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PostPosted: Wed Aug 08, 2012 6:54 pm 
JERRY JERRY JERRY. LOL

i understood your point winningduhepic. i have detoxed from; actually the real question is what haven't i detoxed from? i have in no way shape or form felt any linger PAWS from pain killers or heroin for more than 2 1/2 months. And that was the absolute longest back in the early 90's when i quit Morphine cold turkey. I have quit methadone and suboxone and yes, there is a huge differance in time length of PAWS. They are virtually non existant for SAO's after a few months at best, for me and everyone i know. I'm not a Dr. and neither is hatmacker but from my experienceS i am not withdrawaling from any of the SAO a year or 2 down the line. that is kinda laughable. Im routing for you winningduhep if you leave the forum.


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PostPosted: Thu Aug 09, 2012 1:37 am 
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Well maybe i won't go through long term paws. i am not a long term drug addict.

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PostPosted: Fri Aug 10, 2012 10:26 am 
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as people we no really how long it takes to recover from pain addiction or down right addiction it self. and we no what dr j and other health profesh- are trying to expl- about all this. and hat maker will continue to keep it like this on the forum.

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PostPosted: Fri Aug 10, 2012 3:46 pm 
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Winningduhepic wrote:
"There is no possible way to ascertain what the PAWS you are suffering from now is from. You have to combine ALL the drugs you were on and add up all the time you were on them. THAT IS WHAT THE PAWS IS FROM" HATMAKER-

No I don't believe this is correct at all. What would be the point of suboxone then if you're still going to suffer any type of withdrawals from the opiate you were on before? And that whole adding the drugs you were on and multiple it by the years you used and then divide it by who gives a shit. SAO, you know what this stands for. Short acting opiates. After being on suboxone for 3 years and then abruptly stopping..... you are not going to be having any SAO withdrawals. Why would you? They would have been out of your brain and system about 2 1/2 years prior at best. Short acting opiates (SAO's) will not effect you way down the line as far as having PAWS. Come on, you know this


The changes that occur in your brain that will eventually cause withdrawal and PAWS when you stop taking opiates begin when you first start using opiates, be they short or long acting opiates, period.

If you used heroin (for example) for 2 years before you start Suboxone treatment, and then you go on Suboxone for a year, and then you quit Suboxone, then you will be dealing with the effects of 3 years of opiate use on your brain. If you used heroin for 15 years and Suboxone for 2 years, then you have 17 years worth of effects. These effects include both tolerance (your brain creates more receptors for opiates and produces less endogenous endorphins) as well as thought-patterns that are associated with addiction, response-reward circuts, habits, etc. You have to be aware that after that many years of one type of conditioning it's going to take time, patience and a lot of work to make positive changes.

The best way to ameliorate the effects and decrease the length and severity of withdrawal and PAWS is to slowly taper off whatever opiates you're using before you quit. Tapering gives your brain time to adjust to the lower level of exogenous opiates (opiates you're putting in from the outside) and ramp up production of endogenous opiates (endorphins). Tapering also gives your sympathetic nervous system time to adjust to the lower levels of exogenous opiates, which also helps lessen length and severity of withdrawal and PAWS.

Other factors can also come into play when dealing with withdrawal and PAWS. These include physical and mental health. Exercise and a healthy diet can play a significant role in reducing the severity of PAWS. Getting treatment for underlying health and mental health issues is also beneficial. Another important factor is strength of support systems - family, friends, employment, school, therapy or counseling, and some kind of recovery program. Making changes in environment can also play a role, as environmental associations can be highly triggering. In my personal experience, my experience in school, and from reading stories on this forum - the people who have ALL of these factors in place suffer far less from the negative symptoms of withdrawal and PAWS.

Let me say that again for clarity: People who I know, myself included, plus testimony from this forum, plus information I gathered during my Chemical Dependency Professional program in school indicate that a long, slow taper from Suboxone to a very small (.25 mgs or lower) dose of Suboxone, coupled with exercise, physical and mental health treatment, a strong support system and a good recovery program have less severe withdrawals and shorter and milder PAWS.

