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PostPosted: Sun Sep 04, 2011 9:13 am 
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Hello, I am new here and seeking help for my son. He started suboxone about 4 weeks ago. At first he was on an uber high dose because he seemed to have w/drawal symptoms every 8 hours. He was on 32 mg every 8 hours and began sleeping constantly. We reduced him quickly and he is now on 20 mg every 24 hours with no w/drawal or cravings, but killer headaches started about a week ago. He takes his sub at around 7pm and wakes the next morning with the headache. He has missed most of the last 2 weeks of school. We are still trying to taper, but it doesn't sound from reading this blog that that will probably help with the headaches. His doc called in a migraine med for him, but that just made him sleep more and didn't touch the headache. We are thinking of switching to subutex, but that also sounds unpromising. He has been using the spit out the saliva trick with no results.

I'm terrified for him. I also read we could try the pills rather than film, but that seems iffy too. Anyone have any other suggestions?


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PostPosted: Sun Sep 04, 2011 11:01 am 
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At first he was on an uber high dose because he seemed to have w/drawal symptoms every 8 hours. He was on 32 mg every 8 hours and began sleeping constantly.


Can I just say....Holy CRAP! 32 mg every EIGHT HOURS! I'm sorry, make that holy SHIT! I've never heard of a dose that high. No wonder he was sleeping all the time. OK, the shock has subsided. Sorry about that. Let's move on....

So he's on 20 mg now of suboxone now and even though he's spitting instead of swallowing, he's still got the headaches. First I'd advise trying to lower his dose if you can. Lowering one's dose very often makes the side effects subside - OR - you can ask to be switched to subutex. You could, for whatever unknown reason be absorbing some of the naloxone still. That is probably the better option, especially if he hasn't stabilized on a dose yet or is having trouble getting down in dosage.

I hope this helps. Let us know how he's doing.

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PostPosted: Sun Sep 04, 2011 11:12 am 
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I agree with everything hat said and wanted to let you know I experienced headaches in the beginning and the slowly subsided. Now I do not get headaches at all. I think for me my body just had to adjust to the sub. I was also super sleepy for a while and that is gone now too. I just wanted to relay my experience. Oh and I also agree, holy shit! 32mg of sub every 8 hours is the most crazy high dose I have ever heard of! I hope your son finds the relief he needs!


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PostPosted: Sun Sep 04, 2011 11:30 am 
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I would get headaches on Suboxone when I would take fairly high doses. If I remember correctly, anything above 16mg would give me a headache.

Like Breezy said, his body may still be adjusting to the Suboxone. You have to remember, his brain and body are trying to cope with getting off his drug of choice and get used to Suboxone, for many, it does take some time to stablize on Suboxone. Although, by 4 weeks, I would expect he would be getting pretty close to stable?

Good luck ayladare.

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 Post subject: thanks everyone
PostPosted: Sun Sep 04, 2011 12:26 pm 
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Please keep the advice coming. I know the initial dose was nuts. He started with 24 mg but woke up with a headache vomitting. My son now thinks the headache and vomitting was from the suboxone but we all mistook it for w/drawal and kept upping the dose. Oddly the headache and vomitting did not happen on the really high dose, but the headache returned when we had him back to 24 mg every 24 hours. He is now down to 20 mg every 24 hours and I want keep weaning him. His doc and dad want to do it very slowly. I am less patient and want to drop to below 16 mg ASAP. The headache is his only symptom so I don't think he is having w/drawal.

This may sound like it is from left field, but my son is Asian. His liver cannot process alcohol (he immediately flushes and vomits), so I wonder if his genetics may also have some bearing on his issues with suboxone. Does any one know of special considerations or impacts of this drug on different races.


