Simco no worries, yes I live in the States. My therapist is CBT and DBT certified and it is mostly talk therapy while I’m there, coping skills and the like, talked about my past and how I got here. But there is homework that she likes me to do as well, mainly diary stuff. How I relate to different things and situations. What I want to change and reachable goals to get there. When I stop certain feelings that seem to trigger my use in the past. Then we break that down and dissect those feelings I journaled. And she is licensed to give me the subutex as well. I have seen therapists in the past as I was in a fatal accident that took my father and sister but I survived but was bad off for a long while. Hospital for over a month. I had severe head trauma and was in a coma for three weeks. The core reason for the PTSD I suffered which led me into alcoholism at an early age. It had been a while since I saw someone for help and while doing my search an ex of mine suggested a woman in her group that she thought I would fit with. I really got lucky. I knew what cognitive behavior therapy was but didn’t know much about Dialetical behavior was. Just more coping skills and how to change patterns.
So today I got back on subs and plan to work on myself before jumping off as I relapsed all the same. I felt pressure during meetings that I wasn’t clean even if it was a maintenance and didn’t want to be on another drug and felt that I had just done it for a month so I was sure I could do it without. And I made it until I had some real stress come into my life. I am the oldest child and have two other half sisters and have always been the Man of the house. Always looking out for them as I was devostated loosing one. Anyways I look forward to this as it is going to be a new start. I have always had substance abuse problems. Heroin came late into my life, it was always alcohol and other drugs. Hopefully I can get some sleep tonight, btw I was scripted 8mg but I’m going to try to keep it lower than that, she told me just to feel it out. I think 4 should be enough but I had a very high tolerance so we will see one day at a time. And I go once a week to therapy.
Great work getting back into treatment!
So today I felt light headed and brain farts. I do not like the way that the subtex feels in my system. I took 4 mg yesterday and today broke it into 2mg early and 2 mg after dinner. I feel sketchy in every way. Anxious, loss of appetite and generally just crappy. I ran three and a half miles and that was hard for me while it has been easier off the meds. I know it will take getting used to but I was feeling pretty good prior to yesterday. It’s a harder drug than I thought. Last time was coming into wds well I actually waited 36hrs before starting the subtex so I was already in withdrawl from the Heroin. I called my therapist and she was upset that I was resistant about the medicine. She told me that after the weekend if I wasn’t feeling better to call her and discuss either taking more or cutting it down. She really wanted me to take the 8mg she had scripted and said I need to give it a chance before being so resistant. I don’t know but I would rather not be on anything but I do want to succeed this time. Does anyone have any thought on this? My relapse was almost two weeks ago. Has anyone just started a maintenance program post withdrawl? How long did you stay on the maintenance program? The weekend is upon us and I have a very busy one. Man I feel off, got some sleep last night but not feeling tired at all. Does sub make you feel awful or is it just me. I know those coming off their doc it is a savior but just throwing it into the mix after you had clean time. Just in a fog looking for some answers. D’s Thanks for the info, I do not have a sponsor and have been attending different meetings at different places. I get a little frustrated with the war stories and at some of the people who were addicted to 50mg of hydrocodone for three months. I know take what you need and leave the rest. Man I’m bitchy today.
Although there are some benefits to less buprenorphine than more, during the stabilization period following induction less is not necessarily more. It isn't unusual for people to need 8-16mg the first week or two. For those with more average habits 8mg should be plenty, but there isn't anything wrong with taking more if you need it.
The general rule with buprenorphine is to take as much as you need. There is no magic number that works for everyone. A good base of thumb for a dose that will help you stabilize is the dose you were stable on initially when you used it prior. Another good way of doing it is taking 4mg then 2mg every two hours until you feel more or less normal (during the first week or two on buprenorphine some discomfort is expected, but you shouldn't feel totally sick or anything if you're taking enough).
I started buprenorphine back in the day after I had already detoxed myself. So I got on it about nine days abstinent. I felt that actually worked better than it had previously where I went directly from heroin to buprenorphine.
I stayed on buprenorphine treatment for about 18 months. The first three months were the best, because it was part of an IOP that I attended multiple days each week. After the first three months we were referred to a doctor and therapist combo. Buprenorphine started losing its effectiveness for me at some point around the 3-6 month point.
At 18 months it wasn't working very well at all, and I decided I'd rather just try to go without. Getting off was a lot easier than I thought it would be, although it wasn't a walk in the park. Eventually I got on methadone after continuing to struggle, and I found that a lot more effective in terms of cravings and clinic support.
You might want to consider looking into other meds to help you with this too. Gabapentin can be a very useful mood stabilize and anxiety medication. Likewise antidepressants can help some people (bupropion was really helpful when I was on methadone). A non-habit forming sleep med was also super helpful. Anything you can try that won't cause you more problems (I'd try and avoid benzos if you can, for instance) is worth trying.
Try not to get ahead of yourself with your recovery or treatment right now. Just focus on doing what you need to do to stabilize on buprenorphine and in therapy. Taking care of yourself in the present now, being kind and gentle with yourself as you continue exploring your recovery, will make the long term goals much more achievable.
Things tend to work out well in ways we can't begin to imagine when we focus on trying to live more in the present