It is currently Fri Aug 18, 2017 8:33 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 8 posts ] 
Author Message
 Post subject: What to do? What to do?
PostPosted: Tue Dec 07, 2010 9:16 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Feb 17, 2010 10:03 pm
Posts: 991
It's been almost a year since I jumped off 12mg per day of suboxone and decided to just cold turkey it. It has been about 9 months since I started taking suboxone again. I learned a lot through that process. I learned how much suboxone was in fact helping keep my addiction in remission. I learned exactly how damaged my brain is. I learned to be grateful for the option of taking suboxone. I learned suboxone does in fact help with my pain much more than I ever realized. I found this forum and learned a tremendous amount about suboxone. Through this process of wanting so badly not to be dependent on anything, I learned that we don't always get what we want and that acceptance is key. When I went back on suboxone the decision was two-fold. The PAWS were lingering and I wasn't sure I could make it through the additional 6 months or two years that might be required. I also knew that given the PAWS I was experiencing, as soon as I needed narcotics, I would be right back where I started. I wasn't sure I could go without narcotics to manage my pain. So I went back on suboxone with the intent of staying on it forever. I have been quite happy with this decision and accepted that this might just be the way things are for me.

Recently I have had many thoughts of stopping again. I keep thinking that it was miserable because of jumping. What if I tapered? Many people have done this successfully. Maybe my pain was intensified last time because I jumped and if I just taper maybe the pain would be lessened and I could in fact live with it. Many people live with neuropathic pain. I'm not so sure about the other pain condition, but it is possible I could make it through. I just don't know. I keep thinking that if I taper very slowly and work out that maybe I can decrease the PAWS experience to something more manageable.

On the other hand, I am also a very strong believer that I have damaged my brain possibly to a point of no return. I believe that I always had a tendency toward depression that was non-responsive to traditional anti-depressants. I believe that addiction runs in my blood. My life is quite easy on suboxone. I haven't relapsed and don't even think about it. My husband was prescribed vicodin and valium the other day and neither were an issue for me. They were left out and I never actually considered taking any. I noticed that I wasn't thinking about it and didn't care. But I have no interest. There was a slight tinge of jealousy that he gets to get high (not intentionally but as a side effect), but then immediately I thought....what the hell do I need to get high for? I am happy and there is no need. Suuboxone gives me that ability to have a second, far more balanced and healthy thought. I know that when in active addiction that wasn't possible. There was a time in my life where although I enjoyed my pain meds when prescribed....I still took them as prescribed. I don't know that this is possible anymore. I have no idea. I assume I would always have a hard time managing my own pain meds. I imagine there would always be a fear of taking them and a fear of withdrawal. I know if this is possible, it would be YEARS after stopping suboxone. I have to consider this because I will always have pain conditions that will always require surgery. They aren't going away. There is no cure. So the questions are "can I live with the pain without use of narcotics" and "if at some point narcotics are prescribed, will I get addicted again". Also, I don't want to live my life in a constant struggle surrounding narcotics. I have one life to live and that isn't it.

It certainly hasn't helped that right in the middle of all this, a friend was diagnosed with brain cancer at age 39. Within a week of the diagnosis, they took him in for brain surgery. I can't help but think if that were me, it would be a problem. If that were me, I would have had to discontinue the suboxone and right in the middle of all that stress, I would also be in withdrawal with the HOPE that the pain meds might work post brain surgery. At the point where I was trying to recover from brain surgery....I would also be trying to recover from suboxone. It would just be a mess. It isn't necessarily brain cancer but car accidents, other terminal illnesses that require pain meds. There are so many what if's in my mind. I know lot's of people have to stay on meds their entire life. But I also know that suboxone is the only med that poses such a serious problem when faced with urgent or traumatic events. It is for this reason that suboxone is kind of unnatural and scary.

What to do? What to do? Any thoughts or opinions on this?

Cherie

_________________
Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


Top
 Profile  
 
 Post subject:
PostPosted: Tue Dec 07, 2010 9:26 am 
Offline
Super Poster
Super Poster
User avatar

Joined: Thu Dec 02, 2010 2:28 pm
Posts: 134
What are you doing other than taking sub? I had some of the same concerns while I was on it, especially after having a painful injury and surgery. Worrying about what *might* happen can easily drive you nuts. My experience while on sub, though, is that many folks get all worried about stopping without having done any work at all on recovery. To me, that is where its at.....learning to change one's behaviors and lifestyle, and developing a support system. Taking sub never cures anyone, or gives them a pass on doing recovery work on a continuing basis.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Dec 07, 2010 10:48 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Hey Jack... I know you've done lots for your recovery and that you're in a really good, strong place. For that reason, I think if you decided to taper off that you would be successful. Plus you're so strong and that will only help you succeed. Like you said, the real question is can you cope with the pain without the help of the suboxone? I watch my husband live every day with severe peripheral neuropathy. There is simply nothing that helps him...nothing. What if you tried cutting your dose back for a while just to see how bad your pain will be? Don't make any decisions yet to taper off, but try to give yourself room to taper just to see what kind of pain surfaces. If it comes back strong, then it might be a moot point after all.

