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PostPosted: Mon Feb 06, 2017 7:55 am 
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There are plenty of people who get to this same point where they are ready to taper off the buprenorphine and carry on without it. They are ready to tackle their recovery and make sure that they don't go back on their drug of choice. Or if they do have a slip they will get back up on that horse and try again. Those of us who can get there or those of us who feel the flat affect and need to get there can taper off. We only suggest that they do that very slowly.

We don't consider buprenorphine "highly addictive". You were already addicted to your opiate drug of choice. Most of us have found that we couldn't taper from our percocet or heroin or codeine. We would try but the cravings and the obsession were too strong. With buprenorphine we are still dependent on the drug. If we stopped it cold turkey we would withdraw. However, most of us have found that we can taper down our dose of buprenorphine without much trouble as long as we go slowly enough. I started out at 16mg and I've tapered down to 2 to 3mg a day now I stay on this amount because of the chronic pain I do have. The big difference, again, is that we can taper down our dose of buprenorphine, which was impossible for most of us to do on our drug of choice.

Yes, bupe binds so tightly to receptors in the brain that any dopamine floating around would not bind. The problem when we become addicts is mostly the up-regulation of opiate receptors that are rapidly formed in the brain to keep up with the extra opioids we are ingesting. I haven't read any super clear articles about how long it takes for those extra receptors to down regulate when exogenous opioids are stopped. In fact, I don't believe our brains ever completely go back to what the natural state used to be. The parts of our brain that are involved in noticing what is pleasurable will never "forget" that it enjoys those extra opioids. That's why we can always be triggered back into active addiction. And that's why we always need to work on our recovery so our addiction doesn't sneak up and bite us in the butt!

It's just past 4:45 am and I haven't been to sleep yet, so I will sign off now.

Cheers,
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PostPosted: Mon Feb 06, 2017 2:02 pm 
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fair point, it is not highly addictive. Wrong term. I never crave for it like some drugs I did. I can never get high from it or get any pleasure.

Tricky one as I am still bound to it though and Without it I will be very sick. It really worries me if I will never be myself again if it is the past drug use. I thought the brain was a good healer.

Time will tell if the bupe is playing a good part in this healing or not. It is a double edged sword for me. I have jumped from 12mg to 8mg in the last 5 days and yes I can feel it for sure! Slight wd's nothing to bad.

So complex :/

Hope you had a good kip Amy


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PostPosted: Mon Feb 06, 2017 2:13 pm 
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Hey Fresh,

Well thought out. well written post. You're a good writer. Appreciate the time and effort you gave to us. Thank you.

You've had quite a history of use w many substances. Addiction is a beast... Sorry its come your way, and my way too. Its an equal opportunist, can strike any of us...

I'm not trying to convince you to stay on bup. I hear you loud and clear that you plan to continue to lower and stop. Especially getting to a lower dose -- for many, "less is more". For taper -- lots here go slow and low = it works!! You already know the misery of ripping high dose bup off receptors!

I will not be able to agree that your all your side effects are from a 2 yr history of bup use. That just won't fly w your long term history of multi-substance abuse, including while on bup and binging on weekends. Most readers can see the other substances are clearly entwined. Might be too hard to see or hear this might be more the issue. I see you putting your effort and beliefs toward its all on bup. That's ok.

I will also not be able to agree that bup is 'addictive' and is a 'bitch' to stop. My 10 yr vikes to fentanyl run created the addiction and was a bitch to stop. I could not stop on my own. I lasted 30 miserable days in rehab. then left rehab to start bup. after on bup awhile, one day just started to forget to take bup. remembered then forgot. after a few times of this - that's how I stopped. Unintentionally and was pretty easy. I've been off a few yrs. 6 in May.

What is your testosterone level? could be you are low? we see low T w long term opiate use. Some of your symptoms match low T. Really do. If so, maybe consider T while you taper as you might feel better.

My Berlin friend is a rugby fan. Soccer too. When Germany won the world cup, friends said, I'm so happy for Curt. I said 'happy for Curt' ??? Be happy for ME bc if Germany had lost, it would have been miserable around here!

