Glad you responded and sounds like a good plan you've got going. Hang in there and I'm wishing you a great induction and please keep posting, were here to give you all the support you need.
Jordan thats right AFTER 72 hours sometimes its better to wait closer to 96 hour..I am gald you are hangering in there .... keep posting
Oh, one more thing:
I said I'd report what the Subutex 800 number's help line said about following Methadone with Subs:
The COWS scale IS to be used... no less than 72 hours after the last Methadone dose. In short, Wait three days, THEN evaluate your current state of withdrawal. The lady on the help line actually suggested I switch to a different opiate until said 3 days had expired. I informed her I had no such alternative, and she simply commiserated and gave me the age-old, time-honored advice: "tough it out."
Thanks for checking in...we worry. :)
Hang on until Friday and God Bless~
Vicki
Jessie,
I mentioned in an above post that I've tried to cold turkey a couple of times. I have what appears to be abnormally bad reactions to withdrawal: convulsions, vomiting blood, diarrhea so severe that it requires a saline/sucrose IV drip. The last two times I tried, the hospital (yeah, it gets that bad) actually wound up giving me a morphine injection while making a none-too-subtle suggestion that cold turkey isn't for me, that I should use an assisted quit program like Subutex.
My fear of WD's stems from a combination of those experiences coupled with the heart-stopping, bowel-quivering fear of accidentally inducing a precipitated withdrawal by botching the initial dosing of the buprenorphine. I'm thinking medically-induced coma's the way to go if that happens. Regardless, though I appreciate the advice, and be assured that if I could "mind over matter" this I would, I've just established empirically that isn't a viable solution for me.
I have combat experience, I skydive and bungee jump, I've broken literally dozens of bones, and even with all that said, I'm an absolute coward when it comes to this one thing. Thank God there's other folks out there that understand what it's like.
Sorry for dropping off the posting wire...
I've been doing what I can to get my work done; I'm sicker than hell. I'm up to shakes and vomiting, and occasional mad dashes to the bathroom, but I've certainly not hit the upper ranges of WD, at least as far as my standard symptoms go.
I've not taken any of the subs... regardless of the myriad advice I've received, I've simply read too much about the possible outcome of jumping the gun when it comes to buprenorphine. Considering how severely I react to WD, I genuinely don't think I'd survive if a precipitated withdrawal was forthcoming. I'm pretty much planning on just toughing it out until tomorrow night (that's 84 hours after the methadone: 72 hours plus a half day for safety's sake), or even Friday morning if I can hold out that long.
Regarding my work situation, I'm not going to make my deliverable deadline no matter what I do at this point, so I'm going to approach it with the "better to ask forgiveness than permission" angle. I'm a contract software engineer (I work from home), so the absolute worst case scenario is I lose the contract and get to spend the next few weeks scrabbling for a job.
This has resulted in a less than favorable reaction from my GF (whom I live with), who thinks I'm stalling for the sake of stalling (again, she's never touched anything that even looks vaguely like a drug while squinting heavily), despite my best efforts to explain the possible outcome should I rush into this. Her fear is that I'm continuing to take Norco, despite the contrary evidence evanesced by my current physical state, and my hesitation to begin the Subs stems from that.
The final deal that I worked out with her is that I will be relocating to my father's house until Friday so the first thing she can see is my taking the Suboxone. My father just underwent back surgery and is well aware of my situation, so we - my father and I - feel we can provide her with a sense of "supervision" until I've "safely" begun the subs. Since I work from home, her fear is that I have too much opportunity to obtain or take opiates, as she cannot find herself at home to "protect me from myself." In a way this is touching - she genuinely cares for my welfare and feels helpless to intercede - but with my emotional state so out of whack from the withdrawals it's simply resulting in fights. This is probably best all 'round.
Thanks for keeping an eye on me, I'll stay in touch today and tomorrow. I'll kick off a new thread when I'm about to take the Subs, and I'd certainly appreciate the support at that time. You've all shown a heartwarming interest, and, despite my abject terror surrounding the start of the Subs, your support gives me something to latch on to. Thanks guys.
