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Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 7:44 am
by zon
Not seen any threads about induction from dihydrocodeine (DHC) as it seems to be a UK thing mainly so I will briefly lay out my induction for people in my situation who come across this thread. My doses were between 450mg and 600mg, taking up to 900mg a day.

Reduced my dose of DHC a few days before induction to 180mg-ish and a bit lower.

Took last dose of DHC 26 hours before induction.

Felt very minimal withdrawals during this time and was worried I would go into precipitated withdrawals while being inducted as I wasn't withdrawing enough.

Despite these fears, I was successfully inducted on a dose of 4mg, got instant relief from withdrawals.

Got another 4mg to take at home later (so a total of 8mg today, split into two).

Will begin 16mg doses from tomorrow morning but doctor advises this can be reduced as soon as I want to.

This is free on the NHS. Doses are supervised at the pharmacy but I should get them home after a couple of weeks, just need to keep giving clean urine tests.

No regrets whatsoever and I was so nervous during the run-up!

Currently feeling very clear headed, calm and nicely balanced. My mind is quiet. Had some cravings to be high earlier while this initial dose was still kicking in, but they have now subsided as far as I can tell.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 8:11 am
by jennjenn
Hey zon welcome!

I haven’t heard of the dihydrocodeine (probably spelled it wrong) you’re talking about but I googled it and as far as I can tell it’s a codeine type medication. Is it something like Tylenol 3 in the US or something like that? I’m not sure but if 4mg twice a day is doing it for you then 16mg might possibly make you nauseous. If you take too much buprenorphine it can make you nauseated and since you’re doing great on the initial dose, I don’t understand why your doctor is persistent on doubling your dose from the next day on (or at least until it’s decided to reduce). Why not just stick with the dose you did during induction? If you do take the 16mg, and I’m assuming if you have to go dose in front of someone they’ll expect you to follow doctors orders, and you start feeling nauseous or anything like that then if I were you I’d call my doctor and tell him/her that I was doing better on the induction dose. I’m not trying to scare ya and you may do perfect on 16mg, I have no idea about the medication you were previously taking, just don’t be afraid to speak up if you need to :)

I’m so happy to hear you’re experiencing the peace of mind I so experienced myself. When I first realized that this medication could actually quiet my mind I was amazed and so very grateful because I never thought I would ever feel 'normal' again. I thought my mind would be screaming forever. Peace of mind is so priceless and to be able to wake up that way is huge!

Keep us updated..... especially once you start your increased dose. Good luck!!

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 11:41 am
by zon
Hey Jen,

Yeah it's meant to be twice as strong as codeine but its a totally different effect. Comes in 30mg pills. I can't tolerate codeine in high doses, makes me itch like crazy - dihydrocodeine feels very different. When I was getting up to 20+ pills to feel normal I was thinking about ordering some of the famous American pills online and that's part of what made me take stock of my situation and put the brakes on before I went down a deeper hole. I've been a recreational drug abuser for 20 years now though, and managed to stop everything else, but the opiates (and kratom) were not that easy to stop.

I know hat you mean about the dose amounts, the 16mg tomorrow is probably going to feel like too much. Fully expecting it to. Although I had some brief cravings today on my initial 4mg and some slight fleeting irritability (at irritating things to be fair), not really sure if that's a sign to go up or down or stick where I am but currently taking my second 4mg dose as prescribed by the doctor so it'll be interesting to see how it goes. I think I'll probably end up around between 4mg - 6mg initially, 4mg sounds ideal but with the cravings today I don't think it's fully covering me yet.

I'm quite tired now after a busy day shopping with a friend (usually need to be full of pills and beer for that!) but it kept me going for a good 6h and not in an overtly-buzzed way which is good. The tiredness is to be expected anyway after such tense build-up with thoughts racing the past few days, and waking up with withdrawals this morning.

