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 Post subject: Suboxone Induction
PostPosted: Wed Nov 30, 2016 7:12 pm 
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I'm new here. Been reading forums, gathering insightful information. Thank you all in advance. After about 15yrs (half my life) addicted to pain pills, I'm finally starting on suboxone. I was able to get into see a doctor yesterday and was prescribed a week's worth- 4mg twice a day , I'm to go back in next week. Problem is, after reading horror stories of precipitated withdrawals, I'm terrified to take this stuff. I last dosed last night approx 20 yrs ago with 30mg vicodin, yesterday earlier in the day,in total I took 20mg of methadone as well. I don't take methadone regularly and this was a rare occasion. I was told to wait 24hrs to 1st dose, and that's what I'm shooting for. Will that be too soon? I'm aware of the COWS score, I'm honestly not feeling like death right now, just some aches, yawning, hot cold flashes, a little with the watery eyes and chills that come and go. Will I be OK to dose at the 24hr mark? And if I dose then, and I'm thrown into pw, how long will that last and what are some things I can do to alleviate those symptoms? Tia! You're all amazing!


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 Post subject: Re: Suboxone Induction
PostPosted: Wed Nov 30, 2016 9:49 pm 
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I don't have any answers to your questions, but I hope your induction goes well! Welcome to your new life!


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 Post subject: Re: Suboxone Induction
PostPosted: Wed Nov 30, 2016 10:28 pm 
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I'm in day 6 of sobriety through buprenorphine. I too was very worried about PW, because I was taking opium, which made it impossible for any physician to determine the size of my habit.

If you hadn't taken the methadone I'd suggest you go ahead and follow you docs instructions. PW doesn't normally last very long...mine was about 2 hours. It wasn't the end of the world, though it certainly wasn't fun. Now it seems long ago even though it's been less than a week, and well worth it.

But the methadone might be a problem. Does your doctor know about that? My understanding is it's especially tenacious in the way it occupies opiate receptors, thus making it more likely you would go into PW after just 24 hours.

As I said, I'm a newcomer. I'm sure someone will come along who knows more. I might suggest changing the subject line to read something about your having taken methadone yesterday.

In the absence of any other info, if it were me I'd probably wait 4 or 5 days, then go through your induction. 24 hours is pretty standard, but pay more attention to your COWS, rather than the time.

And don't take methadone again :D

Wishing you the best of luck.

Godfrey


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 Post subject: Re: Suboxone Induction
PostPosted: Thu Dec 01, 2016 8:52 am 
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Hey Alilup welcome to the forum!

Well, like Godfrey, I'd have went ahead and told ya to start ur induction if not for that dose of methadone. Most ppl taking methadone that's wanting to switch to buprenorphine need to wait 72 hrs or longer, but that's with a methadone habit or maintenance. I'm not sure how long to tell ya to wait since u just took it once on a rare occurrence but I'd still think u would have to wait longer for that methadone to leave ur system... and it's a long acting opiate (Vicodin is a short acting opiate). My question is, did ur doctor address the methadone? U did tell him that you'd taken it didn't u? If u didn't then I'd call and tell him so he or she could advise u on what to do from here.

Precipitated withdrawal, even if it happens, will pass. If it happens, u just keep dosing ur suboxone just as prescribed and it'll pass. I totally understand that worry, but the suboxone will finally take over ur receptors.

I wish I could be more help but that question is a first for me. Hopefully someone else will be along shortly to help ya better :)

Good luck!

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 Post subject: Re: Suboxone Induction
PostPosted: Thu Dec 01, 2016 9:24 am 
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Quote:
Precipitated withdrawal, even if it happens, will pass. If it happens, u just keep dosing ur suboxone just as prescribed and it'll pass. I totally understand that worry, but the suboxone will finally take over ur receptors.


Absolutely right. Looking back, I was still woefully ignorant when I made the jump (all of 6 days ago :) I'd been living in fear of PW for months without understanding that it's usually over in a few hours. I thought it could go on for a day or more. No wonder I was worried. Why I didn't just google it I'll never understand The information is all over the Internet.

Also, if you make a good faith effort to wait until you're sick any PW will be short-lived (excepting methadone people perhaps). I was told 24 hours. I went 31, but looking back I could have gone longer.
I just didn't want to wait anymore and my COWS had edged into the "moderate" range so I felt somewhat justified. Still, there was a little voice inside I ignored. (We ignore that little voice at our peril).
Had I waited just one more hour I think I'd have escaped the PW.

As it was it lasted for about 2 hours, then suddenly got about 50 percent better. I was pretty miserable the whole next day, but it was manageable. The worst was the restless legs and arms stuff. But by day 4 just as everyone had reassured me, I was almost normal. Just weak and tired.

Much better now. Yesterday I went for a jog, and today my wife and I are heading into the city. So life is just about back to normal (if I could only take a crap, 'scuse the language..)

alilup, if you're honest with your doctor (I'm guessing he didn't know about the methadone) and make sure you pay attention to your COWS, you'll be fine.


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 Post subject: Re: Suboxone Induction
PostPosted: Thu Dec 01, 2016 2:08 pm 
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Thank you all for the replies. I took my first sub 4mg last night at the 23hr mark and no pw thank God! I wasn't feeling too bad into withdrawals, but I usually can always manage the acute withdrawals anyways, it's the PAWS that always gets me and why I choose the suboxone route. I was honest with my doc about the methadone and all he kept repeating was "to wait until you were in deep severe withdrawals". I just felt like that was never going to come. I took another 4mg in the middle of the night and dosed again when I woke up this morning. I'm to take 4mg twice a day. I'm still having slight withdrawal symptoms. Does that mean I need to take more? I've tried calling my doctors office but apparently they don't answer phones until the afternoon. Thanks again for the replies, this site and its members have been a godsend! & I'm wishing the best of luck to all of you in your journey's, whatever that may be!


