Suboxone withdrawral risks pls help?

[monkeygrrrl]

Hi all
I was put on a suboxone treatment plan for opiate (heroin) dependance about 3 months ago.
I began on 4mgs daily, then was put up to 8the following week, then (due to financial issues) began double dosing (16mg every second day) which costs slightly less  
I thought this was great and my life improved immensely, right up until last week when I was invited to go away camping for 4 days with friends (non of which I have ANY IDEA I was ever a heroin addict, let alone in treatment). So, rather than taking my suboxone (sublingual film where I come from in Australia) at the chemist (which I was required to do by law), I attempted to take it away with me to use on the trip and I got caught.
I was immediately kicked off the program and told not to come back.
The timing was terrible as I'd taken my last (16mg) dose on a Wednesday, and this happened on a public holiday Friday. I did TRY and call my prescribing doctor the night before to ask about taking it away, but it was after hours and for the next three days no-one at the clinic was available.
Now I'm being told I can't  get another appt for a week or so, and even then I have no idea how long it would take to find another prescribing chemist, if one will take me ("diverting" or taking your doses without super-vison appears to be a major crime here).
Anyway, my question here is just how ethical and dangerous is this?
I've tried so hard to get my life on track after over a decade of dependency, and yet jumping from 16mg to nothing has made he feel absolutely F***ing awful!
I REALLY DON'T want to go back to using heroin but I have a job, am studying and have an elderly mother and young daughter to care for.
I'm really struggling to function atm and would love some advice as to how to cope/what I should do?
Thanks
One sick puppy :'(

[msdelight]

I'm sorry you went back to shooting heroin. I'm not surprised though because you were talking yourself into it throughout this entire thread. Now that you're using again, I sure pray you will follow through with that rationalized plan of yours for short term detox. So many times we make those plans with the best of intentions, only to get sucked back  in by our addictions. You said rather cavalier manner that you didn't OD or even get stoned. Well not this time. I shudder to think what may happen when a small crisis hits, or you simply feel like cutting loose. Good luck.

[nursegirl6572]

Just a general statement.  It's GREAT that you want to be proactive when it comes to your treatment (of both your addiction and your mental health), but please remember than many meds NEED to be dosed regularly in order for them to be effective.  Taking a medication that needs to build in your system "as needed" will actually exacerbate your symptoms, because it's going to cause a lot of ups and downs.  Just be sure to always communicate what you're doing and what you're medication goals are with your prescribing doctor.  Don't take matters into your own hands.

Best to you.

[Amandag78]

Just noticed your from Perth, i am too. I did my program at Next Step in East Perth. My understanding is, its up to the chemist you dose at weather they cut you off or give you another chance. Im pretty sure if you ring another chemist and they will take you, then you phone up next step and tell them and ot should be ok. They have a 1, 2, 3 policy, 3 chances and if you stuff up your out. They have heard all excuses at the chemist and telling them you wanted to take your dose on a trip, really wont make a difference.
But like i said you should get another chance.
Im in Armadale and dont dose anymore, finished the program 5 months ago with success.
I would ask a doctor for clonidine in the mean time.
My doctor at next step was Rod Brown and my councillor was Shavaughn ( sp ), they were brilliant. Good luck.

[Amandag78]

Hi, are you doing your program through Next Step.

[monkeygrrrl]

