Does Bupe Help With Most Cravings?

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Cindy56
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Does Bupe Help With Most Cravings?

Post by Cindy56 » Mon Jul 26, 2021 4:29 pm

Hi, I'm new here, and I've spent the last few days reading this forum and looking for answers. I've found many (and a group I'd love to be a part of in my recovery - I relate so much to the stories and feelings), but I really need help with this one because it has to do with my expectations of Suboxone and whether I make the leap from hydrocodone.

Does Suboxone (the bupe part) give us relief from physical (brain chemistry-induced) cravings and psychological cravings (or what I think of as the obsession)? Is there a difference between the two? I got this idea from the thread "Just for Cravings." I may have taken something too literally or overthought something as I'm prone to do, especially when anxious.

Just to feel normal and not spend so much time and energy fighting the addiction while dealing with my inner demons and a not so peaceful home situation would be nice. I probably should say instead of "normal," my preaddiction self because I'm sure the anxiety will return once I've hit the bupe ceiling.

I wonder how soon the cravings without medication go away. I'm very curious about this.

Since bupe is taken to quiet the cravings (besides stop withdrawals, which to my knowledge don't typically last longer than 3 to 5 days for short-acting opioids such as heroin and hydrocodone), and since so many who used short-acting opioids stay on bupe for years, does this mean without it (or methadone), the cravings would haunt us for years?

Or would the cravings eventually dissipate if one were to successfully overcome them enough times? Like a bad habit does? Or do cravings have superpowers? They sure feel like they do! It's weird I don't recall having cravings before - obsessing yes, but not what I've recently felt that hits me out of the blue and hard. And days past being sick from withdrawals. So I get it. I just wonder about the time frame. If these suckers are going to interfere with my brain more than a few weeks,and given my home situation (excuse?), I definitely want to try the Suboxone prescribed.

Any thoughts are appreciated! Is there an article on Suboxone's mechanism that quells cravings? If once at the ceiling, it doesn't alter our minds, as in reducing anxiety or anything like that, so I'm just wondering how it works. There's so little it seems written about it. I read that Naltrexone kills cravings, and that makes no sense because it is an antagonist not a parital agonist like bupe. I'll keep reading here. I've learned a lot and I am very grateful for this forum. I've felt so alone for a long time thanks to my addiction, and when I'm reading your posts, I don't feel quite so alone. I just don't know how to post without droning on and on. I've edited this post about 4 times and deleted my first one. I'm really scared about getting off the hydrocodone and on the bupe. Maybe that's why I want so badly to understand how it works. Understanding the science behind things reduces my anxiety. Thank you for being there

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Re: Does Bupe Help With Most Cravings?

Post by Headseed » Wed Jul 28, 2021 10:30 am

Welcome. I saw your initial post but was hoping someone would answer other than me. And someone is likely to check in just not as quickly as most of us addicts would like. When you're in this mess everything is urgent it seems. And rightfully so I suppose. I'm a lurker here for the most part but because I've been active of late with my own journey and someone replied to my posts I feel a sense of obligation to keep paying that forward for a while. So while I'm not a doctor and didn't even stay at a Holiday Inn Express I'll do my best to relate what I think I know or at least suspect from my understanding (and the limits that entails) and my own anecdotal experiences with bupe. YMMV of course.

My first suggestion is if possible talk to a doctor. I may or may not be spewing the ramblings of a mad man. This is the internet after all. However, I suspect the succinct answer to your question(s) is "it depends". Everyone is different and factors like dose, length of use, current environment, mental health, etc. all play a factor in answering your question(s). Which is why a comprehensive treatment approach is recommended and you need to see a professional(s) for that if possible.

