Detox from subutex by converting to quick release oxycodone

Question

I have tried to ween down to 1mg and then taper off twice. Both times I've taken a week off from work but at the end of the week I was to sick to work and had to get back on the subutex. This time I have taken 2 weeks off and I am trying to convert my dependency from subs to oxycodone. Currently I can completely stop my withdrawals with a 10 mg oxy. The relief lasts 3-4 hours. At the end of 7 days my withdrawals became unbearable and I am afraid now that all of the subutex is out of my system I am needing more oxycodone than initially.  I have 5 days left. Is it possible to convert my daily 1 mg subutex dependency to a daily 40 mg oxycodone dependency? I believe I read that 40 mg of oxy is not that hard to stop taking? Is this possible or am I simply prolonging the agony? Any advice or knowledge is appreciated.

alreadybetter · Answer

I briefly used oxycodone thinking it would be a "safer" drug for my pain, because it doesn't have Tylenol. But, I found the drug to be horrific, mentally at least. It changed my personality, and created an anxiety that was unbearable. I can't comment on your other issue, but my personal experience (and I am a pain patient) is to kick the oxy to the curb. I think it's a really bad drug.

weaver71 · Answer

I'm sorry to hear that. You are doing the right thing. Research and talk with people, gain the knowledge to form a solid plan. Stay on as low a dose of bupe as you can handle, in the mean time. I have a friend who was ready to give up, the bupe was to much to kick. He dropped .25 mg every 21-30 days and started skipping days at.25mg. Actually, I've seen that work for a number of people. 30 yrs of marriage and your kids are worth the effort. Slow and steady wins the race, let us know if we can help in your quest for a new plan. 1mg is too high a dose to jump, in my opinion. So, what's next?

Williesoul · Answer

I want to thank everyone for their help and advice but I could not make it.  I am going to ramble on for a few minute here but hopefully my shared experience may help soomeome else. I quit the oxy yesterday after converting my dependence to a daily dose of 40 mg (4-10mg oxycodone taken about 4 hours apart). I think I spent a little over a week taking only the oxycodone. About 8 hours after I stopped, I woke up at midnight today having the worst withdrawals I have ever experienced. It was truly a burning in hell experience, and that is almost an understatement. My body literally felt like I was burning. I was shaking so hard it woke my wife. I could barely breath and my nasal passages were closed. I also felt like I was having a heart attack. I prayed and almost negged God  for help. I drank water, walked around and did every thing I could to just ride it out. I took 1/2 of a .25mg alprazolam but after 30 minutes I succumbed and returned to the buprenorphine. I took what some describe as crumbs and I'm guessing probably about .5 mg. After 30 minutes I felt fine. I am very disappointed that I could not make it.  I have tremendous respect for everyone on this forum that has. In truth the oxy experiment was a complete failure. The drug is effective for pain, and I have been taking it off and on since the early 70's when it was called Percodan. My first accident involved my leg being amputated and it helped me for the first few years but I rarely took it. I had a lot of pain but I could stand it.. In those days 12 pills might last me a year. I don't know what mg the pills were but I don't remember me reacting to the drug  like I do now. There is no way I can tolerate it more than just a few days. I hate what it does to my mind. My wife and i have been together for over 30 years and we have 2 teenage daughters. In the short time I was on oxycodone all day it made me a different person. There is no way I would be where I am today if I had abused that drug. My wife is ready to leave me. This leads to my second observation. If you have been on oxycodone and developed a dependence, my experience is that buprenorphine is a far better drug in terms of how it effects human emotions.  Buprenorphine has many bad side effects for me, but far less than the oxycodone. At this point I'm going to try to keep my dose as low as possible and I'll keep researching until I find a way to get off. I guess the next step may be to start saving money in hopes of trying the Rapid Detox method. However it will probably take me at least a year to save $10,000 so it is not something I can do now.  Again, thank you to everyone who has been sharing their knowledge and experience to help me through this. I wish I could have proudly proclaimed to everyone how easily I walked away, but as the first post in this thread stated I was just wasting my time.

weaver71 · Answer

I know my pain is less and I'm more aware of my body. I know when to work or rest and that had helped.

nursegirl6572 · Answer

You are very smart and have great insight!  I think if anything, you'll see that your baseline pain level will be better...after you adjust.  It will take a little time, and you'll have some rebound pain initially, but many people find that the narcotics were exacerbating the pain.

