Starting Suboxone

I started Sub treatment this past Friday.  I was given directions on how to begin the treatment by my Dr.  I found that after taking the first 8mgs that I couldnt take anymore that evening.  They wanted me to get 3 pills in that first day but I was/am getting to high off just 8 mgs and so I cant take anymore than this without feeling like Ive been given a shot of demero/morphinel.  After taking just a half pill (4mgs) I feel like I did when Ive had surgeries, lying in the hospital and receiving pain shots.  Also, just like when taking my DOC (vics) I couldnt urinate real well, Im experiencing this on the Sub.  Yes, the good thing is that Im not experiencing any W/D from the vics but I dont feel right on this either.  I am going to call the Dr. tomorrow but I was wondering if anyone has gone through an experience like this when starting Sub?  I thought you werent suppose to feel high.  I feel high and somewhat shakey (shaky) as well.  Is this just the side effects of starting Sub till it gets in your system?  Im not sure what to think.

Thanks,

Ellen

[TrayCee]

I will never understand using Suboxone to come off Hydrocodone.  Its like shooting an ant with an elephant gun.  

The WD from Sub will be SOOOOOOO much worse than WD from Hydros.

But to each their own...

[steveo30]

i would stop using the sub.tracee is right.don't dig a deeper hole that your already in.i dont know alot about sub. and sure you will get many responses from people that will tell you the way it is.i had to post this comment because every thread i've read says using sub. to get off of lortab just dosen't make sense.good luck

[GA Guy]

I wish you would quit talking in absolutes when you talk about Suboxone. WD's from any opiate has many variables. Telling everyone that their withdrawals from Suboxone will be  "SOOOOOOOOOOOOOOOOO much worse than WD from Hydros" is not only careless, but untrue. Show me your documented proof that a proper Suboxone taper produces withdrawals worse than a CT detox from hydrocodone then I'll recing my comments and eat crow. I'd also caution anyone on here to provide "advice" that contradicts the advice of their doctors. To do so is just reckless at best. People should be asking their doctors these questions...not going to a forum and asking for medical advice.

[TrayCee]

if you CAN taper than why not taper from Hydros?

[TrayCee]

FACT!  Suboxone is W A Y stronger than hydrocodone

[tammyk_40]

I personally dont see a problem with tapering the suboxone and apparently either does the doctor.  Maybe the reason the doc wanted you to take so much is because...well, some addicts tend to exaggerate the amount of pills they were taking. I know I did. Suboxone will give you a bit of euphoria, but has a ceiling effect. Your body will get used to it. DONT take more than you need. Take the smallest dose possible.
As for people saying taper from the hydros, well some people have a hard time tapering from their drug of choice. So talk to your doctor and tell him about your symptoms.

[TrayCee]

have you "personally" tapered from Suboxone?

[tammyk_40]

No, why do you ask?

[TrayCee]

because you said you "personally" didnt see a problem with it.  If you dont "personally" see a problem with it you must have "personally" done it.

[avisg]

Traycee is correct we do have to keep in mind sub is a very strong med it much stronger then hydro. Using sub should never be done lightly it can get you in a worse place then when you started.Other times its the right chioce and its a personal chioce .

[dominosarah]

Please get ahold of your doctor tomorrow and tell him what you have told us.  He will be able to help you with your questions...........good luck to you     sara

[tammyk_40]

You're right, I have personally never had experience with sub. Ok, Im sorry . But I was just thinking about something to detox with other than her drug of choice. Ufindme, there are plenty of people on here who have experience with these drugs.  

[triplej321]

I see your already convinced.....but these ppl who told you about bad wd from suboxone are totally right. you need to do some more research and you will see some of the horror stories from WD from suboxone.
I currently take sub and have been for about 9 months. I tried to stop once because i thought i was healed already after 8 mon of the drug.
ALL HELL BROKE loose. the wd were horrible and i will never go through that again, I had to get back on sub because i thought i was going to die from all the wd symptoms.
I am very angry and i feel that i traded one drug for another, and now i feel stuck on sub. I am currently on a slow taper program. Hopefully that will work....but i read your post and if you think you are so right then go ahead and try to stop taking the sub and see what happens....the wd start after 2-3 days because of thte half life of the drug.

