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PostPosted: Sun Oct 09, 2016 7:25 pm 
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I've been on suboxone strips 8mgs/day for about a month now. Ive been on suboxone for around 6 months on a few occasions in the past.
They are not working for me this time and they seem less effective every day. The first day or two worked great but now feel like a waste of time and money. Not only is it almost making my cravings worse, It (sometimes)mildy works for about 4 hrs and then I'm feeling like crap again.
Whats even weirderis both the half life & time to peak vary widely every day. I'm extremely disappointed in it this time. Worked great the previous times on it. Any idea what the problem with it is? i had little tolerance when I went on them this time too. Took an 8mg strip at 10:30am and never felt it take effect and 6 hrs later sitting here feeling like crap. Extremely frustrating, especially knowing how well (and different)it worked in the past, its like a completely different drug now. Idk if its a problem w/ absorption or Is R.B. putting out underdosed meds to encourage higher more expensive doses? Because I know the old orange stop sign sub's worked just fine. (I also tried a generic tab by Anneal and had same problem).
Anyone have this problem?


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PostPosted: Sun Oct 09, 2016 11:37 pm 
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I might have figured it out. I've read about the existence of a patient talking to his dr labout and seeing pure placebo suboxone strips, one said his Dr. Was given a handful by a rep.
The dimensions of the 8/2 strip are identical to the 2/0.5 strip. I'd bet those 2/0.5 strips come labeled as 8/2's, possibly other lower doses so your Dr. Can taper you "blindly" at their will. There's gotta be paperwork on this somewhere. If so does it follow AMA's ethics on placebo use? Surely not in the presence of unresilved symptoms. In this case, the so called placebo effect wasn't so effective supporting non phycologial basis for symptoms. I know drug counselor and surely physician tendency w/o first hand physical experience with opioid addiction and its many different internal and individual factors to "all in your head" symptoms. I'd prefer open disclosure in my medical, especially medication treatment.
It no secret placebos are widely used. Seems like it started right around the strip hitting market with the troves of dissatisfied suboxone users arising around that time, many recalling how differently and more effective suboxone was.


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PostPosted: Mon Oct 10, 2016 9:02 am 
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Good morning 321, Welcome! I am so sorry that you are not feeling better at this point. I do have many questions...you said sub worked for you in the past? How long ago, what happened that you started using again? What is your doc and how long have you been using? I ask these questions because my thought is that you may need to start with a higher dosage this time. In all honesty, I do not think that you can be prescribed a placebo without your permission to be a part of a study group. Hopefully, someone with more experience in this area with post soon. Please, continue to post so we know how you are! Don't give up!


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PostPosted: Mon Oct 10, 2016 12:33 pm 
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Placebo's are not used in clinical practice. Without signed consent, and participating in a study that has been reviewed by a academic review board it just isn't done. Retail pharmacies do not have access to them. Nor can they substitute one strength film for another, even with a doctors order they would still have to label it correctly. They won't risk their license to clandestinely reduce somebodies Suboxone.
I had a few of the training strips that do not have any medication. They are very clearly labeled.


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PostPosted: Mon Oct 10, 2016 11:08 pm 
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Thanks for the replies. The last two times on suboxone I had approximately the same tolerance to opiates in general and was on 8 MG's for the most part both times. The last time, about 8 yrs ago I remember sometimes only taking 4-6mgs eventhough I was prescribed 8 because it was so noticeably effective every time. An increase may help. The lack of effect of these 8mg strips compared to all my previous experience with 8/2 tab (about a year total) is so profound I find it hard to imagine this is the equivalent dosage unit in these strips. I know it sounds crazy, I thought hard about bioavailability problems but the strip is supposed to be superior. Idk, I left treatment last time for a methadone clinic as my cravings were high and it works great for me but there are no methadone clinics near me and am too broke too go much if any higher on dose. Its SO frustrating because of the huge difference in how it effects me compared to identical circumstances last time. I can't. The 8mg strip hits me about exactly what I would expect and imagine how 2 or even 1mg would normally. What more weird is the first day, about 30 days ago he gave me one strip and had me take half first two days and that 1rst strip worked great, exactly as expected. I had to go back 2 days later and all subsequent doses have sucked big time. Its like getting ready to go on a trip and you run out of gas soon as you get out of the driveway. Cravings are high and can't get anything done feeling crappy most of the day. No one else with this problem? I've read quite a few acct's of ppl that say their sub is no longer effective or is nothing like it was before. I wondered if through the new formula, reports of abuse, and doctors resistance to use anything other than the strips, if Reckit B, the licensed docs, and fda, they didn't come up with some tapering program w/o pt. Knowledge. I can't think of why my 8mg strip barely kicks in AND the noticeable effect wears off within 3-6 hrs. Almost feels like a whole different substance sometimes. Another thought is the plethora of counterfeit pharmaceuticals out there.


