Aa
suboxone for the long haul
hi all. im new to this forum and a 1st time poster or questioner or whatever but i had been an oxy user for a number of years before i went to rehab. i left rehab and immediately went to a pain clinic and got on suboxone(they called it God in a bottle - this was b4 strips came out). 24mgs daily. This was in june of 2007. It worked well but i never tapered due to chronic pain or fear thereof. Long story short, in january 2013 i institutionalized myself for reasons i would rather not speak of and cold turkied off of the daily 24. spent 4 months on the "inside" and 2 months out without suboxone. i could not function. misery. i never got any joy out of anything. took about three weeks back on suboxone24mgs b4 i got any relief from the hopelessness. this was in late last july. i just felt like sharing this. imho after 6 years on suboxone(probably much less) there is no turning back. for better or worse im married to suboxone. dr said it changes brain chemistry. i believe him. thank you. sincerely, subs4good
24 mgs a day puts your blood levels above the maximum effective dose. 32mgs supports 100% of your brain receptors. With a 60+ half life, 24mgs plus half of your dose from the day before is much more than your brain can use. 4mgs is enough to block 80% of the emotional centers in the brain. Lots of people taper off after 6 years, hang around and meet a few. First, you will learn about subs, then how people did it, and what steps after quiting are needed. Nutrition and exercise will need to be addressed, pre existing pain too. There is a way. You post sounded like you were venting. Are you interested in getting off subs? You can get a divorce you know?
Welcome to the forum~ You say there is "no turning back" once you've been on subs for 6 yrs.....I disagree. We have a fairly new forum member right now that was on pain pills for years and then subs for 6 yrs and she is over 3 weeks clean NOW and doing it.
I know you said you CT'd off 24 mg and were off of it 4 mos "in" (the institution) and 2 mos "out"....but did you do anything at all to address your addiction once you got out? Did you find new ways to manage your pain? Did you change the people, places and things you surround yourself with? Go to any recovery meetings or counseling?
24 mg of subs is equivalent to approx 480 mg of oxycodone...you're on WAY TOO much bupe. As Weaver said, you have maxed out and are taking more than you can even "use". I agree your brain chemistry has changed....so has mine. That's what addiction is about afterall. It's a disease of "brain chemistry" medically speaking. Doesn't mean we cannot heal......repair....restore.....put our disease in remission.
You CAN get off the subs....but not alone....and not without a program that compliments it medically, physcially, mentally, and spiritually.
Keep reading....keep learning.....and seriously think about cutting back your dose......subs are VERY STRONG.....stick to opiate receptors like stink on sh*t (lol)......and saturate our tissue, bones and brains....it takes awhile to get off subs......but don't believe for a minute that in cannot be done~
I know you said you CT'd off 24 mg and were off of it 4 mos "in" (the institution) and 2 mos "out"....but did you do anything at all to address your addiction once you got out? Did you find new ways to manage your pain? Did you change the people, places and things you surround yourself with? Go to any recovery meetings or counseling?
24 mg of subs is equivalent to approx 480 mg of oxycodone...you're on WAY TOO much bupe. As Weaver said, you have maxed out and are taking more than you can even "use". I agree your brain chemistry has changed....so has mine. That's what addiction is about afterall. It's a disease of "brain chemistry" medically speaking. Doesn't mean we cannot heal......repair....restore.....put our disease in remission.
You CAN get off the subs....but not alone....and not without a program that compliments it medically, physcially, mentally, and spiritually.
Keep reading....keep learning.....and seriously think about cutting back your dose......subs are VERY STRONG.....stick to opiate receptors like stink on sh*t (lol)......and saturate our tissue, bones and brains....it takes awhile to get off subs......but don't believe for a minute that in cannot be done~
COMMUNITY LEADER
HELL NO was i staying on subs forever! 6 yrs was enough! I still don't feel right but i'll tell u what has helped was going to N/A meetings. My dr tried to tell me the same ****, u will be on them forever....no way! Never going back! You have to learn how to live all over again, i have all sorts of wierd feelings hitting me every single day, we just have to learn how to function again.
Im 21 days clean off sub's & was on them 3yrs, i started at 24mgs / day then down to 16mgs for the last year, then took 8mgs the first 3weeks in december 2013 & jumped off at 4mgs after the last week of december..
