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PostPosted: Thu Mar 14, 2013 1:49 pm 
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Hi everyone - I am new here. I have been taking suboxone since July 2012. Prior to that I was taking IR oxycodone, 90mg a day for roughly about 18 months. I was dependent...not sure I was ever "addicted"...at least as I understand the difference. If I lowered or didn't take my oxy dose, I'd experience withdrawal symptoms. I started in the opiate world as a chronic pain patient in 2011. I have severe constant neck pain (I am 35 years old). I switched pain doctors, as I didn't like the rollar coaster IR oxycodone schedule I was on. Thats when I switched to suboxone. I started at 8mg...quickly was down to 4mg (after maybe 2 weeks). Ive been hovering between 1 and 2mg per day of suboxone for the last several months. I'd say it helps my pain moderately...maybe takes away about 30% of it...which is enough to function. Doesn't control it like the oxy did...but then again doesn't have the ugly oxy side effects. In addition...for the last few months I've been struggling on the 2mg a day dose...I break it up and take 1mg in the morning and 1mg in the evening. Doesn't always take away withdrawal symptoms (restless legs and anxiety). I should say about 2 months ago, I switched to Butrans patch 10mcg...only 1 month's worth and it didn't work well for me. I switched back to suboxone...and it was around this time that I started struggling on my daily dose.

My doctor is very nice...very helpful. He has helped taper several patients off suboxone with minimal or no withdrawal (which I confirmed with a few patients there). I know it has to be done slowly...the problem is my chronic pain. Well that's one problem...the suboxone makes things bearable...just barely but without it I'm in horrible daily pain.

So I'm kinda feeling stuck...the suboxone does just enough (for now) to help my chronic pain. But why am I struggling with withdrawal symptoms? I'm nervous to switch to anything else for the pain...especially at a young age. If I had my choice, I never woulda started with the opiates to begin with but that ship has sailed so I gotta deal with the hand I have right now. I can talk to my doctor about all this and know he'll be receptive and understanding...I was just hoping for some other opinions/people with similiar experiences and what they did. It seems like being on Butrans for that month messed things up a bit. I'm not sure. I guess I'm struggling to find a dose now that I don't deal with withdrawal symptoms at some point through the day...and...gives me some pain relief. Or if I should investigate switching medications again. About 6 months ago, I tried going from 4mg a day suboxone to 50mg a day oxy (20mg ER, 30 mg IR) and it was a big mess! After about 10 days, I switched back to suboxone. Ugh...in typing this out it frustrates me more to see the position I'm in haha


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PostPosted: Thu Mar 14, 2013 11:48 pm 
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Hi OOT and welcome to our forum! There are several chronic pain patients on this forum and I hope they will chime in here. One thing I do know about sub and chronic pain is that the dosing should be several times a day, not once or twice. The analgesic effect of sub goes away within 6 hours, so dosing 4X/day is optimal.

It seems to me that if the sub is helping you maintain your normal activities, you shouldn't go off of it. If it is not treating your pain as effectively as it did before, why not increase your dose slightly along with increasing the number of times per day you take it? Some people hate the idea of being dependent on a medication. Is that why you are struggling with the thought of taking more? I hope that you are able to resolve your trouble with sub. Maybe someone with more chronic pain experience can shed more light on your situation. Good luck!

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PostPosted: Fri Mar 15, 2013 1:25 am 
Oh god. You sound EXACTLY like me in the situation i was in. I was only taking between 90-120mg's of oxy for a couple months. Then hoped on over to the suboxone ride like a good little addict. And, i also know exactly what your talking about trying to switch to oxy from taking 4mg of sub for a week. I found out that 60-90mg's of oxy barely kept me out of withdraws from the 4mg's of sub. That's freaking scary!! I knew then and there that this drug has to be respected in the fact that my old tolerance to oxy has probably doubled or tripled by taking suboxone. Therefore my thought process was... I've basically tripled my tolerance by using something that is supposed to be helping me to get away from the pain killers.

