2Mg taper problems

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My History....

About 2 years ago I sustained neck injuries due to an automobile accident followed shortly by complications with my back from an incident at work. At this time I was given vicodine for pain for about a year. After completing physical therapy, I no longer required the pain meds and had relatively no problems discontinuing their use. A few months later due to the deaths of several friends and other emotional life events I began taking the anti-depressant celexa at 20 mg a day along with 2mg ativan 2x a day as needed. As a result of the celexa not really working, my dose was increased to 40mg a day....which shortly put me into a miserable fog where I felt like a zombie. On my own I decided to go back to 20mg a day which caused me to experience severe withdrawal symptoms for the first time in my life. Under the doctors advice, I began alternating between 30mg-10mg for 10 days and arrived at 20mgs with no withdrawal. After losing my heath insurance I began cutting my usual dose in 1/2 for about 3 weeks until I ran out of my celexa. After a few days I again began feeling like I was on an out of control emotional roller coaster. At this point I reinjured my back and began taking vicodan that a friend gave me for the pain. While taking the vicoden my emotions leveled out and I felt as if I could think clearly again. However, when I stopped taking this medication this time around I began to experience withdrawals and cravings that I have never experienced before and ended up severely depressed and begining to habbitually self medicate with them on and off. About a month ago I was prescribed 2mg suboxone 1x a day which seemed like a mirical at first. My depression subsided, I began thinking clearly and I felt like my old self again....it even seemed to help with the minimal back pain I still experience. This feeling was short lived....for after a week or two I began feeling edgy and irritable. Thus I attempted to altenate the days when I would take the 2 mg doses. This didn't work well, and then I tried to quit cold turkey....which was awful. I then began cutting my 2mg tabs in half and taking 1mg early in the morning each day when I wake up. I went through moderate withdrawals for about a week ie; sleeplessness and night sweats. I am now almost through my second week at this dose and am sleeping better for the most part and feeling less neurotic during the day. However, this week I have begun to feel quite dopey/tired at work which is imediately elliviated by taking about 3-4 mg of ativan throughout the day. I am now waiting to see my Dr. again once my health ins. begins again Jan. 1'st but considering tapering down to .50 to hopefully elliviate the dopey/tired feeling I am experiencing regularly. I am wondering if this feeling might possibly subside, or if I should attempt another taper to .50 and if so what the best way to go about it might be. Without health insurance and a Dr for a few more weeks I am feeling trapped. I am also wondering why the ativan appears to have the opposite effect on the severe tiredness I experience about 4-5 hours after taking 1 mg of suboxone in the morning. I am also wondering if taking it at night might help...and fearful once I stop my depression might return full force.. sorry for being so long winded but I am a novice when it comes to dependency/withdrawal and kinda concerned about my recent dependency on ativan. Any help you can provide would be greatly appreciated..Many thanks! Best holiday wishes to you

Subject: Re: 2Mg taper problems Fri 17 Dec 2010, 1:38 pm

Hello to you "Stuck" & Welcome to the forum!!