The quiet mind aspect was a pleasant surprise as it's not something I was expecting. So much of my mind is usually occupied with thoughts like 'how high am I? do I need to get higher? I'm not high. I'm nice and high! I need to get some drugs' etc. so it was nice to just get a glimpse of peace like that. Really looking forward to waking up tomorrow!

edit: second 4mg dose has properly kicked in, it's quite 'heavy' but feeling very nice and comfortable. Not high, but food smells amazing and the lighting in here is looking good. Hoping for no insomnia but one thing I notice is at this dose when I'm walking about it feels kind of like a stimulant...not that it's stimulating me, but it reminds me of Ritalin in a strange way, which I used to get for ADHD.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 3:41 pm
by owlcrow
Hi Zon,

I am happy to hear all went well for you. I figured it would. I understand the stress of the whole situation and the thoughts and feeling you have are not unlike what most people feel.
It is good to know it seems that you may have more control over your doses than you initially thought. I also think that 16 mg. may be completely unnecessary if the 4 mg split doses are holding you just fine. I know that when I was beginning to use suboxone some time back that an increase of dose made me feel nauseous. Don't hesitate to talk it over with the Doctor. Your ceiling dose may not even be 8 mg. but may be more like 4 mg. I have quite a habit using heroin and find that 2 mg. actually works for me in most cases. Just say it like that because of numerous relapses over the years. I am not sure the year I first tried subs but I am thinking it was 2002, I know it was when it first came out and all there was, was the 8 mg. octagon orange pills.
Anyhow keep us posted as to how things are going for you, I am sure it will help others all the information on the net is useful to someone somewhere.
Take Care, and once again I am glad to hear it all went well for you.
Oh, as an afterthought, I am wondering how long it took for you to feel relief. If I had to guess I am thinking 20 minutes to a half an hour.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 6:40 pm
by zon
owlcrow wrote:Hi Zon,

I am happy to hear all went well for you. I figured it would. I understand the stress of the whole situation and the thoughts and feeling you have are not unlike what most people feel.
It is good to know it seems that you may have more control over your doses than you initially thought. I also think that 16 mg. may be completely unnecessary if the 4 mg split doses are holding you just fine. I know that when I was beginning to use suboxone some time back that an increase of dose made me feel nauseous. Don't hesitate to talk it over with the Doctor. Your ceiling dose may not even be 8 mg. but may be more like 4 mg. I have quite a habit using heroin and find that 2 mg. actually works for me in most cases. Just say it like that because of numerous relapses over the years. I am not sure the year I first tried subs but I am thinking it was 2002, I know it was when it first came out and all there was, was the 8 mg. octagon orange pills.
Anyhow keep us posted as to how things are going for you, I am sure it will help others all the information on the net is useful to someone somewhere.
Take Care, and once again I am glad to hear it all went well for you.
Oh, as an afterthought, I am wondering how long it took for you to feel relief. If I had to guess I am thinking 20 minutes to a half an hour.
Yo owl,

Appreciate the input, I'm pretty much set on getting this dose down! But I will give the 16mg a chance tomorrow...as Jen says the pharmacy will want me following the doctors orders and the doctor will likely want me trying the 16mg before I get to reduce it. Doctor says 16mg is chosen as it gives good coverage of the receptors. I'm fairly confident they'll be happy to reduce if I report back that it was far too heavy though.

It is definitely going to be too much though, I mean 8mg split into two 4mg doses is quite heavy itself, I'm overly talkative yet sedated and very comfortable. I'd describe it as a pleasant stupor really. Not euphoric. I don't think I would get much work done like this. Less than 8mg but more than 4mg is where I wanna be I think. The idea of 16mg in a single dose is a bit disconcerting. I'm sure it'll be interesting though. I'll keep the thread updated.

It took me about 10 mins to get that initial relief, 15 mins when I realised it was definitely not placebo as my stomach had gone from cramping to feeling completely at ease.


(Forgot to mention, the doctor did not use the COWS scale for me. Just gave me the script which I took to the pharmacy, and I was inducted there with a pharmacy assistant making awkward small talk, who also didn't use the COWS scale. Unless they were ticking it off mentally in their heads or they know what they're looking for through experience...but it surprised me, especially as I don't think I had any physically visible signs of WD by the time I was with the doctor or the pharmacist as my eyes and nose had stopped watering.)

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Mon Jul 01, 2019 9:53 pm
by BlueLight
Please listen to your doctor. I don’t know if this is the only forum you post at, but I’ve seen the behavior of many other forums. The first and foremost goal right now is to get you to stop using your DOC. I don’t care what dosage of Suboxone it takes to make that happen...it could be 32 mg, 24 mg, or 16 mg. The goal is to break the old habit.