-J-
coffeegirl, I sent you a PM. I apologize for my bluntness but if he had taken that sub so soon after popping a handful of methadone pills he could have been in a world of unbelievable pain. And please do give advice, like I said in my PM to you people could use your support and advice. You've obviously been through wds before and could really help people with a lot of issues. But I think we all (myself included) have to be careful when it comes to medical advice. That's best left to qualified doctors. Anyways Jordan I'm hoping your doing ok, let us know how your doing when you have a sec. And sorry again coffeegirl, please give all the support and advice you can to help people here with their struggle.
Jordan, you remind me of myself 40 days ago. I was more terrified with the potential WD's than I was of quitting [CT]. I had such an irrational fear that I put myself [and my family] in financial hell because I just didnt want to think about the whole detox thing. One day- I said fck this- Im done. I was prepared to tough it out in my bed for the next 3 days and tell my family I was 'sick'. Day 1: I stayed in bed most of the day because- isnt that what youre supposed to do? I got up every now & then to do mundane tasks, and each time I was like "why am I ok"? So I got out of bed. I started doing laundry- and before I knew it, my house was immaculate. Day 2, 3, 4: Same thing. What I realized is it really IS mind over matter. If you truly want this, you WILL get through it. If you start to feel sorry for yourself, youre gonna be miserable. Try not to let your mind go there... redirect your thoughts if you should start feeling weakness or self pity.
For the physical WD's- Thomas' recipe will help considerably. Under the help pages there is a 'Protocol for unassisted opiate withdrawal. It's worth reading. Good luck to you- I have no doubt youre a soldier & you can do this. It feels SO good to be rid of the shackles and chains. :)
Cumberland Heights in Nashville TN was my source.for protocol and expansion of what I knew medically
Well I just did a large post and it was lost. Jordon I have apologized to you via email and to all in a post. I did not mean to send you a "whacked out" post and CERTAINLY did not mean to displace eyeballs. I believe I was misunderstood and misquoted. I WAS NOT suggesting SUBOXONE-it contains narcan which reverses the action of opiates. We use it in surgery to bring a patient out of anesthesia and in the ER for overdose cases. SUBUTEX competes for opiate receptors and has a stonger affinity, therefore it "WINS". Therefore any additional opiates will not attach and make you "high" From MY EXPERIENCE, I was administered SUBUTEX an hour after admission to a well known rehab facility. I suffered NO w/d, only mild fatigue after the rapid subutex taper. Months later after dropping the ball I went to an addictologist-he too, started subutex immediatley. I was not on a long acting opiate, as you are, so I should have been more careful. Both facilaties never used SUBOXONE initially BECAUSE of the pwd with Suboxone. Please forgive me if I caused any harm to you. I only wanted to help and be a part of the group. I will refrain from giving advice-will just listen and learn. Best of luck to you. I DO support you and now feel publically shamed. I meant well.
Hey Jordan what's the latest? Update when you have a minute.
THIS IS STRIGHT FROM THE SUB SITE
No SUBOXONE or SUBUTEX sublingual tablets should be given after the last methadone or long-acting opioid dose until the patient experiences maximal withdrawal discomfort (at least 48-96 hours after last dose). Earlier dosing with SUBOXONE or SUBUTEX is highly likely to precipitate withdrawal
COWS does not matter if he has been taking methadone ......he has to maske sure its ALL out of his system ..
how much methadone and how long ago did you take it
I'm on hold right now with one of the Subutex 1-800 number counsellors. She seems to think that you're right, the COWS is the way to get an idea of where I should be at for initial dosing, but the fact that the last med I took was methadone makes it a "special case." She thinks that means it should be "Moderately Severe" instead of "Moderate" before taking the first dose, but she's checking with her supervisors. I'll post the answer she gives once I find out.
Not sure why my last post got posted 3 times but maybe one of the CLs can delete please? Jordan google COWS scale and see where you rate on it. And no you don't have to be in full blown withdrawls, "moderate" is what's advised on both subs website and the people on that suboxforum told me the same thing so go by the cows scale and see if you can get some feedback over there from people who have lots of experience with it.
