Opioids Switching from 1mg Sub to 40mg oxy (for pain)

[callofduty]

I've been taking oxycodone on and off to relieve chronic headaches over the last six or seven years (I got up to 300mg in 2011, got off using Suboxone in 12-13, stayed off a year, got dependent on Advil, decided I might as well take the thing that worked, stabilized at a healthy 80mg dose, had that fucked up by PM assholes) until this pain doctor told me that Suboxone worked well for pain. I thought, "Hey, that would be sooo much easier," and figured, since I hadn't been totally miserable on it before, it should work. But it didn't. I tried 8mg, 4mg, 2mg, and 1mg over a five month period, and I'm still in pain all the time.


So, finally, I went to a new PM doc (relocation and insurance stuff slowed me down), and he put me on 40mg/day (oxy, 10mg pills). I've been on 1mg of Suboxone for at least a month and before that had been on 2mg for three months.


I know it will take a few days before the Sub gets totally off my receptors (I'm sure that's not the right language, but you know what I mean). Still, I'm only on a milligram, and I won't take it until I've gone without for at least 24 hours (I'd wait 48, but I have to teach tomorrow). So, I'm not too worried about that part. I'm thinking I'll take 30mg/day and just feel kind of shitty (and save some pills) until I can fully feel the oxy.


I'm mostly wondering if I've totally screwed up my tolerance with the Sub and if 40mg/day of oxycodone will do anything for my pain (I'm not looking to get high; I just want pain relief). I know that no one can give me an exact answer on that; we aren't the same people with the same bodies and the same pain. But I didn't feel like I could really ask the doctor without sounding like a shopper (he also called 120mme "ridiculous," which is ridiculous). It's possible that my tolerance has stabilized at almost exactly 40mg/day on 1mg Subs, but I'm still halving the dose that worked best for me. I was happy, but then I saw the Rx and got scared.

I'm in NW Florida, and my PM options don't look good; I don't want to screw up this doctor. Perspectives from others who've done something similar? Advice on how best to proceed if the dose doesn't work?

 

[keeping]

subs are strong but i don't think 1 - 2mgs will have messed up your tolerance too much man.
i was on 4mgs for about 3 months and then worked my way down over another 3 and my tolerance was fine.

 

[callofduty]

Thanks. That helps. I took the last 1mg Sub yesterday morning about 6:00, so I'm going to see how it works out pretty close to now.

When I started on Subs the first time (about eight months), I saved two oxy 20s and took them a month after I'd been off--first a half, then the other, a whole another day--and I was more fucked up than I'd ever been on a 20 (or 10)! I figure the month had a lot to do with it, and I got back to a reasonably high tolerance pretty quickly. I mean, it worked for pain control, but I didn't get high, which is fine. I've just never moved straight from Subs back to oxy.

I appreciate your perspective, Keeping. I'll update this thread later in case anyone ever has the exact same question?

 

[keeping]

I've just never moved straight from Subs back to oxy.

when you say this, how soon after subs do you intend to take oxy? have you heard of precipitated withdrawal? this can happen if the doses between aren't far enough apart.

 

[callofduty]

I actually just took the oxy 45 minutes ago. It had been 25 hours since my last Sub (1mg, sublingual). I am actually really feeling the oxy 10 and think I might be able to get by on three 10s a day for a bit to keep my tolerance down/give myself some pills to play around with on bad pain days.

Because I took the oxy after the Sub, precipitated w/d is not something I even considered worrying about. It's the other way around: had I taken the oxy and then the Sub, I'd have gone into precipitated w/d, but taking a full agonist on top of Suboxone won't do much, if any, real harm (especially at such a low dose and since the naloxone doesn't really do anything when taken sublingually--it's there to prevent IV use, but naloxone doesn't even make that impossible; still, an ex has a condition he described as "heart drowning" from shooting Subs, so I would caution everyone strongly against IV use anyway). I appreciate the warning, though.

When I still had some of an old morphine Rx left in early summer, I took several 20mg ERs a few hours after (and once in place of) the Suboxone (2mg), and while I couldn't fully feel it, I did get some pain relief and a tiny almost-euphoric feeling. I never had any trouble with precipitated withdrawals except for the initial Suboxone transition, and it wasn't so bad when I put 24 hours between my first Sub and last oxy. I just couldn't totally feel the morphine, which has never been a good pain drug for me anyway. I assumed the same thing would happen with the oxy. But, so far, I have a little buzz, and my headache, which was turning into a migraine around 3AM, is mostly gone! Fingers crossed it keeps up like this!

(I'm 5'4" and weigh 100 lbs, and I have a high metabolism, so that probably plays a role.)

 

[keeping]

aaah of course, forgive me my memory isn't what it used to be (because of opiates actually aha)

yeah IVing subs is a bad idea, especially if its suboxone. i've only ever had generic bupe and i used to sniff them a lot which i know is addict behavior but i really hate that goddamn orange taste. there was only one brand i could sublingauly use, its called Gadup and tastes great (see below).

and real glad to hear the subs haven't messed up your tolerance, and yeah i'm sure your weight and metabolism have helped too.
keep us updated ༼ ༎ຶ ෴ ༎ຶ༽

 

[callofduty]

Thanks.

No, I totally understand sniffing the bupe (my phone autocorrected to "vile"--fitting). Suboxone is so, so gross. I'm so happy that I no longer have to wake up and do that. Like, when I was dating someone, I was so self conscious in the morning because it's objectively gross. (Also, I used to have to sniff my Opana because the oral bioavailability is so low. I did not feel bad about it. I mean, it didn't touch the headaches otherwise. When I wanted to switch down to oxy, my doctor back then thought I was crazy.)

So far, it's still working out. I've taken 15mg (the one I took in the morning and then a half about five hours later), and it's a bad head day, so I wouldn't feel great anyway, but I can tell it's working.

 

[musique]

aaah of course, forgive me my memory isn't what it used to be (because of opiates actually aha)

yeah IVing subs is a bad idea, especially if its suboxone. i've only ever had generic bupe and i used to sniff them a lot which i know is addict behavior but i really hate that goddamn orange taste. there was only one brand i could sublingauly use, its called Gadup and tastes great (see below).

and real glad to hear the subs haven't messed up your tolerance, and yeah i'm sure your weight and metabolism have helped too.
keep us updated ༼ ༎ຶ ෴ ༎ຶ༽

Would you say your memory and other cognitive faculties are permanently damaged from the Opiates and if so, how long were you taking them ?
I'm up to 320mgs of Oxy's after 8 years and I feel very dulled down. I read that when it supresses your respiratory drive and your sPO2 levels fall lower than normal for too long, your brain gets staved off of Oxygen and cells die over the years. I wear a recording SPO2 wrist oximeter over night for 5 years and I check it frequently throughout the day. It's Low normal ~ 92-96 but obv not optimal. Do you think memory and brain fog effects reported by many people is the oxygen or the drugs permanent change on the neurones , that are pretty much permanent ?
Thank's in advance

 

[LucidSDreamr]

^ five years of again and chronic pain will dull u down on its own without the drigs...so what's the diff except feeling better?

 

[keeping]

^ five years of again and chronic pain will dull u down on its own without the drigs...so what's the diff except feeling better?

could you re-type that LSD man? couldn't understand it

 

[musique]

Thats true Lucid, good point.