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PostPosted: Sat Jan 31, 2015 4:54 pm 
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I've been on and off opioids for almost a decade by now. I've tried everything else, so I think it's time to see if bupe/Subs can help. I'm not currently opioid dependent, though: I got clean and went through withdrawal about a month ago. Of course, I went right back to oxy and H, and it's just a matter of time before I'm dependent again. I would like to get on a maintenance dose of Suboxone before then, though. I have an appointment for Monday.

I have read that you have to be withdrawing in order to get your first dose of Suboxone. This is, presumably, so it doesn't cause precipitated withdrawal. However, is it a requirement, or just because of precipitated withdrawal? Will I pay a good $500 to see the doctor and then be told that I can't be prescribed the drug because I will not score anything on the COWS chart?

Thanks in advance for any advice.


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PostPosted: Sat Jan 31, 2015 5:46 pm 
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Hello Crossfinger, welcome to the forum. Hope you look around and read some of our experiences and do check out our founders blog, SuboxTalkzone. Dr j 'posts are a weath of information as are the forums members here on the forum.
They say with opiate addiction its not the stopping its the Staying Stopped. Subs will give you this. You used the word yourself:maintenance.

Sub was made for this. At least it has turned out this way. You have trouble picking up again and again. A smallish maintenance dose will work well.

To answer your question, no, you do not Have to be in WD to start Suboxone. However, when it comes time for doseing,please go very very slowly. Meaning, very small doses to start. Over time you will find the dose that will hold off your cravings. Thats what your working towards here, your wd s are over, right?

To ease your mind abit more, give the dr or clinic a call and ask them or tell them your concerns. Im sure they will be glad to answer you.

Buprenorphine is a very potent medicine, so slow doseing in the begining is a must. 1 to 2mgs to start those first few hours, then see how you do. What you want to avoid is bupe overdoseing. This can make you sick also. Headache and tiredness with nausea can be a factor with to much bupe for a person with no tolerance to it...


Keep posting Cross, ask questions and keep reading too. Hope to see you again, and ill say this, i started sub just over 4 years ago, and havnt picked up since..so.....yay Sub!!!!!


Peace....Razor


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PostPosted: Sat Jan 31, 2015 6:02 pm 
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Thank you very much for your response, Razor. I've been reading all over on this forum; it's been a great help. It's been especially good to see that I'm not the only one scared to death over trying to start Suboxone... I'm not even sure why; it just feels like so many things can go wrong, and like pharmacies/pharmacists, bosses, people in general, etc. might cause trouble. I'm afraid of making it "officially" known that I'm an opioid addict, but as you say, I pick up again and again and I don't think I will stop any other way... so I'm gonna give it a try.

It's really good to hear that I don't have to be dependent to get started on the Subs. That's been my biggest fear, that the doctor might tell me something like "we don't give Suboxone just for cravings/maintenance, only dependence/withdrawal"... I was thinking about lying and trying to make it look like I was withdrawing to get my first dose if I had to, but I don't know if that will even work, and I'd rather start off by being truthful. I'm just glad to know the truth will probably work (that is, letting the doctor know that my usage is down but that I need maintenance to stay off).

You're right, my withdrawal is over, but I experience strong cravings (was going to pick up today in fact, but have managed not to); and I'll definitely be careful with the dosage. A small maintenance dose is exactly what I (think I) need. From my experience in obtaining Subutex on the street, once or twice, with my current tolerance I'll only need 4mg (or less). Do you know if I will get to have any input as to how much I'm given (for example, can I tell them "I think I need about 4mg for my cravings and tolerance"?), or will the doctor just decide on a number based on what I tell him? Maybe it varies from doctor to doctor...?

Thank you again. I feel much better about this course of action already. It's been a tough decision but I think I will be glad I did it!


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PostPosted: Sat Jan 31, 2015 7:41 pm 
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Hi Crossfinger

Let me be the 2nd member to welcome you to the forum! Great people here and they tell it like it is, no BS.

I have been on sub a little over a year and have made progress in cleaning up the mess from abusing opiates. Most sub doc's are used to hearing you got sub on the street, after all, most of us get our drugs on the street.

Starting suboxone was scary for me also. I knew i needed to stop the madness but was scared of starting sub. Looking back i should have been scared of continuing abusing like i was. Anyway, i decided in January i needed to stop. Tried CT and that didn't work, tried tapering & that didn't work so finally in September i got an appointment and started treatment. So it took me 8 months to finally be more scared of using and abusing before i got help.

I live in NY and will share what my sub doc does. A person has to be in moderate w/d's & when you get to the office they do a urine to see what's in your system. My doc doesn't start anyone that is not using unless they are referred by a counselor or doctor. The reason is to stop the sale of sub on the street. He also uses vivitrol for some patients that have stopped using but still have cravings.

In closing, Razors suggestion to call first is a very good one. You really don't want to waste your time or money. Every doctor is different so there is no way to really tell what the doc will do unless you get the info from him/her.

It's great that you know you need help to stay clean and i hope this appointment works out for you.


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PostPosted: Sun Feb 01, 2015 8:07 pm 
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Hi Cross,

Tiki makes and excellent point. Although you should easily be considered a candidate for suboxone maintenance there is no guarantee that the doctor you are seeing will agree with us. The potential of diversion makes it very difficult to get some doctors to agree to treat a patient that isn't currently using. It would be a good idea to discuss their thoughts on this before you fork over the $500 and get stuck with nothing. If they do turn you away at first you might be able to get them to reconsider if you cooperate with some counseling or get a recommendation from a current doctor. In other words, you might have to jump through a few hoops to get started, but don't give up without a fight. If they turn you away I would ask them point blank if they would rather you take the chance of an overdose than prescribe you a small maintenance dose. I've always wondered what a doctor would say if a patient really questioned their motivations and gave a good argument as to why they need maintenance treatment in these cases.

Keep us posted, Cross. I'm hoping you won't have any trouble and your doctor will be wonderful to you. :D Welcome to the forum!

Q

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PostPosted: Fri Feb 06, 2015 8:09 pm 
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Thanks a lot for the replies, Tiki and qhorsegal. I really appreciate y'all taking the time to post encouragement and advice.

I was nervous enough that I ended up actually rescheduling the appointment... but I did finally go; and as it turned out, I needn't have worried! Everything went very well. I explained that I was currently using, even if I wasn't at "peak dependence", and I actually did experience a little bit of withdrawal -- so I guess the combination was enoug; the doctor prescribed me the medication, and thankfully he seems to be among the better doctors I've gone to, in terms of listening to patients. My other worry -- that pharmacists would hassle me -- hasn't materialized either, knock on wood!

Thanks again to everyone for responding and helping me decide to give this a try. I haven't felt any cravings at all so far, and I have hope for the future again! :)


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PostPosted: Fri Feb 06, 2015 10:00 pm 
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Crossfinger


YEAH! YEAH! one for the appointment and one for the pharmacist :D And A Hip Hip Hooray For YOU :wink: So Glad things went well for you and so thankful that you came back and told us how it went.

Hopefully, you will continue as an active member. Your experience's may help someone else.

May i ask what dose you are taking? You don't have to answer because honestly it's a nosy question. There really is no need for me to know but nosy curiosity prompted the question :lol: At least you know i am honest :D

Thanks again for updating us!


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PostPosted: Fri Feb 06, 2015 10:23 pm 
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LOL, Tiki. :lol:

I agree, please stick around and post often. I'm sure you will have questions we can help you with at some point and you will definitely be able to help others.

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