A question about detoxing.
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JessFR
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In my experience, methadone vs subuxone comes down a lot to the size of your habit. If your habit is too big subuxone might not be sufficient to keep you comfortable. On the other hand, if your habit is too small and go on methadone you'll be one of those people who complain that methadone made them feel like a zombie and tired all the time.
It all depends on what's going to work right for you. At least it'll be a lot easier to move to methadone from subuxone if you need to than the other way around. Of the two, it's much better to try subuxone first if you think itll keep your cravings under control.
You said your big priority is stability and happyness. Good, that's exactly what your priority should be. But I feel I should ask, why do you feel the need to get off everything as fast as you can? In terms of actually staying off drugs, I think trying to get off EVERYTHING, especially if you have people depending on you being stable and reliable, is playing with fire and asking to relapse.
If you've had a substantial, long term opioid habit, and if you want or need stability, to be able to function in your life again. If that is the priority, I would go for long term maintainence. It can be subs, or methadone, or even Kratom, whatever keeps you comfortable enough to not need to use and that you can maintain in the long term. Trying to get off everything in the short term is going to be VERY VERY tough. It's your life, if that's what you want I wish you all the luck in the world and hope you make it. But it will be harder. And if you have children or others depending on you, I would go for what has the best odds of getting your life back on track and staying in track. And that's maintainence. Which maintainence drug depends a lot on the size of your habit. And your ability to get your dose reliably.
If I may ask, is there any reason in particular why you're so anxious to get off everything? I don't know if you've said so already somewhere but I didn't see a reason in your posts. I want you to succeed I'm just concerned cause I've seen a lot of people who wanted to just get off everything rather than compromise with ORT. And as a result went through a lot of pain only to wind up using again just like they started. That'd have been better off going with ORT and accepting that it'll be a long time before they get off everything.
I'm not saying that has to be you or that that's the case with your situation. Just that that's why I have concerns for you.
I notice you're suffering from a lot of fear and anxiety. Getting off everything will likely result in PAWS which will make that worse, all of which will make it hard to stay clean.
I'm actually trying to get off a long term heavy heroin habit myself right now. I'm not telling you this is what you should do, cause I'm not you, we are different people and our addictions aren't the same so just because this was right for me doesn't mean I'm saying this is what you should do. But I'm gonna tell you what I've done and why.
I was a heavy heroin addict, about a gram and a half a day IV, every day. Been using for years and been using that quantity for quite some time. I decided I'd had enough and wanted to stop. I'd tried methadone before but had little success. But that's cause they were anal about letting me increase my dose fast enough for how big my habit was, and I wasn't trying to quit, just avoid withdrawal. So I missed doses a lot and kept being put on a 30mg starter dose again and again.
They always made my feel like shit if I told them how much I used so I'd lie about it which made it worse.
When I decided to try again I started at a new clinic and they were a lot better. I decided to be totally honest this time. I told them how much I used and that I need to go up as fast as I can. They started me on 30mg, able to increase by 10mg every 2nd day. Finally some smart doctors. I got up to 70mg in just over a week. At my old clinic it would have taken a month, and it worked. I'm now over 30 days clean and have no physical cravings at all. Haven't since I got to a good dose about a few weeks ago.
Longest I've been off heroin in years. I was tempted to go with other options. Subuxone didn't seem like an option with my habit. I could have gone cold turkey, but withdrawal would have been brutal. And once I get off everything, I'm bound to get PAWS. And after all the shit I've done to myself and others while using, all that I've lost. With PAWS on top I'd never have been able to cope well enough to stay clean. And I decided if I was gonna do this, I want it to last or there's no point doing it at all. I could start tapering right away. But this has been a HUGE lifestyle change. I was panhandling every day, prostituting myself. Living with a bunch of other junkies. Now that's all gone, I left it all behind. Combine that with everything I've lost using. It won't take much for me to break and start using again. To give myself the best odds of success, I decided I shouldn't even be thinking about tapering off until long after I've gotten used to not living like that anymore. Not for at least a year or so. At least.