I would like to first of all thank you for opening up & sharing your situation with us as well as to introduce myself. My name is Beth & I have been a Suboxone patient for a few years now & don't know how I would make it through this journey of recovery without the help of the Suboxone. It sounds as if you are ahead of me in wanting to go completely off of it. Is there any particular reason that you want to be completely off of the Suboxone when it was helping you so much? I do understand the desire to be completely drug-free, but it sounds as if you will still be on the other meds despite tapering off of the Suboxone. One thing that I have learned about taking the Suboxone is that it does seem to have a mood stabilizing effect, especially in patients who also suffer from depression, as I also do. My previous doctor told me these facts, particularly when you are also taking a benzo because your body gets so used to taking the opiates that instead of them making you drowsy any longer, they actually begin to give you energy. Now you have stopped the painkilllers & your energy level has plummeted, am I correct? That is exactly what happened to me & the ONLY reason that I ever still have any desire for using opiates again. Yet, I refuse to let the one quality that I miss about a drug that was going to kill me at the rate that I was using allow me the permission in my mind to be able to go back to using again. I can actually understand what you are saying because now that you are tapered so far down on your dosage, you are no longer experiencing that energy that you were getting from the Suboxone, which was nothing compared to the energy that you were experiencing while using the full antagonist opiates, such as Vicodin or pills of the sort. I feel that same lethargic feeling before I get my Suboxone into my system & it does subside somewhat once it "kicks in" as well as I take my Valium at the same time, so that helps me to feel a bit more energetic as well. So, that leads us right into your question about why your Ativan seems to give you energy when it is a downer. It sounds as if you have been on it for a couple of years, is that right? I have been on Valium for 13 years, with little breaks of stopping here & there, but overall, we could say at least a solid 10 years counting the times that I had stopped using it. I also didn't understand why it was giving me energy when it was supposed to relax me. For the longest time, I could seem to take it or leave it, as I had my opiates to sustain me, but upon quitting the use of opiates, the Valium became very important to me. I began to abuse it as more time went by that I was off of the opiates. I was trying to fill that "lacking" feeling within me of even having the desire to move. I wanted more energy!!!! And still to this day, I crave that energetic feeling that I was so used to having, but couldn't obtain from the Valium any longer. I know that I am fully dependent on the Valium, yet I have gotten it back under control to where I only take what I am prescribed to take, as taking more wasn't helping me feel any better, but I couldn't just be completely off of them & although my Provider doesn't normally prescribe both Suboxone & any benzo together, in my case, he feels as if I truly do need this medication to keep myself leveled as I still felt like I was coming out of my skin on the Suboxone & Zoloft. (which is now changed to Prozac, as my depression was not getting any better & am still hoping that this will work better for me) I do also have epilepsy, yet that is another whole story about all of the drugs that they were putting me on & taking me off, then trying something new, etc, etc. The side effects were worse than the disease itself & normally, as long as I can remain calm, I can remain seizure free. That is a big reason that I have remained on the Valium, as well as straight out anxiety. I've been on them for so long that my body doesn't know how to relax on its own- it barely knows how to relax on the meds that I am on, but like you with the Celexa, I often felt like a walking zombie when they put me on these new meds. I didn't feel safe to drive, nor to be here alone with my then babies, who are now 3 & 4. How do you raise 2 toddlers when your sitting in the chair feeling like your watching the world go by, but cannot move to be part of it? Yet, I am getting off topic here, I asked my doctor why the Valium made me feel MORE energetic when it would knock any "normal" person on their behind. He explained to me that by taking ANY medication daily, it re-routes the receptors in your brain to feel "normal" in the long run. The same reason that the opiates made you feel energetic when they would normally also knock a person not used to taking them onto their behinds. Your receptors have been re-routed to feel normal while taking your Ativan & when you try to stop taking them, then you feel the double whammy of having 2 different receptors being unproductive as your brain no longer makes those "feel good" chemicals on its own as it normally should since we have been replacing those natural chemicals with another drug for a length of time. It ONLY takes three weeks to become dependent on any of these drugs when taking them everyday. Yet to go back off of them, it will take at least half of the time that you have been on them to heal your brain enough to begin making its own natural chemicals once again. Therefore, in my situation, it would take around 5 years before my brain "heals" itself enough to begin producing its own natural chemicals yet once again from my benzo use. The biggest difference between the opiates & the benzos though is that there are medications available such as Suboxone or Methadone to help the transition back to normal from opiate abuse, yet there are no such drugs available for going off of the benzos- you just have to suffer through it if you should choose to decide to go off of them as well. I highly recommend not being on any benzos unless absolutely necessary because it is so hard to get back off of them once you have become dependent. That is where I am kind of "stuck"- I have a terrible fear of trying to go off of the benzos because I have tried when I was beginning to abuse them after stopping the usage of the opiates & it was pure hell on my body, mind & soul. I really had no desire to get out of bed in the mornings or even throughout the rest of the day. All I wanted to do was sleep, sleep, sleep! I didn't want to eat as I wasn't burning any energy to be hungry & I could barely swallow food no matter how long I chewed it. The benzos directly effect the nervous system & your nervous system is directly linked to your swallowing abilities. If I ever choose to decide to try to quit using them again, I believe that I would need inpatient treatment to help me actually do it. Yet, that is something that has just not been an option for me with having 3 children who still desperetely rely on me to be here to care for them. I believe that much of this comes from depression & I wonder the same thing about you? I just feel as when I am answering you, I am talking about myself. This is a hard spot to be in & I can empathize very much with what you are going through. I hope that you know that we're here to talk or listen & in just giving you my own personal opinion, I believe that you should stay on the Suboxone until ypu get your insurance back at the begining of January to see what your doctor actually thinks. That is only 2 weeks away & why be sick & miserable throughout the holidays, withdrawaling, when you can remain at your most comfortable level until your doctor tells you otherwise. The holidays are hard enough on all of us as it is. I wouldn't normally be so blunt about it, but you asked what or how someone else would handle it & I am giving you my honest opinion. Of course you can do whatever you choose to do, but I just think that especially at this time of the year & being just weeks away from being able to see a doctor that you should stay where you sre comfortable & not push it too hard & hard on yourself throughout this special time of yesr. You hate to be at a family get together & having the cold sweats & nausea & whole withdrawal thing going on. Yet, that is only my opinion & I hope that you do what is right for you. I really hope that you'll be in contact with us to let us know how you are doing & how it is working for you. You may just inspire someone else who is going through similar circumstances as you. Please let us hear back from you soon. Angels bless & remain with you throughout your journey & I hope that you will honestly keep in touch.

Many Blessings throughout your journey,
Beth I love you

Subject: Re: 2Mg taper problems Sun 19 Dec 2010, 12:09 am

Welcome Stuck,
My name is Dee and it is great to have you with us. I wanted to respond to your post sooner but I have had some things going on here at home that I couldn't put off. I am sorry that I wasn't here earlier.

I read your post and agree pretty much with what Beth has already said. One thing I wanted to point out to you though, you were only taking Suboxone for about a month but after about a week or two you started to feel edgy and irritable. When you start taking Suboxone it takes awhile for your body to level out and find a dose that is right for you.

Sometimes it takes anywhere from one to two weeks for the induction phase of Suboxone, after that comes the stabilization phase. Once your doctor is sure that you are not suffering from any withdrawal or cravings (about one to two months) You are considered to be stable on your dose.
Two weeks isn't enough time for your body to adjust to Suboxone. And when you are taking other medications along with Suboxone it can take longer.
I know it's hard when you feel like crap to stay on one dose and ride it out. Believe me I know.

All of the ups and down of your other medications could be a result of the constant changing of your dose. It just doesn't sound like you gave yourself enough time to level out before changing the dose again. And if you have been taking ativan for as long as you said you have, there's no way you can just stop taking it.
To be honest I wouldn't try to taper anymore on your dose until you speak to your doctor about it.

Even though it isn't recommended people take any kind of benzos while taking suboxone, you just might be one of those people who need to take something for their anxiety. If you find that you really need to take a benzo along with your Suboxone always make sure that you check in with your provider.
Once you start to self medicate that is when you run into trouble. I know that I haven't been of much help to you, but I do want you to know that we do care about you. Please post and let us know how you are doing.
Grateful in recovery,
Dee

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