Fresh, hope you know and can tell we all wish you the very best in your recovery journey, P

Ohh, I just see your newer post... i'll post mine anyway and add -- The brain is Great healer!! Lots of neuroplasticity goes up up there!

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PostPosted: Mon Feb 06, 2017 2:42 pm 
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Pelican I didn't know that's how u stopped buprenorphine, that's cool because an older gentleman I first met at my clinic 5 yrs ago, that's exactly how he stopped too! He's still good to this day. He just started to forget to dose and when he'd remember, he'd take half what he was used to and he did that for about 6 or so months and finally stopped. He did his last drug screen and told the doctor he'd be leaving and he did. I always thought he was so brave. Good job pelican.

Fresh, there's so many ppl stop buprenorphine with little withdrawal because they did it slow and steady. U have to commit urself to that process. Suboxone isn't to blame for everything negative ur experiencing, I'm sure it's easy to think that, but ur on a forum with so many ppl that's been through what ur doing and u should really take their advice because they know what ur going through.

Being dependent on buprenorphine isn't being addicted to it. I've always looked at it that way. It's a medication that we have to take in order to put our active addiction in remission so that we can put our lives bk together. I know ur very smart obviously and I wish u all the best and success!!!! :)

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PostPosted: Mon Feb 06, 2017 4:31 pm 
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thanks all. Some very interesting and fair points for me to take in.

I have heard of people skipping days on bupe. I would like to try this. I wake up proper rough. Headcahe, jittery, poor eyesight then I'm ok after my bupe. Tomorrow I will get up and take the dogs out and take no bupe. See if my head clears through excersise. On 8mg it is no where near as bad as 12mg. When Im on 4/6 I hope even better. 2 wks at 8, 2 @ 6mg then ill go slower.

Its encouraging to read those stories of forgetting to take meds. I forget my SSRI regular. Dont notice it. Im agree some of this is in my head.

I have tried a couple of things on bupe. Stupid I know. Mad moments. They dont work. Dont bother!

I do miss a few beers I must admit. Just doesnt work either. Odd buzz and not nice. Also gives me a hangover from hell. Thats a pro for Bupe!!!

I will find out about low testosterone, thanks. My missus will be happy :D

Cheers for keeping your cool with me regarding bupe and your advice. I do hear you and thanks.

Sorry Pelican I have never binged whilst on bupe bud. That was before I was on bupe. sorry any confuaion.


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PostPosted: Mon Feb 06, 2017 6:22 pm 
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jennjenn, yep, that's how I stopped. was unintentional. I forgot to take. In my Drs clinic groups, there were elective taperers - quite a few that easily stopped. I never knew it was hard till I learned it here. My Dr. kept my spot open 3 mos and called to say she needed the spot. I said, ya go ahead and fill it. I'm quiet about it bc my experience seems unexpected for most that come here. I will say this about that tho -- the folks that come here, come for a reason -- they need help. But I know from my bup clinic days and NA days, folks had good stopping stories. We don't see or read about them here bc they don't need to come here for help. So they don't. That's why they are not here. They don;t need us. I believe folks do stop and just go on w their lives and never look back. For whatever reasons, it goes pretty well for them and that's why we don;t hear from them. They have no reason to come here.

Fresh!! Thanks for the correction, my bad, I got confused w the Mon - Sun changing to Mon - Thurs. ticking over the wknd and misunderstood. Also, I hear you. we hear you that you don;t feel good and in fact feel crappy and lousy at times. We know that's real. And its tough to go thru. Just want to clarify that and not discounting or diminishing what you're going thru. Best, P

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PostPosted: Tue Feb 07, 2017 3:44 am 
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Cheers P and good point. Your right anyone who has come off wont be here and you do normally see the worst on the net. I am always very cautious. I read posts etc but have never posted. This is my 1st.

people here seem bright, balanced and honest. Arguments and debates are fair and well thought out. (except my first post) :)

I am going to pursue the HRT and see if it is that. I can buy the testosterone gel online without script. But noooo. No more of that!!! Ive done enough self medicating!

I will go through the proper blood test channel.

Things like headaches, low sex drive, lack of focus, concentration, mood swings cant just be in head. surely?