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PostPosted: Sun Sep 04, 2011 1:02 pm 
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I do not know anything about the impact on different races but wanted to give you a bit of insight into how sub works. There is a ceiling effect at around 4mg, this means that all of the opiate receptors are saturated at this point. However a lot of people have to take more than 4mg to address their cravings. The dose to address cravings is different for every person. So your son can try lower doses say 16mg or even 12mg to see if it helps his symptoms without fearing withdrawl symptoms. I also use sub to control my pain and my doses can range from 8-24mg and I do not experience withdrawl symptoms when taking the smaller doses. Also sub has a very long half life about 37 hours. For example 37 hours after taking 32mg, there is still 16mg left in his system. So you get a stacking effect. With how much your son was taking he has a ton of sub in his system. Now all that being said you really have to let your son decide which dose works best for him, you can pass on all this info so he is not scared to experiment with a lower dose. I am a parent and know it must be hard to give up control, especially in a time like this but your son is the only one who knows how he is feeling so he really needs to be the one to decide. I also wanted to know if he is getting counseling or attending AS/NA or some other form of support? Sub is a very helpful tool, but it is not a cure all. He will need help to learn why this happened and how to avoid relapse in the future. I hope this info has helped you to better understand sub and you are doing a great job supporting your son and sealing information. It is evident you love him very much and want to applaud you on how you are handling this very stressful situation, your support gives your son a fighting chance!


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PostPosted: Sun Sep 04, 2011 1:48 pm 
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If you don't mind me asking, how severe was your son's addiction since I've never heard of a person being prescribed such a high dose. Suboxone/Subutex has a ceiling effect of 32mg, meaning taking any more medication besides that would prove useless. Also, Suboxone has a very long half life, anywhere between 24 hours and 72 hours, so maybe the doctor isn't that experienced with Suboxone? You'd be surprised at the large amount of doctors out there who really don't know what they are talking about when it comes to Buprenorphine.

Anyways, about the headaches. Your son could be sensitive to naloxone, which is the other active ingredient in Suboxone that has zero purpose. Subutex is the same thing as Suboxone, minus the Naloxone and it comes in a generic version, making it less than half the price of Suboxone. I have been on Suboxone for over a year and a half and I switched over to Subutex due to financial reasons and I've seen a huge decrease in my headaches, as well as sweating. You need to make sure that you keep your son as hydrated as possible too. When people first start Suboxone they either get really, really thirsty, or they literally don't drink any water all day. So, make sure that your son is staying hydrated since dehydration can lead to some nasty headaches that can't be cured by taking a few Advil or Tylenol.

Long-term opiate abuse can really mess with a person's health. Opiate addiction in males can mess with their thyroid levels, as well as their vitamin B levels, and their testosterone. I didn't have insurance so it took me a while to get labs done but when I finally did I found out that all of these levels were very low, so I started out on a thyroid pill, along with Testim, which is a testosterone gel that you put on your shoulders and upper arms once daily.

These medications can take a while to really build up in your system though. So, for the short-term my doctor prescribed me adderall to keep me awake. It has made a HUGE difference. Before, I could literally sleep for 12 hours, then get up, and be dead tired all day. The fatigue. was so bad that I would fall asleep while in the shower, or brushing my teeth, or even standing in line at the store. Since the starting the adderall I can actually manage to sit down for a second without instantly falling asleep. Adderall and Suboxone work great together and there is absolutely no sort of bad interactions between the two.

I'm 23 years old now but I started abusing prescription pain meds and other drugs when I was thirteen. Drug use, especially during puberty can take a toll on the body and throw levels all out of whack. Then again, none of these things could be whats wrong with your son, I'm just trying to provide you with some ideas to look into.


Good Luck.

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 Post subject: Severity of addiction
PostPosted: Sun Sep 04, 2011 6:08 pm 
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I'm told by the doctor that my son had a very high tolorance for a kid his age and it was built over a relatively short time. I was told he had about a $50/day habit of Oxycodone, Hydrocodone or anything he could get. I knew he was lifting money from me, but apparently kids in school pass this stuff around like candy. He didn't pay for a lot of it.

His doctor is a psychiatrist who specializes in opiate addiciton and ADHD, so getting a Rx for atteral would not be difficult; I just hate to add more meds unless absolutely necessary. The doctor said this is the first time he's experienced a patient with severe headache and sleepiness. It's hard for me to imagine him not having experience with these symptoms since they seem fairly well documented. The doctor suggested that my son might be eggagerating to skip school, but I don't think so since he is sleeping 12 -18 hours at a stretch. He might have a low pain tolorance but he's not faking that kinda sleeping. If he wanted to skip school I would think he would want to spend his time doing something more exciting than sleeping, wth mom checking his pulse and respiration ever hour. Not my idea a fun "skip" day.

I don't think he's dehydrated because he is going through Powerade like crazy. I started to wonder if too much sugar or electrolytes were contributing and told him to switch to water, but it had no effect.

