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PostPosted: Sat May 06, 2017 6:48 pm 
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Hi guys, had a question wanted to throw out there. Very quickly, came off a 200-300mg/day oxy habit using a 45day suboxone taper from 4mg to 0.125mg and jump, which I documented on my own thread in the Stopping suboxone forum, now 11 days off everything. Have postgraduate training in this kind of field, so do know about pharmacology, drugs, neutrotransmitters, pharmacokinetics, etc. Had a very smooth taper after a tough first 2 weeks from a mental aspect (lethargy, depression, etc) but otherwise very little physical symptoms, even after the jump. I think most of my WD's were done in the 0.75mg down to 0.125mg range of the taper, so not much tolerance left to lose from 0.125mg to 0 hence the very smooth jump with little to no symptoms... even skipped the skip day regimen I planned when I felt fine the first skip day.


My question is... why is Depression so commonly reported right at the Week 2 mark? These 2 websites show very specifically, week 2 - bam depression. We all know WD's are like a smorgashboard of a dozen symptoms, with different ppl each having their own "worst" symptom, so sites like these all report that giant list of symptoms at the beginning, but very specifically pick out depression hitting week 2 so much so that it makes it onto their visual pictures of sub withdrawals as these 2 sites show:

http://americanaddictioncenters.org/sub ... ithdrawal/
http://www.recoveryfirst.org/wp-content ... wal-rf.png



I have prob spent 100+ hours reading stories on the Internet before deciding on this plan for myself, and you kind of get a feel for the stories that are telling very close to the truth, and the ppl that, ahem, 'exaggerate' a little bit and are mentally reinforcing their own symptoms.... well I distinctly remember reading one thread of a lady who seemed very well experienced getting off suboxone multiple times... and she mentioned how depression hit day 10 for her like clockwork each time, and even before I got to that part I felt she was a pretty reliable information source on the experience, and there were 2 ppl that replied mentioning that yes they too get hit with mood problems at day 10 or so and for whatever reason that thread stuck in my head and I put it in the back of my mind for laters.


I ask because like I said my jump was fine, but the last 2.5 days (day 9, 10, 11) off everything feel like a slight return to the taper days from a mental aspect... waking up with no energy/mood/motivation and bad depression, but otherwise no physical symptoms like no RLS, not even insomnia.... these are days I'll sleep 9 hours and still feel tired. Now, I know getting off ANY opiate is a 6-8 week process as they say, and if I had never run into this information on the week 2 depression, would have just chalked it up to the rollercoaster of the brain getting off opiates, even though it is kind of demoralizing that the 'each day getting better' mantra is now going in reverse the past couple days. I thought maybe the subs just took 8 days to wash out and perhaps these are the real WD's coming on.. but definitely no.. was feeling progressively better days 1-8 off of suboxone energy/mood/motivation wise so that makes no sense, plus zero physical symptoms otherwise, and still no physical symptoms from the jump like diarrhea, runny nose, RLS. Even my appetite was coming wayyyyyy back days 6-8 off everything as I was eating 4 meals a day again up from 1.5 was never hungry during my taper.

Was gonna power through this as part of the healing process nonetheless, but if this was a commonly encountered thing at week 2 I wanted to learn more about it and what to expect. I tried to do some googling first for like "week 2 depression suboxone withdrawal", but the search terms are just too general and you don't find much other than ppl talking about how they are stuck in indefinite PAWS weeks to months out, or ppl jumping from like 8mg+ doses and diary'ing that they still feel like crap all around at week 2 with depression and physical symptoms still, which I feel is quite different from my situation. I remember reading something about Dr. Junig saying action at the kappa opioid receptor could explain antidepressant effects of suboxone, but I can't really tie that in to the timeline of week 2 depression hitting specifically when you come off suboxone during the WD process. Feel like everything should be either be all coming or all going as suboxone releases its grip on all your receptors.


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PostPosted: Sat May 06, 2017 11:43 pm 
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Honestly in my experience after coming off Sub a few times, there isn't any set pattern. Sub, like methadone, is a long acting opioid and as such it lingers in the body a fair while. I would experience waves of detox-type symptoms after days of normality in the month or two after I came off buprenorphine. Usually they were mild - runny nose, sneezing, goose bumps, restless legs etc and they'd come and go throughout the day.

As for depression, it sounds like you're experiencing some post-withdrawal mood swings, which is to be expected. You might experience days of depression and lethargy followed by OK days. Over time these mood swings get both milder and longer in duration, until eventually after a number of months they're near unnoticeable. In my case I never experienced the week 2 depression, at least not in a predictable sense. I always felt an overall better mood off Sub than on. That may have been partly because of the self-esteem boost I experience from being Sub free.

Congrats on coming off and don't give up! It does get better, even if it's 3 steps forward 2 steps back at times. Recovery, both physically and psychologically, isn't a linear process. Some days and weeks are better than others. It's only when you look back in hindsight, say when you're 2 months off and look back to how you felt at this stage, that you realise how far you've come.


