It is currently Sat Aug 19, 2017 11:02 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 9 posts ] 
Author Message
PostPosted: Mon Jul 01, 2013 10:17 am 
Offline
Power Poster
Power Poster

Joined: Sat Jun 22, 2013 3:05 am
Posts: 41
You know I'm also a chronic pain patient, but I'm wanting to see what the level of pain is with absolutely nothing in my system, including the Suboxone. Obviously I need it to detox from the Oxycodone I was on. However, now on the third day I'm feeling EVEN better and like I just don't even need to be taking it at this point. I'm currently on 24mg per day as prescribed.

And this is where I think the danger may come in, because I'm tempted to just stop taking it. Am I correct that I would pay a high price for that in a day or two? The Oxycodone withdrawal that I avoided with this would all be for naught? Or does the Suboxone ride you through that with the ability to immediately stop taking it before your body becomes dependent upon it as well?

Or is it truly at least for the short-term a replacement, meaning the body is still dependent on opiates just as before, just a different one now? You'd think I would have researched this by now, but I've just been reading a step at time.


Top
 Profile  
 
PostPosted: Mon Jul 01, 2013 11:35 am 
Offline
Super Poster
Super Poster

Joined: Wed Sep 05, 2012 12:28 pm
Posts: 117
S.S., The suboxone has filled those receptor sites and is keeping you from feeling the withdrawals. If you were to just stop the sub you will start feeling WD's, most likely in 2 or 3 days as the subs half life wears off. The best thing you could do in my opinion would be to slowly start adjusting your suboxone dosage down. 24mg is alot. You should be able to reduce that in half in a very short time. You need to be careful here. The sub is acting as pain management for you as well as keeping the WD's at bay. In my opinion, reading your story, I think you should look at tapering sub and stabilizing each time as you do. It was very effective for me to take the sub twice a day, once in the am when I got up, and the second time later in the afternoon. This helped manage my pain as well as keeping me from wanting narcotic pain medication for the relief of my chronic pain issues. This is a great time as you are adjusting your dose to put in place a lifestyle that will keep you from going back to pain medication down the road. You might seek counseling, group therapy, NA, this web-site, in other words most of here have all become physically addicted, and harder yet is the mental part of the disease. In my opinion, I would try to put in place some therapy to deal with the issues that you may or may not have surrounding narcotic pain meds. Its sad, but many people relapse because they do not want to really stop or they do not put a game plan in place. Its a great time for you to put a game plan for you together while you taper your suboxone. There have been people who go on suboxone for short term and are sucessful, yet they also can go back to opiates because they still did not deal with there issues of addiction. My big concern for you is how are you going to mange your Pain once you stop? Put a plan in place, taper, stabilize, get informed, talk to educated people about your situation, you can be successful, you just need to be sure you give yourself the chance for the outcome you desire. I hope that helps you.


Top
 Profile  
 
 Post subject: Also
PostPosted: Mon Jul 01, 2013 11:45 am 
Offline
Super Poster
Super Poster

Joined: Wed Sep 05, 2012 12:28 pm
Posts: 117
S.S., My personal story is that I went on sub last year and then got off a week before I had another surgery. I had tapered down to .25 mg in about 5.5 months. I went back to the narcotic pain meds and I am tapering from them(very difficult, but can be done). I took advantage of going to an addiction counselor while I was on suboxone last year, it was very helpful to me. Just thought I would share that info.


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Mon Jul 01, 2013 12:59 pm 
Offline
Power Poster
Power Poster

Joined: Sat Jun 22, 2013 3:05 am
Posts: 41
JustDoIt, thanks so much for your input and advice having the experience with it that you do also as a chronic pain patient. I have read in many places that dropping very high dose like the 24mg that I'm on to 12mg or even 8mg is actually relatively easy, but then it gets more difficult especially at 4mg. That's why I was wanting to jump the gun I suppose and not even allow my body to get dependent enough on the Sub to the point that it would really matter. But I really wasn't thinking when I posted that, more like hopefully wishing and still knowing better (while hoping to read words that I still knew weren't coming) - you know the feeling I'm sure. I was dependent on 180mg Oxy daily until 3 days ago, so what on Earth would make me think that the Sub would knock out the WDs as they have and magically leave me with the ability to put them down as well. They haven't "cured" the dependency, they have for the time being "replaced" it, and stopping them suddenly would yield the same results as would have cold turkey from the other.

