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PostPosted: Wed Feb 17, 2010 10:53 pm 
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This is my first post here. I went off suboxone over 5 weeks ago. I was on 12 mg per day and quit after 2 years. I needed to have a couple surgeries I had put off and my doctor was such a jerk that I felt like I was selling my soul to get the suboxne. I just cancelled my appointment as he said I would have no withdrawals. I missed 1/2 day of work on the 5th day. The withdrawals were horrible but with clonodine, ativan, restless leg medicine, trazadone for a week or so I was ok. I have been sleeping for 2 weeks now without any trazadone.

Now for the down side. At this point I don't care if what I have is PAWS or what....it isn't livable. Taking suboxone made me feel more normal than I have ever felt in my life. I had a hard time tapering from 16mg to 12mg but at the higher dose I was ok. Certainly wouldn't need that much now. I am depressed and have serious anxiety. I had some depression and some anxiety on the suboxone, but I was still happy. I am not happy. I don't want to get out of bed. I am miserable at work when normally I love my job. I am barely functional. I am going to NA which isn't making me feel better. I have a therapist I am seeing regularly and I am lined up to

I have already tried wellbutrin, prozac, trazadone, celexa, Lexapro, stratera to no avail. I have been diagnosed as ADD and for some reason, I focused better on suboxone which is part of why I liked it. I would love to be off of all drugs but I am not sure I am one of those people who can do this. I miss the suboxone. I miss being comfortable in my own skin. I miss enjoying my days. I am dreading the psychiatric appointment I have coming up because we will begin a new trial and error of non-addictive drugs designed to torure me and help me lose my job as my performance decreases when they don't work. I am about to give up, but I have surgery March 1st so I have to at least wait till that is done and I would have to find a new suboxone doc too. I am not sure I will make it. And this is th 2nd surgery since going off and I have to say I had little to no interest in the vicodin post surgery except that I was in massive pain for about a week and that did help.

If I went back on Sub now, it would be for the depression. I will always have to have surgeries so that is difficult on suboxone but way better than this. I have been on one substance or another off and on since I was 15 years old. I think I have self medicated this feeling my whole life. Suboxone took all of that away. I don't think I should have gone off. Can anyone offer words of wisdom here? I also don't trust my addict mind to make good decisions either.

Thanks,
Cherie


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PostPosted: Thu Feb 18, 2010 1:34 am 
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Unfortunately, somebody will blame your symptoms on taking buprenorphine... but they are typical for withdrawal from any opiate. Five weeks is not a long time; methadone withdrawal, for example, usually takes several months to get out of the 'acute' stage. My own detox years ago was from IV fentanyl, and I remember first feeling like I slept for more than a few hours at about the 6 week mark. At that same time, though, I entered a deep depression that eventually lifted on 80 mg of fluoxetine.

I want to make one point very clear-- there is NO evidence that buprenorphine has some 'especially horrible detox' despite what is often posted here and there. I won't prevent people from posting their stories, but after 16 years of opiate addiction and treating 450 patients with buprenorphine, including some for years who then tapered, the withdrawal from agonists makes a person non-functional. often to the point of requiring a hospital bed (although people rarely get that far, as the drive to use makes tapering extremely difficult, and impossible for most people). On the other hand, some people CAN taper using buprenorphine, and while they complain and feel horrible, they can walk... and often remark in the middle of the horrible experience that if something distracts them, the symptoms decrease markedly. This does not happen to near the same degree with agonists.

Whew-- had to get that off my chest.

I think, Jack, that it is just too early. I'm a little confused as you say you have been off bupe for 5 weeks, then you list a bunch of antidepressants you have tried-- most of those meds, including lexapro, citalopram, prozac, and wellbutrin take at LEAST 4 weeks to even START working. The typical process would be to start an SSRI and at 6-8 weeks increase it, say from 20 to 40 mg, then after a month to 60, then after another month to 80 mg. It would take a year to do real trials of several antidepressants, so I am not sure if you stopped some prematurely or if you took them in the past. About 70% of people respond to the first SSRI prescribed; the other 30% take more trial and error, but eventually depression responds to treatment. But it takes much longer than 5 weeks-- even for the first medication to work.

ALL addicts can be in a 'dry drunk' where they have stopped using but they still have the addict mind-- and an addict mind without the substance is probably more miserable than an addict mind WITH the substance. That is the reason for recovery programs; nobody 'likes' them initially; we all go because we needed to go to stay alive, or to find a life. Addicts tend to have that 'terminal uniqueness' that makes each of us believe we somehow don't need the meetings that everyone else needs. But that is just folly! Why should YOU be any different?!