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PostPosted: Sun May 07, 2017 9:27 am 
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I don't believe there's any 2 week pattern, I believe it's absolutely possible for ppl to experience depression coming off any opiates but not at hitting week 2 and depression begins..... I don't believe it happens like that to everyone or that it's specific to buprenorphine.

When I was in inpatient rehab for morphine and oxycodone, I stayed depressed the entire time. I stayed depressed for 5 months after. There were ppl coming off suboxone in there with me and their moods were much better than mine. They were exercising and eating, I couldn't eat a bite. The ppl that entered treatment on buprenorphine had an eight day detox and the ppl on oxycodone and stuff like that had a five day detox. We were all in there for a 28-90 day treatment and regardless if it was bupe or full opiates, most everyone had the same experience as far as how they acted and felt. I was depressed and craving the entire time, couldn't eat or sleep or do much of anything, I don't know why I reacted so much different than everyone else. I was wondering if I was in the twilight zone lol. But my point is, the ppl stopping buprenorphine, after their 3 day longer detox, were just like everyone else. There were no specific symptoms they had that others didn't. Do some ppl get depressed after stopping suboxone, yes, but so do some ppl stopping full opiates.

I wouldn't think too much on all this, ur doing great!!

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PostPosted: Sun May 07, 2017 3:20 pm 
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Alrite, thanks for the quick replies guys. As I suspected, most people's experience are again the smorgashboard of symptoms, with everybody's pattern of WD's slightly different, without much to indicate that very specifically mood problems will strike 2 weeks in.

I always knew this was gonna be a marathon process, not just during the taper but after the taper as well. Even though the actual jump went very good, brain still just needs time to heal and the rollercoaster will continue but in the long run even with runs of bad days here and there the overall trend is perhaps not every day better than the previous but at least every week better than the previous.


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PostPosted: Mon May 08, 2017 7:29 am 
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Ur doing great dsh! Keep pushing because u are a lot braver than me and ur journey is definitely inspiring.

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PostPosted: Mon May 08, 2017 1:00 pm 
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The pictures are from a marketing department. I wouldn't take them too seriously.

I usually point out that nobody comes off one opioid or another; the issue is coming off a high opioid tolerance, and going through the process of resetting your tolerance. But You wrote that you were on up to 300 mg of oxycodone per day, and then on Suboxone for 45 days?! If that's the case, you aren't coming off buprenorphine at all-- you're coming off oxycodone!

If you were just coming off buprenorphine, your misery would be much, much less-- because the maximum tolerance would have been limited to about a quarter of where yours is. The challenge is pushing tolerance back down, and on buprenorphine, tolerance never goes very high.

Other than the tolerance issue, it doesn't matter which opioid is taken. Endorphins support mood, and during withdrawal, endorphin tone is low, so mood drops. People prone to depression probably struggle a bit more than others.


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PostPosted: Mon May 08, 2017 3:40 pm 
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Hey thanks for the reply. You are right, at the end of the day, which specific opioid you take is less relevant as they all work on the same receptors in the brain. Yes, suboxone has very helpful special properties to help treat physical dependence/tolerance, but at the end of the day we are still talking about mu receptor activating substances.

My last day of high dose oxycodone was about 7 weeks ago, but obviously 5 weeks of that time off oxycodone was spent on a different opioid still activating mu receptors. Now 2 weeks out from all that stuff, I'm still a baby in terms of clean recovery time so it will be an ongoing process of slow gradual recovery.

This is what tripped me up my only real previous serious attempt coming off opiates... it happened in Summer 2016 I did it CT, made it fine through acute WD's those weren't even that bad, but what I wasn't prepared and did not expect was the 2-8 weeks of slow recovery of sleep/energy/mood/appetite that followed. I didn't educate myself enough back then, and I thought I would be waking up on like day 5 all sunshine and rainbows and it was all over. Granted, by day 4 I was already feeling 90% better so in comparison to how the acute WD's felt, it seemed like I was not just already 100% but 120% so I felt I was in the sunshine and rainbows part and had the dependence completely beaten, but then as the days went by and kept going by, it turned into a dog day slog as just laying on the couch I felt fine, but any attempt to get up and do anything would be a total lead suit weighted down feeling; also still no appetite and poor mood but again all improving. Even though I started turning a major corner at the 3 week mark, the marathon process made me justify to myself "well I'll just take some 5mg vicodin/oxycodone 2-3x a day to get my energy back faster and then drop that habit CT no problems no symptoms after just 1-2 weeks of that no sweat" which of course led to a full relapse.


This time around, I am much more educated on the process, much more aware of the fact that it will take months to heal but each week better than the next, so I am mentally stronger and more prepared for the future. I know where and how I screwed up last time, so going into it this time know much better what to expect and will be ready for the process.


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