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PostPosted: Tue Jan 30, 2018 10:03 pm 
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What the title says. I won't write my 'story' because it will be an essay, and I'm already writing a book anyways.

Basically I started eating boxes and boxes of codeine once I realised they stopped the voices and the pain. I was an undiagnosed epileptic at 15. The amount of course went up etc etc to the point of eating several hundred tablets at once. I don't know how I didn't end up in a hospital.

That lasted for 8 odd years, and I finally got myself ready for rehab. It was insanely cult like and luckily I was booted out for my actions while withdrawing. I didn't remember any of it but apparently it pissed off a lot of people, and I was eventually kicked out for acting like a lunatic, even though their literature said it was a CO-MORBID facility. Ha.

Ten days out of rehab I lapsed. I was at the point there were I could tell my parents and they helped me find the only sub doctor I know of in Adelaide. I tapered and stopped it entirely in June this year, after six years on it. In September the cravings came back. I wasn't ready for them, I hadn't prepared myself for their intensity. I cracked and bought a pack of codeine tablets and ate them all, felt like utter shit yet wanted more. It got gradually worse, it was never a full blown relapse but I was using about 7-8 times a month from September/November to now.

I just tried to go buy some now ffs but they asked for ID and I only just used it on Monday.

I knew this would be an essay.

POINT IS, i need to go back on sub. Having my brain make that decision, that we are gonna use today, having that decision fail today makes me want to eat a shitload of medication to get some sort of escape. I have unfortunately plenty of options.

I am lucky that I kept an assload of strips when I was on the program. So I don't need a doctor atm, I can do it myself but have to do it right.

SO...............

What amount would you guys say is a good amount to start at? 1mg? 2mg? I was on 32mg for six years so I'm not entirely sure, and for the last three-four months I have been eating 13mgx30 of codeine. All I know is I need to do this otherwise I am going to ruin my life, one that I have spent six plus years resurrecting.


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PostPosted: Wed Jan 31, 2018 10:43 am 
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gotta love the dude....

If I was treating you, I would recommend staying on buprenorphine for at least a year... again. But as most people here know, I'm a strong believer in long-term medication. I just don't get the stigma. If we took it away, there would be no question over the issue, and we would treat opioid dependence like we treat hypertension, asthma, rheumatoid arthritis, heart disease, and every other chronic recurring illness.

I realize people want to be off buprenorphine. People also want to be off heart medicine. People who have nearly died from DVT want to be off coumadin. But we tell them 'the risks of stopping are too great'. The risks of stopping THOSE medications are less than the risks associated with stopping buprenorphine-- so what gives?

The point of buprenorphine treatment is to create enough separation from using that the patient no longer sees him/herself as someone in that world. We want patients to grow in healthy ways, and to correctly associate using with all of the bad things that happened during that period of time.

So dude.... that's what I would recommend. But if that is not an option for whatever reason, I'd say that the value of buprenorphine is based on having a ceiling effect. That effect allows a person to feel normal all day long, because there is no drop in opioid effect throughout the entire dosing interval. If you take 1 mg of buprenorphine, it will be similar to taking one tab of oxycodone or methadone, and you will feel withdrawal by the end of the day. From my experiences with patients, at least 4 mg is necessary to take advantage of the ceiling effect.


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PostPosted: Wed Jan 31, 2018 5:08 pm 
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You were just given a suboxone doctor's advice! I hope you take it.

When he says that you should stay on buprenorphine for at least a year he is making that recommendation based on current research that shows that addicts who don't stay on buprenorphine at least a year will relapse very quickly once off of it. None of us want that to happen to you.

When you are on buprenorphine you are putting your addiction in remission. The best thing that you can do is to use that time and space to turn your life, finances, relationships, etc. around, and to work on your Recovery. I always suggest finding a SMART Recovery meeting because it is founded on evidence based cognitive behavioral therapy techniques. Also, it's definitely in your best interest to seek an addiction therapist to work on reasons that you were susceptible to addiction in the first place. I always suggest these things because they will help you turn your life around.

We are glad to have you here! Thank you for sharing your story!

Amy

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

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