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PostPosted: Tue Oct 11, 2016 3:45 am 
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This is very strange and something I've never heard anyone else complain about. I'm sorry that this is happening to you and that it doesn't make sense!

One thing I'm not understanding is who is giving you your suboxone strips. Is your doctor or a pharmacist? It is quite unusual to receive suboxone from your doctor. Can you think of any reason that the person in charge of your medication would want to mess with your dose? The idea baffles me!

There are a couple of scenarios I can think of but they're both pretty far-fetched. First, there could have been a mistake in production of the strips that was missed by quality control. The second idea is that your ability to absorb the medication is somehow compromised. Also very unlikely. I wish I could be more help, but this is very strange!

Amy

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PostPosted: Tue Oct 11, 2016 9:52 am 
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Like Amy, I was stumped about the getting strips handed to her from the dr. I've never heard of that. What is ur routine like when seeing ur doctor then getting ur medicine? Does he hand u medicine or give u a script to go to the pharmacy? What's he write on that script (if ur given one)? I'm all kinds of confused.

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PostPosted: Tue Oct 11, 2016 2:45 pm 
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I see my Dr.every 1-2 weeks right now, we discuss how its going. I just saw him today and voiced my concern, he seemed not to know why it wasnt working either and was pretty hesitant to increase but went up to a 12/3 strip and have the 1st one in now. We'll see.


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PostPosted: Wed Oct 12, 2016 7:35 am 
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Maybe you were referring to your first visit when the Dr. first put you on Suboxone. I've read that some Dr's give their patients their 1 day dose. That way they can evaluate how it goes.


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PostPosted: Wed Oct 12, 2016 12:55 pm 
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Nevermind, he did "great" the first couple of days. My bad.


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PostPosted: Wed Oct 12, 2016 4:01 pm 
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1st day of 12mgs went in yesterday, at least it lasted all day but took my 2nd dose today and still feels a little weak. I swear something different with these. Read the post below that I found by a different member and its just one of many. Anyone have experience with the old name brand stopsign sub tablets? If so what's your take on these strips? Here's another post I found:

"Best Suboxone film ROA?
Wed Feb 13, 2013 7:09 pm
I am very happy to see real Dr.'s here helping with these questions. All of the drs I've used over the year had very little knowledge of this treatment so I pretty much on my own. I was taking sub tablets for last 3 years coming off multiple surgeries for massive accident. I started on 4mg then lowered to 2mg once a day. After my last surgery I was really craving something to make me comfortable so started dosing twice a day 2mg each dose. This month I finally got insurance so I getting some help with the massive expense of taking subs. The only problem I found out the ins only covers the sub film strips. So I get my month of meds and trying them for the first time very open minded. To my surprise the usual 2mg dose did absolutely nothing for me what so ever. I talking nothing like I just took a piece of tissue paper. So I try double the dose and still nothing. This getting me nervous and I end up taking the full 8mg. I do feel tiny amount of bup in my system but not enough and it wears off very fast. If I took 8mg of the tablet I would be passed out on the couch all day. How is it that a major pharma company can release a product that clearly does not equal their own product. 8mg of film is not equal to 8mg tabs, not even close. It should be real 8 mg reguardless of format in my opinion. I have read people saying how great the strips are and I wondering if I missing something. Is there some trick to getting the bup out of these."


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PostPosted: Wed Oct 12, 2016 4:27 pm 
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A couple more posts I found below.

Tablets VS Film and dosing issues
Tue Apr 12, 2011 5:00 pm
I am sure someone has posted on this topic before, but I didn't see a specific thread and I was hoping for some fresh perspectives.
I started taking suboxone about 3 years ago in the tablet form and found that i only needed about 2-4
mgs a day. I stopped the suboxone when I found out I was pregnant, but got back on it after having my daughter. However, now I am being prescribed the film form.
The problem is that now I seem to need 8 mgs a day, which doesn't make any sense to me. I am trying to figure out if maybe it is something about the film form that is less potent or if that has nothing to do with it at all??? Something with my metabolism, perhaps?
Has anyone else experienced this sudden need to increase their dose after switching to the films? I am strongly considering asking my doc to put me back on the tabs if possible.