I still feel lethargic & havent slept more than 1-2hrs a night & i feel like im going crazy half the time , but hey im clean at least, its gotta start getting better, I HOPE...
I still feel lethargic & havent slept more than 1-2hrs a night & i feel like im going crazy half the time , but hey im clean at least, its gotta start getting better, I HOPE...
This is more of a question than an answer (sorry), but here goes...
We all know it's much more difficult to detox from Suboxone and Methadone than, say hydros or Oxys, because the half-life is much longer. Since subs and 'dones stay in our system longer, the withdrawals are prolonged.
I was addicted to hydrocodone, which was a rough detox, but do-able. Why don't folks switch from Subs (or 'dones) to hydrocodone - to avoid withdrawals while the system flushes-out the subs? Then taper or jump from the hydros?
Maybe this is too simplistic, or assumes a doctor would switch a patient from a maintenance med to a med with a higher coefficient of abuse.
Just seems like it would be easier to avoid a prolonged withdrawal that way.
Subs and methadone are so much stronger than Hydros, it would take way to many to reduce the withdrawal. I would take 800mgs morphine, chew up 25 Norco, still barely function in methadone withdrawal. By the time the hydro works for detox, it's time to get off hydros anyway. That's my take on that anyway.
COMMUNITY LEADER
I went looking to get off of hydros which is how i found the subs. I finally had to come to the realization that no matter what c/t was gonna suck and it did! But every day seems a bit better, but its not smart to think that 4 or 5 days and the detox from subs is done, cause its not. It wasn't until day 5 the REAL **** started to happen. Then around day 10 for me, it got a bit better. I am now going to have to learn how to function off of them. And trust me, its not easy. I feel like whats in my brain and coming out of my mouth are not the same. I have no filter??? I'm very angry at myself for getting in this boat, but i put me here. I think detox has to hurt so we know how we got here and try to remember how not to come back. My opinion though. If i had it to do over again i would have never gone to the subs!
done counseling. aa. na. no trouble being honest. not boo hooing. even though 6 months isnt long it was long enuff for me. no pleasure. none. couldnt put two words together much lest a sentence. basically incompetent without subs. my family plus all friends and 2 physicians urged me strongly to get back on suboxone. dont drink anymore. was alcoholic for 21 yrs. i know i am gonna get blasted but i would rather be on subs than a suicide. and i wasnt far. thanks for feedback tho. sincerely
If I quit subs at 24mgs, I'd have gone back too. It's not easy at low dose, but I have yet to see anyone quit that high a dose and make it. If you change your mind and want to get off it, let us know, there are several tips than can help.
everyone is different in there desires and how they are wired there are so many variables in environment and genetics as far as predisposition factors in.
attitude and perception plays a big part to, I honestly believe it is possible to have a great life after bup. ( suboxone, subutex) no matter how long or how much a person has been on. Desire plays a huge part......
attitude and perception plays a big part to, I honestly believe it is possible to have a great life after bup. ( suboxone, subutex) no matter how long or how much a person has been on. Desire plays a huge part......
Hello there, and thanks for sharing your story! It sounds like you've been through a lot.
I used to work at a sub clinic, and I can say that there definitely were a small portion of our patient populace who had basically chosen to stay on subs long term. There ARE scenarios where it makes sense, mostly in situations where a person has been a chronic relapser, among other factors.
That being said, I agree with the above posters that your dose was (and IS) way too high. There is no reason anyone would ever need to be maintained on a dose that high. Buprenorphine reaches a ceiling effect at about 16mg, meaning any dose over that is just extra, it's not therapeutic in any way. Now, initially, at the time of induction, a person may need a dose higher than 16mg, but that should be short lived. A person should not be kept at high doses like that for more than a week or two.
Even people with very heavy habits can be easily maintained and kept stable on a much lower dose, like 2-4mg/day for example. I also agree that your experience of CT'ing off such a high dose played a big role in the way you found yourself feeling after the fact. If you had been properly tapered, slowly and gradually, down to a much more reasonable ending dose (under 1mg), you may have felt completely different in the long run, and perhaps not felt as though you needed to go back on the sub. It takes a pretty long time for a person to readjust post subs, and your situation would have been no exception, as a matter of fact, you would have faced even greater challenges in the way you came off the sub. I just don't think you ever got to where your brain and body readjusted yet. While in theory, medications like sub CAN make long term "changes", plenty of people come off sub and other opiates with no long term adverse effects. You definitely went back to the sub prematurely, IMO, and it didn't help you that you were encouraged to do so by your doctor.