I don't wanna be on methadone the rest of my life, but I wanna make it this time. My loved ones have been put through so much by me. If I fail this time they might not help me again. And if I experience PAWS or severe long term anxiety and depression, I know I won't make it. So when I do eventually get off methadone, I'm gonna do it as slow as I possibly can. Snails pace slow.
That's what the evidence says has the best results statistically. That's what should be the most comfortable. Don't get me wrong here id love not to be a slave to drugs anymore. And so long as I'm on methadone I still am. I gotta go get my dose almost every day. See the doctor every month. But that's a small price to pay if the alternative is getting back on heroin. And it wouldn't take much for that to happen.
That's how I'm doing it and why. Maybe you can relate and maybe it'll be helpful to know. Then again maybe not. You're welcome to PM me if you have any questions or just want someone to talk to.
No matter how you do it I hope you make it. I just wonder if perhaps you're trying to achieve too much too soon. There's nothing wrong with trying to get further than I have sooner, so long as you won't wind up using again as a result. I feel like if I start using again, all the pain and effort I've put in to quitting, not to mention all the pain effort and money my loved ones have put in to help me, it'll all be for nothing if I don't make it. So I want the best odds I can get. If that means I gotta go slow and accept that I'll be on methadone for a long time, so be it.
It all depends on what's going to work right for you. At least it'll be a lot easier to move to methadone from subuxone if you need to than the other way around. Of the two, it's much better to try subuxone first if you think itll keep your cravings under control.
You said your big priority is stability and happyness. Good, that's exactly what your priority should be. But I feel I should ask, why do you feel the need to get off everything as fast as you can? In terms of actually staying off drugs, I think trying to get off EVERYTHING, especially if you have people depending on you being stable and reliable, is playing with fire and asking to relapse.
If you've had a substantial, long term opioid habit, and if you want or need stability, to be able to function in your life again. If that is the priority, I would go for long term maintainence. It can be subs, or methadone, or even Kratom, whatever keeps you comfortable enough to not need to use and that you can maintain in the long term. Trying to get off everything in the short term is going to be VERY VERY tough. It's your life, if that's what you want I wish you all the luck in the world and hope you make it. But it will be harder. And if you have children or others depending on you, I would go for what has the best odds of getting your life back on track and staying in track. And that's maintainence. Which maintainence drug depends a lot on the size of your habit. And your ability to get your dose reliably.
If I may ask, is there any reason in particular why you're so anxious to get off everything? I don't know if you've said so already somewhere but I didn't see a reason in your posts. I want you to succeed I'm just concerned cause I've seen a lot of people who wanted to just get off everything rather than compromise with ORT. And as a result went through a lot of pain only to wind up using again just like they started. That'd have been better off going with ORT and accepting that it'll be a long time before they get off everything.
I'm not saying that has to be you or that that's the case with your situation. Just that that's why I have concerns for you.
I notice you're suffering from a lot of fear and anxiety. Getting off everything will likely result in PAWS which will make that worse, all of which will make it hard to stay clean.
I'm actually trying to get off a long term heavy heroin habit myself right now. I'm not telling you this is what you should do, cause I'm not you, we are different people and our addictions aren't the same so just because this was right for me doesn't mean I'm saying this is what you should do. But I'm gonna tell you what I've done and why.
I was a heavy heroin addict, about a gram and a half a day IV, every day. Been using for years and been using that quantity for quite some time. I decided I'd had enough and wanted to stop. I'd tried methadone before but had little success. But that's cause they were anal about letting me increase my dose fast enough for how big my habit was, and I wasn't trying to quit, just avoid withdrawal. So I missed doses a lot and kept being put on a 30mg starter dose again and again.
They always made my feel like shit if I told them how much I used so I'd lie about it which made it worse.
When I decided to try again I started at a new clinic and they were a lot better. I decided to be totally honest this time. I told them how much I used and that I need to go up as fast as I can. They started me on 30mg, able to increase by 10mg every 2nd day. Finally some smart doctors. I got up to 70mg in just over a week. At my old clinic it would have taken a month, and it worked. I'm now over 30 days clean and have no physical cravings at all. Haven't since I got to a good dose about a few weeks ago.