My other issue is dosing methods. I prefer splitting my 8 mg film into 2 mg pieces and taking them every few hours rather than taking the whole film all at once. I have gotten the impression that this is not necessarily the best method....
Any thoughts?

#3
Tue May 17, 2011 3:10 pm
I've been reading here from
people who feel the film is stronger but that wasn't my experience either.
I was put on 8mg 2x per day about a year ago.
About half way through this year the film came out and so did the free coupons so I switched to the film.
When I started I could not take the full 8mg tablet it was way too strong, I felt sedated and I threw up. On the tablet I wound up only taking 4mgs 2x per day.
Since I switched to the film I now need to take the entire 8mg 2x per day.
I called the help line and talked to one of the "medical" counselors and asked some pretty straight forward questions about absorption and tolerance. She told me it was not possible to get a tolerance to suboxone and the strips absorb better than the tablets. she was kind of rude about it too, maybe she thought I was trying to "dope fiend" someone into getting me a higher dose :roll:

Its making me wonder, and I know it sounds a little crazy but something has to explain this. Are there 2 formulations doctors use? One for induction containing the real amount of bup and another underdosed formula only some doctors use thinking they can retain patients off the placebo effect? The manufacturer trying to encourage higher more expensive dosing? Either way is it ethical to decei e patients? Financially? Does it violate the informed consent doctrine?


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PostPosted: Wed Oct 12, 2016 5:16 pm 
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Sorry I called you "he" lol I only have experience with the strips but I feel some others who have experience with the pills will come along later. Good luck 321bupe321.


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PostPosted: Wed Oct 12, 2016 9:40 pm 
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Thanks for the replies. Its about 8 hrs after I dosed this am and it wore off completely about 5 hrs post dose. Been having w/d symptoms since, aches, lack of appetite, general w/d crappiness. I'm positive I'm being lied to and detoxed. I don't know how its even bup at all where what little effect wears off so fast. I'm considering not wasting any more time or money, its too frustrating.


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PostPosted: Thu Oct 13, 2016 10:28 am 
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Well my goodness 321bupe321! That beets all I've ever heard!! I am so sorry you are having to go through with this. A few questions you haven't answered and we need the answers to solve this dilemma. 1. Did you get the Suboxone strips from the Dr. or where? If you get a script, I would definitely go to a different Pharmacy. I don't know. This has me mind boggled to say the least! Take your dose today and see how long it last. Maybe split the dosed, but you said you do that already, Right? You aren't taking it correctly if you are taking it in a bunch of different doses though. Maybe just try dosing 2 times a day? I don't know, smh?!? :shock:


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PostPosted: Thu Oct 13, 2016 4:55 pm 
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There is another possibility. There are some people who, for some genetic reason, do not metabolize opioids like other people. Some of them metabolize opiate medications at much faster rate.

This is a scholarly article on the subject:

http://www.practicalpainmanagement.com/ ... d-patients

You can be tested for this condition. I highly suggest that you bring up the subject to your buprenorphine doctor.

Good luck!