[GA Guy]

At what dosage did you try and jump?

[ufindme2008]

This is so screwed up here I dont know whose asking who what now

[allaboutmary]

ufindme..........I also felt awkward the first week on Sub. . Sometimes it's just a matter of getting your dose right.  How many Vic's were you taking per day ? I was taking about 80-100mg of Vicodin  and found I was comfortable on 6mg of Sub per day. Hang in there.  I'm sure your doctor will get you straightened out.

[sarahsmiles1244]

I felt like you did when I first starting taking Suboxone.  I did feel "high" i guess just the first couple of days and that was it.  I was taking 8mg morn, 8mg night.  My history of "using" was Hydrocodone/Lortab, about 8-12 pills daily, for about 5 years.  If it scares you to have that feeling than call your doctor.  It's probably because he put you on too high of a dose.  Let us know what you do.

[avisg]

Lots of people get high off of sub ....people are buying it off the streets its an issue with the highshoolers where I live .


U talk to your doctor tommrow . How much hydro were you taking ?

[triplej321]

I started at 16mg a day and several months later igot down to .5 am then .5pm and then i jumped.

I really thought i was ready to stop and it was a rough experience. Some people have done very well stopping sub. Its very expensive and it dd help me beat a 8yr Hydro addiction so im very thankful. Im still trying to understand why my body reacted teh way it did.
I went back to the sub dr and he put me back on 4mg am and 4mg pm and im doiing just fine. I didnt immediate take what he wanted me to since i was down to .5mg. I find some days are better than others. What im starting to see is my brain is becoming dependant on sub, which i dont like. the trick of the whole recovery thing is to stay busy. I noticed in the summer time when i started sub i was always busy and even forgot some days to take the medication. Now with it being winter, i got to much free time on my hands. so needless to say im ready for spring so i can move forward.
good luck all

[hrsebz]

I have been clean from sub now for ten months I w/ded off 2mgs(because im a *******) and it was pure hell but my girlfriend who went on it with me did a slow taper and had vary minimal w/d symptoms I have not had any cravings for the vics since I got on the sub and am vary thankful for that....I would talk to you dr about doing a short taper insteed of maint.The sub made me high the whole time i was on it,so dont worrie thats normal.good luck

[GA Guy]

Personally, jumping at even 1mg a day is too much. I jumped at .5mg every other day and had very little withdrawals. The only major wd symptom was moderate anxiety. I am not unresponsive to people saying Suboxone withdrawals were bad. I know they are for most people. I just want people to take what they read about on the internet with a grain of salt. It's just like getting a bad meal at a restaurant. The first reaction is to shout to the rooftops how bad the food was. But, when you get a decent or good meal, you're just satisfied and may recommend it to a couple people. People's bad side effects with drugs (and, this is all drugs, not just Suboxone) is just like the bad restaurant. Your first reaction is to get online and tell everyone that will read it how much it screwed up their lives (and it very well may have...all drugs have their  casualties). The problem is that people never seem to make a point of posting good experiences with a drug they've taken. Why? They're too busy living life and going forward. Please, take your time tapering down, cut the Sub into slivers with a razor balde if you must. Slow and steady wins the race.

