Is 4mg of suboxone a good start out dose??

Question

hi guys, i am in need for major help! i am an addict of 17 yrs and i am currently in the suboxone program. my story is a long painful one as is most addicts, i started using many street drugs, always in combo's such as oxi, xanax, meth, etc. i have tried quitting many times only to fail and fall back straight from the gate and end up 100x worse than before! one of the hardest drugs i have dealt with the stay away from is tramadol, i am guessing this is because they are easy to get from any family doctor and there extremely cheap on the streets, but at my worse i found myself swollowing 20+ at one time. i forgot to mention while intoxicated i was in a near death auto accident that i lived thru only to add a broken pelvis. i stopped using for 1 yr and 4 months after that only to return to an orthopedics doctor to find i now have chronic sciatica and an s.i. joint disfunction which combined is a horrible painful life. one week ago i joined the suboxone program and my doctor started me with 4mg. i am still suffering back pain and i am unsure if this is because i am still going thru tramadol withdrawls or if 4mg of suboxone just simply isn't enough. last night i woke up with my legs jerking and i was overly emotional for no reason. just unsure what to do, should 4mg be enough ???

This discussion is related to Starting to Withdraw from Suboxone.

Andie015 · Accepted Answer

It sounds like you have been on some hard drugs for a long time. I was taking pain meds literally by the handful for many years so I can relate. When I went into rehab I was put on 16 mg of suboxone a day...a very high dose, but given my history it was necessary. When I started taking subs this dose worked well for me, I had very few uncomfortable wd symptoms. I gradually reduced this with a doctors help to where I felt comfortable stopping. It worked well as a tool to finally stop pain meds, I don't think I could have done it with out them frankly. I'm not saying your dose is good or not good for you but personally at the beginning, 4mg would not have cut it for me because of my history. If you don't feel like this dose is adequately controlling withdrawals speak to your doctor and let them know ASAP, there is no need for you to suffer when suboxone is there for the purpose of minimizing what you are going through. Good luck!

tramhead82 · Answer

thanks for the advice, however i tryed gabapentin (neurotin) bout 3 yrs ago, it was also to come off the tramadol, it helped for withdrawls but it was too much of a downer for me which of course i went from an entire script of tramadol a day to 10 800 mg neurotin and the buzz hit fast. i actually started takin tramadol to help with withdrawls from opana and roxi's. it helped until i realized the tramadol was worse withdrawls than the opana and roxi's. basically i was using any kinda of drug available to me at the time. however since i have been upped to 6mg i do feel a tad bit better, just hoping to go up again soon :)

michael1953296 · Answer

I feel for you. There is no easy fix. When I was on Trams I was taking up to i2000mg/2grams of trams a day. It's a wonder it did not kill me. I went cold turkey off the Trams(not recommended) and had a hell week not to repeat. I then went onto oxy;s and I am now working hard to stay off them Sub comes with it's own problems. I can't speak of Trams cuz I did not know about Gabapetin then but I went off the Oxy's taking Gabapetin around 2000mg a day and had no WD's at all.
This is a fairly common experience of not having WD's when using Gabapetin to come off opiates. IT may be a little different with Trams as Trams have a built in anti-depressant that messes with your serotonin levels so a mild anti-depressant along with Gabapetin may be the ticket. I would certainly give the Gabapetin a try since their is normally no WD's from it before I went on Sub that does have WD's.
Michael

Andie015 · Answer

Sorry...hit post accidentally....I was saying I don't have the tramadol experience, so I apologize for posting earlier. I didn't mean to comment on something I don't have extensive experience with. What I can say is this....give the subs a little while to kick in.... You still may not have an adequate dose. If you feel like this isn't the path for you than let your doctor know but do give it a chance, they can really help you if used correctly.

Andie015 · Answer

I have to say that I only took trams for a short time so I don't know the withdrawals from them, I was always on norco or vicoprophen.... That's what I detoxed from, which was brutal.... But I don't have the tramadol ex

nursegirl6572 · Answer

So, you have been on Subs for 4 days?  If so, you need to give yourself some time to adjust.  Sub isn't AS effective initially with trams for a lot of people because it's NOT a true opiate.  Keep that in mind too.

I would tell you to hang in there, you should be feeling pretty normal by beginning of next week.

tramhead82 · Answer

also i need to add that i was a street drughead for 17 yrs, basically my drug of choice being opana, roxi, & xan's. usually mixed meth w/ xan's to get that speed ball effect. but i have been on suboxone since mon july 22,2013 after 3 days of being on only 4mg i had severe wd symptoms along with a near nervous breakdown from my xanax abuse, so i visited my doctor and he upped my suboxone to 6mg... a day, which honestly is helping me very little. not sure if this program is gonna work out because i still want to use so if i'm not up to at least 8mg a day SOON i will no longer be able to continue this program THANKS GUYS FOR ALL THE ADVICE MUCH APPREICIATED

tramhead82 · Answer

i was abusing any street drug that was in the "form" of a pill, along w meth. basically any drug that gives u a buzz, the tramadol started w the doctor who gave me 3 a day, then in the end i would take a script of 90 in 3 days, and anyone who has abused, or took tramadol knows it is an EXTREMELY hard drug to wd from.

KLB84 · Answer

Do give yourself some time to see. I was on hydrocodone and started at 8mgs, but wish now I had started at 4 - just so it wouldn't be taking so long to taper from. Just saying - give yourself some time to see....

nursegirl6572 · Answer

Well, this is something you would want to discuss with the sub doctor.  When did you start the subs?

There IS an adjustment period, it's not unusual to feel some mild w/d symptoms while adjusting in the first week.  It's typically better to at least wait that first week out and allow yourself to adjust before going higher in your dose.

So, were you just abusing tramadol, or something else at the time you started sub?  How much were you taking?  Remember that a little sub goes a long way.