Amy

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PostPosted: Thu Oct 13, 2016 10:41 pm 
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I get my scripts filled at the pharmacy. I don't have insurance so pay cash, for the script and the visit. I've used 3 different pharmacies now, one of which were WALMART. I took two 12/3mg strips today for 24 freaking mgs as the first kicked in as a mediocre dud. They ended up working just right, not too much or little, now about 6 hrs later wearing off. And into withdrawal. Any time I've been on methadone or suboxone, neither wear off straight into withdrawal, both peak out for about 4 hrs then just wear into an effect that at least carries me to the next day. With methadone I'm usually withdrawling minorly by the next morning but not usually w/ sub. The 12mg strip feels exactly like 2mgs would but then wear off too fast and given my extensive experience with opiods of ALL kinds, with how it sits w/ me at first, it should not wear off that dramatically. It reminds me of a drug like hyrocodone as you plumet into shittyness over a half hour at the 5-6 hour mark. Something is wring and someone along the line from Dr to pharmacist to some sadistic bastard coming and switching them like the g.d. evil toothfairy in the night. Why the hell anyone would do that is beyond me. Idk. I really don't think its buprenorphine. I am a fast metabolizer but I don't think that fast, a peak and trough test would be perfect, I'll ask my doc how and how much for one Monday. He seemed all irritated when I saw him Tuesday after asking how its going and me telling him. Its like, if you don't want to prescribe suboxone then don't and save all of us some time and money. As I'm sure you're all familiar with that old murderous feeling when you get ripped the f*** off. Frustrating to say the least given enough heroin to last a week would be 1/20th the price. I don't want that old rollercoaster ride though, hence seeing a suboxone Dr. Either my tolerance and or metabolism has multiples exponentially, the Dr. Is B.S.ing and somehow between him and the pharmacy giving me grossly underdosed strips, the manufacturer is involved in some money making/saving scandal, or some sadistic bastard is slipping me mass amounts of naloxone unbeknownst to me. You tell me which is is most likely/ crooked. Even scarier is coming across a Buprenorphine/NALTREXONE combo drug inline.
Anyway, thanks for letting me vent. I'm sitting here 7.5 hours post 24mg dose, feeling my skin start to crawl like I'm plugged into an electric socket and my heart pounds in my chest.


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PostPosted: Thu Oct 13, 2016 11:28 pm 
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Bupe I am sorry you are feeling this away and I sure hope someone with some experience comes along and can help you figure this out. Sorry I couldn't be more useful. Just see if the Dr. will prescribe you the pill form next time is all I got. ANYBODY????


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PostPosted: Fri Oct 14, 2016 11:10 am 
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Hey 321bupe,

Ur issues are definitely not common imo so it's kind of a mystery. But when u say u "feel it peak" or "feel" it stopping, what do u mean? I don't ever feel anything from my suboxone except for when I first take it in the morning, I get like a tiny energy boost of just feeling better. I don't feel anything else at all, especially a peak. So I'm just wondering if ur expecting to feel something that's not gonna be there. Now I know that doesn't explain the withdrawal issues ur having, could that be mental? When I was using, I'd think I was in withdrawal way sooner that it would ever be possible. I literally drove myself crazy during that time. The mind is a very powerful thing.

When I first started suboxone treatment, I didn't do much research at all because honestly I was just to strung out to focus. So I thought I'd feel some type of high on suboxone, and when I didn't feel that I was confused at first. Then I finally realized that ur not supposed to. Ur just supposed to feel "normal". Suboxone has such a long half life, it should last u for 2 days at least before you'd start feeling withdrawal. That's why ur situation is so baffling.

Now please don't go thinking I'm saying it's all in ur head or anything like that, I'm just trying to help give ya some things to rule out. I don't think that ur doctor or pharmacist is messing with u though, they aren't allowed to do that. Whatever it is, I really hope u get something figured out because u can't keep putting urself through this.

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PostPosted: Fri Oct 14, 2016 8:56 pm 
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Well I finally figured it out and unless you've ever been on suboxone previous to these strips youd probably never know. Here's a cut and paste of the FDA website of its NDC (National drug code database), the 12mg strips come in 12mgs bup/1 mg Naloxone & 3mg bup/1mg naloxone.
Both labeled as 12/3!

12496-1212-3 | Suboxone | buprenorphine hydrochloride, naloxone hydrochloride | FILM, SOLUBLE | 12 mg/1, 3 mg/1
NDC Package Code: 12496-1212-3
Product NDC: 12496-1212
Labeler Name: Indivior Inc.
Proprietary Name: Suboxone
Nonproprietary Name: buprenorphine hydrochloride, naloxone hydrochloride
Substance Name: BUPRENORPHINE HYDROCHLORIDE; NALOXONE HYDROCHLORIDE
Product Type Name: HUMAN PRESCRIPTION DRUG
Start Marketing Date: 08-24-2012
End Marketing Date: N/A
Market Category: NDA
Application Number: NDA022410
Package Description: 30 POUCH in 1 CARTON (12496-1212-3) > 1 FILM, SOLUBLE in 1 POUCH (12496-1212-1)
Pharm Class: Partial Opioid Agonist [EPC],Partial Opioid Agonists [MoA],Opioid Antagonist [EPC],Opioid Antagonists [MoA]
DEA: CIII


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