A blood workup is something I will have done; although it's strange. Once he wakes up and the headache subsides he's his usually very (and I mean very) energetic self. It's like a light switch that goes on and off. I would think any systemmic problem would manifest itself all day and night, not just through the early afternoon.


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PostPosted: Sun Sep 04, 2011 8:24 pm 
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It sounds like your son overdosed on Suboxone and maybe is till recovering from the overdose. If you read the prescribing information (either online or the package insert) the MAXIMUM first day dosage is 16mg. If he took as much as you say he did he could have toxic levels in his body right now, as the half life is 36 hours. You need to drastically reduce his dose and find another doctor immediately. If you look under "dosing discussion" you will find a chart that shows how Suboxone builds up in the system. At a 16mg dose the blood level reaches the 40mg range. I can't imagine what his blood level would be if he took over 100mg in one day.
So he sleeps for 12-18 hours and wakes up energetic, then you give him another 24 mg and he goes back down for for another 12-18 hours? The next time he wakes up try giving him 8mg. And for the love of God, get a new doctor.


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PostPosted: Sun Sep 04, 2011 8:50 pm 
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I have to agree with Lilly. After reading everthing, I also think he is WAY over-medicated - overdosed? perhaps - and he will likely feel much MUCH better on a lower dose. I don't think it would be a bad idea to look for another doctor either. So I'll just say "ditto" to everything Lilly just said.

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PostPosted: Mon Sep 05, 2011 12:42 am 
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I agree also with Lilly, and would like to add that $50 a day is not a huge amount. Now in my opinion its not particularly how much oxy you are taking, but the severity of your behavior. It really surprises me that an addiction specialist would think that was a lot of oxy. $50 a day probably equates to somewhere between 50-80mg a day. Now I am not saying your son did not have a problem. He absolutely did and you did the right thing seeking out treatment for him. I also see a psychiatrist/addiction specialist and had a 200-300mg a day habit and my dr. told me while that is good amount it is not a huge dose and that he has many patients that were on 800-1,000mg of oxy a day! I find the amount I was taking to be pretty common. That coupled with the outrageous amount of sub he prescribed your son leads me to believe he has know idea what he is doing. At least as far as treatment with suboxone goes. I hope this all gets taken care and am sorry your son had to go thru this, especially since this was completely avoidable.


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PostPosted: Mon Sep 05, 2011 2:33 am 
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Well, of course there is always a worry when having yourself or someone you know take another narcotic but adderall is very, very safe and could be used to get him through those very sleepy periods that you described. They have Adderall and Ritalin (a little different from adderall) in long-acting and extended release formulas which prevent any sort of abuse. They work by releasing certain amounts throughout the day, rather then taking everything at once.

Before thinking about obtaining another prescription I would highly reccommend you get a full blood panel done ASAP to check his liver functions, testosterone, vitamin levels, etc.

On a side note, $50 dollars a day is relatively low amount no matter where you live. In most parts of the country Oxycodone/OxyContin can sell for over a dollar per a milligram, and for someone with a high tolerance you would need at minimum 60mg to feel anything. Hydrocodone is grossly expensive as well, reaching prices of $6-$7 dollars per a pill. However, all bets are off if he has a good friend that has a family member with a boatload of unsupervised pain pills siting around the house, but the more the friend takes, the more he will become addicted and the less he will share the pills with anyone else.

Regardless, 32mg every 8 hours is WAY, WAY, WAY, WAY too much for a habit that size. I had a friend who was going through full-blown methadone withdrawal which can lost months and is more severe then basically any other type of withdrawal process out there and he did fine on 8mg a day.

I, myself had been an addict for 8 years, and an severe everyday addict for about three of those years. I would on average spend $100 dollars a day on pills, primarily hydrocodone but at least 2-3 times a week I was taking large amounts of oxycontin, methadone, and morphine. The last few months of my addiction I was doing a few days a day of very, very potent black tar heroin and I only started out between 16-24MG a day and I would high all day long. I was almost as high as I was on black tar heroin, except it would last all day long.

