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Quitting Suboxone (recently switched to subutex) Cold Turkey- Physical danger??

M

MotherJupiter

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Aug 25, 2017
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Hello, i have been on suboxone for a couple years amd i recently discovered i am about 6 weeks pregnant. I talked to my doctor and they switched me to subutex and talked about doing a slow taper from my 20mg dailey dose, dropping me down a couple mgs every MONTH.

I want OFF AS SOON AS POSSIBLE. When i take it i go into instant panic attack feeling like im OD'g, the thought of my baby being born addicted send me into horrible panic attacks and i am just READY to be done.

I KNOW i have ZERO risk for relapse, if anything i would have a mental desire for more suboxone but with how the last doses have been, i am disgusted with it. I want OFF AS SOON AS POSSIBLE. I AM READY TO BE DONE in the next couple weeks.

MY PLAN is to drop half a tab every week till its gone so about 2 or 3 weeks.

MY QUESTION, other than the obvious severe withdrawl, pain, abdominal craps sweats yawning gastrointestnal issues, chills, all the basic withdrawls, and other than risk of miscarriage, are there ANY DANGEROUS physical effects like seizure or death or heart related dangers that could possobly kill me if i do this?
 
Greetings MJ -

Congratulations on your pregnancy! Will this be your first? By the way, feel free to not answer any question I ask, I don’t mean to ask anything uncomfortable.

First and foremost, we aren’t doctors here and can’t give medical advice. But I can tell you what I would do. I would take as little as I need to feel ok - regardless of the doctors direction. Especially if it was causing a lot of anxiety and discomfort, you don’t need to go at their pace, you need to go at hours.

However, I wouldn’t want to go through significant withdrawals early on in my pregnancy (or any part of it). I would absolutely never cold turkey off of any drug, much less one with as long of a withdrawal.

I also think that after you get down to about 2mgs, you need to go significantly slower. At that point I would start dropping by about 20% depending on how I tolerate it.

Best of luck!

- VE
 
Hey MotherJ, I want to preface this by saying you should definitely be asking a doctor these questions, and shouldn't take the word of someone on the internet over your doctor. And that if you don't trust what your doctor says, that you should get a second opinion from other medical professionals.

Opioid withdrawal isn't commonly known to lead to seizure or death, but people should be monitored for any complications in extreme situations, this probably being one. Certainly some people have reported having seizures related to opioid withdrawal, but it definitely isn't common. Heart related dangers would probably also be on a case by case basis, as I don't think the withdrawal directly causes harm but will increase risk factors. But it sort of just highlights the necessity of working closely with a trusted doctor, as if something were to happen there wouldn't be much to do besides dial 911. Most treatments and preventatives for the heart, that I'm aware of, come in the form of medications. Things like beta-blockers if high blood pressure is a concern.
 
Thank you guys, i have my first OBGYN appointment next week and i fully intend on disclosing my situation, and i did tell my suboxone doctor like i said, who said they wouldnt want to lower me more tham a few MGs every month or two. Idk if this is to prevent WD all together, or to prevent risk of relapse, or if its something more serious. As i said the only thing im at risk of relapsing on is the subs again. I took a 12mg dose this morning, had a horrid panic attack about it all while i was peeking, felt drained amd shitty the rest of the day amd 12 hours later on the dot the WD's started to set in. Restless legs, chils, intestinal distress and the anxiety. By 13 hours the anxiety had gotten to be too mucb given my horrendous anxiety dissorder situation and i ended up taking about 1,1.5 mg just to cut the racing pounding fluttering heart. Ive kicked heroin, crack, meth, and pretty much every other pill cold turkey in my youth, all some 10+ years ago, but all while i was younger, my anxiety was NOTHING compared to it is now and i didnt have any children. I do have 1 child, almost 2yrs old. I fully belive my surge of panic attacks and new intense anxiety is because now that i have my child i have something to live for, a reason to be good, so the threat of death or seripus injury is the absolute worst.

My fiance does not know im on the subs... He is HORRIBLY against all hard drugs ESPECIALLY pharmaceuticals due to family having awful problems with it. I thought i could get myself a script on the DL and enhance my ability to be a happy bubbly productive mother ( i also suffer from borderliner personality dissorder and major depression) but here i am some 3 yrs lateron 20mgs weened down from 24mgs (cut back half a tab a year or less ago) and more addicted than ever. I thought id be able to handle the WD's due to my past experiance kicking ass and cutting the shit when enough is enough bit with my current anxiety issues and new pregnancy i just dont think i can. Im going to discuss a slightly quicker taper plan with my doctors and i plan on sitting down and explaining everything with my fiancee. I stupidly thought id be able to nust quit before the fetus turns baby and possible neonatal WDs could effect little one so no one would ever have to know. The fear of his discuss for me not just for what ive been doing all these years and not telling him, but am also now doing to little baby, is just about too much for me to bear but it is all going to come to light one way or another weather i like it or not.