You have two choices in my opinion; make a go of it without buprenorphine, by embracing a recovery program with all your might.... or wait for the inevitable relapse that puts you back on buprenorphine (providing you don't OD or end up in prison). I encourage you to examine the part of yourself that thinks that you, for some reason, can escape this nasty addiction without doing what everyone has to do, if they hope to escape. Usually it takes months of residential treatment and total surrender; if you are desperate enough you might have a shot by doing a meeting at least once per day. But to think you can just stop buprenorphine, and everything will be fine?! Why should that happen for you, when it never happens for anyone else?

I don't mean to be hard on you, by the way-- only to point out the crazy way all of us addicts think at the stage you are currently at. Most people have a very hard time staying clean, even WITH the help of buprenorphine. It is a very rare thing for a person to do it through the steps-- but it CAN happen if you want it bad enough. But sobriety and a good life will not come after opiate dependence, unless you work on it-- probably for the rest of your life.

Hang around-- there are some people here who will tell you how hard it is. But as they say at meetings, 'if you are willing to go to any lengths....' than you can find the better life you are hoping for.

Take care, Jack-


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 Post subject: Clarification
PostPosted: Thu Feb 18, 2010 8:15 am 
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Thanks for the response. To clarify, the anti depressants were all in the past. I see the psych doc to try something new in 1.5 weeks. My skepticism is that they have never helped in the past. I feel like I am doing what the medical community and my family think is "best". But my family is full of addicts and both my partents are on multiple antidepressants, benzos, and/or mood stabilizers and whatnot so why should I think it would be different for me? My Dad has been on disability for bi-polar disorder for years. I don't recall EVER feeling comfortable or normal so why should I think I will now? I didn't think the withdrawal was that horrible. I mean it was bad but oxy withdrawal was at least 2x as bad and I only took the drugs to get through it for about 4 days. I wouldn't know about the length of withdrawal from oxy because I never stayed off the oxy long enough to know how long the PAWS would last.

If I ignore all of the outside influences, then I would have to say I have one life to live. Regardless of the past, this is where I am now. I felt great on suboxone. I didn't have negative side effects. I did withdrawal a bit but like others have said, I do that when I am not on it even worse. It controlled my intermittent chronic pain for the most part. I never noticed my peripheral neuropathy until I got off of it which is highly annoying. I never had a dirty UA. I never wanted to use and never had cravings. I could spend months of misery with trial and error of more antidepressants or I could just take suboxone. Quite frankly I am spending more money on therapy and medical appointments now than I was then anyways. BUT...if someone told me this feeling would go away, I might be more interested in trying to stick it out. Right now it just seems like a pain and a waste of time.

FYI: My suboxone doc told me there was no point in going to NA when on suboxone because you still had a substance. It would have been a lot easier to do this with a support system. My straighto potato husband thinks NA is for people who ARE using so he gets nervous when I go. I am sneaking around just to get into them. I just don't think this was well planned for a variety of reasons. Either way....I still have at least another 3-4 weeks to see what happens before I can make a decision anyways since I have a surgery.

Thanks,
Cherie


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 Post subject: Cherie
PostPosted: Thu Feb 18, 2010 2:05 pm 
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Classy return post, I hate when people get VERY professional advice, disagree with it and are shitty, please continue doing everything you can do to get your suboxone.... only take what you need, Good Luck, Mike


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PostPosted: Thu Feb 18, 2010 4:52 pm 
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I'm not sure what I would think about a suboxone doctor that says there is "no point in going to meetings" while on suboxone. Wow. Really? :roll: No point?

I disagree.

Completely.

Now, with that said, I don't go to NA meetings and I'm on suboxone, but I DO go to weekly group substance abuse meetings and I do see a substance abuse therapist every other week. I think suboxone is just one piece of the recovery journey. At least that's how it is for me.

My suboxone doctor *requires* that I attend meetings of some kind. He doesn't specify NA or AA and he doesn't audit me, but he asks me every month when I go in for my appointment "are you still going to meetings?" Because I think he knows that recovery is more than just a pill you take.


