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 Post subject: symptoms and dosing
PostPosted: Sun Jul 31, 2011 1:04 am 
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Hey Everyone, Hope you guys are doing well. Have a new question for you. I have been on Suboxone close to a month now. For the last 9 days I have been on 3 mg a day. 2 mg am and 1 mg evening. As a reminder, I was on Methadone for 6 weeks trying it as a pain management drug and I hated it. I had been on ms contin before that for 2 years. I'm on Suboxone to taper off completely. So, here I am at this dose and every afternoon I get some mild withdrawal sx- ringing in my ears, then kind of shaky, jittery, anxious feeling. What puzzles me is that I am 9 days into this dose ( was on 4 mg) and was feeling good until a few days aqo when the symptoms got worse. I would think that they would calm down as my receptors would start to down regulate. So, I am confused. I was thinking of dosing 3x a day. maybe 1 mg 3x a day to stave off those mid day episodes. Or, my main question really is this: If I ride these sx out for 3-4 more days, shouldn't my body get used to this new lower dose and the shakiness calm down ? The other thought is that maybe the methadone I stopped 4 weeks ago is now completely out of my system and maybe I need to increase the suboxone ? I'd hate to go backwards. My preference would be to ride it out- if that is correct that the receptors should stop bugging me in a few more days. All comments appreciated
Anita

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PostPosted: Sun Jul 31, 2011 2:16 am 
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Hi Anita,

What doses were you on before you were on the current 3 mg? And how long did you stay at that dose before you dropped to the next lower dose? If you dropped too quickly you could still be having some withdrawals and they can sometimes come and go. And yes, you should adjust, but I can't say how quickly. You'd probably only need the tiniest sliver of sub to feel better. I wouldn't call that going backwards.

On the topic of stopping in general, have you seen Dr. Junig's most recent blog post at the Suboxone TalkZone? If not, check it out. Here it is: http://suboxonetalkzone.com/2011/07/29/ ... -suboxone/

The title this week is "stopping suboxone". In it he mentions that at really low doses there is sometimes a need for multiple day dosing - like 2-3 times a day. So you might very well need the three times a day. Or...you could start by trying 1.5 twice a day and see if that carries you over...just a thought, it could work.

So you have an over 2 year history of addiction, but you only want to use suboxone as a detox tool. It's thought that getting "clean" is the easy part, but it's the staying "clean" that's the hard part. So however you're going about it, be it individual therapy or groups or 12 step groups, good luck to you.

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PostPosted: Sun Jul 31, 2011 2:32 am 
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Hey Hatmaker, ya... just as a review.. I'm a chronic pain patient and I think my underlying condition has improved and I want to see what my baseline pain is and I think I may not need pain meds. I was on opiates for a total of 4 years, so definitely tolerant/dependent and chose subox to help taper. I started a few weeks ago and was induced and settled at 4 mg pretty quickly, stayed there for about 5-6 days then went to 3 mg. 6 mg made me feel sedated so went to 4 right away. After about a couple weeks at 4 I went to 3. So I'm early on in the program. I'll read that blog post but yes, my goal is to look for non-opiate treatment for my neuropathy. I'm one of those that actually had almost an "aversion" to being on opiates and I was on super low doses and never increased my doses over that 4 year period and discovered that I was probably in a low grade partial withdrawal for 2 years. It would happen at night, every night and I finally figured it out. I couldn't sleep, had bone pain... it was awful. I was fed up with the treatment being worse than the disease and told my pain dr. I wanted off the Methadone that she had just started me on a few weeks before. So, you'll remember from my intro post, I talked about my Methadone withdrawal ( terrifying) and then starting suboxone. Ok, so thanks for this answer. I may take a sliver more like you suggest if the 3x a day dosing doesn't work. Thanks, Anita.

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PostPosted: Sun Jul 31, 2011 2:43 am 
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Ah, yes, Anita! Forgive me for not recalling. I'm sorry, but I of course remember all of that now. (I feel :oops: for not remember it right away.)

