Aa
Day 2 Subutex Reduction
Hi friends
I am here in the UK and on a subutex script.
For 8 yrs. I was on massive amounts of dihyrocodeine - I guess a mixture of hydro and vicodin - powerful stuff. I had built up to about 40 x 30mg a day and it was killing me. Originally started taking it for pain for an old spinal injury and stuck to the 8 per day. But with all addicts we tend to have heavy baggage and kid ourselves we are taking it for pain but really we are taking it to block of all the bad stuff that has happened to us in our lives that we cannot deal with, or can no longer cope with. We like the euphoria, the energy and being able to block things off. So we end up addicts.
Beg. of Nov. started on 6mg of subutex. First 6 weeks no withdrawals and just felt normal but emotionally nothing.
Started taking vitamins and minerals, good diet and building up a good exercise regime which for me was walking - now 40-50mins. per day. Stopped taking valium at night. Then first 6 weeks of year felt fantastic! Was reducing at 0.4mg per week. 'Natural energy', or so I thought, tremendous peace of mind and a zest for life I had not felt in years. I thought I was winning all round - the addiction and all my demons. Night meant pain at night and sleeping on and off all through the night and temp. swinging up and down. But okay. Head was clear and I looked a million times better. Sussed!
Down to 3.6mg and breakthrough pain started so I was told to stay on the 3.6mg and that was 9 weeks ago then the depression started. And boy oh boy it has been a roller coaster of horrors. With subutex, people talk of the 'honeymoon period' of feeling great, and then falling down. Fall I did. Anxiety attacks, pessimism about the future, no hope, severe anger about the whole of my life, bitterness, hatred, real extremes - the demons truly came to visit, and real, deep, profound unhappiness. Depression personified. The odd days bearable inbetween. Started researching subutex and found this could happen to people who had mental health problems, had not had such a great deal in life through things happening to them such as traumatic car crashes changing their lives and **** childhoods(!), and history of depression. Had not chosen methadone to get of the pills as knew I did not have the discipline not to abuse it. So ... what to do?
The shorter time you are on subutex apparently, the easier the withdrawal at the end, and the less likelihood of PAWS from what I can gather. I just want off it. Have had 3 days of feeling okay mentally and want to be rid of it. The dihydro should be gone and now this stuff, yet another addictive chemical needs to **** off too!
Docs need to tell you about the negative sides of the drugs that help you come off your DOC when they prescribe them. Had I known what was in store ..... I would never have stopped reducing back in Feb. Have wasted 2 months letting the subutex get more of a hold.
Day 2 - am down to 3.2mg. Need to take into account the half life, storage of subutex in body fat people talk about. If I feel stable after 5 days I will drop another 0.4 mg. Get the tablets in 2mg and 0.4mg.
Prior to starting, I began taking vitamins and minerals and making sure I was on a good diet, which I had let slip during the bad depression, which is when you just don't care. Had kept up the exercise because my dog needed to still get out and she has helped me a lot. Taking her to the fields and woods has helped me think a lot of stuff out. When I don't want to go, I force myself to. Seeing her enjoyment as she hunts and plays brings me pleasure when nothing else does.
Would be happy to hear from others - good stories and bad, and those that want to take the same journey. I will always reply.
Take care all
- F
I am here in the UK and on a subutex script.
For 8 yrs. I was on massive amounts of dihyrocodeine - I guess a mixture of hydro and vicodin - powerful stuff. I had built up to about 40 x 30mg a day and it was killing me. Originally started taking it for pain for an old spinal injury and stuck to the 8 per day. But with all addicts we tend to have heavy baggage and kid ourselves we are taking it for pain but really we are taking it to block of all the bad stuff that has happened to us in our lives that we cannot deal with, or can no longer cope with. We like the euphoria, the energy and being able to block things off. So we end up addicts.
Beg. of Nov. started on 6mg of subutex. First 6 weeks no withdrawals and just felt normal but emotionally nothing.
Started taking vitamins and minerals, good diet and building up a good exercise regime which for me was walking - now 40-50mins. per day. Stopped taking valium at night. Then first 6 weeks of year felt fantastic! Was reducing at 0.4mg per week. 'Natural energy', or so I thought, tremendous peace of mind and a zest for life I had not felt in years. I thought I was winning all round - the addiction and all my demons. Night meant pain at night and sleeping on and off all through the night and temp. swinging up and down. But okay. Head was clear and I looked a million times better. Sussed!
Down to 3.6mg and breakthrough pain started so I was told to stay on the 3.6mg and that was 9 weeks ago then the depression started. And boy oh boy it has been a roller coaster of horrors. With subutex, people talk of the 'honeymoon period' of feeling great, and then falling down. Fall I did. Anxiety attacks, pessimism about the future, no hope, severe anger about the whole of my life, bitterness, hatred, real extremes - the demons truly came to visit, and real, deep, profound unhappiness. Depression personified. The odd days bearable inbetween. Started researching subutex and found this could happen to people who had mental health problems, had not had such a great deal in life through things happening to them such as traumatic car crashes changing their lives and **** childhoods(!), and history of depression. Had not chosen methadone to get of the pills as knew I did not have the discipline not to abuse it. So ... what to do?
The shorter time you are on subutex apparently, the easier the withdrawal at the end, and the less likelihood of PAWS from what I can gather. I just want off it. Have had 3 days of feeling okay mentally and want to be rid of it. The dihydro should be gone and now this stuff, yet another addictive chemical needs to **** off too!
Docs need to tell you about the negative sides of the drugs that help you come off your DOC when they prescribe them. Had I known what was in store ..... I would never have stopped reducing back in Feb. Have wasted 2 months letting the subutex get more of a hold.
Day 2 - am down to 3.2mg. Need to take into account the half life, storage of subutex in body fat people talk about. If I feel stable after 5 days I will drop another 0.4 mg. Get the tablets in 2mg and 0.4mg.
