Been through Inpatient detox - need help

[JB1939]

I just completed 5 days of Hospital opiate inpatient detox. I was released 1 week ago with instructions to take 4mg of Suboxone film 3 times a day. Two days after I was released I started to have all the symptoms of withdrawal. I went back to the doctor that administrates the hospital detox program (who I have to see to receive suboxone refills) and he insisted that I was not in withdrawal and there must be something else wrong with me. He took X-rays of my stomach and said if I'm not better in a couple days to come back to see him; otherwise he gave me a script for 8mg suboxone twice a day and in answer to my question as to whether I needed more or less suboxone, he said he didn't know, but if I changed dosage to say on the changed dose 3 days. He then sent me on my way. Logically I thought maybe I needed more suboxone and started the 8mg last night. I planned to wait 12 hours before taking more, but woke up sick after only 10 hours. So I took another 8mg. It took about 6 hours to feel better. The same thing happened during the day and had to take another after only 10.75 hours after I had taken the last one. I had ask the doctor if I could just stop taking the Suboxone all together and he said I would go into terrible withdrawal. Is this true even after I did the in patient Detox? I DO NOT want to take any habit forming drugs and no matter what, I eventually want off Suboxone even if I can't just stop NOW! I got started on pain meds for chronic back pain, but I would trade the meds for the pain. Please help me with some good advice. Thanks much.

[atthebeach]

congrats on going to the detox and wanting to reclaim your life.
what was your drug of choice, how long did you use and how much?
most times less subs is better.
subs are very strong.
withdrawal usually isnt gone in 5 days.
16 mgs is alot of subs.
how much of a script did they give you?
how long do they want you to stay on them?
were you abusing them or only dependent?

[atthebeach]

let me clarify.
how long do they want you to stay on suboxone?
were you abusing your pain meds?
what type of symptoms are your having?
it would be better to treat your withdrawal symptoms
than stay on the suboxone.
your withdrawal symptoms will improve each day.
you will begin to typically feel better within a week or so.

[JB1939]

Thank you for your response.
I got started on pain meds because of DDD & spinal stenosis.

My drug of choice: Norco 10/325 4 times/day for 8 - 9 years then dependent and switched to oxymorephone working up to 40mg 2 times/day with percocet for break through pain as required, Sometimes 1, sometimes up to 4 /day. Did not abuse, only dependent for 3 years.

First script was for 4mg 3 times/day. Went back to see doctor 6 days after release and he said that he didn't think I was having withdrawal, but gave me a script for 8mg 2 times a day and said he didn't know if I needed more or less Suboxone. He felt 4mg 3 times a day was enough. He left it up to me to decide how much Sumboxone to take. I wish I didn't have to take any Suboxone! I can't stand the nausea, shakes, light headedness etc..

Thanks again.

[Back2Me]

Suboxone does not agree with some people. I could not take it I tried ONCE. it was a disaster I felt like I was in WD and I did wait the time needed and everything.   I just quit you know. I have personally quit cold turkey multiple times on at least twice the amount of pain killers you were on. I'm sorry you had to go through all that in patient just to come out and have subs stick you like this. That's why I am totally against suboxone and methadone. I know it saves desperate people and have been there myself but it creates a whole other problem coming off of that stuff which is even WORSE then coming off of pain meds. And you are not truly clean while on them. You are still taking a synthetic opiate. That's just how I feel about them. I think you should have just stayed on the pain pills and slowly weened down. Or even just go cold turkey. Most people on here go that route. I have just found that trying to take the sub way out of it all does not always work. But cold turkey always works. And weening works good if you have the willpower.
I quickly got off of the suboxone, I actually went back to percocets and just stopped the suboxone and then weened down from the percs. But that's just me. That way I was just free of all of it. You are Going To experience some pain and suffering from even weening just depends how fast you taper. You can do it without the subs or inpatient. I have done this dozens of times. And yes it is a real batch. Staying clean forever is something I do NOT know about. But I am an expert on withdrawling.  It won't kill you, unless you have some crazy other condition you will not die from the withdrawls. You will just suffer a few weeks.

