Start subs next week. Very concerned so any advice welcome

Will methadone and buprenorphine together cause withdrawal? How do I stop precipitated withdrawal? What dose of buprenorphine is best? Do I have to be in withdrawal to start Suboxone?
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JayGee
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Start subs next week. Very concerned so any advice welcome

Post by JayGee » Sat Feb 08, 2020 4:54 pm

Hello everyone! I joined today and this is my first post :)

I start subs on Tuesday and am terrified of being addicted to them and becoming more socially isolated and depressed than I already am. Having read so much on reddit, I’m now terrified of going on them but I just cannot go on like this, a slave to pills. It affects everything :(
I have a long history of poly substance abuse (30 years) but I did manage to kick coke after years of chronic use.
I cannot leave the house without pills on me and my libido and general zest for life is in rapid decline e.g. I've been a hermit this week declining social invites.

It seems my ope habit isn’t large at all from what I read - between 25-75mg oxy a day, plus smaller doses of dihydracodeine, tramadol and Kratom. There’s no fixed usage amount each day.

I’m not even sure that I should be going on subs but the addiction worker and doctor think it would benefit me and they don’t make money off it here in the UK so know they are not advising it for that reason.

I can’t seem to manage tapering on my own and have CT’d about 4-5 times over the last 2 years, on MUCH lower doses than I’m on now, and never got past 11 days due to the insomnia and depression and that was mainly off weaker opes. Last time I tried, a few weeks ago, by day 2 I was a complete wreck due to my increased oxy habit - hence going to Community drug and alcohol service (in London, UK) in desperation.

I function with work as I mostly work from home but I seem to wreck my personal relationships and am very lonely. This is due to the effects of drugs and behaviours - I have a psychotherapist I’m working through stuff with.

So I guess my questions are:

1. - Should I even be considering subs?

2. - Should I try and go on the lowest dose possible and taper sooner rather than later? Some things I’ve read suggest the shorter time on subs the better regarding the withdrawal. I just want opes out of my life while still being able to function in society so, like everyone, I somehow want a painless taper with minimal WDs so I don’t relapse.

3. - Does anyone have any advice for starting and getting off after not too long on them so I don't become a slave to just another drug? Ie is the a time limit (weeks / months) before the withdrawal gets much worse?

I also have issues with benzos, alcohol and GHB (dr knows and ok prescribing subs) but opes are now the worst.

I am determined to use Tuesday as a ‘reset button’ so am motivated. I’m just terrified of swapping one bunch of tablets a day (that I can hardly get high on now) for a strip that could be the same thing or, worst case, make my addiction And withdrawals worse...

I’m also worried about meeting a prospective partner and how they would take it as I’m single and dating.

Ultimately I want to be off everything ASAP but experience has shown me (tried rehab and all sorts) that it’s more of a process than a race.

I hope this doesn't sound like a 'woe is me' post, I have a lot to be grateful for, I just want rid of this addiction BS and to better myself :)

Sorry for the war and peace and panic :oops: but I’d be really grateful for any thoughts / advice :)

Thank you!

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Re: Start subs next week. Very concerned so any advice welcome

Post by Justin999 » Sat Feb 08, 2020 10:46 pm

Hey Jaygee,

Welcome to the forum. I think you have answered your own question as to whether or not you should start suboxone. Many of us here have tried to quit without it and failed many times. I know you want to change your life and when your in a “self improvement mode” (for lack of a better term). You want it to be all or nothing. But you have seen this movie before in your life and it always seems to have the same ending, aka you being back on drugs. From first hand experience, being on suboxone is a million times better than being addicted to opiates. I was able to lead a normal healthy life without getting or trying to get high all the time. My life improved in so many ways while I was on suboxone you would think I was taking the limitless pill. And that’s because I was able to have a clear head and focus on doing great in school, work and working out and not nodding off the whole day away. And this is coming from someone who is off of suboxone.
I have taken subs just to get past opiate withdrawals and that hasn’t worked for me either. I was on subs for years before I stopped and I haven’t taken a sub in over 2 years or an opiate in 5. I’m not telling you this to brag or patronize you but only to let you know that I and many of us on here have had that mindset for a long time. You think now that your options are suboxone or total “sobriety” but your options are most likely suboxone or keeping on doing opiates, at least that’s what history tells you. Insanity is doing the same thing over and over and expecting different results.
I think you should listen to your doctor and try subs for a while and work on yourself and the reasons why you use. Your quality of life, motivation etc will be dramatically improved over what it is now. It is not a magic pill but at least subs allow you to work on your life in a way you can’t when you’re taking oxys every day so by the time you’re ready to stop subs you will be ready to stay sober. And this is a race. A race to build a life you want even if that means not being on subs forever. But don’t blow out your knee mid track by rushing to the finish line like you did in the past. Remember... the turtle won in the end.