Williesoul · Answer

My pain has been moderate for a year or more and I think I can manage it. I may find out differently but for at least a years the Buprenorphine  has not helped my pain but I've been tapering down to a very low dose so I think that's why I'm feeling some pain. I have a friend that had 3 neck surgeries similar to mine and he spent 3 years cycling from morphine, hydromorphone and fentanyl but was able to stop a year ago and he said his pain tolerance improved after opiates. I believe I too have outlived their usefulness and that they don't really help me anymore. I may find out I'm wrong but can always go back if needed.

Williesoul · Answer

I think the aversion to Tylenol was form the past and due to me needing the medication for at least several months. It's in my medical records with all of my doctors so I may be able to use hydrocodone short term. I'll call him today.

weaver71 · Answer

I found subs easy to taper, but quitting entirely was harder. Nursegirl brought up good points, I'd talk to your doc about those idwas. Norco are 10mg of hydro and 325mg acetaminophen. Oxycodone is basically synthetic heroine, while hydrocodon is synthetic codeine. Maybe sub to Oxy to low dose norco would help your transition. There's no way to avoid discomfort, unfortunately, but there are easier ways than others. What is your pain management plan after opiates?

nursegirl6572 · Answer

Does your doc want you to stay away from tylenol all together or just keep any usage minimal?  If the latter, there are preparations that have smaller amounts of tylenol, like 325 mg per pill versus 500 or 750 mg.  Something to ask about.  You may even be able to go that route.

Williesoul · Answer

That's scary news. I have to be in San Francisco on Monday for work. This has always been my problem. When I started the subutex I read a lot of articles, including one in my local paper and they all touted how you could easily taper. Not one doctor warned me but at the time my doctor knew I used my pain meds very sparingly so I don't blame them. I'm going to do my best until Monday and if I have to I'll try to make future plans for more time off. The worse part about this is I have a family and every time I do this I am absent from their lives.

nursegirl6572 · Answer

sit...Wow...coming off Subs at 8mg??  I cannot imagine.  Even our patients who came off at 0.5mg-1mg still had moderate w/ds.  That's insane!  Definitely cannot compare what you went through versus someone coming off at a reasonable dose.  Usually, it will be like night and day...both in severity AND in duration.  Sounds like you're through the worst of it...good for you!  

Willie...thanks for the clarification.  It sounds like you're dealing with dependency, not addiction.  So, that's one good thing.

Keep in touch with your doctor.  The process won't be free of discomfort, but I'm sure with a proper taper plan, your w/ds can be managed.  Most likely, the doc will advise staying on your current dose of the Oxy for a little while, to allow for the Sub to leave your system (like weaver stated).  

Then, at that point, you can start a gradual taper down off the Oxy.  The most optimal way would be to do minimal dosage reductions, with the stabilzation period.  That's an important part of any taper.  Obviously, the lower the dose you can taper down to, the easier the final jump will be.

With tapers, slow and steady really does win the race.  Sure, it drags the process out a bit, but a lot of people prefer to tolerate mild w/ds for a longer period, than very severe ones for a shorter period.  

Good luck to you!!

