Bupe Problems with bupe, need help

[desurion]

Ok I'll give a short background on myself before going into the problem. I've been a drug addict for 7-8+ years, lots of cocaine, every painkiller known to man, lsd, amphetamines, extasy, alcohol... basically everything you could name besides crack and meth. Painkillers and then heroin was my my DOC and what ultimately destroyed me. I was perscribed and addicted to xanax and klonopin for 6-7 years which I stopped cold turkey by myself in may to get into the suboxone clinic, because he wouldnt perscribe it till I was off the benzos. I've been on it since last summer, was buying it on the street taking 4mg a day because it was all I could afford and it worked, for the most part. I had 5 slips between now and last july. I would start to feel sick 3-4 hours before I took it every night around 8pm, but not nearly as sick as I feel now. Since May of this year ive been in a suboxone clinic, and havent touched heroin or painkillers for 6 months. I was initally perscribed 12mg a day, 8mg morning, 4 at night, but I went up because I was still spending half the days sick. So I was switched to 16mg (8mg 2x daily), no change.

My insurance doesnt cover suboxone and I was paying $120 per week plus 2 $25 copays just to be on this med. It was just as expensive as getting it on the street. My insurance does cover zubsolv, the newer formulation of suboxone, which I have been on for the last month, 2x daily of 5.7mg.

My problem is that just a few hours after I take my sub, I'm already feeling w/ds, and bad... its nearly unbearable... I have tried everything. Splitting my twice daily dose into 4-8 smaller doses, snorting, taking more than perscribed... Ive tried every potentiation method... tagament does nothing, I take 6-8 25mg benadryl with my doses and it used to seem to enhance it, now it doesnt seem to make a difference. I have to get all of my teeth pulled from years of neglect and drug use, and my doctor wants to have me stop bupe for 24 hours then go on painkillers, which scares me because I know the first time I take them ill be right back to pills and eventually dope. I cant sleep past 6-7 am because I just wake up extremely sick and cant go back to sleep and have to get up and take my dose.

So today I went to my local methadone clinic and they told me the same thing they always did.. that even though im perscribed the buprenorphine I would need to get off it completely and give a urine without any in there before they put me on methadone, which I cant do. I want to go on methadone because the suboxone just isnt working... im miserable, sick half the day... it almost seemed to work better on just 4mg a day but I cant go back now that im addicted so such a high dose. And I cant get on the methadone because I cant be sick for weeks or use heroin for weeks to get my urine clean... I wont be able to get thru it.. my last relapse nearly killed me and I dont think I can handle another but im so close to just saying fuck it and using dope again...

So my question is, is there ANYTHING I can do to stop these withdrawls that come just a few hours after I take the suboxone... A year ago I could go a day sometimes without it and not be anywhere near as sick as I am 3 hours later. I dont know if its because im not on benzos, or if its because im on a higher dose.... but ive tried everything... and I cant even switch to methadone, which I know works better for me personally and helps with the chronic pain I am in. Why am I getting sick so soon after I take my subs, why is it worse than when I was on just 4mg (I know less is more but ive tried less and now that im on a higher dose I cant go back) I cant smoke weed anymore, take benzos, or drink. My doctor has no idea why im sick a few hours after the sub. Cravings are under control but this sickness is killing me. Im just looking for any advice in how to fix this or make it better.. im at a loss and I dont have any other options at the moment. I just lost my girlfriend who ive been with for a long time, and am severely depressed and the sickness has been making all of it worse. Like I said I really do think it wasnt as bad at 4mg a day, but ive tried to cut back and cant do it, it just all seems like theres no hope and no solution. I have tried searching, ive read hundreds of bupe related posts here and cant find an answer, so I am just looking for some input.

Im on zubsolv 5.7mg 2x daily (8mg 2x daily suboxone equivalent) (also zubsolv hasnt worked either better or worse compared to the suboxone)
wellbutrin 300mg XR 1x daily (just started 2 weeks ago at 150mg, went to 300mg last week, isnt helping my depression at all yet)
hydroxyzine 50mg 3x daily for anxiety
Ambien 10mg 1x night for sleep

Also, at 4mg a day suboxone used to make me FEEL GOOD, like really good... slightly euphoric, crazy euphoric and nod in the beginning. 0 Good feelings at 12/16mg a day, and even if I just take 2-4mg doses I still dont get that good feeling. Im not looking for that though I could care less about a high, just figured id mention it. I just want to not be in withdrawls, thats all. In the beginning from last july up until around this march/april it worked SO well that I actually PREFERED it over heroin or oxy, as crazy as that sounds it physically made me feel better than any dose of oxy or heroin (not higher, just more "normal" and not sick)

Currently im taking the zubsolv 4x daily (2.85mg 4x daily = 4mg suboxone 4x daily) because 5.7mg (8mg) doesnt seem to hold me or do anymore than 2.85mg (4mg), so this way I get it more often and im in withdrawls for less hours of the day but its still excruciating.

