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PostPosted: Mon Apr 29, 2013 9:25 pm 
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This past weekend I took Suboxone pills that belonged to my partner. I know that's not the right way to try a medicine, but I needed to know what it was like.

I was in a car accident in 2006 and given Hydrocodone for the pain from post-concussive syndrome. I found that it helped with some of the pain, fatigue and other symptoms I had from disabling Chronic Fatigue Syndrome. Therefore, my doctor just let me keep taking it-permanently. About 3 years later I was up to 6 pills a day and the pain was so intolerable it literally made me cry.

That's when I actually did some research (3 years too late) and discovered that Hydrocodone was actually Vicodin, and I learned all about what opioids actually were, how you always need to increase the dose, etc.

So, I did a cold-turkey withdrawal. A month of pure Hell. I never knew what drug addiction was until that awful month.

I stayed off of it for about 5 months. Then after the aches and pains of gardening-one of the only exercises people with Chronic Fatigue Syndrome can do-my partner gave me one of his. That one pill turned into another prescription and an addiction all over again.

Last summer-June/July 2012-I did another cold turkey withdrawal. I couldn't believe I was back in that state again. It was a good month of torture. I swore I'd never use an opiate again.

After a month or two of not feeling right. I realized my withdrawal symptoms were just not going away-maybe the Chronic Fatigue Syndrome makes it harder for me to get over it. Anyway, I needed to have a spinal tap-the doctor screwed it up big-time (I have 2 messed up discs.) So, I got a prescription for Tramadol. I thought it would be less powerful that Hydrocodone and non-addictive.

I am currently taking an extended release 100 mg. twice a day. But, it's not staying in my system for 12 hours. It got to where I needed my 2nd dose after 10 hrs., then 8 hrs., now 6 hrs. At night I take extra sleeping pills and, basically go into withdrawal while I'm asleep, wake up feeling like Hell. Take my morning Tramadol (it's right beside the bed) fall back asleep for an hour or two and wake up medicated.

Obviously this can't go on. Hydrocodone is not an option, nor is a prescription for more Tramadol. My insurance company already wants to cut me down to 30 pills a month (half what I take now!) And overall, there's suddenly an "anti-opiate climate" in the health care field.

When I tried my partner's Tramadol, I was suddenly free. This past Saturday and Sunday, I took no Tramadol, yet had no withdrawal symptoms. I'd like to find a doctor who can prescribe it to me.

I know my opiate dose may seem small, but it's my 3rd addiction to opiates, none-the-less.

MY CONCERN/QUESTION IS THIS: If I do get on a regular Suboxone regimen, will I need increasingly strong or frequent doses over time? Also, my partner still has pills, he tried the films and the side effects were awful-his legs swelled up so bad his shoes didn't fit, it got so his ankles were barely visible. The excess water retention was so bad his heart was in danger. We will already have to figure something out for him when his current supply runs out (hopefully there will be a generic pill form of the drug.) But, what if the same thing happens to me? I wish the manufacturer offered pills as an option for people who could not take the films, but apparently they don't.

It probably seems like I should just "bite the bullet" and withdrawal from Tramadol, but even today-taking it, but not having it work because of the Suboxone still in my system, I woke up in full-blown withdrawal. I believe I will never NOT be addicted to opiates, I will always find a justification for taking them. But, will suboxone be another drug that I need more and more of?

I know it's a long post, if you read it all-thank you. Please, anyone give me advice.


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PostPosted: Mon Apr 29, 2013 10:12 pm 
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I am not a professional, just a recovering addict, and this is my opinion.

I started on Suboxone 14 months ago. I started at 16mg in a rehab facility on a rapid taper. In 8 days I was down to 6 mg, it was a little low for me, but I was comfortable with it. So for over a year I have been at 6mg. When I first started out I would take more than that, 8-12 mg a day, some days. I know now that it was my addict mind. Some days I only take 2 or 4mg, instead of the 6, because I am trying to taper. Most days I do not notice a difference.