Williesoul · Answer

My Md didn't want me to take hydrocodone because of the Tylenol.. I have some kidney and liver issues otherwise I would have preferred it as well. It is less intense than the oxycodone and my brain seems to function better.

sitdownbrother · Answer

I jumped off suboxone 8mg 3 weeks ago.  Just let me tell you briefly what I've experienced.  First week was hell, as you probably know.  Severe RLS, insomnia, hot/cold skin, anxiety and crushing fatigue.  I had clonidine and it helped a little with sleep.  Second week was mostly just awful, awful fatigue but I have a script for clonazepam and started sleeping again.  Third week a little better, occasional tingling skin but still tired as hell.  I'm near the middle of the fourth week and starting to feel normal again.  Not great, but normal.  I've found that taking four immodium in the morning with tonic water (quinine) relieves my stomach discomfort and takes the edge off.

I read someone on another post who jumped at 12mg and her timeline was similar.  It takes about 30 days, and you'll feel a hell of a lot better at week four than week two.

Also, I could not have worked during this time.  I am returning on Monday, which will be the end of week 4.  I can't speak to the Oxy, I haven't had access to opiates.  Tapering is the way to go but I didn't have the discipline.

weaver71 · Answer

You will likely be in sub withdrawal still, after the Oxy. It takes 21 days for your last dose of sub to leave your body. You will not feel very good when you go back to work. I'd say insomnia,RLS, and digestive issues will go on for 21-30 days after last sub dose. The Oxy's are helping for now, but they will leave your system in 12 hrs. Your plan sounds good, but I would have chosen Hydros tapered over a month or more. Hope that helps.

Williesoul · Answer

Thanks again I will move to the other forum. I don't have any problems running out. I still have old bottles of pain medications never finished and I don't like the way oxycodone makes me feel.. I have been off the buprenorphine for 8 days but I am maintaining at 40mg of oxycodone. I do have a doctor and I'm going to quit the oxycodone in a few hours. I don't smoke or drink and I eat fairly healthy. My current pain level is very low so I want to attempt to become drug free.

nursegirl6572 · Answer

Well, to be honest, your post is a bit confusing.  You say you're a chronic pain patient, do you not want to be on opiates anymore?  Were you on Sub to get off other opiates or for pain control?  If so, what were you on and for how long?  How long have you been on the Sub?

Only YOU can make the determination if you're dependent or addicted.  Addiction would involve mental cravings, abuse of your script, taking more than Rx'ed, for reasons other than pain, seeking more of the drug, running out early, just to name a few..  

Here's a  few selfs test you can take if you're unsure:

http://www.brookhavenretreat.com/cms/making-a-change/addiction-mental-health-self-tests/prescription-drug-addiction-self-test

http://www.councilonchemicalabuse.org/wp-content/uploads/2011/08/Prescription-Drug-Abuse-Assessment.pdf

If you're just looking to detox, then the best way would be to enlist the help of your doctor.  Switching from one to another will keep you stuck in that trap...taking A to get off B, then C to get off B.  

There's no way to avoid w/ds completely I'm afraid, but there ARE ways to help treat some of the symptoms of w/d.  If you had never gone to the Sub, I would tell you that due to half life, and other factors, a full agonist opiate like Oxycodone would be the preferable detox IMO, as it would tend to be shorter lived, and in a lot of cases, less severe, but since you're on the Sub now, I wouldn't advise flip flopping.  I would advise tapering down to a low dose of Sub, slowly, with stabilization periods (at least 2 weeks) in between your dosage reductions, before jumping off completely.  The sub doc I worked with recommended not jumping off until a pt tapered down to at least 0.5mg/day, if not lower.  Coming off Sub at 1-2 mg can be pretty rough.  People think those are low doses, which, for sub maintenence, they are, but a little sub goes a long way...so for detox purposes, those aren't "low" doses.  

Then, when you jump off, ask your doc for help with the w/d symptoms.  There are some non habit forming medications that can help with detox symptoms.  You can look up the Thomas recipe here as well, that offers different remedies to help one through w/ds.  Then, it's really just a waiting game.  It will take time to get back to "normal".  There's no magic way to get there...other than to be patient and do whatever you can to help your body adjust (exercise, healthy eating, staying away from any mind altering substances, etc)

If you determine you have an addiction problem, then you're going to have to put a recovery plan in place that involves more than just the physical detox.  That would involve aftercare, which comes in the form of meetings, addiction counseling, whatever it takes to maintain long term recovery.  For an addict, GETTING clean is actually much easier than STAYING clean...yet most addicts have tunnel vision, only worried about the w/ds.  Sure, they are awful...but there is so much more to consider than that.