Prior to starting, I began taking vitamins and minerals and making sure I was on a good diet, which I had let slip during the bad depression, which is when you just don't care. Had kept up the exercise because my dog needed to still get out and she has helped me a lot. Taking her to the fields and woods has helped me think a lot of stuff out. When I don't want to go, I force myself to. Seeing her enjoyment as she hunts and plays brings me pleasure when nothing else does.
Would be happy to hear from others - good stories and bad, and those that want to take the same journey. I will always reply.
Take care all
- F
Best Answer
Try to give yourself a break. I have found that most addicts are really great people, so awesome in fact, they beat themselves up for not being perfect. The problems in the world and life seem to touch the addict in a personal way. You will have the rest of your life to make up lost time, you will have time to be the person you intend to be. I found that I am becoming a better person and living a better life than I thought I was capable of. Stay focused on recovery, all the rest will fall into place. Great work so far. Time heals all things.
Hi Weaver, Just checking in.
Hope all is good with you.
Things were indeed really tough with dealing with my mother and when she came out of hospital. I was totally exhausted! Not sleeping through sheer stress and over-tiredness. Of course she cannot quite get her head round what it is I a doing and how important my 'routine' is and how extra stress can have adverse effect shall we say but I have been doing my duty and looking after her but it has been hard work. I had the day off yesterday as I was falling down. I kept on 1.4mg for 10days. Didn't want to push it and am now on 4th day of 1.2mg. Have appointments for mother and myself coming up this week and still need to be with her every other day, so will keep it at 10 days unless I feel I am strong enough to reduce again.
It has not just been the physical looking after, but her Alzheimer's leapt up due to the fact that SHE was in a stressful situation i.e. going in hospital and it reacts like that.
Have had added stresses on the my own home front too so the last 14 days - no thank you to a repeat of them!
Still, today the sun is out. I actually managed to get 12 hours lying down and slept well.
So ...... rock on!
Hope all is good with you.
Things were indeed really tough with dealing with my mother and when she came out of hospital. I was totally exhausted! Not sleeping through sheer stress and over-tiredness. Of course she cannot quite get her head round what it is I a doing and how important my 'routine' is and how extra stress can have adverse effect shall we say but I have been doing my duty and looking after her but it has been hard work. I had the day off yesterday as I was falling down. I kept on 1.4mg for 10days. Didn't want to push it and am now on 4th day of 1.2mg. Have appointments for mother and myself coming up this week and still need to be with her every other day, so will keep it at 10 days unless I feel I am strong enough to reduce again.
It has not just been the physical looking after, but her Alzheimer's leapt up due to the fact that SHE was in a stressful situation i.e. going in hospital and it reacts like that.
Have had added stresses on the my own home front too so the last 14 days - no thank you to a repeat of them!
Still, today the sun is out. I actually managed to get 12 hours lying down and slept well.
So ...... rock on!
Ok Weaver, I will go after the mother crisis is over and dealt with - or this one at least! And keep on reducing slowly.
Have just learned two things of great interest - there are opiate receptors in your stomach - described it almost like a second brain for excessive opioid users. Second, opioid induced hyper-algesia which would explain why the pain reduces as the detoxing takes place! Downloaded some papers but only managed to get through a couple as am so busy at the moment but it made things even more clear for me. So glad you kicked me off on this subject. I may have started thinking about it but you clarified I wasn't just perhaps being wishful in my thinking!
Weaver - will be no doubt be crying to you as the reduction gets way down low as it's gotta come, but look forward to being free. But whatever, rock on for sure!
Have just learned two things of great interest - there are opiate receptors in your stomach - described it almost like a second brain for excessive opioid users. Second, opioid induced hyper-algesia which would explain why the pain reduces as the detoxing takes place! Downloaded some papers but only managed to get through a couple as am so busy at the moment but it made things even more clear for me. So glad you kicked me off on this subject. I may have started thinking about it but you clarified I wasn't just perhaps being wishful in my thinking!
Weaver - will be no doubt be crying to you as the reduction gets way down low as it's gotta come, but look forward to being free. But whatever, rock on for sure!
Just checking in. How are you today? Don't worry about taking subs and going to meetings. The only requirement for NA membership is the DESIRE to stop using. It's in the book. You can listen at first. You'll find those who will support you. You have a lot coming up, if you feel you need it, then go. I had to take time off in the acute detox, but my new friends offered to bring a vomit bucket, if I wanted to go. Anyway, you will find what works for you, I'm certain of it. Keep on keepin on and don't forget to Rock On!!!
Great - thank you Weaver. There is NA which I was told I could go to even at early stage of being on subs. although 'some' people may think it a bit strange me attending when I was not 'clean'.
This I know I need in the near future. Have a tricky time coming up with mother having a knee op in 5 days which will mean daily attendance for 2 weeks (and the world revolves around her like it's a triple bi pass op! Plus it will all be a bit exhausting as well as bang in the middle of my son's important exams. After that is over I will go to my first meeting.
Should be down to 1.2mg at least then yee ha!
What does feel wonderful is that I am in control now through listening to my own body, research, and not being willing to be told what I should put into my body. Because I know what that can do!
I believe it will be good to meet new friends at NA too, as I cut myself off from people when I was a full on addict - shame, disinterest, in my own little world and knowing that others would not understand or would be appalled.
Also have to keep in mind that dangerous trigger point time when son goes to college in 2..25 yrs. and mother's Alzheimer's will really be showing its face. So I will need to be out there in the world with a proper social life and support and 100% strong in every sense
Never thought I would be one of those people needing support. It was always me supporting other people. How things change!
'Plan and accountability' were key words that you used, and I feel that NA would be of great assistance towards the end of the detox.
As ever, wise words Weaver. Rock on! x
This I know I need in the near future. Have a tricky time coming up with mother having a knee op in 5 days which will mean daily attendance for 2 weeks (and the world revolves around her like it's a triple bi pass op! Plus it will all be a bit exhausting as well as bang in the middle of my son's important exams. After that is over I will go to my first meeting.