It's funny that we both tried the switch back to oxy thinking it would be easier. Only to realize that suboxone further dug us deeper into this pit of opiate misery by jacking UP our tolerances. I've had good luck trying to taper like this.

day 1 4mg's of sub
day 2 2mg's of sub
day 3 2mg's of sub
day 4 4mg's of sub
day 5 2mg's of sub
day 6 2mg's of sub
day 7 try to take 2 maybe 2.5mg's if you have to.

Of course you could tweak this method any which way you want to. I think the idea in doing this is to sorta trick yourself. The faster you taper. The easier it is to stock pile up on subs and once your down to 2mg's of sub or so. Say your prescribed 12mg-16mg of sub. You can easily stock up on subs. Visit your doctor two or three more times to further stock up on more. Then just stop going there as this will leave you with PLENTY of extra sub to continue your taper nice and slow from 2mg to 1.5 to 1.0 to .05. Then from there take it nice and easy. Stay at 0.5 for as loooong as you need to before you either taper further or hop on off and dive into the great unknown.


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PostPosted: Fri Mar 15, 2013 9:56 am 
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Hi Amy/Will - thank you for your responses!! Its so nice to hear from other people that can relate.

I don't want to be unclear - I didn't switch from oxy to suboxone because I was addicted to the oxy. I suppose I was...although my doctor diagnosed me as physically dependent and not really addicted (or maybe pseudo addicted). I enjoyed the relief from my anxiety that oxy gave...but it wasn't hard to give it up. I switched to the suboxone as a way to get away from the horrible oxycodone schedule I was on (taking 30mg of IR oxy 3 times a day had me on a physical and emotional rollar coaster daily). So I have no intention of tapering my dose...what i'm looking for is a good dose that will help at least moderately with the pain + not make me feel withdrawal symptoms during each day.

See i'm a chronic pain patient first...the suboxone scared me when I was taking 4-6mg a day...it didnt help with my pain at all. Thats why I tried switching back to the Oxy (but using oxy ER this time). As I said, that didnt work...youre right Will...apparently the suboxone has shot up my tolerance, which really sucks. I have a really bad neck condition thats only going to get worse as I get older.

Once I got down to around 2mg of suboxone per day...it actually started to help with pain a bit. For anyone that's taken suboxone for pain management...lower is better with this medication. My dr confirmed that. 4mg of suboxone doesnt help nearly as much as 2mg. Basically, with suboxone...a good pain management dose is between .5 and 2.5mg.

Thats interesting that breaking it down into 4 doses instead of 2. I've always taken my dose in 1 or 2 doses per day. I supposed I could try that...taking .5mg 4 times a day. What you said seems to be the issue. if I take 1mg at 7am...by 4 or 5 pm the pain management has worn off and I'm feeling mild withdrawal symptoms. At that point I take another 1mg...which works ok until around 11 or 12 at night. At which case I just "deal with it" and wait til the morning.

The problem with suboxone is...there is no "going up". I'm at the pain management dose. Increasing it to 4mg won't help. So once this stops working...what then? switching to another medication? As we already said my tolerance has gone up so that would be difficult. Its quite a frustrating situation. I kinda wish I never switched to the suboxone to begin with...and just switched to a better medication schedule - im sure I could have had a doctor set up a schedule which wouldnt have had me on that up and down daily rollar coaster.

Thanks!


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PostPosted: Fri Mar 29, 2013 2:18 pm 
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Hi Amy, I can relate to your probleml. It seems as if you are going in the right direction with the Suboxone. You do not want to try switching to anything else. Like you have already experienced you will just go through withdrawl and risk being blackballed with the doctors in your area. Continue with the Suboxone..it is by far the safest one of the bunch(when taken correctly) with the least amount of withdrawl symptoms. It will be very hard to keep lowering your dose but it is very possible and with time you can be drug free. I was at one point almost there myself..but I got stupid and stopped taking it seriously. I was in hell but I knew that I had to go through hell to meet my goal. It's much easier to focus on NOW than much further down the road, but everyday we get a bit closer to our goal. You just need to find a comfortable dose where you can still function and get through the day and try to lower it sloooowly...the key is going slow..it sucks but it's the only way. Trying to take on more than we can may cause us to relapse. I wish you the best of luck and you can do it if you just stay focused.


