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PostPosted: Thu Jan 16, 2014 12:28 pm 
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Hi Everyone, I am going to start weening from 2 mg of sub to one mg. I have to have a stomach test on February 3, and I have to be completely off sub when they do this procedure. I am having the test where they go down your throat and check your stomach. I had this procedure a couple months ago when I was getting off sub completely. I found that no sub made me anxious. I was told by my doc he wants me to stop sub 3 days before the procedure. My question is i don't want to just stop 3 days ahead of time, because i don't know what the outcome will be. Here is my plan. I am going to take 1 mg of sub today and see how I feel tomorrow. My original addiction on opiates was small. I am a addict who had some really bad tooth surgery and a couple root canals, and a tool pulled. I was in a lot of pain and thought it would be okay to take vicodin just long enough to get through the pain. I was wrong and should have known better. I got hooked on vicodin for a couple months. I tried to stop but it was always in my mind so I got hooked. My pyhciatrist but me on a small dose of sub. I have been on 2 mg since November. I really think this is my chance to get clean from sub. I am planning on taking 1 mg of sub today and start to ween off. I don't really see that this will be a problem. I have until Feb 3 to accomplish this. I would appreciate any advice that you have. They need to go down in my stomach and remove a nodule. The nodule isn't cancerous, but they said it should be removed so it doesn't become cancerous. I don't think it will be a hard detox, and I have a strong recovery group and lots of support at home. Just want to think what the group thinks. I have got a lot of help on this forum. Thanks for the help in advance. I just don't want to wait until the last three days and end up in some type of bad withdrawl just going cold turkey off the sub. My original vicodin addiction was 40 mg a day and only for a couple of months. What I am asking the group is should I start the ween down or wait 3 days before the procedure. I will see my sub doc next Tuesday and then I could ask him. I think he would be fine with my idea.


thanks rung


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PostPosted: Thu Jan 16, 2014 2:13 pm 
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Hi Rung,

I had a situation similar to yours and I will let you know how it went for me. I know Dr. Junig has a protocol for those having medical procedures and stopping sub here on the forum that you might want to take a look at.

I was in the process of tapering the subs and was down to a dose of .50mg each day when I had to have emergency surgery to remove my appendix. I used the surgery to stop the subs just as your considering doing!

I took Extra-Strength Vicodin for only one day after the surgery, and never went back to the subs after that. And it worked extremely well for me too! I left the hospital with no script for narcotics. I had very little trouble with symptoms from stopping the subs, but again I had been previously tapering. It's all on my thread here.

I'm sure your doctor is correct by telling you to stop the subs 3 days before your procedure which is called an EGD. I personally believe that if you do that any symptoms may not even begin for 2-3 days due to the dose you are now on, and the long half life of bupe. Or you could taper as low as you possibly can as your considering beforehand. I do believe it's best to stop sub completely at least one day before any procedure and that's my opinion only.

I think if you are REALLY READY to be free of the sub this would also be a good time for it.

Anyway that's what happened in my case. I'm doing very well now going on 5 months sub-free. I had been on bupe for about 3 years and a high dose of 24mg in the beginning.

I hope this helps and wish you the very best. Please keep us updated how it goes, and what you decide to do. Take care Rung.

Karen xoxo


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PostPosted: Thu Jan 16, 2014 6:43 pm 
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I wanted to share my surgery on sub experiences. I've had 3 while on sub. Tapering off 2 mgs is not easy in the time you have but it can be done. Good luck! Worst case if you have to have surgery on sub, hopefully these stories can help ease your worries.

#1 i was on 1.5mg sub I did not stop and I was able to take my vicodin afterwards according to the prescription and it helped with pain very well in conjunction with the sub. *I THINK* Dr. J has posted at one time on here that taking a small amount of sub like this will help from going into withdrawal between pain med doses after surgery. Anyways, they did that surgery with no opiate pain med during surgery, just put me to sleep and used a nerve block. When I woke up the pain wasn't too bad.

