Need help with use

Number of posts : 8 Registration date : 2009-10-10

I am really looking for assistance here, after my surgery I feel into addition to opiates. Over the past four years I was taking between 9 and 14 30MG of OC and told myself enough was enough. I tried quitting cold turkey and it was not happening, even when I had about 60 pills of OC in the house I could not sleep, shortness of breath just knowing what was waiting for me. When I went on Vacation I ran out of pill and could not stop the crave, the restlessness, no sleep. Well on Tuesday morning I took my last three OC’s, on Wed I took 16MG of Sub, Thur I took 8 mg, Friday I took 4.5 MG, Sat I had some aching joints I took 2MG and today I took maybe 1MG, last night I did start getting a crave but was able to fight it off and at 10PM I took a Xanax and slept through it. This morning I had no crave, felt pretty good but I still took the 1MG just incase I started to get craves later in the day at least I can tell myself you took the med and not take the sub when getting the crave.

Do I take the Sub just to take it, or do I wait it out until I get WD symptoms? My Doc rx me to take 24MGs a day and knew it was a bit much. I mean really how am I doing , is this good or bad. Mind you if I had an OC on me right now it would be flushed down the drain, no BS!

Subject: Re: Need help with use Sun 11 Oct 2009, 4:50 pm

Hello ,
My name is Kim..I started taking the suboxone just a week ago ..The dr told me I had to wait at least 24 hrs before I took my first does of suboxone after no more of the opiates . I did now I on 12 mgs a day . I called these numbers and they gave me a lot of help and supportPhone number:
Office 770-428-0871~Cell 770-527-9119 ..Please call them if you will not regret the cal

Subject: Re: Need help with use Sun 11 Oct 2009, 7:20 pm

Hello WannaStop,
Usually when people take Suboxone they take it as a maintenance medication to mange their symptoms of addiction. Usually on day one of suboxone treatment, you are given 8mg for that day.
On day two you are dosed in the mornings and may increase your dose by 2 or 4mg if needed. In the beginning of treatment most people level out at 16mg per day.
Do not wait for withdrawal or cravings before taking your medication. It is to be taken as a tool in your recovery.
It is best if taken at the same time everyday. You can find the Suboxone Treatment Protocol on our website at:
http://suboxoneassistedtreatment.org/40.html

There are three stages of maintenance with Suboxone. They are Induction, Stabilization, and Maintenance.

The following comes from the Clinical Guidelines For The Use of Buprenorphine in the Treatment of Opioid Addiction (TIP 40) Chapter 4.
Before the initial buprenorphine induction dose is administered to a patient dependent on short-acting opioids, a minimum of 12-24 hours should have elapsed since the last use of opioids. The patient should preferably be exhibiting early signs of opioid withdrawal (e.g., sweating, yawning, rhinorrhea, lacrimation). Patients who are not in active withdrawal because they have not abstained from using opioids for a sufficient period should receive a careful explanation of the advantages of waiting and should be urged to wait until they begin to experience the symptoms of withdrawal.

Patients who are experiencing objective signs of opioid withdrawal and whose last use of a short -acting opioid was more than 12-24 hours prior to the initiation of induction can receive a first dose of 4/1-8/2mg of the buprenorphine/naloxone combination (buprenorphine monotherapy for pregnant women). (meaning Subutex)
If the initial dose of the buprenorphine/naloxone combination is 4/1 mg and opioid withdrawal symptoms subside but then return (or are still present) after 2 hours, a second dose of 4/1 mg can be administered.

The total amount of buprenorphine administered in the first day should not exceed 8 mg.

For patients who do not experience any difficulties with the first day of buprenorphine dosing, and who are not experiencing any withdrawal symptoms on the second day, the daily buprenorphine/naloxone dose is established as equivalent to the total amount of buprenorphine/naloxone (or buprenorphine) that was administered on the first day.

Doses may be subsequently increased in 2/0.5 to 4/1 mg increments each day, if needed for symptomatic relief, with a target dose of 12/3 to 16/4 mg per day to be achieved within the first week, unless side effects occur. If side effects occur, the dose of buprenorphine should be maintained or lowered until these side effects disappear.