Longest I've been off heroin in years. I was tempted to go with other options. Subuxone didn't seem like an option with my habit. I could have gone cold turkey, but withdrawal would have been brutal. And once I get off everything, I'm bound to get PAWS. And after all the shit I've done to myself and others while using, all that I've lost. With PAWS on top I'd never have been able to cope well enough to stay clean. And I decided if I was gonna do this, I want it to last or there's no point doing it at all. I could start tapering right away. But this has been a HUGE lifestyle change. I was panhandling every day, prostituting myself. Living with a bunch of other junkies. Now that's all gone, I left it all behind. Combine that with everything I've lost using. It won't take much for me to break and start using again. To give myself the best odds of success, I decided I shouldn't even be thinking about tapering off until long after I've gotten used to not living like that anymore. Not for at least a year or so. At least.
I don't wanna be on methadone the rest of my life, but I wanna make it this time. My loved ones have been put through so much by me. If I fail this time they might not help me again. And if I experience PAWS or severe long term anxiety and depression, I know I won't make it. So when I do eventually get off methadone, I'm gonna do it as slow as I possibly can. Snails pace slow.
That's what the evidence says has the best results statistically. That's what should be the most comfortable. Don't get me wrong here id love not to be a slave to drugs anymore. And so long as I'm on methadone I still am. I gotta go get my dose almost every day. See the doctor every month. But that's a small price to pay if the alternative is getting back on heroin. And it wouldn't take much for that to happen.
That's how I'm doing it and why. Maybe you can relate and maybe it'll be helpful to know. Then again maybe not. You're welcome to PM me if you have any questions or just want someone to talk to.
No matter how you do it I hope you make it. I just wonder if perhaps you're trying to achieve too much too soon. There's nothing wrong with trying to get further than I have sooner, so long as you won't wind up using again as a result. I feel like if I start using again, all the pain and effort I've put in to quitting, not to mention all the pain effort and money my loved ones have put in to help me, it'll all be for nothing if I don't make it. So I want the best odds I can get. If that means I gotta go slow and accept that I'll be on methadone for a long time, so be it.
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Jabberwocky
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Thanks for chiming in Jess 
Beenbetter
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Jess u are very right.
I guess I just want off everything so fast because I'm deathly afraid of the long term wd that comes along with subs. I cold turkeyed them years ago and it was beyond brutal, but the time I spent on subs was some of the most stable years of my life aside from the years after I got off them. it was a month after being off before I felt like myself again. But once I did I was like high on soberness.
The subs so far have kept me from being sick but the cravings are still ridiculous and sleep is not coming even with seroquil and doxylamine, etc....
I can fall asleep ok but wake up in a cpl hrs with ridiculous anxiety and end up pacing the house.
My kids come home today and I'm super nervous I sure hope they never have to deal w addiction. . I'm still ever so worried about returning to work Monday. I feel like if I had enough benzos to get me through these first few days on subs I'd be ok.
I guess I just want off everything so fast because I'm deathly afraid of the long term wd that comes along with subs. I cold turkeyed them years ago and it was beyond brutal, but the time I spent on subs was some of the most stable years of my life aside from the years after I got off them. it was a month after being off before I felt like myself again. But once I did I was like high on soberness.
The subs so far have kept me from being sick but the cravings are still ridiculous and sleep is not coming even with seroquil and doxylamine, etc....
I can fall asleep ok but wake up in a cpl hrs with ridiculous anxiety and end up pacing the house.
My kids come home today and I'm super nervous I sure hope they never have to deal w addiction. . I'm still ever so worried about returning to work Monday. I feel like if I had enough benzos to get me through these first few days on subs I'd be ok.
Beenbetter
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Do subs have the tendency to make any of u guys that have used them extremely volatile?
I'm not an angry person but I have found myself wanting to snap on everyone.
I'm not an angry person but I have found myself wanting to snap on everyone.
simco
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Do you mean, like, emotionally volatile?
Emotionally volatility (especially anger) is a very common side effect of ceasing opioid misuse. Obviously you're still getting opioids via the bupe in your subs. But it doesn't surprise me at all to hear that this is an issue for you. You've stopped using a drug that your body was dependent on (replacing it with buprenorphine, which is quite different from your DOC), and you've stopped all the behavior associated with your habit (scoring, the rituals around actually using, etc. I believe the anger you're feeling is due to these changes, not due to the suboxone in any direct sense.
