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PostPosted: Fri Jan 27, 2012 5:32 pm 
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Well. The inevitable has happened. Needing surgery on wrist (fracture of ulnar stloid and scapholunate tear/reconstruction of both bones) Cast 8 weeks (hard cast) then another 8 weeks with splint.

On .5 mg twice daily. Doctor says to discontinue 1 week prior to surgery. Is this going to work? Are the pain meds going to work at all???? Really scared as doctor said this is a painful surgery.

I fear I will go through withdrawals too if I stop for that week. I know I will as I do when I reduce my dose anyway. :(

Doc. wants to do the surgery sooner rather than later because the bone shifting will get worse. Scheduled for February 12th.

Thanks for the support.

Diane
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 Post subject: full agonist??
PostPosted: Fri Jan 27, 2012 5:53 pm 
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Also wondered if I should start on some vicodin (to prevent the nasty withdrawal of stopping sub) and to help with pain before surgery??

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PostPosted: Fri Jan 27, 2012 11:51 pm 
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Hi BK!! It's good to hear from you again, albeit under crappy circumstances.

I really don't have any experience with surgery while on Suboxone, but I've read a lot of the threads about it and it is suggested to quit Suboxone well before the surgery. 1 week sounds like plenty of time to me. Yes, you would more than likely feel wd when you quit your Suboxone and if I was you, I would take Vicoden for that week. You're gonna have to be careful though, pain pills are what got us into trouble to begin with.

Hopefully someone with more knowledge on this subject matter swings by and offers you some more advice.

Take care Bud!

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PostPosted: Sat Jan 28, 2012 12:55 pm 
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Romeo wrote:
Hi BK!! It's good to hear from you again, albeit under crappy circumstances.

I really don't have any experience with surgery while on Suboxone, but I've read a lot of the threads about it and it is suggested to quit Suboxone well before the surgery. 1 week sounds like plenty of time to me. Yes, you would more than likely feel wd when you quit your Suboxone and if I was you, I would take Vicoden for that week. You're gonna have to be careful though, pain pills are what got us into trouble to begin with.

Hopefully someone with more knowledge on this subject matter swings by and offers you some more advice.

Take care Bud!


Thanks very much! Yes the withdrawal from suboxone isn't fun. I missed a dose once and that was enough proof to me! I think i definitely will do the vicodin for that week and hope it helps me from most of the nasty withdrawal to get through surgery. Thank for your reply.

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PostPosted: Sat Jan 28, 2012 2:25 pm 
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Hey Ustar,

I have been through two major surgeries in two months and know something about pain. Like you, I was on 1mg and stopped the day before the morning surgery. It took about a week for the Hydro 10's to make a dent. The second time I went onto Hydro three days before and that seemed to help.

My problem was not getting strong enough pain meds in the hospital. You will probably receive proper pain treatment as mine was an unusual case. My Sub Dr. said I should have been on Morphine or equivalent.

With you being on 1mg split, your body will rid itself of it fairly soon. It's your tolerance that poses the problem. Your plan of taking Vicodins sounds good on paper but can you not abuse them? I did okay three days before because I knew I was in for some major pain. That was my motivator.

Good luck with your surgery and post back how the pain relief went. There really isn't enough information online for others to find.

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PostPosted: Sat Jan 28, 2012 4:05 pm 
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6. 7..Well i can tell you one thing i have dealt with stopping suboxone and going back to opiates when i switched to methadone. And i was on alot more subs than you as in 24mgs did a two week taper and than went without any sub for a few days. And the wd sucked but were not so bad as i think alot of people make it out to be. I was sick but still going to groups hanging out with my gf seeing my counselor so it wasnt terrible. I mean you are on such a low dose u might have very lil wds but nothing serious. But dont convinced yourself that is going to be a nightmare bc if u do than thats what will happen. Your mind is very powerfull and the best advice i can give u is stay busy.

As if starting the pain meds early i would wait and see hriow u feel during the taper/detox bpefore doing that. The less time on the pinkillers the better.

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PostPosted: Sun Jan 29, 2012 1:39 am 
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rule62 wrote:
Hey Ustar,

I have been through two major surgeries in two months and know something about pain. Like you, I was on 1mg and stopped the day before the morning surgery. It took about a week for the Hydro 10's to make a dent. The second time I went onto Hydro three days before and that seemed to help.

My problem was not getting strong enough pain meds in the hospital. You will probably receive proper pain treatment as mine was an unusual case. My Sub Dr. said I should have been on Morphine or equivalent.