Patients who return on Day 2 experiencing withdrawal symptoms should receive an initial dose of buprenorphine/naloxone equivalent to the total amount of buprenorphine/naloxone (or buprenorphine) administered on Day 1 plus an additional 4/1 mg (maximum initial dose of 12/3 mg). If withdrawal symptoms are still present 2 hours after the dose, an additional 4/1 mg dose can be administered. The total dose on Day 2 should not exceed 16/4 mg. Continue dose increases on subsequent days according to the induction schedule up to a maximum of 32/8 mg per day.

We are all different and our bodies are different, what works for me may not work for you. That is why it is important to work with your doctor in treatment in treatment so that he can help you find the dose that is right for you. Do you have a followup appointment scheduled with your provider?
I have to ask you, when your doctor first started you on your Suboxone, did he start you in his office or did he write you out a prescription and leave it at that? Most inductions are started in the doctors office. That way if you should have any adverse reactions to the Suboxone or should you need a higher dose he can guide you through it.
It seems that more and more doctors these days are writing prescriptions and leaving the initial dosage up to the patients.
I am glad that you have posted. Please, if you have any other questions let us know.
I do try and be on here often throughout the day so that I can catch any questions, but today being Sunday I came on much later than usual. Thank you Kimbo for being here when someone needed help.
You did a great job.

Yours in recovery,
Dee

Number of posts : 8 Registration date : 2009-10-10

He wrote me out my script for 3 X 8MG a day as needed, but I did my homework on the stuff and took everything that was good about it and used it to my advantage. I have another appt next week. He is a good doctor just not familiar with Sub. My intent is to take my experance and inform him how I used to help others. Today is day 6 and I started with a small crumb but in my head I do not treat sub day as 24hrs but the half life of 37.5 so when I say I took a crumb it was 32hrs between doses.

Also I want to say that what you are doing with this discussion board is just flat out careing. It is comforting to see that there is still good in this world. Prior to me falling into my hole I was one who thought addition was a charcter flaw and not a sickness. I can tell you that it took just one of those blue demons to fall into the hole and because the were rx post surgery I thought it was okay. I lied about my pain to get more pills and for the past 5 days advil works just fine for my pain.

Subject: Re: Need help with use Mon 12 Oct 2009, 11:00 am

WannaStop
You have done what I wish most others would do. You have taken the time to educate yourself, as have most of the members of this forum. Once here they find they have a need for learning what has made them the way they are today.
We didn't start out as addicts.
Most of us, started our addictions as pain patients. Over time the addiction took over and the pain, though was still there kind of took a back seat. Your doctor is not unlike many others. There is not much that is required to prescribe Suboxone.
But it does take an understanding of addiction to treat addicts. Most doctors don't have the time that would be required to even start to understand what the life of an addict is.
Which brings us to the function of this forum. Deborah created this forum and our websites in order to create a safe haven for patients that are being treated with Suboxone and Methadone. This is a place that addicts can come to for help with the support and understanding they need in order to have a more successful recovery.
Our websites are designed to educate people on Addiction, The role of medication and show people that recovery is possible. Have you been to the Suboxone website yet? If not please do. The link to the website is www.suboxoneassistedtreatment.org there is a wealth of information there that you can copy and take to your doctor next week. Hopefully it will help him when he treats his patients. You can be a great source of education for him.
Please don't stop posting, we need more of our members to become and stay active.
I can make you this promise, as long as you are a member of this forum no one will judge, ridicule you or make fun of you for taking a medication to help manage your addiction. We are not like a lot of the other forums out there. I have seen many "Support Forums" that once you are there turn on you for speaking our for medication. That is so wrong. Why do those forums even exist? To me it is just another source of drama. Drama will not be tolerated here.
I would like to apoligize to you once again for not being here yesterday when you asked your questions. I try and be here as much as I can, somedays I seem to be busier than others. Kimbo posted our phone numbers to you. If you ever get into a situation that you ened to speak to someone right way, please give us a call. Dean & Deborah are oncall 24/7 and will be more than happy to speak to you should the need arise.
Yours in Recovery,
Dee