I should also add this little kicker: given all my anxiety based issues, the simple solution would seem to be to get on some sort of anti anxiety med right? WRONG. With my recent "omg am i dying am i ODing will my child find me" panic attacks, i CANNOT take anything other than motrin or tylenol (and these god forsaken subs apparently) without my panic taking over. Perhaps a pregnancy based non benzo antidepressant? Again i do plan on discussing this all further with my docs, i was just wondering if there are bigger picture WD symptoms here i was unaware of.
 
Funny side note, i haven't posted much here, but ALL of my posts refard such and such drug and panic attacks. I need to work in some sort of therepy to my impossible pregant with a toddler working a 2nd shift job schedule. Ughh
 
Opioid withdrawal while pregnant is VERY dangerous. I highly recommend you do not do anything to destabilize your bodies opioid levels on your own initiative.

Normally opioid withdrawal carries a virtually zero risk of death. But this is an exception. Opioid withdrawal in pregnancy is very dangerous. The standard practice is to use opioid substitution therapy until the baby is born then ween them off. This is very safe. And this is likely why they didn't want you reducing your dose quickly.

Find a trustworthy, competent doctor who has experience with pregnant women experiencing opioid dependence, and follow their advice.

I'm sorry, I can understand the desire not to have the baby exposed to opioids because of your use, but the simple fact is that the stigma people have about pregnant women and drug use is at odds with medical reality. Once you've become pregnant, getting off opioids is not advisable until after the baby is born. For both your safety and your babies.

Please, for your health and the babies, express these concerns to your doctor and follow their advise. If you have any doubts, and maybe even if you don't, consider getting a second opinion. If they recommend not adjusting your dose, regardless of your feelings I would follow their advise.

I know emotions aren't always rational, especially not while pregnant, so I totally get why you might be kinda freaked out right now, but you and your baby are much better off not putting your body through any avoidable stress. Withdrawal is very stressful. Staying on a consistent long lasting opioid is not.

Congrats on your pregnancy, I wish you all the best. I'm sorry if I've added to your anxiety at all, but what I read had me concerned for your health. Take care. :)
 
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I have a friend that switched from suboxone to Subutex while pregnangt and stayed on the Subutex till birth and thank god had a beautiful healthy baby. Hope that helps you alittle bit in your choice making. Looks like you are going to be a great mother considering how you care so much for the well being of your fetus :)
 
One of my best friends wife gave birth to her children while on Methadone, both girls are healthy. They are 11 and 9 years old now I believe, time goes fast seems like Lily was born yesterday. Like others have stated it would be very dangerous and could cause you to miscarry to suddenly stop. The baby having to be born sick isn't ideal but it's better than them never being born at all.

They are so young that they will have no memory of the withdrawal they went through. Physically they will be okay and this is the safest route. Don't worry about what others may think, it's none of their business whatsoever. I congratulate you on your pregnancy, you seem like a really sweet woman.

Take care ❤?
 
Hey motherJ!

I see you got some good advice. I think Jess is right that you need to find a doctor that has experience with this. That should also alleviate some of your fears (by the doctor talking you through how this is effecting the little one). I also think that if anxiety is an issue you should talk to them about beta blockers - they aren’t benzodiazepines but do work surprisingly well for the bodies physical response to anxiety.

On another note - I’m sorry this is forcing you to come clean about a medical issue you hoped to keep private. There are thousands of woman in your situation and that does NOT make you a bad mom/person. In fact, in my opinion, it is admirable. You have a medical condition (opioid addiction) and you are responsibly treating it (with subs). Now circumstances have changed and you need to adjust.

Please don’t spend much time beating yourself up for this - and don’t let anyone else spend any time doing that either. Come up with a plan, tell your husband what’s up, and move forward. Education on this will help you both I think.

My heart goes out to you because you have to deal with this. I know you want to be done with this - not for you but for your baby - but it’s more than likely best if you stay on the subs and let the doctors ween your little one off after birth. It appears to be the safest option (but check that with your doctor!). If you need any help finding a doctor with experience with this, feel free to PM me your general location and I can do some research for you!

