HELP need advice

[Crisk]

Its been 24 hours since i took 2 oxy 80's and i am going through withdrawel! I have suboxens but am afraid of taking them to early and going through precipitated withdrawels. Its been 24 hours am i ok to take a suboxen?

[ochooked]

It sounds like you have allowed enough time --- the main thing is that you are really in W/D's -- If you are then go ahead -- take the minimum amount you can to get relief ---- take 2 mg and then wait 30 minutes -  if that takes away most of the W/D's then don't take any more - if not then take another one mg.  Allow your own body to determine its need for the Sub. All the best.

[daystrom]

I second the motion.  If you are sick you are good.  The precipitated wd's from bupe/naloxone is in many cases exaggerated (but not unheard of).  I actually tested it on myself once.  Naloxone has a very low bioavailability sublingually and the buprenorphine, while it does have a much higher affinity for the mu receptor and does indeed vacate that receptor of full mu agonists once it binds, the wd I found was not terribly bad and went away in short order.  That being said, I have heard that some people have a harder go of it.  I dunno.  In any event, 24 hours since your last oxy, you are good now.  Good luck.

Ray

[Kova]

i agree with ockooked about taking as little as possible of the Sub.  you will be surprised at how little it takes to just make you functional.  as i've said before, when WD from methadone i would take 2mg and it would keep me good for 2-3 days!  i couldn't believe it, thought i was just done with the WD, but then sure enough i could almost feel the Sub leaving my system and i'd get hit with all of the WD goodies again.  the point is, it is very strong stuff and if you can use just enough to get by you won't have to then go through Sub WD as well.  good luck.

love and light,
Kova

[OXY_FREE]

Hi crisk,I put cows work sheet up for you,it will help you to see where you are at on your withdrawal.If you can wait a little longer,i would.I would hate to see you make yourself sick.If you dont mine me asking what dose did they put yo on?

Clinical Opiate Withdrawal Scale (COWS)
Flow-sheet for measuring symptoms over a period of time during buprenorphine induction.

For each item, write in the number that best describes the patient’s signs or symptom.  Rate on just the apparent relationship to opiate withdrawal.  For example, if heart rate is increased because the patient was jogging just prior to assessment, the increase pulse rate would not add to the score.



Patient’s Name:___________________________                         Date: ______________
Buprenorphine induction:
Enter scores at time zero, 30min after first dose, 2 h after first dose, etc.
                                                                                      Times:       ­­______       ______      ______      ______
  
Resting Pulse Rate:  (record beats per minute)                  
Measured after patient is sitting or lying for one minute
0 pulse rate 80 or below
1 pulse rate 81-100
2 pulse rate 101-120
4 pulse rate greater than 120   
Sweating: over past ½ hour not accounted for by room temperature or patient activity.
0 no report of chills or flushing
1 subjective report of chills or flushing
2 flushed or observable moistness on face
3 beads of sweat on brow or face
4 sweat streaming off face   
Restlessness Observation during assessment
0 able to sit still
1 reports difficulty sitting still, but is able to do so
3 frequent shifting or extraneous movements of legs/arms
5 Unable to sit still for more than a few seconds   
Pupil size
0 pupils pinned or normal size for room light
1 pupils possibly larger than normal for room light
2 pupils moderately dilated
5 pupils so dilated that only the rim of the iris is visible   
Bone or Joint aches If patient was having pain previously, only the additional component attributed to opiates withdrawal is scored
0 not present
1 mild diffuse discomfort
2 patient reports severe diffuse aching of joints/ muscles
4 patient is rubbing joints or muscles and is unable to sit still because of discomfort   
Runny nose or tearing Not accounted for by cold symptoms or allergies
0 not present
1 nasal stuffiness or unusually moist eyes
2 nose running or tearing
4 nose constantly running or tears streaming down cheeks
  
GI Upset: over last ½ hour
0 no GI symptoms
1 stomach cramps
2 nausea or loose stool
3 vomiting or diarrhea
5 Multiple episodes of diarrhea or vomiting   
Tremor observation of outstretched hands
0 No tremor
1 tremor can be felt, but not observed
2 slight tremor observable
4 gross tremor or muscle twitching
  
Yawning Observation during assessment
0 no yawning
1 yawning once or twice during assessment
2 yawning three or more times during assessment
4 yawning several times/minute   
Anxiety or Irritability
0 none
1 patient reports increasing irritability or anxiousness
2 patient obviously irritable anxious
4 patient so irritable or anxious that participation in the assessment is difficult   
Gooseflesh skin
0 skin is smooth
3 piloerrection of skin can be felt or hairs standing up on arms
5 prominent piloerrection
  

Total scores

with observer’s initials

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Score:
5-12 = mild;
13-24 = moderate;
25-36 = moderately severe;
more than 36 = severe withdrawal

[avisg]

I agree with everyone here the only thing I might try diffrently is instead of the 30 min 2 mg if you can try 60min inbetween

[Crisk]

Thanks for you advice i took the suboxen in increasing doses and i feel fine now! Thank you for helping me!!!