[JB1939]

Can I go back to the 4mg 3 times a day and what do I need to treat the nausea and shakes? Then after a few days can I step down to 4mg twice a day? I don't want to stay on Suboxone!!

Can I cut the 8mg film? The doctor said yes, but I read the Suboxone insert that said not to cut them.

Thanks more than you can know! Your info makes a lot of sense.

[nursegirl6572]

I would agree that probably most of your symptoms are related to being on too high a dose, versus not enough.  Most people, even those with very heavy habits, can be comfortably maintained on a pretty low dose.  Yes, you can cut the films.

My advice to you would be to try a lower dose, then like your doc said, stick with that for a few days, it DOES take some time to adjust to the subs.  4mg 3 times a day is a LOT of sub.  You could ask your doc about maybe even starting out with half of that daily dose, and that STILL may be too much.  What were you detoxed with in the facility?  Were they giving you Subs there too?  Again, ask your doc, but my personal, unofficial opinion is that you probably wouldn't need more than 8mg daily, and even that is pretty significant.

Best of luck to you!

[JB1939]

Thank you very much. In detox after they knew that it had been 24 hours since I had taken any opiates, I was given 2mg 3 times a day. The next day they upped it to 4 mg 3 times a day. That is what they sent me home on after completing detox. I am going to take your advice and reduce my dose. It would help if there was something I could take for the nausea and shakes.

I had gone back to see the doctor 2 days ago and he insisted that I was not going through any withdrawal and he didn't know if I needed less or more Sumboxone. He gave me a script for 8 mg.

Thanks again!

[atthebeach]

for nausea take small sips of ginger ale. Eat bland foods, crackers,toast.
The shakes will subside. It will take time.
You can take magnesium tablets.Hot baths with epsom salts will help.
The light handedness comes from dehydration.
Make sure you are drinking plenty of fluids.
You will feel better each day.
Cut down on the subs.
You have been on the subs a week?
Praying for your healing,
Debbie

[motye51]

Hey, I read through your post and some of the comments above.  I was taking subs for 7 years which was supposed to be for a heavy opiate addiction.  I should NOT have stayed on them that long, that's for sure!  From the detox I experienced off the subs, it's my understanding that detox off of straight opiates lasts 5/6 days, where sub detox lasted me 4/5 weeks, just the physical part.  If I were you, I'd just bite the bullet and finish the detox off of the pills minus the subs.  From the date you posted the first post, you should be on day 8 I think.  I started at 24 mg for the subs which from what I was told was WAY too high, just remember this, if you start taking the subs, your going to have to wean and w/d off of those too.  Do you want to w/d once or twice?  The tapering process off the subs is very slow and I was told you feel mild w/d while you taper????  Your choice, and again, I'm not a doctor, just a person who got sucked into subs and thought they were a miracle cure (they did prevent me from having opiate w/d's) however, no matter what....we ALL HAVE TO W/D!   In order to have everything out of us....we must go through it.  Good luck to you!

[JB1939]

Thank you and everyone else that have taken the time to try and help me. I really appreciate all the feedback!

I am going to cut back on the Sub and try and ween off completely over the next 2 weeks. I hope I have not become dependent on the Suboxone. I do not want to take any opiates.

Thanks again to everyone!

[motye51]

I hear ya on not wanting to get a "new" addiction.  That's all we don't need!  While tapering, consider what type of aftercare your going to do, N/A, counseling, etc...  I do N/A now about 4 x's a week and it has helped tremendously~

[Back2Me]

You may be going down a rough road staying on subs for two whole weeks. Like others and myself have said have you considered just stopping the subs and weening off of pills and biting the bullet? You are gonna start down a miserable path with those subs I'm afraid.