I try to be a pretty upbeat and positive person. I know the mistakes ive made. I can relate and understand them. I can talk it but I most certainly didnt walk it.

It could be lack of confidence and stress. A self fufilling prophecy type syndrome. Hmmmm

One other thing I notice is as the day goes on and the bupe lowers in my system I do feel worse, More tired, even less energy.

Most of you are doing OK on it.Dont have my symptoms. I'm really happy for you. Puts a smile on my face. Good sucsess stories!

I need to look at all the possibilitys, but cant beat myself up over it. It is what it is. My own fault. no one elses.

Cheers all and thanks again


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PostPosted: Tue Feb 07, 2017 6:11 pm 
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Funny you said what u did because I always tell the ppl in my group D/A counseling that I don't consider myself clean on Subs. I won't start counting clean time again until I'm off it... Don't give up.. .. We are a determined group of individuals !!! ( or just hard headed) not sure which!!!


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PostPosted: Wed Feb 08, 2017 12:01 am 
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If I were in your counseling group I would say that I am totally clean on my dose of buprenorphine and that a focus on clean time in 12 step groups is one of the reasons that people relapse so badly and sometimes overdose and die because they figure, "Well I lost my clean time so I might as well enjoy myself and go on a complete bender."

I also enjoy having things to say regarding buprenorphine, recovery, and other addiction related topics because I have access to article after article based on actual scientific evidence at my disposal from being in graduate school. Makes it a lot easier to back opinion with facts. I don't know why, but I'm just really into facts lately.

Amy

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PostPosted: Wed Feb 08, 2017 5:38 am 
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I can see both sides and I think its down to the indivdual if they class themselves as clean or not. We could debate and bounce for days.

Whatever works for the person, I guess.

I could say I'm not clean if I am on an SSRI for example or even if ive had a beer. Grey area. I think the key point that Amy made is "it saves lives and people have a much better chance of recovery"

Bupe is not perfect for me by a long shot but it did get me off oxys and my life improved a great deal. No other rehab aid or drug came close.

I dont know the scientific facts but I still feel bupe (on a high dose) is holding me back from where I truely want to be. My low testosterone kit comes today. I hope it is that. Bupe and oppiates can lower T as someone kindly pointed out.

I really hope it is the bupe to be honest as I can actually work with that over time and I know where I'm at. Its like a stagegate process for me. Off the opiates, onto bupe. Then off the bupe.

I can do nothing if Ive mashed all my brain receptors and done permenant damage for life. I'm confident thats not the case. That thought is extremely comcerning.The mind will heal but it takes time.

We all need to be completely honest with ourselves about bupe, and eduacte. what is does,excatly, how it works, what impact it may have on us, side effects, good or bad. The W/d process, dosages. Theres a lot of good info and experiences here to make up our own minds fortunetly.

More than my docter or keyworker ever has.

On a lighter and brighter note 2 great US documentaries ive just watched. "Prescription thugs" and "minimlist" certainly makes you think! I want a "tiny house"

https://minimalismfilm.com


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PostPosted: Wed Feb 08, 2017 1:44 pm 
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I'm sorry if I came off as snippy. You're right, each of us have our own recovery journey and our own definitions of where we are in recovery are the ones that matter.

It's unfortunate that not everyone has an open mind about that. We get people here all the time who try to tell us that we are not clean or that we aren't truly in recovery.

I'm sorry that you're having problems with your dose of buprenorphine. We support plenty of people here who feel that it's time for them to come off.

Amy

P.S. I can totally see myself living in a tiny house too! But where to put my husband and son!

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PostPosted: Wed Feb 08, 2017 4:56 pm 
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This has sure been an interesting read. A shout out to aFreshStart1 for having an open mind and giving us a great debate to clear up some mis-conceptions about Bupe.

For me, I take a testosterone gel to help even me up. Is it the Bupe? Can't say for sure unless I stop it, wait a few months and then get tested again. It's just easier to have a script that works.

There is no reason to be on a high dose of Suboxone for an extended period of time unless the patient really feels/thinks that they need it or they'll use again. (not trying to give advice here) A whole lot of us here started off on a high dose and after months and years we've very slowly tapered down to what feels right. For me, 2 mg's a day is okay. But the lower you go it seems to get stronger. At least with me. The last time I tapered I got down to 1 mg and even that felt like too much. We'll see how it goes this time around.

