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PostPosted: Sat Mar 26, 2016 4:45 pm 
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Hi there!

I've been reading all the sub use discussion boards for two days and this is my first time posting. I wish I would have started reading a lot sooner. After looking for help with my 50-60md/day methadone habit since June I finally found a Suboxone program I thought was a perfect fit for me. But now after reading about proper inductions being very important to ultimate success (success for me is eventual taper to zero Sub and relapse free - I know "success" is individual and different for everyone so I'm not judging anyone else's definition of success) I'm not sure if the program is indeed set up for the best interests of the patient or a one-size fits all program. I'm sure this will be long, it's my nature, so thank you in advance if you keep reading.

BACKGROUND: 40-something female started with hydrocodones 10 yrs ago eventually discovering more bank for my buck with methadone 5 yrs ago. Started with breaking the meth. pill into 8 pieces taking one piece a day and ended up taking 5-6 whole pills/day the past year - 18 mos. I split my dose to 2x/day - upon waking and upon returning home from work. I am a professional in a high-pressure consulting firm so needed to be on my A-game 24/7 and I believed opioid abuse was the only way to maintain the level at which I needed to perform. I dabbled with adderall but that was significantly harder to keep a steady supply. I thought because I could go a couple days without using methadone to switch to adderall with little to no wd I wasn't addicted. Most recently I was using the minimum of meth amount to not feel sick - not on my A-game, just enough to get up and go to work. This was a wake up call, my work was slipping. Worst of all, I have 3 children and days I knew I would have low or no supply of my DOC, they got those days. They got "sick" mommy and it was beginning to get old to them. Mommy was always sick. This was/is no life. I tried a few treatment programs. They were mostly filled with 20-something, court ordered, mandatory 3-4 days/week group, urine tests in front of the newly graduated "counseler" who never even took more than a sip of wine in her life and not even getting into see the medical staff for several weeks. I tried CT a couple times...ending up in front of my primary phys. crying and getting sent home with Xanax and a suggestions to try private detox or therapy. Ended up in therapy and prescribed Effexor and klonipin while still searching for a sub program. Lots of waiting lists, many with unrealistic requirements for someone with any responsibilities (kids, job, life)like daily counseling, AA/ NA mtgs and little papers needing signatures to confirm attendance, observed urine tests, etc. this past Monday found naabt.org doc match. Signed up and 2 docs contacted me. After looking at the spa like facilities on a snazzy website I thought I found everything I was looking for and made an appointment for Thursday. It was like a dream, 2 days! I was so excited and hopeful.

(If you are still reading - thank you. It feels therapeutic to tell my story so I'm going to keep going. Sorry about the length!)

FIRST APPOINTMENT: sweet voiced, kind, compassionate nurses checked me in, allowed a private urine sample, offered water, and asked about my comfort. Less than 5 min wait time. The other two people in the waiting room could have been drug reps or patients. The doctor herself (one of three) drew my blood. She chatted while drawing. I was impressed all sample analysis was done on site. Once she escorted me to her office she took a full medical and use/abuse history. She expressed concern in all the right places, very compassionate but almost a little too much. I know my addiction is ultimately my fault. I can't blame the dentist that took my wisdom teeth 20 yrs ago that prescribed lortabs but it seemed as if she was trying to assure me, it wasn't my fault, it's a non-discrimating disease (yes, but I have some responsibility). She did a full physical. We spend at least 40 min together before she said I was a fit for the program (nurse brought in results of tox screen, kidney & liver value while we were talking). She explained that my ins would cover the meds. The first appt was $300, cash only. I would need to come back weekly for a month at $135/appt, biweekly for a month and then monthly. She said that she recommended at least a year of maintanance before tapering bc relapse rates were high for <1 year.

INDUCTION: Anyway, I was 27-hrs from my last dose. I said I didn't want to take any until at least tomorrow. She gave me a script for 14 8mg, instructed to take 8mg at 6 am and another 8 mg at 6 pm.

QUESTION: I didnt do research beforehand bc no time. And, I trusted the doctor. No doctor has spent that much time with me, seemed as concerned, and passionate about helping people get on with there lives. Surprising luck I took vacation Friday (induction day) and all next week to spend time with the kids over break well in advance of all of this. I've been reading everything there is to read for the past two days but not before I took 16 mg in one day in a split dose did I learn about proper induction. So, 8 mg was really too much to start? Following up with another 8mg was a bad call - that explains the awful headache and nightmares? Should I stop and do induction in a coupme days in increments for better chance of my definition of success? 16 mg is really too much to stay on? Do I confront my doc or play dumb asking probing questions? What should I take the rest of the week? I took 8 mg this morning, feeling ok so skip evening dose? I'm afraid the split does is too similar to my abuse habit. Throw the Klonipin out (she didn't even bat an eye when I mentioned I take as needed)? The other large discussion board at the drugs.com site advocates a quicker taper/wean....her statistics are correct based on my reading, so is there any evidence at all to shorten the taper except for Roberts123's cocky insistence?

Thank you for reading my book! And, any insight or guidance is very much appreciated. I need to make this work and I want to do it right.

Namaste.


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PostPosted: Sat Mar 26, 2016 7:40 pm 
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There is no science behind the idea of a 'quick taper/wean'. There have been several studies of people treated with buprenorphine, and they always show the same thing-- that use of buprenorphine for a year or less has a relapse rate over 95%. That issue has been settled for years, and I'm surprised anyone still argues the point.


