Irritable on 2mg

Does buprenorphine treat depression? Is my depression from Suboxone? Will Suboxone treat bipolar? Will naltrexone or Vivitrol make me depressed?
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Optioidmistic
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Irritable on 2mg

Post by Optioidmistic » Wed Apr 17, 2019 12:13 pm

I was wondering why I feel so persistently agitated / irritable on 2mg of suboxone. I take that because I don’t want to take more than I need, but I could be taking 8. When I take more I do feel better, but won’t I end up just as irritated and cranky once I am tolerant of the dose, or does it not work that way? Should I go ahead and take what makes me most comfortable? I don’t feel like I’m at risk or anything at 2mg, but damn being agitated most of the day is no fun either. Anyone experience this?

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Re: Irritable on 2mg

Post by BlueLight » Wed Apr 17, 2019 3:07 pm

It sounds like you’re on too low of a dose. I’m not sure what your opioid addiction looked like but you easily could need 4 mg or 6 mg, just to feel ok. My guess is without your opiate receptors filled, you are edgy, and anxious, which is manifesting itself as irritability.

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Re: Irritable on 2mg

Post by jennjenn » Thu Apr 18, 2019 7:38 am

I honestly don’t think it’s worth feeling the way you’re feeling every day just to be on a lower dose. At the end of the day, what is this accomplishing if you feel like you’re going to jump out of your skin every min of every day? I know that feeling you’re talking about, I’d say most of us do, and it is kind of miserable. If you raising your dose makes you feel better then just do it, that’s my advice. I don’t think you’ll regret it, I think it’ll be a relief. Some ppl focus too much on keeping their dose as low as possible, I’ve never understood that if it’s a dose that is making them miserable for whatever reason. It isn’t a race or competition, so make yourself feel better & raise it a little bit :)
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Re: Irritable on 2mg

Post by BlueLight » Thu Apr 18, 2019 8:09 am

Jenn, agree fully! Besides if I’m taking such a low dose and feeling edgy and irritable I’m going to let day to day things make me angry, stressed, and a little beat down, which isn’t going to help my resolve of staying clean and sober. The addiction doc at Hazelden wanted me on the dose that wipes out any low level cravings I had. Her position was that early in recovery I shouldn’t be fighting to not use every day. Taking the lowest dose that keeps me free from cravings most days means I’m able to conquer those cravings when I’m stressed or triggered. Otherwise, if I’m fighting low level cravings every day I will be too exhausted to say no, when stress or temptation strikes unexpectedly.

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Re: Irritable on 2mg

Post by Optioidmistic » Thu Apr 18, 2019 10:33 am

Yesterday when I posted this I opted to take my full dose. I felt better. I am concerned about it happening again when my tolerance catches up. I feel like split dosing at lower doses helped this issue, but I want to just take my dose once a day like we are supposed to. I am hoping it was just because I was getting ups and downs being under the ceiling.

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Re: Irritable on 2mg

Post by BlueLight » Thu Apr 18, 2019 11:48 pm

Optioidmistic wrote:Yesterday when I posted this I opted to take my full dose. I felt better. I am concerned about it happening again when my tolerance catches up. I feel like split dosing at lower doses helped this issue, but I want to just take my dose once a day like we are supposed to. I am hoping it was just because I was getting ups and downs being under the ceiling.
But Suboxone doesn’t carry the same characteristics as full opioid agonists like traditional opiates. So “tolerance” really isn’t a thing. There aren’t large swathes of patients out there upping their dose continually over the months and years on Suboxone therapy. In fact it’s the opposite. The vast majority of patients slowly begin reducing their dose on their own as they get stronger in recovery and further away from active addiction. The brain begins healing, and patients begin needing less.