Number of posts : 8 Registration date : 2009-10-10

I have seen forums as you have mentioned and I have got to be honest it was forums like those that keep me away from sub but it did help me not just jump into this blind and do as much reading as possible. And yes I have visited assistance website. The problem is that there is no litmus test for progress or base line to compare your progress to. I have to admit it was the anxiety of not having a pill that caused me to spiral. Suboxone has taught me that I can be happy and productive with out having to be tweaked out and speak a mile a minute (I am a NYC boy and we talk fast as it is), I was taking pills just to take them and when the crave kicked that was it. Today I took maybe a little more than 1mg (31hrs since last dose, defiantly less than 2MG) and I am A okay. I would tell anyone who wants to stop taking to stop, just see how he or she feels, I am confidant that the OC was bringing on depression, it is either that or I am happy with myself that I do not need an Oxy to start my day because mentally I am here and here is a nice place. The biggest trigger for me was waking up and feeling like crap, well I have learned that I only felt like crap because I popped 9-12 oxy’s the day before! I wake up feeling rested and wanting to get out of bed instead of having to lay in it for 20 – 30 mins before getting my day started and reaching in the night stand draw for my pills. Also, I recognize I am not cured, but I am better today than I was yesterday and I know I will be better tomorrow then I am today.

Dee in my mind I am nothing to you, just another person who takes too many pills, but your efforts are so welcomed and appreciated and proved that you really do care! THANKS

Subject: Re: Need help with use Mon 12 Oct 2009, 5:02 pm

Let me assure you that you are more than just another person who takes too many pills. And you are right, I do care.
I remember back before I started Suboxone, I was an MMT patient and had to move to a state that didn't support Methadone so I had to stop taking it. I was in withdrawal for over a month before I found the help that I needed. I didn't know where to go or who to turn to. Then I stumbled upon the website that Deborah created. It was there that I was able to to locate a provider. I remember going to the ER to beg for help. I didn't want to go back to using but I knew that if I didn't get help, it was only a matter of time before I did. The doctors acted like I was just another junkie out looking for a fix.
I decided a long time ago if there was anything that I could do to help someone in that situation I would. There is no reason why anyone that has the desire to get help shouldn't be able to.

By the way, I had to change the color of the fonts on your post. The red is hard for the other members to read. That and black. They don't show up well against the brown background.
Enjoy your evening
Dee

Number of posts : 8 Registration date : 2009-10-10

Well just as an update, I took my last DOC at 9:32AM October 6th, started my Sub treatment on Oct7, I took 1MG of sub on Tuesday October 13th at 5:30AM and have not taken anything since. I have minor headaches but Advil works just fine. When will I know I am behaving because that is just me or if the Suboxone is still in my system over the course of 8 days, I calculated my intake at a total of 23MGs. Thanks!

Subject: Re: Need help with use Thu 15 Oct 2009, 11:06 am

Wannastop,
If you have only taken a total of 1mg of the Suboxone the whole time, then I would imagine that this is you and not the Suboxone in your system. I must have misunderstood your intentions of taking Suboxone when you first posted. I was under the impression that you would be taking it for maintenance and not a detox tool.It really doesn't matter at this point. What matters is how you feel. No cravings right? No withdrawal symptoms right?
Today is the 15th that is two days since any Suboxone use and the amount was such a small amount at that.
Please keep yourself aware of your triggers and cravings. Keep yourself busy. Boredom is a major cause of relapse. Keep posting, we are here if you should need us. I am glad to hear that you are doing well in your recovery.
Enjoy your day,
Dee

Number of posts : 8 Registration date : 2009-10-10

My sole intention was to stop taking the pain meds, I delt with why I felt I needed a drug while on my pain meds. Anxiety of WD is why I went to suboxone. I am not wonder boy or a better addict than the other person, but the prolonged use of pain meds had to have caused very bad depression, I found when I moved to suboxone I was in a better mode. After care indicated I may have suffered from depression due to the loss of a sibling, so I will continue with my sessions. When getting any crave now, which I do from time to time, I am trying to train myself about why I want to take a pill rather than take a pill just to take it! Is the pill a want or a need is what I ask myself, and it always turns out to “well you do not need it if you have gone a week with out one". I can see how it can be a vicious cycle for stress related triggers; you are in financial hell because you are buying pills and the money that should be going to bills is going to pills so you just get deeper and deeper. I think any addict owes it to them selves to be sober for one week and see why they feel they need a pill, if it were not for always being depressed on my pills, I do not think I would have ever stopped.