The good news is that emotional lability tends to decrease over time during recovery.
Keep at it, man. You're making good choices and doing all the right things.
-Sim
Emotionally volatility (especially anger) is a very common side effect of ceasing opioid misuse. Obviously you're still getting opioids via the bupe in your subs. But it doesn't surprise me at all to hear that this is an issue for you. You've stopped using a drug that your body was dependent on (replacing it with buprenorphine, which is quite different from your DOC), and you've stopped all the behavior associated with your habit (scoring, the rituals around actually using, etc. I believe the anger you're feeling is due to these changes, not due to the suboxone in any direct sense.
The good news is that emotional lability tends to decrease over time during recovery.
Keep at it, man. You're making good choices and doing all the right things.
-Sim
Jabberwocky
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Antihistamines can increase RLS, so just a heads up if that becomes an issue.
Beenbetter
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I have noticed that tpd.
Dang diphenhydramine makes it worse!!
Dang diphenhydramine makes it worse!!
Jabberwocky
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What comfort meds do you have access to?
How are your withdrawal symptoms: What symptoms are you experiencing? How intense are they?
How are your withdrawal symptoms: What symptoms are you experiencing? How intense are they?
Beenbetter
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The main thing I'm experiencing right now is insomnia and mild rls. Not to mention unbelievable cravings, depression, anxiety and anger.
Beenbetter
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Sob.
I cracked.
Somehow I knew I would.
All the bs about the blocking ability of subs. Wut a joke. If anything it potentiated my DOC.
Well no way to get anymore because of funds. I have screwed my family out of so much money I feel like the biggest loser ever. I make good money and have pissed most of it away over the last little bit.
Shame hurts.
I've got O motivation to get out and work.
I hate this.
I wish the subs did what they used to for me. Maybe I'm not taking enough.
Either way, I have to stick with them and only them because I will have a uA Thursday when I go see the sub doc again.
Feeling pretty down right now.
I cracked.
Somehow I knew I would.
All the bs about the blocking ability of subs. Wut a joke. If anything it potentiated my DOC.
Well no way to get anymore because of funds. I have screwed my family out of so much money I feel like the biggest loser ever. I make good money and have pissed most of it away over the last little bit.
Shame hurts.
I've got O motivation to get out and work.
I hate this.
I wish the subs did what they used to for me. Maybe I'm not taking enough.
Either way, I have to stick with them and only them because I will have a uA Thursday when I go see the sub doc again.
Feeling pretty down right now.
Beenbetter
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Yes sim.
Emotionally volatile.
Just straight anger!!
I woke up in the middle of the night the other night and for no reason at all I felt rage towards one of the few people that truly supports me.
My wife.
No idea why. The feeling didn't last long thankfully but everything just seems so bla.
Emotionally volatile.
Just straight anger!!
I woke up in the middle of the night the other night and for no reason at all I felt rage towards one of the few people that truly supports me.
My wife.
No idea why. The feeling didn't last long thankfully but everything just seems so bla.
JK25
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I just came out of a 90-day rehab program. I quit cold turkey. I was on everything, stimulants, psychoactives, anaesthetics, downers, deliriants, opiates, pharmaceuticals you name it. I stopped every illicit drug on the day I got there and after 4 weeks I stopped all my psychiatric meds also. I feel pre-drug again.
Yes obviously it is problematic to quit like that because of the negatives but hey, I didn't seize, I didn't stroke out and I'm doing good. I hope this is it. I don't have another rehab in me.
Yes obviously it is problematic to quit like that because of the negatives but hey, I didn't seize, I didn't stroke out and I'm doing good. I hope this is it. I don't have another rehab in me.
Jabberwocky
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Just be frank with your doctor about this. Any doctor who knows what they’re doing with this expects a certain number or mis-steps by their clients as they get stabilized. Most people end up slipping up during the transition to ORT, and it isn’t the end of the world.