Most of us here are in no way medical professionals, however I can say definitely that we know our stuff, and it seems like we're all in agreement that the person treating your son has no idea what they are doing where it comes to Suboxone. It's not just him either, a lot of doctors don't really know what they're doing since Suboxone has only been around since 2003 so versus other drugs there really isn't much research out there. Also, Suboxone and Subutex have just become so massively popular in such a small amount of time that a lot of medical professionals are just not educated enough. Maybe, the doctor was kind of treating it like Methadone, where some people are on doses as high as 1000MG plus.

I have been lucky with my doctor, he is primarily a pain specialist/management doctor so he is very knowledgeable where it comes to long-term Buprenorphine treatment. If you decide to call around for doctors make sure you ask some questions over the phone before going there. You don't want your son being over-medicated again, but you also don't want a doctor that thinks he can "cure" your sons addiction by doing a short-term 2-3 week Sub treatment program since that just doesn't work. Maybe it might keep him clean for a few months, maybe a year but he will eventually fall back into it. Your son's brain chemistry will be altered for the rest of his life, even though it's only been a six month long addiction. I know you said you got your Son down to 20MG every 24 hour which is great but you're just getting started in this process, so both your son and you deserve to have a doctor that knows what he is talking about.

In no way am I trying to undermine your sons problem. He is without a doubt an addict and you are a great parent for helping him, instead of punishing him for his addiction.

Lastly, does your son take his 20MG all at once or does he have it spread out over two doses? In the beginning usually a person needs to take their sub twice a day to avoid any sort of withdrawal, but eventually after a few weeks it's best to give the dose all at once since Suboxone has a long half life, meaning the effects will easily last throughout the day, versus the short-acting opiates your son was taking which would require multiple doses throughout the day to avoid withdrawal. The main purpose however is to help re-train your brain to eliminate former addict behaviors. The physical addiction is the easy part to get over, the mental addiction is a life-long battle. If a person is clean, but continues to think and act like an addict then it is only a matter of time before they become a full blown addict again. A dose should be taken all at once and forgotten about, rather then having a second dose, which you then will start almost obsessing over. Oh, before I go out I gotta take my second dose. Oh, I feel so angry right now and agitated right now, I need my second dose to help calm me down. Even though you physically do not need the dose, mentally you do, which then tricks your body into thinking you need it as well.

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 Post subject: Is this a plan?
PostPosted: Mon Sep 05, 2011 1:15 pm 
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Again, thanks everyone.

Tomorrow I will get a full blood workup for my son and find another doctor.

We have an appt with the original doctor this evening. Strange on Labor Day! From what I understand from you all, my son should be able to take 8mg and be above the ceiling so withdrawal should not be an issue, but cravings may be. Therefore I want to take him immediately from 20mg to 8mg and watch for cravings. If he is OK I'd like to taper him down by 2mg every few days until he is at 4mg. From what you have said it sounds like that should be a reasonable maintenance dose and the aweful headaches may subside.

Am I going to fast? I still have to convince the doctor and my ex husband to go along. My son seems open to trying.


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PostPosted: Mon Sep 05, 2011 1:31 pm 
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I think this sounds like a good plan. Because he has so much built up in his system he probably won't even feel the dose reduction right away. So once you get down to 8mg reduce very slowly so he can monitor his cravings. I wish you and your family the best of luck, and please keep us posted on how he is doing. In fact, maybe you could encourage him to post. We would love to hear from him.
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PostPosted: Mon Sep 05, 2011 1:47 pm 
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Hi again, with the amount of sub your son must have in his system he should have absolutely no problems dropping to 8mg. Now even though the ceiling is at 4mg most people like to stay comfortabley above it say 6-8mg a day. That's not to say he couldn't do well at 4mg, its just kind of a trial and error type thing. The goal is to find the lowest dose possible that still controls your cravings. With all the sub your son has built up in his system it will take a while to tell if the dose is too low. If this had been done properly in the beginning your son probably would have been fine at 4mg or even less for the small amount of oxy and hydro he was taking. Besides making your son needlessly sick his Dr also increased his tolerance a lot, giving him such high doses of sub for a month. So he may now need 8mg. If it were me I would take 8mg and stay stable at that dose for at least a couple weeks, if not a month to give time for all the built up sub to work its way out, until that happens you will not truly know what dose he will need.