Should be down to 1.2mg at least then yee ha!
What does feel wonderful is that I am in control now through listening to my own body, research, and not being willing to be told what I should put into my body. Because I know what that can do!
I believe it will be good to meet new friends at NA too, as I cut myself off from people when I was a full on addict - shame, disinterest, in my own little world and knowing that others would not understand or would be appalled.
Also have to keep in mind that dangerous trigger point time when son goes to college in 2..25 yrs. and mother's Alzheimer's will really be showing its face. So I will need to be out there in the world with a proper social life and support and 100% strong in every sense
Never thought I would be one of those people needing support. It was always me supporting other people. How things change!
'Plan and accountability' were key words that you used, and I feel that NA would be of great assistance towards the end of the detox.
As ever, wise words Weaver. Rock on! x
That's a great idea. If you need medication after detox, then you'll know if it works. I bet you will not need any meds., which stop working anyway. Hang around and take your time. Again, slow and steady wins the race. We will be here through the whole process. Are there any other resources, counseling, 12 step meetings, church, or anything in your area to build a support team? I found getting involved with other people around me, before I got off subs, very helpful. I go to AA mostly, and group counseling, but it really made a difference in those final steps of detox. Most like to detox first, though I couldn't wait. I needed a plan and accountability from the start. You have the right attitude and your knowledge is growing. You realize how short of a part of life this is. You have made a decision, now how can we help you to follow through, like I know you will?
Hi Weaver and Nursegirl
Amazing switch around with my useless 'outreach worker' yesterday. Saw her for the first time in 4 weeks. She was actually respectful and showed genuine interest! Had emailed her a few days before our app. about the reduction I had chosen to do at a faster pace, and more importantly the natural remedies I had put in place to prepare myself, and the research I had carried out prior to the reduction. Also said I had found invaluable support online and I mean you guys in particular. Thank you!
I left feeling good for a chance instead 'what was the point of that!' Got an appointment with the head honcho at the clinic for the switch to bu trans from sub as apparently it is complicated. However, as Weaver was saying, and I had just started thinking about ..... pain is under control and I do NOT want any bupe in my body. So I am going to carry on reducing.
I will try my hardest to get off these subs and not have any bu trans. I want to wait for the spinal unit referral - maybe there will be a blockage that can be done rather than chemicals be in my brain 24/7 that I don't want. All the severe and chronic depression didn't start until chemicals started being fed into me and then I started feeding them myself! So ... makes sense to avoid them if at all possible. Limit life physically ok, accept. Feel good mentally? That is fantastic! You can do so much with that!
To go through a difficult time for a relatively short period of time is comparatively nothing to 8 years of wastage. As the old sea saying goes, and when I used to sail: Steady as she goes.
Thank you both again. You are inspirational and have helped me so, so much. Fee x
Amazing switch around with my useless 'outreach worker' yesterday. Saw her for the first time in 4 weeks. She was actually respectful and showed genuine interest! Had emailed her a few days before our app. about the reduction I had chosen to do at a faster pace, and more importantly the natural remedies I had put in place to prepare myself, and the research I had carried out prior to the reduction. Also said I had found invaluable support online and I mean you guys in particular. Thank you!
I left feeling good for a chance instead 'what was the point of that!' Got an appointment with the head honcho at the clinic for the switch to bu trans from sub as apparently it is complicated. However, as Weaver was saying, and I had just started thinking about ..... pain is under control and I do NOT want any bupe in my body. So I am going to carry on reducing.
I will try my hardest to get off these subs and not have any bu trans. I want to wait for the spinal unit referral - maybe there will be a blockage that can be done rather than chemicals be in my brain 24/7 that I don't want. All the severe and chronic depression didn't start until chemicals started being fed into me and then I started feeding them myself! So ... makes sense to avoid them if at all possible. Limit life physically ok, accept. Feel good mentally? That is fantastic! You can do so much with that!
To go through a difficult time for a relatively short period of time is comparatively nothing to 8 years of wastage. As the old sea saying goes, and when I used to sail: Steady as she goes.
Thank you both again. You are inspirational and have helped me so, so much. Fee x
Do you now what Weaver, it's a coincidence that you have addressed this issue - as I have been thinking along these lines too! My pain has markedly DECREASED since I overdid and was laid up a couple of weeks ago, yet carried on reducing.
After seeing my outreach worker today, it seems switching to bu trans patches from subs is 'complicated' and have to see a specialist drugs doc again to make the switch. That's in anor 3 weeks.
Meanwhile, i will just carry on reducing the subs. In a couple of days it will be 1.4mg. Steady as she goes. I DO want to be opiate free and look at the pain picture again. My whole outlook on natural therapy, steady exercise, limiting life (okay a pain in the arse but nothing I can do about) is better than being filled up with chemicals 24/7. And, mind over matter - that all powerful tool that can be utilised to certain degrees, but can be used.
Thank you for making me think. It helps everyone gain valuable insight too, and think of things that seem 'impossible'!
All the best
- Fee
After seeing my outreach worker today, it seems switching to bu trans patches from subs is 'complicated' and have to see a specialist drugs doc again to make the switch. That's in anor 3 weeks.
Meanwhile, i will just carry on reducing the subs. In a couple of days it will be 1.4mg. Steady as she goes. I DO want to be opiate free and look at the pain picture again. My whole outlook on natural therapy, steady exercise, limiting life (okay a pain in the arse but nothing I can do about) is better than being filled up with chemicals 24/7. And, mind over matter - that all powerful tool that can be utilised to certain degrees, but can be used.
Thank you for making me think. It helps everyone gain valuable insight too, and think of things that seem 'impossible'!
