Buprenorphine and family physicians

[Dan]

Dear Doctor:
Is it possible to switch from methadone 60mgm.'s to buprenorphine eight mgm's?  When will our family physician be able to prescribe buprenorphine for maintenace or detox purposes?
Does methadone or other opiates have to be out of our systems to switch to buprenorphine for maintenace or detox purposes? How long does bup. stay in our body for maintenace reasons? Would you take you dose daily or q 72 hours?Thank you for your reply.
Dan...

[Dee]

I'm a little confused as to what you mean...can you explain this a little more?...where is the vicodin board? thanks..take care

[J.B. to Brian and Vicky]

Welcome back!  It's been a while since you last posted so I assumed you were hard at work and doing well.

I'm puzzled about the copying and pasting thing on the Vicodin board.  Where are they pasting these things at?  It sounds kind of strange that someone is out to break someone's anonymity but I suppose that some sick individual could get pleasure doing it.

Please keep us informed about this as I am definately concerned about my own personnal anonymity as well.  

Take care and be well!

J.B.

[Patrice]

Hi guys

Just wanted to let everyone know that there is a person who is copying and pasting some of these posts we are writting on the vicodin board.  I am fairly new to this board (and new to recovery again) but I know this is a place where we can relaxe and say what we feel and someone is breaking anyonimity, if someone knows anything I can do about this PLEASE E mail me at ***@****.  And I will stop it.  Something I wrote very private showed up, and I dont want it to happen to anyone else.  Also just wanted to let you know, I am still struggeling with the heroin addiction.  I am trying so hard, but I cant seem to put it down.  I am still going to my meetings and not lying about being loaded, but why cant I stop?  I had 12 years clean, and now I cant even put together 1 day!  I try to talk to people, but I think they get tired of hearing it.  I was doing good, and now I am up to about 1/2 gram again.  Please think of me in your prayers.  I know I can do it, it just I am so afraid of being sick again, the legs kicking, the sleepless nights, any suggestions from any of you out there.

Love Ya

***@****

[J.B. to Brian and Vicky]

Today is the 28th and I hope you are still with us.  I do care about you as a fellow suffering addict.  You made the goal of the 26th to get clean and I can only hope that things are going reasonably well.  God, I've been where you are so many times that you would think that I had it all figured out!  I'm just smart enough to know that I don't know very much at all.  But I can at least try to share your pain and maybe be of some help.

My words are inadequate but my feelings run deep and true.  I know what you are going through!

[Patrice]

Hi JB

Please E mail me I would love to talk to you, I feel we are somewhat in the same boat.  I pray that I can keep my promise to quit the 26th.  I am being 100% honest at my NA meetings, and have a lot of support.  Some people in my group think they are better than others, but that is their shiat, not mine.  I acually had a guy tell me he got loaded because I did.  Thats BS, we do it to ourselves, if you want to talk privatly my addy is ***@****  Have a wonderful Holiday Season, I care about you, because you are an addict just like me.  May be different drugs (I dont know) but a drug is a drug.  Like I told my sister, "when you put down the vodka you can rant and rave all you want"  Shes not in the program, so she doesnt understand.  My family has deserted me, and I can live with that.  I have my hubby Mike my dog Sparky, and anyone in recovery is my family

Take Care and God Bless

Patrice

[J.B. to Brian and Vicky]

My family found out about me when I got busted for script forgery.  To say the least, it was humiliating and yet I felt that a great weight was lifted from my shoulders.  To this day some of my family shun me but that's their problem.  Help comes from unimaginable places at times when you are down and out.  I found that people who ranted and raved at me the most were the very ones who helped me the most.  Listen to all, you have it coming.  It's the indifferent ones that bother me the most.  In my way of thinking indifference is the opposite of love.  When we are in bad shape we need all the love and attention we can get until we can begin to love ourselves again.  I'm just rambling here but maybe you can make some sense out of it.

You are going to be just fine!

[Patrice]

To JB from Patrice.  Hi JB.  Thank you for writting me.  I feel the walls closing in on me.  Now my family found out and they are normies and dont understand.  They say its willpower, Fu&& its a diease, nothing moral about it.  Than you for keeping me in your prayers.  I need all the support I can get.  Some dope fiends forget where they came from and judge me.  I am sooooooooooo greatful BBB gave me this website.  Please everyone have a safe Holiday Season

Love to all

***@****

[J.B. to Brian and Vicky]

Maybe the only hope you have of making it right now is your support group and your honesty.  One of my group left the program after nine years and lasted less than a week out there.  The problem was that we could see the trouble coming but could not manage to keep him from the big relapse.  It was like a death wish and he got his way.

I will include you in my prayers.  Thanks for posting about the so-called pill detox.  I still believe in the old fashioned way.

Please keep us posted!