I'm all for supporting someone who has decided to stay on Sub long term if it's the right thing for them, but in all honesty, I don't think your situation allowed for a fair assessment of your "need" for sub. In the very least, if you decide to stay on the sub, find yourself a sub doctor who understands the importance of setting goals to get the patient on a much more reasonable maintenance dose. You could (and should) function just fine on a dose as low as 2mg, even less. It will take some time and patience to taper down to a lower dose, but it's totally doable. You will likely not even experience any kind of w/d symptoms until you get down to the lower doses. Most people who are decreasing their dose when it's high tolerate it very very well. It's when one gets to lower doses (usually under about 4mg) that a person will experience more noticeable w/d symptoms, but they're not unbearable, are short lived, and once you readjust to the new dose, you should feel the same (if not better than you do on the higher dose).
But, you need a sub doctor who doesn't have ulterior motives of keeping his patients on a higher than necessary dose, for indefinite periods of time, for monetary gain. Unfortunately, there ARE bad sub docs out there like that, and it sounds like yours may be one of them (just from the little you've said here).
Try to have a conversation with him about wanting to get down to a lower dose for now, and that you want to remain open minded about your future with subs. It doesn't have to be a permanent "all or nothing" decision for you. Right NOW you feel it is more of a long term option, but that may change for you, and I think you owe it to yourself to at least TRY to come off sub the proper way at some point, so you can more accurately assess how you'll do with life post-sub.
If after a sit down with your doc, you feel he is going to be unwavering about your dosage and continues to stress that you "need" it forever, I would strongly recommend finding a new sub doctor.
Lastly, it's also important to do the "work" involved in recovery. Aftercare can come in the form of NA/AA meetings, addiction counseling, etc. Taking sub should only be ONE aspect of a recovery program. The work still needs done to help you learn healthy ways to cope with life, and to learn how to stay on guard for the possibility of triggers and relapses. If you just take the sub without the aftercare, your risk if relapse will be much higher, even if you DO remain on the subs.
Subs do a pretty good job at keeping cravings at bay, but not always, and the aftercare portion of recovery is where you learn how to handle them when they emerge. Addiction is something you have to address for life. Cravings are a SYMPTOM of the disease of addiction. Just taking an opiate replacement medication isn't enough.
Very best to you, stick around, you will get priceless guidance and support here, from people who have lived through addiction as well. There's nothing better IMO than people supporting one another through the battle.
I used to work at a sub clinic, and I can say that there definitely were a small portion of our patient populace who had basically chosen to stay on subs long term. There ARE scenarios where it makes sense, mostly in situations where a person has been a chronic relapser, among other factors.
That being said, I agree with the above posters that your dose was (and IS) way too high. There is no reason anyone would ever need to be maintained on a dose that high. Buprenorphine reaches a ceiling effect at about 16mg, meaning any dose over that is just extra, it's not therapeutic in any way. Now, initially, at the time of induction, a person may need a dose higher than 16mg, but that should be short lived. A person should not be kept at high doses like that for more than a week or two.
Even people with very heavy habits can be easily maintained and kept stable on a much lower dose, like 2-4mg/day for example. I also agree that your experience of CT'ing off such a high dose played a big role in the way you found yourself feeling after the fact. If you had been properly tapered, slowly and gradually, down to a much more reasonable ending dose (under 1mg), you may have felt completely different in the long run, and perhaps not felt as though you needed to go back on the sub. It takes a pretty long time for a person to readjust post subs, and your situation would have been no exception, as a matter of fact, you would have faced even greater challenges in the way you came off the sub. I just don't think you ever got to where your brain and body readjusted yet. While in theory, medications like sub CAN make long term "changes", plenty of people come off sub and other opiates with no long term adverse effects. You definitely went back to the sub prematurely, IMO, and it didn't help you that you were encouraged to do so by your doctor.
