I'm very sorry to hear you can't go back to your doctor right now, and that you are almost out of morphine. That just means you are going to have to be a little stronger, and do more prepetration on your own, but you can do it. I hate the idea of me saying anything that causes you discomfort, but I would try my hardest to not ever start on the suboxone. And that means going cold turkey first(which I believe is your plan) I wasn't sure if you actually had 5mg oxycodones on hand or not, but if I were in your situation and had such little experience with tapering, opiate WD, and suboxone, I would use them as sparingly as possible to deal with my pain until I could get in to see my doctor, I don't know what your financial situation looks like or if you have to report in to work or not, popping 5mg oxycodone every 4 hours because you have to show up to work could actually be a step backwards. I'm honestly a little self-conscious about what I say right now, because Keif was totally correct in what he said. I don't want you to take anything I say as gospel or get you to do something you aren't totally on board with.
But if this is a good time to do this, don't let me stop you.
That sounds like you plan on taking 1/4th of a strip, or 2mg. Not that this is an outrageous dose, but If you are trying to taper off the sub in 4 days, in my opinion, it is going to be easier, in the long run, to induct with the smallest amount possible. Although it would definitely be easier in the short term to just dose 2mg, and move down from there. Honestly, if you have the time, I would start with .5mg, or 1/16th of a strip. and then add .25mg every 90 minutes until you feel better. But that could mean feeling pretty awful for a few hours. I know working with the strip at these small doses can be tough, you can use tweezers and a very small pair of sharp scissors or a razor blade and cut the strip into tiny squares. Or create a solution, and use volumetric dosing.
Just getting it down to .5mg per dose means cutting that strip in quarters, then each quarters into quarters. You'd then have to half each peice to get down to .25mg, you can see how quickly this becomes a physical barrier to taking such low doses. Now I do know quick tapers are much more forgiving, for all I know you would be fine taking .5mg a day or even .5mg twice a day then stopping if taking bupe for less than a week. But in my personal experience, which is with people taking it for very long periods of time, they want to get to .25mg per day or less and stabilize on that dose before stopping.
Here is a quote from another message board about someone doing just that.(volumetric dosing)
You can also google volumetric dosing and read up on it a little until you have a firm grasp on the concept, and can adjust the amount of liquid to both meet your needs and suit the tools you have available. You can use a metered dropper, an oral syringe, or a real syringe with no needle on it. I know for a lot of Americans the metric system can be a little tricky at first, but its based on 10's. 1 liter = 1000 milliliter, 1 gram = 1000 milligrams, 8mg = 8000 micrograms. 500 micorgrams(mcg) = .5mg(milligrams)
A good idea might be to use 8ml of water so that 1ml = 1mg, and half a milliliter would be half a milligram. If thats help conceptually.
I don't want to deter you from your stated goal of 4 days, but if that pace seems unreasonable or at the end of the 4 days you aren't quite ready to stop don't be too hard on yourself, if you need to extend that to a week there is nothing wrong with that. I don't know how much suboxone you have on hand, if it is only 1 strip, then I personally would try to struggle through the WDs during induction the best I could so I would have more on hand to extend my taper if necessary.
I know these seem like miniscule doses, but jumping off at even .5mg per day of suboxone can be rough. Of course this applies more to someone who has been on suboxone maintenance for a very long time, quick tapers are much more forgiving. Since you have chronic pain where people would normally try to tough it out at night to stick to 1 dose a day, I know that is when you are going to be hurting the most, and I think its probably going to be better to not be exhausted and drained both physically and mentally from not sleeping at night due to no pain relief; perhaps try to get down to .1mg twice a day.
And let me just say that when it comes to QUICK buprenorphine tapers, I am NO EXPERT. If one of our wonderful moderators such as toothpastedog, Kief Richards, or one of our many very knowledgeable members has more first hand knowledge of the subject and is already helping you through private messages, take their advice over mine. Especially when it comes to how aggressively you should taper, and what is a good stopping dose.