- VE
 
Was the baby born with sny sort of withdrawl?
totach said:
I have a friend that switched from suboxone to Subutex while pregnangt and stayed on the Subutex till birth and thank god had a beautiful healthy baby. Hope that helps you alittle bit in your choice making. Looks like you are going to be a great mother considering how you care so much for the well being of your fetus :)
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Thank you all of the support and love and advice, it warms my heart to hear all the outpour of support. I really really thought i could bite the bullet for my little one. Husband is NOT going to be ok with the idea of baby born with wd, addicted and having to be weened off. We wanted another baby, we did nothing to prevent it, my sub use had become so normalized to me at that point that i honestly didnt even think about it being an issue. Once the teat was positive i thought id just kick it and it would be ok.

Its been about 14 hours since my last dose of 1.5mg. Im feeling it moderatly but not super severe but its hurting as you can imagine. My plan is to wait till im really feeling it and take the smallest dose i need to feel "better" not great and perfect but better. My husband is having a surgery tuesday that he is extrenely anxious about. Cant smoke weed until then so im going to wait till after all that to talk to him lol i think it will be better. My ob apt is 2 days after hia surgery so im going to try to go alone, talk with the doc and figure out a game plan before i come to him with all this. I just hope he will be as understanding as you all have been. ?
 
Everyone is talking about risks to the baby from WDing while pregnant, im wondering if the risks are just misscarrige or if there are other risks like birth defects and such. I know this is going to sound extremely awful and cold, but i feel like id rather risk loosing the pregancy while till in the very eairly non viable out side of the body stages than risk habing baby born dependant on this awful stuff.
 
Great links, kleiner.

totach said:
switched from suboxone to Subutex while pregnangt
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Suboxone and subutex both contain buprenorphine, a partial opioid "stimulator". The only realy difference is that suboxone also contains naloxone, which is supposed to "block" other opioids from binding to the receptors.

It may be wise to switch, as naloxone is generally unnecessary if you aren't relapsing one other opioids, as that is the reason the two drugs are combined and marketed as one.
 
Mafioso said:
It may be wise to switch, as naloxone is generally unnecessary if you aren't relapsing one other opioids, as that is the reason the two drugs are combined and marketed as one.
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Good advise

If the clinician determines that the risk/benefit favors buprenorphine, Subutex® (buprenorphine alone) is the preferred medication over Suboxone® (buprenorphine+naloxone). Subutex® is preferred for two reasons. The first is in order to avoid prenatal exposure to naloxone. Pre-clinical data suggest that fetal naloxone exposure produces maternal and subsequently fetal hormonal changes (Brunton et al., 2005; Douglas et al., 2005). The second is to reduce the likelihood of precipitating maternal and fetal withdrawal if buprenorphine was crushed and injected. For stabilized Suboxone® patients, guidelines recommend transfer to Subutex® following confirmation of pregnancy (CSAT, 2005). However, data to support the safety and efficacy of this recommendation are not currently available. Furthermore, the risk of diversion of take home Subutex® needs consideration.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633026/

Depending on how much you know about (clinical-) pharmacology it's always good to read up on guidelines etc
Here are some:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633026/
https://www.racgp.org.au/afp/2013/october/opioid-dependence-in-pregnancy/
https://www.acog.org/Clinical-Guida...d-Use-Disorder-in-Pregnancy?IsMobileSet=false


Methadone seems to still be the prefered opioid
For opioid-dependent patients entering treatment upon pregnancy awareness, methadone is the ‘standard of care’
Since methadone is the only medication recommended for pregnant opioid-dependent patients, buprenorphine should be prescribed only when the benefits outweigh the risks and the patient has refused methadone
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Edit: forgot to add the link
 
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Can you provide the reason and/or source as to why methadone "seems to be the preferred opioid"? Does it have a higher safety profile or something?
 
I made a mistake in the title of my OP I meant to say subutex not suboxone as i have already switched
 
Little progress update:
So far today i have dosed my suboxone 2 times to reduce the WD pain and anxiety, 1 initial dose of 4 mgs and then 2 hours later an additional 2mg dose. Usually before trying to taper my dose at this time of day would be 16mgs and im feeling alright (not great but managable) at 6mg so cut out about 10 mgs. Feeling somewhat optomistic about being able to taper but still really wanting to just be able to be done with it completely before damage is done to my baby.
 
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