I'm all for supporting someone who has decided to stay on Sub long term if it's the right thing for them, but in all honesty, I don't think your situation allowed for a fair assessment of your "need" for sub. In the very least, if you decide to stay on the sub, find yourself a sub doctor who understands the importance of setting goals to get the patient on a much more reasonable maintenance dose. You could (and should) function just fine on a dose as low as 2mg, even less. It will take some time and patience to taper down to a lower dose, but it's totally doable. You will likely not even experience any kind of w/d symptoms until you get down to the lower doses. Most people who are decreasing their dose when it's high tolerate it very very well. It's when one gets to lower doses (usually under about 4mg) that a person will experience more noticeable w/d symptoms, but they're not unbearable, are short lived, and once you readjust to the new dose, you should feel the same (if not better than you do on the higher dose).
But, you need a sub doctor who doesn't have ulterior motives of keeping his patients on a higher than necessary dose, for indefinite periods of time, for monetary gain. Unfortunately, there ARE bad sub docs out there like that, and it sounds like yours may be one of them (just from the little you've said here).
Try to have a conversation with him about wanting to get down to a lower dose for now, and that you want to remain open minded about your future with subs. It doesn't have to be a permanent "all or nothing" decision for you. Right NOW you feel it is more of a long term option, but that may change for you, and I think you owe it to yourself to at least TRY to come off sub the proper way at some point, so you can more accurately assess how you'll do with life post-sub.
If after a sit down with your doc, you feel he is going to be unwavering about your dosage and continues to stress that you "need" it forever, I would strongly recommend finding a new sub doctor.
Lastly, it's also important to do the "work" involved in recovery. Aftercare can come in the form of NA/AA meetings, addiction counseling, etc. Taking sub should only be ONE aspect of a recovery program. The work still needs done to help you learn healthy ways to cope with life, and to learn how to stay on guard for the possibility of triggers and relapses. If you just take the sub without the aftercare, your risk if relapse will be much higher, even if you DO remain on the subs.
Subs do a pretty good job at keeping cravings at bay, but not always, and the aftercare portion of recovery is where you learn how to handle them when they emerge. Addiction is something you have to address for life. Cravings are a SYMPTOM of the disease of addiction. Just taking an opiate replacement medication isn't enough.
Very best to you, stick around, you will get priceless guidance and support here, from people who have lived through addiction as well. There's nothing better IMO than people supporting one another through the battle.
Yeah, what Nursegirl said. I agree with her 100%. On another nite, my best friend is a lifer on subs. He has bolts up and down his neck and was at 1800mgs of Oxy a day. No, that was not a mis type. He went in a comma and a couple weeks later woke up on subs. He takes 4-8mgs a day for 7 years now. Snow season is 8, warm season is 4. He couldn't handle to detox, pain, withdrawal, and risk of relapse and death are too great for him. He functions fine and nobody would ever know. He did have to work aftercare to feel okay with it, but that's the only example of a lifer I personally know really well. His emotions are a bit dull, his memory isn't what it used to be, but he has a functional life. The benefits out weigh the consiquences for him. Just sharing another story. Keep us posted.
thanks weaver71, after listening to u guys' posts i have decided to taper down to a reasonable amt. of suboxone. again no way i will quit but getting down to 8 mgs daily may be a reasonable goal. thanks again
I recently quit using 16 mg of buprenorphrine's around 19-20 days cold turkey. I was wishing I were dead! Hardest thing I've ever done in my life. Unfortunately after, reading numerous comments online about tapering, how it makes it easier, etc. I decided to have 1 1/2 sent to me. Boy was I wrong! I still have no energy, restless leg syndrome is back, no appetite, & constantly using the restroom. This drug is a beast! How long should I expect to feel a little better? I am contemplating, getting more or seeing a new dr where I moved to a year ago. Just don't wanna be on these for the rest of my life! I've been sober. I know it's a better life! Help!!!
You have 20 days off sub, well it takes 21 days for your last dose to be out of your system. You took another 1 1/2, but that is a small amount compared to the daily accumulation you were taking. It takes awhile, no matter how you go about and you have come so far. It won't be long until you start to feel the healing more distinctly. Take amino acids, vitamins, EmergenC, Cal/mag/zinc, and keep moving. Take walks or any exercise you can do will help a lot. See if you can ride it out and be done with it. Go to meetings, visit sober friends, go to church, counseling, just stay as busy as possible and don't use. It will be worth it. I went through months and months of methadone detox and don't regret the worst if it now. You are investing in the rest of your life, this is a temporary phase. Keep your eyes on the prize and try not to analyze how you feel or when it will be better. You have this thing.
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