All the best
- Fee
It seems like you are equipped with a lot of the knowledge you need to succeed. You have the right attitude as well. Now, you are tapering and trying to make plans to deal with the pain that remains. I don't understand how the doc thinks that a smaller dose of sub, the patch, is going to work better. If you weren't an opiate addict, I think it would work fine, I just don't see the logic in tapering down to 20mcgs and staying there. I just want you to consider rebound pain. The pain that is caused by a reduction or termination of opiate use. I usually suggest getting back to a base YOU, before going to the next treatment. My pain is far less, without opiates, even when I was on them. I think it has to do with being more aware of my body and when it's time to rest. I also feel the tension building and go to the chiro or do the stretches and exercises that help. Sometimes I need an OTC med, but rarely. Dealing with pain in clarity is much easier. I've had back pain since I was 11, so I've tried lots of things. I've yet to meet a person who says, "I found the perfect med and have had no pain for many years." Anyway, something to think about. If nothing else, the bupe will work better, after getting all the opiates out of your system. Oh yeah, all the nutrients, made a huge difference for me, in symptoms and healing. You're doing great.
Hi nursegirl
I was very interested (again!) in your detailed and helpful information - thank you!
Subs took away all of my desire to take my opiate DOC but then I was 100% ready to stop! I had hit rock bottom. So yes, psychologically that had a great deal to do with it naturally and I would not have dared to try. Also, I had tried to taper etc. etc. been forced to do CT and was absolutely terrified of the WDs (with an spinal cord injury (equina cauda syndrome with some damage to lower legs and feet, but ambulant, you can imagine certain things that were from pleasant too!)
Totally agree you do not take subs just to stop WDs! You take them to stop your habit and stop full stop! You have made a very important point there.
Personally, I chose to only drop 0.4mg this past 7 days when I got to the 2mg mark, to stabilize as the WDs, albeit moderate had started occurring 2 weeks ago. In a couple of days, another 0.2mg drop and so on. My 'outreach worker' advised 0.4mg every 2 weeks but i have beat the target of 1.6mg in 4 weeks and made a 2mg reduction. When setting the 'target', which I don't think she thought I could do(!) as we do not have a rapport, at no time did I receive advice on preparing for the reduction which I think is all important i.e. the vits, minerals, and amino acid protocol, which I found on here. That helped enormously to send WDs from moderate to min. and got rid of the awful depression.
I DO believe in the 'honeymoon period' followed by severe depression with subs for a significant number of people, purely down to the lack of information they are given about possible side effects. I have heard it from too many people now (on anor Forum too). It is not something my worker recognises and only the good medics and nurses such as yourself are fully educated about the power of this drug and the correct way to reduce etc. Some individuals are more vulnerable e.g. those prone to depression/have long history of addiction with a lot of baggage from the past. Subs give such a clarity of thought, and when someone has been in a long, long opiate haze, blocking stuff off it suddenly hits you all at once after the 'honeymoon period' is over. And you can crash badly.
Exercise all you can! (I can't run but I walk as far as I can and I built up my back muscles and forced myself mind over matter, pain be damned as far as I could from the beg. 6 months ago. My dog helped!) and drink at least 1L of water on top of other drinks like fruit drinks, tea. I love proper ground coffee but coffee dihydrates so people need to be aware of that even though it is still a liquid! .
And I cannot stress enough about being prepared with the right vits, minerals, looking at the amino acid protocol on here. L-Tyrosine has been wonderful! Will move on to 5HTP in the future too.
It is a gradual and slow process if you are aiming for success. I think if someone feels so darn awful, they can possibly relapse back to their DOC - and I know of this happening to some because they mentally and physically just cannot take it.
I wish you were attached to the clinic I went to! Your knowledge is invaluable and you are not only of great help to me - but to other people to reading this thread.
All the very best to you No. 1 nursegirl!
- Fee x
I was very interested (again!) in your detailed and helpful information - thank you!
Subs took away all of my desire to take my opiate DOC but then I was 100% ready to stop! I had hit rock bottom. So yes, psychologically that had a great deal to do with it naturally and I would not have dared to try. Also, I had tried to taper etc. etc. been forced to do CT and was absolutely terrified of the WDs (with an spinal cord injury (equina cauda syndrome with some damage to lower legs and feet, but ambulant, you can imagine certain things that were from pleasant too!)
Totally agree you do not take subs just to stop WDs! You take them to stop your habit and stop full stop! You have made a very important point there.
Personally, I chose to only drop 0.4mg this past 7 days when I got to the 2mg mark, to stabilize as the WDs, albeit moderate had started occurring 2 weeks ago. In a couple of days, another 0.2mg drop and so on. My 'outreach worker' advised 0.4mg every 2 weeks but i have beat the target of 1.6mg in 4 weeks and made a 2mg reduction. When setting the 'target', which I don't think she thought I could do(!) as we do not have a rapport, at no time did I receive advice on preparing for the reduction which I think is all important i.e. the vits, minerals, and amino acid protocol, which I found on here. That helped enormously to send WDs from moderate to min. and got rid of the awful depression.
I DO believe in the 'honeymoon period' followed by severe depression with subs for a significant number of people, purely down to the lack of information they are given about possible side effects. I have heard it from too many people now (on anor Forum too). It is not something my worker recognises and only the good medics and nurses such as yourself are fully educated about the power of this drug and the correct way to reduce etc. Some individuals are more vulnerable e.g. those prone to depression/have long history of addiction with a lot of baggage from the past. Subs give such a clarity of thought, and when someone has been in a long, long opiate haze, blocking stuff off it suddenly hits you all at once after the 'honeymoon period' is over. And you can crash badly.
Exercise all you can! (I can't run but I walk as far as I can and I built up my back muscles and forced myself mind over matter, pain be damned as far as I could from the beg. 6 months ago. My dog helped!) and drink at least 1L of water on top of other drinks like fruit drinks, tea. I love proper ground coffee but coffee dihydrates so people need to be aware of that even though it is still a liquid! .