[Patrice]

Hi everyone.  As some people know, I was on the Bup/NX detox.  Now I am asking that anyone considering this detox, ( I am not talking about the one Dr. Goberman does)  This one is the detox in the pill form.  PLEASE stay away from it, it made me feel worse the longer I took it.  I was retaining water, couldnt go to the bathroom, and just kept getting sicker.  I walked off at 18/.05 mg.  I was ok for 5 days, then I started having the worst withdrawls I have ever had.  I have now relasped,just to keep from going insane.  My arms ache from skin popping heroin and I am scared.  I have been in NA for 16 years, and I see that people like me who had a lot of clean time, usually dont ever make it back, well I am determined to get clean again!!!!  I am still going to my meeting everynight, and last night finally got honest.  I told my support group I am using again, and have a lot of support.I set a goal, my clean date is going to be Dec, 26th.  I know I can make it (one day at a time)  I know that kicking heroin is going to be easier than this shiat that I was on.  Thanks for listening, if anyone wants to write me my addy is ***@****.  And big hugs to BBB and all the people who have answered me and been so understanding and kind.  Please everyone have a wonderful holiday Season

Love

Patrice

[Brighty to JB]

Well..... I have to admit... I like your style !!! I think your information is as clarifying as I need !! BTW....you're a really nice guy!! I see Gina on the weekend and I will give her the hug. I know it will make her happy....Thanx soooo much. Christmas peace to you and Marty. Love, Brighty

[Frankinscense]

When methadone is administred properly through methadone program useage of heroin or hydrocodone is blocked with your doseage of methadone.There is no high from heroin or hydrocodone. The blocking dose of methadone is usually around 70 mgm's. But you cannot continue to use heroin or hydrocodone. You have to slowly work up to your dose of methadone. Even a person on two grams or more of heroin a day still has to work up to an adequate dose of methadone. The combination of drugs is what caused your OD, not the methadone alone. Once you enter the methadone program or any other program you have to swear off the other drugs. Are you serious about quitting? Do whatever you have to do to do to get rid rid of your bad influences!!! Methadone alone, without any other combinations of drugs is very safe. There is very little success trying to use methadone at home without medical supervision. This is very dangerous. In fact any unsupervised detox is not recommended. MMT programs offer supervision that all opiate addicts need while trying a detox.
                                                                
What kind of program is this bupe./nx program? Private or federally funded? Putting a cap on your dose of buprenorphine is in question here. A bias by the doctor, or the feds have put a cap on it because, I think you cannot continue to raise the dose of bupe. without raising your dosage of nalaxone. Nalaxone may be toxic at high doses. I DO NOT KNOW ENOUGH about bupe./nx combination to comment. I know very little about the program or the combination of drugs that you are taking to give you an honest comment.
                                                                  Methadone has thirysome odd years of research behind it to prove it is very safe for detox or maintenance purposes. There is no long terms effects on any of the vital organs. But you cannot continue to abuse other drugs while on methadone. At an adequate dose of methadone will stop your desire to use other drugs. (such as vicodin or any opiate.) Methadone can even help a person with alcohol problems,by stopping cravings for alcohol.
                                                                  What I have read about buprenorphine is very good. If half of what is written about bupe. is correct, then there is another genuine blow to the disease of opiate addiction. Patrice, continue with you program. IMO your are very fortunate to be able to participate in such a program. There are people all over that would love to be in your shoes. Bupe. is a schedule V drug and should be easier to get off of than almost all other opiates,due to its chemical makeup. It is a very unique drug. It has the same pain relieveing properities of morphine but without the sedation and respiratory depression. It is also a very safe antidepressant for some.
Stay with the program if you can. For heavens sake, have your surgery if it is necessary! Is it a necessary surgery?  If it is, by all means have it. I am on methadone maintenance and have had surgeries w/out any problems. Ask as many questions that you need
to feel secure with your program. The Dr. should not deny any answers to any of your questions. After all,you are there to help him(the dr.)and not just yourself. Best of Luck and Best Wishes!
Dan..
ps: e mail me at ***@**** if necessary...

[Patrice]

Hi Dan, I would really like to talk to you!!  Would you E mail me at ***@****.  I am starting to get worried because now I am hearing all of these bad things about my detox.  I have begged the doctor to increase my dose, but he wont.  I am on 18mg of buprenphine and.5mg of NX.  I want to talk to you, because I tried kicking using methadone this summer and I ODed on 30 mg.  For some reason my body cant tolerate methadone, and I was shooting a gram of heroin a day and also taking 100mg of norco.  So WHY would I have a bad reaction to methadone.  Of course I wasnt taking it from a clinic, I was buying methadone pills from someone I know.  Is this Buprenphine/NX really that addicting?  Then what do I do when its time to quit?  Also I was told that I could take a medication called Talwin NX, for a surgery I am supposed to have, but my doctor says if I choose to have surgery, he will kick me out of the program.  I am really lost here

Take Care

Patrice

[J.B. to Brian and Vicky]

It is kind of confusing when you only look at names of opiates.  In my opinion, they are all the same.  It's like asking how much beer is equivalent to whatever amount of scotch or wine.  The point is that they do the same thing in whatever form.