You should have your husband come here and read through this thread and encourage him to ask any questions he may have. Staying on the dose he is at will not help anymore with his addiction than 8mgs would, it will only keep him sick and experiencing the side effects he is currently experiencing. A good Dr. should have absolutely no problem with some one wanting to decrease their dose to 8mg. There is NO added benefit to take more except to control cravings. Most importantly your son is the only one that knows how a particular dose is affecting him so I would encourage your husband to let your son decide. I do realize he is only 16 and you should be involved but he needs to have some control in his recovery as well.

There is a Dr finder on this site that will list drs in your area that prescribe sub. I encourage you to use it and find a new Dr and do not be afraid to ask questions before deciding on a new Dr.

Please keep us posted, and as a mother my heart goes out to you.


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PostPosted: Wed Sep 07, 2011 1:06 am 
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I'm not a medical professional, but I personally would ween him down from his current Suboxone dosage at 2-4MG a day, until he is in the 8-12MG range. His body is adjusted and now extremely tolerant of insanely high doses of Sub, so cutting his daily dose by more than 50% in just one day may cause him to experience some discomfort, and when just-clean addicts are in discomfort, they are almost always unstable.

Be sure to keep us updated on the process. Also, maybe you should introduce your son to this site. This site has helped me so much during my recovery. It's nice to be able to talk to someone who has experienced the same exact thing you have gone through before while also being in the comfort of your own home.

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PostPosted: Wed Sep 07, 2011 10:40 am 
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Hi ayladare, I was wondering if your son is doing any better. If you have time I would love an update. I really hope things are going better for him and I think about your family quite often.


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 Post subject: progress at last
PostPosted: Wed Sep 07, 2011 3:12 pm 
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We took my son down to 16mg once a day. The doc and my ex fought me on dropping to 8mg all at once. He's having no cravings or w/drawal. His headaches seem better. He's taking 2 Advil liqui-gels with a 5 hour energy in the morning and it seems to help. I plan to wean him further, but I'm more patient since he's able to go back to school.

We have an appt with a headache center at a children's hospital because the doctor doesn't think suboxone is causing the headaches. I still disagree and I'm seeking another opinion on the headaches and dosage. It's tough to find providers with drug experience for people under 18 years old. Most only accept adults.

My son's supposed to start outpatient rehab soon. He's not happy about it. It was supposed to be 3 hours, 3X per week but the councilor dropped the requirement to 2 days a week. That disappointed me. The more therapy the better as far as I am concerned. My son doesn't think he needs it, so I am glad it's required. He is both adopted and of a different race than the rest of his family. We live in a overwelmingly white, fairly rural community and his sister is the uber-achieving never do anything wrong type. I think there are pressures that he's not acknowledging and may have contributed to his desire to use. I've met the parents of 3 other addicted teens in the past few weeks. All are adopted kids. I read going into it that adoptees had a tougher time in adolescence. Now I know it from experience, but I would do it over again in a heart beat.

He's starting to ask really good questions such as, will the sub block any of the emotions he is supposed to be processing in therapy and can he really call himself clean if he is on sub? He plans to stay on sub quite a while, but wants a military career, so he'll eventually have to fly with out a safety net.

Thanks for all you help and concern. He's a funny, smart and sweet kid. I hate that he stepped into this mess. I hope it makes him a kinder, stronger person for all this suffering.


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PostPosted: Wed Sep 07, 2011 4:37 pm 
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Thanks for the update. I just wanted to address something. I've been in therapy for years and I've gotten more done since I've been on suboxone than I did before it - even before my addiction. I feel great on suboxone. I don't lack any emotions. I can be deeply sad or laugh hysterically. This is just me personal experience.

Oh and I'd recommend you read Dr. Junig's blogs or watch his videos regarding young addicts. Things are a bit different for younger people. After all, they're still growing, their brains forming new neural pathways.

Anyway, I hope suboxone, at the right dose, helps him. Thanks again for the update. Be well.

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PostPosted: Wed Sep 07, 2011 8:34 pm 
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If it were my son?? I would lock him in his room for the next 2 months put 4-5 square meals a day under his door and then put him on house arrest for the next 4 months and then evaluate at 6 months. Get him off the sub right now. 16 years old, the kid is still growing and he needs this crap out of his body ASAP and never look back. Will it be painful? Hell yes, but he has a long life ahead and this will be a huge step in getting back. This is just my 2 cents and I am sure people in here will disagree, but from own personal experience I suggest you get him off right now and face the heat. It will get better and then he might have a shot at a normal life. Good Luck


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