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 Post subject: Winning
PostPosted: Wed Feb 27, 2013 8:42 pm 
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Hi - I am a first time poster, having just found this forum. I've read a lot of your posts and am really impressed by the openness with which everyone is confronting their problems. It's refreshing to read the honesty, love and support everyone is offering. If you're here, you have courage. And it takes courage to confront this dragon we call addiction.

I am a two-back-surgery survivor, and was on Oxy for a little over 3 years (July 2009 - Jan 2013). My max was about 140mg at the worst; luckily I had diminishing returns after that, so I couldn't go any deeper -- no "benefit". I've had a very open and honest relationship with my family and with my provider about taking these pills, never lied, never hid, and always have discussed the end-game with my GP. I'm not an escapee from life's pain, or carrying unmanageable emotional baggage. I have considerable, chronic, unending, life-distorting pain from an original injury and only partially-successful back surgeries to fix the problems. So right off, let me say that I would rather not be taking anything -- that's the goal -- but that if taking nothing means being in pain all the time, I'll go back. A life in pain sucks. I'm too young (almost 50) to feel as lousy as I do all the time.

In my opinion, there's a difference between being an addict, a seeker, or being physically dependent. I'm the latter. I know a lot of people just like me who got in over their heads as a result of legitimate use, or, being irresponsibly over-prescribed by well-meaning but really irresponsible MD's. But in my case, I knew I was getting into this. It was all I had for the pain. I walked in, eyes open. I'm grateful these things exist, but they're dangerous and nobody does a good enough job telling people what they are getting into, IMHO. Too many people get sucked in without having any idea what they're doing.

That said, I felt like it was time to get 'clean', get off everything, and see if I could reset the Dopamine receptors in my brain and get everything cleared out. My goal is/was to wean myself off everything, take a new baseline, and see what I can do about the pain from there, rather than staying doped up. So far, so good. The pain is there, but the clarity of being off the drugs is wonderful so I'm not missing being on the Oxy. What a wonderful change getting off Oxy and unto Buprenorphine. Wow. But honestly, I really, really, really miss the absence of pain. No lie. There is nothing like the warm blanket of the drug covering my effing back pain. But the price is just too high.

My doctor had told me about Buprenorphine and I did a lot of research before starting it. I'm glad I did. I induced withdrawl (for me it was 10 hours to get good and deep into it, and I lasted 13.5h before starting BUP), and took 2mg. A little while later I took another 2mg, and that night I took another 2mg. My doctor had recommended 8-16mg, which I am glad I disobeyed. Buprenorphine is SO MUCH STRONGER and long-lasting than Oxy. I am grateful my instinct was to a) spread it out during the day, not taking it all at once, and b) immediately see how little I could take. This was January 7th. I think once or twice I took all 8mg in a day, but 90% of the time I was on 6mg and it was ample.

Some doctors insist you take it all at once, and some say it's ok to spread it out. My logic in spreading it out was that I never wanted that strong of a 'charge' of the BUP in my system, because I figured it would condition me that much more to higher levels. I'm probably completely off-base, but it worked out. I began tapering for real a little over two weeks ago. It has basically put me into a chronic state of anxiety and pain, but every time I make it nearly a day by stretching out the doses, I feel like I'm winning. Yesterday was awful, because for the first time I had stretched down from 2mg per day, to 1mg for 18 hours instead of 2mg. Mmmmm, 50% reduction. Dumb. I was completely miserable, and finally relented with .5mg at 4pm, and took a sleep aid and slept. I woke up feeling awesome. Had dinner, took a sleep aid for the rest of the night, and woke up feeling really good this morning. I'm going to get through this.

Now it's Feb 27th, and I've worked myself down to 1mg this morning. I use the 8mg films, and cut them evenly into little squares to measure my doses. The transition from 3mg to 2mg to 1mg was awful - simply awful. But today I woke up feeling like the end is in sight. Tomorrow morning I'll take another 1mg, and the next day I'll probably shave some off that. My calculations are that 1mg of BUP is roughly equivalent to 20mg Oxy, but it's a very inexact apples to oranges comparison. I am hoping that my method of taper has spread out the discomfort sufficiently that I don't get whammed when I finally pull the plug. But as I'm taking so little, it's not going to be a burden to ride this down to .75, .5 and .25 until I simply forget to take it and realize one day that I AM FREE.