With you being on 1mg split, your body will rid itself of it fairly soon. It's your tolerance that poses the problem. Your plan of taking Vicodins sounds good on paper but can you not abuse them? I did okay three days before because I knew I was in for some major pain. That was my motivator.

Good luck with your surgery and post back how the pain relief went. There really isn't enough information online for others to find.


Thanks for posting. I appreciate your input tremendously. My question on the time you started the hydrocodone 3 days before surgery. How long did you stop the sub. before you started the vicodin?? How often did you take vicodin before the surgery to stay comfortable (out of withdrawals from the sub??) I won't abuse the vicodin becuase I too am afraid of being in some major pain after surgery!! I just don't want to be sick from not taking any sub. I feel withdrawal from those rather quickly (when I am ready for night dose I know it). I hope they give me strong enough meds in the hospital. What did you discuss with you doctors for them to keep you comfortable the second surgery??? Were you on vicodin post surgery for very long and did you go back on the suboxone?? I know these are alot of questions but please post if you can!

My sub. doctor wants me to stop taking suboxone on Monday and start tylenol 3 (really???) I told him that tylenol 3 makes me nauseous (it really does). he wants me to take that over the vicodin for obvious reasons but I don't think it will help at all with sub. withdrawal before surgery.

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PostPosted: Sun Jan 29, 2012 1:43 am 
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Bboy42287 wrote:
6. 7..Well i can tell you one thing i have dealt with stopping suboxone and going back to opiates when i switched to methadone. And i was on alot more subs than you as in 24mgs did a two week taper and than went without any sub for a few days. And the wd sucked but were not so bad as i think alot of people make it out to be. I was sick but still going to groups hanging out with my gf seeing my counselor so it wasnt terrible. I mean you are on such a low dose u might have very lil wds but nothing serious. But dont convinced yourself that is going to be a nightmare bc if u do than thats what will happen. Your mind is very powerfull and the best advice i can give u is stay busy.

As if starting the pain meds early i would wait and see hriow u feel during the taper/detox bpefore doing that. The less time on the pinkillers the better.


Thanks for the reply. The withdrawals likely are not going to be s bad as yours but the sub for me is very powerful! I feel sick when I don't take my next dose in time! I can my body "needs" it right now. Also get very depressed without it unfortunately. When did you finally feel "well" after not having any opiates in your system? (especially the sub) Thanks!

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 Post subject: Time Gap
PostPosted: Sun Jan 29, 2012 3:14 pm 
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Even though you and I were taking the same 1mg dose, you are splitting it and I didn't. So to answer your question about when I stopped the Sub; I take my dose at 10am once a day. The next day I started the Hydro. I suppose I could have waited for several hours until some w/d kicked in but why suffer needlessly? Barely felt the first dose but it improved as days went by.

You are way below the ceiling so the w/d's come on fast. I too would feel minor w/d's by around 3-4pm if I skipped my morning dose. Only tried that once to see how long it would take.

Warning, warning, warning.....once you get that fuzzy good feeling again you will be tempted to take more than prescribed. That was my downfall. Went a little nutty for 2-3 days and went back on my beloved Sub. For the pain I took two Aleve and those actually work pretty good. Pissed me off that I couldn't control my meds. But damn I felt good for a few hours.

My next painful journey is radiation treatment. Either my Oncologist or a Pain Clinic will give me pain pills. This time around I will have my wife dole them out. My plan is to go out and buy a small combination safe that she and only she will have the number to. There isn't a hiding place in or out of the house that I can't find. Addicts can smell their doc's. It may sound silly but if anyone has a better idea let me know. Stupid F##king addiction!

After I'm dead, I will leave my brain to science to see just how different an addicts brain works vs a non addict. I've seen a TV show that had a CT scan of an addicts brain and a normal one. There is a difference.

Addiction is "Covert Suicide"

Rule

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 Post subject: Re: Time Gap
PostPosted: Mon Jan 30, 2012 12:43 pm 
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rule62 wrote:
Even though you and I were taking the same 1mg dose, you are splitting it and I didn't. So to answer your question about when I stopped the Sub; I take my dose at 10am once a day. The next day I started the Hydro. I suppose I could have waited for several hours until some w/d kicked in but why suffer needlessly? Barely felt the first dose but it improved as days went by.