You make a very good point about the pain management. I'm just really wanting to know what the level is with nothing at all in my system, but perhaps it's just as efficient to gauge that while dropping the Sub as low and comfortably as I possibly can. I suppose that should yield the same information really. If I need "X" amount of Sub to continue to keep the pain under control, then I would obviously still need "X" amount of Oxy (or whatever) to do the same. And honestly, if the Sub is doing the job, even not as well but enough so that Excedrin can give the extra boost, then I'd much rather go that route than back to ANY full-agonist opiate.

You also touch on something that I'm still struggling with - the terms "dependence" and "addiction." When taking narcotic pain medication for an extended period for pain (or any other not so above-board reason), dependence is simply a factual consequence of it. That and tolerance cannot be avoided. But it is also true that there are those who are dependent upon it who cross the line into addiction, and that is a FINE line to cross. Let me explain. I've NEVER gotten a "rush" or serious "euphoria" from the medicine. I don't know why some have a hard time believing this (perhaps if I knew that feeling I'd understand), but it's true. Now, I DID get a "relaxing" feeling somewhat, but certainly nothing that I would go chasing after. At least, and this is the "fine line" I refer to, I actually was chasing it and didn't realize it. Can we really be so blind to ourselves - to our own behavior - as to not clearly see when we're doing something like that? It's a question I have to consider - have BEEN considering, but still haven't determined. Don't get me wrong - I in now way "judge" those who have become addicted either as a result of legitimate or recreational use. All are human beings and deserve humane treatment. I don't want anyone here to think I look down on them or judge them in any way. However, even addicts will admit that they don't take pride in having become an addict. Though they, and absolutely SHOULD, take an IMMENSE amount of pride in facing their addiction head on and confronting the causes of it. I am having an extraordinarily difficult time calling myself an "addict," whether it's true or not. I'm incredibly uncomfortable with the thought that I could let myself spite myself in such a way.

If I have simply become dependent upon and tolerant to the medication and need a different plan, then that's one thing and the Suboxone is certainly useful. If, however, I became addicted, then Sub is still useful but only one tool in what I imagine would be a multifaceted approach with counseling and things along those lines. I have had absolutely no "craving" at all for the Oxy, but then the Sub is supposed to quell that as well so I can't point to that as proof of anything I don't suppose. I just don't know, and maybe I need to talk to someone with a more objective view of things to help me decide which is the case. I think I mentioned in my intro that there was one time that I caught myself reaching for the Oxy in a stressful moment. I wasn't hurting and it wasn't even time for the next dose, and I caught myself and stopped. You know, I haven't forgotten it, but maybe I've put it out of sight and out of mind on purpose until now. We'll see.

In any event, I'm not going to just drop the Sub. The science of it alone testifies to the foolishness of that - like I said, hoping to hear different but knowing better. I DO plan to taper it as low as I can, I think that's only wise. I'd have to do that anyway given what 24mg/day would cost each month - nearly $700!! If I can get it down to 4mg in the morning and 4mg in the evening, that is financially doable - equivalent to what I was paying for the Oxy prescription.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 01, 2013 2:20 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Fri Mar 08, 2013 1:02 pm
Posts: 1342
Location: West Tennessee
Hey Snap...

I'm glad to see that you have realized that just because you are feeling better in no way means that you are "cured". It is simply the subs doing what it was designed to do. You are still "dependent" on opiates. I agree, it's a good thing to drop your dose as low as possible and hang out there. This will help to eliminate unnecessary side effects and not raise your tolerance more than it needs to be.

However, I wanted to address what you said about addiction. I agree that there is a difference between dependent and addicted. But I don't see much difference in the way of the shame attatched to the diagnosis. The shame is more related to what we allow ourselves to do as a result of our addiction than the addiction itself. Let's just be clear here. If you were suddenly released as a patient from your pain management doctor and had NO LEGAL access to oxy or any other opiate what would you do? Would you consider buying off the street? If so, does that mean you're an addict or simply dependent? Where is the line? There are alot of addicts that get to the end of their active addiction and are no longer getting any kind of euphoria from their drug of choice. They take it only to function and feel "normal". Does that mean they are not addicts, only dependent?

