I was about sub.

Anyway, I think you have gotten some great advice from Romeo and Amy already. All that I wanted to add was if you are completely honest with him, he SHOULD understand. Tell him what you told us. It's a damn good reason not to taper just yet. On top of that, you haven't even begun to deal with the underlying issues with an addictions counselor. Oh, and a film isn't a pill.....idiot doctor....did someone say that already???? Romeo???? Was it you???? I can't remember....oh well....LOL

I think that you should rehearse what Amy typed out for you. Don't go in there sounding like you are auditioning for a role in a movie, he'll be able to tell. Just shoot straight from the hip. You got this. And if he is still adamant(sp) about tapering you, you should already have another doctor lined up, because you are looking for one right now correct? Please do that if you aren't already.

Best of luck to you and let us know how it all works out....[/font]

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PostPosted: Thu Sep 06, 2012 7:49 am 
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Hey scared, I don't know where I got the part about you being a single dad. I must have transposed that from someone else. (That's what I get for posting in the middle of the night!) Of course, anything you could say to bolster your case is alright to say in my book. If you have to use a few white lies to combat your doctor's stupidity, I say go for it. Just don't lay it on too thick. Make sure that you speak from the heart when you talk to him. Goinstrong brings up a good point about the fact that you haven't even started with your addictions counselor, so you still have issues to work on before you should taper off all the way.

Amy

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PostPosted: Thu Sep 06, 2012 9:37 am 
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He said he wants to rip you off 6mg? That's a bit steep. It's especially nasty if he's considering doing a straight switch to naltrexone. That could be really ugly.

I honestly can't guess where your docs head is with this, because it really wouldn't surprise me that some doctors might think their patients will be fine doing a switch from 6mg bupe to vivitrol even without a washout period.

There is fuck all research about naltrexone for opioid addiction alone let alone inducing on naltrexone from bupe. Whatever your doctor has planned would be largely experimental. However, when naltrexone is used with a person already dependent on opioids, there is big potential for pain.

If I were you I'd start asking questions. Has he done this transition before? What measures does he have in place to prevent precipitated withdrawal? Can he guarantee there won't be precipitated withdrawal? Will I be able to function? Can I have this shit in writing?

I get the feeling that some doctors feel they have more leeway to "experiment" with patients who are addicts. My doctor suggested to me that he could rapid detox me off buprenorphine using naltrexone. Don't let yourself be a guinea pig. Make sure he knows what he's doing.

Here's a post from years ago where someone got sucked into something similar by their foolish (or sadistic) doctor:

Quote:
A few years ago (before most medical professionals knew anything about Sub detoxes), my Dr recommended and implemented the follow method for my Sub detox:

Decrease dose to 2mgs every 24 hrs. Stop taking, wait 48 hrs, then take 1 100mg Naltrexone tablet every 2 hrs until withdrawal symptoms subside.

Let me just say (as I'm certain you have already guessed) that this was complete and utter HELL. What I was technically doing was the same thing as a rapid detox using a large quantity of pure opiate antagonist-- sans the general anesthesia that is normally given during such a procedure.)

From a 2mg Sub jump-off, imagine squeezing a 10-15 day detox into an afternoon.... I'm surprised the experience didn't give me PTSD. I still felt pretty bad for the week after, and my skin crawled for the next 13 1/2 weeks.

However, I am currently at the end of a slow, liquid taper, have a few tablets of Naltrexone left, and I'm thinking of MAYBE trying it again if my withdrawal symptoms wind up dragging on and on. Two hours of slight discomfort (I'd be coming off .1 mg this time, instead of 2mgs) would be better than 2-3 weeks of nagging WD symptoms.

We'll see how brave I get. I'll post if I try it.


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PostPosted: Thu Sep 06, 2012 10:09 am 
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[quote="Amy-Work In Progress"]
It's crappy doctors like this that make people feel like they have to hoard sub "just in case". What a butthead!

Yes Amy, this is exactly why I am doing things the way I am. I'm sure some of you know that I am prescribed 16mg a day, but I am only taking around 4-6mg a day, sometimes a whole 8mg, depending on my pain level.

It's stories about drs like this quack that scare the daylights outta me and the reason I am "hoarding" my sub! My dr. seems great, was actually an addict himself at one point, and says that when the time comes, we will taper very slowly... but, you just never know. What if I'm in the program a year or two and my doc decides that it's time for me to jump at 6mgs like Scared's doc? I just cannot imagine having to go through that.
I am doing so well in the program, and I've already paid him almost a thousand bucks just since starting 3 months ago. I know I have a lot more cash that's going to go into this program too before I'm done. I have insurance now which is a huge help with getting my script filled, but I also worry about the economy and what would happen if my husband suddenly lost our health insurance.

Both of these factors are the reasons why I keep my left over subs in my parents safe so that I know I will have enough to do a slow taper if I have to.

Scared, I am so sorry your dr is putting you through this. Who knows why or what his motives are, but I sincerely hope you're already searching for another dr. You sound like you really have been a model patient and you just need a little more time to do a slower taper. I hope you can talk some sense into your dr and get him to understand this. If not, look for another dr asap! I'll be thinking of you and wishing you THE BEST OF LUCK!

Please keep us updated and let us know what happens!


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