Precipitated withdrawal from trying to start suboxone & my messed up doctor

[QUEENCOOKIE]

So yesterday I had my appointment scheduled with my doctor to get help with my heroin addiction and finally start taking subs. My Doctor told me I should wait 42 hours before I take my first dose of 8mg of sub film. So yesterday when I went into my docs office I had been just about 30 hours clean but still not with that bad of with drawls... It was really weird. Usually after 12 hours with out H I am dying. So for me to go that long and not feel that shitty is very fucking weird. I have been using "China White" recently, It's very strong. My first expierences with "China White" were that its very strong but left my body so quickly, like after 4-6 hours I would start to go through WD if I didnt consume any more, so to my surprise when this new "China" shows up and its 50xs stronger and even lasts ten times longer I was thrilled. So when I had explained this to my Doc he brushed off what I said like he new more than me and didnt take into consideration how terrified I was about going into precipitated withdrawel at all!!!! I like to think I know my body better than anyone and as user of 3 years with a pretty heavy habit it was VERY WEIRD to not be into that much WD pain at that level of time and not have my doctor even the slightest bit worried for me or show care.

So either way at about 30 hours I was getting hot and cold symtoms with some mild sweating. THATS ALL. I kept expressing my concern and nobody in the office cared. I asked if I could take the subs home that WERE PRESCRIBED TO ME & they told me I had to take my first dose there. So I was told by my doctor to take 2 WHOLE FILMS EVEN THO I WAS BARELY INTO WITHDRAWLS & HE KNEW THIS!! The nurse gave me both of them and told me to put them both under the same spot on my tounge which i'm pretty sure is wrong and she brought me water right away when your not supposed to even consume water for 30 min after TAKING ONE!

Well 15 min was all it took to set my world of happiness right on it's ass. 15 fucking mineuts these percipitated withdraws hit me like a ton of brick's. Immdeiatly I couldnt sit still, Was sweating my ass off like the most ive ever sweat from a withdrawl, I was severely hot and cold,was very pale and had goose bumps, I had uncontrollable diarrhea, Uncontrollable puking, My body was in so much pain, ugh, just so much pain. I felt like I was possessed! Litterally I was a monster, kicking, screaming, thoughts of suicide, you name it. I was so scared of this happening but put faith in my doctor when I should have just picked up the script and just said fuck it im done. Im so pissed that he thought he new my body more than me and ignored me!!!! Not every person reacts the same. We all know this. How did my doctor not?! Either way I was very lucky I survived the 2 worst hours of my life thanks to puking out an entire sub ( I drank water too soon and one of them didnt disolve and i swalloed it) and racing to my dealer's house to get me out of my Percipitated withdrawals. I have heard you ususally cant even break even when that happens but I did. I was completly normal after with a few mild sweats and aches with only doing under a half a gram of this " China White". I did however have to keep doing china through out my day because the sub was still trying to push my new stuff out.

I really want to quit still but this has scarred me. That orange citrus bitter taste from the sub still lingers and it haunts me because I keep thinking how I felt and how I so wanted to just be put out of my misery... How someone could do that to me after I told them I really thought that was going to happen and have them give me the whole " Im the doctor, I know you, you dont" speech is messed up to say the least. What do you guys think are some tips I can use to put forward in my sobriety? Any other drugs you might reccomend other than subs? Is methadone a good option or am I really going to fuck my life up if I go on that? I just want to regain control of my life and need insight and tips. If you can help, wonderful!

Thanks for reading

 

[crisler]

Im so sorry to hear this I really am. I dont have much advice but I will say this, trust your doctors guys, but when something doesn't sound correct, dont go with the flow. Find that balance between trusting doctors' knowledge, and also thinking for yourself when it comes to feeling a different way about something. Trust your instincts. I had a doctor last year well from oct 2014 to february 2015 i was on alprazolam then he cut it abruptly when I mentioned that my employer didnt want me to take it while working for the hospital i was working for. Well I went cold turkey because of my doctor I didnt see it coming never new about withdrawals until then.

Doctors ey.

 

[Felonious Monk]

Because Doctors don't truly understand opiate addiction or the action of Suboxone.

