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PostPosted: Sun Nov 22, 2015 7:09 pm 
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Hello to anyone who may be reading this. I am in desperate need of some guidance and people to talk to that know what I am going through. I'm 28 years old and have been on suboxone for about 6 years, after abusing opiates for a couple of years before that. I started out at 8mg twice daily, and over those 6 years have found myself at 2mg twice daily. I know that I still have a long way to go. I desperately want to get off this medication and tapering down seems like the only option for me but I also have some other questions and concerns. I don't mean to clog up the forum by posting something that can easily be answered with "go to the taper thread and read that", I feel very alone and scared and confused and would greatly appreciate someone to talk to about this. I do have some questions about the best way to taper from the current dosage I am on, but also just need some general guidance from some of you that seem to have more experience with this. I know that everyone is different, but I am hoping that some of you great people that seemed to have helped so many others can help me. I just dont know how long I should take to taper down considering I have been on suboxone for 6 years (or if it's even possible to come off this medication after being on it for so long), and I don't know if I should keep dosing 2x a day in decreasing amounts, or first work towards only dosing once a day. I think that trying to get rid of that second dose is going to be near impossible for me, but I also don't know if tapering down while still dosing 2x a day is a viable option. I do have other questions about this process but I am trying to keep this post short. I am just so confused reading so many different things about people's experiences with this drug and just knowing that someone is there and listening would mean so much. I don't know where else to turn and I am really scared. I would be forever grateful to anyone on here that can reach out and offer some guidance.


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PostPosted: Sun Nov 22, 2015 7:28 pm 
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From a neurochemical perspective, you low little by taking buprenorphine for a long time. There are some studies suggesting that long-term mu receptor effects are harder to reverse than short-term mu-receptor effects. But those effects are minor compared to the primary issue-- which is reversing the tolerance caused by all opioids at mu receptors. To say it differently, once you are tolerant, you are tolerant-- and time is less of an issue than the degree of tolerance, i.e. the dose of agonist at mu receptors.

From a behavioral standpoint, time is almost always your friend. Your desire to be free of opioids will change your perspective towards opioids over time, and at least in my own opinion, your desire will be converted, to some extent, into motivation to avoid opioids. I am guessing about the process that goes on, but I see people on buprenorphine change their attitudes toward opioids over time, eventually getting to a point where they are less likely to relapse. I don't know if the important thing is fear or something else.... but many patients on buprenorphine develop new attitudes toward the medication over time, where they stop feeling compelled to take it during periods of depressed mood, and the taper becomes entirely about tolerating physical dysphoria--- instead of responding to some internal 'need' to take the drug.

The general idea of most threads here is to taper as low and slow as you can.... and then jump when you can't taper any longer. At that point, comfort meds can make a big difference. For my patients, I will offer comfort meds when they get to the point of completely stopping buprenorphine, giving a bit of incentive to get to that point.

More than anything else, I recommend that you ease up on the drama, and try to chill out about the process. Despite what you read in some low-information web sites, you are NOT killing yourself by taking buprenorphine. It doesn't make a huge difference whether you stop now vs last year vs next year. You need to find a couple weeks off work--- and hopefully your doc will help with some meds to reduce the physical symptoms of withdrawal. Until then--- try not to fret too much-- as that doesn't help in ANY way.


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PostPosted: Sun Nov 22, 2015 8:59 pm 
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Hey Dan & welcome!

Well u definitely got great advice from Dr J, he's the main person u wanna listen to that's for sure. Since u know now that it doesn't matter if you've been on sub one yr or six yrs, that should make u feel better. I've not gotten down below eight mg once a day, so I can't give u personal experience on that, but if it were me I'd go down slowly a little bit at a time. Taper so low u can't go any lower and then stop...that's how I would do it. Don't rush and definitely don't read horror stories on the internet. Horror stories will create issues in ur head that u would have never thought of before u read it.

I know I wasn't much help because I'm not ready to stop sub yet and after four years on it, I may stay on it for life, who knows. I'm sure ur scared and I don't blame u, but just try to stay calm and if ur truly ready to stop u will be ready to face whatever u have to. Is that why ur stopping, because ur ready or is there another reason?

This forum is the absolute best for getting support and advice with no judgment. I wish u all the luck in the world :)

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Jennifer


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PostPosted: Tue Nov 24, 2015 1:42 am 
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thank you guys so much for answering. I'm going to try to keep lowering my doses for now. One thing I'd like to mention is before I started suboxone I definately struggled somewhat with depression and anxiety and I've read that some patients that are like that shouldn't even try to come off suboxone because the depression and anxiety that comes with stopping will just be too much too handle and that scares the crap out of me. It still doesn't stop me from wanting to stop suboxone though. The thing is, I know that the effects of suboxone definately do a great job with curbing my symptoms of depression and anxiety, and I don't know if I should try tapering off, deal with the physical withdrawal and depression, and then once I am stable enough, treat my depression with an anti depressant or something. OR should I talk to a doctor now about my depression and attempt to treat it even before I start to taper and eventually quit, in hopes that that will ease the depression during withdrawal. Even just thinking about stopping subs and anticipating the discomfort and depression that I will surely experience is already bringing back the anxiety and depression that I have known so well and I don't want that to sabotage my willingness to stop this god awful drug. Any insight that someone can provide on this would be greatly appreciated. I just know that I don't want to be on this medication forever but I am so scared that because of my underlying symptoms of depression and anxiety, that it will make it impossible to stop taking subs. I have read that some people that are like me should not even attempt to quit because it will just be too much. I just don't know if I should try to taper and stop first and then attempt to deal with my depression (if that's even possible) or if I should try to deal with this depression first to make coming off suboxone easier. I'm sorry if I have repeated myself, it's hard to put my thoughts together. I have so much going through my mind and just don't know what would be the right thing to do given my prior conditions, not even taking into account the physical and mental hardships that coming off this drug will bring. Can anyone offer some insight on this? I'm so scared that I'm one of the people that just should stay on suboxone and that I'm naive if I think I can stop. Please help :(


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PostPosted: Tue Nov 24, 2015 11:24 am 
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Hey Dan,
Well ive read your posts and the replys. What Im not reading or hearing from you is Why? Why or what reason do you feel you must get off this medication that to this day has kept you from useing?

Your depression and fears will make this jump very difficult. Imo. It is helping with your depression right? Keeping you off drugs.
You ve said it yourself, Buprenorphine helps with your depression and anxiety, so if you could or would tell us why you want to ditch the one thing that is helping you the most.

Say you get to a point were the sub isnt going to stop blocking other opiates, your depression gets to a point were your in danger of useing or you use. So then what? Back on suboxone. See what im saying here, to go though all of that pain and fear just to end up back where you started. Witch is Fine. We see it all the time.
I just would hate to see you hurt yourself for nothing. So again, Why do you want to stop this Medication? .

Oh and many people take low dose Buprenorphine for depression. .We are here to help you...
Razor


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