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 Post subject: Two weeks!!
PostPosted: Tue Apr 12, 2011 9:37 pm 
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Hi every one! I've been reading what seems like every post here for the past couple weeks, and I finally decided to introduce myself and ask a couple questions. I won't go into too much detail about my history but enough to explain my situation to get some answers. In 2004 I did a cold turkey withdrawal at home in order to get pregnant. I was taking about 15 Norco a day. The withdrawal was pure torture but i survived. Jump to 2006, after both my sons were born, I became hooked again on Norco/vicodin. I was up to about 25-30 10mg a day when I decided I just couldn't do it any more. (for all the same reasons most of you probably wanted to stop). Knowing what it is like to go through withdrawals, I mustered up every bit of courage I could find and called a Suboxone prescribing physician. So here's where my question(s) come. My dr. Had me do my induction at home. He simply gave me 8 mg a day, one dose in the morning, and sent me on my way. I never received a Phone call or anything for 7 days when I decided to call him. I spoke with his secretary and told her I was concerned I was still having cravings. She told me it just takes a while to get used to it...I still never heard back from the doctor. Finally, on day 11, I called and told her I wanted to speak with him. Finally he called me back. When I told him I wAs still having cravings and some slight withdrawal symptoms, about 8 hours after dosing, he said I am getting enough and 90% of his patients do just fine on this amount. After another 3 minutes of discussion he told me I guess you should just take another pill in the Afternoon but he wasn't convinced I was have actual cravings or withdrawal symptoms. He then said try it out and let us know, but 8 mg should be enough. Something else must be going on. "are you taking valium or xanax?" i have never tken a single benzo in my life. So, I've been taking an additional 4mg in the afternoon not 8. Infeel so so so much better!!! So now of course I need to call them to get 8 more pills for the month and I feel embarrassed and a little ashAmed. Is there any one else who was taking the same amount of hydrcodone as I (300 mg/day) who needs more than 8 mg or is he correct? Should I be scared to call and ask for 8 more pills?
Thnk you all so much for sharing your stories and opinions. This forum has been a godsend for me the past couple weeks.
Sincerely,
S


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PostPosted: Tue Apr 12, 2011 10:14 pm 
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Hi Proudmamma,

I'm glad you decided to jump in and ask your question, it's a good one. I too was given my initial suboxone prescription and told to do my induction at home. From my very first prescription, my doctor had me dosing twice per day. I was taking 8mg in the morning and 8mg in evening and never really had any cravings. In the weeks leading up to my induction, I had switched from OxyContin to Lorcet (hydrocodone 10mg). I was taking anywhere between 15 and 20 per day at that time.

I know there are several people on this site who will remind you that once a day dosing is best, but I dosed twice a day for my three years on Suboxone and I was able to discontinue Suboxone 10 months ago. Now, after you have been on Suboxone for a little while, you may find once a day dosing works fine for you. Were all different, you're gonna have to do what works best for you.

Do not be afraid to call and ask for more sub. You should probably call sooner, rather than later, just in case the doctor "forgets" that he told you to take that extra pill and makes you wait until your next appointment to come in for more sub.

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PostPosted: Tue Apr 12, 2011 10:23 pm 
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Hi Proudmamma and welcome to the forum. I hope you don't mind my saying that you seem to have a really crappy doctor. Ideally he would have done your induction in his office. Also, you can't just say that "8 mg works for most people, so it should be fine for you". It doesn't work that way. Everyone is different. If you need 12 mg to suppress your cravings, then that's what he should be giving you - especially in the beginning of your treatment (that's my non-medical, non-expert opinion). Try not to compare your dose to that of other people. If you're having cravings while on suboxone then it defeats the purpose of even being on it, don't you think? That's one of the main things suboxone should be doing for you (that and addressing withdrawals).

When will you see your doctor again? Most doctors see new patients following induction at 7 days, some at two weeks, but I've never heard of them waiting any longer than that. I would just be honest and tell him that the extra 4 mg worked for you and so you kept taking it. Explain that at 8 mg the cravings were so bad that all you could think about was using/relapsing and it scared you (which I assume is true).