I don't think you will have to increase your dosage over time, due to the ceiling effect of sub. Everyone's experience is different. But most people, from what I understand usually stay at a doseage once the are stable, and rarely move up over time. This is just my opinion. I hope that if I am incorrect someone will let you know. But from my experience and what I have read, people usually don't have to move up once they are stable. Again this is my opinion but I hope it helps.

Good luck, and we will be here to support you if you need it. :D

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PostPosted: Mon Apr 29, 2013 11:48 pm 
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One of the reasons suboxone works for many addicts is that you do not have to take more over time. Suboxone reaches a consistent level in your body and you shouldn't need to increase your dose. Most of the reasons that people take more sub over time are psychological.

Are you on about 400 mg of tramadol per 24 hour period right now? Suboxone is a very strong medication. If you take too much you can seriously push your tolerance sky high. I looked up equivalencies between opiates here: http://en.wikipedia.org/wiki/Opioid_comparison If you are taking 400mg of tramadol, you should only take 1mg of sub per 24 hour period. Because you are dosing for chronic pain, you should take .25mg every 6 hours for maximum analgesic relief. Anyway, that is my opinion. Most suboxone doctors start you on a much higher dose, but, like I said, that can push your tolerance level way up. Then, if you try to go off sub in the future, you'll find that you need to take much higher doses of opiates than before.

There is a generic pill form of the drug. The patent just ran out on the suboxone pill, so there have been a couple of recent entries to the market. Because the generics are so new, the price isn't that much lower yet, but at least it's a start!

We have quite a few people here who take sub for chronic pain, so I hope some of them will post here! Keep us posted on what you decide!!'

Amy

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PostPosted: Fri May 03, 2013 10:39 pm 
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Thanks for the feedback. I've decided that I need to be on suboxone. My Tramadol use has already increased from 2 a day to 3 a day, and I'm still experiencing withdrawal. I have seen my partner use it over the past year successfully-even reducing his dose.

I think all the years I was on Hydrocodone has permanently changed my brain structure so that I just don't feel right without it-no matter how completely (and agonizingly) I withdrawal, or how long I am off it. I can't live like this. I don't mind taking suboxone everyday if it means I can get off this nightmare cycle of increasing my opiate dose until it's unmanageable-then going through withdrawal-then finding my way back to an opiate and starting the cycle again.

I don't honestly think I need anything beyond prescription Advil for my pain. Thinking I needed Tramadol was a lie my brain told myself, and one I repeated to my doctor. After years on Lortab/Hydrocodone/Tramadol my brain chemistry has just been permanently damaged so that it demands opiates. This time the cycle is going faster.

I have an app't with a nurse practitioner who is going to help me find a doctor to prescribe it.i just hope I won't have to jump through a lot of "hoops" to do it. With CFS it would make me so tired to go to drug counseling, or NA. Truthfully, I'm not an addictive person. I never got high off of any of this stuff. I think my DOCTOR should go to drug counseling-for just giving my partner and I 6 Lortab a day for as long as we wanted it, for a temporary injury on my part and-just because he was there with me-on my partner's part. It was madness. We had no idea what a nightmare we were entering into until years later.

I just hope I can get the suboxone soon. I want as much of my life back as possible (I'll always have disabling Chronic Fatigue Syndrome, but this makes it worse.)

My only concern now, besides getting on a suboxone program soon, is the side effects of the films. They caused dangerous edema in my partner, his legs swelled so bad his shoes didn't fit, we could barely see his ankles and it put dangerous strain on his heart. He switched back to pills and easily lowered his dosage, but his pill supply will run out soon. I will only be able to get films-because the drug company discontinued the pills when they went generic and is only selling the films because they aren't generic and they cost three times as much. I called their number and told them about the side effect problem, but they didn't care.

Hopefully, another manufacturer will step up soon and begin manufacturing generic sublingual tablets. But, for now the goal is to get off opoids and on suboxone-my Tramadol will run out Wednesday morning!


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PostPosted: Fri May 03, 2013 11:16 pm 
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There are options other than the strips as there are already a couple manufacturers making generic Suboxone (buprenorphine hcl/naloxone) and many more making Subutex (buprenorphine hcl)...They are available at this time.