If you truly feel wronged contact your State Medical Board and report the doctor. You might also talk to a lawyer about malpractice as well. (Crisler too, hard to believe a doctor would be so ignorant as to force CT of benzos--his malpractice would pay out on that one if you had any negative effects)

Don't give up on Subs in general because of that one experience. Methadone is definitely an option as well.

 

[Ilove2nod]

Oh man... that does suck, to both of you actually, precip WDs are fucking terrible! I've only experienced them one time, when I did dope too soon after my sub, didn't feel anything and stupidly took more sub like 4 hours later... It was pretty bad, compared to regular withdrawls, because when you go into precipitated wds, the bupe rips all of whatever opioid is binding to your opiate receptors off and throws you immediately into the worst withdrawls besides methadone(from what I have heard) and benzo withdrawls that you can feel.

That is totally wrong too about your doctor.. sounds like a total quack! telling you that you will be fine no matter what after 30 hrs of not doing H, how the hell could he possibly know that, it can take anywhere from as soon as 8 hours to 3 days to get whatever opiate is still in your system completely off your opiate receptors, I believe it can be even longer than 3 days you have to wait switching from methadone to sub, since 'done has a super long half life. A lot of it depends on your metabolism, for sure. I can take subs like 8-10 hrs after doing oxy, dilaudid, or H and be fine usually. But I have a very fast metabolism, that is why. Everyone is different when it comes to precipitated wds and how long they have to wait after a full agonist to take the sub. Plus 16mgs is too much.. 8 is just fine when your starting. I think anything over like 8-10mgs of sub in one day is overkill IMO. Plus why would the nurse make you drink water with the sub?! that is so stupid, wow... it's like "Hey, I don't want to sit here and wait for you to let this thing dissolve for 20 mins so just swallow it, it will be fine!". lol dumb ass nurse and doctor at that place, I would try to find a new sub doc who actually knows the facts about subs, not some dumb ass who just took a test on how to be an addiction specialist/sub doctor in 10 mins and cheated the whole thing lol. I honestly think some sub docs don't know a thing about subs and just wing it. Go online and rate that doctor, give him like a 1 star rating, or a half a star if you can.

Whenever I go to see new docs I always look at their rating ever since the first sub doc I went to was a stuck up, full of himself, asshole who literally made videos of himself, because he thought he was too good to talk to people with addiction problems in person for more than 2 mins, just to write you a script of subs.. in person, so he made his patients like me, watch these bogus 30 minute videos of himself talking about how he was great and all his patients are junky low life scum to him basically, like "Hey I am doing wonderful for myself because I never used drugs before, so you should try and just be like me...". Plus he was the most strict sub doc I had ever been to and charged like 3x what a normal visit at a legit sub doctor would be, and if u failed a UA he taxed you like 50 extra bucks or some shit. Turns out he had a 1 star rating from about 50 people who rated him.. I think he was truly a scam artist or something, worst sub doc I have ever been to, needless to say after going to him I stayed on sub for a week then relapsed and used oxy(this was before my H addiction) for the next year or so until finally getting back on subs with a much better doc. Luckily my current one has been awesome to me! always listens to me and when I say something she always has a response, doesn't just think I'm some low life junkie seeking drugs, she treats me like a person, as if we are friends or something! Best sub doctor I have yet been to. but op: DEFINITELY LOOK FOR A NEW SUB DOCTOR! I probably don't need to tell you though, sounds like you hated him. Best of luck with the next sub doc!!! It will get better when you have a good doc...

 

[sm0kestack]

Yeah, it is very messed up that they started you right off at 16mg at induction. They are supposed to induct you with smaller doses then work you up until you've reached comfort.

You also mentioned that the dope you were getting was stronger and lasted longer. It must have had a longer acting opiate in it of some sort. I have had dope that had me not feeling WD symptoms even start to set in til well past 24 hours. But when they did set in, oh man was I sick. It also depends how big your habit was and for how long you were using. When I had larger habits like over ½g+/day, it would take me a good couple days to feel WD really set in.

I would have prolly refused the medication at that point and just insisted you weren't not ready. They can't force it on you. Like mentioned above there could be malpractice issues.