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 Post subject: Re: Suboxone Induction
PostPosted: Thu Dec 01, 2016 4:05 pm 
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You may need more but don't exceed what has been prescribed. You will end up short and perhaps on the clinic's fecal roster. Wait until you get clearance and enough films to cover any increase.
I will often start at 8 mg for the first 2-3 days depending on the history and tolerance, then increase to 12 and perhaps 16 after the first week. Easy to go up, harder to go down. Give it some time, you may be able to stabilize at 8 mg a day. Be sure you are maximizing absorption.


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 Post subject: Re: Suboxone Induction
PostPosted: Fri Dec 02, 2016 12:54 am 
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Thank you! How do you maximize absorption? I often feel like I'm not taking the film right.


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 Post subject: Re: Suboxone Induction
PostPosted: Tue Jan 03, 2017 7:17 pm 
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I'm 72 hours from my last bean bean of heroin. It hasn't been too bad. Just very weak and tired. My therapist says 72 hours will be fine to restart induction, but I have been down the P/W road before. He told me to start with 2mgs and see what happens. He is convinced I'll be fine. I'm not so sure..


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 Post subject: Re: Suboxone Induction
PostPosted: Tue Jan 03, 2017 11:19 pm 
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Hi Cardinal4, Welcome! My doctor told me that I would be fine starting at 24 hours but I waited an additional 12. My drug of choice was tramadol and I was taking massive amounts. I had no problem after the 36 hours and started at 24mgs which I soon realized was too much. I have since tapered down to 4mgs. Good luck! Please keep us posted!


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 Post subject: Re: Suboxone Induction
PostPosted: Wed Jan 04, 2017 10:03 am 
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I think 72hrs is a good amount of time to wait and would think you'd be fine to induct now.....but I have no idea what a bean bean is lol is that a lot of heroin or a little?

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 Post subject: Re: Suboxone Induction
PostPosted: Sun Jan 08, 2017 5:13 pm 
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It was no problem. After 72 hours, I started with 2mgs and was up to my normal dose within 24 hours.
Clean 7 days!


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 Post subject: Re: Suboxone Induction
PostPosted: Mon Jan 09, 2017 8:56 pm 
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I took my last oxy at 10am yesterday because i was supposed to have my induction appt at 4pm today. Well i arrive at 4 with mild w/d and im told the doctor wouldnt be there today and they had to reschedule me for 4pm on Wednesday. Im trying not to take anymore pills and by the time wednesday gets here im going to be miserable and will score higher on the COWS worksheet. I really want to do this and i was so ready today but now i dont know if i can make it until Wednesday. Any advice?


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 Post subject: Re: Suboxone Induction
PostPosted: Mon Jan 09, 2017 9:58 pm 
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That sucks Dana,

Do whatever you need to do to stay comfortable. Try your best not to take too much of the Oxy or it will make it worse like you said. Are you capable of taking just enough to stay out of w/d's?

It will work out. Just don't overdo it thinking you have a free pass to get high. The line in the sand has already been drawn by you so don't cross it. Border it, don't cross it. Jeez, I hate saying that. But what else is there to say?

Anyone else have a better idea?

r

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 Post subject: Re: Suboxone Induction
PostPosted: Tue Jan 10, 2017 12:03 am 
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Probably a dumb question. Can you just so it at home? Do you have a prescription you can fill?
I don't really understand making patients come out to a doctor's
office while in WD. I wouldn't even have been able to drive. It sounds dangerous to me.


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 Post subject: Re: Suboxone Induction
PostPosted: Tue Jan 10, 2017 7:13 am 
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Oh it definitely happens Godfrey, my doctor only does induction in his office. That's how I had to do it and I was miserable. I wish I could have done it at home now that I look bk on it.

Dana this happened to a couple ppl at my clinic Thursday. I was there for a regular routine doctor appointment and get my medicine and there was two new ppl there waiting for their induction. The Doctor had to cancel everyone because the roads were icy, which meant my medicine would be called in by the nurse and the two new patients that were sick for the last 32 hours had to reschedule til next Thursday. I felt awful for them.
I wondered how they'd handle having to wait another 7 days before another induction. I know what I would have done bk then if that had happened to me, I'm sure I would have went bk to my opiates until my next appointment. I wasn't going to sit and be sick for a week. A week to a using drug addict is a lifetime! I don't think ppl understand that. IMO I think if something happens like that, can't their medicine be called in, but rules are rules I guess...... it just sucks so bad for the addict.

Just hang in there Dana, I don't know exactly what's the best answer for ya other than just show bk up for ur appointment, I promise it'll be worth it once u get there!

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 Post subject: Re: Suboxone Induction
PostPosted: Tue Jan 10, 2017 1:32 pm 
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Thank you all for responding. Last night was rough. I did sleep off and on but i think thats only because Im on seroquel and have been for the last 10+years. Today i dont want to get out of bed or move my body aches and hurts so bad. After researching i found another bit of bad news not only do i have to wait until tomorrow at 4pm for my appt. But Im on medicaid and they require prior authorization to fill suboxone.Anybody know how long that takes?


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