Number of posts : 8 Registration date : 2009-10-10

And when I say sober, I am talking about block your high with the suboxone....

Subject: Re: Need help with use Thu 15 Oct 2009, 4:13 pm

Hi WannaStop,
I am glad to hear that you are doing so well with your recovery & on such a low dosage. As Dee said, if your not having sickness nor withdrawals or cravings that you cannot control, then that is the important thing. That is the purpose of the Suboxone, but at the dosage that you are taking, it may not be the medication that is helping you, as you really are not at a therapeutic dosage to change (block) your receptors. I am not quite sure that I understood your post about trying to not take a pill for a week or blocking your high with Suboxone. Do YOU think that the Suboxone has helped you to remain off the opiates & have helped you to not be physically sick when you stopped using your drug of choice? Do you think that by taking it that your cravings have been eliminated or are pretty close to gone? Are you planning on completely stopping them altogether right now or are you planning on remaining on them for a while for maintenance? I think that I am just confused by your post. Are you saying that your not sober because of taking Suboxone?
I just went & re-read your posts again to see if I was missing something because if I understand correctly, you started your Suboxone treatment on Oct. 7th & have taken a total of 23 mgs of Suboxone in a week, then stopped the Suboxone altogether on Wednesday. So you only used the Suboxone for one week & now you feel fine? Or decent enough that Advil takes care of the problem? What dosage did you first start on & how did you take your medication? 23mgs seems like an odd number to have taken. I guess what I continue coming back to is that I am confused by your intentions of using the Suboxone for maintenance or were you simply using it as a tool to detox from the pain meds, then plan on not using anything? How long had you been taking the pain meds? Can I be nosey and ask what you were taking or what your drug of choice was? And the dosage? I am simply concerned for you as I went through what you just did. But, I went into a detox treatment center for five days & was detoxed from Oxycontins by using Subutex & was given enough to last me through exactly one week as well. Yet, in that one week I felt fine, it was after a couple of days that I hadn't taken anything that it hit me again & I started right back with the withdrawals & extremely horrible cravings. I won't lie. I went right back out & got myself some more Oxycontins, so that whole week that I was gone (five days) was for nothing. I had already relapsed & although I sincerely wanted to be clean, I couldn't handle feeling the way that I was. That is when I went to my regular doctor who helped me get into an outpatient treatment facility where I could receive Suboxone on a weekly basis when I went in to see a counselor & give a urine drop. I remained in that program for nearly six months before switching over to a doctor that could write me the script for the Suboxone, an "Addiction Specialist" and didn't cost $300.00 a week to do so. Not that she was cheap, but being a cash patient, anything helps. I still had to remain in counseling, but was doing that by choice already. Although, this doctor did make me see her counselors. I wasn't able to remain with my own. I still see my own counselor now, despite if I have to see someone else or not. The point of me telling you all of that is that although I felt great for over a week of not taking Oxycontins & using the Subutex to block my receptors, after it was out of my system, I was right back where I started. Your situation doesn't seem to be the same as mine if you have only taken 23mgs within that week & after a couple of days that your withdrawal symptoms have not returned, it sounds as if you are in the clear. I did not have the inner strength to remain off of everything as my receptors were crying out, begging & pleading to be filled. I was a mess, inside & out because I was still feeling the sickness that comes with stopping the opiates. I hope that this is it for you & that you have gotten the opiates out of your system & that you shall do wonderfully from here on throughout your journey of recovery. I realize that all of us are different & took different opiates, different dosages, different lengths of time using them, etc. The Suboxone may not be a necessity for you to have to remain on, but please do pay attention to your "warning signs" & triggers so that you you can be aware of a possible relapse. As I told you, I immediately relapsed & felt worse than ever because that whole week that I did great while off of them, I felt like I was on top of the world because I was finally off the opiates, the anchor around my ankle had been broken, or so I thought.. Then to turn around & immediately fail made me feel hopeless. That I was beyond curable. This was just how my life was going to be and it was only a matter of time before I would either be dead or in jail because I could not afford the amount that I needed just to not be sick. Not to even feel "high"- I could not even afford a maintenance level just to stop the sickness. The only option that I had left was heroin. But I was scared. Thank you God for that fear that kept me from taking that fork in the road rather than the one that I took by scheduling an apppointment with my family doctor.
Okay, I have rambled on for long enough. Need help with use Fresse