[Bigdaddy1313]

I really struggle with many posts here regarding Suboxone. After a long time opiate addiction I was put on 4 films 32 mg each day. I took the entire dose at 6 am in the morning and was good until the next morning. They saved my life and I started to feel normal with zero side effects. That was years ago. I than began to come down and over a period of time went from 32 mg to 8mg with zero WD's. I am a firm believer that a slow taper works and is wonder also why people break up their doses since Suboxine has a long half life. I've read so many horror stories about subs but I've also read a lot of stories just like mine. It leaves me very confused.

[motye51]

I hear ya...and I've read on here, for some people, the slow taper works....Just not for me. We're all different, no biggie.  But I will tell you I've NEVER heard of taking the whole dose at one time.  I was told, and it was on my RX bottle, to take 8mg, 3 times a day.  Never said anything about taking it all at one time? That's new to me.  I just think back to when I was doing opiates, how many times I tried to taper and just couldn't.  The amount of $$ and time wasted on the subs was ridiculous and honestly, should I have just gone c/t off the opiates then gotten my *** to a meeting?  I was never told to do counseling or N/A while taking the subs.  I know that I am one that is totally against the subs and some people, they work.  I think everyone is different and we just have to do whats best for us!  Maybe your just lucky! :)

[atthebeach]

Good morning. How are you feeling today?
Keep moving forward.
Keep the faith.
You are healing.

[JB1939]

Thanks very much for your encouragement. I dropped down to 4mg Subs on Thursday night. Took 4mg at the same time Friday night. This morning at 1:45 am I took 2 Ginger Root caps for the nausea and fell back asleep. Took more ginger this morning. The nausea and shakes are my worst symptoms.

I don't know how soon to step down to 2mg Sub. I don't want to stay on Sub so long that I become dependent on it! I hope I'm not already dependent. It has been 2 weeks today when I was first given Subs during my inpatient detox and then after.

Thanks again.

[Dane74]

You are doing great!  I know you want this over with but try to drop slow, it really helps with the withdrawal.  Allow your body to get adjusted to the 4mg and then i suggest dropping again.  I did a slow and steady taper off subs and still experienced the WD but i went slow.  Good luck to you, keep pushing forward.....

[JB1939]

This is my 4th day on 4mg Sub. This morning I feel more nausea than the last few days. When should I drop to 2mg? You are correct . . . I just want this over, but I am being patient. I don't trust the detox MD, but I feel like I'm not sure if I'm doing this correctly. Thank goodness for all you folks on the forum!

Thank you all.

[atthebeach]

You should be able to drop again. It probably just doesn't agree with you or else the dose is still too high. Subs are very, very strong.
Did you already dose for today?
Does your nausea last all day and night?
Praying for you

[Ballgame]

Odd to me that after 5 days still on suboxone. Would think you wouldn't need those 5 days in the hospital to end up on suboxone.

[JB1939]

The Detox doctor said it would take 1 year to wean me off the sub. I do not want to stay on sub if I don't have to. I am dosing at 9pm and it is lasting until the next night. I think I'll drop to 2mg tonight. After that I'm not sure how long to stay on 2mg and when to stop all together.

Thanks again.

[clean_in_ks]

Hi there, JB....I just now have read through this whole thread and find myself REALLY relating to you.  I became addicted to pain meds due to numerous medical crises in my life and when the time came to get off of them, I was referred to a sub dr. and ignorantly went on subs and ignorantly jumped off the subs.

I wanted to share a conversion chart I found here on MedHelp that shows you how much suboxone (buprenorphine or it's nickname "bupe") is equivalent (approximately of course) to many of the pain meds.  I think it will help you...it sure did me!