How much buprenorphine have you been using, and what did you slip up by using?
cj
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Emotional confusion is a totally normal part of this. Like TPD said let your counselor know and try to get to the bottom of why you are angry. Feelings are not right or wrong they just are
Beenbetter
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Goodness gracious.
I’m tryin guys. It takes some people a serious long time to get stable on subs.
Benzos Help more than anything with cravings for me. Kind of ridiculous high doses tho. Maybe it was just having to have some kind of mind/mood alteration while trying to stabilize. I’m doing a bit better. Would love to quit the subs completely now but that’s probly not a good idea. I am definitely in a better place right now as far as my addiction. Other areas of my life such as work are struggling atm tho. I find myself completely unmotivated and wanting to do nothing.
I’m tryin guys. It takes some people a serious long time to get stable on subs.
Benzos Help more than anything with cravings for me. Kind of ridiculous high doses tho. Maybe it was just having to have some kind of mind/mood alteration while trying to stabilize. I’m doing a bit better. Would love to quit the subs completely now but that’s probly not a good idea. I am definitely in a better place right now as far as my addiction. Other areas of my life such as work are struggling atm tho. I find myself completely unmotivated and wanting to do nothing.
Jabberwocky
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Try to focus on one thing at a time, right not putting your primary efforts into stabilizing on the medication. What kind of stuff are you struggling with in terms of work?
Once we start making progress, like with cravings and not having to do shitty stuff in order to fund/feed our addiction, it can be easy to feel like we need to make all this progress in other areas of our lives. Like we're making progress with the addiction stuff, so we feel we need to be making more progress in other areas of life. However, this stuff takes time. We can't force our personal and professional development. All we can do is put in the effort, planting seeds and tending to our proverbial garden so to speak.
As long as you can keep putting in the effort into healthy choices and responsible habits, you'll get where you need to be. Might not be what you imagined originally or happen as quickly as you'd like (although sometimes it happens faster than we'd like too), but sooner or later if you're putting in the effort things chance for the better. It's just a matter of learning to cultivate more patience and resiliency - no small matters true, but stuff anyone is capable of.
What areas are you struggling in right now Beenbetter? What areas of your life are you feeling better about?
Once we start making progress, like with cravings and not having to do shitty stuff in order to fund/feed our addiction, it can be easy to feel like we need to make all this progress in other areas of our lives. Like we're making progress with the addiction stuff, so we feel we need to be making more progress in other areas of life. However, this stuff takes time. We can't force our personal and professional development. All we can do is put in the effort, planting seeds and tending to our proverbial garden so to speak.
As long as you can keep putting in the effort into healthy choices and responsible habits, you'll get where you need to be. Might not be what you imagined originally or happen as quickly as you'd like (although sometimes it happens faster than we'd like too), but sooner or later if you're putting in the effort things chance for the better. It's just a matter of learning to cultivate more patience and resiliency - no small matters true, but stuff anyone is capable of.
What areas are you struggling in right now Beenbetter? What areas of your life are you feeling better about?
cj
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I highly recommend you stay on sub.
Prescottdave
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This is a perfect example in which tapering before induction is necessary. I was in a similar position after being on painkillers for 10 years due to a MVA. Why I am responding to this is many times those trying to induct will think they did not take enough suboxone and instead of reducing their dose of a full agonist they will just take more sub during the first few days. What happens in this situation is even worse PWD and the individual will go immediately back to a full agonist. Try reducing your dose of what ever opioid you take and get it down to an equivalent of about 30 mg of methadone or 60 mg of oxycodone.
Per guidelines set forth I think possibly by the NIH it is encouraged to have your dose equal to about 30 mg of methadone before induction onto buprenorphine. You also have to remember that with an extensive history of narcotic use it can take up to a week to stabilize onto buprenorphine. This means you will likely feel somewhat sick for the first week while your body adjusts to the lowered dose. I was able to adjust to suboxone transitioning from a dose of about 200 mg of methadone per day. It just took about 10 days of tapering down to 30 mg before I was able to properly induct.
cj
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To me those patients would be better off on methodone if all things where equal. Of course with the clinic system all things are far from equal unfortunately