Bupe Relapse 2 days into sobriety - seems to have shortened WD's?

[suessmayr]

I was on bupe 2mg after many months of reduction. I had closer to 4mg on monday when I had an exam, early in the morning, like 8am, then on tuesday I had about 1mg, thinking it would make things easier than reducing from 4mg.

Tueday I was ok, but wednesday night had TERRIBLE insomnia and RLS. God, I can't even begin to describe it. I took 600mg seroquel and it did fuck all. At about 7am on thursday morning I caved and took about .5-1mg of bupe to sleep.

I thought that this would have the effect of 'resetting' my withdrawal, so that I would have to begin again. But thursday night and, crucially, friday night, I was ok. It's been longer since that 1mg on thursday than it had been since the 1mg on tuesday, and I'm in much better shape.

My doctor suggested that rather than resetting my progress, the thursday dose could have had the effect of making the transition to sobriety a bit smoother, and it certainly feels that way.

I came off bupe once before at like 16mg, and after 5 days my WD's had not even begun. So I was prepared for like a solid 2 weeks of withdrawal, but it really feels like I've started to improve.

What do people think?

S

 

[amapola]

I think the last 1mg of bupe is helping ease you down just like a taper should. I don't believe you are out of the woods yet but if the next time you are hurting your try .5mg and then later .25mg you can gently withdraw over a period of time. Buprenorphine has a long half life so it is tricky to determine exactly how much is in your system and when you'll be hurting but slowly working your way down is a good way to go about getting off of it.

Bupe is bloody strong stuff and I can't imagine cold turkeying even off a few milligrams never mind 15 8(. Work your way down as needed and jump at .1mg or so and you'll be much more likely to succeed. Though of course it will take longer to get clean and you'll spend more time quasi sick which is the downside of the extended taper .

Some resources which might help...
The Opioid Withdrawal Megathread and FAQ
Tapering Plan Mega thread - community project
Suboxone/Buprenorphine Mega Thread and FAQ v13.0

 

[suessmayr]

Thanks for the advice and for the resources. I'm on uni holidays at the moment and I really need to use this time to sort my shit out. So I don't really have the luxury of tapering any more.

I began at 90mg methadone, then reduced 10mg weekly. Before the methadone I was on 28mg subs for about 3 years. I switched from 30mg to 4mg bupe and reduced from there. I was very fortunate to get some codeine and valium (only a very small amount, 7 days' worth) from my psychiatrist, so I'm just going to use that and try not to use anymore bupe.

I was able to go to the gym today; I didn't do much, but I was still able to do like 30 min of cardio. That is a very good sign for me, as, earlier in the week, I was practically bed-ridden. And I haven't had any bupe since thursday (60hrs ago), and only 4mg diazepam + 60mg codeine last night (17hrs ago). I feel stronger and happier.

I also have a pretty good anti-histamine called 'Restavit' which seems to be helping, if only for a few hours at a time.

It was a major setback for me to have to take that 1mg on thursday morning, as I couldn't tell my family and they think I've been clean since monday. That's mainly why I can't afford to use anymore bupe. Not that they know about the codeine, lol. But it seems somehow more harmless.

S

 

[suessmayr]

Also, the surest indication of how sick/high I am has always been for me the state of my stomach, viz., the liquidity of my turds. But as I've been taking immodium - once on wednesday, once today - I'm totally fine in that respect and as such can't tell how sick I really am. By the way I don't see what the fuss about imodium is, is 8mg-10mg too small a dose?

But as I said I feel happier and stronger.

S

 

[amapola]

Yeah doxylamine succinate will knock you the fuck out. Also you are right about if you want to get clean off bupe in a short period to stick with shorter acting opioids as it will progress much faster. If you feel guilty about the codeine (though 60mg is quite small) you could also try loperamide instead. It at the very least will help with the PNS issues and in larger doses has been said to help with CNS as well though it seems dirtier than codeine if you can get over the moral issues and not switch to abusing it.

The exercise is good even to just get your mind off things and help sleep.

edit: haha good timing with the Immodium. 8-10mg is too small to have any CNS action but will help with PNS symptoms.