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PostPosted: Fri Mar 29, 2013 3:05 pm 
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Hello OUTOFTOWN, sorry about my prior post.I'm new here and obviously confused between posts. Suboxone is NOT for pain. it may help but there are far better drugs to take for pain. If it's not to late to get off the Suboxone then do it. Suboxone will raise your tolerance sky high making it imposible for any other pain medication to work if you ever need to switch over. The withdrawl you will experience with Suboxone is much much worse than with any other drug. You just need to accept the fact that you are going to be in some pain and that with age it will get worse. Suboxone will help very little with the pain but will make your body very dependant on it to where you will wish you were dead without it. In my opinion the little reward is not worth the risk. I wish you the best and hope it's not to late to get off it.


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PostPosted: Mon Dec 30, 2013 2:27 am 
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kelmar2l wrote:
Hello OUTOFTOWN, sorry about my prior post.I'm new here and obviously confused between posts. Suboxone is NOT for pain. it may help but there are far better drugs to take for pain. If it's not to late to get off the Suboxone then do it. Suboxone will raise your tolerance sky high making it imposible for any other pain medication to work if you ever need to switch over. The withdrawl you will experience with Suboxone is much much worse than with any other drug. You just need to accept the fact that you are going to be in some pain and that with age it will get worse. Suboxone will help very little with the pain but will make your body very dependant on it to where you will wish you were dead without it. In my opinion the little reward is not worth the risk. I wish you the best and hope it's not to late to get off it.


I beg to disagree. First, I have chronic pain from scoliosis and surgery gone bad. I am on 2gm of sub a day and would like to quit altogether but my doc says sub does help with pain - and it does. I tried a faster taper (down to 1.5) soon after I tapered to 2 mg a day and found my pain went up. My pain mgmt dr. says there is no reason why I can't continue on 2mg per day for as long as I want for pain control, that it is proven for pain control. I didn't believe him until I tried a faster taper. I am still going to try and get off sub and rely on Lyrica and a motley crew of other meds for pain control (I just dislike suboxone for some reason). But it does help with my pain and the medical studies my Dr. referenced also confirmed this. But - everyone is different! Maybe it didn't work for you and that's what's important. Like you, I want off of it.

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PostPosted: Mon Dec 30, 2013 3:04 pm 
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I'm not sure why no one has mentioned Butrans. It's a transdermal patch that delivers microgram dosages of buprenorphine continually over the course of one week. It's indicated for the treatment of moderate to severe chronic pain. Ask your DR about BUTRANS, seems like the perfect option for you unless it's contradicted for some reason you haven't shared. Good luck!

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PostPosted: Mon Dec 30, 2013 7:44 pm 
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I do agree that Suboxone does help with pain. But it is not meant for pain and as far as I know it is not yet FDA approved for pain. There are allot of Dr.'s that are switching to Suboxone for pain, but the problem is that even though is does very little for pain compared to opiates it is still a VERY strong drug. Once the body becomes dependant it is almost impossible to get off of it. If there is anyone out there that has gotten off of it and everything else please let me know because I have not heard of anyone doing it as of yet.
The reason why I am so bitter is that I was 100% clean for several months before I tried Suboxone. Someone that was on it told me about it helping him out so I went to his doctor which started me out on 16mg. Shortly afterwards my back started bothering me so he increased the dose to 32mg which was my dose for about 5 years. I have spent the last 2 years trying to get off of it and I am down to 16mg a day, anything less and I am sick as hell and feel like I'm an 80 yr. old man.
My only point to any of this is that Suboxone is not as innocent as it seems to be, but is becoming the choice for doctors because people feel it is safe and does not get people high so it it socially accepted.
But not to many people are aware of the fact that they will need to be on it (and pay the $600 a month) just to feel normal , and for the rest of their lives..