And I cannot stress enough about being prepared with the right vits, minerals, looking at the amino acid protocol on here. L-Tyrosine has been wonderful! Will move on to 5HTP in the future too.
It is a gradual and slow process if you are aiming for success. I think if someone feels so darn awful, they can possibly relapse back to their DOC - and I know of this happening to some because they mentally and physically just cannot take it.
I wish you were attached to the clinic I went to! Your knowledge is invaluable and you are not only of great help to me - but to other people to reading this thread.
All the very best to you No. 1 nursegirl!
- Fee x
Hi there! Sounds like you have a good plan in place.
A few things I wanted to address, just for clarification purposes...Sub is actually not a full agonist, it is a partial agonist opiate. That's the main reason people are mostly unable to get high on other opiates while on sub, it has to deal with the way sub fills the opiate receptors. When a person has been stabilized on sub, their receptors would be filled to a high precentage, up to about 95%, which basically doesn't leave room for anything else. When a person tries to take another opiate while on sub, they won't feel the high from that med because there isn't enough room left for that opiate to hit the receptors in the same way it would to cause a high (without the sub). That's actually the way sub blocks other opiates. many people thinks it's the opiate blocker nalaxone, but that only has a very small effect on the blocking of other meds. It acts more as a psychological deterrant more than anything.
Also, unfortunately, sub absoutely can be abused, people do it all of the time. Not with the same level of frequency as full agonist opiates are abused, but it does happen.
I would never recommend methadone as a way to detox off codeine. I think even Suboxone most of the time would not be the most optimal choice to recovery from codeine addiction, but that's an indivdual decision everyone has to make for themselves. If a person is looking into any replacment med treatment (sub/meth) as just a way to get around w/ds...then it's the wrong decision. There IS no way to completely avoid w/ds (as you know). Whether it's w/d'ing off the initial DOC, or the Sub, it's something the addict has to face at some point. It's extremely rare for someone to experience no w/ds.
Also, there is a common misperception that the longer someone in on subs, the longer and tougher their w/d will be. That's typically not true, once the body has adjusted to the subs, w/d will be inevitable in some respect. Psychologically it can be harder if a person was on subs for many years, but the physical w/d part shouldn't be extended, not by any significant amount of time. The reason there are so many horror storues coming off subs is because a lot of times, the taper process is not done correctly. It's taken too fast, with little to no stabilization period, and people try to jump off from too a high a dose at the end. Many people think it's reasonable to jump off from say 2mg of sub. SOUNDS like a low dose, but in the world of sub, it isn't that low. The doc I worked with recommended that patients taper down to at LEAST 0.5mg/day before making that final jump. Those people did better, although even at that low dose, most of them still had to contend with some level of w/ds.
One of the biggest benefits of sub therapy is to allow a chronic relapser to get some "clean time" under their belt, alowing them to be fully functional while working their recovery, while building their self esteem. That of course is the most important part...working on education onseself on what brought them to addiction, what their triggers are, what will place them at risk for relapse, and how to handle it if they recognize that they are in early stages of relapse. Without the aftercare factor, they are no better off then when they started.
Glad to hear that you're educating yourself, that is so important. Just be cautious, as there is a lot of bad info out there about subs. A LOT of misinformation.....some of that comes from the very clinicians who are managing sub programs.
Good luck...keep on trucking! :0) We'll be here, cheering you on!
A few things I wanted to address, just for clarification purposes...Sub is actually not a full agonist, it is a partial agonist opiate. That's the main reason people are mostly unable to get high on other opiates while on sub, it has to deal with the way sub fills the opiate receptors. When a person has been stabilized on sub, their receptors would be filled to a high precentage, up to about 95%, which basically doesn't leave room for anything else. When a person tries to take another opiate while on sub, they won't feel the high from that med because there isn't enough room left for that opiate to hit the receptors in the same way it would to cause a high (without the sub). That's actually the way sub blocks other opiates. many people thinks it's the opiate blocker nalaxone, but that only has a very small effect on the blocking of other meds. It acts more as a psychological deterrant more than anything.
Also, unfortunately, sub absoutely can be abused, people do it all of the time. Not with the same level of frequency as full agonist opiates are abused, but it does happen.
I would never recommend methadone as a way to detox off codeine. I think even Suboxone most of the time would not be the most optimal choice to recovery from codeine addiction, but that's an indivdual decision everyone has to make for themselves. If a person is looking into any replacment med treatment (sub/meth) as just a way to get around w/ds...then it's the wrong decision. There IS no way to completely avoid w/ds (as you know). Whether it's w/d'ing off the initial DOC, or the Sub, it's something the addict has to face at some point. It's extremely rare for someone to experience no w/ds.
Also, there is a common misperception that the longer someone in on subs, the longer and tougher their w/d will be. That's typically not true, once the body has adjusted to the subs, w/d will be inevitable in some respect. Psychologically it can be harder if a person was on subs for many years, but the physical w/d part shouldn't be extended, not by any significant amount of time. The reason there are so many horror storues coming off subs is because a lot of times, the taper process is not done correctly. It's taken too fast, with little to no stabilization period, and people try to jump off from too a high a dose at the end. Many people think it's reasonable to jump off from say 2mg of sub. SOUNDS like a low dose, but in the world of sub, it isn't that low. The doc I worked with recommended that patients taper down to at LEAST 0.5mg/day before making that final jump. Those people did better, although even at that low dose, most of them still had to contend with some level of w/ds.
One of the biggest benefits of sub therapy is to allow a chronic relapser to get some "clean time" under their belt, alowing them to be fully functional while working their recovery, while building their self esteem. That of course is the most important part...working on education onseself on what brought them to addiction, what their triggers are, what will place them at risk for relapse, and how to handle it if they recognize that they are in early stages of relapse. Without the aftercare factor, they are no better off then when they started.
Glad to hear that you're educating yourself, that is so important. Just be cautious, as there is a lot of bad info out there about subs. A LOT of misinformation.....some of that comes from the very clinicians who are managing sub programs.