#2 i was on .5mg this time for a similar surgery (btw on my ear, going in behind the ear, yuck) This time they did a bit of reconstruction in my middle ear so a bit more pain waking up but not too bad they shot me up with something (maybe demerol) and i was good. recovery was the same- took my prescribed vicodin along with my .5mg sub, all good

#3 hernia surgery when my taper was down to .125mg sub, very low. This was the most pain when waking up and the nurse was only feeding me 5mg percocets one at a time. After two hours of that she broke down and gave me a shot of dilaudid and i was fine. same deal with recovery, few days with a percocet prescription along with my small sub dose and then switched to tylenol. not bad at all.


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PostPosted: Sat Jan 18, 2014 11:38 am 
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Thanks to all that have replied to my post. I am having a scope put down my throat to have a nodule removed. There shouldn't be any pain involved. The doc told me to just stop the sub 3 days before the procedure. I didnt want to do that. My goal is to taper down to nothing by Feb 3 and then have the scope test done they will remove the nodule and that's it. my goal is to try and stop sub comepeletly and that will be the end of it. if things get to ruff, i am planning on going back on the small dose of sub i have been on. The sub has helped a lot. I never think of drinking or picking up a pill. My doctor says this is a perfect time to get off the sub completely. Will see what happens. I guess they give you some fentynal to put you out. Thanks to everyone that responded to my post. Replie to this post and let me know what you think of going completely off of sub for good

rung

Thanks brown eyed girl and glen bee for your help. I dont want to go off sub and then relapse. Im scared that will happen to me


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PostPosted: Sun Jan 19, 2014 8:54 pm 
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Hey Rung,

I agree with your doctor that this may be a good time to get free of the subs because as I told you I did it that way myself. But I was tapering from a 3-year sub therapy stint. I will also tell you that you have to be 100% POSITIVE it's what's RIGHT for you at the time. I was absolutely positive it was right for me to get off.

rungsat69 wrote:
I dont want to go off sub and then relapse. Im scared that will happen to me
Well in my opinion if you have the slightest doubt that you may indeed relapse you need more time on the sub. If your scared as you say then maybe you should consider remaining on the sub a while yet?

Why go off, relapse, then have to begin all over again? Might as well remain on the bupe in the first place.

rungsat69 wrote:
My pyhciatrist but me on a small dose of sub. I have been on 2 mg since November.
There should be zero doubt. Looks like you have been on sub for give/take 3 months. In my own personal opinion that's usually not long enough, depending on the level of addiction and drug abuse in the past.

There are many here that believe bupe should be for life, and that's perfectly ok. Some believe they should get off and that's fine too in my opinion. I would weigh all the options very carefully and make an informed decision. This has to be your decision. Think it over and best wishes.

Karen


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PostPosted: Tue Jan 28, 2014 6:41 pm 
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To the OP,

Hope you're well. Real briefly, in my professional opinion you have absolutely nothing to worry about. Yes buprenorphine is a semisynthetic partial opiate agonist with high affinity at the mu receptor. And yes most other agonist opiates won't be able to bind to those opiate receptors due to bup's high affinity. However, your procedure is an endoscopy aka EGD, and the anesthesia protocol for mostly all endoscopies are IV fentanyl and IV verced (midazolam). Verced's a powerful benzodiazepine and fentanyl is basically the Zeus of opiates. It has been proven through many clinical studies that both fentanyl citrate and it's analogs such as sufentanyl have such a strong binding affinity for those mu opioid receptors that it will not matter if any buprenorphine is present. If you still don't trust me, do research on a basic molecular chemistry concept known as "competitive inhibition". Wish you all the best. Key point, just remember yes bup has a strong affinity but there are opiate anesthetics being used daily in every OR throughout the modern world that have an even higher and stronger affinity. Be well, peace.

- anonymous MD


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