A trusty tool I use to really make sure I am ready for suboxone induction is the COWS sheet (clinical opiate withdrawal scale) you rate how intense your WD symptoms are and gauge your readiness to induct suboxone. You want to be in the high moderate to severe WD range, and generally I wait 12 hours after I start to feel WD set in.

As for methadone, it's a viable option, but it's more of a hassle to stay on. Going to those clinics daily for dosing and such. Bupe is easier, and more readily prescribed. And once you stabilize, you will feel fine.

Good luck bro.

 

[QUEENCOOKIE]

Thank you so much for reading and responding!!! That was the most fucked up shit I've ever seen. I wouldnt wish it on my worst enemy! I def will trust my instincts next time. Right when the nurse gave me the subs I was going to spit them out when she left the room but she talked to me for a good 5 -10 min so I figured I was fucked and just left them (( I cant believe your doc would take you off your meds like that!? Like what are these doctors thinking?! Im glad you got through it tho!

 

[QUEENCOOKIE]

Seriously I love2nod Those precip WD are no fucking joke... Boy was I not prepared. What a dick too Like how many times could I have possibly said Im not ready/this doesnt sound right for them to have said hmm maybe we should reschedule??? Ugh, I should have just went with my Gut and spit them out. So many people have told me that about starting off at a low dose AND i even said that to him when I was going through the precip WD in his office and he responded with " It doesnt matter how much I give you you will still go through the precipitated withdrawal effects no matter what". Such a douche. I also said "OKAY so now that the worst thing has happened to me that I was trying to prevent, what do i do? " he just looked at me and said with no emotion " Just truck through it" NOTHING ELSE. He didnt ask me to stay so he could moniter me he just let me go with no fucks given. Im 5'2 115 pound girl who just took two full blown subs and was sick out of my mind and he didnt care at all. I contimplated suicide I was so sick and Im not the kind of person that does that.

lol your doctor and my doctor should meet and jerk each other off haha!!! Fucking assholes. Its okay tho I bet they secretly hate their lives and are miserable people. I definetly need to find a new doctor If I go back I dont know how I will look this guy in the face with out slapping him. Ugh! I cant believe he made you watch videos of him!!! WHO DOES THAT?! Jeez I really hope I do find another Doctor because this is the only guy in my area unless I travel.

Thank you again and I hope I find a new doc!!

 

[QUEENCOOKIE]

wow Smokestack Im glad I know now how long I might have to actually wait! My habit is a Half graham a day sometimes a whole. There is definetly some malpractice going on forsure. They just didnt seem like they what they were doing...This guy isnt even my actual doctor. He despise's all drugs & when he asked me what drug I tried first I said weed, he than said " you know weed is terrible and the gateway drug for worse things". IMO that is not true at all. I know plenty of people who smoke weed and wouldnt dare touch dope, or meth, coke, what ever. Its all preference and everyone is diffrent! He thinks all people who do drugs end up on heroin... He's a fucking idiot.

I really want to try methadone but there is a state hold right now and its been going on for 3 months!!!!! Isnt that crazy?! So many people actually want the help and cant even get it because of this damn hold. Subs are very expensive and alot of people cant afford them. I just dont get what the goverment thinks when this happens... ugh lol

Thanks again for responding!!!

 

[Ilove2nod]

Seriously I love2nod Those precip WD are no fucking joke... Boy was I not prepared. What a dick too Like how many times could I have possibly said Im not ready/this doesnt sound right for them to have said hmm maybe we should reschedule??? Ugh, I should have just went with my Gut and spit them out. So many people have told me that about starting off at a low dose AND i even said that to him when I was going through the precip WD in his office and he responded with " It doesnt matter how much I give you you will still go through the precipitated withdrawal effects no matter what". Such a douche. I also said "OKAY so now that the worst thing has happened to me that I was trying to prevent, what do i do? " he just looked at me and said with no emotion " Just truck through it" NOTHING ELSE. He didnt ask me to stay so he could moniter me he just let me go with no fucks given. Im 5'2 115 pound girl who just took two full blown subs and was sick out of my mind and he didnt care at all. I contimplated suicide I was so sick and Im not the kind of person that does that.

lol your doctor and my doctor should meet and jerk each other off haha!!! Fucking assholes. Its okay tho I bet they secretly hate their lives and are miserable people. I definetly need to find a new doctor If I go back I dont know how I will look this guy in the face with out slapping him. Ugh! I cant believe he made you watch videos of him!!! WHO DOES THAT?! Jeez I really hope I do find another Doctor because this is the only guy in my area unless I travel.