Then there is the method of delivery into one's system to consider.  Whether it's IV, oral, IM, or snorting and smoking-it's going to get into your system rapidly or slowly.  Then there's the matter of personnal preferences as to drug of choice.  I prefer morphine to heroine for instance because I think it's a "cleaner drug".  And I like it IV because of the orgasmic rush I get.  See how complicated it can get?  And yes, a megadose of hydrocodone will kill you just as dead as a smaller dose of heroine.  Lastly, I've smoked opium and my bronchial tubes and throat suffered as a result.  Some people just love the high though from smoking opium, regardless.

BTW hello and merry Christmas Brighty and Daughter!  Please give her an extra hug for me.

[Patrice]

Thanks for your support for me Shelly!  What I meant by one bad day was I was taking 100mgs of vicodin and shooting a gram of heroin a day.  I didnt get my detox until 1:30pm that afternoon and I was sooooooooooo sick.  My hubby Mike had to shower me, dress me and blow dry my hair, I just said f%%k it with the makeup.  It took a whole day to get feeling better because the doc had to fix my dose, and now I feel great.  Still crave the drugs,but that is normal.  I just want to say thank you for caring.  If you want to ever talk my E mail address is ***@****

Take Care

Patrice

[Frankinscense]

Buprenorphine! You said that you still crave the drugs? With methadone,if you still crave the drugs,you are not @ an adequate dose. The idea with opiate agonist therapies(buprenorphine,methadone,LAAM and others) is to have absolutely NO cravings. If you are having cravings or withdrawals or both you must get a dose increase!! If you still have the urge to use a dose increase would be in order. If the prescribing doctor will not allow this,ask him/her why? If they say that you cannot have an increase, then there is something wrong with the doctor or the buprenorphine/nalaxone treatment. Putting NX in the formula is poor formulation. I see nalaxone is necessary for IV drug abusers because it keeps them from overdosing. But,for those of us who are not IV drug abusres NX is not necessary. IMO nalaxone should only be taken for a short time (year or two)
tops. Because some studies show nalaxone have a little negative effects on the liver. I am not a medical doctor so I cannot say that this negative effect is warranted. But if the addict has
hepatitus NX may not be a good idea. But in the case of "harm reduction" it may be necessary. These are just my opinions on this subject. Best Of Luck to you Patrice, Be Spiritual, God Bless You and your Loved Ones >>>
Dan.....
                                                                
post script: if this program does not work for you,consider LAAM or MMT they are proven positve therapies for this horrible disease of opiate addiction or for people who are "Endorphin Challanged". One Gram of heroin + 100 mgm's of hydrocodone =  a defiency in you endorphins (endorphin challanged)Dan..

[Brighty to Dan]

What a great and informative post you sent to Patrice. Now I end up with a zillion questions. Is one gram of heroin the equivalent of 100 mgs of hydrocone ?? Is one gram of heroin what a common "1 bag" would be ?? Also, I have been reading here for months about vicoden, oxycontin, percoset etc... Frankly, I have no clue what is in them such as morphine, codeine etc... and then I really don't know the difference between them all... I think you know what I mean... and I am also curious about strenghs... I realize that heroin is the strongest... but why is that ?? I mean couldn't a megadose of vicoden be stronger than a mini dose of heroin ???? I have never really understood all this. I realize an addict is an addict... but you know... somehow heroin is the worst...top of the list stongest. Can you make sense of this for me. I wonder if I am the only one who does not understand all this... and then, how is opium different or the same from all these other drugs. I have not yet seen an opium addict post in this forum... but I am told they exist. Well, I've seem them in old movies actually :-)) Thanks for you help... hope I am not putting you on overload !! Love, Brighty PS... I realize this may not be a good post if people here are looking for specific help and not general information like this.. so I apologize in advance... and my e-mail is ***@****

[barbara to pain and lortab]

J.B., Thanks for the welcome back.

No, I don't get offended too easily and if I was to dislike a comment I just ignore it or take it for what it's worth. There are some constructive criticisms on the board occasionally so I don't mind the differing opinions. Some are just plain entertainment! Thanks again and keep coming back!

[J.B. to Brian and Vicky]

Congradulations and welcome back!  I was wondering what had happened to you all these weeks.  Egotistical me thought one of my posts had pissed you off!  Anyway, I glad that you are doing ok and posting again.

[barbara to pain and lortab]

Hello again, I was out for six weeks because I went under the knife and do not have a computer at home and wasn't allowed by my Doc to climb my three flights of stairs at work for six weeks.