Good luck...keep on trucking! :0) We'll be here, cheering you on!
Oh yeah i am thrilled she disnt have to go through any wds! And iam healing well, and i couldnt ask for a better baby! She is so content and the sweetest thing! She sleeps very good! She only wakes up 2 times during the night and the only time she cries is if shes hungry or has gas, i mean she is just perfect! And she has been smiling since we left the hospital! She smiles all the time, it just melts my heart! Thank you again for all the support! :) <3
Hi Eveleivibe
You can't abuse subs with taking codeine - they are a pure antagonist - so don't worry about that. My addiction was up to 40 x 30mg dihydrocodeine per day after 8 years which are a lot stronger than codeine, as you prob know.
At first, you pick up subs from the pharmacy each day, then after a few urine samples to show that you are not taking anything else, such as valium, for example, you pick up your prescription three times per week.
At first, you will have to take your sub at the pharmacy, but very quickly you will take them home with you to take. I hope you have a local pharmacy you have a good relationship with, or choose one that has a 'private room' you can go into. Mine is great as I have known them for many years as I have so many diff meds for other things and they are family run,
Take the advice of the specialist doctor you will see at your drugs centre with your key worker. Discuss whether subs are better for you or meth. However, if you feel that you have the potential to use codeine (is that your DOC (drug of choice)?) on top of the meth, then do not choose meth. Reduce off the sub as soon as poss. - slowly, gradually.
It is not a fairytale, although you will feel great and normal and first and you will not want your DOC. Hopefully for you, it will be fine all the way through as it is for some. Do NOT be afraid by any of this. You have made your decision to stop and you are doing it. It sounds like you have the support your family, and that is great!
I found that interests I had lost for years came back even. Go do it and good luck!
- Fee
You can't abuse subs with taking codeine - they are a pure antagonist - so don't worry about that. My addiction was up to 40 x 30mg dihydrocodeine per day after 8 years which are a lot stronger than codeine, as you prob know.
At first, you pick up subs from the pharmacy each day, then after a few urine samples to show that you are not taking anything else, such as valium, for example, you pick up your prescription three times per week.
At first, you will have to take your sub at the pharmacy, but very quickly you will take them home with you to take. I hope you have a local pharmacy you have a good relationship with, or choose one that has a 'private room' you can go into. Mine is great as I have known them for many years as I have so many diff meds for other things and they are family run,
Take the advice of the specialist doctor you will see at your drugs centre with your key worker. Discuss whether subs are better for you or meth. However, if you feel that you have the potential to use codeine (is that your DOC (drug of choice)?) on top of the meth, then do not choose meth. Reduce off the sub as soon as poss. - slowly, gradually.
It is not a fairytale, although you will feel great and normal and first and you will not want your DOC. Hopefully for you, it will be fine all the way through as it is for some. Do NOT be afraid by any of this. You have made your decision to stop and you are doing it. It sounds like you have the support your family, and that is great!
I found that interests I had lost for years came back even. Go do it and good luck!
- Fee
Hey Mak!
I'm so thrilled for you! A big congratulations to you and your new family. Wow I bet you are delighted that your little one has had no WD's. That is the greatest news!
Is she sleeping well at night? Hope your C-section area is healing well - that sounded like a bit of a 'mare! Friends said it was really difficult to breastfeed after a C-section - sore because of the position!
So, now you are a 'mummy' and in a new club so to speak.
Wishing you lots of luck and future happiness which I know you will have. Your little girl is with you now.
All blessings to your family
- Fee x
I'm so thrilled for you! A big congratulations to you and your new family. Wow I bet you are delighted that your little one has had no WD's. That is the greatest news!
Is she sleeping well at night? Hope your C-section area is healing well - that sounded like a bit of a 'mare! Friends said it was really difficult to breastfeed after a C-section - sore because of the position!
So, now you are a 'mummy' and in a new club so to speak.
Wishing you lots of luck and future happiness which I know you will have. Your little girl is with you now.
All blessings to your family
- Fee x
Hi nursegirl
Great to hear from you. Hope you are well and thank you as ever for your continued support on this Forum!
What you say makes total sense. And you obviously worked for a very wise doctor! I have now read many stories where people have got into a lot of trouble by being putting on subs unnecessarily and it turned their lives into hell.
I am biding my time with completing research/empirical evidence (sounds like I'm back at uni!) until I approach my old key worker and existing inexperienced outreach worker/prescribing nurse as they really are in denial about the negative side of subs!
The amino acid protocol assisted me immensely when I 'crashed' on the subs. It helped with the depression and has helped with mild WD symptoms. So very good all round. However, I had to insist on the reduction, and at that time had gathered in certain vitamins, minerals etc. prior to reading about the a.a.p. so I got myself prepared for reducing from the amount they were more than happy for me to stay on (3.6mg) because of breakthrough pain. It was the wrong advice! The whole point of subs is it is a pure antagonist, you cannot abuse it, once you are stable, which happens very quickly, then reduce and do not stop. The longer you are on it, the worse it will be.
Don't feel angry all the time! But there is a lot in the past - and when you have been in a big opiate fog for 8 years, one thing subs do is bring excessive clarity into your head so your get a rush of everything all at once. And you have to deal with it. During the 'honeymoon period' - all peace and love, and acceptance. Then the opposite. You have to get through the range of emotions. It is not an aggressive anger - it is anger at myself for wasting years to have been so weak to have let the pain and some very bad stuff get so much on top off me - I stopped coping completely. When I was young and arrogant (the arrogance of youth!) I fought it all like a tiger although I hurt like hell about what had happened. The latter has not gone away. Then you get a little worn out by it all. And I did. And I accept that.
Thank you very much for your great advice, as ever! You're fab!
- Fee x
Great to hear from you. Hope you are well and thank you as ever for your continued support on this Forum!