The physical issues IMO are mostly or completely dealt with by bupe depending on dose etc. You didn't say what dose you were given so I won't speculate. I'm trying to avoid specifics and still be helpful but if you're reading stuff like the patient medication guides and the prescribing information I think you'll find what you're after. You seem to be grasping what's needed when you see it. Those should be available from the manufacture of whatever brand of bupe you are taking. If you weren't given one with your prescription check their website. I was given a handy fold out brochure when I started that spelled out what you're looking for with diagrams even someone as lacking in intellect as me could decipher but a short search didn't produce what I was looking for so I can't share it. If I have time/energy later I'll make a broader attempt if nobody gives you more concrete info before then. It sounds like you're on the right track with educating yourself though. As to the mental cravings.... again "it depends". What bupe did for me was to very quickly begin to take away the physical issues. I wasn't withdrawing and bupe has a high affinity for opioid receptors making it difficult (but not impossible if you are damned determined) to use full agonists to effect . So that obsession you have starts to dissipate over a period of time. Once the physical issues were under control it allowed me to make peace with the demons that I didn't have the strength to cast out while using. For me it was a couple of months before I had been through the addict phase of seeing what happens. Or dealing with those "cravings". I wasn't damned determined to get high but I have to touch the stove to see if it's hot sometimes. A couple of attempts of swallowing my favorite blue pretties had little to no effect and my brain saw it was pointless and I wasn't really suffering physically so the "cravings" started going away. So it's both physical and psychological. The brain takes some time to rewire itself but bupe quiets that down a great deal from the start which allows for dealing with the psych stuff. Again, depending on length of use etc. etc. etc.

When people ask me "how long should I take it?" my answer is always "as long as it takes". 7 days, 7 months, 7 years or 70 years it doesn't matter. Whatever you need to have the time to get life into a place where you're healthy physically and mentally and have the stability needed to disengage from MAT. Some people never do. Withdrawals from all opiates (full or partial agonist either one) can be a many headed monster. For some people it's a small one and they kill it in a few days/weeks and never have "cravings" after that (those people are just dependent IMO) and others fight demons out of the pit of hell and are hard wired to seek the medications. Or maybe they are using to cover trauma that they just can't face. Those things can take time (and help) to overcome. I can remember having drug dreams regularly for 6 months after I came off oxy/fent. However, leaving bupe behind after being on it for many years I've had zero thus far (just under a month without bupe). Bupe is a tool. It's a fantastic tool and it's versatile enough to help a lot of people but you may require additional tools i.e. counseling/meetings/in treatment etc. if you want to get past active opioid use. It's a complex issue for most of us. Once you get past the physical though I think it boils down to "why?". Why do you use and why do you want to stop? How important is that last "why" to you and how do you deal with the initial "why" of use? Those are rhetorical btw. No need to explain to me unless it helps you in some way. That's the kind of thing the additional professionals can help with if you have access.

Because the forums aren't all that active I would suggest you reach out elsewhere as well. I don't have a whole lot of specific suggestions. I know reddit has a topic for everything though. If you're feeling alone any connection is helpful. I'm continuing to lurk on and off here for another week or so at least so I'll try to keep interacting if you keep posting but a party of two might not be quite enough to keep the loneliness at bay. I'm not a fan of AA/NA but if you are needing contact with people that understand what you're going through that is the one reason I would suggest going there. Apologies for my rambling. I type stream of consciousness sometimes and it can be a bit disjointed. I hope this helps in some way until someone with adequate knowledge and ability to communicate it can give you more solid answers. I'm glad you're here and I wish you luck on your journey! Take care!

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Re: Does Bupe Help With Most Cravings?

Post by Cindy56 » Thu Jul 29, 2021 9:49 pm

Thank you Headseed for your thoughtful post. Just gotta see if the stove's still hot LOL. I've had insomnia for last two nights, and honestly, I wanted to wait and reply after a nap, because I'm no good without sleep. Numbs all my positive emotions, even with my pills of which never work for this but I always gotta try again. Took my last hydrocodne today :D (I have meds to help with the WD) and will start bupe in 36 to 48 hours at a quarter of the 2mg prescribed because while I have a moderate addiction, I have a low tolerance this time around. AnywayI couldn't nap either so won't be responding till tomorrow because your long reply deserves more, especially when I was begging for help. I want to let you know that I researched some more and have been reading a long article from Front Psychiatry journal and in spite of needing to translate medical terms as I go along, I'm learning a ton about opioid cravings, and it looks like the bottom line is going to be that [drumroll please].......they vary according to several factors. Which of course you told me. It is interesting though how the brain changes with addiction and how various treatments help and don't help so much with cravings. I feel like the bupe will help me, along with that buzz word so overused I cringe at typing it - mindfulness. As for the rest of recovery, including social connections, I'm looking at SMART. The steps aren't for me either, but I do see value in them for many out there and like some of them. I'll provide a more detailed response and one to more of the things you actually wrote to me. Thank you again. zzzzzzzzzzzzzzzzzzzz