Thank you again and I hope I find a new doc!!

For sure... And yeah I am glad I stopped going to that fucking kook sub doc I first went to... Seriously, it was like 1 hour sessions consisting of his assistant, this psychiatrist/hypnotist fucking weirdo, talking the normal shrink talk, then he would leave me in this room alone, to make me watch this assholes videos, and if not the videos, as if those weren't bad enough, I just remembered he also wrote a fucking book about himself that we had to read most visits as well! The whole thing was the same as the videos, this guy had no idea what it was really like to be an addict, but acted as if he had been to hell and back, that all his patients should emulate him, and it just fucking sucked... lol. Anyways, yeah I hope u get a new sub doc to, that is cool. I'm super happy with my current one! Gonna go there as long as I live here, and am on subs.

 

[paranoid android]

Because Doctors don't truly understand opiate addiction or the action of Suboxone.

If you truly feel wronged contact your State Medical Board and report the doctor. You might also talk to a lawyer about malpractice as well. (Crisler too, hard to believe a doctor would be so ignorant as to force CT of benzos--his malpractice would pay out on that one if you had any negative effects)

Don't give up on Subs in general because of that one experience. Methadone is definitely an option as well.

^ This exactly! I would contact whatever body overlooks doctors in your area as well as contact a lawyer who's main bit is personal injury as you might be able to get something out of this. Most times if there is a case at all insurance would rather settle then pay all those court fees and roll the dice and maybe end up paying out even more depending on the judges ruling.

But yeah don't throw the baby out with the bathwater and write off Buprenorphine simply because your doctor was too stupid to know how the medication he fucking prescribed worked. I learned the hard way to never take a doctor on their word especially when it comes to meds. After that incident where i took the Carbamazepine for 3 days which the idiot Nazi i was seeing at the time assured me had little in the way of side effects or any addiction potential unlike the very evil Oxy Ir's i had been taking i never took another med again without first looking it up. Up until day 3 i had just felt abit nauseous and like i had a constant low grade headache then all of a sudden it felt like i was poisoned which in a way i guess i might have been. I was puking sick for days and it took weeks for the headaches to go away after stopping the med. My doctor had not only not warned me about any of the potential life threatening side effects but had in fact basically lied to me about them! Needless to say after that incident i not only got a new doctor but also never took another med in my life without first researching it myself to see if it was worth the risk for myself.

 

[Darkdancer917]

I'm new to this site and wondering who may have an idea how much black tar you would have to use for Suboxone to not have an effect. Would a two gram a day habit be too much to get relief from Suboxone? And if so would it send you into precipitated withdrawals?

 

[sm0kestack]

I'm new to this site and wondering who may have an idea how much black tar you would have to use for Suboxone to not have an effect. Would a two gram a day habit be too much to get relief from Suboxone? And if so would it send you into precipitated withdrawals?

Buprenorphine is some 28x more potent than morphine. A 2 gram a day habit would not be to big for buprenorphine to be effective in eliminating withdrawals. I know quite a few people who made the transition from habits that large, and are doing quite well on buprenorphine maintenance. There are underlying factors in that may affect buprenorphines effectiveness tho.

How long have you been using dope for? Have you ever been on suboxone or suboxone maintenance? Have you ever switched back and forth from sun to dope and back to sub many times? This affects tolerance.

Black tar can be tricky at times it can have other alkaloids and derivatives in it that can hit different receptors in the body. Poppy seed tea can be like this too, they are pretty organic substances. Buprenorphine has a very high affinity for the MU OPIATE RECEPTOR, and mainly only deals with that one. So if you were to be dependent on a substance that hit other receptors as well, buprenorphine may not seem to be as effective. East Coast powder as they call it, seems to be more of just heroin itself and does not have many other things inside it that hit other receptors, making buprenorphine work relatively better.

But providing your black tar is mainly just heroin, it should be very effective. It just depends on if you go thru the induction process properly.