What you say makes total sense. And you obviously worked for a very wise doctor! I have now read many stories where people have got into a lot of trouble by being putting on subs unnecessarily and it turned their lives into hell.
I am biding my time with completing research/empirical evidence (sounds like I'm back at uni!) until I approach my old key worker and existing inexperienced outreach worker/prescribing nurse as they really are in denial about the negative side of subs!
The amino acid protocol assisted me immensely when I 'crashed' on the subs. It helped with the depression and has helped with mild WD symptoms. So very good all round. However, I had to insist on the reduction, and at that time had gathered in certain vitamins, minerals etc. prior to reading about the a.a.p. so I got myself prepared for reducing from the amount they were more than happy for me to stay on (3.6mg) because of breakthrough pain. It was the wrong advice! The whole point of subs is it is a pure antagonist, you cannot abuse it, once you are stable, which happens very quickly, then reduce and do not stop. The longer you are on it, the worse it will be.
Don't feel angry all the time! But there is a lot in the past - and when you have been in a big opiate fog for 8 years, one thing subs do is bring excessive clarity into your head so your get a rush of everything all at once. And you have to deal with it. During the 'honeymoon period' - all peace and love, and acceptance. Then the opposite. You have to get through the range of emotions. It is not an aggressive anger - it is anger at myself for wasting years to have been so weak to have let the pain and some very bad stuff get so much on top off me - I stopped coping completely. When I was young and arrogant (the arrogance of youth!) I fought it all like a tiger although I hurt like hell about what had happened. The latter has not gone away. Then you get a little worn out by it all. And I did. And I accept that.
Thank you very much for your great advice, as ever! You're fab!
- Fee x
Yeah and i was the same way at one point, i would abuse them and sell them to get what i really wanted...which was heroin but this time around becoming sober while pregnant and being so hopeless, has changed my outlook on everything, yes i think about getting high still sometimes but i know where getting high takes me...and thats, homeless, hopeless, and a lot of other things and i just know that i can't live a productive life while getting high. I think that it's great that you know what is best for you, and know your boundries and limitations! That is half the battle!
I'm glad that worked for you but I'd really hate that as I know I would abuse them n thus replace one addiction for another. I like the idea of going to the pharmacy each day because it's being controlled n there are no nice associations with it eg 'laying in bed taking pills.'
On the downside if there were day trips / holidays I'm not sure how that works but all n all i would prefer that way as I've proved myself that I can't control myself with codeine at least.
On the downside if there were day trips / holidays I'm not sure how that works but all n all i would prefer that way as I've proved myself that I can't control myself with codeine at least.
Hey e, no your not being nosey lol i put my story up for a reason, hopefully it could help someone. But yes im from maryland usa and we get scripts of them, but my doctor gives me one for a month and i check in with him once a month aswell and he gives me a urinalysis aswell to make sure all the levels are the right level, i know there are some docs that dont care and give ppl scripts that are still using which is so stupid to me and dangerous! But thank you for the well wishes, and feel free to msg me if you have any other questions or concerns!! :)
You have a point. If someone was taking 3 - 4 vicodins per day then taper / cold turkey would be best n if flame was referring to 'light' addictions in this respect then she is quite right in saying putting people on subs would be silly. To be honest I'm not sure as to what the criteria is, or how goes about, being prescribed subs in the USA. So really I cannot comment any further re the matter.
Flame i wish you all the best in successfully weaning off subs n beating your addiction
Evey x
Flame i wish you all the best in successfully weaning off subs n beating your addiction
Evey x
I don't blame you for being honked off! It doesn't sound like you're receiving a whole lot of support from the people who are supposed to be helping you, that's a shame. Instead of waiting to the end, why not express how you feel now? Maybe things could improve a little bit, so you feel more supported? You can also seek out others sources of support, in the form of NA/AA meetings, private therapy. Everyone here who attends those kinds of meetings (NA/AA) report that they benefit from being with others who understand, and getting a sponsor is a wonderful idea also. You can never do too much to work on your recovery...so do some seeking and see what other services/resources you can find.
What you said about people being prescribed Sub for more "light" addictions is all too true, unfortunately. You're absolutely right, and people who REALLY understand sub will totally get what you're saying. I've watched many people successfully complete a sub program, but I've also seen people who came from other clinics, who were put on insanely high doses of sub for a very "small" habit, struggle unnecessarily.
By "small" I don't mean unimportant, or insignificant as any level of addiction needs addressed, but there ARE circumstances where a replacement drug therapy, like sub, isn't indicated. If a person is taking 3 or 4 Vicodin a day, going to subs is like killing a fly with a shotgun, it's insane. SO many people are just not educated about subs, enough to understand just how strong it is...and a little goes a LONG way. Not to mention that sub is typically a little rougher to come off of than a full agonist opiate. Sub can be a great tool used in recovery, but from my experience, no sub doctor should take in people with minimal usage, and actually, there ARE standards for sub treatment that if they were more closely observed, wouldn't allow for someone with a much smaller habit to be admitted into a program. It's really compounding the problem for that person, IMO. The Sub doc I worked for wouldn't take patients like that. Her rule of thumb was that, if according to the equivalency chart, the dose of sub needed to cover the usage was under 2mg, that Sub wasn't right for that person. The only exception I saw her make was people who had relapsed after stopping sub and had just returned to using, even if it was a small amount...or if it was someone with a long standing history of relapse, and those exceptions were rare.
Just remember that a slow and gradual taper off Subs is the key. Usually the w/d doesn't get too bad until you are at the lower doses (about 2mg or so). That's when it's important to really go slow, and allow for a stabilization period in between dosage reductions. You're at the lower doses, so you may feel some more w/ds. PLEASE give yourself at least 2 weeks in between reductions to allow yourself to stabilize. If you're constantly reducing every few days, you will be in a constant state of acute w/d. The stabilization period really helps a lot. Some people even choose to stay at that next dose for longer, to give themselves a break. The people who were the most successful coming off Sub that I saw took their time, especially towards the end.