 

[ss2brandon]

bupe provides relief for a very long time. even in minute doses. bupe tapers are just damn hard to get right. even if you can get to a ridiculous low dose, you will still feel a drawn out w/d

 

[DustnRoses]

suessmayr, glad I saw this thread, you and I are in similar situations. Well, somewhat similar...I just came off a month long binge on H, OC, etc. and got one 8mg Suboxone and about 12 tramadol to try to minimize the WD's while starting a new job, moving to a new city, etc. My doses went as follows...

Tuesday, woke up about 5 AM in WD (cold sweats, restless legs, very depressed, GI issues, etc.) took 3 tramadol immediately, then 2 more at night, with about 1 mg bupe...

Wednesday, took 2 tramadol, drove for 8 hours moving to my new city/job, felt like I was in some degree of WD when I finally got into a hotel that night, so took about .5mg bupe, no tramadol though...felt better, slept fine.

Thursday, felt depressed and probably just convinced myself that I was in WD, took 2 tramadol and maaaybe .2-.3 mg bupe around 5PM. When I say .2 - .3, it was such a small amount of powder, I barely felt it go up my nose, probably should've just put it on my finger and swabbed it in my nostril.

Friday, nothing...first day totally med free...really trying to be strong and get through it, keep telling myself that with my relatively short binge and only using bupe for a few days at minuscule doses, I should be OK...I even went to the gym, like you said, to at least try to help myself get some sleep at night...wasn't able to do a whole lat, but got a decent workout in...if nothing else it took my mind off of things for a little while.

It's now Saturday morning, 10:20 AM, so about 41 hours or so from last dose, and I feel alright...had trouble sleeping last night, but took a few melatonin and that helped a little...still slept for only about 3-4 hours. But today I don't have sweats, much anxiety, I'm able to sit on a couch and watch TV and feel normal. My emotions are still out of whack though...the smallest things make me cry. Things I don't even care about...like a classic sports story on ESPN. It doesn't make any sense.

Probably should add that I am not opiate naive...a month long binge for me is probably equivalent to a first time user going for 3-4 months...I've been through addiction many times, and my tolerance sky rockets within the first few days. Some people say a month long binge isn't enough to feel withdrawals, or enough to necessitate suboxone, but with my history, it is.

 

[TheMoney]

Nice, I didn't notice you were dealing with a similar situation suessmayr. I also wonder whether or not when I take opiates if I have 'reset' my withdrawals.

For example, as I said on my thread, I've been taking oxys for 3 1/2 weeks now, and I've often times felt withdrawal symptoms. I know oxys are weaker than bupe and that they don't last nearly as long... I do feel like being on them in the low doses that I have been taking them HAS lowered my tolerance and not worsened it. I think that's the case because yesterday when I took the 4mg of suboxone both in the morning and at night, it was noticeable. Whereas before I started the oxys, 4mg of suboxone would not have registered at all.

I don't think the 1mg you took 'set you back'... like amapola said, I think it's just part of the tapering process. From all indications, it's helped you. I'm glad things are working out. I'm also trying to get my shit straight between spring and fall semesters of college/university ; )

 

[xburtonchic]

ew for me it was the exact opposite! I jumped off Subs at .5 mg per day, couldn't handle the w/d's.... started taking Vicodin to try and battle them. The most I took in one day during my w/d's was five pills... FIVE, that's it. The rest of the week, I was taking one or two, maybe three depending on how bad the w/d's were. I took 25 over the course of a week, and when I ran out I assumed the worst of it would be over since hydro is so much weaker than bupe... HELL no. If anything, the w/d's hit me ten times harder after the half life of the hydro wore off. I was in so much agony with the shakes/chills/cold sweats/hot flashes/aches/etc. that the best I could do was lay outside on the concrete under the sun... for some reason, that's only way I felt comfortable. My mom finally dragged me to the hospital under my doctor's suggestion because my withdrawals were so bad, and guess what? I go into the hospital for help with withdrawals... and instead end up in the ICU for liver damage. Where they would not administer me ANYTHING.... no benzo's, no sedatives, nothing... because everything is metabolized in the liver. All they would give me was some sort of liquid that tasted like rotten eggs every few hours. Not complaining since it saved my life, but you get the drift. Basically, in my attempt to lessen my withdrawals with other opiates, I managed to accidentally overdose on tylenol. I would be dead right now if I hadn't been dragged to the hospital that day... I had absolutely zero idea that my liver was being damaged. After all, I used to take 25 vicodin per day... it blows my mind that the amount I used to take EVERY DAY, now taken over the course of ONE WEEK, was able to almost kill me. It was enough to convince me to scare me the hell away from any product containing any amount of acetaminophen. I won't even take cough medicine now. I was put back on the Subs so I wouldn't take more tylenol products (LOL like that would have been a problem anyway)... but after that experience, you can bet everything you have that I will be sucking it the fuck up next time I jump off and just dealing with the withdrawals. Better a few weeks of pain than an eternity of nothingness.