You are way below the ceiling so the w/d's come on fast. I too would feel minor w/d's by around 3-4pm if I skipped my morning dose. Only tried that once to see how long it would take.

Warning, warning, warning.....once you get that fuzzy good feeling again you will be tempted to take more than prescribed. That was my downfall. Went a little nutty for 2-3 days and went back on my beloved Sub. For the pain I took two Aleve and those actually work pretty good. Pissed me off that I couldn't control my meds. But damn I felt good for a few hours.

My next painful journey is radiation treatment. Either my Oncologist or a Pain Clinic will give me pain pills. This time around I will have my wife dole them out. My plan is to go out and buy a small combination safe that she and only she will have the number to. There isn't a hiding place in or out of the house that I can't find. Addicts can smell their doc's. It may sound silly but if anyone has a better idea let me know. Stupid F##king addiction!

After I'm dead, I will leave my brain to science to see just how different an addicts brain works vs a non addict. I've seen a TV show that had a CT scan of an addicts brain and a normal one. There is a difference.

Addiction is "Covert Suicide"

Rule


Thanks for the reply. I wish you the best with your treatment too! I too am a little worried about taking more vicodin than I need due to addiction but I am going to try my best. Did you find that the 24 hours was sufficient to not put you into precipitated withdrawal whenyou started the full agonist?

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PostPosted: Mon Jan 30, 2012 12:45 pm 
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"You are way below the ceiling so the w/d's come on fast. I too would feel minor w/d's by around 3-4pm if I skipped my morning dose. Only tried that once to see how long it would take. "

Rule-you state the above. Can you explain why withdrawal happens faster in those below the ceiling?

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 Post subject: Ceiling
PostPosted: Mon Jan 30, 2012 1:16 pm 
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I can only give opinions but it's probably just because you and I were on a lower dose. The ceiling is supposed to 4mgs. Anymore after that and the body stacks it up. That is why with someone on 8mg of Sub doesn't experience w/d's for several days. The lower you go under 4mgs there isn't a stacking effect anymore so the drug wears off faster. 1mg is really a low dose even though we both know it still feels strong.

And no, I had no w/d going from Sub to Hydro or back to Sub from Hydro. You can mix the two you know? Read Dr. J's article on pain management on Sub. He recommends low dose Sub with full agonists. I don't quite agree with that but he is a Dr., not me.

Did I answer all your questions?

FYI, I am out of Sub and have no pain meds. Am I freaking out? No, because I was taking 6mgs and know it's stacked up inside. What happened was most all of CVS pharmacies don't have any Lortab 10/500. They suggested calling my Dr. and having it changed to 10/325. Noooooo, I will not call him. I'll start calling other RX's until I find one that has it. If it takes a day, it takes a day. If I have to go back in to my Sub Dr., I will. No big deal.

Rule

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PostPosted: Mon Jan 30, 2012 4:20 pm 
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Hey BonoKisser,

You asked, "Did you find that the 24 hours was sufficient to not put you into precipitated withdrawal when you started the full agonist?", I think you're asking about going from Suboxone to pain meds with this question. It's my understanding that you can go from Suboxone to pain meds without worry of precip. wd because of Suboxone's massive affinity for the mu receptor.

It's going from pain pills to Suboxone that can bring on the risk of precip wd because with Suboxone's high affinity for the mu receptor, it will "knock off" all other opiates that are attached to the mu receptor and this is what causes precip wd. I believe the fact that Suboxone is an antagonist at the kappa receptor has something to do with precip wd too.

Anyway, you shouldn't have to worry about precip wd while going from Suboxone to pain pills.....if that was even your question? :?

Hey Rule, I hope you find your 10/500's soon, I'm surprised most every pharmacy doesn't carry those?

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PostPosted: Mon Jan 30, 2012 4:35 pm 
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Romeo wrote:
Hey BonoKisser,

You asked, "Did you find that the 24 hours was sufficient to not put you into precipitated withdrawal when you started the full agonist?", I think you're asking about going from Suboxone to pain meds with this question. It's my understanding that you can go from Suboxone to pain meds without worry of precip. wd because of Suboxone's massive affinity for the mu receptor.

It's going from pain pills to Suboxone that can bring on the risk of precip wd because with Suboxone's high affinity for the mu receptor, it will "knock off" all other opiates that are attached to the mu receptor and this is what causes precip wd. I believe the fact that Suboxone is an antagonist at the kappa receptor has something to do with precip wd too.