Saw my Suboxone doctor today and we agreed to lower my dose by my suggestion. He still gives me twice of what I take so now I can go 3 months between appt's. That saves me some serious money. And it's good to have some backup stock too.

Thanks for all the great posts everyone! I've been following but today I decided to finally post. Plus, some days I just can't get into the site for some odd reason.

rule

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PostPosted: Thu Feb 09, 2017 12:38 am 
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Rule,
Agree this is a great thread!! Hopefully those that are attracted to the title -- will read far enough to learn from ALL of it!!

Hey Fresh.
Been thinking of how crappy you feel in early AM prior your bup dose followed by real improvement and then at midish day where it wears off. According to a Talkzone article of Dr. J's where 6% of folks are slow and 6% are fast metabolizers, wondering if you are a rapid metabolizer? Means bup wears out faster. Can tell you are smart, intellectual and are a thinker so you'll want to look this up more...

Wikipedia
"CYP3A4 is a member of the cytochrome P450 family of oxidizing enzymes. Several other members of this family are also involved in drug metabolism, but CYP3A4 is the most common and the most versatile one."

Poster Teejay who is a rapid metabolizer says "The CYP enzymes related to Suboxone are CYP3A4 and CYP2D6. Some studies emphasize CYP3A4, others CYP2D6. CYP2D6 is more well known for interactions, and there's a class of people called Ultra Rapid Metabolisers of CYP2D6 who may find themselves burning through their buprenorphine faster than others."

Dr J, the best source, wrote to a recent poster who felt bup might be building up and one of Dr J's thoughts was a possible SLOW metabolizer. "Most people start having more withdrawal as they drop below 4 mg, but buprenorphine is blocked by specific liver enzymes called 'cytochromes', specifically cytochrome cyp 3A4. That enzyme varies in potency between individuals, and is also blocked by a number of medications. You don't list your age or the medications you are taking, but you may be a slow metabolizer, in which case you will be maintained by very low doses of buprenorphine.

In the US, its a simple blood test. One US lab called it the Cytochrome 450 3A4 test. If you are, then more info is available on how to manage.

Food for thought! As always, wishing you my best! P

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PostPosted: Thu Feb 09, 2017 1:27 am 
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Quick post as 5am and im off out.

Amy you didnt come across snappy at all. promise.

Very interesting post about the rate of metabolism! hmm got me thinking.

When ever I done anything in my younger days or adult for that. I came up in minutes.Very quick. I remember doing E's and I would be flying within 10 minutes. All my mates were like what, how? I will look into it and thanks for all the great posts and feedback.

Ive done my testosterone test.T and prostate. Waiting game now. Cheers all


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PostPosted: Sat Feb 11, 2017 11:40 am 
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Well I got the results. 5/Nmol

Low!!

How low I now need to investigate.

The gel any good?

Cant thank you all enough I would never have found out if not for you guys.

Cheers


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PostPosted: Sat Feb 11, 2017 1:43 pm 
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Hey Fresh!!
I assume you mean 5 nmol per LITER?

A major US lab states "No uniform recommendations exist for diagnosing low total testosterone levels, however one large consensus statement from the International Society of Andrology (ISA), the International Society for Study of the Aging Male (ISSAM), the European Association of Urology (EAU), the European Association of Andrology (EAA) and the American Society of Andrology (ASA) advises:

Total testosterone greater than 350 ng/dL: No treatment (Paduch 2014).

Total testosterone between 230 and 350 ng/dL: Repeat total testosterone levels as well as SHBG, the sex hormone binding globulin to calculate free testosterone.

Total testosterone less than 230 ng/dL: Consider replacement therapy."

Your result is 5 nmol/L so need to convert that to ng/dL, to compare to ng/dL ranges in above statement. 5 nmol/L looks low per above.
5 nmol/L = 144ng/dL
8 nmol/L = 230 ng/dL
12.1 nmol/L = 350 ng/dL

Not sure what T options are available in Britain...options might be injections, skin gels or solutions, skin patches, buccal (cheek) tablets, pellets implanted under the skin and nasal gel.