[worried878]

does sound like she is at too high of a dose of sub as hydro is a weaker narcotic in the scheme of things...and as far as "getting used to the dose"    seems like that would be good for some who planned to use it long term for mainteneance..but if to be used short term to avoid wd i wouldnt see the point of being on a high dose and "getting used to it"  i do agree that some need sub to get clean and others may be digging a deeper hole with a stronger narcotic than they were on in the first place...i used sub when i was out of pills several times in the past..i was a hydro user..80-100 mgs a day for 4 years...2 mgs would give me a jolt everytime...1 mg in the am and 1 mg in the afternoon was enough to keep wds away and 2 mgs was enuf to give me a buzz...light weight i guess...but why use more than u need and "get used to it"   I never have seen the point of that

[ufindme2008]

Thank you worried878.  That makes perfect since to me.  It was just that the Dr and pharmasist were pushing me to take at least 16mgs a day for it to work, but if I did that I feel Id be overdosing.  I will take very very small does twice a day from here on out. 1 mg, during day and 1mg at night.  Ive only been on it for 3 days now so it hasnt had too long of a time to build up in my system.  Ill call my Dr. tomorrow and tell him what Im doing.  I dont care if he likes it or not.  Plus, I want to be clean, not high.  Id really only like to take 1-2 mgs at night before bed because they make me tired, dizzy and hight (not my choice of high either), but the pharmasist I spoke to said theyd rather have me take them through the day.  Why???  What does it matter. Ill take the jolt, and pass the high. 1 mg sounds like all Id need.  Heck, Im even retaining water like I did when I was abusing 15-18 vics a day.  Pluse I cant urinate correctly.  It sounds to me like Im receiving the full narcotic effect from Sub.  Its suppose to block that part, as so I thought.  Well, Im rambling on here.  Thanks for the imput.

Ellen

[avisg]

Ellen,
make sure you let the doctor know you are retaining water and having trouble urinating OK just to be safe.

[CoachDrew]

My only advice to you is to post your question to Dr. Junig in the "Ask A Doctor" Addiction Forum.
He can tell you what you need to do. Plus he is very quick to respond to your question.
Also, while you can get some encouragement and some good advice at times, you can also get some people who are very quick to give their "OPINIONS" that are not based on any first hand experience, like with Suboxone. And, their are a few to give their opinions and will be validated by others because they have a history on this site together.

As a matter of fact this is my first post and after going reading alot of posts on this site there are a few people I skip over.

Ga Guy gives alot of good advice that is very well articulated and thought out. It's an S.E.C. thing I guess.
Good Luck and go post your question to Dr. J....................Drew.

[flmagi]

I've been on Sub for almost a year now along with both my sisters being on Sub too. Was addicted to Vics & Percs for about 4 1/2 years.
Everyone is different in how they seem to handle Sub and what the best dose is for them. It definitely sounds like your dose is way to high for you and you'd be much better off taking about 1-2 mgs daily.   The lower your dose, the better off you are in the long or short run.
I would suggest taking your daily dose in one dose in the AM, for 2 reasons......you need to break the habit of taking pills throughout the day, and Sub has a long half life, so you don't really get the ups and downs like with pain pills (unless your taking to much Sub & it's getting you high).
Good luck to you.

[avisg]

She NEEDS to be asking the doctor that prescribed her sub that knows her and her medical history !!!!

[refusingbondage]

I agree with Avis. She absolutely needs to discuss with her doctor to adjust her dosage.  

I have to say to coachdrew and ga guy
why on earth would people give their opinions and share their experiences and lie about them.  I am tired of people saying that those of us who have had a negative experience with suboxone dont know what we are talking about, are lying, or have no experience with it.  I have personal, first hand, INDIVIDUAL, experience with suboxone.  Long term use and withdrawal off of it.  Why would I lie about that.. I didnt become a member of this site until trying to stop my suboxone treatment.. which I was able to do with a lot of strength and the support of people on this site.  And the mere fact that you can pull old posts, new posts etc and see both PRO and CON experiences regarding sub shows you that this site and forum allows all people to express their opinions.. I posted a question in the beginning of my sub withdrawal at a different site a pro suboxone site where I thought I could get good advice from, which I will not name, and because I asked why my w/drawal was so bad (not being negative, but concerned about myself), my post was immediately taken down and I was sent a private email from their 'doctor' telling me basically that he "looks at people who claim to have w/drawal from quitting suboxone the same way he looks at people who claim to get high using advil - he listens but he just doesnt buy it."  Obviously if you are running a site and only allowing questions and posts that fit with your views, then your running a biased site.  I read lots of positive suboxone stories on this site.  None of them are taken down and I BELIEVE every one of them.  Different reactions from different people.  Some will struggle more than others.  