It pisses me off to no end when Suboxone users who have been on it for years and even decades, lecture newbies that they should only take “XXXX” mgs (2 mg or 4 mg for instance). They lecture from their viewpoint today, all the while forgetting what it’s like getting on Suboxone for the first time.

Suboxone and treatment saved my life. It saved my marriage, job, and sanity. I’m coming up on 18 months clean by using the Suboxone tool. Don’t worry about the dosage for now. Break those chains of addiction! That’s your #1 goal right now.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Tue Jul 02, 2019 10:48 am
by zon
Hey BlueLight,

I totally get where you're coming from about listening to the doctor first and foremost, I'm giving the doctor's 16mg a try. Will take it again tomorrow and see how I feel then consider asking for reduction, as I do feel like it's a bit much for me.

I have so far found the 16mg to not be as heavy as I expected but it does feel like I'm on something, a bit like when I've taken too much dihydrocodeine and it's put me in a slightly weird place making it a bit more awkward to interact with strangers etc. Compared to yesterday's 8mg anyway. Today I'm a bit more edgy, and a bit more lethargic. I still managed to get everything done that I need to do, and happily too, without any need or desire for the usual drugs I'd take, but I have lazed around after that for quite a while, was nodding on the couch for a while. And I'm feeling quite heavy in my head whereas yesterday I felt much lighter. I definitely feel that 8mg is closer to being the right dose for me to negate some of these effects, especially the tiredness. I'm going to give the 16mg a fair shot for a couple more days though to see where I'm at and take it from there. Haven't really had any effects that would put me off this medicine though, no real nausea or headache, no insomnia. Definitely feel I'm 'on something' with the 16mg though. Got a dry mouth and lots of thirst!

One thing I will say though is that I miss not having that other dose to take in the evening, like I had yesterday. I don't know whether to put this down to a craving, or whether it's getting used to the previously-alien reality of only dosing once per day. It's certainly not an insufferable longing or strong desire, and the 16mg isn't wearing off, but it was nice to have that second dose yesterday. I'm assuming this is a throwback to the habit I've only just come out of with all the microhabits and actions that have to die along with it, and a second dose kind of takes it out of medication territory and more into a drug of abuse, so the sooner I get used to the once a day the better.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Wed Jul 03, 2019 6:57 pm
by zon
Some notes on my experience so far with Suboxone and 16mg doses.

It lasts all day and night but comes in waves. Sometimes it feels like it's worn off but once I forget about analysing that and looking for 'something' it comes back.

I haven't experienced any euphoria, but my mood is stable and very positive.

It definitely eliminates cravings for other opiates but I do 'miss' having a second dose of Suboxone to take in the evening although I am at peace with the fact it's staying at once a day. I came into contact with my favourite pain pills today and had no pangs of desire or any particular thoughts about it.

I wake up with no withdrawals and don't feel any urgent need to go and get my dose from the pharmacy as soon as I get up. I can take my time and pick it up when I'm ready.

I sleep in a lot later than I normally do, but at least I have no insomnia.

Feels like it gives me a lot of physical energy in the mornings lasting until late afternoon, meaning I'm able to walk around for hours and get a lot of things done, meet a lot of people, shopping etc.

Less edginess and social awkwardness than I was getting when I was on my drug/s of choice - I now just get on with social interactions when they come up and don't overthink them while they happen...my own insecurities are there, as they should be if I ever want to deal with them, but I don't feel the need to escape from or cut the interactions short.
It hasn't cured my feelings of awkwardness during social interactions but heavily mitigates them. I think I feel a bit exposed as I still feel 'on something' and assume it's visible. This could just be something that disappears as I get used to the feeling of Suboxone though, and it's not something I worry about.

It doesn't cause the opiate rage I used to get...noticeably less irritation.

Weirdly I feel like I want to be nicer to people and consider my words more when texting.

Seem to get tired late afternoon/early evening but this passes.

A lot of talkativeness with friends. Possibly over-talkativeness.

In the evening when I'm naturally relaxed anyway I can tap in perfectly to the warmth and atmosphere of the room and really appreciate how comfortable I am. It feels like a second wave of the Suboxone kicking in. This has happened both nights on 16mg.

I have more attention span (important for me as I have ADHD).

Slight cotton mouth and very thirsty, so happily drinking lots of water.