Anyway, you shouldn't have to worry about precip wd while going from Suboxone to pain pills.....if that was even your question? :?

Hey Rule, I hope you find your 10/500's soon, I'm surprised most every pharmacy doesn't carry those?


Thanks Romeo. This seems logical to me. Thanks very much.

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 Post subject: Thanks!
PostPosted: Mon Jan 30, 2012 4:37 pm 
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Romeo wrote:
Hey BonoKisser,

You asked, "Did you find that the 24 hours was sufficient to not put you into precipitated withdrawal when you started the full agonist?", I think you're asking about going from Suboxone to pain meds with this question. It's my understanding that you can go from Suboxone to pain meds without worry of precip. wd because of Suboxone's massive affinity for the mu receptor.

It's going from pain pills to Suboxone that can bring on the risk of precip wd because with Suboxone's high affinity for the mu receptor, it will "knock off" all other opiates that are attached to the mu receptor and this is what causes precip wd. I believe the fact that Suboxone is an antagonist at the kappa receptor has something to do with precip wd too.

Anyway, you shouldn't have to worry about precip wd while going from Suboxone to pain pills.....if that was even your question? :?

Hey Rule, I hope you find your 10/500's soon, I'm surprised most every pharmacy doesn't carry those?


Thanks Romeo. This seems logical to me. Thanks very much.

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 Post subject: Thanks again
PostPosted: Mon Jan 30, 2012 4:42 pm 
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Romeo wrote:
Hey BonoKisser,

You asked, "Did you find that the 24 hours was sufficient to not put you into precipitated withdrawal when you started the full agonist?", I think you're asking about going from Suboxone to pain meds with this question. It's my understanding that you can go from Suboxone to pain meds without worry of precip. wd because of Suboxone's massive affinity for the mu receptor.

It's going from pain pills to Suboxone that can bring on the risk of precip wd because with Suboxone's high affinity for the mu receptor, it will "knock off" all other opiates that are attached to the mu receptor and this is what causes precip wd. I believe the fact that Suboxone is an antagonist at the kappa receptor has something to do with precip wd too.

Anyway, you shouldn't have to worry about precip wd while going from Suboxone to pain pills.....if that was even your question? :?

Hey Rule, I hope you find your 10/500's soon, I'm surprised most every pharmacy doesn't carry those?



So I don't have to wait until I am in full on withdrawal to start the vicodin to help with the sub. withdrawal. I would like to be off of suboxone at least 1-2 weeks pre-surgery. Wouldn't that be best for pain control even if I am going to start some vicodin?

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PostPosted: Mon Jan 30, 2012 5:06 pm 
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Yeah, you can actually be on Suboxone and take Vicoden without worrying about precip wd. The Suboxone grips those receptors so tightly that lowly Vicoden isn't enough to "knock" the Suboxone off the receptors, thus, no precip wd.

When I quit Suboxone, I made it 18 hours before I panicked and took 2 hydrocodone 7.5mg. Those 2 Hydro's kicked in like nobody's business. I was really quite surprised that I felt their effect after having only been off Suboxone for 18 hours. BUT, there are also many people who state they've been off Suboxone for days and days and still barely feel Hydro's if they take them.

This uncertainty is why we suggest you discontinue Suboxone well before surgery.

Not to muddy the waters, but there is also the question of tolerance that comes into play. Suboxone can raise your tolerance to opiates, so if you switched to Vicoden the day before your surgery, Suboxone may have raised your tolerance so high that you wouldn't get any real pain relief from the Vicoden. So, quitting Suboxone early gives your body a chance to lower its tolerance to opiates too, BUT, you can NOT mess around and take a shit load of Vicoden during this time or it will raise your tolerance and you'll end up with no pain relief.

Also, you need to know this, I have NOT experienced any kind of surgery while on Suboxone so most everything I just said is information that I've picked up while cruising this here web-site. None of what I said, as it pertains to the surgery, comes from personal experience, at best, it's all educated guessing.

BTW, Bono emailed me yesterday and he told me to tell you that he thinks you're super cool and he said you're a great kisser!!! :D

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PostPosted: Mon Jan 30, 2012 7:17 pm 
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Romeo wrote:
Yeah, you can actually be on Suboxone and take Vicoden without worrying about precip wd. The Suboxone grips those receptors so tightly that lowly Vicoden isn't enough to "knock" the Suboxone off the receptors, thus, no precip wd.