One cannot give an absolute regarding what withdrawing off of suboxone will be like. There are No absolutes with anything.  However it must be taken into consideration that withdrawal from sub can be hellacious because for some of us it was..  My Documented proof is that Ive detoxed off of every opiate around exccept methadone (from H to Oxy) and Suboxone was the WORST of the worst for me.  There is my documented unbiased proof.  However I am open and honest enough to know that is MY experience. Not everyones.  Nor do I claim it will be. And another thing - just because someone has an MD next to their name doesnt make them all knowing.  My suboxone doctor who I LOVE and who I believe is a great doctor has an MD next to his name -at our last appointemnet hugged me and promised little to zero withdrawal.  I found this site on day 11 or so because I was so sick and in such terrible withdrawal I thought something was wrong.   So yes, he was a great doctor.  And Yes he knew how to dose properly and I truly believe had my best interests at heart, but he wasnt ALL KNOWING when  it came to the aftermath.  How could he be?  I dont fault him for that though.  Sorry for this long post.  I just want to stick up and validate a little what some of us are trying to caution re suboxone.

[avisg]

Fefusing good post !!!!! There is both good and bad experiences with sub everyone here is welcome to express there experience .Sub has pros and cons all of which are welcome here .

[Lynn79]

Doctors start everyone on too high a dose of this stuff, which is WAY stronger than most opiates.  Most people stay out of withdrawal with only one 2mg pill every morning.  If I were you, I would seriously drop down to 2mgs the next time you take it, and I bet you won't even feel a difference.  You will probably feel much better, and just feel "normal."  And like Ga Guy implied, if used properly, Sub does have very little withdrawal.  It is because doctors start people on 16 mgs and then their bodies get used to having so much, that the withdrawal is horrible.  But the key is to use as little as possible to minimize the withdrawal, and begin tapering immediately.  After two weeks, the Lortab is completely out of your system, and so is the Suboxone.

[Lynn79]

I read the rest of everyone's posts AFTER I put my two cents in.  So let me clarify that I gave the advice I gave because it is what I wish I would have done.  Disclaimer: It may not work for everyone, as we are all different.  This medication is so new that the only thing doctors have to go on is the pamphlet they are given from the med company.  Someone really needs to get in touch with these people and tell them that not everyone can be started on 16mgs of this sh*t.  Maybe this works for people coming off a really bad and really large habit, but for the minimal opiate users, most say they feel fine on 2-4mgs.  And I can share from experience that you shouldn't be taking them more than once a day.  I made the mistake of adding an evening dose to my regimen, and it threw me right back into the addict mindset.

[GA Guy]

The ceiling effect is why most Doctors start on the higher dosages. As long as you're at 4mg and stay over 4mg, then the withdrawals should stay at bay. The problem is that Suboxone does eliminate from the body. It does so slowly, but does eliminate. So, if you dose a person with a fairly big opiate addiction at 4mg, then as the drug goes below that 4mg, withdrawals will return. Thus the higher dosages at first...to make sure the addict stays above that 4mg ceiling effect level. I do agree that after 5 days or so, the dosages should be reduced and that can be done quite dramatically until you hit that 4mg level. The problem comes when getting into dosages below 4mg. At those levels, Sub acts just like any other opiate, and must be tapered down.

And to refusing bondage, I never said people could or would lie about what they personally experienced. I even pointed out the contrary in my post. I just wanted to point out to those that are contemplating Suboxone that in the noninternet world, the bad experiences aren't nearly the 100 to 1 ratios like it seems on here or other message boards. This goes for any drug, not just Suboxone. I must also point out that finding a competent Suboxone doctor is of upmost importance. Good healthcare is your right. Never feel bad about "firing" a doctor that doesn't share your vies or believe your feelings.