I do have a bit of a lack of motivation in some areas I wanted to tackle once I started this treatment, such as hitting the weights, cleaning up my diet, some other things that I should be starting on, and I think that's due to feeling affected by a drug around the head and eyes...it feels like I've taken drugs, feels like I have a warm and fuzzy head. Little bit foggy, kind of lazy feeling when I'm indoors, slightly lethargic. I could live with that though if it's just part of the deal.

I can't say I've had any of the commonly reported negative side effects that I was worried about - no real nausea or headaches or bothersome anxiety, and no nightmares or sleep issues. Very lucky so far!

All the positives of Suboxone already completely outweigh any benefits I got from my drugs of choice (it's an amazing realisation)... but my head was a lot clearer at the lower dose and that is something I'd be really happy if I could get back and maintain, but even on 16mg I am mentally stable and able to deal with the day just fine.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Thu Jul 04, 2019 5:38 am
by jennjenn
Bluelight, are you talking about me when you say 'lecturing newbies' and whatever else you claimed to know what I was saying or lecturing? Please enlighten me on how I did that.......

I was at NO time lecturing anyone and if you read ANY of Zons posts, you’d see that he or she has been concerned about the 16mg dose which is WHY I was explaining what too high of a dose would feel like and to tell the doctor if that happens. If you read all our posts, you’d also see that I said I’m not familiar with the medication zon was taking and that 16mg may be perfectly fine but just in case it wasn’t, don’t be afraid to speak up to their doctor. AGAIN.... zon was concerned about the 16mg being too high of a dose which is why I explained what too high of a dose feels like. Maybe if you read the entire thread Bluelight, you’d see I wasn’t lecturing anyone. You know what bothers me sometimes....... ppl automatically accusing others of things that they know nothing about what is really going on.

I’m sorry zon, for me to get upset on your thread, but I had to speak up because nobody at any time was lecturing you about your 'high dose' so please don’t think that. As a matter of fact, 16mg was the dose I started on 7 years ago and stayed at that dose for a year or longer and im STILL at 8mg today. I’m not like that, I knew you were concerned about the 16mg being too high and you talked about it on another thread too so I wanted to address that with you. Not lecturing at all.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Fri Jul 05, 2019 1:19 pm
by BlueLight
jennjenn wrote:Bluelight, are you talking about me when you say 'lecturing newbies' and whatever else you claimed to know what I was saying or lecturing? Please enlighten me on how I did that.......

I was at NO time lecturing anyone and if you read ANY of Zons posts, you’d see that he or she has been concerned about the 16mg dose which is WHY I was explaining what too high of a dose would feel like and to tell the doctor if that happens. If you read all our posts, you’d also see that I said I’m not familiar with the medication zon was taking and that 16mg may be perfectly fine but just in case it wasn’t, don’t be afraid to speak up to their doctor. AGAIN.... zon was concerned about the 16mg being too high of a dose which is why I explained what too high of a dose feels like. Maybe if you read the entire thread Bluelight, you’d see I wasn’t lecturing anyone. You know what bothers me sometimes....... ppl automatically accusing others of things that they know nothing about what is really going on.

I’m sorry zon, for me to get upset on your thread, but I had to speak up because nobody at any time was lecturing you about your 'high dose' so please don’t think that. As a matter of fact, 16mg was the dose I started on 7 years ago and stayed at that dose for a year or longer and im STILL at 8mg today. I’m not like that, I knew you were concerned about the 16mg being too high and you talked about it on another thread too so I wanted to address that with you. Not lecturing at all.
Nope, not you or anyone on this forum. I haven’t seen anyone here do it. If you gander at Reddit, for instance, a lot of posters who have been on Suboxone for years tell newbies to just take the absolute minimum amount (like 1 mg or 2 mg) or else they will be sorry. They scare noobs that if they take too much they will never be able to get off of it, and woe is me...I coulda, shoulda, woulda....and lament still being on Suboxone. They have forgotten this is a life and death situation, I believe they are doing a huge disservice to newly clean Suboxone users.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Fri Jul 05, 2019 4:46 pm
by Amy-Work In Progress
Quote from Jennjenn:

" I don’t understand why your doctor is persistent on doubling your dose from the next day on (or at least until it’s decided to reduce). Why not just stick with the dose you did during induction? If you do take the 16mg, and I’m assuming if you have to go dose in front of someone they’ll expect you to follow doctors orders, and you start feeling nauseous or anything like that then if I were you I’d call my doctor and tell him/her that I was doing better on the induction dose. I’m not trying to scare ya and you may do perfect on 16mg, I have no idea about the medication you were previously taking, just don’t be afraid to speak up if you need to :)."