I'm looking into this COWS scale now; I've never seen anything on this before.
Don't take my being snippy earlier personally; I apologize if I'm coming across harsh/like a jerk. I acknowledge the fact that I screwed up here, and I'm very frightened that I have. I have VERY negative reactions to WD (see my post above), so I'm quite frankly a coward when it comes to it.
Going through the process is bad enough, but getting repeatedly hospitalized for it makes anyone a tad gunshy. Couple that with the possibility of precipitated WD's, and I'd rather face down an oncoming army than risk it. I've never thought of myself as suicidal, but I flat out don't think I'd choose to survive the idea of two or three solid weeks of what I went through on my CT attempts.
Thanks for all your input and support.
NO if you took methadone its NOT safe to take sub RIGHT NOW
Thanks for the advice.
The problem with the medical literature for buprenorphine is that its "safe-to-start" time is so vaguely worded. The official line is "when the patient is experiencing full-blown withdrawals."
The pain here is that everyone's WD symptoms differ, so they, in fairness, have no way of truly quantifying what "full-blown" means.
My addiction-management doc tells me I have some of the worst reactions to WD he's ever seen. I've tried to CT three times now, and tried with Subs once. My most severe reactions are convulsions, persistant and near-continuous vomiting/dry-heaving, and diarrhea so severe that I've been hospitalized in both the latter two out of the three CT attempts within the first four days (vomiting blood, dangerously low blood sugar, and so dehydrated an IV was required). In both of those cases, I was given morphine by the hospital, and was told to use an assisted-quit plan, like buprenorphine, because it simply wasn't safe for me to CT.
Bottom line though, while I'm definitely withdrawing right now; I feel like crap, sweats, cramping, nausea, etc., I'm NOT vomiting blood and experiencing full-body spasms. So which is "full-blown" for me? How I feel now? Or how I get if I CT for a couple of days?
My NORMAL WD symptoms are so extreme that I have a sneaking suspicion that a multi-week precipitated withdrawal would likely be fatal, or at least certainly require continuous hospitalization. I'm scared sh*tless to risk getting myself into a position where that's a possibility, so I'm kinda finding myself in the position of waiting until the "bitter end" before switching to the subs.
Never mind I saw your response to the question after I posted. Anyways check out the COWS scale and that site I told you about. It's a very good forum for anyone on or considering suboxone. It's run by a guy named Dr. Junig and he really knows his stuff when it comes to sub so check it out and keep us posted. You got my prayers and I think your headed in the right direction. And sorry I made those comments about you not being serious, I misunderstood you.
120 mgs on Sunday is a lot of methadone. Considering it's only Tuesday if it were me I don't think I'd take the gamble and risk precipated wd's. Also, having researched sub for myself when I was going to start it I was told that it's really how you rate on the COWS scale, not a set amount of time that one should go by in determining in you are ready to start sub. Check out this website: suboxforum.com The people there have a lot of experience with sub and who might be able to help you determine if your indeed sick enough to start sub. Are you planning on using sub as a quick detox tool or for maintenance? Either way that site is excellent for all things sub.
Thank you for explaining.
Sara,
I'm not sure you got the full context here... I'm not looking to take the Sub for a couple of days just to get by... I'm trying to figure out how to get by for a couple of days so I can start taking a doctor-prescribed and -monitored program utilizing Suboxine to quit my opiate dependency. Backwards, you see?
The reason I'm trying to "get by" for a couple of days was the last opiate I'd taken was methadone, which apparently lingers in your system for 72 hours or so. Since you're not supposed to begin Subs while ANY opiate remains in your system, and since I've not taken anything since Sunday (and am therefore already withdrawing), I'm trying to figure out what to do to minimize the WD symptoms until it's SAFE for me to start the subs.
I have to disagree with the sub. It shouldnt be used for a couple days to just get by. That is only prolonging the inevitable with a very strong opiate......sara