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Re: Start subs next week. Very concerned so any advice welcome

Post by BlueLight » Sat Feb 08, 2020 11:31 pm

Short answer, GET ON SUBOXONE!

All of the medical and scientific studies have shown that you need to be on buprenorphine for a MINIMUM of 12 months, and that even at 18 months and 24 months the success rate is much higher.

Don’t kid yourself, you’re not addicted to some “low dose” of opiates. You are hitting your brain (Mu AND kappa receptors plus dopamine) in virtually every way possible given you’re taking oxy, codeine, tramadol, AND kratom (not to mention blasting your GABA receptors with alcohol, benzos, and GHB). You have a severe opioid use disorder.

I too was like you. I had been abusing opiates for 20 years plus being an alcoholic, so I get where you’re coming from. I thought the same way you are, by wanting to only use a small dose of Suboxone for a short period of time and then get off them. Purge this idea from your head. Get on the dose that handles your cravings completely. I tried white knuckling it on only 6 mg to start (200 - 250 mg per day oxy and fentanyl addict) which the doctor explained why that was silly. It was taking everything I could do just to not use WHILE IN TREATMENT. LOL. As he explained, “you’re struggling now when you are at your strongest and away from home and work stress, what happens when you face all of that on only 6 mg Suboxone”? I upped my dose, and am glad I did.

I’m almost at 2 years clean, and on less than .5 mg per day. I started at 12 mg for the 1st month, then dropped to 10 mg. Suboxone doesn’t get people high. Right now if I took a 12 mg strip again, I wouldn’t feel anything, other than it would make me a little more tired, and harder to urinate. Suboxone gave me my life back. I had been holed up in my corner of the house for 18 to 20 hrs a day. I worked from home and had ZERO friends. I just had my spouse. Suboxone returned me from the dead. I have several friends now and have regained everything I lost in active addiction.

Another medication I found helpful for my alcohol cravings is Campral. Definitely check it out. I know some people find Baclofen helpful for alcohol cravings. Baclofen just made me sleepy.

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Re: Start subs next week. Very concerned so any advice welcome

Post by BlueLight » Sat Feb 08, 2020 11:44 pm

Also, I’ve never taken more Suboxone in a day than I was prescribed. Not even once! I could never do that with full agonist opioids. I always kept taking more. Suboxone gives me no euphoria, and when my cravings are gone, I have no urge to use more Suboxone.

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Re: Start subs next week. Very concerned so any advice welcome

Post by jennjenn » Sat Feb 08, 2020 11:50 pm

Hello Jaygee! Welcome!

I agree with everything Justin said and I too think you answered your own question. Listen, you cannot let people who know nothing about you personally or your situation scare you from this medication. This medication along with you truly working on your recovery will change your life! I promise you!

I’ll explain it like this...... do you know how you feel when you don’t have your opiates, that feeling like your brain is just constantly screaming and obsessing and you can’t focus on anything else? Especially when you’re trying to stop using them? Imagine if you could take a medication that stopped that screaming and you woke up each morning in peace.... even before you’ve taken your dose that day. Wouldn’t that be amazing? Well that’s what suboxone can do. It gives you peace so that you can work on your recovery. You won’t feel like you wanna use 24/7. It literally gave me peace and that’s when I could start truly feeling like I could recover. I don’t isolate, I don’t close myself off emotionally or socially, I just feel ‘normal’ again. Suboxone doesn’t make me emotionless either, I cry, I get angry and I love.

Don’t let people online take this amazing opportunity away from you. They don’t know you and who really cares what anyone thinks? This is your life, if someone doesn’t understand then who cares, you aren’t happy right now so what other choices do you have? My advice is do this for yourself without one thought about who in your future will understand.