Good points, Jennifer. I, too, question the way the doctor is doing the induction, automatically doubling Zon to 16mg. My doctor had me start at 4mg, wait, add 4mg more when I didn't notice a difference, wait, and then go up 4mg more to 12 mg. That's when I felt relief, so we stopped there. In the next week we decided I should try 16mg and that felt like the right amount to me. At the time, I was using from 80 to 100 mg of oxycodone a day, which isn't that much compared to some.

What I think that you said, Jennifer, that's important to emphasize to new folks, is that you need to speak up if you find a dosing amount that is too much or too little. The only person who knows the right dose for you is you! There are so many variables, including metabolism, that no one can predict the correct dosage for another person. And Jennjenn gave you a good way to figure out if your dose is too high, you will probably get really nauseas.

BL, it annoys me too when I hear anyone giving newbies the message that they ought to stay down at 1mg or 2mg because it might be hard to get off of later. Whether it's methadone or buprenorphine, that is the wrong approach. What a newbie should worry about is whether or not their cravings and withdrawal symptoms are gone. When I went to 12 mg the day I inducted, it was night and day from what I had been feeling. The withdrawals and cravings were there, and then 15 minutes after I went to 12 mg, I was free of both. That's what you're shooting for.

I easily tapered from 16mg to 2mg when I decided I wanted to taper. I went pretty slow and listened to my body and the taper was easy. I then went back up to 6 for some pain reasons. I recently dropped to 4mg though and have barely felt any symptoms, just some yawning around 24 hours from my last dose.

If you don't get to a therapeutic dose of buprenorphine or methadone, you're defeating the purpose of being in medication assisted treatment.

BL, thanks for clarifying that you weren't responding to the posts on this thread. I can see that it might have seemed that way at first.

Zon, I'm so glad that your induction seems to have gone well and that you're feeling much better! You're responding to the buprenorphine just like you are supposed!

Amy

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Sun Jul 07, 2019 9:15 am
by zon
Hey folks! Yeah there is definitely a push to get people to taper. I mentioned on Reddit I was on Suboxone without mentioning dose and some random person's immediate reply was "TAPER NOW, PLEASE!" Didn't even know the dose I was on or my intentions regarding Suboxone. It's a weird attitude of self professed experts.

I also have no idea why I was doubled up the next day but I get the impression that's how they do the inductions in Scotland...start you on a half dose, then get you on your full dose from day two. I could be wrong there though.

As it is I did get reduced down so I'm now on 12mg as I feel a bit of sedation at the 16mg. The sedation is gone and I'm still not getting any cravings or withdrawals.

TMI alert coming up but one very odd effect I am getting is diarrhea which I've had since going on the meds even at 16mg. I did have constipation for first two days and since then it's been diarrhea only. It seems to be a rare side effect, possibly of the naloxone. I really hope it settles down. It doesn't seem like the kind of stomach issues I get with withdrawals and I don't think I'm on too low of a dose because as I say it works for me in every other way. Has anyone else had or heard of this side effect? Very weird for an opiate I know, I've been used to the opposite issue for the past decade.

Re: Successful Induction from Dihydrocodeine (UK)

Posted: Sun Jul 07, 2019 11:59 am
by jennjenn
Hey Bluelight, I just assumed you were referring to me and my post. Sorry if I assumed wrong, trust me, I’m a bit mind boggled lately with a lot going on. I’m starting a new job soon and my starting date keeps getting pushed bk due to a class I have to take...... I am on edge! Plus it’s a million degrees where I live right now and I’m miserable! So if you weren’t referring to me then that’s awesome. Thanks Amy for listening to my post and agreeing with my advice.

Zon, good news about your dose and if it’s still too high then don’t be afraid to speak up but I promise you’ll adjust to whatever dose you’re taking. Like I said in an earlier post, it really does take a good month to adjust and it is important to stick to one dose so you can adjust. The diarrhea thing.... that’s odd because it’s usually constipation that ppl sometimes complain about. Maybe something else is possibly causing that.