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PostPosted: Tue Jun 29, 2010 3:12 pm 
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Well, i am still wondering what the right dose of sub is for me and I have to say my doctor didn't really give the subject much discussion at my recent appointment. Just--try to take as llttle as possible is all. The last "official" dose we'd settled on was 4 mgs a day. but i was taking more compulsively, adn more than once a day. Now I'm really trying to stick with a once a day dose of 4 mgs and hoping I can get to a lower dose than that ultimately. But, it seems to me it makes sense to try to stabilize at 4 mgs and also....I'm really happy that the main objective is going well-- I'm not using street drugs any more, and this is the longest stretch of that in a while, plus, I'm now taking my sub almost consistently. Now I've been taking sub for over a year and never had any side effects. I've seen some people post about extra sweating as a side effect but I have never noticed that. However, really bad night sweats has always been one of the worst symptoms of WD for me. I mean waking up every hour or more in the night just drenched in sweat, all my bedclothes and bedding just soaked. A few days ago i decided to try taking just 2 mgs of sub. That night i slept poorly and had night sweats (though not the worst case I've ever had by any means). since then I've been taking 3 or 4 mgs, in the morning. And I've been having some sweats at night. One day I took an extra dose in the evening and didn't have the sweats that night. Now, maybe the sweats are unrelated...Or maybe I've developed the side effect of sweats though I never had that before. Maybe ther'es no way to know. I'm also going through menapause. I also KNOW that sub lasts a long time and I wouldnt' expect to have WD symptoms after less than 24 hours from the last dose, at the earliest. On the other hand though, since I WAS dosing more than once a day, I wonder if my shystme has gotten used to more frequent dosing. I also wonder if maybe I should try dosing in the evenin g before bed instead of in the morning.

I know that sweats sounds like not that big a deal, and really, it has not been that bad, but it reminds me of WD and think in a way that is a trigger. I also feel chills in the morning.

Basically, I'm just still confused about what the right dose of sub is for me and wondering if stablizing at less than 4 mgs is a realistic goal. At this point, I'm thinking stabilizing at 4 mgs probably is a realistic and reasonable goal and it is also the last agreed upon dose from my doctor, though clearly my doctor thinks i should take an even lower dose if I can. At 4 mgs the sub does seem to block other opiates ( i have enough experience relapsing to know, I'm sorry to say).

Anyway, I'm doing pretty well overall. and i know no one other than my doctor can tell me what dose i should be on. but I'm just wondering if anyone has any experiences regarding dosage and sweats that you might share or any ideas. Ideally I'd like to discuss my dosage in more detail with my doctor but...well, appointments are costly and also my doc doesnt' seem to think exact dosage is a big issue and just hasn't seemed concerned about it other than really encouraging me to take as small a dose as possible. What I AM thinking really, is that I should stick with 4 mgs a day and that almost certainly I'll be fine. Then LATER I might want to try to lower the dose. My dosing has been just all over the place until I recently started to do better (last couple of weeks but as I said, I STILL am having some trouble being 100% consistent.) So...maybe I just need to be patient. As well though...I'm concerned about cravings....I DO still have cravings to get high and I wonder if being on a slightly higher dose will help that. On the other hand, I know that sub cannot be expected to take away all the psychological cravings and that it is important for me to be patient and meanwhile the main thing i can do to help myself have less cravings is to NOT RELAPSE at all...and gradually I'll get more distance from my addictive behavior, etc etct....

Anyway, I know no one can just tell me what to do, but I just wanted to post about what's going on with my dosage and see if anyone has any ideas about it or any experiences to share. (Thanks). I'm really happy to be posting this from such a much better place than my earlier posts from last month....I was so desperate then and taking my sub so compulsively. I wish I could report also that I don't want to get high....but like I said, I know that more time will help that and meanwhile, the main thing is to NOT RELAPSE. And....one cannot expect life to be completely free of pain and anxiety all the time. I am a person with a lot of good fortune in my life and I know that turning to heroin will only make things WORSE. Nonetheless...i still wish for escape from myself sometimes.

