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Opioids Coming off another Oxy binge, armed with Bupenorphine...advice wanted

S

SaosinEngaged

Bluelighter
Joined
Oct 25, 2010
Messages
449
I've been averaging about 90-150mg of Oxy/day for the past 2 months. Most frequently around 90mg, some days higher. I've successfully W/D from lower doses of Oxy using Lyrica and Kratom and Tramadol in the past (been a pain management patient for a while), but this time I have exactly 16mg of Suboxone sublingual film to work with. Time to bring out the big guns eh?

For my pain, I still take a mere 100mg of Tramadol daily (which actually helps, believe it or not) and do NOT wish to stop taking that as I switch to Bupe. This is mostly what I need advice with. I've read you CAN take Tramadol with Bupe and because of how different Tramadol is (part opiate, part SSRI), it doesn't screw up the bupe use. The reason I want to continue taking it and just not stop like I'm doing with the Oxy isn't because of the opiate part, but because of the SSRI. I simply do not want to deal with the SSRI side effects of the Tram w/d on top of this right now, so I wish to continue taking it until I can taper myself down.

My last dose of Oxy was 60mg at 10pm last night. I was planning on waiting until 10pm tonight before taking the Subs. I do need advice on how much to dose? If I recall properly, it's 1mg of Bupe to 30mg of Oxy? So 2mg should work? And is 24 hours enough time for sure? I find sometimes it takes my body a while to recognize it's in W/D. I usually don't feel it much until the next morning but would rather take it tonight to prevent that.

And lastly, does anyone forsee any issues with continuing the Tramadol while I switch over to fast taper Buprenorphine? Is what I've heard accurate that you can still take the Tramadol and most likely receive the SSRI effect from it un-impeded by the Bupe?

Thanks guys.
 
My plan is to wean off without even touching the second 8mg Sub (keeping that for another time, or if I have an unsatiable craving while I'm abstaining from use). Does that sound feasible here also?

I was thinking: 2mg tonight at 10pm, 2mg tomorrow, 2mg third day, 1mg fourth day, .5mg fifth day, .5mg sixth day.

How does that sound?
 
I don't know about how to wane off, but I'd recommend dosing only when you absolutely need to. Good luck bud, you'll thank yourself later
 
Make sure you wait until youre in withdrawals from BOTH before you dose the sub. So take at least 24 hours off from tram and oxy. Then when you dose the tram, MAKE SURE TO TAKE IT AFTER YOU TAKE THE SUBOXONE! I am not sure about how bupe works with tramadol, you seem more knowledgeable than myself, but I would assume that you must take the tram after the bupe to avoid PWD from the opi aspect of the tram.

And your plan sounds good. Except take as little as necessary. Try 1mg that first night. Even if it doesn't have you PERFECT, if youre good enough where youre not freaking out, only do the 1mg and deal with the minor annoyances (aches, stomach, etc). Take as little as possible of bupe and taper as rapidly as possible if you are trying for a quick taper such as that.

Like, dont even take it on day 5 if you can suffer only minor annoyances without it. Sure, you might not be 100%, but youd rather be a little bit miserable for a short time, than a little bit miserable for a long time, believe me. No matter how you cut it you will reach a point where you're uncomfortable: if you take as little as possible and only when you need, you will actually minimize the length of time youre suffering for, believe it or not.
 
Thanks for the replies.

Like I mentioned, I haven't touched Oxy since 10pm last night. I took one 50mg Tram this morning as usual, perhaps that was a mistake? Can I still take the Bupe later on? I mean, worst case scenario I'll get a minor amount of precipitated W/D from the Tram but it would ease the Oxy WD no?

That's the crux of my confusion as I don't know how to approach this with Tramadol in the mix. I am not trying to abstain from the Tramadol as it causes SSRI w/d side effects like seizures. I wanted to continue on the Tramadol while I detox from Oxy.

A few quick searches on the site had several people mentioned you can take both without ill effects which is why I'm looking for clarification here.

If I can't or shouldn't take the Bupe later because I took a Tramadol this morning I'm going to be very sick later and very unhappy. I'm already starting to feel classic WD here at work.
 
http://www.bluelight.ru/vb/archive/index.php/t-390275.html

This is the thread I'm referencing. They seem to imply Tram before or after Subs is not a problem. But what's not specified if it changes if one is dependent upon the Tram, which I am.

I'm very confused. I just want to detox without any SSRI side effects (which is why I thought I'd stay on the Tram a bit longer) and didn't have enough Oxy to allow me time to taper the Tram to nothing. So here I am.
 
It doesn't matter when you take you tramadol. I take 250-400mg, sometimeup to 650mg throughout the day, four out of seven days a week, and I'm on 8mg bupe/suboxone a day. Never had a problem regarding how to dose.