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PostPosted: Mon Dec 30, 2013 9:37 pm 
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Kelmar, I'm so sorry you're stuck at 16 mg and can't seem to taper down from there. I also don't want to be argumentative here, but buprenorphine was originally created as an analgesic that would be resistant to addiction. The goal was pain relief without the addictive properties that opiods usually produce.

I'm sorry to say that your doctor sounds like a doofus. When buprenorphine was used as an analgesic the dosage amounts were small. Basically, your doctor put you on an addiction dose rather than a pain-relieving dose. As you've said, the result is that your tolerance was pushed sky-high. For your doctor to increase your dose to 32 mg only proves that he doesn't understand how sub works. I'm sorry that your doctor's ignorance ended up screwing you over. The problem is not sub; the problem is that your doctor didn't know how to prescribe it. The fault also lies with the drug company who taught an 8 hour cookie cutter course that promoted the prescribing by doctors of unnecessarily large doses of sub.

It sounds like you would really like to taper down if you could, so I have a suggestion. Since the analgesic properties of sub work best when it is taken every 4 to 6 hours, try this. Create 4 -3mg doses and take a 3 mg dose every 6 hours. The frequency at which you are taking the sub may fool your body into thinking it's getting all 16 mg when you're really giving it 12 mg. Plus you'll get the fullest analgesic benefit. You could even do two 3 mg doses and two 4 mg every 24 hours if you want to take it slower. If that works, keep slowly reducing the amount you're taking every 6 hours. It can't hurt to try!

Let me know what you think of this idea. I certainly hope it could work for you!

Amy

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PostPosted: Tue Dec 31, 2013 1:34 pm 
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I agree with the posters and take a lot of offense to that belligerent one that was referenced. (Not an attack in the person who referenced it, I understand you were quoting and disagreed with it.)
First off, like the last person said, suboxone does help pain when taken at smaller increments every few hours. I take between 2 and 4 mg at a time for my fibromyalgia pain and it works so much better than any other opiate I was strung out on, in fact very few people report that full opiate agonists help for fibrom pain, but there's a lot more success with buprenorphine or tramodol. Also suboxone for pain management made me not as tired and relieved the kind of dependency where I had to be jus doped up enough to feel like doing anything, so once I went on subs it made it a lot easier for me to get up and be productive and do the physical therapy that I needed to be doing to relieve the pain long term.
I won't get into the disputing the suboxone good drug/bad idea bull shit, everyone else has done it for me. But if you were someone trying to manage your physical pain still not knowing what you did to deserve it, you'd never wanna be told to "accept it". Someone more qualified will explain the prognosis in a much more appropriate context.


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PostPosted: Tue Dec 31, 2013 1:53 pm 
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I am currently 2 days off my last dose of .5mg of suboxone. The first night off it I slept for just a just a couple hours with the help of Seroquel and Xanax and gabapentin. My wife said my legs and arms were convulsing like crazy but I'm glad it was in my sleep. I am almost feeling completely better today. Im thinking because I was so uncomfortable while tapering I must of been w/d or detoxing from suboxone during the taper. I think this because I couldn't sleep good with anything under 1.5 mg of subs. But now its 48 hrs past my last dose and I feel just fine! Its so much more do-able then trying to come off heroin or such. I was worried about how bad these w/d were gonna be but its much better and easier then the street drugs I was using. The first day sucks but it gets better after that. I tapered fast too, like from 8mg to .5 in a month. Its not as bad as I thought and I wish I did it sooner. I wish I would have found a dr who specializes in treating PAWS and detox but Im sure theres not many out there. Hang in there and let me know if you have any questions. Ill stay on here keeping everybody posted. Thnaks for caring it helps to be heard. Don't listen to the horror stories they are mostly people who are going back and forth between drugs a lot. I used heavy IV opiates btw. hope this helps


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