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PostPosted: Thu Feb 18, 2010 9:55 pm 
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Well I suppose some ignorant people might take desperation for being shitty but those people might be wrong. Low and behold there was a cancellation with the psych doc and I got in early. There may be a God after all. Regardless, he put me on a much needed increase in my neurontin and put me back on wellbutrin for anxiety, depression, and ADD. Call him in 5 days and can increase the neurontin for the anxiety. Now that I have something to hold on to and don't have to wait 2 more agonizing weeks, I am feeling a little better. I don't have a whole lot of faith in the wellbutrin but anything that gets me another day is better than nothing and for now I will not be finding a new suboxone doc. We shall see how I feel in a couple of weeks.

Some people probably shouldn't reply to posts when they don't have anything professional or constructive to say. Also, some people shouldn't reply to posts when they have tendency to infer tone and/or intent that just plain isn't there.


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PostPosted: Thu Feb 18, 2010 10:03 pm 
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"Some people probably shouldn't reply to posts when they don't have anything professional or constructive to say. Also, some people shouldn't reply to posts when they have tendency to infer tone and/or intent that just plain isn't there."

Huh???? What the heck is this about? I don't see anything written in this entire thread that fits this short paragraph. What is it that was not professional or constructive, other than perhaps, dare I say, the above paragraph?


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PostPosted: Sat Feb 20, 2010 3:30 pm 
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I owe an apology. I took that post to be sarcastic seeing as I have never seen anyone respond poorly to the doc. Mike I apologize.

Cherie


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PostPosted: Sat Feb 20, 2010 6:04 pm 
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Jack
Dont let that misunderstanding keep you away....you are in distress right now and we all have been there. The fact that it was pointed out and you recognized it and apologized is huge. The longer you stick around you will see that some people do not respond well to the good doctor when he tells them the way it is....and some show who they really are by being "a total ass" to the doc. Mike was just pointing out how classy your post was compared to the reaction of others. I am glad you got in to see the psychiatrist early and are getting some relief. My dad used to tell me when I was always wondering what people think about me. He would say if you only knew how little people think about you on an average day you wouldn't worry so much.......see how important we think we are. I hope you stick around and keep us up to date on your progress....like the doc said and I said on your other post a relapse could result in death or prison. Best of luck......


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 Post subject: Info on stopping
PostPosted: Tue Feb 23, 2010 11:11 am 
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Thanks for posting! Great topic!

This is with respect to your question regarding depression. This is almost a universal question for people trying to get off of suboxone after having used it for a year or more. If an individual had depression issues before, then they will know what that depression is like, as opposed to the type of depression associated with Post Acute Withdrawal Syndrome assoc w/ suboxone. A common question when coming off of suboxone and entering the 5 or 6 or 7 week is "I can barely function". "Will I feel normal again" "I am very lethargic and do not seem motivated to do anything" "I cannot concentrate"
"I have never had this sort of depression- it is a grey emotionionless depression" etc.

I used full agonist short term opiates on and off since 25 yrs of age (I am 50). Yes, it was hard to stop each time and I would feel horrible for about a week, but then gradually get better. By 2.5- 3 weeks I was feeling pretty close to normal. I will not go into my history, but I had 10 yrs opiate free prior to using again, then going on suboxone.

I went on suboxone in August of 2006. I tried stopping many times. Since the company/manufacturer mentioned that the w/d was relatively minor and to not stop taking suboxone prematurely to avoid relapse- I waited a year before trying to stop.
I lasted 3 weeks. I had the above aforementioned symptoms. Dizziness is another symptom I hear a great deal. I had that as well. I tried several other times in the 3.5 yrs I have been on.