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PostPosted: Sat Mar 26, 2016 8:34 pm 
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Charm, welcome to the talk zone. I'm not sure what you want a "do over" on here or why. You are already inducted to sub. You can't un ring that bell. If you want to take a lower dose that certainly could be considered. However you don't need to re-induce to do that.

Secondly it sounds like you have a great doctor. Now it's time to start listening to her.

Which brings me to my main point: you want to be in charge, in control, and do it your way. STOP! If your way worked, you would not be in This situation. The goal should be to restore your life and remain out of active addiction for many, many years - hopefully the rest of your life. Rather than that goal you seem to want the goal of getting off of sub. That can be a secondary goal, but not the number one. Do you want to win the battle or win the war? You may well win the battle and get off of sub. That may cost you the war.

It's time to give up the battle for control and be The patient. We can all help you do that along with your doctor but you'll have to want To listen. As two doctors have already told you and a paramedic is about to tell you, stopping sub in then next 12 months will lose the war. Don't do it.


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PostPosted: Sat Mar 26, 2016 11:24 pm 
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Hey Charm,

Welcome Welcome!

Agree w Donh in every way!!! Imo, bup docs hear lie after lie and often do not really know what dose to start. Or, its their standard dose bc it covers most needs. If your start dose is too high, that's easily fixed. But that's not an issue, the rapid taper-only is the issue! Bup is an important remarkable tool that will get you out of active addiction. It will stabilize you to live a good life and help keep your family and job. But you have to do the rest, which takes time, while on bup, to make changes in your life. I had a long hard 10yr run on fentanyl. Major fail. I'm now a few yrs off bup and NO way could I have gotten here wo my time on bup + recovery work. And coming here counts.

There is incredible valid information here that can help you. I hope you keep reading and reading and that you come here to listen and to learn. If you do, it will be well worth it for you. We are here to support you. Wishing you my very best, P

_________________
Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


Last edited by Pelican on Sat Mar 26, 2016 11:56 pm, edited 1 time in total.

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PostPosted: Sat Mar 26, 2016 11:48 pm 
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Thank suboxdoc for the reply and confirmation. I'm guessing it's a case of someone in the 5% that can't accept that the other 95% are different. Ive encountered a number of instances where the minority is often the loudest and most persistent and therefore most often quoted despite the accuracy of their views.

Thank you Donh for your comments. You are an excellent observer. I'll admit I have been pegged as a control freak now and then. I am wired tight and goal oriented. I have lists everywhere. I seriously get enjoyment from crossing something, anything off a list. Lots of jokes come my way...."did you have an agenda for your honeymoon" sort of thing and I do have a dry erase board in my kitchen for family meetings. Being a bit in control isn't necessarily all bad but to an extreme, yes that is, I'm working on this with my therapist. I'm understanding that my expectations, including for myself, are at times not realistic and cause many of my problems. I didn't mean to sound like I expected this to be a short walk in the park. I was just surprised that over a year is the often necessary and maybe indefinitely to keep from abusing. I didn't really know much about sub until the last couple days, just heard its benefits and praise. My doctor took almost an hour explaining it to me so I could decide if it was for me. What we didn't talk about (I couldn't expect her to spend all day with me,lol) was execution, I trusted her as the expert. Then I got on the Internet and started second guessing...maybe I wasn't doing it the best way. So many seemed to start so much lower or did it observed in the doc office. More individualized seems more logical to me. Would being at too high or too low a dose for a week impact me negatively later? Those are the sort of things eating at my thoughts.

I got a really bad headache last night. Too much sub, too little, unrelated? I had horrible sleep. Around 2 am I started to finally sleep but entered right into a sleep paralysis episode, twice! They are so terrifying for me I went to sleep on the recliner in the den knowing I wouldn't sleep deeply there and enter rem. related to late sub dose or anxiety of something new? I took my 2nd dose as instructed today. That is habitual for me. I was watching the clock, looking forward to it but I don't know if I really needed it. I was quite irratible until I took it. I'm looking forward to tomorrow. Everyday I don't use my DOC is like crossing something off a list :D


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PostPosted: Sun Mar 27, 2016 1:00 am 
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Thank you for your reply Pelican. I get the support thing, especially platforms like this. About seven years ago I went through something else and met some amazing friends with a similar issue. We're still in touch well after our problems were solved. I keep thinking about AA/NA groups too but....not ready yet and I have such limited free time during the day with my job and children. They are still young. I've read posts on many discussion boards but found the community here more supportive in their interaction and less drama filled. I want to learn from folks who have been there, done that but without the drama. Thanks again. I hope I can sleep a bit tonight. Still a little freaked out about the sleep paralysis last night.


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PostPosted: Mon Mar 28, 2016 7:32 pm 
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To be honest with you, you in all likelihood will feel the same on 8 mg per day rather than the. Somewhat standard 16 mg dose you have been started at. As a practical matter you'll likely Not feel any different if you cut the strips in half. For most people it's far more mental than physical. It really won't matter if you start at 16 mg and quickly drop to 12 and then 8. You are not doing damage as for the average person anything over 8 mg makes no difference in how they physically feel other than how long it lasts.

Therefore if You want to try cutting the stips in half and take 4 mg am and 4 mg pm, you should do fine. If not, go back to 8 and 8. The sleep issues should resolve at either dose. Many people expierence a boost in energy from opiates - bup included. Doing a lower dose may even improve this for you. That said your body will quickly get tolerant to either dose and your sleep will adjust. After a few. Days to a week you won't. Feel anything after dosing other than feeling normal. The long life of. The drug evens out your tolerance.

If you want to check off goals, that's fine. There will be many to check off. Just making stopping bup the very last goal. You'll have many others to check off before that.


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