I don't know if this helps or not, but it's what occurred to me. Good luck.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Tue Dec 07, 2010 11:50 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Oct 21, 2010 10:39 am
Posts: 4028
Location: Sitting at my computer
Hey JackCrack, that's a tough decision you're looking at.

I agree that lowering your dose and seeing what you get pain wise is a good idea.

Just a personal note, as I tapered to 6mg my pain got worse, but when I quit taking sub, my pain is very minor now. I take a couple of advil a few times a week and that's it. As you lower your dose you will experience dis-comfort and if your anything like me it will seem to make your pain worse, but it may actually be mostly due to adjusting to the new lower dose.

I experienced pain all the while on sub, especially as I lowered my dose and now that I'm not taking it anymore, hardly any pain. That is my own experience and I would guess that it's quite atypical, just wanted to get it out there though. My pain was caused from a few broken bones in my ankles, I'm not sure what or where your pain is, it may be totally different than mine was.

I wish I had a better answer or could provide more insight for you.

I have seen several times on the forum people speak about having to quit sub before surgery and Jack you mention how sub and surgery don't go together, is it the lack of powerful pain control from sub or is there another issue with sub and surgery that I haven't run across yet?


Top
 Profile  
 
 Post subject:
PostPosted: Tue Dec 07, 2010 12:05 pm 
Offline
3 Months or More
3 Months or More

Joined: Sat Sep 25, 2010 11:21 pm
Posts: 94
Jack,

I think it's great how well the Sub treatment works for you - and that is a wonderful thing. With regards to traumatic events/surgery, I thought I saw a post from Dr Junig (but I might be wrong) somewhere that it is very possible to switch someone off Suboxone to a Full Agonist. The anesthesiologist or surgeon just needs to know what they're doing. So if your doctor has the same knowledge or could connect you with an anesthesiologist who does for a consult, maybe it would eliminate that concern.

But if you and your doctor feel like you're ready to try stopping slowly, there is nothing wrong with that either. You can always move your dose back up if it's not working out for you. The only thing I might suggest is to focus more on the dependence and depression factors during the tapering process and the chronic pain issues after the taper. Only because, for me, it was hard to get a real read on my pain level (I'm also a chronic pain patient) until about 30 days after my taper ended. I was surprised how much pain control Sub gave me all the way to the end of my taper (.3 mg). Around day 15 post-Sub I had an unnaturally high pain spike. Around day 28 my pain settled into what I think is my true pain level. I have spinal disk and bone spur issues so my issues are different. But I've been surprised by how well I've been able to manage them so far.

Best wishes with whatever path you choose.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Dec 07, 2010 6:01 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1543
I rarely stop Suboxone for people who need surgery; there are guidelines that include ways to avoid the need for withdrawal. For example, I lower the buprenorphine dose to about 4-8 mg per day, and then treat pain with oxycodone, 15-30 mg every 4 hours. It works pretty well; I have had patients go through major procedures, even an open-chest case in one person for bypass surgery, without any more pain than a 'normal' patient would have. There are many bad things about having brain cancer-- and I'm sorry for your friend- but you wouldn't necessarily have to stop Suboxone even for that; the brain itself has no pain receptors, so there is very little need for narcotic after brain surgery.

As for terminal cancer pain, there is no issue there-- you would stop the Suboxone and replace it with a high-potency agonist.

I've had many patients have surgeries, and about 15 women go through pregnancy and delivery on Suboxone; I can honestly say that everyone has done OK. The main problems have been related to docs freaking out, thinking there will be problems. Once we get people calmed down and educated, it is not a big deal.

I hear you-- there are reasons to stop. But the risk of needing surgery is not a major concern for most people. And it isn't a horrible option to 'cross that bridge IF you get to it.'

Just my two cents...