Thanks heaps for that weaver,
I'm feeling better today but that's most likely due to the decent nights sleep I got after a had a shot! :/
I have a great psychiatric nurse/counsellor I'll try to see asap, hopefully tomorrow. I just want to be free to manage my own recovery in a way that allows me to use the subs as and when I need them, rather than having to dose within a daily/regular regimen.
This is how I manage my Bipolar. I'm fine most of the time, but had 2 major psychotic (manic) episodes at 21 and again at 24 which required hospitalization. After trying lithim (which was awful) I later changed to sodium valproate and olanzapine, but also dropped these when I felt normal/myself again.
This must sound strange but I refused to take these drugs/medications on a continual basis and chose heroin (which was free while I worked for my dealer) to keep my moods stable.
When I got pregnant I stopped using everything and my daughter born small but on her due date and perfectly healthy.
I did experience some  Post Natal Depression when she was about 2 months old and took antidepressants for a while until this lifted.
The year I turned 28 (note the 4 year cycles?) I didn't become full blown manic but did lose my job and was prescribed Seroquel/quetiapine which helped (although being hypomanic I was annoyed because I felt great!)
So now, while prescribed it, I don't actually take it.
I just try to use valium and sleeping tablets only when I need them (rather than daily as they're prescribed to me) because I'm well aware of the living nightmare of benzo withdrawal!
Anyway, I AM grateful to suboxone , it did help me turn the stagnation of my life around. I'm just paranoid now about being on it for too long and having to go through the BS that comes with getting off it!
Thanks again, I had no idea about this site and living in Perth (one of the most isolated cities in the world!) it was great to be able to communicate with some caring people from all over who don't owe me a thing but were kind enough to listen and reply with their thoughts/ideas.
One day at a time right? :)
take care mate
monkeygrrrl

[weaver71]

It's not a shocking or horrifying to me. Subutex really helped me get my aftercare in place. It sounds like your support and idea is a good plan anyway. I am also BP1 with psychotic mania tendencies, so I agree that you don't want the sub detox to drive you off the edge. I detoxed to fast and it was hard. I could feel the mania returning as I detoxed. I am glad you have professional help. I was doing 12 step meetings and here a lot, but I should have had a therapist and doctor on board. I tried to find them, but it was easy to give up on finding one I trusted in detox state of mind. The subs can give you that time to build that structure of support. I deal with my addiction and my bipolar as the same thing, the solutions are very similar, though it gets hard to see oneself in detox, in particular in mania or depression, accountability was what helped me the most, and I sure wanted to isolate. It's a marathon, don't have to be first, just have to get to the finish line.

[monkeygrrrl]

Thanks for all your suggestions and advice guys,

Just so you know, I WAS an addiction counsellor but am not anymore, although the question about what advice I would give them is still a valid one.
I guess I would encourage them to re-visit their prescribing Dr asap and taper off slowly as I've learnt (the hard way), jumping off that high a dose is not only unhealthy it has the capacity to completely unhinge you, physically, mentally and emotionally.

Thankfully I have a partner who, although currently living on the East Coast (while my daughter and I are on the West) DOES understand me, and I didn't include him in family and friends before because being in a depressed state and feeling absolutely sick/awful, I wasn't thinking clearly.

I'm very fortunate in that he's one of a few people who knows what a double life I've lead, and can also empathize with me having mental health and addiction issues (I also have Bipolar type 1- hence the benzos). Because (incredibly), he's also a mental health professional specializing in dual diagnosis/co-morbidity with his own mental illness (AD/HD) and once had an amphetamine problem which is now just a legal dexi-amphetamine Prescription - hehe what a pair, right?!

I didn't want him to know I'd been kicked off the program (because he was so proud of me and I didn't want to disappoint him), BUT (just like a bunch of you said) when I finally confided in him he not only understood and supported me, he also wired me just enough money to be able to use so I can function until I can get back on a program.

**This is the only reason I'm able to write to you from a place of functional, rational normality now, hey, sorry - but it's true!!**

I'm sure this will horrify a bunch of you, but I can tell you now I didn't OD, or even get stoned, I simply stopped feeling sick and depressed and can now think/feel normal again without the fear/anxiety I was experiencing before.

Thanks again to all of you who posted in reply to my dilemma.
I won't go back to being a heroin addict, but neither will I let a drug as powerfully evil as suboxone rule my life either.
I'm going to to talk to my dr about detoxing in the short term rather than staying on a long term/eternal maintenance program.
I will also consider this as a blessing in disguise in terms of discovering just what nasty drug buprenorphine can be.