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Re: Irritable on 2mg

Post by jennjenn » Fri Apr 19, 2019 11:00 am

Like Bluelight said, tolerance is not really an issue with buprenorphine in the sense of once you start a certain dose, you’ll start needing more and more to feel normal..... that makes buprenorphine different, at 8mg (which is what I take and been taking for years) you would more than likely feel completely satisfied with this dose for however long. You aren’t going to have to raise it once you’re there and it’ll keep your cravings away too.

At 2mg you’re under the ceiling level. The ceiling level is usually under 4mg but some of us argue it’s between 4-6mg. Once you’re over the ceiling level, you aren’t going to have to worry about your dose wearing off until you dose again which means you’ll be steady on 8mg if that’s the dose you’re feeling the best at. Don’t worry about once getting to 8mg, your tolerance will make you eventually feel the need to keep taking more..... that isn’t how this medicine works. It really can be confusing I know.
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Re: Irritable on 2mg

Post by suboptimus » Fri Apr 19, 2019 11:03 pm

Optioidmistic wrote:I was wondering why I feel so persistently agitated / irritable on 2mg of suboxone. I take that because I don’t want to take more than I need, but I could be taking 8. When I take more I do feel better, but won’t I end up just as irritated and cranky once I am tolerant of the dose, or does it not work that way? Should I go ahead and take what makes me most comfortable? I don’t feel like I’m at risk or anything at 2mg, but damn being agitated most of the day is no fun either. Anyone experience this?
Agitation / irritability is the most common wd effect I encounter. You obviously dropped your dose fast enough to initiate a degree of withdrawal. You can either try a slower taper or just tough it out until your body adjusts to the lower dose.

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Re: Irritable on 2mg

Post by rule62 » Fri Apr 19, 2019 11:13 pm

I have to agree with Suboptimus about doing a slow taper if you want to feel normal at 2 mg's. 10% week should do it.

In my years here this is the first time I've read a complaint like yours. To me, it can only be a symptom of withdrawal so just taper down slowly or stay at 8 mg's. Whichever works best for you.

Welcome to the forum!
Don't take yourself so damn seriously

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Re: Irritable on 2mg

Post by Optioidmistic » Tue Apr 23, 2019 10:33 am

I was fiddling with my dose to see if I could handle it. I’ve come to the conclusion it’s much too early for me to be doing that. I am taking my 8mg and feeling no more agitation, so I think all of you are right - I was inducing some withdrawal.

Now I do feel that I’m feeling tired and achy at about 5pm - I take my 8mg around 8am. I am feeling a strong desire for a second dose or to split my dose into 2. What do you guys think of that? It totally feels like it’s wearing off although I don’t feel physically sick. I don’t feel like I wanna feel this way until bedtime at least.. I also wake up with a headache that goes away after I dose.

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Re: Irritable on 2mg

Post by BlueLight » Tue Apr 23, 2019 11:10 am

Optioid, the number one goal of Suboxone treatment is....don’t relapse. So if you need to split your dose, fine, do it. That said, one of the goals of recovery is to also break the mental obsession with using. As addicts we are accustomed to constantly monitoring how we feel, moment to moment, minute to minute. “When did we dose last, what time is it, how long before I dose again, how many pills/much dope do I have left, how do I feel...” goes thru our heads consistently in active addiction. Ideally, you want to get to a point where you take your meds and forget about until the next dose.

Right now your body and mind are adjusting to having a stable, long acting medication, taking care of it. No longer are you blasting your dopamine and euphoria receptors every couple/few hours. If you can, I’d try to spend the next few weeks acclimating to your dose. Most of the side effects will go away or abate substantially. But, if you are getting cravings to use in the afternoon I’d go ahead and dose twice per day. Just make sure to keep it consistent and not dose “as needed”. So 8 am and 4 pm, every day for instance, not 8 am and then again when I feel like it later that day. Make sense?

Trust me, in a few months, you’ll all of a sudden realize you haven’t thought about your immediate physical state for a couple or few days, and that mental burden has been reduced from a raging scream....to a whisper.

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