For a 2 gram a day habit, I would recommend tapering down first. Get yourself down to like ¼g or less a day. Then start the induction process. When starting it wait at least 24 hours after your last use, then rate yourself on the COWS SHEET HONESTLY. (Clinical Opiate Withdrawal Scale (google it)). You want to score in the HIGH MODERATE TO SEVERE RANGE. This will determine your readiness to administer buprenorphine. I usually wait til I feel the beginning symptoms of WD set in, watery eyes, runny nose, joint and muscle aches, and chills, as this means the opiates are beginning to leave your body. Once I feel that start, I wait another 12-24 hours before inducting buprenorphine. By that time the WD should be full blown, and most, if not all the opiates should be gone, and you should be ready to start induction.

When you do start taking the bupe, start small. Dose like 1-2mg sublingually at most, then wait 30mins-1hour and see what it does. If PWDs do happen to hit, it should be mild and not last very long. Then once it goes away, if you waited long enough to dose, you should feel the bupe settling in and start feeling a bit better, since there wasn't a lot of opiates left on the receptors to displace, and the bupe was able to take over pretty easily. From here, wait another hour or 2 then dose again. Repeat this process until you feel comfortable.

If you happen to make the mistake of taking the bupe way too early and get thrown into PWDs, it is going to be rough, and continuous dosing of bupe isn't going to help much, because there was still a lot of opiates attached to those receptors and your body is still dependent on a full agonist to fill them. So when buprenorphine rips them off and places itself in, it is only a partial agonist, and is only going to partially keep them activated. That's why you will feel the very intense PWDs for a short time, because the bupe is ripping all the opiates off all at once, instead of them slowly leaving on their own, then once that is done and the bupe fills itself in, you will still feel halfway shitty, and will still have to wait a while to take more bupe. That's why it is best to wait for those receptors to be all the way vacant. So when you induct bupe, those receptors are screaming for a fill, the bupe comes in partially fills them, but they become satisfied and say hey this is better than nothing. That is why you don't feel high really like from your drug of choice, but good enough to feel normal and no WD.

So to sum it up, no, 2gram black tar habit isn't too large for buprenorphine to be effective, as long as you taper down first, the transition will be quicker and easier instead of doing 2 grams the previous day, then trying bupe the next, it most likely won't work cuz it will likely take longer than a day or 2 for that amount to clear your system. But if you tapered it down like I said, the transition will be quicker and easier. Then as long as you waited as long as possible while in WD to take the bupe, and started out small, then worked your way up, PWDs shouldn't be much of an issue. Remember, once you start feeling those early WD signs, that is just the opiates BEGINNING to vacate those receptors. They are not gone yet. So after you start feeling those early symptoms, try waiting another 12-24 hours. I usually notice 36-48hours being the sweet spot. Then you should be in full blown WD, and likely almost all opiates have vacated those receptors. Then you are ready, and at those point buprenorphine should work very well. Just waiting til the 24 hour mark and assuming you are ready can be disaster. Go by how you feel and that COWS sheet is very useful for that.

It is a different story with long acting opiates like methadone for instance. It has a very long half-life like buprenorphine itself does. People wanting to switch from opiates like this to bupe have to go thru a whole different process.

 

[sm0kestack]

Sorry for that long post. I think I hit the max characters allowed... Lol it wouldn't let me type no more.

But anyway what I meant to finish saying up there is users switching from long acting opiates like methadone have to go thru a whole different process than one switching from fast acting opiates like heroin or oxycodone.

They must taper their dose down slowly, then switch to a fast acting opiate like heroin, morphine, or oxy, then make the switch to bupe.

Someone coming off methadone may go 3 days without a dose, feel like shit, but the drug leaves so slowly , that they may think it's out of their system because they are experiencing withdrawal symptoms, but it really isn't all the way out. They think they are ready to induct buprenorphine, take it, and all hell breaks loose. They experience the absolute harshest PWDs because of it.

Shit can be tricky sometimes. Heh. But everything I said up there is just based on my experiences. Everybody is different. Buprenorphine may not work for some individuals too well no matter what. But this is just what I have learned from dealing with it over the years.