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PostPosted: Sat May 04, 2013 12:20 am 
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Yeah and if you live in a state like mine, getting Subutex is like finding a barrel full of 100 dollar bills sitting on your front porch. Generic Suboxone that has just came out is the same freaking price of the strips, I understand that the strips are causing the problems. Its just that the Subutex around here is only given to pregnant women, I cant find one single doctor that will write it for non pregnant women because I have tried. I don't know how much faith that I would put in Wiki, not saying that its not always true but it is a editable website. We weren't allowed to even quote it in college classes whatsoever or our papers were auto failed. I do read a lot of it for TV episodes if I am trying to find something.
If it is even somewhat correct on the potency, I never figured that Bupe was that close to the strength of Morphine. I have had Morphine shots and those felt like a wall smacking me in the face and then gradually getting a strong high. I might have to switch over to pills though, because I am having ALOT of water retention in my legs and Im guessing that the strips cause that. I don't ever recall the Subutex doing that or the Suboxone pills doing that. I swell a lot more now than I ever did before, I know for a fact that I used to never have a problem with swelling. Im a big girl, but Ive never had a problem when it comes to that. I guess that I might should start cheking my BP on a regular basis. I know over at the doc's office last month, it was like 140/90 which is crazy high for me. Mine usually hangs around 102/60 and that is normal for me. Not sure, something to keep an eye on for definite.


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PostPosted: Wed May 15, 2013 3:37 pm 
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After being on and off prescription Hydrocodone, Liquid Lortab, OxyContin and Tramadol for about seven years. I've realized I need to get on a Suboxone program. I talked to my General Practicioner (who is 90 min. away) and met twice with my partner's Nurse Practicioner, she ordered blood and urine tests (no problem), I am held up a bit because I need a faxed referral from my Psychiatrist-I've seen her for over 10 years and continue to see her, but she's always "antsy" about doing paperwork regarding opioids (despite the fact she got me hooked on Hydrocodone originally.)

My problems are:
1) The doctors the Suboxone website recommends have a policy of no patient taking Suboxone for more than a year. I need help from the people in the Suboxone company to actually find a doctor who understands that after seven years-I'm probably going to need Suboxone for life.

2) The other problem is my partner does not believe I am addicted. Because I currently take 400 mg. a day of Tramadol (my prescribed dose is 200 mg.), but aren't a heroin addict, he has convinced himself and is trying to convince my family that I am over reacting and doing this to create "drama." He's also angry that I passed up a chance to goon Suboxone with his doctor last summer-but, I was too bull-headed and still believed the "cold turkey" method would work.

He also told me that he needs an increasing amount of suboxone because-as with Lortab-he's building up a tolerance to it and is experiencing the wrenching withdrawal symptoms when he is due for another dose. This really frightens me-I hoped to find a correct dose and stick with it for life. He tells me, based on his own experience, I will be exchanging one pill for another and will end up in the same place. He also said that because I have Chronic Fatigue Syndrome and took opiates for so many years: I have caused permanent brain and neurological damage.

Either way, I am about to go over a waterfall. I am taking Tramadol given to me by a relative plus my prescription, but I can't sustain this. That extra Tramadol will run out next week. Suboxone sounds so good, but I really need more support from the company in finding a doctor who will subscribe it-their list is not up-to-date and it doesn't mention the doctors who want people on Suboxone temporarily. That won't help me: I willhave to handle Tramadol everyday because two of my dogs take it for arthritis. I would rather kill myself than steal pain medicine from my beloved dogs.

The stress at home is unbearable, my partner is going to use a guest bedroom, because he is too disgusted to sleep with me-because I took an extra 8 months to get on a Suboxone program! I could have done it with him. I should have. It's too late-his doctor already has 100 patients. I'm trying so hard-have had all the blood, urine tests, hoping for the Psychiatrist's referral so I don't have to be delayed in starting a program. But, I am afraid that I will "taper up" like my partner has and end up worse off. I really thought Suboxone avoided that-doesn't it?

And what's the point if none of the doctors on the Suboxone website believe in the lifetime maintenance dose. I am more scared and depressed each day. Getting into a Suboxone program seems so impossible even though I have a referral from a GP, I've seen her two weeks in a row, had all my blood tests and a urine test. I just need a doctor to start me on a Suboxone program, but it's turning out to be nowhere as easy as the website suggests.