Again ive tried every potentiation method I can do while in the program... diphenhydramine, tagament, GFJ... Ethanol solution under the tounge, snorting. Tried swallowing vs spitting the spit (I get a mouthful within minutes if that makes a difference) I keep it under my tounge for a minimum of 30 mins. Tried 8 small doses, and one large one of 16mg at a time... Nothing seems to help.

Any input or advice would be greatly appreciated... I just cant stand being sick everyday for half the day, its draining the life out of me.

 

[Mad Dash]

I think I can answer this one for you. I was one of those people as well. We could not figure out why I was always sick. No matter what we did, I was sick sick sick sick sick. Raise dose, lower dose, take breaks, spread it out, etc... you get the idea.

Well when I moved to Gainesville I couldn't find a sub clinic that would write sub while being on valium which I was taking from the VA due to PTSD, MDD, Anxiety, fucked up back, etc... so I went to a pain management doctor who writes a lot of bupe and I have legit combat and training injuries. He writes it more often than anything else, because this is Florida it was the pill mill factory for years, so even people with minor to pretty bad pain problems are addicts now too. Unless the patient has a legit problem (like terminal or something else) he does bupe. I told him about my problem and he said "oh yes I see this sometimes in some patients it is very rare but some people have an incredible sensitivity to naloxone, so I will just write you the generic subutex." As I am also a cash pay patient so I needed something cheaper than those +naloxone drugs.

I go to the pharmacy pick up my RX, a little skeptical at first, and then I look in the bottle and there are 60 tiny white pills. I mean the size of a roxy 30. I was already impressed because my ROA of choice is insuffilation and with bupe sublingual BA is like 40-50% whereas nasal BA is like 60-70%. So I went home crushed up one of those bad boys and within minutes I was zonked. I mean I just could NOT believe how high I was. It worked! You probably have the same problem as I do. You need to get on generic subutex, and if you can try to get the manufacturer by the name of Hi-Tech Pharmaceuticals. It is owned by a company called Akorn now as well so sometimes they are called that. Once I got on subutex my life changed, I did a full 180. NO cravings, and I can get a great feeling by taking lower doses for a few day (2) and then doing a full 8 mg again. Truly has been a miracle for me, that and the 10 mg of valium along with 50 mg hydroxyzine I take along with it, has me feeling good pretty much every day.

Hopefully this is your case and you can get nice and fixed up. Changed my life, hopefully it can change yours as well.

 

[desurion]

I'll bring it up to him again when I go back on thursday... but he's an asshole for many reasons... hes completely against subutex, claiming people might inject it ( obviously too dumb to realize that the naloxone is practically useless no matter what RoA) but i'll bring it up to him... he just thinks hes ALWAYS right, with no chance of being wrong. Thank you ill see if I can give that a shot because the zubsolv isnt doing any better than the suboxone.

 

[Mad Dash]

This is why I had to go to a pain mgmt doctor, who is certified to write bupe. He deals with addicts trying to scam shit like oxy and fentanyl. So when little ole me comes in and asks for subutex he was thrilled. He loves me because I never try to ask for anything else. He told me I was his only patient that in the beginning asked for bupe and never tried to get anything stronger. Maybe try seeing if there are any PM docs around you that can write bupe. And I have never done this and I do not know if it is a good idea, but maybe bringing in some research about naloxone sensitivity, and about how sick it can make people. Along with a drastic reduction of usefulness the naloxone also gave me migrane headaches and severe stomach pains. Like it felt like knives mixed with cramps. Even if you don't get that it might help to say you do. At a certain level it becomes malpractice to ignore that kind of pain. HATE, the pharma idea to put naloxone in opioids. Because it makes the Dr.s more inclined to write it out of a sheer lack of education on it, and ends up ruining lots of peoples lives.

Maybe even try saying "doc please just write me 10 for this month and I will keep a journal of how each medication effected me. I have no interest in abusing this medication, I just think I am one of the people that is allergic/sensitive to naloxone." You can even print out my story and give it to him if you think it will help. I could never figure out why people thought bupe was such a miracle drug until I went on subutex... like I said... changed my life.

 

[adder]

I think you should do everything to try to switch to Subutex first before you decide to switch to methadone. I was on methadone for ~2.5 years, then I tapered off and I went through a nightmare, 2-3 months later I was put on Suboxone maintenance and I suddenly started living a different life even though I was still on 2mg of clonazepam a day. It's been almost 3 years since I started taking Suboxone and almost 2 years since I quit benzodiazepines. If you really want to change your life, then I advise against methadone, no opioid ever ruined me like it did and I took various synthetics apart from morphine and heroin. On buprenorphine I was finally able to start studying chemistry again and I'm doing well, on methadone and clonazepam it was just impossible for me to deal with maths even though I used to be very good at it, now it's all coming back finally. And it looks like I'm just lucky not to be sensitive to naloxone because here in Poland Subutex is not available as a maintenance drug at all, at least that's how it is in my city and always has been. I hope you find a way to switch to Subutex and see how it works out for you.