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Re: Does Bupe Help With Most Cravings?

Post by Headseed » Thu Jul 29, 2021 11:24 pm

Anytime. Happy to try to help. However, don't feel obligated to respond to my incessant chattering unless it's benefiting you in some manner. Taking care of whatever issues you're having physically/mentally for sure outweigh me tapping on this keyboard or you responding to it.

I'm going to assume someone pointed out precipitated withdrawals to you. If not another google search should be on your to do list before you dose with bupe. If you're waiting 36-48 hrs I can't fathom that being an issue though. Especially if you aren't eating norcos like tic tacs. I think most people are safe in 24-36 hours. I went to induction after like 30 hrs off of oxycodone without issue. But again... it depends. Tired of hearing that yet? Just make sure you're into moderate withdrawals before you take that first dose. You do NOT want to go through PW.

Sleep is the bane of every addicts existence when trying to stop using I think. Hopefully the meds you have will let you get some rest though. It sounds like you're not too deep into your substance so hopefully you won't deal with too much. I don't have any magic formulas or too many words of wisdom. Just find comfort where you can for a moment at a time. The shower has always been my refuge when nothing else helped.

That mindfulness you're talking about has helped me quite a bit through this process as well. I'm not religious and I don't consider myself "spiritual" but stopping what you're doing or focused on and trying to quiet those thoughts in your head that never shut up can be beneficial. We tend to like wallowing in our misery and suffering is largely of our own making I think. I've found Sam Harris's book/app "Waking Up" to be helpful to get me out of "self" a bit. If you are religious Sam obviously isn't likely to be up your alley. Though prayer etc. serves much the same purpose for many who need to find a way to quiet their thoughts or direct them away from "self" or misery.

Whatever you find peace in is the tool to use. I don't knock how anyone chooses to confront this beast. I'm not a big fan of cookie cutter approaches to anything. Addiction is a weird semi exception in that I think most of us need some structure though. However, if it's too rigid or demanding of perfection then it can do more harm than good. At least in my case. I can be quite unyielding when pushed repeatedly because I don't fit some mold. As one of my favorite authors had his main character say "I've been known to be contrary. When something pushes me, I shove back. Even if the one doing the pushing is me." But like I've said multiple times on this forum... I am not a smart man and I do not recommend taking the scenic route I stumbled upon. Find one a little straighter but that works for you. I haven't spent time digging into SMART but it seems to be worth a look at a minimum. Especially given in person meetings are likely destined to be shuttered again for a time. I might register myself just to lurk if nothing else. I'm glad you mentioned that. Appreciate that.

Anyway, I'm rambling again. Thanks again for SMART and I hope you make this transition smoothly. Take care and catch you on the flip side.

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Re: Does Bupe Help With Most Cravings?

Post by rule62 » Sun Aug 01, 2021 12:43 pm

To answer your question about cravings, yes it does do a great job of overriding them. The first time I received it my cravings went away immediately and that blew my mind. But back then I didn't know suboxone was an opiate too. A much milder one. Similar to how methadone works but easier to get off of.

Today I take only a small amount as it is easy to taper down from. My induction dose was way too high so I tapered down almost right away. To live without cravings is such a gift. If you know quitting won't work then what choice do you have ?

Glad you're here and we hope you stay around.
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Re: Does Bupe Help With Most Cravings?