To make a long story short- I recently went to a 4 week treatment center to get off of suboxone. I did not like the numb emotional state that I was in while on suboxone, the zero libido, and other symptoms that are typical of opiate use (GI tract stuff etc).
So I decided to take drastic steps to stop: inpatient detox. The acute withdrawal was not fun, but not horrible either (so that is accurate info from the company- not the rest though). At about week 3 the weakness was getting worse and worse. By the time I left the center, I could hardly lift my tiny suitcase. I made it home, and was very weak, unmotivated, zombish but forced myself to walk. By week 6 I was no longer achy and a bit less weak, but I was zapped of motivation, and was unable to function normally. By week 7 things were not improving. I began to get more and more depressed.
I was literally going to check myself into a mental institute because I was convinced- BECAUSE the medical community insisted that my depression likely had little or nothing to do with coming off of suboxone. Especially since I had been off for so long at that point.
I decided to experiment- If I was suffering from depression outside of coming off of the suboxone ie not suboxone w/d related- then a tiny dose of a short acting opiate would give me little opiate effect, and my depression would not improve ie there would be no change in depression since the depression would have nothing to do with my brain's opiate receptor cicuitrey. If, however my depression was lifted immediately- even if it was slightly- then it would be associated with the neurophysiology of suboxone use and withdrawal. So I did this
I took one percocette. I did not get much of a buzz at all. My depression lifted significantly, and weakness went away while under the influence. I felt relieved and better. It did show that a- I was not going crazy b- it was the PAWS from suboxone c-I was in a precarious situation to say the least. But this, of course, clicked the "on" switch to wanting to use. I went through two days of craving hell.
Yesterday I broke down and found a new suboxone doc, and was put back on my low dosage of 4mg/day. All the depression is gone. I have motivation, the weakness and dizziness are gone.
Summary
I made it about 9 weeks off of suboxone. When I went on suboxone 3.5 yrs ago I had been taking percocette (oxycodone 5mg/300 APAP)- probably about 25-20 a day. I had been doing this for a month. From early 2006 to this month of perc abuse, I had started using opiates again, on and off- which culminated in the month long jag on percs.
Prior to this I had not taken opiates for over 10 years (early 97- late 06). What started the use was a series of kidney stones in early 2006, which set of an addictive cycle. So that is how I ended up on suboxone.
Since Suboxone is approx 100X potency of Morphine, but a complex opiate having both agonist and antagonist properties, it is being discovered that in the case of people that have addictions that do not involve high dose and long term use such as my case (as opposed to someone using 3-400 OxyContin per day for a year or more)- the use of suboxone has a remarkable effect on the receptor system. As mentioned- it is a very strong opiate. You do not get "high" from it because of he antagonist properties and ceiling effect. However your brain's receptors receive the flood of agonist/antagonist suboxone opiate just the same. So someone taking (in my case) even low dose suboxone for more than say six months is creating a brain receptor system equal to someone using a huge amount of a heavy opiate like morphine. ie the receptors do not really know the difference- they are being occupied, and partially turned on (depending on which one mu alpha etc).

It is for this reason that stopping suboxone is so difficult, and poorly understood. Yes people may have an underlying problem w/ depression (as is my case), or they may not- but the nature of the PAWS depression is quite different. It is the result of suboxone's brutal PAWS.

I could not take it anymore ad went back on.

This medicine is very poorly understood. In some cases it is a miracle drug, in some cases it totally changes your life unexpectedly. Used properly suboxone is great- for detox from opiates or maintenance for people that have no intention ofe ever wanting to stop using. Otherwise it takes a tremendous amount of strength to get off of suboxone after using it for several years.
This does not just reflect my experience- this is a typical story, and I would encourage people to look up on the internet forums (such as this one) that discuss coming off of maintenance meds for opiate abuse.

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PostPosted: Tue Feb 23, 2010 11:17 pm 
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Thanks for all of this information. Definitely helpful. I certainly have underlying depression. I am sure the wellbutrin isn't working yet, but I feel great.

I agree with you that suboxone is great for some things and not for others. I did not think the physical withdrawals were that horrible but the CRAVINGS & ANXIETY 24/7 non-stop..all day..can't think...can't sleep...can't sti still...can't watch tv..can't make coffee...(seriously....I didn't shave my legs till 3 days ago and it has been 6 weeks). Too much energy to do basic life tasks. Work was all I could tolerate and I wasn't doing a very good job. I too thought I was going frigging crazy. I have had depression but never that deep and never including the fatigue.

One reason I struggle both on or off subox is because I have a condition that can be extremely painful. It will be horrible for a week or two, and then go away for a few weeks. Sometimes it is gone for a few months (generally following surgery I get a very nice break - like right now :-). But the longer I go without getting surgery, the worse the condition is each time it comes back until it is unbearable. BUT....on suboxone it was hard because of the lack of pain control after surgery. Plus I had to go into minor withdrawal before going in for surgery just to get minimal effect from the post surgical meds.

Off suboxone this is a difficult condition because when it is bad it is AWFUL and intolerable. So I will no doubt end up having to take pain meds. Then I have to go through the nervousness of asking, taking, and stopping. A lovely reminder of the nice comfortable warm feeling. Plus I have to take pills after surgery. This puts me at high risk for relapse I think. When I was on the suboxone, A) some of the pain was controlled by the suboxone and if not, I could generally sleep through it ok B) Even if I was in intolerable pain, I never knew how long the flare would last. Could be 3 days, could be 3 weeks. The suboxone made it easier to wade through it. No highs and lows.

I just wish someone else could make decisions for me. I suck at it.


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