Hopefully someone on T or past T experience will come along! Good luck w all this. Could very well be you'll start to feel better! Best, P

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PostPosted: Sat Feb 11, 2017 4:28 pm 
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Working in a Methadone clinic I have to take issue with the OP's statement that Methadone "gets used in 70% of cases to back up a habit". Yes, people do sometimes "game the system" as you said. But honestly, most people I've worked with on Methadone are legitimately trying to get off of opiates, trying to repair broken lives, and ultimately trying to achieve recovery, just like those on bupe and those in abstinence based programs.
We all choose different pathways. I wish you the best as continue addressing your side effects and work toward recovery.
Lilly


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PostPosted: Sat Feb 11, 2017 6:18 pm 
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Thanks for all the info P appreciated mate. I think I will go on the gel. Keep you posted buddy.

Lilly im sorry to offend, i know a lot of friends on meth, people picking up down my local boots and at recovery. Most have or do use on top of meth. On and off. Circles. Thats were I came up with 70%. very wrong of me I know. was just a figure plucked out of the air. Based on what ive seen over many years. Sure there are lots of sucsess stories too.

A few used to also sell it on. Ive heard all the tricks to pass pee or swab tests and have seen it on the street level, beneath the clinics and keyworkers.

The whole system is in a pretty sorry state due to poor funding and its all about getting stats. The "true" picture is so different from where Ive been sitting the last 6 years :( Im certainly not undermining the workers. The people on the front line.

I really hope my insight into it is wrong and is isolated. Maybe geographic, demographic.

Not many that I know are taking bupe. I also abused on meth. was too easy. I couldnt with bupe nor need I feel like I needed too. We also know a lot of deaths are linked to abusing both meth and brown :/


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PostPosted: Sat Feb 11, 2017 8:11 pm 
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Hi Afreshstart1- I just wanted to say hello and welcome. It is so refreshing that you were able to open your mind about the responses to your OP. It is just lovely to see that. I wish you well and hope that you find the root of your symptoms (seems like you found an answer about the low T for some of them). I'll see you around


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PostPosted: Sun Feb 12, 2017 5:50 am 
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Thanks Htown. Same to you pal.

Yes I was a bit of prick in some of my posts. Blamed subs outright. Not fair or well thought out. I jumped the gun.

Stumbling across low T here could be a miricle for me. I am so grateful to the chap who mentioned it. My GP would just throw anti deppressants down me. Didnt work so up the dose.

I ended up nearly dieing on strong anti depressents. I think it was "pregbalin" lyrica. I think its a stronger version of Gabpentin. They put me on a huge dose (>300mg/day) and I ended up having fits and extremely ill for 2 days. Found out it was something called "serotonin syndrome" overload of serotonin to the brain. Ended up in A@E again. Admitedly I was also dicking about with oxy and benzos as well.

I cant expect standard GP's to know everthing about depression, anxiety, drug use. I used to believe they knew everything and had all the answers. They dont and i dont expect them too.

Its a specialist area and I even question some of the so called specialists at times. So complicated.

I thought I knew better and self medicated many times. That all went tits up too as you can imagine.

I also used to buy benzos and other drugs online. Most are bunk, some are dangerous!!! it wasnt diazepam but a highly addictive bi-polar type benzo drug developed by the russians in the 1960's. Nasty Wd's and head screwing. Lots of nasty fakes that "look" real. Boxes, instructions, you cant tell the difference really.

I also got caught importing a few bits for personal use a few times. Customs just sent me a letter and little slap on the wrist. No further action. Bonkers.

Do you get legal highs in the USA? They are also called "bath salts" or "plant food" They have just been banned here thankfully. Caused a huge issue. On the street,schools in prisons.You could just buy them from a shop and the drugs were more potent than some of the common ones. They got round the laws by just moving one molicule in the drugs structure. Dirt cheap too. But nasty. Lots of fatalities and they claim one called "spice" is more addictive and stronger than heroin. Scary! People and youngsters thought. Its legal it must be OK. Only a few months back it all got banned.

I've gone off on a complete tangent here........ Sorry.


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