 

[NorthernNMTar]

precipitated withdrawal from methadone via suboxone

what I meant to finish saying up there is users switching from long acting opiates like methadone have to go thru a whole different process than one switching from fast acting opiates like heroin or oxycodone.

They must taper their dose down slowly, then switch to a fast acting opiate like heroin, morphine, or oxy, then make the switch to bupe.

By no means "must", but it helps. Usually what I used was IV hydromorphone for a few days (the K4s) before jumping over.

Someone coming off methadone may go 3 days without a dose, feel like shit, but the drug leaves so slowly , that they may think it's out of their system because they are experiencing withdrawal symptoms, but it really isn't all the way out. They think they are ready to induct buprenorphine, take it, and all hell breaks loose. They experience the absolute harshest PWDs because of it.
.

RE: precips and methadone- I can attest to the truth of this. I thought I was going to die- actually die, and I've been hardcore dopesick, PLENTY. But this was unlike anything I'd ever experienced, and I've kicked 500-dollar-a-day NYC early-90's 80-percent pure white dope habits/300mg hydromorphone/Dilaudid a day cold. This was off the scale; I genuinely thought I was going to drown in my own fluids.

I'd been on subs since a year after FDA approval, having had a use history (heroin) that began in '87. The incident described below happened in Philly's Fishtown in early Dec. of '06.

I had a sub script (24mg daily- at the time Subs were still under trademark and I was using the Reckitt-Benkiser 8mg orange hexagonal tablets) and had successfully continued to use dope (IV) for years at this point; using the subs when I couldn't get dope or was genuinely trying to mitigate the negative social effects of using. I'd pretty much figured out how to keep from ending up with Precip; matter of fact had never experienced it- fearing it greatly and always being very careful about how soon after my last dope use I administered the buprenorphine. Thought I was pretty slick with it, actually.

Anyway, I took a road trip from Denver to Philly to visit a girl I was seeing and also to handle some "business" in the Philly/NYC area. At the time I had many NOCAL and Sinaloan connections and ran back and forth a lot (driving) to handle biz. Just prior to this trip I'd received two 1000-tablet bottle of 10mg Methadone generics in trade from someone. I actually enjoyed getting completely hammered on methadone very occasionally; I'd had bad luck with previous attempts at maintenance and the effect methadone had on my day-to-day existence... the sedation and stupidity factors made it no good for "maintenance" for me, but for high-dose sleeping/nodding for 72 hours at a time occasionally, I enjoyed it (often breaking down, filtering, and shooting these type of tabs, but that's another tale). Nothing floored me and yet left the very deep semi-conscious/lucid, warm, content drop-your-cig-and-start-fires nod for me like high (4-700mg) doses of methadone.

Anyway, on the drive from CO to PA I stayed on about 100 mgs a day- keeping myself from nodding and crashing with regular doses of a few 10mg IR Adderall tabs- a pharma speedball. Anyhow, I got to Philly, hung out for about a week, crashing at chicks place while she worked during the day, enjoying myself staying under the covers (cold damp winter, shitty boiler) and nodding. The time came about ten days in when I only had like 200mgs left, and planned on finishing them and waiting a few days and starting up the subs again.

I waited 3 1/2 days. I was starting to tear up and sneeze, bowels were feeling like they might be moving, a bit of nausea (no outright puking yet, tho). I thought it would be close, but plenty of time, as this was usually the point I re-started the subs when coming off other opiates. I was wrong.

I started with two tabs, letting them dissolve per usual. Then about ten minutes later, I started to get a hot flash or two- and thought oh fuck, what have I done. I started rinsing my mouth and under my tongue vigorously. Then it REALLY hit.