Moral of the story: Relapsing for the sole purpose of fighting withdrawals tends to do more harm than good... at least in my experience. Sure I've heard of it working for other people (which is why I tried it in the first place)... but clearly, everyone is different. And even if it's not a product containing tylenol... when you're in withdrawal, your tolerance is lower than it used to be, your body is out of whack... it's just too unpredictable, you really don't have any idea how ANY sort of drug is going to affect you at that point. I mean is that really a chance you want to take?

 

[suessmayr]

Dust n Roses - Thanks for sharing. Two things: (1) I don't think you should really be taking bupe simultaneously with full agonist opiates as this is a recipe for disaster or for feeling shit at the very least. Are you aware of this? Even at small doses it is unadvisable, because bupe is a partial antagonist and blocks full agonist opioids. (2) I relate deeply to what you say about uncontrollable emotions. Last time I tried to get clean, and went 5 days with no subs, I was literally beginning to cry at all sorts of things on the tv, at music, art. It was a bit absurd, like my body and mind were waking up after a long time.

The Money - Thanks. It sounds like you perhaps will not have as difficult a time as I might, given that you were only using for 3.5 weeks. From what I've read, the length of time a person has been using is crucial, as longer use leads to much higher blood concentrations.

xburtonchic - That's awful and a bit frightening. But I think my liver is basically fine (I vaguely remember having it tested once) and I never really got into the whole CWE/codeine + paracetamol thing, preferring instead to either use oxys/morphine or just go without. CWE tastes like piss and in my opinion is just not strong enough to justify so much disgustingness. Also, when I relapsed I took 1mg of bupe, which obviously does not contain any other toxins. I did get 20x (30mg codeine + 500mg paracetamol) from my psychiatrist but I'm only taking 3 daily, at night, and I think he would have warned me if there was any danger.


Well it's now about 76 hrs since my last dose of bupe. It would be so wonderful if, because I was only on a small dose when I stopped, I am already past the worst of it. Also I think I'm probably just used to feeling constantly shit, as the opiates interact in my case with the mood issues generally and I haven't really felt 'good' in many years.

S

 

[DustnRoses]

The only full agonist I use with bupe is tramadol, not anything else. Tramadol can actually be taken before, with, or after bupe, with no adverse effects. It has something to do with it not being a 'real' opiate agonist, but an antidepressant that activates the opiate receptors...IDK much about it, except that it helps with WD's and is safe to take with bupe.
But yeah, my emotions are fucked...I get extremely emotional over trivial things. Another weird thing though is that I feel like I have a new zest for life...I know it sounds cheesy but it's almost like you've been in a coma for a long time and are coming back into the world. Life on opiates is fun while you're doing it, you had a mission to accomplish every day and by the end you knew you'd be sitting on the couch high which was all that mattered in life. But afterwards you realize you were a pathetic loser, like a mouse in a maze, lying and scamming your way to get your cheese. lol. I have this new appreciation for everything and everyone in my life.

I'm over 50 hours now since any bupe or tramadol and really don't feel too bad...sleeping will probably be difficult tonight but that seems to be the only issue...I can get through the days doing normal activities, like showering, doing laundry, talking to people, eating meals, etc. things I typically can't do with WD's from short acting opiates.

 

[TheMoney]

suessmayr, yeah I've only been using OXYCODONE for 3 weeks, but I've been taking suboxone since January 2010 - for a year and a half now at 12mg's most of the time. I'm trying to break my opiate dependence that I built via suboxone just like you are... I just happened to have surgery and have been using other opiates the past 3 weeks; pales in comparison to my suboxone history.

But I think we're both gonna be alright : ) As addicts we fuck up our brain chemistry, and I know you already mentioned this earlier in the thread, but exercise is crucial for me to keep a balanced state of mind and somewhat happy because it releases all that good stuff we're used to getting from drugs.