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PostPosted: Wed May 15, 2013 4:17 pm 
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Draper7734, If you have a NP that is working with you and will still have pain issues from your CFS; you could consider Buprex (buprenorphine in a patch form). If your NP can prescribe Vicoden then they can prescrbe Buprex. It is approved for longterm management of pain, not addiction.
Regarding the clinics 'rules' about prescribing for only one year; that is a long time, after 6 months if you still think you will need it long term you would have 6 months to find an alternative provider.
I agree with Amy, your tolerance is quite low, you might get by with .25 or .5 mg twice a day. Generally need to dose twice a day for pain management, particularly at lower doses.
Whoever made the comment about an antiopioid environment developing is correct. What annoys me is these dickheads who get their patients up to the equivalent of 600 mg of morphine a day, then get 'nervous' and cut them off.
You've done your research, advocate for yourself and don't get induced on too high of a dose. PAX


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 Post subject: Three New Concerns
PostPosted: Thu May 16, 2013 12:05 am 
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This process has turned out to be so much more complicated than I imagined. I suppose I expected that once I admitted I had a problem the medical community would rush to offer assistance in freeing me from the opioid addiction-that's not the case.

Every doctor in my area either is "out of the business" or are booking new appointments months in advance. The only place I could get into sooner is a methadone clinic in the inner city. I would have to show up during "walk-in hours" and possibly wait hours to see an intake specialist who would then refer me to the next step, seeing the doctor-who is there only one and a half days a week. I'd also have to attend their N/A groups and meet with one of their drug counselors regularly. Plus, even if I got the Suboxone the prescription would only be for a week at a time!

The reason these are issues: is because I have Chronic Fatigue Syndrome. To me this is an an enormously busy schedule and one that would practically kill me to maintain. As for N/A and Drug Counseling, the thing is: I never took Hydrocodone, OxyContin and now Tramadol for recreational uses, I literally never got high from then. They were subscribed to me for pain from a serious head injury after a car crash, two different surgeries and back damage from an incompetent spinal tap. The reason I am taking the Tramadol now (and taking more and more of it) is to stave off withdrawal symptoms. If I had a Suboxone prescription-no one would be happier than me to leave opioids in the past than me. I have no desire to use them, I hate them and want to be free of them. There's really no emotional component to my using/abusing them. It's all physical. My partner's doctor gives him scripts that last 2 or 3 months because the co-pay is the same whether you get 90 days worth or one week's worth. I can't afford to pay for a weekly prescription fill. This place seems to be geared more toward people with heroin, OxyContin, cocaine problems who are on Medicaid (which doesn't require a co-pay) as opposed to Medicare (which I have) that does require co-pays for everything, which is a huge hardship being on SSD.

My two other concerns are because of something my partner reminded me tonight: for quite a while after he began Suboxone it was very difficult (almost impossible to urinate.) I've had that problem the two times I was on anesthesia and/or morphine for surgery-so I am very worried about this side effect.

The other side effect, he still experiences, is chronic-sometimes frightening-constipation. After a year he needs an enormous of stool softeners-sometimes enemas-just to defecate. The thought of going through that scares me, too. Especially since my father died at age 48 of colon cancer.

I am bewildered. I'm thinking that maybe since I'm only taking 400 mg. of Tramadol a day I could wean myself off it and avoid all these problems. But looking back at the last seven years I have been on these pills of some sort or another continually-except for two "cold turkey" withdrawals: neither of which lasted.

Tomorrow (Thursday May 16) I plan to try cutting my dose to 75 mg. every four hours (1 1/2 tablets) instead of 100 mg. (2 tablets) every four hours. Maybe, it won't be a big deal and I'll be able to drop again to 50 mg. (1 tablet) every four hours on Sunday. They say to taper every three days. If that works, maybe I can be over these drugs. The thought of going to a Methadone clinic once a week just exhausts me-I would be in bed a day or two afterward: it's just how Chronic Fatigue Syndrome works.

I'm as confused as ever. I guess I'll just see how tomorrow goes and if the 25% taper step-down works.

