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PostPosted: Thu Nov 25, 2010 12:38 pm 
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I take 2 mgs of suboxone a day, usually after work because the taste of the Subs is too much to handle first thing in the morning. Anyway....I feel anxious, a little sick to my stomach, no appetite, I also gag very easy, and I just can't sleep or sit still. I want to feel a little drowsy on the subs not hyper. I'm a high anxiety person to begin with and a huge worrier. Any advice on if I should ask my Dr. about increasing would be great.


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PostPosted: Thu Nov 25, 2010 12:58 pm 
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Hey downing, glad to have you here.

I'm sure there are sevreal of us who would like to try to help you, but we're going to need some more info.

How long have you been taking sub? Always 2mg once per day?

Why are you on sub, a little history about your drug of choice and how long you were on it would be helpful.

Just taking a shot in the dark, I'd say taking the sub after work could be part of your sleep issues, when I first started sub I could not take it after 4pm because it would keep me up at night...I don't know if I'd say I was hyper, but my mind would go into overdrive.

As for sick to your stomach, opiates do that to a lot of people, usually only opiate naive people though...and since your on sub I'm guessing your not opiate naive. Although sub does work differently than full agonist opiates do so this may be the issue.

Again, a little more info would help greatly.

Look forward to hearing from you.


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PostPosted: Thu Nov 25, 2010 1:13 pm 
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1st of all Welcome and I'm not a Dr. This same exact thing happened to me, My psychiatrist scripts me both Suboxone and Lithium, I was having the same problems ( sleeping was impossible) for 4 months before he helped me with it, he told me he has been diagnosing me for the 4 months, I guess he thought I was a bit hyper.. He said I was mildly bipolar.. I only take 500mg of Lithium all at nite before I go to bed... It has been a life saver for me. You dont want to take to much though, you,ll be in zombie land for sure... for me Lithium took care of EVERY issue you listed .. and I had them all, Mike (1mg, no need to go any farther )


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PostPosted: Thu Nov 25, 2010 1:37 pm 
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Hi downing and welcome,

From your symptoms it's kind of hard to say if you need a dose increase or not. For some people, suboxone always makes them a bit hyper, others always sleepy. For me, it makes me neither sleepy nor tired.

I did want to point out though that you are more likely than under the ceiling, which is generally thought to be around 4 mg. The idea of opiate replacement therapy is to saturate the opiate receptors. Doing so address all withdrawals as well as cravings. That happens if dosing is at or above the ceiling. That said, I'm not saying you need to increase your dose. I just wanted to mention the ceiling effect. Below it, suboxone tends to act more like a full agonist.

I'm sorry I can't be of more help. Like Romeo said, more information would be very helpful.

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 Post subject: Some more info...
PostPosted: Thu Nov 25, 2010 3:11 pm 
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Wow, thanks everyone for the speedy responses!

Ok, here's my brief story. I used heroin..sniffed if, never IV and used Oxycontins as well. My addiction was short lived but to me it was too long, 8 mos aprox. It was destroying my life, I'm also an older addict and my addiction didn't start until I was about 30 yrs old. I used methadone for about a yr and then switched to subs. My dr started me on 8 mgs of subs a day but I never needed that much. Now I'm down to just 2 mgs. I do have depression and anxiety issues. I take ativan 1mg a day, go to a psychiatrist. I have tried several SSRI's but they don't seem to work for me. I'm going to mention lithium to my dr because the sleeping issue is really getting old. Thx for mentioning that! Ativan doesn't seem to work as well for me anymore and I don't want to become addicted.

Anyway, this seems rushed because I'm on my way out the door for Thanksgiving. Thank you so much for the info. I read on this forum every day almost but this is the first I've posted except for a pm I sent Dr. J.

I was just reading what Lilith1209 has posted and the replies. This is such a fantastic group of people. I'd also like to mention that I read what Dr.J posted about OC's getting changed and people switching to heroin, while at the same time FDA puts out extended release Dilaudid. Ridiculous. Wouldn't u think the govt or whomever would want us to use a RX drug that is the same every time then heroin which could be weak one time and strong the next......exactly why overdoses happen.

Thank you all! I'll def be posting here more often.

Downing2b


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 Post subject: one more thing
PostPosted: Thu Nov 25, 2010 3:14 pm 
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I've been on Suboxone for over 2 1/2 yrs, forgot to mention that.


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PostPosted: Thu Nov 25, 2010 3:54 pm 
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I didnt get hooked on pain pills till I was 47yrs old...I squeezed in a life of pill addiction in 4 yrs ( had spinal fusion and for 3 yrs prior to surgery thats all the Dr.s would do is give me pain pills, where I messed up was having 2 Dr.s. I was working a Pain mangement Dr. and a Neurologist, I believe its called Dr shopping ??? ) I have also tried a few things ( anti depressant drugs ) and they did absolutly nothing.. Tried them for months ( my Dr does not give up easy on meds, he'll make you bitch for a couple months before he listens ) I will be honest, patience here is manditory, just remember that..


