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opiate withdrawal again see Sub Dr tonight, help

Looking for all those who have tried subs as part of their detox from opiates. I failed everytime going ct. i will also be seeing an addiction specialist to work on my recovery. took my last hydrocodone at 2pm yesterday. Appt is at 6pm with a psychiatrist who will administer the sub. im so scared and emotional today. All feedback is so appreciated. i just want help so bad. im a single mom and need to be better for my daughter. thank you Michele
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Avatar universal
I used opiates of all kinds for over 10 years.  Lost a wife to a methadone OD.  Its been a pretty costly habit all the way around.  Two years ago I started using Subs bought off the street.  One year ago I went into outpatient treatment and legal suboxone.  I'm around 80 days clean, with littel to no cravings.  I still have a one-on-one counselor whom I talked to today.  I had a random UA about 3 weeks ago.  It keeps me honest.  :-)  I have a couple suggesstions about using suboxone.

First, I can't suggest that you do anything that's contrary to your doctor's directions.  With that said ...

Doctor's who prescribe suboxone/Subutex are required to complete an 8 hour online course!  What does this mean?
Some docs are good and some, well .... They all have at least 8 hours      training.

I see and read about people being prescribed what seem to be very high doses of subs.  16mg, 23mg, even 32mg per day!  Discuss with your Doc about taking the lowest effective dose.  You're going to have to taper off this stuff and the higher the dose, the longer it takes.  My doc wanted to give me 8mg.  I asked for 4mg and we agreed on that.

Discuss with your doctor whether this is a detox using suboxone (6weeks or less) or longer term maintenance with suboxone (6 months to 2 years).  I used the longer term maintenance strategy which I believe helped my reward system to normalize.  Every other time I quit, I have serious cravings.  This time it seems like so long ago that I had that opiate buzz.  I just don't have serious cravings like before.  The downside is that I had to go through suboxone WDs.  Honestly, for me, they were like most WDs, only longer.  I think for me, a moderate hydro habit would that about a week and a half for WDs and another 3 weeks for my energy to come back.  With subs, its still about the same length for WDs but I had serious lack of energy for 2 months.
Subs can also be used for a short term detox to help minimize the withdrawal effects of your DOC.  Just remember that suboxone/Subutex is an opiate.  Its a partial agonist opiate, which means that you won't get high.  Many will argue that you can get high.  The definition is kind of blurry.  When I'm having WDs and subs take that away, one could call that a high. I take it and I feel better; exactly why I took opiates in the first place.   So, detox or long term maintenance, you and your doc will need to decide.

One last thing; Is it worth the effort to get clean.  For me, its wonderful.  I feel good without medicating myseof for the first time in almost 15 years.  Wish I would have done it sooner.

I hope this helps.  If you have any other questions I'd be happy to give my opinion.  Remember, most advice is just that, an opinion.  Addiction, withdrawals and treatment are unique to the individual involved.  

My best wishes and hopes to you.



23 Responses
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Avatar universal
This is wonderful news.  I'm very happy about you being stable at 2mg.  Do you have a schedule to taper down?  You do need to get down to .25 mg,  .25 is roughly equivalent to 10mg of morphine.  You probably don't want to jump off higher than this.  Keep us posted
Helpful - 0
Avatar universal
Hi Michelle.  Wishing you all the best. Don't forget to come here for support during these six weeks and be sure to attend the meetings and therapy sessions. Good job honey! Keep it going.
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Avatar universal
Suboxone helped me, and I hope it helps you too.  If used correctly it is a very good tool.  In a perfect world there would be no such thing as addiciton, or it wouldn't be so hard to withdraw and stay off.. but we are in the a world where addiciton and all the horrors associated with it are real.  

To start on 2mg sounds reasonable ...and if you can be down to .25/day or .5 every other day, in 6 weeks you should be okay to come off.  I have heard of some people even going to down to crumbs and then those every 2nd or 3rd day.  Just remember to do the research yourself so you can make an informed decision.  Suboxone is a very powerful drug and should never be taken lightly.  The goal is to get you back to living a good clean happy life.  We are all unique how much we need, and what tools we need to beat this disease.  