Post by Cindy56 » Mon Aug 02, 2021 3:13 am

Thank you both so much! I wrote much of my reply this afternoon and forgot to save draft until tonight, so I guess it didn't save. Just as well as I wrote way too much again. It takes longer to write shorter, right headseed? I hope to see you at SMART. My user name there is cynthilee. Lots of subforums but we all are required to post intros. And meetings off and online. I read about SMART here in posts by amy work in progress (rule62 I see your posts in many of the threads with hers and jen jen) You three are so knowledgeable and helpful. So you and headseed were right on about the cravings. I knew that was the main reason for taking Suboxon, but I didn't realize that without it, cravings could go on for months, even years, which I confirmed. If they only lasted a few weeks, I'd feel kinda weird about taking it, unless I couldn't make it through the few weeks, and I likely couldn't. Anyway....I took my first Suboxon dose yesterday. I couldn't believe how normal I felt an hour or so later. No cravings whatsoever all day or through the night. That was the amazing part. As you said rule62 -- such a blessing.

Because the MAT doc hadn't given me any induction instructions (Take one a day and see you in 2 weeks), I found many suggestions here, which is where I first heard the term, and then settled on directions online from a university that made sense for me, given my atypically low dose (I have a moderate bordering severe addiction but this time around a low tolerance but that would have gone up easily if I'd continued - i have a history, including H). I wait 100 minutes after my first dose, and since I still had a few WD symptoms (mainly edginess as nausea was gone), I repeated the first dose making for a total of 1/2 of 2 mg tab. So Day 2 I began with total of yesterday. Probably was just the right amount, but I felt kind of sick still and took another 1/4. More likely I felt sick because I stayed up late reading the night before and woke up too early. No cravings till tonight. But I had a major stressor and my BP shot up above crisis level to 197/90. So I took another 1/4 and about an later felt sick to my stomach. Serves me right. I think my dose for now should be 1 mg or if I truly still feel cravings without outside major stresses or feel WDs then 1.5 mg. But my eyes were pinned today and I felt high when talking to my neighbor, and I didn't like that. So 1/2 a tablet/1 mg until??? My doctor told me to take 2 mg a day. I noticed on here that many increase their doses during induction. The directions I found were for the first 3 days and based on WDs felt. Is this why the increases are done in the first few days - because you want to find the right dose while you're still in WD period so you can tell how much will be your ceiling? And hitting the ceiling is what keeps the cravings at bay? Without feeling high or dope sick?

I hope I'm making sense because I am so sleepy. But no cravings :-) And I know recovery is about the inner work too. And sometimes making changes in our environments/living situations. I'm really excited to being this journey. I began it because I was at the crossroads of either driving down our mountain to find doctors to prescribe me my opioids or quit. And I couldn't imagine doing either. I saw a MAT brochure in our pharmacy. I called when in WD but it was a 3 week wait to see a doctor so I went back to my addiction until 27 hours before my induction yesterday morning.

Headseed, I see you're off the Subs now - I can't imagine but hope to be there in the not too distant future. I hope to see you on the SMART site. It's science, rather than spiritual based with lots of resources. Rule62, what is rule 62? Again I've enjoyed your posts here - have run across many along with Amy work in progress and jennjenn's - a nice balance from the 3 of you. See you around and thanks again for making me feel welcome!

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Re: Does Bupe Help With Most Cravings?

Post by Cindy56 » Mon Aug 02, 2021 3:37 am

Whatever you find peace in is the tool to use. I don't knock how anyone chooses to confront this beast. I'm not a big fan of cookie cutter approaches to anything. Addiction is a weird semi exception in that I think most of us need some structure though. However, if it's too rigid or demanding of perfection then it can do more harm than good. At least in my case. I can be quite unyielding when pushed repeatedly because I don't fit some mold. As one of my favorite authors had his main character say "I've been known to be contrary. When something pushes me, I shove back. Even if the one doing the pushing is me."
Headseed, story of my life. My therapist even admitted to trying reverse psychology on me a few times because I tend to do the opposite of what she advises. I'm not sure it's always pushing back in that case as much as asking for advice but only intending to use it if I want to. You mentioned structure. I do need a little of that. Going to bed around the same time every night would be a good start! WD can wreak havoc with sleep but thanks to Gabapentin, it didn't much with me. My folly is doing things online late at night - research, emailing with one of my adult kids who I'm having problems with, Amazon, work...if I'd just pick up the novel on my nightstand, I'd be asleep in no time. So yes, structure. Outside exercise and a bedtime. If I stay up late, I still wake up early and rarely can return to sleep. And then look what happened today. I didn't know if the subs was working or not because of that.