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PostPosted: Thu Nov 25, 2010 4:51 pm 
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Your original post posed the question of should you ask your Dr. for more sub, if I read it right...but you mention you were already at a higher dose, so I have to ask the obvious question...while on the higher dose (8mg) did you experience the same symptoms that you mention in your original post? If so, I'm not sure an increase in your sub dose will help. Unless you were considering going higher than 8mg.

You went from 8mg to 2mg of sub, do you think maybe you went from 8 to 2 too quickly? Some of your symptoms do seem to line up with too rapid a taper.

I'm sorry downing2b, but that's all I got.

Good luck and I hope everything gets sorted out quickly.


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 Post subject: yes it was a quick taper
PostPosted: Thu Nov 25, 2010 10:11 pm 
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I went from 4 mgs a day to 2mgs. I've been on this dose for about a month. I don't like the way I feel. Has anyone had problems with their pharmacy filling the pills when your script says film and they gave you pills? And why do you think some people get drowsy and some people can't sleep? Does it have to do with the dose? I've never gotten drowsy from my suboxone but then again I've never had trouble sleeping like this since my dose is lower. My thought is... I'm not feeling withdrawal symptoms or cravings its just the anxiety and hyper feelings that seems to be affecting my sleep. So you see, this is the only effect I'm feeling.

Thanks guys and I hope everyone had a nice Thanksgiving as well.


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PostPosted: Thu Nov 25, 2010 10:28 pm 
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sullimi wrote:
I didnt get hooked on pain pills till I was 47yrs old...I squeezed in a life of pill addiction in 4 yrs ( had spinal fusion and for 3 yrs prior to surgery thats all the Dr.s would do is give me pain pills, where I messed up was having 2 Dr.s. I was working a Pain mangement Dr. and a Neurologist, I believe its called Dr shopping ??? ) I have also tried a few things ( anti depressant drugs ) and they did absolutly nothing.. Tried them for months ( my Dr does not give up easy on meds, he'll make you bitch for a couple months before he listens ) I will be honest, patience here is manditory, just remember that..



Hey. Thanks sullimi. Did you ever find an anti-depressant that did help? I hear you on squeezing in a lifetime of addiction in a short time. I was to the point where I was taking cash advances on my credit card to have money for dope, terrible I know. I racked up about $10K in a little more than 6mos and I knew better. I was and am totally ashamed with my behavior. I even got pulled over by a cop on the way out of a bad neighborhood because he saw me pick someone up and then drop them off and knew what was going on. He searched my car, found straws for sniffing but i hid the dope in my belt between the belt and my pants. That was a real close call and that was not the last time I went in that neighborhood. I'm sure other people can relate, I should have gotten caught or wrecked my car, somehow by the grace of God, I wasn't caught.

Any how, I see myself getting off point and rambling. lol


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PostPosted: Fri Nov 26, 2010 8:03 am 
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So you went from 4 mg to 2 mg and it's only been a month (or so)? That's a huge drop - you cut your dose in half. I'm going to go out on a limb and suggest that you went down to quickly. Withdrawal symptoms for many people include anxiety and an inability to sleep (that's one of the most common symptoms). Maybe you need to go back up. You might feel better.

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Fri Nov 26, 2010 8:45 am 
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I'm not a Dr. OK try this, Hat is 1000% correct ... Just for the hell of it add 1mg back to your 2mg 1+2=3mg try that, I bet you you will feel so much better.. If you do have some mild mania issues, going fom 4mg to 2mg in one jump is way to fast.. I spent 9 months going from 4mg to 2mg and it was still miserable for me.. You need a little sub on your receptors to sleep, maybe move your dosage time an hour later, So your taper in 1 month was 1mg not 2mg... A 2mg drop is way way way to much , try not to go back to 4mg though.. This why people hate and bitch ( not you ) about Suboxone, There in a constant taper . If 3mg works , stay at it for a couple months..Now is where the film comes in handy.. Start getting 2mg strips.. Now it will take a while for you to feel your best , BE PATIENT


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PostPosted: Fri Nov 26, 2010 10:11 am 
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Hi There:

I agree with Hatmaker and the others about that change in dose. Changing your dose that much (50%) that quickly can have all sorts of consequences, depending on what other medications you are taking and a number of other factors.

What I would suggest you try is instead of going down to 2mg as you have, try 3mg for a while, see if it makes a difference, then after you've stabilized at 3mg (that is, IF you stabilize at 3mg) for about 10 days to 2 weeks, you can then try making the jump down to 2mg, but even that might be rushing it.......

I'm sorry if I missed it, but are you going to get off suboxone? I'm asking because 2mg is a pretty low dose for maintenance.


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PostPosted: Sat Nov 27, 2010 10:53 am 
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I was trying to get off suboxone but like many of you know, this is a disease that may have to be treated for a lifetime.