I'm here to support you.

liliansdream
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Avatar universal
Glad to hear you're feeling ok,and glad to here you have a plan in effect to get clean clean in 6weeks. Always makes it a bit easier when we make a plan.
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Avatar universal
Hi thanks so much for checking in. I am doing really well. I am on 2 mg and feel normal honestly. I just dont have much of an appetite. I ate a lot on the pills so losing a few lbs is a good thing. I am only staying on for 6 weeks. I am seeing a counselor and focusing on my recovery. Thank you so much again for your advice and support. How are you feeling?
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Avatar universal
How is it going?
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Avatar universal
I just need to submit proof that I am actively attending meetings or sessions with a therapist while under the dr's care which will not be long term. I actually never gave aftercare much of a chance so this is actually a good thing for me. Thanks for the wishes.
Helpful - 0
Avatar universal
That sounds like a long term plan not a detox plan? The 12 steps will help though. We all need to find the root of why we are addicts and what our triggers are to set off looking for the pills. Meetings will help with this. I wish you luck!
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Avatar universal
I saw the dr. I am starting on 2 mg of subs. He said i can increase it but I dont plan to. He told me to cut 8 mg in half however I cut them in 1/4's. I signed papers that I will see a therapist and attend a 12 step program. Thank you all for your feedback. This is the route I chose and I can only hope for the best.
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Avatar universal
Nobody can tell you what to do,this is your choice. They are all just telling their experiences and what the subs can do in the long run.
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13354001 tn?1432155513
This is very hard for me.  I say ROUGH IT!
Suboxone is NOT A GOOD DRUG.  I have to share my opinion on it since i'm going through withdrawl STILL after 19 days.  Am i better ?MUCH BETTER! I see it like this..by getting on Suboxone you are only putting off the inevitable.   Just pleas edo whats right for your life.
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242912 tn?1402543492
Hi there...I just read through this entire thread.  I think you have time to read through it again before your appt.  Do that, then make your decision.    

I wish you the best with whichever choice you make.
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Avatar universal
ugh do i cancel? he just called to reschedule for 7:30pm. im so lost
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Avatar universal
Its a complicated issue.  There's a place for suboxone but there's lots of ignorance out there regarding its use.  I'd like to have some of these doctors jump off at 2mg and tell me how easy it is.  My doc told me "I'm the pen", meaning he wrote the script.  I asked him how previous succesful patients had quit suboxone.  He said he didn't have any.  He said "70% relapse and 30% disappear"  He was a 70 year old doctor with a small office in a run-down stripmall.  I started reading about how people were getting down to doses as low as .125mg.  I jumped at .25mg.  Not ,25t of a strip but .25mg, and I thought maybe I'd made a mistake by not going to .125.  Be very careful if you use this drug.  Be and active partner in your treatment.  Do research, ask questions, take charge of your future
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Avatar universal
Wow motye51 that just blows my mind that a doctor would do this to you,and so scary to boot!! So awesome you quit and c/t at that!!!

Iwantmylifeback
I really hope you take into consideration what these guys are saying. You say your gut is telling you to go tonight,but it's not your gut it's your addiction. You sound terrified just to have to go through these w/d's for the weekend. BUT when you get through them you won't have that much longer to go before you start to feel better,you'll already have 2days under your belt.  Please think long and hard,and if you do go have a list of questions for the doc. Don't let him let you go in blind.
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7163794 tn?1457366813
COMMUNITY LEADER
You couldn't be more right Krissy.....my getting on the suboxone was WAY stronger than the opiate addiction that I had acquired!!!!  For sure....Someone had sent me a conversion chart of what 1 8mg strip was equal to and I was like WTF???  I was taking 3 8mg strips a day for 7 years. However, I went into the sub program with my eyes totally closed just looking for something to stop the pain of the pills.  What I ended up doing to myself was way more damaging.....because I sat in my room for a month, throwing up, having #3 for months, not eating, not sleeping, praying for my brain to stop, praying for some type of relief, I'm a bit hesitant to recommend it.  Unless your talking about a 20 year addiction to heroine or something like this, then I would say yes, but......?
I'm not familiar with it being used short term (like a week or 2) because NO ONE i know used or uses it like that.....Everyone I knew and know that take it have been on it over a year and every time I turn around were getting more and more people in our N/A group on it and not small doses either.  I don't know what to tell them....
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Avatar universal
Pillguy