I don’t think you should worry about how long you’ll need this treatment. You won’t know that until you start working on your recovery. This isn’t something you can predict. This could be life and death for you, it was me. It’s been 8 years and I’m on a maintenance dose and I may need this for life. I’m ok with that because my life before was nothing. I couldn’t even be a good parent to my children. My opinion, take this opportunity and run with it and become the best person you can be and enjoy life again :) doesn’t that sound amazing??
Jennifer

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Re: Start subs next week. Very concerned so any advice welcome

Post by jennjenn » Sat Feb 08, 2020 11:52 pm

Great post bluelight! Amen!
Jennifer

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Re: Start subs next week. Very concerned so any advice welcome

Post by JayGee » Sun Feb 09, 2020 4:51 am

Justin, Bluelight, JennJenn,

thank you SO much for your words and understanding, they really touched me (made me very emotional...). As you know, this is such a lonely illness and it means everything to be heard, understood and encouraged.

You have comforted me to go into Tuesday with hope rather than fear and a negative attitude.
I will aim to go on the lowest dose that safely holds me and forget ideas about trying to get off ASAP and live a day at a time trying my best to rebuild my life and recover.
This also means giving SMART another go, rather than isolating, as you've reminded me of the joy and power of being understood and understanding others. I need to re-connect not stay disconnected.

If you guys, the medical professionals AND my addiction therapist think it's a good idea, why am I questioning it?!

I read your responses in full withdrawal (17 hours) - sick, shivering, depressed, alone, hopeless - and they made me cry because yes, I CANNOT go on like this!!! And I cannot kid myself that "I'm not too bad".
I can't do this alone or without help. I've tried many times, as Justin pointed out, and failed.

The tablets are starting to kick in now but this is no way to 'live'. The comfort of any 'high' went a while back and now all it is is a prison.
I will go into Tuesday proud and grateful that I have been given and have given myself this opportunity to get better. If nothing changes, nothing changes!

THANK YOU again, you have helped this boy and alleviated his fears :)

p.s. Jenn, yes that does sound amazing!

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Re: Start subs next week. Very concerned so any advice welcome

Post by jennjenn » Sun Feb 09, 2020 12:06 pm

Jaygee you made my day and remember you’re not alone. I know it feels like nobody understands and nobody is like you.... I used to think that I was somehow different because I’d watch ppl in rehab that were able to pursue relationships after their detox and I couldn’t even shower let alone think about chasing some guy around the facility lol. I thought something is wrong with me. There wasn’t though, it’s just my PAWS had obviously kicked in plus I was just obsessing over opiates and a 5 day detox and a 28 day stay in inpatient was not enough and 5-6 months down the rd I was still in the exact place mentally that I was on day 6 of rehab. I needed more. I needed more help. That’s where MAT comes in. If someone can do it without it then I’m so happy for them and there are ppl who can but I am not and was not ever one of those ppl.

I’m so happy to hear you’re proceeding with your appointment and definitely don’t go into this worrying about what anyone thinks. You have to live in your skin each day and if those negative ppl were in your shoes they’d do anything that they could to help themselves!


Good luck! Please update us!
Jennifer

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Re: Start subs next week. Very concerned so any advice welcome

Post by BlueLight » Mon Feb 10, 2020 3:55 pm

JayGee, I’m glad to hear you are going to give Suboxone a go. We will be here if you have any questions or concerns moving forward. I’m also glad to hear you’re going to try SMART again.

I’m a firm believer that the opposite of addiction is not abstinence or non-addiction, but rather...CONNECTEDNESS. Due to my use of drugs and alcohol, plus the guilt and shame, my addiction had me extremely isolated and lonely. My closest “friends” were the liquor sales clerks and pharmacists who I made small talk with.

Now with the help of Suboxone and treatment I’m not simply surviving without using drugs and alcohol, I’m THRIVING! I love my life again. I have time and energy to volunteer to help others in need. I have a life I’m proud of again. Yes, I’m still paying off some debt and some days suck and I wish I could use opiates to get thru it, but that’s only one or two days per month these days.

Things are slowly going to get much better for you!

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Re: Start subs next week. Very concerned so any advice welcome

Post by JayGee » Tue Feb 11, 2020 6:14 pm

Update:

Went to the clinic today and they’ve been amazing!
They are going to put a whole programme in place both psychological and medical to get me off absolutely everything in roughly 3-6 months with full support at my own pace (all free on the NHS).

Induction day today. So I had to come home and not take Bupe till I reached a 12 on the COWS scale they gave me.

I felt like DEATH at 23 hours into withdrawal. Then I took the Bupe.
I felt so sick etc etc and couldn’t even think about food.
2.5 hours after taking the Bupe and I finished a curry that was delicious!!