Conversion table other drugs equivalent to sub  

Jul 24, 2008 from Avisg's Journal

#Pain Killer Equivalent Doses (Oral)
1.2mg.............Buprenorphine (Bupe)
200mg............Codeine (Tylenol 2, 3, 4, etc)
30-60mg.........Diacetylmorphine (Heroin) (orally it = morphine, IV/IM/insuffilated it's 2x as strong)
100mg............Dihydrocodeine
30mg..............Hydrocodone (Vicodin, Lorcet, etc)
7.5mg.............Hydromorphone (Dilaudid)
37.5µg............Fentanyl (not sure on this one, anyone know the oral dose equivalence for Fentanyl?)
4mg................Levorphanol (Dromoran)
300mg............Meperidine (Demerol)
10-20mg.........Methadone
30-60mg.........Morphine
20mg..............Oxycodone (Oxycontin, Percocet)
10mg..............Oxymorphone (Numorphan)
200-300mg.....Propoxyphene (Darvocet)
150mg............Tramadol (Ultram, Ultracet)
**************************************************************************************Now, from what I've read above, for 8-9 yrs you were on 40 mg a day of Norco/hydrocodone....then were switched to oxymorphone...I think that's right.  Here's what you said above:

"My drug of choice: Norco 10/325 4 times/day for 8 - 9 years then dependent and switched to oxymorephone working up to 40mg 2 times/day with percocet for break through pain as required, Sometimes 1, sometimes up to 4 /day. Did not abuse, only dependent for 3 years. "

So when you went to inpatient detox you were on 80 mg (total) of oxymorphone/day and using Percocet/oxycodone for break thru pain, right?

The equivalency chart should help you to see how much sub is = to your total day's dose.  You have a HUGE advantage over me, JB, because I didn't find MedHelp until I was already off the huge sub dose the sub dr put me on.  I was on about 100 mg/day of hydrocodone when he saw me and he put me on 16 mg per day of suboxone...that is = to 480 mg of hydro!!!!
More than I was on when taking the pills.....The whole ordeal was a VERY BAD experience for me....and after finding MedHelp I realized what I had been thru was just plain CRAZY!!!  

I see above that there are some varied opinions about HOW you dose your sub....once a day or split doses.....I read the Rx info sheet from the mfr of subs with a fine tooth comb when I was on it and it clearly states you can do "either".....take it all in one dose or split your doses.

Another thing, JB, is that our age must be taken into consideration, too.
At your age, I would think "less" would be better than "more" because we metabolize all drugs differently as we get older.  Just a thought, ok?

I'm sorry we cannot tell you exactly when and how to reduce your sub dose....just know that because it is a synthetic form of opioid, it takes about 21 days to totally get it out of your system once you stop taking it.

I was only on subs a total of 28 days.  I didn't go "on it" correctly....my dose was WAY too high....and I jumped off at 16 mg/day which was just NUTS!!
(but I didn't know it then..LOL)

I commend you for what you are doing! Please keep talking to us and asking questions.  You are SO fortunate to have this forum NOW.  I have learned WAY MORE from participating in this forum than I ever did from my doctors.
Hang in there ok?  Your pain levels may increase when you go totally off the subs.....but that is due to rebound pain from nothing being on your opiate receptors.  It will level out...and your pain should lessen in time.

I wish you only the best....sorry for such a long post....but I thought knowing all of this might help you.
Blessings,
Connie  

[madge23]

Hi,
     I dont know if it would be helpful for you to read what happened to me in my last post. I became very sick in January  after a 2 week detox at an addictions clinic and was hospitalised for 4 days. I have been codeine free for 15 weeks today. I live in Northern Ireland and i sometimes get confused on here as we have different names for the same drugs. I fully understand your frustration with being 'fobbed off' by doctors who cant tell you what or why you got so sick. The doctors in hospital kept telling me 'withdrawals'  even though id told them id detoxed 2 weeks before. Keep well .xx.

[bigscott69]

Hello I'm just now to the point I'm ready to get clean I have been on Narcos  for 5-6 years up to 15 a day my question is this I'm afraid to ask my DR for sub because he is the one who has been prescribing them to me, He gave me 180 a month of cores I had to buy extra is he going to get mad at me and not help me he is the only DR in my area that will prescribe subs. Will he still help me or will he just kick my out when I finally tell him the truth I need help I cant go on anymore. Also will i be able to function at work i could take a 2 week vacation i have 6 weeks coming to me. Any help would be great thank you