When I quit Suboxone, I made it 18 hours before I panicked and took 2 hydrocodone 7.5mg. Those 2 Hydro's kicked in like nobody's business. I was really quite surprised that I felt their effect after having only been off Suboxone for 18 hours. BUT, there are also many people who state they've been off Suboxone for days and days and still barely feel Hydro's if they take them.

This uncertainty is why we suggest you discontinue Suboxone well before surgery.

Not to muddy the waters, but there is also the question of tolerance that comes into play. Suboxone can raise your tolerance to opiates, so if you switched to Vicoden the day before your surgery, Suboxone may have raised your tolerance so high that you wouldn't get any real pain relief from the Vicoden. So, quitting Suboxone early gives your body a chance to lower its tolerance to opiates too, BUT, you can NOT mess around and take a shit load of Vicoden during this time or it will raise your tolerance and you'll end up with no pain relief.

Also, you need to know this, I have NOT experienced any kind of surgery while on Suboxone so most everything I just said is information that I've picked up while cruising this here web-site. None of what I said, as it pertains to the surgery, comes from personal experience, at best, it's all educated guessing.

BTW, Bono emailed me yesterday and he told me to tell you that he thinks you're super cool and he said you're a great kisser!!! :D


Woo-Hoo!!! That is awesome. I always knew Bono loved me and my lips!!! Thanks for the information!

BK!

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 Post subject: Re: Time Gap TO RULE
PostPosted: Mon Jan 30, 2012 7:39 pm 
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rule62 wrote:
Even though you and I were taking the same 1mg dose, you are splitting it and I didn't. So to answer your question about when I stopped the Sub; I take my dose at 10am once a day. The next day I started the Hydro. I suppose I could have waited for several hours until some w/d kicked in but why suffer needlessly? Barely felt the first dose but it improved as days went by.

You are way below the ceiling so the w/d's come on fast. I too would feel minor w/d's by around 3-4pm if I skipped my morning dose. Only tried that once to see how long it would take.

Warning, warning, warning.....once you get that fuzzy good feeling again you will be tempted to take more than prescribed. That was my downfall. Went a little nutty for 2-3 days and went back on my beloved Sub. For the pain I took two Aleve and those actually work pretty good. Pissed me off that I couldn't control my meds. But damn I felt good for a few hours.

My next painful journey is radiation treatment. Either my Oncologist or a Pain Clinic will give me pain pills. This time around I will have my wife dole them out. My plan is to go out and buy a small combination safe that she and only she will have the number to. There isn't a hiding place in or out of the house that I can't find. Addicts can smell their doc's. It may sound silly but if anyone has a better idea let me know. Stupid F##king addiction!

After I'm dead, I will leave my brain to science to see just how different an addicts brain works vs a non addict. I've seen a TV show that had a CT scan of an addicts brain and a normal one. There is a difference.

Addiction is "Covert Suicide"

Rule






This is not helping the op...but I just had to tell you my husband got a small safe (it is a real nice one we had at the funeral home with a key to open it)...I was just like you ...I could find those damn things anywhere he hid them...well........he has the key on his car keys chain and yes i have...walked back to the bedroom..got the key right out of his pants he took off and walked right passed him in the den to the computer room where the safe is kept...got what I wanted and took the key back....so I STILL CHEATED!!!!///...damn addiction is right....Of course I had to pay at the end of the month when I was short i pill (klonopin).....and fess up...caused all sorts of shit....so please get a combination lock that she memorizes and does not write down ANYWHERE....because we are what we are....

Judy


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 Post subject: Long acting pain meds
PostPosted: Tue Jan 31, 2012 3:23 am 
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I am curious why the thought of using ling acting pain meds post surgery may be an option??? I heard MS Contin and Oxycontin, Opana are long acting and wouldn't it prevent the highs and lows off needing a pill every 4-6 hours just to stay out of withdrawal?

Stopping my suboxone before the upcoming surgery is awful. I tried not taking my evening dose and felt terribel!! So I placed a little bit of the sub. film under my tongue and was able to fall asleep and feel better. The sub doc. wanted to do tylenol 3 which in my opinion isn't going to do anything to keep me from sub. withdrawal. Even if I decide to try and get some vicodin and go that rute before surgery I would need to try and keep my doses small and not every 4-6 hours so I am thinking I will still feel crappy taking these if not taken often. The sub. has given me more even "feeling better" days over the short acting full agonists.

Any thoughts?

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"Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way."
— Viktor Emil Frankl (Man's Search for Meaning)


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

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

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