The point of Suboxone treatment (in my informed opinion) is not to give addicts a withdrawal-free way to quit opiates. The point of Suboxone treatment is to break the cycle of addiction by removing the trigger-use-reward circut. Breaking this cycle allows opiate-addicted people to be free from the roller-coaster of using, being high, coming down, withdrawing, repeating that dominates the life of an active addict. Suboxone also supresses cravings and the blocking mechanism of buprenorphine makes it difficult to relapse on SAO. Combined, these effects of Suboxone provide a measure of freedom and stability that allows addicts to get their life together and progress in ways that are just not possible within active opiate addiction.

How you use that freedom and stability is up to you. If you use it to identify what your triggers to use are and develop ways to deal with those triggers, repair damage done to your life and relationships while in active addition, make new friends and get new hobbies, take care of your health, start working toward life goals and whatever else you need to do to learn to live as an non-opiate-dependent person - then all of that work will serve you well when and if you decide to taper off Suboxone. And as I said above, the tapering process is an effective way of letting your brain and body adjust to less opiates coming in from the outside.

And before anyone says that not everyone can taper, I'm sure that's true to an extent. While some people find it easier to taper Sub than it is to taper SAO's, others find that tapering is not for them. Even so, there are people here and in my off-line life who quit without tapering and were still successful - and the main factors in their success were still what I talked about above. Exercise, support system, recovery program, therapy, life goals, employment, etc.

PAWS is always going to be individualized to some extent. I don't think there is one perfect way to get off opiates and there is no certain way to avoid withdrawal and PAWS. But you can be smart about things, you can stop reading horror stories and start looking for success stories and analyze the successes to see what those people have in common. We are lucky here as we have quite a few success stories on our forum; I even started gathering them into one thread in the Stopping Suboxone section of the forum.

Ultimately it is up to each of us to figure out what works for us and to figure out how to best use whatever recovery tools we have at our disposal, including Suboxone. There are lots of people here who have good help and support to offer. I hope you find a way to utilize that.

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PostPosted: Sat Aug 11, 2012 1:05 am 
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Do you guys agree that PAWS lasts longer for long acting opioids?

ie cos Sub acute withdrawal lasts 2-3 times longer than heroin / morphine, therefore Sub PAWS lasts 2-3 times longer than heroin PAWS?


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PostPosted: Sat Aug 11, 2012 1:12 am 
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If a person is in active addiction on heroin for 5 years and on sub for 1, how can you even ascertain what "part" of PAWS is from suboxone? You can't. It's just PAWS from 6 years of opiate use. It's not possible for that kind of information to be obtained - that kind of experiment can't be done.

And thanks, DOQ, for taking the time to explain what I wasn't able to in the short time I had available. And you worded it better than I could have, too.

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PostPosted: Sat Aug 11, 2012 1:29 am 
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hatmaker510 wrote:
If a person is in active addiction on heroin for 5 years and on sub for 1, how can you even ascertain what "part" of PAWS is from suboxone? You can't. It's just PAWS from 6 years of opiate use. It's not possible for that kind of information to be obtained - that kind of experiment can't be done.


If I jumped off Sub today, I'd be withdrawing off Suboxone because there's no heroin left in my body. Wouldn't it be the same for PAWS?


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PostPosted: Sat Aug 11, 2012 1:45 am 
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I agree with Diary's post, that PAWS is related to the OVERALL time a person is on opiates. She explained it very, very well. I'd say re-read that rather than me trying to explain it when she did such a good job. But suffice to say that it's the total combined years on ALL opiates that contribute to PAWS...not the very last drug used. That's how I see it. We were talking about this lately and I posted a link...let me try to find it. Hang on while I look.....(jeopardy theme...)

OK, I found it. It says that it comes from many types of drugs, not just opiates. Here's the article from Ohio State University, University Medical Center: https://patienteducation.osumc.edu/Documents/paws.pdf

Something it says about what PAWS is: "Recovery from alcohol and drug use causes many symptoms.These occur as the body attempts to repair the brain and other organs." This tells me it has nothing to do with the last drug in the body. Short or long acting, when a person tapers off, the long half-life doesn't apply, nor does the long stacking effect so sub does't stay in the body as long as some people think it does. Also reading this tells me PAWS is simply the process of our brain going back to normal because the drug (no matter what drug) is no longer present - meaning it doesn't matter whether sub has a longer half-life or not. It leaves the system and that's when PAWS begins.

I feel like I'm not explaining myself well. Sorry if that's the case. It's late and I can't sleep and I'm in pain. Just ask for clarification and I'll try again if I'm not making sense.