One quick note. Due to the nature of withdrawal, I highly suggest you have something like xanax or Clonodine or Ativan at your disposal, to take in moderation (I take .25 of a pill toward the end of a 'shift' as anxiety increases, and 1 tablet at night to get to sleep) to help you through the anxiety and restlessness. Sleep is important. If you can't sleep, you can't function, period. I'm grateful my doc prescribed these things. He knows I'm using them properly, and frankly when I'm done with this I'll be tired enough on my own to sleep without them.

But what about the pain? At one point I thought my goal was to come off the Oxy and BUP and reset my receptors, so that I could start back at the bottom of the Hydro/Oxy chain again (hydro 5, hydro 10, oxy 5, 10, etc..), but I realize what an idiot I am for even considering that. Literally, I'm an idiot! After the crap I've gone through to get this far, I NEVER want to consider taking anything that can physically addict me like this again. For me, Oxy was a tool, and it has outlived it's usefulness in my life. I am eternally grateful it was there to get me through the incredible pain. But, I need to find alternate ways, including yoga, massage, naps, TENS, epidurals, or even other non-opioid-based drugs to get past the pain. But really, to even consider going back to the narcotics is to disrespect the living hell that we call withdrawal, and all that have come before me and their sacrifices.

Remember, if you're trying to taper from BUP/SUB, it is SUPER POWERFUL and concentrated. 1mg is roughly equivalent to 20mg Oxy. That's two Percocet. So if you're on 8mg BUP/SUB, you're taking an equivalent dose to roughly 160mg! Give yourself time. Remember percentages. You can't cut 50% at a time without being miserable -- really miserable. Make a calendar and try to stick to it, but don't do too much at a time. Remember what I wrote up above -- I'm at 1mg now, but then it's going to be .75, then .5, then .25. I'm a certified chicken -- I don't like pain, and I don't like feeling like crap. You just have to be disciplined, and no matter what keep your eye on the prize. If I can do it, you can do it. And I still have juicy back pain waiting for me -- but at least I'll own it, I'll know what I'm feeling -- it's all mine. I'll figure out another way.

Good luck. Hope to hear from you. If anyone wants to talk I'll stay tuned.

E


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PostPosted: Thu Feb 28, 2013 2:18 am 
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Congratulations for following through on your goals! From what you describe, I agree that although you're physically dependent on opiates, you are not addicted. I also agree that tapering slowly is the best course. Have you asked your doctor to prescribe a few of the 2 mg strips so that it's easier to shave off a little at a time?

I commend you for recognizing that you were not happy being on narcotics and I hope your pain isn't too overwhelming when you finish tapering. Living in pain is not any better than living on narcotics, so I hope your alternate pain reducing therapies work for you. Good luck!

Amy

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PostPosted: Thu Feb 28, 2013 5:00 pm 
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There is no linear equation between buprenorphine and full agonists such as the Oxycodone you referenced. Sure, 1mg buprenorphine may be roughly equivalent to 20mg Oxycodone, 2mg buprenorphine may be equivalent to 40mg oxycodone and 4mg buprenorphine may be equivalent to 60mg Oxycodone. But that’s where the opioid effects of buprenorphine begin to diminish. Buprenorphine is a PARTIAL-agonist with a ceiling effect on opioid effects whereas oxycodone, methadone, heroin, morphine, fentanyl are all agonists with no ceiling effect on opioid effect; so though 4mg of buprenorphine is roughly equivalent to 60mg oxycodone, 6mg of buprenorphine is also equivalent to 60mg, 16mg buprenorphine is also equivalent to 60mg Oxycodone and 32mg buprenorphine is equivalent to 60mg oxycodone. Once the cieling of buprenorphine's effect is reached, there is no going above it!

T

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PostPosted: Fri Mar 01, 2013 10:29 am 
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Thank you so much for sharing. It was realty refreshing to read something like this. Keep us updated! Love love love your outlook on life.

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