I’m only on a very low dose by all accounts - 2mg. So happy and also surprised that I don’t seem to need more but will see if 2mg holds me for the next few days (have to go back to the clinic again tmrw).
It stopped my wds dead after an hour or so.

Assuming this holds me, a mate said getting off 2mg will be a walk in the park.
Was tempted to pop another 2mg but it really doesn’t seem that I need to at the mo so won’t.

Am amazed as it doesn’t feel like I’m on anything. There’s no buzz like oxy. At least not at 2mg. So nothing to ‘chase’.
I just feel in a great mood (would be an amazing anti depressant) and LEVEL.
Have gone from being zero % functional to 100% in the space of a few hours?!

Would easily be able to function with work (did some work emails before dinner as wasn’t unable to function earlier as the wds got so bad), sport and not worry about socialising if I continue to feel like this.

What a humane way to go about it.
And you’re not chasing a high like with oxy as it’s just not there. Just feel normal, level and in a really good mood.

Truly amazed at how well it’s worked as I can now see light and hope rather than constant highs / lows / shame / crazy mood swings / isolation.

I know it’s only the end of day 1 but I can really see this helping enable me get my life and relationships back together again :)
Still can’t believe 2mg is holding me!

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Re: Start subs next week. Very concerned so any advice welcome

Post by BlueLight » Wed Feb 12, 2020 3:21 pm

Buprenorphine is a powerful opioid but because of its partial agonist structure it doesn’t make the brain scream “more, more, more”! Let your body be your guide and don’t get too caught up in the number of mgs. The main goal is to start building up some “clean time”, so the brain can start to heal itself, and begin producing feel good chemicals on its own again.

It sounds like you found a great addiction clinic that will help you rebuild your life again. For those of us with over a decade/s of active addiction and heavy use/abuse, I don’t even think we can pinpoint when we lost control. It took me several months for me to regain some clarity and help from mental health counselors to begin to piece together my timeline of addiction.

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Re: Start subs next week. Very concerned so any advice welcome

Post by JayGee » Wed Feb 12, 2020 3:47 pm

I had my induction yesterday and my first 2mg at 8pm seemed to be enough to stop physical WDs.
However, I had strong cravings today before taking the 2mg dose at 4pm.

The clinic suggested I go up to 6mg?! But I had 2mg (4pm) + 1mg (6pm).

2mg seems enough to hold me out of physical wds. I want to keep the dose as low as possible for obvious reasons of making it easier to taper off when the time comes.

I didn't like the 3mg effects as much. It felt more like an ope and I became more irritable whereas the 2mg dose felt more like a good anti-depressant. I just want to feel normal and level as I did after my first dose last night.

May try 2mg in the morning and 1mg PRN for cravings. Will ask the clinic about this tomorrow as I'm not sure if it's a sound approach. What I read states it should be one dose otherwise it's more like old addict pill popping behaviour...

I guess I will get into a normal routine of having it in the morning, when I've finished the induction, as yesterday, day 1, I took my first dose at 8pm and today, day 2, took it at 4pm.
Hopefully it will be smoother when I start to take it in the mornings and I should be asleep during the craving part, if that continues.

Does anyone use 1mg or any PRN dose for cravings later in the day?

I guess another approach would be to split the 2mg tablet and have 1mg in the morning and 1mg in the afternoon to be more evenly covered.

Any suggestions welcome :)

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Re: Start subs next week. Very concerned so any advice welcome

Post by jennjenn » Fri Feb 14, 2020 6:04 am

Just don’t forget that the physical withdrawal is only part of the issue, the mental cravings and everything that goes along with that is the biggest part, at least with me it always has been. You want a dose that covers withdrawal but you also want your cravings to be totally covered. I know you’re being careful to not go too high in dose but without those cravings being covered then is it going to give you the relief you need in order to focus on your recovery? If I had not had my cravings covered then I know I would have continued to use or be miserable. I know we’re all different and each of our recovery’s are sometimes going to be different but just make sure you’re comfortable..... at least that’s my advice.

It sounds like you’re going to a good understanding doctor, that’s a good thing because not everyone has that. Just remember to take your time and don’t make this about getting off the medicine as soon as possible. It’s really about your recovery and you can’t put a time limit on that. You didn’t become addicted over night and you definitely won’t become completely stable over night either. This medication is such a blessing to those of us that couldn’t do it alone. So just take your time and make sure those cravings are covered :)
Jennifer

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