Love and Light to you all, thanks again
monkeygrrrl

[weaver71]

My old dealer took 16mgs subs for 3 months and went CT. He was on high dose methadone before that. His withdrawal was nothing like the stories of people on 8mgs for a year. The main thing he had to do was not stress or anticipate whT was coming. Short term use of subs doesn't cause the same level of physical dependence, though all the excuses and legit reasons we had to use are still there, I sense that is why heroin is still calling you. Trying to be sneaky and outsmart the chemist is another red flag, your job won't matter anyway, if you get back on dope. I like Nursegirls question. What would you say to a client in your frame of mind?

[motye51]

Lay off the benzos!!!!!! U r going to find yourself right back where u started. And I'm going to b as honest as u can, and some might not like it, but I so appreciated when people didn't pussyfoot around with telling me the truth. It took me approximately 3/4 weeks to be able to function and go back to work....and that was pushing it! If your last dose was wednesday, of last week then you should be on day 5 and yeah, real w/d should be kicking in. But supplementing with the benzos is only going to prolong it! I missed 30 days of work....u are not going to be any good to any of your patients like this! I had help though, I did it at home, but was not alone. U know, maybe your not giving your friends and family enough credit? I didn't think mine would understand and instead, they rallied around me. It might be worth a shot to talk to them? And yes, VERY SICK! U need to employ some help!

[nursegirl6572]

I'm sorry for your situation, but it sounds like you're rationalizing going back to heroin.  That should just NOT be an option for you, and like mentioned above, you'd be at a HIGH risk for OD under these circumstances.  Also, it's worrisome that you're abusing benzos to get you through.

Every situation requires a decision to be made.  You can make the RIGHT one, endure a brief time of w/ds and get your RECOVERY back on track, or you can take a step back and resume your DOC.  If you are an addiction counselor, you KNOW your brain is messing with you.  What would YOU tell a patient if you were their counselor in this scenario?

Best to you, keep posting.  

[monkeygrrrl]

Friday lunchtime is appt. I don't know what kind of a reception I'll get though, or if I'll even feel up to going by then! :(

[monkeygrrrl]

Hi
I can't get an appt till Friday, and even then it may take another week or so to get re-accepted into another pharmacy.
Just how sick were you girlfriend? (how long is "quite a while"?)
I can't really afford time off work (too many bills/payments due) but at the same time I don't think I'll make it to work if I this gets much worse...
You said about 4 days for real wds to kick in, well my last does was 16mg last wed... but I've been taking plenty of benzos and panadine to try cope...
No point begging the drs mate, I broke the rules so this is kinda what I get, u know?
And no my friends/family don't know and wouldn't get it anyway. But I appreciate the sentiment xx

[motye51]

I remember someone commenting on australia's program,sort of like old methadone program.    This is about the mg that i jumped from and YES, i was sick for quite a while. Whatever u do, do NOT go back to opiates! Today is Monday, when can they see u? Maybe, now is the time??? It will b rough but an be done. U seem to have alot on your plate, mother, child, work,do u have. Any time u can use from work? Siblings or friends u can call on? U know, this is where real friends really shine! They can help. It took. About 4 days for real wd to kick in.....can u get appt. In 4 days??? Beg them if u have to?

[msdelight]

Listen girl if you go back to heroin now you could OD. That is very common at this stage if you relapse. And who is going to take care of your mom and sweet little girl then? Dig deep girl. Your brain is messing with you. When is the appt?

[monkeygrrrl]

Thanks for the sympathy man
Yes in Oz if you become a "registered addict" (something I intentionally avoided for years, esp as I worked as an addiction counsellor, and was well respected in the professional addiction community) you get on an opiate substitution program (methadone/subutex/suboxone or naltrexone) From there they expect you to go to a specific chemist regularly and they have to watch you dose,
I know going back to smack is a bad idea but I don't feel I have much choice hey :(... I have people who depend on me and right now I'm a total mess... Also (and I'm telling you straight man) I would choose heroin withdrawal over this experience ANYDAY!

[msdelight]

Wow puppy so sorry this happened to you.  I'm not familiar with the program in Australia. Are you saying that you have to take it in front of the chemist while he's watching? Whatever you do girl, DO NOT GO BACK TO HEROIN!! You got to tough it out until the next appt. Wishing you strength!