I don't know if you are an addict or not. Only you know that, and it usually takes awhile for us to accept that in ourselves. But just because a doctor says you don't exibit the signs of addiction doesn't mean anything. I think you posted that your doctor told you that somewhere. My doctor had NO IDEA I was an addict. He was in COMPLETE SHOCK when my husband told him that I had been using all my prescribed meds and then buying on the street. I had him fooled, along with almost everyone else in my life. But I was and am an addict.

Just don't close yourself off to the possibility. I would say that you were pretty much in full panic mode last week while you were considering giving up your oxy...and kind of obsessed with the whole process. That is a sign of addiction. Again, I'm not saying you are an addict...but it is a sign. Being an addict doesn't mean you are a bad person. Just that you need a little help. But you can't really deal with it efficiently if you don't acknowledge it.

I'm sorry if I've stepped on your toes here. But I've been thinking it and wanted to get it out there.

Q


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 01, 2013 3:47 pm 
Offline
Power Poster
Power Poster

Joined: Sat Jun 22, 2013 3:05 am
Posts: 41
qhorsegal, thank you for taking the time to reply, and you certainly did not step on my toes. I opened that door talking about it myself. I have thought long and hard about the "dependence v. addiction" thing, and still am. And you bring something up that I see from both sides.

Yes, the behaviors you speak of are certainly signs of addiction, though obviously cannot alone be interpreted as such without other circumstances in the mix. Let's take the scenario you speak of - immediate release from doctor. Would I personally have sought out the Oxy on the street? No, I wouldn't. I can honestly say that I probably would have ended up in the emergency room in withdrawal explaining why. But that's me. I would not think automatically though of another that WOULD do so as an addict. And I think that for the same reason that I was definitely very anxious about the Oxycodone. It was a medication I was receiving for a legitimate purpose that I had always taken as prescribed, never abused (though I admit to that one instance that I had to step back and take an inward look) - no different from any other person with receiving any other medication for any other condition. If they were on a type of medication which was suddenly removed, and they knew that such removal would send them into intense agony - you bet your bottom dollar they just might do whatever they could do to get it. Because they're addicted? Maybe they are, maybe they're not - but it is certainly not unreasonable to expect them to want to avoid the misery they know is coming without it. If the measure of addiction is the desire to avoid intense misery and agony and the willingness to do just about anything to do so, then there are a WHOLE slew of different types of addicts out there.

Again, yes, I do agree that is is ONE SIGN of addiction, but it must be taken into consideration with the whole picture. Do they have a history of abusing the medication - taking it not as prescribed or for the purpose intended? Do they have a history of "losing" their medication or having it "stolen"? Many other things to consider obviously. If however that person were only seeking the medication on the street after the immediate separation and no other factors or circumstances were present to indicate addictive behavior, then I would very likely see the person as someone who has been abandoned as a patient through no fault of his own (not someone who was "fired" for addictive behavior) and is desperately trying to avoid the consequence of it.

I am not contending that this is my case. I don't know if it is, only because of that single instance that I've always remembered of reaching for the Oxycodone at a time of intense stress, though I did back off. And that's my problem. If I had been abusing it - knowingly taking it not as prescribed, losing it or it being stolen, etc., then I would certainly be lying to myself not admitting to addiction. But those factors do not match my experience. Basically, I have two KNOWN things that are "matches" I suppose:

1) There was an instance in which I reached for it when I did not need it but instead as an emotional response.
2) I have become stressed and anxious when suddenly no longer having my doctor and finding a new one.

I may very well have been receiving some unconsciously realized benefit from it other than pain relief, I just don't know. That instance I refer to may have been more telling than I thought it was after some consideration. Again, I don't know. I am however trying to be open with myself (and here with you) in admitting that the possibility exists and deserves more serious contemplation. I absolutely do make a clear distinction between addiction and dependence. There are may who must have this medication for legitimate treatment. I have been one of them. Dependence and toleration cannot be avoided when it is used long term. When suddenly removed from it, such patients are then facing not only a return of the pain for which they initially sought treatment but also horrendous withdrawals from the medication that has been used to treat it.

Now, let's add a THIRD factor to the two I posted above:

3) The pain has returned and is not controlled as well, but it IS tolerable. There are times - once or twice a day - that everything locks up badly, the pain is through the roof and I'm eating Excedrin. Usually after an hour of that misery it does begin to subside. It is NOT, however, as constant as I remember it being initially when all this began.