After reading all about those drugs I got to try a number a pain killers. Dilaudid definately did the job in the hospital, knocked me right out. I only had to stay one day, got good sleep.

Percocet was a waste of time, codeine was okay but Ultram still does a better job and the constipation from the codeine gave me a blockage that almost killed me. I threw the rest away.

I still prefer my Klonopin and Ultram combo. It seems to keep me going. The seizures still break through but I get groggy from the Neurontin and now am on too low a dose to completely stop the seizures. I would prefer more Klonopin but my Doc put a limit on the 8 MGs a day. Oh well it could be worse.

At least I have not had a drink in six months.

[From Aunt Lindy to Mariah]

Patrice,
  Just wanted to say best of luck with your treatment.  It sounds like you are doing very well.  Keep it up!  You can do it.  What did you mean when you said that you had one "bad" day. Meaning you felt bad or meaning that you cheated for one day?  I am very curious how you are doing.  Can you  work/function okay during the day? Again, best of luck to you.  Patrice, what a great Christmas present to yourself and what a great way to start 2001! YOU GO GIRL!!!!!!!!!!!
Sincerely,
Shelly

[Patrice]

Hi everybody

I am on the buperphine/Nalxon treatment as I write this.  It is much beter than methadone,  (I tried that one many eons ago)  It is a miracle for me I have been on this drug for 5 weeks, and had only one bad day(my first).  I would love to help anyone interested in this program,where the offices are here in the US etc.  Please E amil me anytime  ***@****

Patrice

[Brighty to Dan .... and all .]

Dan....you speak from experience and information gathered from sources that has yet to be refuted.... keep up the good posts. I know I learn alot from them. And to all the regulars... posters and lurkers alike.... we all recognize that the doctor assigned to this forum may be doing good for his patients on  a daily basis somewhere.... but is unable to spend much time here with us. This board is essentially a patient to patient support forum. Frankly, addiction is not an accurate science... pharmacology is ..... but the effects of dosing and pain relief vary from person to person.... and for this reason all the accuracies lend themselves to major inaccuracies.... so we really do need all the input from everyone who is willing to offer it. Anyone who is offended that they get info from others than a doctor can write to ***@**** and complain. In the meantime, Dan has supplied a whole new ,positive perspective to the methadone thing... it is very misunderstood, and certainly not for everyone... Dan is proof that it can work... and who wouldn't be touting something that has given them their life back??? This is what Dan is doing... and doing it very well. Love, Brighty

[to Kat]

As usual, good post Dan. I appreciate your input and perspective, even if some others don't.  As long as you don't get TOO moralizing on methadone, they probably won't get so upset.  I understand your enthusiasm for it, but some people take your posts as too energetic shall we say.  To Oxy Tom:  I really do think that you need to strongly consider methadone.  It would do several VERY important things for you: 1. provide adequate pain relief; 2. stop craving, withdrawal, etc.; 3. ensure adequate amounts of narcotic to allow proper brain functioning (i.e. mood stabilization, etc.); 4. be cheaper; 5. easier than rationing pills, going to lots of docs; constantly taking pills throughout the day, etc.  The ONLY negative I see is the difficulty in withdrawing from it, BUT, with someone like you, why not see it as a lifetime of relief, rather than a life sentence?  Why would you ever want off it?  It seems the only logical route at this point,and I hope you SERIOUSLY consider it.  What other options do you see?  Good luck to you.  Phil

[Frankinscense]

Methadone has been the answer to my problems. You missed my point. I am not stuggling with methadone. Methadone has created very little problems for me. Methadone is not a drug substitute. It is a medicine to stabilise an imbalance caused by opiate abuse. I do not get high on methadone. Methadone is used in my case in other pill addicts cases to stabilise the imbalance in my endorphin receptors. It is used much like insulin is used to stabilise an imbalance with the sugars in your body. So,you see  methadone programs allow addicts to live without cravings and to function without the sufferings of withdrawals. I would consider it oxy Tom. It is a program that would allow you to have your life back. Tom you have to try to understand methadone causes changes in your life for the better not the worse.
  Its a lack of understanding of what opiate agonist therapies are about that stops people from using it as a tool to get off short acting opiates.  I know you know that oxycontin is a timed released short acting opiate. That makes it all the worse to deplete endorphins. Oxycontin is probably one of the worst drugs to cause an imbalance in endorphins,that is available through prescription. I am trying to get off methadone to take my state board exams.It is an archaic requirement. Thats the only reason. You can bet if I suffer just one relapse, I will  be back on it in a heart beat. I have had very little problems with my detox. I have gone down 75 mgms. If I cannot accomplish this it will not be a disaster because other states do realise that methadone is a medicine and will allow me to take methadone while taking the exam. My state is still in the dark about methadone. Like most of the general public. My sincere best wishes to you.    Dan