Holy flippin crap!!! That's insane!!!! So ppl on low to moderate doses of opiates can be put on something 1000 times stronger well trying to get clean??? Makes no sense,IMHO these ppl with pill addictions (say like what I had 30-60mg oxy a day) are way better off to c/t and get it over quick. But what about herioin pillguy? Is that more like what subs be would for? Or a 200-300mg habit of oxy a day?
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Avatar universal
Its hard to explain to folks just how strong.  A little over 1mg (1.15) is equal to 80mg of morphine.  Various calculators use different values because narcotic equivalence is affected by several variables, but a rough rule of thumb is that subs are 80 to 100 times more powerful than morphine.  Then keep in mind that the halflife of Suboxone averages 37 hours.  That means the levels are rising everyday.  If you take 16mg per day, by day 11 your blood level is at 45mg!
Lets factor that with the 1:100 rule.  So if I'm taking 16mg per day by day 11 I'm taking the equivalent of 4500mg of morphine per day.  This would be a lethal dose of morphine.  3 grams (3000mg) of morphine is about the max that can be tolerated.  Suboxone doesn't depress the respiratory system as much as full agonist opiates; part of the reason its used for opiate maintenance therapy so these high doses can be tolerated.  It explains why someone who jumps off at even 2mg is facing a real tough task.  Even without factoring in the halflife of Subs, a 2mg dose of suboxone is equal to 200mg dose of morphine per day.  That's going to hurt!
Helpful - 0
7163794 tn?1457366813
COMMUNITY LEADER
You know....Ready2befree brings up a good point....how powerful are subs??? Powerfull enough that they instantly take your pain away.  I never put that together, but it's totally true.

As far as suboxone is concerned, I am on the fence most of the time. Subs were my DOC for 7 years after a year love for my other DOC which was opiates.  I had to have everything out of my system for 48 hours (started detoxing on a Friday and went in to doctor on Monday a.m.) before they would start me.  I only missed one day of work.....wasn't required to do any type of aftercare, therapy, etc....  I started on 24mg per day and ended there as well.  ThMis is just my opinion, so it is what it is, but the idea of quitting never entered my mind until the end of 7 years when I woke up and realized that I was so lost.  Subs to take away w/d but they also take away love, life, excitement, sex drive, feelings, drive, etc...  The other point I'd like to make is that in order to avoid the w/d off of subs you MUST taper....and for me, I am an addict and tapering doesn't seem to work very well for me.  I quit subs (I tapered for about a week) on Jan 1st, 2014 and was extremely sick for about 1/2 months....it was hard, not going to lie, but thats because I didn't taper!  And length of time I was on them, etc...
I was probably taking 10/12 hydro 10s a day and was immediately put on the 24mg of subs which I NOW realize was total overkill.  It was told to me it's like killing a fly with a bat.....getting on the subs, I actually increased my opiate consumption.  
Go into the sub program with your eyes WIDE OPEN....it's not a miracle cure. If it's what you need, well, that's up to you, but I fear your trading one addiction for another. As addicts....we can be addicted to anything.
Helpful - 0
13354001 tn?1432155513
Pillguy  you should pursue Addiction Counceling.  I'm not a doctor but I would only use subs very briefly.   When I 1st got on them after withdrawaling  for 1 full day..they administered it right on spot.  Felt instant relief.   That to me is enough to show you how powerful  these things are.  Good luck
Helpful - 0
Avatar universal
Thank you for taking the time to post your experience. I prayed on this and my gut tells me to go to this appt tonight. i want to try this on a low dose and short term. I just hope my body responds well to this. i will be in wd 28 hours at my appt time. Please pray for me. Thank you again for your input it means so much! Will post tonight to let you all now my outcome.
Helpful - 0
Avatar universal
Awesome post,that is a great detailed post pillguy!!
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