I am also still stablizing on prozac. i think it's helping. I know I'm doing overall better fro sure. I do wonder what's going on with the night sweats though. Whatever I do though, I guess I have to keep in mind that it takes TIME to stabilize when changing dosage or medications. Boy, it seems like being impatient is one of the unfortunate things that goes along with being an addict...

Anyway, if anyone has any thoughts to share, I'd appreciate it, thanks.


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PostPosted: Wed Jun 30, 2010 12:57 am 
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I read that you are beginning to stabilize your dose on two different meds. Prozac I really can’t say how that med will work or interact with the subs. I do know that there is a beneficial mood stabilizing bonus effect with the suboxone. Perhaps you can discuss with your doctor about the possibility of concentrating on one med at a time. :idea:

I think Suboxone IMO is the first one to address as it is going to stabilize quickly and you may notice other benefits from taking it properly that you aren’t aware of yet. Take the 4mg a day and take it in the morning not at night. Fighting your cravings and your thoughts about using is usually the hardest when you are awake. So keep the dosing to the morning and not at night and the sweats will stop as I am thinking they are from slight withdrawals due to your dosing all over the place and not sticking to any one routine or fixed 24 hour dose. Try and stick with 4 mg all at once in the morning.

Once you are comfortable you can try multiple doses of 2mg several hours apart and eventually dose 1mg at a time every 3-4 hours until you've hit 4mg total and see how that feels. There is a chance that as you are stable on 4mg a day, once you start multi dosing you might feel the effects more and then you can try and eliminate a 1mg dose from your day after a while.

I am not at the taper stage yet. I am still dosing at stable levels and am not dropping with the intention of getting off suboxone yet, I am trying to control my intake and the efficacy of my doses. I struggled with bouts of insomnia a little bit in the first 2 weeks and headaches....but you can supplement with OTC meds to help with that or talk to your doc. As far as the Prozac stability I really can’t say as I am not at all familiar or experienced with that med...check with doc and make sure you remember to to tell him/her exactly what you are feeling, both good and bad.


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PostPosted: Wed Jun 30, 2010 8:09 am 
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Hi Auto,

I'm so proud of you for how well you're doing! You've come a long way from when you joined this forum a month or so ago. So give yourself a pat on the back for me.

Since you're still stabilizing, I wouldn't suggest trying to go lower than 4 mg and I would keep that dose to once a day, especially considering you history of taking extra doses when you feel you need "something" to help or alter your mood. I would stay away from multiple dosing during the day. Remember, dosing once per day helps us to stop taking a pill when we don't feel "right". 4 mg is still a pretty low dose; some would say because you're still stabilizing and having cravings that you might need 6 mg. I'm not saying that's what you need, but it is an option. As long as you're not tapering off, the dose you're on is just a number. You need to take what's best for YOU.

I don't know if this helps or just gives you more questions, but I wanted to throw that out there. Good luck and keep us posted.

OH and one more thing....I hate to say it, but the night sweats you're describing sound an awful lot like menopausal or pre-menopausal hormones at work.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Wed Jun 30, 2010 2:10 pm 
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Thanks you guys. Actually, I agree with Cheshire, that dosing al over the pace wasnt' very good and it might take me a little time to stablize and maybe I have had some mild WD as a result. though, Hat, you're right too, sweats COULD be menaapause related adn also i really agree with you that I should dose once a day for now...I think I'll be ok at 4 mgs if I stick to it...though, I wonder a little about the ceiling effect and cravings, if maybe a slightly higher dose would be better...but...I'm gonna keep trying for 4 mgs once a day for right now because I AM doing so well really.

Anyway the other day I found 2 tabs of .1 mg clonidine. so yesterday i took 'em both, just because, ie, addict behavior, even though they had exp. dates from like 6 years ago. I don't know if it had any effect on me, but today I have a headache, maybe from sleeping too long.