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PostPosted: Sat Aug 11, 2012 11:38 am 
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I dunno.

I've jumped off high doses of methadone, buprenorphine and heroin... and the recovery process was definitely longer for methadone and buprenorphine than for heroin. Just in general things like sleeping, sweating, pain, anxiety. I "bounced back" quicker off heroin with both acute and post-acute symptoms. But that's also a bad thing, because getting too well too soon can make it easy to forget how painful it really was.

I'm in no way saying it's a good idea to use heroin, or heroin is a lesser evil to suboxone... because it isn't. Buprenorphine serves a great purpose and it's a fantastic medication. But withdrawal is definitely not its strong point.


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PostPosted: Sat Aug 11, 2012 11:47 am 
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lets go back a couple of years and see . i all ways worry why the hospital wanted me on subs for only 10 days. they new that if i stay on it paws would be bad foe me.

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PostPosted: Sat Aug 11, 2012 1:49 pm 
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My opinion would be that PAWS is so different for each individual that's it's almost impossible to say whether doing a short acting opiate years prior to taking suboxone would increase the time of PAWS or not.


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PostPosted: Sat Aug 11, 2012 7:14 pm 
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eric is wrote:
My opinion would be that PAWS is so different for each individual that's it's almost impossible to say whether doing a short acting opiate years prior to taking suboxone would increase the time of PAWS or not.


I agree. There are just way too many factors to consider with each individual person. I think Diary explained it best.

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PostPosted: Sun Aug 12, 2012 9:42 pm 
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Paws duration and acute stage WD is governed by how consistant the dosage is, regardless of the opiate.
How you deal with the recovery determines how acute and long its gonna be. Lets not forget once your body is saturated with an opiate, the process includes cleansing bone and marrow detox as well, and your body has to rebuild from the core out. That can take a long time.
Taking into account mind, body and spirit and all the variables of age, health, dose quality and quanity etc, it's better to focus on proactive steps to minimise the acuteness of paws, cause I don't recon the price can be valued on opiate type alone.


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PostPosted: Tue Aug 14, 2012 12:18 pm 
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heroin is sooooooooo much easier than suboxone!!!!!!!! trust me done both! made it thru heroin not suboxone!

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 Post subject: Scary stuff
PostPosted: Tue Aug 14, 2012 7:19 pm 
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Ahh the almighty question of questions. I was on black tar H for 4 years and now have been on Suboxone almost 5 years. The thing that scares the absolute shit out of me is going through w/d again to go off Suboxone. I fear w/d to the point I don't even want to think about going off sub for good. I am at a high dose 24 mg and just recently my Dr. said something about dropping to 20 mg, I automatically go into panic mode. I went through heroin w/d many many times and dear god if I had owned a gun at certain times there is a greater chance than not that I wouldn't be here now. So as for my opinion I can't weigh which detox is worse because as of yet I haven't been off the "lesser evil". One thing is certain reading posts on this forum about weaning off sub has hightened my fear of it. So a word to the wise: if you intend to come off sub then I wouldn't start wading through information on the topic as you may not be so inclinded to do so afterward.


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PostPosted: Wed Aug 15, 2012 12:29 am 
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Stargazer wrote:
Paws duration and acute stage WD is governed by how consistant the dosage is, regardless of the opiate.
How you deal with the recovery determines how acute and long its gonna be. Lets not forget once your body is saturated with an opiate, the process includes cleansing bone and marrow detox as well, and your body has to rebuild from the core out. That can take a long time.
Taking into account mind, body and spirit and all the variables of age, health, dose quality and quanity etc, it's better to focus on proactive steps to minimise the acuteness of paws, cause I don't recon the price can be valued on opiate type alone.


I think that's a big reason.

When I was using heroin, there were times I was "hanging out" between doses. Many in fact. My levels would go up and down through the day as I went from high to withdrawing, high to withdrawing. There were times I'd go 24 hours before using again, occasionally even 2 days. There were also the many times I tried to kick and failed, where I might not use for 3 or 4 days.

On Suboxone we have our receptors saturated 24/7. Even the heaviest of agonist addicts (apart from methadone) couldn't have high levels of the agonist maintained while they were sleeping. They'd wake up in withdrawals.

This is one of the big reasons why I think Sub and methadone withdrawals are much worse for me, because they saturated the receptors 24 hours a day 7 days a week. Because of this the receptors have to downregulate much more when we get off.