Thanks again, everyone for your support and feedback.


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 Post subject: Reply to DOCM
PostPosted: Thu May 16, 2013 12:22 am 
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I hope I remembered your name right. My short-term memory seems to be gone from these drugs. Your reply was very helpful and useful, I will print it out and take it with me to any appointment I am able to get. Right now, I have no idea how much pain I am in-the Tramadol is exacerbating the pain n order to get me to take more, same thing the Hydrocodone did. These drugs have a "mind of their own" and it's a devious evil mind.

I am actually afraid of and avoiding the pain of withdrawal. I've done it twice and it was the most Hellacious experience of my life. It also took me about a month, not three days, maybe because of my Chronic Fatigue Syndrome. Then each time I went back to the painkillers anyway.

If I could only go back to my 2006 self and warn myself about what I was getting into when I accepted the prescription for Hydrocodone, it would be so different. If only the doctor prescribed OxyContin, even, I would have known what it was and just stopped taking it after a few days. But, I had no idea what Lortab was and my brain was, literally, injured from the car accident. I was in no shape to research it myself.

I'll never understand why doctors prescribe this stuff knowing their patients will always get addicted and need more and more or go through withdrawal, and in the process suffer so much and lose big chunks of their life. Taking those pills is like swallowing a bit of a curse that grows overtime into a full-blown crisis.


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PostPosted: Thu May 16, 2013 1:06 pm 
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I loled reading about your chronic fatigue syndrome. There are so many names for shit these days that it's crazy. Everyone wants a diagnosis or an excuse to do something or feel better. I mean... 30 years ago there wasn't nearly as much crap out there. We are a society of constant buffers. Lol. Whether it's ADHD, adult ADHD, chronic hand itching syndrome, or hair brushing phenomenon. It's crazy to me.

Not saying you don't feel how you feel at all. It's just a common trend that gets weirder every day.


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 Post subject: Butrans not buprex
PostPosted: Thu May 16, 2013 3:00 pm 
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DocM made a typo actually as Buprex (probably meant Buprenex) is actually an injectable form of buprenorphine hcl for pain control. BuTrans, on the other hand might be a really good option for you and would be what you would want to mention to your providers. It is a CIII medication as is hydrocodone/lortab/vicodon so any doctor who has a DEA # can prescribe it for pain management. It's a patch similar to the Duragesic (Fentanyl) transdermal patch only BuTrans actually lasts 7 days. Any Dr can also write you a prescription for Suboxone or Subutex for pain OFF LABEL but it's rather unlikely. A problem is that you have already been through the process of looking into obtaining suboxone via a maintenance clinic or through Dr's who prescribe under DATA 2000, so if your primary Dr's/psychiatrists who you have standing relationships with thought that an off-label RX or even the use of BuTrans would be for you they likely would have already suggested going that route. Still, mention BuTrans, if it's appropriate for you it just might be the ticket or at least a place to start. One thing to keep in mind, though, is that buprenorphine has a MUCH more potent opioid effect than tramadol and even hydrocodone and you will feel that upon induction for the first couple days until your body adjusts. Though it seems counterproductive to take a stronger opioid to treat dependence on a milder opioid, buprenorphine and to an extent methadone have unique properties that keep your receptors saturated for much longer periods of time than other opioids, thus losing the histrionic nature of the opioid roller coaster and creating a more balanced life; keeping the addict inside satisfied, essentially so life can be focused on something other than active addiction 24/7. Keep posting here, good or bad, we're all invested now, I know I am and I hope all works out with you!

Travis

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PostPosted: Fri May 17, 2013 10:28 pm 
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I'm not sure I have any "magic advice" for you....

I know for ME,,, getting ON suboxone to begin with was REALLY HARD, and I was on a waiting list for almost a month.

but you know, it made me really take it SERIOUSLY when I finally got that first appointment, so I guess everything happens for a reason..... and I wouldn't have changed one thing NOW... two years later,,,, my life is NOTHING like what it was, and that's EXACTLY what I needed/wanted and didn't know how to get there....


