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Opioids A few questions about buprenorphine

B

bluesteyes

Bluelighter
Joined
Mar 11, 2016
Messages
126
A few questions about buprenorphine (update: now an OxyContin taper)

I have been taking Oxycodone for awhile for chronic pain, and I need to come off of it. I do about 80mg per day. I am going to be seeing my doctor tomorrow to tell him that I have used enough of my current script to where I am going to run out before the 30 day period ends. However, I still have a decent amount of the script left. I swallow the tablets. I wouldn't consider myself an abuser. I have just taken this drug longer than I should have.

One of the ideas that I am going to suggest is to immediately switch over to buprenorphine with the idea that I would take that for a few weeks, and then begin a slow taper.

What I hate about Oxy is that it is so short lived. I take 2 tablets, and within 4 hours my mood sucks and my neck hurts. I sweat like a hog, both when on the drug, and especially while I am sleeping. My central nervous system feels like it is on a constant roller coaster ride. Up and down, up and down, up and down. I hate it, and I want no more of it.

The reason why buprenorphine appeals to me on a temporary basis is because its effects are long lasting. I won't be up and down all day and night. It is to my understanding that I will not experience the same level of pain relief and mood elevation with buprenorphine, but I just need something to allow me to be functional. I am at a very important time at work. The next 4 weeks are critical. There are things that I do at work that no one else can do, so my presence is very crucial. I just can't take 7 days off and cold turkey from the Oxy.

I do not believe my doctor is licensed to write scripts for buprenorphine unless it is off label. There are 6 or 8 family practice docs in my area who have the necessary training to write up scripts for addicts, although I really don't consider myself to be one. I live in a semi-rural area.....so it's not like I live in a major city like L.A. That could be a good thing or a bad thing, depending on the amount of addicts in this area. I know they can only treat so many patients.

What are people's experiences on buprenorphine compared to Oxycodone? I don't expect to be on it more than a few weeks before I start to taper. I am going the non-narcotic route for my pain starting in July.
 
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It allows you to be functional and offers a little mood lift, don't expect to feel nearly as good as oxy but like you said there isn't any downs, just take once daily and you don't have to think about dosing. When I first switched from 160mg oxy to sub years ago I felt great on 8mg a day, felt a nice mood lift, and weaned down to 1mg over 2 months without any noticeable withdrawals and then quit and was fine 2 weeks later. Didn't even have any cravings after I quit or during the sub use.

Now years later and a much bigger habit I still get pleasant effects but doesn't feel as good as the first time on it
 
Don't switch immeadietly to subs, you MUST be in moderate to severe withdrawal before you take your first dose meaning wait at least 24 hours. I know that sucks but you will be in a world of hurt if you take it too early...read up on precipitated withdrawal, I'm sure the prescribing doc will explain all this to you.

Also, with your fairly small habit I think you could get away with max 4mg a day to stabilize which will make a quick taper much easier. My first time on subs I had about a 120-150 mg oxy a day habit and 4mg sub was easily enough to hold me. The doc will want to put you on a ridiculous dose like 8-16 mg a day that's WAY too much, unless he's watching you break that 8 mg bitch in half and pocket the other half...most doctors don't know what the fuck they're doing when it comes to subs.

One more thing, I've heard a lot of people on bluelight talk shit about the guy but he sure helped me..,,Google "robert 325 sub taper plan" great info on there...good luck!
 
Roberts method will work for you but he is an arrogant know it all, pretty much anyone here could give you as good as or better advice but it's a just a common sense easy taper method.
 
Be careful how much buprenorphine you take, while 80mg of oxycodone is for some considered a medium habit, buprenorphine is MUCH stronger. The difference is that buprenorphine is only a partial agonist, meaning that it will only produce greater opiate effects with increased dosage to a certain point. If you're thinking of replacing oxycodone with buprenorphine, and using that for a while as a pain-management therapy, you would probably want to take it at dosages under 2mg, or maybe 1mg 2xday or less. At lower dosages Buprenorphine acts much more like a full agonist, which is why when indicated for pain it is prescribed in microgram dosages.

If you start taking something like 8-16mg/day, you might feel more stabilized, but you will likely increase your opiate tolerance further then it already is.

If you're looking for a long acting opiate for pain management, a low dose of methadone might be a better idea (in terms of the treatment of pain). Methadone unlike buprenorphine is a full agonist, and though my experience with pain is rather limited, I think it is a better analgesic. Again with methadone you would have to be careful with how much you would dose, as it is also much stronger, and longer acting then oxycodone.
 
