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PostPosted: Sun Aug 18, 2013 1:36 pm 
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I've been a lurker here for a while and will appreciate any feedback. I'll try to be brief with my background info, but I think it's important. I've was a pretty heavy user between age 16 and 21. Then I was straight for about 7 years. I got addicted to opiates after a car accident about 15 years ago or so. I went on Methadone to quit and tapered slowly and successfully over about a 3 year period and was clean for a couple of years. Then in Sept. 2010 I took a nasty fall at work and cracked my kneecap in half. (I am 54 by the way). I have been in pain management for the last 2 years and on the train of running out of meds early, scrambling to fill in the gaps, taking a little more than prescribed each day - you know the drill. At the max - I was at 100 mgs per day of Percocet. My history makes me a poor candidate for tapering off any short-acting opiate. I also work a high stress job as a paralegal specializing in - don't laugh - medical negligence.. for a busy trial attorney. I decided I didn't have the stomach for another round of methadone and decided to give Subutex a try. I must interject that I was an extremely compliant patient when I tapered from Methadone. No cheating, and when I made the decision to quit I stuck to it. I am a bit of a control freak. Anyway - I made an appt. with a local addiction doc. First - he flat refused to prescribe Subutex, which made me a little wary, but I understood where he was coming from when he explained he didn't want the liability of a patient misusing Subutex with opiates. I'm sure my profession was a factor, along with my access to opiates through my pain management doc. I decided to give Suboxone a try at least - I figured if I had bad side effects I could always find another doc that would switch me to Subutex. Anyway - I started 10 days ago. My first concern I'd like feedback on - is the dose the doctor started me on. He started me at 8mgs, 3 x per day. I think 24 mgs for someone coming off a max of 100 mgs per day of Percocet is excessive. As of yesterday, I have "stabilized" myself at 4 mgs x2 for 8mgs per day and it seems fine. Of course this is day #2 at this dose so I can't be 100% sure. Once I am sure its fine - I intend to use this site to taper on my own. The doc is telling me I need two years before I taper in order to allow my receptors to heal, etc. I think that's crap. What do you guys think? If I do a slow taper from now and complete it over say...60 days - can I avoid some of the nastiness of Suboxone addiction? And - what do you think about the need to switch to Subutex, or is it fine to stay on Suboxone for this plan? My primary side effect - I'm never sure if it's effect or affect - is nagging headaches that come and go. Other than that I feel pretty normal. I'm heading out for some errands and will respond to any feedback when I return this evening. Thanks so much in advance for any opinions or information you can share.


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PostPosted: Sun Aug 18, 2013 2:28 pm 
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Hi KimS, and Welcome here! We do get many lurkers who finally decide to join later on.

I agree that 24 mg's of Suboxone may be a bit too much but that is between you and your doctor. What he prescribed is fairly common, mine did the same with a Norco habit, albeit a large one. Give your body at least a week to stabilize onto the Suboxone. The headaches should go away with the reduction of your dose plus your body getting used to the medication. I say be up front with your doctor about the dose. Mine got mad at me and said I cannot reduce the dose, he must do it. What ended up happening was I had a bunch left over every month. I'm sorry, it is my body telling me what feels right, 24 mg's didn't feel right. I could barely keep my eyes open. I went to 16 mg's and to 8 within a few months. Had to be careful what I told my doctor but overall he was just doing what he was trained to do.

As far as you getting Subutex. Forget it, won't happen unless you're pregnant or have terrible side effects from the Naloxone in the Suboxone. That's the only difference. Suboxone is Buprenorphine with Naloxone. Subutex is just plain Buprenorphine. The vast majority of people tolerate the Naloxone just fine because it is swallowed, not injected. The reason for it is to try to prevent addicts from shooting up the Suboxone. I'm not sure it works very well. IMO

Will you be able to taper and get off it quickly w/o going through withdrawals? Not likely. Some have been able to do it and not feel too bad. If you are determined to taper off, more power to you. That was my intent too when I started. I got down to 1 mg after one year. Then I got sick and needed several surgeries so I'm back now at 6 mg's and stable.

Do you have any recovery program in place if you do succeed in quitting? Doing it without support is not very good. There needs to be some sort of plan like NA or AA, or any of the other ones that don't use God as the primary helper. If you'd like the names of those other programs, PM me and I'll dig them out of my email folder.

Once again, welcome to the forum and let us know how you are coming along on the medication. Sorry for making this a long post but you asked several questions.

Rule

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PostPosted: Mon Aug 19, 2013 10:32 am 
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Hi Kim,

24mg of Suboxone does seem excessive for a 100mg per day perc habit, especially if you plan on tapering off soon.

IMO, the lower you can get your dose now (and not have cravings), the better off you'll be when it comes time to quit altogether.

As for your doctors statement that you need to be on Suboxone for 2 years to heal your receptors.....Suboxone doesn't heal your receptors, Suboxone gives us time away from active addiction that allows us to develop healthier coping mechanisms. For some, that may take 2 years, for others, it may be months. There is no hard and fast rule here. We do what works for us.

Also, like Rule said, your headaches should go away with the reduction of your dose plus your body getting used to the medication.

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PostPosted: Thu Aug 22, 2013 11:00 pm 
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Thanks for your input. I have lowered my dose to 4mg x 3 and I find that dose has eliminated 75% of my headaches and I have few side affects and of course, no w/d symptoms at all. I'm going to let my doc know when I follow up that I lowered my dose on my own and see what his attitude is like. *crosses fingers* Things are too hairy at work right now - I'll put off another reduction for a week. I found this lovely tool by browsing this site that will be helpful in cutting the films accurately. Nifty! This really is an incredible forum. I do have another question. I wonder if more people have success in cutting the doses but keeping them at x 3, or in cutting out one of the doses and divide the total into two equal doses. Or...is it a wash?


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PostPosted: Fri Aug 23, 2013 12:33 pm 
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I have heard that there is more success for people that stay on Suboxone for a longer period of time ie: 1 year or so. I was on it for 2.5 years and am now 14 days off and feel good. Let me know if there is anyway I can help.


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