The only way to counteract this is to taper and spend a long time on a very small dose of Sub - ie the doses of Sub that mimic a shorter-acting opioid when its levels throughout the day dip to the point of experiencing withdrawals before the next dose. This allows receptors to begin to recover even before jumping off completely. But you're still experiencing mild withdrawals for a longer period.


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 Post subject: Re: Scary stuff
PostPosted: Wed Aug 15, 2012 2:08 am 
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taran1 wrote:
Ahh the almighty question of questions. I was on black tar H for 4 years and now have been on Suboxone almost 5 years. The thing that scares the absolute shit out of me is going through w/d again to go off Suboxone. I fear w/d to the point I don't even want to think about going off sub for good. I am at a high dose 24 mg and just recently my Dr. said something about dropping to 20 mg, I automatically go into panic mode. I went through heroin w/d many many times and dear god if I had owned a gun at certain times there is a greater chance than not that I wouldn't be here now. So as for my opinion I can't weigh which detox is worse because as of yet I haven't been off the "lesser evil". One thing is certain reading posts on this forum about weaning off sub has hightened my fear of it. So a word to the wise: if you intend to come off sub then I wouldn't start wading through information on the topic as you may not be so inclinded to do so afterward.


Taran, you are listening to too many horror stories from people who obsess about withdrawals and expect the worst. When a person sincerely EXPECTS the worst, guess what? That's exactly what they will get. The thing with suboxone vs heroin is this: Were you EVER able to wean down on heroin? I'd guess not. But with sub we actually CAN! Also, we were already hooked on opiates and we already had withdrawals coming our way. Suboxone isn't a free ride. We have to go thru them some time or another, but with sub all we have to do to avoid the suffering is to do a long, slow taper.

I was on 16-24 mg for over 3 years. Last months in about 2-3 days I dropped my dose from 16 mg to 4. I didn't perseverate or freak out, I just did it. And guess what? No withdrawals. That's mostly because both doses are above the ceiling. You should be able to get down from 24 to 20 with ZERO problems. Both are so far above the ceiling you shouldn't feel a thing. You're freaking yourself out, I'm sorry to say. And that's just going to make your reservations and anxiety and panic that much worse.

Try not to put so much thought into it. I don't even schedule my doses. (I'm also on it for pain.) If I feel like I'm starting to withdraw or I have pain, that's when I dose. Sometimes I forget altogether. I truly believe taking a big step backwards and just putting it as far out of your mind as possible can really help in the anxiety that most people have when it comes to tapering.

I hope this helps, even a little bit. Good luck and take deep breaths. :)

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PostPosted: Wed Aug 15, 2012 2:13 am 
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Goinstrong wrote:
eric is wrote:
My opinion would be that PAWS is so different for each individual that's it's almost impossible to say whether doing a short acting opiate years prior to taking suboxone would increase the time of PAWS or not.


I agree. There are just way too many factors to consider with each individual person. I think Diary explained it best.


Quote:
Diary said: If you used heroin (for example) for 2 years before you start Suboxone treatment, and then you go on Suboxone for a year, and then you quit Suboxone, then you will be dealing with the effects of 3 years of opiate use on your brain. If you used heroin for 15 years and Suboxone for 2 years, then you have 17 years worth of effects. These effects include both tolerance (your brain creates more receptors for opiates and produces less endogenous endorphins) as well as thought-patterns that are associated with addiction, response-reward circuts, habits, etc. You have to be aware that after that many years of one type of conditioning it's going to take time, patience and a lot of work to make positive changes. (emphasis mine)


This is what I've been saying and trying to get across for quite some time. I'm unclear as to why it took someone else to get it across to everyone. I've tried saying it in every different way possible including practically the same words; 3.5 years later and sometimes I wonder why I even try.

(Not talking to or about you, Goinstrong, just making a point)

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PostPosted: Wed Aug 22, 2012 5:40 pm 
Ex GnR's drummer Steven Adler's nickname is Stargazer.... How bad ass would it be if that was actually him!!! or not still seems like a cool guy :D


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 Post subject: common garden type
PostPosted: Fri Aug 24, 2012 12:52 am 
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That's funny Winningduhepic, but I blew my opportunity for fame and fortune, after slipping one too many times.
Now I just sit under the night sky waiting for the guy in the silver thunderbird to take me for a ride.


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