I also mentioned to Hat, separately, that, I face another potentially bad situation....I've decided it's best to talk about it and that I am less likely to act on temptation if I've discussed it with others. so...I've been working some for a friend of mine who is disabled. I'm helping her work on cleaning up her home. She has ALL kinds of pain meds...dilaudid, phentynol..and then other stuff too, like valium. So...have I thought about it? Yes. Luckily I'm never alone when working there. And I've decided I'd better keep it that way--that is, if my friend ever suggests I work there without her, I'll say no. Also I finally know for sure that the suboxone does work to block opiates so the last thing I want to do is steal pain meds from my friend and employer when they won't even WORK on me!!!!! But...as I mentioned to Hat too, I really would hate to end up breaking trust and doing something like that. I know that I AM capable of it, but....it really would be bad. I know I could just take one or two, and probably she'd never notice (in fact sometimes she ends up throwing pain meds away, now if THAT happened in front of me, I don't know that I could resist) but...I also know that once you cross a line....it's easier to cross that line again, and then pretty soon you are way over your head in a bad situation--like taking so many of your friend's pain pills that they don't have enough for their very real pain!!!! Besides, stealing is wrong anyway. And from a friend who also employs me? And trusts me in their house.....

My friend knows something of my addiction history and knows I'm on sub. In fact, I now realize I should tell her that it would be good if the pain meds were not right in front of me, or..just mention that I should not be left alone with them. Of course I don't want to tell her that...but I know I should. I know she'll understand--I don't really have to be worried about being judged. But....I dont' want to because actually I am hoping that somehow I CAN get some of those pain meds and that somehow I can stop taking sub long enough to get high.

Well this isn't great, but I guess it's not exactly unexpected. And...at least I have taken the step of talking about it here. Right now I'm not in any immediate trouble as I dont' have a date scheduled to work at my friends house. but I probably will soon.

Anyway, addict behavior and addict mentality. I still wish i could get high. At least i'm talking honestly about it to someone.


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PostPosted: Thu Jul 01, 2010 4:36 pm 
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First thing - Hat is right IMO about maybe needing to increase dose of sub (by 1 or 2mg daily)and definitely stick to single morning doses....for now until you are stable physically and probably with that will come some emotional stability too. Any dose manipulation that I have tried was all done after taking my meds religiously for 3-4 weeks. I'd say talk to your clinic doc about the dose level so you don't run out of tabs before your next script. I wish you felt your doctor was more attentive to your needs.

Next thing - I think that you should, at the very least explain to you friend/employer, how seeing her pain meds laying around makes you feel uncomfortable. You don't have to mention that you are tempted to snag a few but you can explain how it makes you think about how they used to make you feel, since she already knows about your treatment, that conversation shouldn't be that uncomfortable for either of you. Remember out of sight out of mind goes along way to removing the temptation. Maybe she could keep them put away somewhere that you don't have to clean or wouldn't come across them during your visits. It is good that you are telling yourself that they wouldn't satisfy you anyways, that is part of you recovering from the abuse of them in the past.....lets face it ...before we took Suboxone, there is no way any of us would've had that moral debate with ourselves. Satisfying our need for drugs was to powerful to consider the consequences......so take that as a sign that you are making good progress.

Last thing - those Clonidines you took are to help cope with WD's. They lower your blood pressure and assist in diminishing feelings of anxiousness.
I have heard reports of expiry dates on pharmaceuticals being a bunch of bunk......but the Pharm companies wouldn't admit to that in a million years in order to maintain sales numbers.

Everyone has your back here...you keep doing what your doing and don't doubt your strength. Your posts read like they are being written by someone with strength, who is introspective and willing to ask for help with out letting pride get in the way.
Good to hear also that someone is reading what I write...I hope I don't come across as a know it all. I only advise on what I've experienced and what I know to be true from multiple sources. I think it extremely important to seek council and information from more than one source when dealing with a condition as serious as the one we all have in common. I will be posting some questions of my own soon and hope to hear your thoughts as well as others on some of the things that I deal with.

Cheshire :)


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