[liscamdave]

I also agree with Lynn. If sub is used properly and NOT taken in amounts that are way too much, it is very beneficial. I am over one year clean and detoxed with Sub. I started out with a small dose and tapered immediatley. I think what Ga Guy meant is that people who have taken sub and had bad experiences with it, tend to make it a certainty to others that they WILL have worst w.d. And that they WILL be trading one drug for another. This poster should talk to her dr and tell him the symtoms (symptoms) she is having. But also, 3 8mg tablets of sub is a heck of alot. I was on 1200mgs of Oxy Contin a day and was not given that much sub. I know she only took one, but the fact the dr even gave her that much is wrong in itself. Good luck and I hope things work out.

[Kova]

to my knowledge doctors way over prescribe Sub.  they put people on large doses for extreme lengths of time.  seeing this happen again and again to people in my life makes me not trust in any SUb doctor i have seen so far.  in my opinion, they are either extremely ignorant and careless, or just plain greedy for your money.  that, again, is my opinion.

Kova

[worried878]

So if you take sub in doses over 4 mgs, it does not act like an opiate ?  only when taken in doses less than 4 mg does it act like other opiates?  i need to read up on the new sub data....this drug is getting to be more and more interesting as time goes by

Lynne, If you are having trouble urinating then i would definitely talk to my doctor as i had not heard of that being a normal side effect of opiates..everyone is different but like avis and refusing said..keeping your doctor informed of how u r responding so he can be aware of ur needs is important..we are the only ones who know how we feel but letting him know is important so if something happens there are no surprises..
Some cant tolerate 16 mgs of sub..a friend was put on it..120 mg oxy user but had been off and on oxies for a few months trying to quit but failing, when she got on sub...she took 16 mgs as directed the first day and was out of it..extremely sick for 3 days til it passed out of her system...then she was afraid to take the sub again due to the bad experience and went to methadone..needless to say she is now addicted to methadone after 4 months on it at 50 mgs...she did try and call the sub doctor to tell him she felt bad that first day but got the nurse on the phone who blew her off..i went over and spent the night with her that first night cos i was worried about her...
There are many good sub doctors out there who will listen to you and adjust your dose to the amount u feel comfortable with..i guess just like with any doctor, be it an obgyn or an ent, there are good and bad doctors out there...hopefull you have called or went in to see him and got everything in order..good luck to you

[refusingbondage]

There is a big debate on the long term/short usage issue.  Many doctors, including mine, advocated long term use as a maintenance drug - even to the point of telling people they can stay on a low dose forever.  Was not an option for me, but was an option given to me.  I think many advocate long term use because it does help keep you clean.  For me, during my sub use I rarely ever craved after the first few months.  And it does give you freedom from your drug of choice and the addict behavior that comes along with it.  And that is a great thing.  I will never say its not a good option for some people.  But its the lack of information about afterwards that floored me.  I was never warned about what happens after.  Only told it was a piece of cake to quit.  I struggle all the time now on the pro/con issue.  I really make an effort to not frighten anyone with 'my' story.  But I do think to myself that I wished I would have found real information on suboxone from real people having used it and stopped using it, before I started it.  I never did though.  I was searching for a 10 day detox center and found suboxone.com.  Made an appointment and the rest is history.  If I would have come here and gotten the advice that so many give about how well a short term taper works etc, I would have done it.  If somone would have warned me about what its like to stop, starting at 24mgs and stopping at 1mg after over 2 years, I would have been appreciative.  All I read and was told is that its a miracle drug, etc.  I heard nothing negative about it and the experience was shocking.  That is where the anger comes from with a lot of people who have negative things to say about sub, I think.  Being told you will have no problems with this medication and no withdrawal and buying it and then having a really hard time stopping. If my doctor would have told  me, warned me in the least... even said 'its a possibility' I would have at least been given a chance and a choice - with full knowledge.  And if I was smart enough to have come here for some information and good guidance, I would have definitely done Liscamdave's and others suggestion in doing a short term treatment..I come here now and read stories from people who are just starting and getting good advice and I am grateful that they came for advice.. and stories from people like myself who spent far too long on it and are unable to quit.. and I feel bad for them and try to tell people that yes, it can be good but its not all good and should be used very carefully.    