Top
 Profile  
 
 Post subject: My experience
PostPosted: Tue Dec 07, 2010 8:17 pm 
Offline
Super-Duper Poster
Super-Duper Poster

Joined: Thu Dec 17, 2009 8:58 pm
Posts: 322
I take 150 - 200mg of tramadol for pain because my C6-C7 spinal fusion has been acting up for some reason.. The pain that runs down my right arm is incredible, I also need that arm to work.. I talked to my Sub Dr ( also my psychiatrist ) how I should handel this.. He jumped out of his chair and told me in NO way was I to stop Suboxone.. I take 1mg of suboxone per day.. The tramadol takes almost , well about 75% of the pain away, I dont get high or warm, not even a hint of the feelings I fell in love with... Its been 3 yrs since my fusion surgery, I would be in BIG trouble without Suboxone, Jack- You can get help from pain meds on Suboxone. Speaking for myself only, I need Suboxone more now than when I stopped using recreationally, Mike


Top
 Profile  
 
 Post subject:
PostPosted: Wed Dec 08, 2010 9:12 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Feb 17, 2010 10:03 pm
Posts: 991
Thank you for all the responses and food for thought. I will answer a couple of the questions and then comment.

I have done a lot for my recovery. I started therapy before I got on suboxone three years ago and still go to the therapist. I have learned some great meditation techniques which I use regularly. Overall, I think I have decreased my anxiety ten fold. I feel much more balanced and much stronger now than I ever did. I have coping skills I never had before. I am entirely removed from anyone who uses and if I had the urge, wouldn't even know where to go so I would have no choice but to either find a doctor in some other town who would prescribe or get over the urge. I was always too afraid to doctor shop so I don't see that happening either.

Medical conditions: The one that got me addicted is called hidradenitis suppurative chronic stage 3 or 4 if that exists (been a while since I looked it up). I have had well over 16 surgeries for this and probably need two now that I am avoiding. It might go away when I hit menapause but that is a ways off for me. ON sub there are about 6 days out of the month where I really can't do anything but struggle to find a comfortable position and stay in it. OFF sub, there are about 2 weeks each month where I would be highly uncomfortable, probably depressed, and might not be able to work full time anymore UNLESS I could figure out a way to deal with it. If I were off sub and needed to control the pain, I would prefer to only use sub in short duration to deal with it if possible. But the only doctor likely to do that is the sub doc and she charges $500 per quarter and doesn't take insurance. Part of the decision to go off is the financial concern.

Peripheral neuropathy: We have no idea why I have this. When I went off sub it surfaced. We thought it was idiopathic as the result of withdrawal maybe. After 3 months it didn't go away. I had a hard time sleeping because of it and in the evenings it was so awful that all I wanted to do was go to sleep so I didn't have to feel it. I tried neurontin which worked but I kept having to increase the dose because I got used to it and as I increased the dose, it seemed my brain got slower and slower and slower. I was having a hard time thinking at work. Then I tried Lyrica which really didn't do anything at all for it. This is the one I am hoping was worse BECAUSE I jumped and that maybe it wouldn't hurt so bad if I tapered.

My doctor: She is aware that the reason I am taking sub is really because of pain management and she is aware that if I were off of it, I would need pain meds periodically to control pain. She is aware that I am afraid to take full agonists to do this because I fear active addiction. She is perfectly ok with me staying on forever at the dose I am on which is 1 1/4 8mg tabs per day or 10mg per day on average. I actually take 8mg per day and when the pain is bad, I take either another 4mg or another 8mg to control it. This dose prevents me from feeling the neuropathy in my feet almost entirely. It prevents the depression associated with the pain from the HS and it enables me to move most days when the HS is bad. It is up to me and she would be supportive one way or the other I think.

I doubt Dr. Junig will get back into this thread because he is busy, but if so, THANKS! I know it is possible to manage pain while on sub. My fear is finding a doctor who gets it. But either way, it is nice to be reassured that if I got cancer or something I would be okay if I found the right doc. I have always been advised to stop the sub entirely prior to surgery so I have always had to suffer the misery. I have never really had my pain controlled well after the surgeries so I avoid them like the plague and allow my HS to get way out of control. My current doc is the first who said no more surgeries totally sub free. I have a surgery appt. for my elbow on Thursday (different condition entirely) so we will see what happens there.

Overall, I still don't know what I want to do. I may go ahead and taper it a little just to see what happens. I probably wouldn't tell my doc because I don't want to be locked into it. I want the freedom to just change my mind for any of the above reasons without being pressed. On the other hand, if you don't make a conscious decision to taper and be successful, I am not sure the necessary resolve would be present to be successful anyways. Can't hurt to try and see what happens though. That is probably what I will do.

Cherie

_________________
Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 8 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: shadow and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group