I have a tendancy to do this when I start writing & just don't stop. I am concerned for you though. I am very happy for you deciding to go off the pain meds & get your life back. Need help with use Icon_exclaim

And the Suboxone does also help as a mood stabilizer, so it does make sense to me that your depression did lift when you went off the pain meds & onto the Suboxone. If you do not feel the need to remain on the Suboxone, you may still want to talk to your doctor regarding your depression so that does not act like a trigger that you feel the need to relieve. Does that make sense? Congrats on your first week of being opiate-free & I encourage you to continue to post to let us know how it is all working out for you. The more support that you have around you, the better that you will do. Great job, WannaStop & look forward to hearing from you again soon! I am very happy for you that your already doing so much better! Need help with use Star3

Talk to you soon! Need help with use Icon_wink

Your Friend in Recovery,
Beth Need help with use Herz

Subject: Re: Need help with use Thu 15 Oct 2009, 6:17 pm

Hi Wannastop, I am happy you are doing so well. It sounds like you might be one of the lucky ones that are only Phy. dependent on Painkillers rather than being addicted to them. I hope that is the case for you. If you have any problems at all you can always go to the doctor. I wish you the best. Cathy

Number of posts : 8 Registration date : 2009-10-10

Beth, if you are at one of those phone numbers I will call you to explian, basically the short of it, is that I believe that the long term use of OXY's caused depression, there was also depression of feeling addicted. My intention was to go the maintenace route, but once I took the Suboxone and had no crave and felt good mentally I pushed myself to lower my doasge everyday. After a few days I realized that I did not want to be high on pills. Every morning I woke up feeling like crap where as now I pop up and I am out the door... Today I truly feel that not taking an oxy has the effect on me that I wanted when I was taking them, meaning that I wanted to be happy, wanted to be aware and etc... This is why I am posting, I am just as confused as you are, it I had an Oxy on me right know I would flush it down the drain. I know there will be hurdles everyday but none as hard as the first one to say that I have a problem that I need to stop taking drugs.

Subject: Re: Need help with use Thu 15 Oct 2009, 7:01 pm

Wannastop,
The phone numbers that we have listed are for the main office of Medical Assisted Treatment Inc. Located in Kennesaw Georgia. Beth herself is in another state. I think that what you have just now posted may have cleared up any confusion that she may have had. I know it did for me and I wanted to thank you for that. Knowing Beth if she has any more questions she will post them right away.
For some people, taking Suboxone as a tool for detox for a short amount of time can work for them. It helps them over the withdrawal period, which is all that some people may need. That little bit of extra help. Another tool that I feel is necessary for a successful recovery is counseling, which you are already attending sessions and plan to keep on with. Please keep posting, and let us know how you are doing.
Yours in Recovery,
Dee

Number of posts : 8 Registration date : 2009-10-10

I have to believe that the 52 day taper helped, if did not go from between 330 - 390MG a day of OXY down to 30MG per day for a 52 day period I would not have been here. The sub helped me transition form an intoxicating opiate to maintenance opiate. Without it, I did not have it in me to go to nothing as any WD would have caused me to go back on my DOC. I pray and thank god I hope it is behind me.