[worried878]

Also...did u exagerate the amount of pills u were taking so that the doctor put u on a higher dose of sub?  as a rule, people under-estimate the amount of pills, cigarettes or alcohol they consume ..when we assess someone for this type of thing, normally we assume the true amount is a bit higher than the answer given..if someone says they smoke a pack of cigarettes a day, often they actually smoke a bit over that..alcohol is the same way...if someone says they have 2 drinks every friday night, it is usually safe to assume they drink 3-4 drinks on friday night...i must say i have been gulity of answering these types of questions on the low side myself.....very few people will say they drink 4 drinks if they only drink 2...if they take 40 mgs of hydrocodone a day, few would exagerate that and say they take 60 mgs a day because as a rule, people want to "look good" to doctors and professional people, even to friends and family

[GA Guy]

I just wanted to post this for some of the people who may have missed it in Dr. Junig's expert forum. This is his explanation of the ceiling effect and how sub becomes a somewhat different drug under the 4mg ceiling. Again, these are not my words, just the explanation from Dr. Junig:

In your specific case, allaboutmary, things are a bit different   My comments apply to cases where a person is taking a dose above the 'ceiling' dose of about 4 mg.  If a person is taking 8-16 mg in the morning, his/her mu receptors are fully blocked-- that is why a second dose late in the day has nothing to offer as far as additional opiate effect.  But YOU are taking only 1 mg-- and at doses below the ceiling dose, the dose-response curve for buprenorphine is a straight line.  This is an important point to understand, because it is at the heart of the issue of why buprenorphine is different from opiate agonists like methadone, which have linear dose/response 'curves' throughout their dose range.  

When you plot out dose on the x axis and response on the y axis, and plot out buprenorphine, you get a diagonal line going up and to the right until a dose of 2-4 mg;  at that point the line flattens out to become parallel to the x axis (hopefully everyone took geometry in high school!).  If a person takes 16 mg in the morning, as the blood level decreases slightly over the next 24 hours the opiate effect remains constant-- no loss of opiate effect means no cravings.  On the other hand, a dose of 1 mg is on the diagonal part of the line.  At this dose, buprenorphine behaves and 'feels' much more like an agonist than a partial agonist.  This is why, by the way, people who abuse Suboxone tend to do poorly;  they tend to 'chip' the tablet 'as needed';  they are staying in the diagonal part of the dose/response curve, and they might as well be using vicodin or oxycodone, as that is how the buprenorphine is working at that dose!

Back to the case at hand...  with a dose of 1 mg, I would expect you to have an effect similar to the effect of taking methadone, where the effect would tend to wear off over time.  I would expect a dose in that range to need to be repeated at least a couple times, to cover an entire day.  I don't want to get too specific with recommendations as I want you to talk to your doctor, but that 4 mg dose is an important thing to be aware of, as buprenorphine and Suboxone become a different drug at doses beyond that level.  Below that level, a person will continue to have cravings, because as the buprenorphine is metabolized the opiate effect decreases.  If a person on that low dose complained of cravings, the correct response would be to increase to a higher dose taken once per day-- say 8 mg or so.  The downside to that is that you would then have constant stimulation of the receptors, resulting in rapid tolerance to the buprenorphine-- although people tend to continue to claim pain relief even after becoming tolerant to the psychic effects of the drug.  The benefit of going to a higher dose would be the reduction in cravings, and the more level opiate effects throughout the day.

[OuToFc0ntRol]

Ive been taking 300 to 450mil of percocet a day for the the past 2 monthes.  Last time was a day ago.  I want to stop right now.  I have a bunch of SUB. film 8mil and dont know anything about it.  What do I do now?  Open to suggestions.