I started full-on pharesis- in the snap of a finger- as long as it took to type this sentence- sweat saturated my clothes.I got hit with a hot flash more intense than anything I'd previously experienced. Then my intestines- all the smooth muscles in my abdomen, actually- lurched and seized up, and I ran to the bathroom. I barely made it, jerked my jeans down and I shat- NO exaggeration- five huger-than-full-sized, anus-tearing, rock-hard, compacted methadone-formed bowel movements in less than five minutes. This means five SEPARATE movements, not "connected", if you know what I mean- ONE. PER. MINUTE. I hadn't shat really in ten days. I was now. The cramping as my muscles moved that shit through was incredible, excruciating pain. During the third one the retching and then projectile vomiting started, and I couldn't control it. At the same time, my eyes were pouring to where I effectively couldn't see... but what was most terrifying was that my upper respiratory tract started to produce so much mucous, I couldn't breathe. My nose was PACKED with fluids- couldn't inhale or exhale through my nose at all- and my airway was closing. I was struggling to gasp in through my mouth/throat at the same time that my larynx and esophagus were in spasm from the uncontrollable vomiting (the 'trapdoor" to your airway reflexively closes when puking so you don't inhale vomit). I could't breathe except the occasional ragged wet gasp shudderingly sucked in between retches.

While all this was going on, the muscle cramps started. My calf muscles in particular felt like they were going to rip themselves from the bone. I had the cramps in the bottoms of my feet that you can sometimes get during sex. I had cramps in my FACIAL MUSCLES, and the smooth musculature of my skull. The muscles between my ribs. The muscles in my fingers. My balls were jerking on their cords and trying to retreat up into my body. IT WAS UNBELIEVABLE. I remember thinking if this was what death from cyanide poisoning or a nerve agent was like (your muscles will actually tear from cramping), and also furious, thinking that this was how I was going to die, puking, shitting, and gasping for air on a toilet, and what a wretched, stupid way this was to go, and how it was of course entirely the stupid wretched fault of my wretched, stupid ass. And, as this was jogging through my head, I began experiencing something I'd never felt before. My BONES THEMSELVES actually felt as if they were bursting- splitting from the inside, from some sort of inside pressure. They hurt from the inside out. I'm not talking about your standard 'joint pain' that comes with kicking; I've never felt it before nor since. It was so strange I'm actually at a bit of a loss to describe it other than I've just attempted. It felt like my marrow was aflame and boiling. I didn't think there were even nerves in there (not sure there are, but it sure felt like it). I was, again, terrified. My heart rate had to have been easily well over 225bpm, and I don't even want to think about what my BP was doing. This was BY FAR the worst pain I'd ever experienced, in a life noways tame. Again, I was terrified, and that terror was filtered though the lens of what felt like the worst acid trip I had ever had. I was beginning to have that feeling of intense un-grounded unreality and distorted, ringing vision of a bad trip. Every chemical reaction in my body and nervous system was in shutdown/freakout/fight-or-flight mode.

The GF was there, and (to top all this off), she'd been weaning herself off her anti-psychotics (unbeknownst to me, although I'd noticed a little weirdness). I have (HAD rather- I've been clean a bit, so that kind of thing is no longer attractive) a thing for hot, crazy, artsy, constantly horny and dirty-minded AF Fetlife-browsing SnM submissive, compulsive counter-culture chicks with salad-tossing fetishes, and she was one- one who, apparently spurred by panic and the stress of the moment, started- unbelievably- having a psychotic episode (what else could go wrong?). So I have a wide-eyed, freaking out chick whose eyes had glazed over and was suddenly saying things that made no sense, talking to people who weren't there. She was together enough to suggest going to the ER/calling an ambulance, but I said no. One, I was unable/unwilling to move. Two, I knew there was nothing that could be done for me, or, rather, WOULD be, There wasn't and isn't an ER doc on Earth who would have been willing to dose me with what would have been the required elephant-sized dose of opiates to have had any effect at all on what I was experiencing, even if they were standing there with ten doses of Narcan in case they overdid it. Actually, no, I felt it far more likely that I'd be mocked and sneered at and condescendingly talked down to sadistically rather than given any effective treatment (I hadn't had good experiences with Hospital care; ER's in particular), and I didn't relish the idea of being strapped to a stretcher while shitting, puking and thrashing around. In retrospect, I should've taken the Ambulance ride. At the very least I should've been intubated and sedated and had bags of fluids hung. If the same thing were to happen to me today (I'm 50 now, with high BP/pulmonary hypertension from all the microfibers and trash packing and scarring my kidneys and aveoli) I have ABSOLUTELY NO DOUBT it would kill me via stroke or cardiac arrest, or worse, stroke me out and leave me alive in a wheelchair drooling whilst being spoon-fed pap. I probably came closer to such an outcome than I realize on that day itself.