I have no insurance, and actually got on the manufacturer's program, they pay for up to 90 films/month for twelve months. each dr. can have UP to three patients on the program, at a time.

here's some videos On HOW suboxone works, and why MOST people are actually on LESS of a dose, after time... for me, I started on 24mg, two years ago, and now I'm on 8.... and I have chronic pain issues, too.

Good Luck with everything

[youtube]http://www.youtube.com/watch?v=_Ls1F6vNhYw[/youtube]


[youtube]http://www.youtube.com/watch?v=VE0FLHpru8U[/youtube]


[youtube]http://www.youtube.com/watch?v=lrqjJGoSQgc[/youtube]

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 Post subject: My Input
PostPosted: Sat May 18, 2013 3:08 pm 
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Draper7734,

You are getting bad information from your partner so my suggestion is to put some earplugs in and ignore him. I will try to make this simple for ya.

Twincitieshardcore had it right. I don't know if DOCM made a typo or not about the Buprex/Butrans, etc. All I know is I was given a 20 mcg patch for pain and it worked great. Ask for that or something similar if you can.

Do not even think about urinating problems if you are given Buprenorphine. I've only heard of one or two cases and they probably have nothing to do with the Bupe. Plus, you are not your roommate. We all have different reactions to medications, that is why every drug has a huge list of side effects. One never knows what will happen. You worry too much.

Opiates, including Buprenorphine, cause constipation. I have never had a problem with it. Why? Because everyday after lunch or dinner I take a fiber supplement in large doses. Buy the generic Metamucil (orange flavor) with teaspoon doses, then with a full glass of water add three heaping tablespoons and mix it up. Follow it up with another full glass of water. Do this after a meal and you'll never have constipation again. You can even add more fiber if you want but don't make it too thick or it's hard to drink.

That's it. Take a deep breath. Let it out slowly and repeat once more. Relax dude and stop worrying.

MM1, your post did not help the situation. There is an old saying "if you can't say something nice to someone, don't say anything"

R62

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Last edited by rule62 on Sat May 18, 2013 3:53 pm, edited 2 times in total.

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PostPosted: Sat May 18, 2013 3:49 pm 
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moviemaker, you just cant help yourself can you?
reread what you posted..gezz..
wheres the spritual princaple in that??
Good advice Rule..


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 Post subject: Forgot One
PostPosted: Sat May 18, 2013 4:06 pm 
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Amber said it correctly. Your tolerance does not go up and up with Suboxone. Most of us go down over time. The main ingredient, Buprenorphine, is used in micro doses for pain. I mentioned getting a 20 mcg patch. That's micrograms, not grams. It doesn't take very much for the pain killing effect to work.

I hope you were able to make some sense out of everyone's replies. (sans one) We all speak from experience, not from what we've heard unless it was from a physician or professional. There are hundreds of opinions regarding Suboxone. Some good, some not so good. The only opinion that counts is your own. If you do decide to go onto Suboxone for long term pain, only you will know the side effects. It mostly just makes me tired if I'm just sitting around. Otherwise I don't feel it as long as I keep busy.

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PostPosted: Sun May 19, 2013 7:34 am 
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Rule isnjt this the same guy with the different identities?

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PostPosted: Sun May 19, 2013 7:54 am 
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I just double checked the stories and it is the same guy. Just a heads up. On a different note problems with urinating can be a side effect of suboxone. I experience hesitation.

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PostPosted: Sun May 19, 2013 7:34 pm 
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If you're talking about moviemaker he is not the guy who posts under different names. He has been here for awhile and is actually very knowledgeable and can be very helpful. He is just kind of blunt sometimes. Don't take it personally he's like that with everyone. What he said could have been said in a nicer way and doesn't really have anything to do with the conversation but he is right people are being over diagnosed with a variety of diseases. Something to look out for and always advocate for your health and get a second opinion if you feel like something isn't right.

And draper you won't know what side effects you will have until you try the medication. Everyone is different. I say if you decide suboxone is right for you try it! And if the side effects are unbearable you can always go off it and try something else.

Good luck to you,

Squeaky

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PostPosted: Mon May 20, 2013 2:30 pm 
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Hi squeaky. Naw I am talking about draper. Movie maker rocks. :D

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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