Don't tell your Dr you're out early especially if you're not. You'll get labled an opiate addict and cut off your script. That's a really dumb move especially if you have enough to get through the month.
 
I saw my doctor today, and he decided to taper off via OxyContin. Expensive way to go. I am starting with 30mg, 2x per day.

I didn't have enough Percocet script to get me thru the month.
 
Hopefully you can get through this way, ultimately it is probably better to do so as you can easily get stuck taking bupe for a while. You're correct to assume Buprenorphine, particularly Suboxone will keep you level, it's as much a mood stabiliser as it is an ORT - no more 'Up's and Down's' that we all get with Oxycodone after a while but try to stick with it as your Dr guides you. Good luck and Take Care.
 
So I took my first 30mg OxyContin pill last night at 8:30pm. I woke up at 6:20am this morning shaking in a completely drenched bed. I was sweating like a hog. I immediately took an OxyContin pill, and the symptoms died down in about 50 minutes. Just what I needed.....a friggin' pill that doesn't last as long as advertised :( Hopefully this was just a one time occurrence. I am going to see if I develop withdrawal symptoms before 6:20pm this evening. If I do, I may need to use my leftover Percocet tablets to fill in the gaps, which I really want to avoid doing. I am keeping my doctor abreast of what has been happening. All I am asking is to be off of these pills without having to go through horrible withdrawal symptoms.
 
Why should I be surprised by Big Pharma? Lots of reports that OxyContin doesn't really last 12 hours:

http://static.latimes.com/oxycontin-part1/

It's just after noon, and I am developing minor withdrawal symptoms. I am a little shaky and sweaty. I have a feeling that we should've started at 40mg, but I think I am going to just tough it out because it's not intolerable, and I have a 3 day weekend coming up. Do you think my body should adjust over the next 3-4 days so long as I stick with the 30mg OxyContin pills?

The fact that these pills wear off after 8-10 hours for some people is a different matter. I may need to use a 10mg Percocet to fill in the gaps until I see my doc again in a couple of weeks.
 
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The weekend should allow you to stabilize a bit more for Tuesday, try to time all your dose reductions for Thursday or Friday so you can fine tune your doses over the weekrnd
 
A good pain management Dr prescribes oxy as a thrice per day drug as opposed to twice. I always found after 8hrs I could hack it no longer but if I took some Lyrica in the evening then I could comfortably make it through until my morning dose without any WD's making my morning a misery and desperate chase for the pill packet to crush a bunch of oxy to take powdered on an empty stomach for quick relief usually feeling better within 10-15mins and then pain relieved in 20-30mins (And if not too tolerant a nice lil high/euphoria would accompany and enhance the pain relief).

It took about a year of twice daily use f ever increasing doses of oxycodone before I would wake up or be woken up by WD's and be gasping for a dose by morning. It creeps up on all of us although if your brain is switched on then by using daily it's not too hard to figure out what's going to happen. Having been a drug user most of my life I was fully aware that once a started pain meds that I was knowingly going to addict myself but pain drove and motivated me to eventually seek medicinal help for my Chronic pain.
 
I realize that the topic of this thread has morphed from buprenorphine to oxycontin. That being said, I had a question about oxycontin. Is oxycontin known to induce anxiety in some people? When I was taking percocets, I certainly felt the energizing, euphoric properties of the medication, but the oxycontin thing just feels like plain anxiety. As discussed above, my doc started me on 30mg oxycontin tablets, and that may have turned out to be too low of a dosage to start with. Probably should've gone with 40mg. However, I have a three day weekend coming up, and I am going to see if my body adjusts to the new medication level. That being said, I am not sure if this anxiety is a withdrawal symptom from not getting enough opiate, or if it's just the nature oxycontin, which, of course, is an extended release medication. I am used to taking shorter acting percocets. Normally I feel the anxiety 4 to 5 hours after taking a dose, but when I took an oxycontin tablet about 90 minutes ago, I felt a wave of anxiety almost immediately. It was very strange. I had to take a Lorazepam to calm down. It makes me wonder if an extended release med like buprenorphine might also induce anxiety in some patients.
 
Bupe isn't known to cause anxiety but some rare cases it does just like with oxy. It's the same chemical as percocets so it shouldn't have a different reaction, could be anxious about something else in your life like the pain or anxious you won't get relief or it will wear off too quick
 
If at all possible do not use bupe for longer than like seven days...if you go longer yous end up getting wds from that shit.

No detox is painless and bupe will sure as hell cause anxiety...so anything over 4 mgs is overkill for your habit. I haven't been here in a while but I know my shit on bupe detox.

