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PostPosted: Thu Sep 07, 2017 1:15 am 
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I'm on my second week of suboxone and have tapered to try and be on as low a dose as I can handle. It seems I can't go lower than 2-3mg per day (inducted at 12mg, took 8 the second day, and have tried to be lower since). At 2mg I sometimes don't feel awesome but bearable, however it's the cravings that scare me. I tried 1mg in morn and 1mg in afternoon but catch some serious plotted relaspe thoughts. Today I took 2mg in morning and still had such thoughts and was feeling a little crappy 15 hours after that morning dose, so I took 1mg (taking 3mg total today). This seemed to help the bad thoughts to calm down, but just a little. For some reason I'm afraid to take more than 3mg daily and it has a lot of different reasons behind it, but the most concerneing one is that my addict brain seems to want to leave room to test suboxone blocking effects and get high on my DOC after refraining from a few days dosing. I know this is bad thinking and my non-addict self knows this is dangerous. The other reasons include not wanting to have pin prick pupils noticeable, wanting to stock up on sub since my insurance is not stable and can be discontinued any moment, and lastly because I'm on sub for a 2 month relaspe and have fear of being dependent on sub for too long at too high a dose. I read Dr. j post about the topic of missing the point of suboxone, which seemed reassuring that higher doses are ok, but my background of recovery comes from NA and suffering cold turkey off a heavy IV heroin habit to being mostly successful without any medications. I seem to have the idea that I'm supposed to learn how to work through cravings and that is part of my job to stay clean (as well as learn to differentiate what are addict thoughts vs logically sound ones).

Anyone relate or have comments to my situation?


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PostPosted: Thu Sep 07, 2017 3:14 am 
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Our suggestion here is that you take enough buprenorphine to calm your cravings and obsession to use. Our reasoning behind this is that it is much easier to work on triggers and the reasons you use in the first place when your brain is not preoccupied by cravings. As you know, trying to accomplish anything while you are craving is almost impossible. When we taper, we do it slowly and comfortably. No one wins a prize for doing the most suffering! White knuckling abstinence shouldn't be viewed as a badge of honor.

At the same time, we are big proponents on working on recovery! Many of us prefer SMART Recovery meetings when compared to NA, but there are still plenty who have used 12 step groups with success. We encourage addiction therapy as well. It is important to garner insight regarding why we relapse and how to prevent that from happening again. That way, if and when we get to the point of tapering off buprenorphine, we have some knowledge and skills to apply. There are plenty of people on this forum who don't plan on going off buprenorphine, however.

I would like to see you try to take enough buprenorphine to quell any cravings for several days in a row. Feel the normalcy of not feeling desperate. It's truly a revelation. Building up an extra stock of suboxone is not a bad idea, but don't do it at the expense of experiencing the benefits of suboxone. If you need to taper someday, you can do it slowly.

I hope that everything I've said here makes sense to you! Let us know if you have any more questions!

Amy

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PostPosted: Thu Sep 07, 2017 12:30 pm 
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I agree with Amy, I wish you'd just take a dose to cover all ur cravings for more than a day or two at a time. Ur not adjusting because ur dropping too quickly and ur taking 1mg and then another 1mg...... that's a lot of bouncing around when you've only been taking buprenorphine for a short time.

I totally understand why ur trying to get to the lowest dose u can financially. The pupil part I don't understand because when u were using u experienced that too and if ur mind is wondering about challenging the suboxone, what would how ur pupils look matter? I think u should try to put ur worries aside and find a dose that covers all ur cravings and stick to that routine for a few weeks. Just look at it as temporary if that makes u feel better but I guarantee u that you'll be much happier. Get some addiction counseling and meetings like Amy suggested, and see how much better u will feel.

My nephew is an addict. A couple years ago I talked to him and my brother about getting him into my suboxone clinic. They formed a plan and he ended up going to a neighboring clinic (I wasn't happy about that because I knew that clinic wasn't as strict). Since I knew that place wasn't going to give him the strictness he needed, I told my brother exactly what to do because I knew my nephew hadn't asked for this treatment so I was worried he'd just keep using. I told my brother to hold his medicine (my brother was the one paying for the treatment anyway) and every morning give him his dose and watch him take it. Every single morning. I knew that if my nephew could be proven how this medication would work and he'd be so much happier, he'd finally get it and even if he tried to use it wouldn't matter. Well my brother didn't listen to me. He didn't take his medicine, he didn't watch him take it, he didn't make sure my nephew went to counseling...... he only lasted a few months before he was discharged or quit. I can't help but think that if he'd done how I'd told him to, my nephew would have taken it long enough to get it himself. After all, I knew he hadn't hit rock bottom yet because my brother won't let him hit rock bottom. I did think if he saw how great this medication was after awhile he'd 'get it'.

My point is, if u just take ur medicine as prescribed long enough to adjust, you'll understand what I'm talking about. You'll be so happy to wake up without the first craving. It's peace of mind :) Just imagine that obsession being lifted and no withdrawal. I know the insurance and other stuff is a worry for u but take it one worry at a time.

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Jennifer


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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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