 

[desurion]

Well I just got back from my sub clinic after I made them fit me in.... He wouldn't aknowledge that there is a such thing as nalaxone sensitivity. He said its impossible and doesnt understand why I'm in withdrawls so fast... He was a complete asshole today saying he had better things to do and that I was wasting his time. He said he refuses to perscribe subutex to anybody... also if I wanted to get in the methadone clinic he would rapid taper me off... Then he just said well if zubsolv and suboxone arent working for you ill just taper you off completely then you can go do what you want... I was shocked, I explained that that wasnt going to work... the whole reason I came back and was talking to him was because I was sick, and he wanted to immediatly taper me and make me more sick... so he offered me tapering, or to go back to paying $120 a week for subuxone... I figured that it did get slightly worse when I was on zubsolv but things wern't all that good on suboxone either... he filled me 10 strips until my group on saturday when I'll get a weeks supply... so basically im screwed... wont adjust dose either he wont perscribe anybody over 16mg/day which I dont really want to be on more anyways because I dont think it works... so basically it was stay on zubsolv which insurance covered and be sick and have nothing change, have him taper me so I could get into the methadone clinic (which they by the way will NOT take me unless I have clean urine with NO suboxone, my doc didnt understand this and neither do I, at all... no risk of precipitated w/d as long as I dont take any subs after the methadone...), taper me off immediatly and be sick as hell, or try going back on 8mg 2x daily suboxone, which is what I decided...sigh... I feel like a prisoner at this place with no options.. I spend every day of my life sick... I dont sleep, I cant do anything, I cant work... No energy, depressed, miserable... and it all comes down to the fact that im dopesick for most of the day everyday... and at least when I was using yeah id be dopesick all the time but id get relief when I used, at least... I dont know what to do at this point.. hopefully suboxone MIGHT help a little bit more after being on the zubsolv for a month, but I dont see it happening.... ughh

 

[Mad Dash]

Holy shit. That doctor is a son of a bitch. Is there any other doctors you can try going to like pain mgmt? I HATE to say this and I am probably going to regret saying it... But if you are not getting the treatment you need then maybe it is best to go on oxy until the bupe is 100% out of your system, then wait 48 hours oxy should be out of system and go to methadone clinic. I don't even like saying this but this is just cruel. Something has to happen and this is ONE option. I am typing on my phone b/c I'm away but wanted to check on you. When I get back home I am going to help you brainstorm nobody trying to get better deserves to be treated like that.

 

[stlouisgirl]

I will throw out just another scenario that may or may not be the reason you are feeling bad. I tried transferring to Buprenorphine off methadone with disastrous results. I was on 40 mg of methadone and as soon as I put the 8mg Bupe under my tongue I went into PW's for 72 hours. Okay, fast forward to when I got down to 25 mg of methadone I AGAIN tried 8mg Bupe under tongue. After a few minutes same thing--felt a whoosh and then terrible dysphoria and then became SUPER agitated--could not quit kicking or make my legs stay still. It was absolute misery & NOTHING to counteract. Absolutely dertermined to try and make then transfer, I got down to TEN mg of methadone and dr. ASSURED me there's no way it will send you into prec. withdrawals now.. So this last time I make sure I am in moderate methadone withdrawal and I take the 8mg of Bupe and to my absolute horror the SAME symptoms come on AGAIN.

At this point we REALIZE it is not PW's that I am suffering from. Its because the 8mg dose was WAY too high for me--Too much Bupe is NOT PLEASANT & at least for me the symptoms of putting me into precip. withdrawals and of taking too much were VERY similar and both horrible. I am evidently VERY sensitive to Bupe and too much can be as miserable as pw's. Too high a dose causes akathisia-(a horrible internal restlessness), agitation, sweating and a DEEP dysphoria. I felt SUICIDAL.

SO I wonderred if for some reason you could be actually experiencing the effects of too much instead of too little? Just another angle to consider...

 

[Mad Dash]

That I guess could be it too I have never heard of it, but it would make sense. But your symptoms sound far worse than his... so I am not quite sure this is the issue.

What I would do today is start some research, in your city and around it. Find out what doctors exist in your area that RX bupe, it can't just be this one guy unless you live out in the middle of nowhere. Do you have any real pain issues that you think you might be able to go to a PM doctor in order to get the script? That is what I am doing and I thank God for it everyday. Try everything you can think of, and if all else fails, as a LAST resort if you must go to methadone there is my suggestion above, but please if you do that at least let me give you my phone # so we can try to talk through you using more or for longer than you should and get you straight to the methadone clinic. Please keep me updated.