The concern here is to get you off...not to keep going out of fear of wds. Suck it up and push threw the shitty moments. Drink the FUCK out of water, even now. It flushes the toxins out.

If I sound directive and irrational about bupe, it's because I've seen countless peeps do pills to sub and wish like HELL someone said...."don't fucking do it."

Just remember, no more than 5-7 days...something like 4, 2, 1, .5, .5, .25, .25 off

Sub has very long half life so even finish this taper about 4 -5 days after sub you'll be sneezing, watery eyes....from the sub.
 
I've always found that Oxy's last a long time in my system but everyone is different and react differently with medications.
Back to the question at hand, i wouldn't recommend swapping opioids at such an important stage in your life, I've been using/abusing opiats for 25 yrs and have been on bupe many times with canges from H, oxy's, morphine and others to the Buprenorphine maintenance program and am currently on 32mgs of Suboxone. People say this dose is to high but everyone is different and i was never stable and held for the whole day until i reached 32mgs.
I still get a very nice mood lift and some euphoria for the first 2hrs of onset and for another couple after that then am just stable for the day.
I do believe Bupe was first used as pain relief medication in the US for 20yrs before it was available in AU were it is pretty much usually only used for opiod maintenance just like in the US now.
I think it sounds to me like it might just be a better option as you will only have to dose in the morning then you can go eventually go about your day without having to think about redosing.
Of course as people have stated you would have to wait at least 24hrs or until you are in significant WD so as to not fet precipitated WD which trust me is no fun!
I hope everything works out for you and my first bluelight post has been of help.
Please keep us updated as to how you go.
 
I tried to schedule an appointment with a buprenorphine doctor on Friday, but his office told me that he was no longer accepting new patients. He's probably booked to the max. He's the leading addiction specialist in our area. I live in a semi-rural area, so it's not like the area is overflowing with guys who are qualified to prescribe buprenorphine.

I was telling my primary care doc that I wish I could just go somewhere for 7 days and just get it over with. I tried kicking cold turkey a couple of weeks ago and failed after 2 days, but the experience was enough to show me that with better withdrawal meds and a medical staff looking after me - especially to give me hope and emotional support when I'm feeling agitated, desperate and depressed - I could rid myself of the opiates. It's not like have a serious habit where I am taking mass quantities. Unfortunately, I am in a very important stage with my work for the next 3-4 weeks. I can't just go away for 7 days and come back. Also, inpatient rehab is so friggin' expensive. All the rehab places around here try to provide 5 star accommodations and gourmet meals instead of more beds for patients in need of help. The local hospital only provides outpatient care.

At about 2:30pm today, the OxyContin (or my withdrawals - I can't distinguish them at this point) was making me so wired and was making me sweat like a hog. It's almost as if I have some central nervous disorder. Anyway, I took a 10mg Percocet and two 1MG Lorazepam's, and I got it to calm down. It's amazing how different the short acting Percocet makes me feel. However, that ends up leading to depressive symptoms which are no fun to deal with. I sit and bed and don't want to do anything. But at least I don't feel like I am hyperventilating.

Part of the problem that I have is that I am doing this all on my own. I'm not in a relationship, I don't really have any friends (and even if I did, at my age, they would be preoccupied with their kids and spouses), and my family lives thousands of miles away. I see a counselor every other week, and I attend physical therapy and chiropractic sessions every week for my chronic pain. Money is real tight for me due to all of the medical expenses and pre-existing debt.
 
I am happy to report that much of the anxiety I have experienced over the last several days since I started taking Oxycontin has abated. What I am doing now is taking a 5mg Percocet along with the 30mg OxyContin. It seems to be working, but honestly, the anxiety was probably just my body going through 4-5 days of withdrawals getting used to a consistently reduced amount of medication. I also read somewhere on the net that it sometimes takes people several days to really feel the full effects of OxyContin. It sort of needs to build up in your system first as an extended release med.

Doing it alone is truly bad. When I feel calm like I do right now, I feels these waves of depression come over me. The realities of life start creeping in. When am I ever going to get rid of this medical debt? When will I ever find a relationship partner to love me? When will I have friends? Can I ever find happiness living in a semi-rural area when so much of what I like to do is located in a big city. Then again, I don't have much money to throw around, so maybe living in a less expensive area is more ideal. And then I start thinking about all my job stress, and how my chronic pain is exacerbated by sitting at a computer all day. All this crap used to mean nothing when I was under the influence of 60mg of Percocet and a couple of Benadryl. They were just problems that would work themselves out.

It's not that simple.
 
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