Anyway, after the first hour, the symptoms began to abate a bit, enough where I could lay down. The extreme and involuntary physical reactions began to slow, almost as quickly as they began. I was still jumping up to shit, though, about every fifteen minutes, but at this point it was straight yellow water/mucous, and I was dry-heaving that frothing, yellow-orange bile when I puked. The worst of it was over in six hours- six LOOOONG hours, and the GF was also calmer, although not stable. She got it together enough to run out and get me some Gatorade, which I was (finally, in hour seven) able to hold down. Everything hurt. Every muscle that had been in spasm was now stiffening up in another manner- like from extreme over-work. After the Gatorade and some Pedialite, I was able to keep some water down. Suffice to say I didn't sleep, nor did I really for a few days. I felt very strange and lightheaded- far worse than you normally feel after a 'normal' kick. I was paranoid and defensive/psychologically aggressive- standard for a post-trauma/stress period. It was a good ten days before I started to feel "normal" again; and that was even with going out and copping a decent amount of (fairly shitty- Philly wasn't my town) dope off the street on about day three when I felt steady enough go outside walking around. Even after a bundle of that stuff I still couldn't really eat, that went on until day five. Again- I didn't feel right psychologically or physically for the better part of two weeks. It was by far the worst experience I had when using, and by far cumulatively the worst physical pain I'd ever experienced, not to even mention the soul-shattering psychological effects. I was already re-evaluating the 'career path' I'd chosen; this experience accelerated that process, but only by a year or two, probably- as I continued to use for 2/3rds of another decade.

Never, NEVER let this happen to you. The easiest way to prevent it? Never start using in the first place. But in the meantime, if transitioning from Methadone to subs, do it the RIGHT way. Under KNOWLEDGEABLE and actually compassionate medical supervision, because this CAN kill you (I only learned later how lucky I'd actually been- people go into cardiac arrest and/or drown in their own fluids via sudden pulmonary edema WHILE CONSCIOUS), and kill you fairly unpleasantly, at that. Of course, I was using subs to cover my ass/to ping-pong back-and-forth off of whilst using. I'm sure many reading this do/have done the same. Anyway,this particular combo is NOT one to play with.

And here endeth the tale.

 

[Pickledlemons]

Methadone is a much more serious addiction than suboxone. I know exactly how you felt... I've been through precipitated withdrawals and I know they are 10 times worse than regular withdrawals. I still think sub is your best option. Your doctor is an idiot. You should never take sub if you are not in withdrawal. Even though 24 hours is usually enough... if you are not in withdrawals DO NOT TAKE IT. I understand that you are scared of sub but it really does work if used correctly, I would highly recommend that over methadone.

If you really dont wanna do sub again... you could use kratom to maintain your addiction and taper off that. Thats what I'm doing right now. You can get it super cheap online. This way you can be in complete control of your recovery. But... that can be a good or bad thing... depending on how determined you are.

Good Luck.

 

[Lorne???]

Yeah don?t be scared of suboxone/buprenorphine, precipitated wd off of intermediate acting opioids can only happen once- wait 12 hours, and start with 2mg, wait at least 100 minutes, and then another 2mg... if you are fine ~40 minutes later, you are in the clear, and can take another 3mg, or if you already feel a lot better, maybe just 1mg...

Remember it takes a couple
Of hours to reach maximum effect generally;

Also dissolving it in ~1ml of water, and administering half first under the tongue, and then the other half later will
Make it 1.5-2x as potent, and it will absorb faster

Again, don? Be afraid, your doc was completely ignorant About buprenorphine; 2 8mg strips at once is WAY too much to start off with, you are supposed to start with a small dose, maybe 2mg, at most 4mg, and then 30-40 minutes later a little more-8mg-12mg should be at most your initial dose, and then if you truly need a bit more, you titrate. Really, 12mg should pretty much cover most people, and a lot will be easily covered on 8mg(varied of course) though would have venir another shot before you go the route of methadone maintenance, which is highly effective and sometimes necessary, although also a lot notent of a hassle, until several months of clean urine screens

Good luck, and going the route of ORT is great man(?man? a general term, no statement in your gender which is unknown)