Lastly, the anger issue. You're right in that sometimes anger can be cathartic, but it can also be self defeating. Anger doesn't exist alone, without another driving emotion...usually fear, or uncertainty. Allowing anger to continue, or to feed anger can often times make you feel worse...so just keep that in mind, and try to limit your reactions to the anger and don't feed it unnecessarily. When you feel angry, go for a nice brisk walk (or run if you're in shape)...it helps to get those endorphins pumping, that will help the anger feelings.
Keep doing what you're doing, and keep working your recovery...it's ALL in your hands. So, even if the professionals are kind of dropping the ball, YOU can seek out other resources to make up for where they lack. Don't let them discourage you. While it stinks that they don't do a better job, don't let that discourage you, or sabotage your recovery, okay? Keep up the GREAT work...and keep posting.
What you said about people being prescribed Sub for more "light" addictions is all too true, unfortunately. You're absolutely right, and people who REALLY understand sub will totally get what you're saying. I've watched many people successfully complete a sub program, but I've also seen people who came from other clinics, who were put on insanely high doses of sub for a very "small" habit, struggle unnecessarily.
By "small" I don't mean unimportant, or insignificant as any level of addiction needs addressed, but there ARE circumstances where a replacement drug therapy, like sub, isn't indicated. If a person is taking 3 or 4 Vicodin a day, going to subs is like killing a fly with a shotgun, it's insane. SO many people are just not educated about subs, enough to understand just how strong it is...and a little goes a LONG way. Not to mention that sub is typically a little rougher to come off of than a full agonist opiate. Sub can be a great tool used in recovery, but from my experience, no sub doctor should take in people with minimal usage, and actually, there ARE standards for sub treatment that if they were more closely observed, wouldn't allow for someone with a much smaller habit to be admitted into a program. It's really compounding the problem for that person, IMO. The Sub doc I worked for wouldn't take patients like that. Her rule of thumb was that, if according to the equivalency chart, the dose of sub needed to cover the usage was under 2mg, that Sub wasn't right for that person. The only exception I saw her make was people who had relapsed after stopping sub and had just returned to using, even if it was a small amount...or if it was someone with a long standing history of relapse, and those exceptions were rare.
Just remember that a slow and gradual taper off Subs is the key. Usually the w/d doesn't get too bad until you are at the lower doses (about 2mg or so). That's when it's important to really go slow, and allow for a stabilization period in between dosage reductions. You're at the lower doses, so you may feel some more w/ds. PLEASE give yourself at least 2 weeks in between reductions to allow yourself to stabilize. If you're constantly reducing every few days, you will be in a constant state of acute w/d. The stabilization period really helps a lot. Some people even choose to stay at that next dose for longer, to give themselves a break. The people who were the most successful coming off Sub that I saw took their time, especially towards the end.
Lastly, the anger issue. You're right in that sometimes anger can be cathartic, but it can also be self defeating. Anger doesn't exist alone, without another driving emotion...usually fear, or uncertainty. Allowing anger to continue, or to feed anger can often times make you feel worse...so just keep that in mind, and try to limit your reactions to the anger and don't feed it unnecessarily. When you feel angry, go for a nice brisk walk (or run if you're in shape)...it helps to get those endorphins pumping, that will help the anger feelings.
Keep doing what you're doing, and keep working your recovery...it's ALL in your hands. So, even if the professionals are kind of dropping the ball, YOU can seek out other resources to make up for where they lack. Don't let them discourage you. While it stinks that they don't do a better job, don't let that discourage you, or sabotage your recovery, okay? Keep up the GREAT work...and keep posting.
Hiya I'm pleased for you that subs saved your life. Sorry to sound nosey but can i ask where you're from? Reason for asking is I am waiting to be allocated to a keyworker n hopefully go on subs n i know you in the UK you go to the pharmacy every day n they watch you consume it.
Is this different in the USA? Because i often hear of people getting it as scripts n tapering off it themself (Please know I'm not judging) but this sounds frightening to me. The idea of getting it from the pharmacy daily n reducing slowly with a health care profession, sounds much more safer plus it's in a different environment to where the person uses so less of a trigger.
To me giving an addict something to wean off their addiction in scriptform, that has the potential to be abused, sounds extremely dangerous n is counterproductive to the reason for sibs in the first place.
Evey x
Evey x
Is this different in the USA? Because i often hear of people getting it as scripts n tapering off it themself (Please know I'm not judging) but this sounds frightening to me. The idea of getting it from the pharmacy daily n reducing slowly with a health care profession, sounds much more safer plus it's in a different environment to where the person uses so less of a trigger.
To me giving an addict something to wean off their addiction in scriptform, that has the potential to be abused, sounds extremely dangerous n is counterproductive to the reason for sibs in the first place.
Evey x
Evey x
Hiya - i don't know you or your story but just to say how very pleased I am that your baby is well. Wishing you bothall the best n great health xxx
Thats disgraceful. Mind you when i saw the drug n alcohol team they told me that, until I get a keyworker, to continue having lots of nurofen plus (codeine) my parents were disgusted about this. Professionals should be careful what they tell people.
Do you mean UK? I am not being funny but I take offence to that. What may seem a 'light' addiction to some may not be to a person hoing through it who has / is spending hundreds of pounds, who has tried Weaning off n tapering etc, is not ready to stop but knows they have to as the 'light addiction' is causing problems with family, relations, money and so on....
Plus a lot of people have progressed from these 'light addictions' to heavier addictions like heroin
So yes doctors put people on subs for 'light addictions' n for a lot of people it has proven successful. Everyone is different n what works for one person may not work for another.
Plus a lot of people have progressed from these 'light addictions' to heavier addictions like heroin
So yes doctors put people on subs for 'light addictions' n for a lot of people it has proven successful. Everyone is different n what works for one person may not work for another.
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