 

[suessmayr]

I didn't know that tramadol could be taken concurrently with bupe; you'd wanna make sure that it's not dodgy advice. So many doctors are uninformed when it comes to these things. Some of the best ones I've heard include: "valium's not addictive, take as much as you want as often as you want and then just stop" and "bupe doesn't have bad withdrawals; just stop taking it at 2mg and you'll be fine". So you really need to be vigilant.

I'm a bit concerned about the role this codeine is playing for me at the moment. I don't think there would be a chance of me sleeping if I didn't take 60mg codeine + 4mg diazepam at night and I wonder whether I've essentially just swapped a codeine habit for a bupe habit, and whether I'll get fucked when the codeine runs out.

I also agree that exercise is good - though whether this is because it makes you feel proud of yourself for having done something, or whether it's because it does something chemically, I can't really tell. I'm so cold and uncomfortable that getting up, having a shower, getting dressed, leaving the house (etc.) is by far more difficult than the exercise itself.

S

 

[suessmayr]

And just to recap it's been about 100hrs since I last had any bupe (1mg) but I can't really tell what sort of state I'm in - apart from general despondency and discomfort. It's like I don't know if something will hit me tomorrow or if I'm getting better. Fuck bupe

 

[suessmayr]

Annoying, teary yawning with opiates/opiate WD's?

Does anyone else get this? It started with me the day I started to reduce my dose. Now I'm a few days clean and it's often uncontrollable, especially when I get into bed.

Not a big deal really but it's a fucken pain in the ass yawning every 30 seconds and having to wipe your face as it can make sleeping difficult.

S

 

[Jabberwocky]

yes, it's common. don't go on your usual rampage of starting 10 different threads on pretty much the same topic when you can add it into your original post. which i'm going to do now, merge this into the thread you started just before....

 

[DustnRoses]

Yeah the yawning and watery eyes is usually one of the first signs for me that I'm starting WD's. Everyone's different though. You said you're at 100 hours since that last bupe dose...that's great man, good job. I'm a little over 72 hrs myself, and feel OK...I can manage to sleep at night and exercise a little, and I'm eating more every day. I hear so many conflicting reports on how long to wait to be in the clear, some people say the WD's from bupe don't even start til the third or fourth day, but I hope that's only with people who have been using for months, at higher doses.

And I wouldn't worry too much about the codeine...I would try to keep it under control though...you definitely could just be substituting one addiction with another, I mean codeine IS an opiate, be it a very weak one.

 

[TheMoney]

I also agree that exercise is good - though whether this is because it makes you feel proud of yourself for having done something, or whether it's because it does something chemically, I can't really tell. I'm so cold and uncomfortable that getting up, having a shower, getting dressed, leaving the house (etc.) is by far more difficult than the exercise itself.

S

Well, both, but chemically definitely it plays a huge role. That's why there's the stats on addicts who enter into recovery/rehab and their relapse rate is highly correlated with the sugar they take in; if they eat sugar products in the beginning - which provide the dopamine release - they're less likely to relapse by far.

In fact, in my experience, the feeling of feeling good emotionally better about yourself is of course good and significant, but even that is a byproduct of the chemical releases in my opinion - and releases further dopamine and good things for you. I go for walks and stuff, and I don't feel 'good about myself' because I walked -- because I do it all the time if I'm healthy, but the exercise itself lifts my spirit and helps keep me stable.

 

[suessmayr]

yes, it's common. don't go on your usual rampage of starting 10 different threads on pretty much the same topic when you can add it into your original post. which i'm going to do now, merge this into the thread you started just before....

I don't really follow but I do find that offensive.

I remember when I came off bupe at 20mg I still felt at day 5 like nothing had really happened. It's hard to describe, but I somehow knew that the bupe was just slooowly leaving my body. It has to make some sort of difference that I stopped at 1mg, and that before that I was on 2mg for like a month. But I'll let you guys know if I've miscalculated.

Thanks for the help and good luck to those of you in similar situations!

S

 

[Secobarbital]

Does anyone else get this? It started with me the day I started to reduce my dose. Now I'm a few days clean and it's often uncontrollable, especially when I get into bed.

Not a big deal really but it's a fucken pain in the ass yawning every 30 seconds and having to wipe your face as it can make sleeping difficult.

S

Yawning and watery eyes were always the least of my worries during w/d.....