So, THAT so far tells me that I probably could do without the pain medication and instead only needed it maybe once a day - the periods that it gets intense. And just like that instance I referred to earlier, this is an area of concern for me that I factoring into the equation. I see two possibilities here:

1 - I psychologically enhanced the pain by equating pain relief with pain medicine, regardless of the intensity.
2 - Hyperalgesia (instances in which taking pain medication over a long term can actually have the OPPOSITE effect in which it creates more "pain" so that you'll take more of it - the brain's way of making you give it more of what you've been giving it.

In any event, I MUST make some determination on this. If I am merely dependent as a result of tolerance and length or a medical issue such as hyperalgesia is present, that's one thing. If however I have actually become addicted to the medication, then that is a horse of a different color. Each of those requires a different approach. Until I know which it is, I don't know what approach to take.

In the end, the use of pain medication long-term to treat chronic pain develops problems for both dependents and addicts, and sometimes (perhaps often) that line is heavily blurred. It certainly is for me right now. But I really do appreciate the input of yourself and others - it helps in the process of trying to "unblur" it.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 01, 2013 9:18 pm 
Offline
Power Poster
Power Poster

Joined: Sat Jun 22, 2013 3:05 am
Posts: 41
I'm wondering if I've already messed up, but I don't think so from what I've read. When I inducted and yesterday (two days) I was on 24mg each day, but today I'm stopping at 16mg and will do that again tomorrow, then 12mg the next two days and then 8mg the two days following that, then 4mg, then 2mg, then 1, to .5, none. That seems, from what I've read, more than doable (total 14 days on Suboxone, tapering it down as well).

Did I mess up? Should I jump back to 24mg and just hold there for a while? I'm okay with not stopping it immediately like I was thinking, but I do want to taper it off and get a handle on the pain level. The reading I've done (and is why I'm asking because I could be wrong) would indicate that this 14 day induction and taper gets me through what would have been the bad Oxy withdrawals and also allows me to taper the Sub quickly enough not to get dependent on that now.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 01, 2013 9:26 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Oct 15, 2012 11:27 am
Posts: 1454
Snap,

Do whatever you feel is best for you. No one could or should be able to tell you how to manage your treatment. Obviously, most people here are addicts and are on a longer term maintenance program. I think you should just do what you're going to do, it seems like you've made up your mind, no? Are you going to let people on the internet tell you to stay on 24mgs? Or to jump off suboxone? That sounds kind of silly and I think, based on your writing skills, you're more intelligent than that. You need to make this decision based on how you feel and the research you've done. I understand that hearing responses and advice can be comforting but the final decision you make needs to come from within. Know what I mean jelly bean?

The only advice I will give you is not to stay on 24mg.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 01, 2013 10:20 pm 
Offline
Power Poster
Power Poster

Joined: Sat Jun 22, 2013 3:05 am
Posts: 41
Thanks so much Tiny, and I should clarify what (or why) I was asking that. I wasn't asking it in the sense of, "Hey, is the right thing to do?" That, as you say, can most certainly only come from me. And you're right, I have decided to try my best to taper off of this as well so that I can gauge the pain.

The reason I was asking was in the sense of WDs. Does that schedule seem reasonable to avoid the withdrawals from the Oxy that the Sub prevented as well as WDs that would occur with coming off of Sub. I don't know if you're dependence on Sub, when initially taking it and using it to get through the opiate WDs, is then equal to the dependence you had on that opiate or not. If it is, then I don't know if that schedule is too fast. It it isn't, then that schedule shouldn't be too fast.

And something else I'm going to watch for as I do it - if while tapering off of the Sub I find myself "craving" Oxy (not for pain but just for it alone), then I know I have a much more deeply rooted issue to address along with the pain.

I apologize, it did sound like I was nearly asking for confirmation that I was making the right decision to use the Sub as a detox tool and taper off it as well. I was asking more if the methodology is sound.

Oh, and no matter what, your advice on the 24mg even if for some reason I stay on it is well taken and already decided - I don't want to mess around and be on a high dose of this stuff too. If not dependent during this detox upon it, at some point I would be and certainly don't want to make that horse any larger to ride than it has to be.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 9 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

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

Powered by phpBB® Forum Software © phpBB Group