Keep the communication open with your Sub doctor (are you under the care of a doc for the subs?) and just put a plan in place to get you off the opiates.  Depending on your pain issues, you are going to have to address that as well, finding non opiate analgesic options.  It will take a while (at least a month, if not 2 or 3) before you will be able to fairly assess your real pain level after coming off the opiates.  Often times, chronic opiate use actually exacerbates pain.  Look up hyperalgesia.  Many people don't realize that the very pain pills they depend on for pain control actually made their pain worse.

Best of luck to you.  If you don't have an addiction problem, we have a great pain management forum you may want to check out too.  Those folks are all too familiar with opiates and detox too. This forum is really for addicts looking to recover.  We certainly can help with tips for detox...again, search the forum for the Thomas recipe...for starters.

Williesoul · Answer

Thanks, and I understand.  I certainly don't mean to separate myself from an addict or appear to consider myself in a better place than anyone.  I respect  anyone that's in the same place I am. In reality I am addicted but I I have a long history of accidents and surgeries dating back to the 70's and was prescribed opiates many times but never abused them or became addicted. After my last survey I was in intense pain. This was the third time in my life I had reached a level of 9 or 10, and literally in shock from the pain. They put me on a  patch and I hated it. This is where the subutex comes in. It didn't seem to be the same so I used it to get through the recovery but the withdrawals are so long I'm forced to stop because I have to go back to work. I'm not in the position of having a month to recover. Based on your advice though I'll atop the oxycodone today.  I can make it because I hate it. I read in another thread last night that someone used suboxone crumbs to taper and they claim there were no bad withdrawals. Do you think that's true.

jethro733 · Answer

From what I've read, subutex has a longer half life than Oxy's.  I've been on 400-600mgs a day of oxy up until recently, but I can say the first time I cold turkeyed it was on 60mg's per day and it was still a hell then.  I was like you and telling myself I wasn't an addict too and maybe you're not yet a full blown drug addict as you say, but for sure you're addicted and the line is blurry. 

Back to the point, I think that possibly yes you will able to get off with a shorter withdrawal from oxy's because of the shorter half life BUT you will find it very very difficult to taper them.  I never could taper, not a chance and I've heard most others also find this with oxy.  It's one hell of a drug.  To add, to do this you'll have to get hooked on oxys before you take two weeks off work.  So as far I can tell yea you're prolonging your agony.

For a real answer you need someone who's CT'd from both drugs I'd say, and I hope that info was in some way helpful.  Good luck with it, kicking the dirty little thing with responsibilities on your shoulders is a bloody drag.

kyle505 · Answer

Just reread your post. You call what you're experiencing dependency.  It sounds like addiction to me. You are trying to avoid detox; and thats what we addicts do, at any price. So, like I said initially - foolish to substitute one drug for another.  No matter which way you go you will have to go through detox. Either from subs or from oxyies. Quit the excuses.  Pay the devil his due and get on with your life. 
K

kyle505 · Answer

Well, this forum is aimed at addicts. And that's what you'll get here - opinionated comments. Opinions based on years of using. You should have been clear about not being an addict at this point. Your post sounds like many that have been posted in the past. Sorry for the mix up. But be careful - you are playing with fire. 
K

Williesoul · Answer

This was a plan suggested to me by someone who successfully tapered from suboxone  to hydrocodone, and then opiate freedom.  I discussed it with my doctor and he supports my effort but is uncertain of  the results.. I am not an opiate addict, but a patient in pain management due to several neck surgeries. I am looking for knowledge not opinionated comments.