We can only hope that he will listen to you and your needs and have your best interest in mind. Please do let us know how it goes. If you have more questions, please just ask. Again, welcome to the forum!

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PostPosted: Tue Apr 12, 2011 10:35 pm 
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You guys are awesome!! As far as seeing him again, he said "see you in six months or later." I swear. I thought that was weird!!! He just wants me to send him $ every month and they will call in my refill. So I'm guessing you are all going to tell me to find a new doctor!! And thanks for the reassurance that 12 mg isn't an exceptional dosage. I didn't think so and perhaps if he continues to give me a hard time, it will make me find a new doctor that much sooner! The good news is tomorrow is my son's 5th birthday and I promised myself his present would be to "clean" and I did it! No lighning McQueen toy or hot wheels set compares to this gift (which I did get him too by the way). Thank you all so much! I have tears in my eyes from gratitude and pride.


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PostPosted: Wed Apr 13, 2011 11:29 am 
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Wow, what an awesome birthday present for your son!! Good for you!! The lightning McQueen toy and the hot wheels set are nothing to sneeze at either!! :lol:

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PostPosted: Wed Apr 13, 2011 12:09 pm 
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As much as I hate to say it, your doctor actually sounds pretty average. From all I have seen, read and heard, there are certainly worse Sub docs out there - and thankfully there are better. However, all things considered, your doc seems about average. On the plus side he is allowing you to take more than what he sees as the norm. He is certainly not taking advantage of you and making you come in for excessive appointments - although six months seems to be the longest I've ever seen. He is probably right in saying that many of his patients do fine on 8 MG. It really is hard to get a good read on the situation just from what you have written but it sort of sounds like he is taking a very laid back, hands off approach to your treatment. That can be both good and bad. Keep in mind that some docs out there require all sorts of things and make patients jump through needless hoops. Others charge huge amounts and require every two week or once a month appointments. At least you are not getting that. However, it does mean that you have to pick up the slack and provide your own recovery treatment. Then again, that is often what many of us get. I mean, the way healthcare is today, all any of us really get is 15 minutes or less with our doc every month or two. I'm not convinced you need to hunt for a new doc at this point. Honestly you could actually end up with someone worse.

Getting to your items, I have a couple of thoughts for you. First of all, make sure that you are getting good absorption. In general, 8 mg should be able to hold you. I have no doubt that it is not. However, the question is why? Is it that for some reason you need more? Or perhaps is it that you are not absorbing a full dose? It is worth considering. Just make sure that you are using best practices, including not swallowing, not eating, taking 10 to 15 minutes to absorb, etc. If you search around on here you'll find some best practices to dosing.

My next thought is, have you tried just splitting up the 8 mg dose into an AM and PM? Rather than take 8 in the AM and 4 in the PM, try 4 for both. That might do the trick for you and will get you back to 8 MG. Again, if you get good absorption, it should work for you.

Lastly, I would not worry too much about talking to your doc. You have to see yourself as a team member or partner in your care. Let him know that rather than take a full 8 mg at night you have "only" gone to 4 and it is working well for you. Impress upon him that this is not in your head and that you FEEL better with the dosing you are taking. Stand your ground. Be nice but be firm and let him know that with 8 in the AM only you have withdrawal symptoms, cravings, etc. and when you take the additional 4 at night you don't. You may even want to offer to try the 4 and 4 and tell him that if it works you'll stick with that as well but if it does not, that you really do need the 12 for now. After a couple of months, you can and perhaps should try to drop back down again. I can tell you that I was started at 16 MG and was able to taper down to 8 and am doing just fine. Your doc is correct in that 8 MG will hold many/most people just fine. Don't feel bad if you don't fall into that category. Just try the other things I have suggested and if you need 12, then you need 12. Best practice guidelines say 16 MG should be the max, so at 12 you are still well under that.

Thanks for stopping by. Hopefully you'll continue to participate here. Please let us know how you continue to do.


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