I'm just trying to offer as many plausible choices as I feel comfortable suggesting, and hoping they are able to inspire you to come up with a plan that works for you, I'm very sympathetic to someone in your situation who has only been following the advice of their doctor, and imagine you must be feeling pretty lost and overwhelmed right now trying to soak up all this new information so quickly, and knowing which choice to make must feel impossible.
edit: Here is the link to the thread that quote can be found in. It's basically a diary of said user tapering off lower doses of suboxone. I thought reading his experiences and what symptoms he faced could be useful.(there's no problem with linking to another message board is there mods?)
http://www.suboxforum.com/liquified-suboxone-taper-method-far-good-t296.html
But if this is a good time to do this, don't let me stop you.
That sounds like you plan on taking 1/4th of a strip, or 2mg. Not that this is an outrageous dose, but If you are trying to taper off the sub in 4 days, in my opinion, it is going to be easier, in the long run, to induct with the smallest amount possible. Although it would definitely be easier in the short term to just dose 2mg, and move down from there. Honestly, if you have the time, I would start with .5mg, or 1/16th of a strip. and then add .25mg every 90 minutes until you feel better. But that could mean feeling pretty awful for a few hours. I know working with the strip at these small doses can be tough, you can use tweezers and a very small pair of sharp scissors or a razor blade and cut the strip into tiny squares. Or create a solution, and use volumetric dosing.
Just getting it down to .5mg per dose means cutting that strip in quarters, then each quarters into quarters. You'd then have to half each peice to get down to .25mg, you can see how quickly this becomes a physical barrier to taking such low doses. Now I do know quick tapers are much more forgiving, for all I know you would be fine taking .5mg a day or even .5mg twice a day then stopping if taking bupe for less than a week. But in my personal experience, which is with people taking it for very long periods of time, they want to get to .25mg per day or less and stabilize on that dose before stopping.
Here is a quote from another message board about someone doing just that.(volumetric dosing)
You can also google volumetric dosing and read up on it a little until you have a firm grasp on the concept, and can adjust the amount of liquid to both meet your needs and suit the tools you have available. You can use a metered dropper, an oral syringe, or a real syringe with no needle on it. I know for a lot of Americans the metric system can be a little tricky at first, but its based on 10's. 1 liter = 1000 milliliter, 1 gram = 1000 milligrams, 8mg = 8000 micrograms. 500 micorgrams(mcg) = .5mg(milligrams)
A good idea might be to use 8ml of water so that 1ml = 1mg, and half a milliliter would be half a milligram. If thats help conceptually.
I don't want to deter you from your stated goal of 4 days, but if that pace seems unreasonable or at the end of the 4 days you aren't quite ready to stop don't be too hard on yourself, if you need to extend that to a week there is nothing wrong with that. I don't know how much suboxone you have on hand, if it is only 1 strip, then I personally would try to struggle through the WDs during induction the best I could so I would have more on hand to extend my taper if necessary.
I know these seem like miniscule doses, but jumping off at even .5mg per day of suboxone can be rough. Of course this applies more to someone who has been on suboxone maintenance for a very long time, quick tapers are much more forgiving. Since you have chronic pain where people would normally try to tough it out at night to stick to 1 dose a day, I know that is when you are going to be hurting the most, and I think its probably going to be better to not be exhausted and drained both physically and mentally from not sleeping at night due to no pain relief; perhaps try to get down to .1mg twice a day.
And let me just say that when it comes to QUICK buprenorphine tapers, I am NO EXPERT. If one of our wonderful moderators such as toothpastedog, Kief Richards, or one of our many very knowledgeable members has more first hand knowledge of the subject and is already helping you through private messages, take their advice over mine. Especially when it comes to how aggressively you should taper, and what is a good stopping dose.
I'm just trying to offer as many plausible choices as I feel comfortable suggesting, and hoping they are able to inspire you to come up with a plan that works for you, I'm very sympathetic to someone in your situation who has only been following the advice of their doctor, and imagine you must be feeling pretty lost and overwhelmed right now trying to soak up all this new information so quickly, and knowing which choice to make must feel impossible.
edit: Here is the link to the thread that quote can be found in. It's basically a diary of said user tapering off lower doses of suboxone. I thought reading his experiences and what symptoms he faced could be useful.(there's no problem with linking to another message board is there mods?)
http://www.suboxforum.com/liquified-suboxone-taper-method-far-good-t296.html
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was it about how to treat acute withdrawal?