I'd try the 1.5 twice a day first off and see if that might last you a full 24 hours. You just never know. If not, then try the 3x per day. But remember, eventually, you'll have to start eliminating those doses when you get lower and lower.

Oh, BTW, as you get lower, is any of your neuropathic pain coming back yet? They are giving my husband shots in his lower back, but so far it isn't doing much. It's peripheral neuropathy, nothing works!

Hopefully those icky feeling that returned will disappear just as quickly as they arrived. Again, sorry. :oops:

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PostPosted: Sun Jul 31, 2011 8:23 am 
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Hatmaker, most definitely my neuropathic pain is coming back but in my case right now.. what is encouraging is that it is very localized and not widespread, "centralized" pain like it used to be. When I do get to the point that I have to start some new meds, it will likely be some Gabapentin or Nortriptyline, but I would imagine your husband has already tried that. I am so sorry to hear that his treatments are not working, cuz I sure know how unrelenting neuropathic pain can be. Is he going to a tertiary care center, with lots of specialists who might be thinking about treatments he can't get in more conventional centers ? Ya know like a mayo clinic, cleveland clinic kind of place ?
Anita

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PostPosted: Sun Jul 31, 2011 8:32 am 
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He's going to what seems to be a pretty good pain management clinic. But he's only been seeing them a couple of months. He even has a pain mgmt psychologist assigned to him, who I hope can maybe help him to manage his stress. That could only benefit him.

And better still, they don't seem to be a bunch of pill pushers, which I'm of course thankful for, not that he'd take any more pain meds. And you're right Neurontin and lyrica and the rest of those don't help him at all. Just like Lyrica does nothing for my fibromyalgia. He's still wanting to get off the pain meds and is slowly weaning himself down. I sure feel for him.

I hope you can find a non-narcotic way to get relief once you're off the sub. Neuropathic pain is severe and can be so debilitating. Keep us posted on how you're dosing is going.

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PostPosted: Sun Jul 31, 2011 9:56 am 
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Hi Anita, good to see you here. I just started a new med, a generic of Wellbutrin (bupropion), and among the symptoms listed were ringing of the ears and anxiety. I thought it sounded weird, and then I did experience that ringing the second day I was on it. I'm just wondering if you are on any other medications. It may be possible that what you are experiencing isn't related to the Subs, especially since you have been at your current dose for a decent amount of time.
Hope you feel better,
Lilly


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PostPosted: Tue Aug 02, 2011 11:54 pm 
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thanks for asking lilly- I'm not on any other meds and the ringing in my ears happened too when I was on the Kadian and then Methadone. I was the one who was going through w/d at night probably for about a year and a half cuz I was on that real low dose. ( I wrote about that when I first came on the forum) My ringing in my ears seems to subside after I take a dose.. so I don't know.. maybe ultimately I settled in too quickly at a dose of 3 after induction ? I was just so determined to get below 4 as fast as possible. I've been on 3 now for 10 days and it is getting better but I do get kind of jittery in the middle of the day and then the ringing starts as well. Calms down about an hour after my mid-day dose.. But you have me wondering thisi: I can totally tolerate the symptoms and I'd rather do that than bump up my dose since my intention is a taper. Is it possible that my receptors are being more "stubborn" and they just haven't even calmed down all the way since I stopped Methadone a month ago? I tapered off and it was true hell. I am really hanging on to what you all say that at the end... if slowly tapered, the subox taper is nothing like coming off Methadone. I have a psychiatrist friend who said "Methadone withdrawal is the closest feeling to dying without actually dying" I'd really rather not experience that again. Hope everyone is doing well and thanks for the support. Do most people end up going on an anti-depressant too while tapering ? Just curious cuz that is also an option I've been thinking about and if I did, I could pick one that helps with neuropathic pain
Anita

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