How is life after subs? Are the cravings still gone? It sounds like you're on solid ground.

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Re: Does Bupe Help With Most Cravings?

Post by rule62 » Tue Aug 03, 2021 10:16 am

Congratulations on your recovery! Give yourself a few weeks to acclimate to the Suboxone. Then slowly adjust your dose as you see fit. It's best to start off on the high side and then work down. The cravings need to be crushed into oblivion and never come back. Most doctors will suggest a dose of 8-16mgs, some want you on 24mgs which is way too high for someone who only took hydrocodone.

What I noticed when I first joined this site was the members knew much more about buprenorphine than most all medical professionals. The doctors who prescribe had to take a class from the makers of Suboxone so they only got one view. Not their fault that they didn't get accurate information. Being a new MAT drug we the addicts figured out the best way to take it and stay clean. My doctor did not want to hear my opinion on how to adjust my dose. He forbid me to adjust it myself so I didn't tell him as I worked my way down. He thought I was on 16mgs when really I was on 4mg's. No big deal. That was over 10 years ago so maybe they all know better by now. My doctor today, which isn't the original one, still doesn't know very much about it. He does not question me anymore about being on it for life. The only problem I'll face in the future is if I move away and have to find another doctor.

Glad to have you with us here. I wish we had more active members but at least those who are here post often. Thanks everyone!
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Re: Does Bupe Help With Most Cravings?

Post by Headseed » Tue Aug 03, 2021 12:38 pm

Cindy56 wrote:
Mon Aug 02, 2021 3:37 am

How is life after subs? Are the cravings still gone? It sounds like you're on solid ground.
I've tried to answer this a couple of times and had the form crash so I apologize for a shortened answer in advance.

The short answer is life is on the upswing and I'm feeling good barring some minor physical issues still lingering. No cravings to speak of but like rule62 I'm around 10 years out from active addiction. For me stopping was an option I wanted to make a good faith attempt at. I just had to have the right time to do it. So yes I feel like I have turned a corner and have both feet firmly on the path. I just have to keep taking positive steps and watch out for any looming precipices.

I don't have anything to say to contradict rule62 to any degree. You asked about the ceiling effect so while I'm working from vague remembrances at best I don't think you're going to be approaching it with 1-2mg doses a day. That isn't a good or bad thing by itself. It's just something that is. If you are not having cravings and aren't suffering physical issues my advice is to stay in that range. As rule62 suggested for those of us who had more substantial tolerance we weren't stable on lower doses to start and cravings could be an issue if not dosed properly. I don't think I would feel comfortable telling you go increase your dose to 8-16mg just to make sure you don't experience a single craving but I would be comfortable saying cravings shouldn't be the norm. If they are and you have intentions of a long stint on suboxone to stabilize your life and as your means to escape opiate addiction then by all means talk to your doctor about increasing the dose. If we are talking short term bupe use I run up against my ignorance and lack of experience there. I could see a situation where someone with a norco habit of a few a day could feel like they cut off their hand to get rid of a splinter if they start increasing doses and then don't intend to stay on bupe. Every situation is different. Your situation is your situation. You're the only one that knows what issues norcos are causing in your life and the value that might be attached to the varying options in front of you. Again, that's my intuition admittedly likely rooted in a measure of ignorance and lacking direct experience so like with everything I happen to blather on about you should consult a doctor if you have concerns.

I really do applaud both your effort to educate yourself and in taking the first steps toward recovery. All the uncertainty can be daunting but you seem to be killing it!

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