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PostPosted: Sat Nov 27, 2010 11:10 am 
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downing2b you said, 'this is a disease that may need to be treated for a lifetime', you are absolutely correct. If the subs work well for you then there is no shame whatsoever in staying on sub indefinitely...it's probably the best thing you could do.


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PostPosted: Sat Nov 27, 2010 12:10 pm 
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Hatmaker nailed it right on the head. You're experiencing w/drawals. When I detoxed off methadone I expected to be "dope sick", but nobody told me about the HORRIBLE anxiety you go through. For ME, switching from methadone to Suboxone did nothing for increasing or decreasing the anxiety. For me, the anxiety was worse than being sick. I too suffer from real bad anxiety and 6mg's of Xanax a day did nothing for the anxiety, so I switched to Klonopin because of the longer half-life, (same dose as xanax). Now being on Sub and detoxing, the K-pin barely scratches the surface of my anxiety. I also am in the middle of detoxing off Suboxone. I take 4mg's, twice a day, and when I woke up early to take my morning dose around 4a.m., when 8a.m. came around, I was finally ready to fall asleep but didn't want to because it's time to wake up. Again, no dr. speaking here, but I have read peoples' posts where, if they take their Sub too late in the evening/night, they have a hard time sleeping. I just talked to my gf about this same thing this morning. I have been able to get about 5 hours of sleep a night usually, but last night I took my med about an hour before going to bed, (which is what I usually don't do), and hardly slept. Try taking your last dose a few hours before going to bed and see if that helps. If not than you most likely dropped your dose too fast.


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PostPosted: Sat Nov 27, 2010 5:45 pm 
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Yea, the only time I was able to sleep good was on methadone. I could sleep whenever and for a long time. When I was on my "drug of choice" I had trouble sleeping in the long run, could fall asleep just not stay asleep.

I didn't think that 2mgs was that low of a dose for maintaining on because I heard about Temegesic being 0.3 and 0.6 mgs for cancer patients and that's straight Buprenorphine. My doctor seems different than what I hear other suboxone drs doing. She had me on 2mgs 4X's a day initially. Most dr's would have you take the 8mgs 1X per day. I know why she bumped me down fast from 4 mgs to 2mgs, i thought i was pregnant and that's when she did that. Again, most drs wouldn't lower your dose drastically if your pregnant, with the fear of causing a miscarriage. Good thing i was indeed NOT pregnant. I really like Dr J's way. He's so knowledgeable about Subs, he actually was in our shoes at one time. My dr is all about the $, don't think she really cares about addicts, she just sees dollar signs. i could b wrong but that's the feeling I get from her. She also made me wait 72 hours without methadone before switching to suboxone, where other dr.s give you subutex to start out on so you can start sooner.

I go to see my shrink this week (dr who prescribes me ativan for anxiety) Should I ask for Clonazepam (klonopins)? Or should I just say the ativan isn't helping with the anxiety? I certainly don't want him to think I'm shopping for benzo's.

Thx guys. This is the best site for information and support. I find this group is more supportive then at NA meetings.


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PostPosted: Sat Nov 27, 2010 5:59 pm 
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Honestly, the best "cocktail" of meds to help with detox is Klonopin and Clonidine, (be carefull cause Clonidine causes real bad constipation on top of what you are taking now, but helps with sleep, and pure restlessness), and possibly an anti-depressant, but that's something to talk to your psych about, (if you have one). Get a real good multi-vitamin, get as much exercise as possible, even if someone has to push you, and take long, hot baths/showers, or better yet, spend time in a steam room. Sweating actually gets rid of the toxins your body has built up. Then just eat healthy. I learned that after I make it through this detox process, I'm going to be the healthiest I've ever been because of the way I am eating now and keeping myself in better shape than I ever have.


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PostPosted: Sat Nov 27, 2010 6:27 pm 
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When bupe is used for pain management it is indeed used in small doses. What we take, suboxone/subutex, is also known as "high dose buprenorphine"or HDP. Suboxone has a ceiling effect, which is generally accepted to be at or around 4 mg. The idea of sub is to have our opiate receptors saturated to address withdrawals and the physiological cravings - this only happens at or above that 4 mg mark. (It's not set in stone though.) This is why when people are on maintenance and not tapering off, usually they are on a dosage of 4 mg or more - USUALLY. Like I said, we're all different. Generally, at doses under 4 mg, suboxone acts more like a full agonist than the partial agonist that it is. The opiate receptors aren't saturated and so there's a certain "up and down", for lack of a better way to describe it.

Oh, and clonidine is not a benzo. It's a blood pressure med that is pretty much the gold standard in treating the discomfort of opiate withdrawal.

I hope this helps clear things up a bit. I know the whole ceiling effect is very confusing. It took me a while to really understand it. If you have more questions, just let us know and we'll try to answer them to your satisfaction. Hang in there.

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PostPosted: Sat Nov 27, 2010 9:53 pm 
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Thanks Hat, you really know your stuff!

Amy


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