The above user was good to point out that you want to wait to take the suboxone until you're w/d from the oxy. I could take suboxone back in the day a mear 8 hours after my last dose of horse, but I am somewhat of an anomaly. You should wait an absolute minimum of 12 hours, but better off with 24 - the more the merrier in this case - before you dose you suboxone.

OP - your dosing schedule should work fine. Honestly I'd do 4mg/day one, maybe two doses of 2mg throughout the day, then 4/mg day two, again spread out absolutely in this case, then day three 2mg at once, day four 2mg in two different doses, day five 1mg, day six .5mg, day seven .25mg, day eight ,25mg.

Good luck OP! taking 100mg of tramadol each day is gonna make this a lot easier on you.

P.S. if the suboxone isn't doing it for you, get some diphenhydramine (benadryl) and tagamet. Take 50mg diphen and 600mg tagamet with your dose of suboxone and you'll notice a significant improvement. Do not do this every day though. it would only be advisable to do so on days one through four.
 
Honestly amigo if youre doing your research and feel comfortable trying it, go for it. 50mg tram isn't even a lot anyway. But as I admitted: i have little knowledge when it comes to tramadol, and virtually 0 knowledge when it comes to mixing bupe with tramadol. I honestly do not know; my assumption was based solely off the fact that tramadol does display some opioid effects, and I BELIEVE binds to a certain opioid receptor. Correct me if im wrong someone, but if tramadol does bind to any opioid receptors, the bupe will rip it off just the same as another opiate. It just wont stop the SSRI effects.

I guess if its such a small dose of tram it wouldn't really cause PWD since the bupe will then bind to the receptors. I mean its not like youve got 100mg of oxy on your brain suddenly being pushed and displaced. As far as I know, PWD is a result of opioid molecules being "ripped off" of the receptors and replaced with buprenorphine. Someone correct me if im wrong on any of this, but this is why i believe PWD are POSSIBLE.

In fact, someone else chime in regardless of whether im right or wrong. I do not know enough about tramadol to give any more than my conjectures Saosin, but I hope some of this was helpful? As I said, perhaps read those other threads if they seem to have more info specifically about the tram.

And definitely wait as long as possible to take that bupe! Some people only wait 12 hours but i always try and make it to 24. I'd rather be a bit uncomfortable that much longer than suffer PWD

EDIT: I saw theres a new post above me. Perhaps its because the tramadol is such a weak opiate to begin with, that your brain doesn't feel 'bad' when its being displaced from the receptors? Whereas if it were a stronger opi, like say, oxy, the opi is strong enough where you feel actual opiate effects, so then the PWD kick in.

To me, PWD is like this: imagine being high is a 10, and being withdrawal/sober is a 0. Normally when you suffer withdrawals, you slowly go down the chain: 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0. PWD are like going from 10->0 suddenly. So that drop from 10->0 is why it feels so much worse than regular withdrawals, where you go from 3,2, 1->0.

Again, i'm unsure how tramadol works with this because i guess tramadol is never going above like 2 anyway (for me at least!).

Hope i helped!
 
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Thank you so much. THAT was the answer I was looking for. Oh that's good news. In some ways I was dreading this Tramadol issue more than the Oxy because I know the Bupe is going to set me straight.

I've never been on this high a dose of Oxy consistently, so without the Bupe I'd be panicking right now. It's 1:30pm here since my last dose at 10pm last night and I'm already feeling mild WD. I have that general feeling of lousyness, feel very heavy/anxious and have been sweating for no apparent reason. Mentally, I want ot take the Bupe now but I know it'd be better if I try to wait out a full 18 hours, right?
 
Nah you guys have all been helpful, thanks. All information is helpful when you're in a situation you don't fully understand. We all try to make the best decisions based upon the knowledge we acquire through here and other outlets. I'm just grateful for this site or I would have never even heard of Buprenorphine, let alone how to use it and how wonderful it can be.

I'm gonna start with 2mg at least 18 hours post last dose, then see how I feel after an hour. I may go for the 4mg total today.
 
Absolutely. You'll want it now, but you already know why you feel like that. the more you can wait the better off you'll be in the long run. what do you think about the dosing I suggested in my first post? or are you going to stick with your schedule?

edit: nvr mind, you double posted and answered my question.

in the future OP, use the edit button and try not to double post. thx mate!
 
Even if you do get PWD with the Suboxone, that will only last from a half-hour to and hour before the bupe fills the remaining opiod receptors and you will stop withdrawaling. i would reccomend ^ the above dosing schedule, 4 mg of bupe the first day... well, that is the amount you will probably need, but try 2mg first and see how your body reacts.

It only feels better to take the bupe in heavy withdrawal because of the relief from heavy withdrawal, ya know? So if you want, you can take the bupe now without any problem. I'm a long-time suboxone patient... wish I knew how to get bupe by itself, but unless you are allergic to naloxone, my dr. only will prescribe the sub. Hope that helps, and good luck. I'm also weaning off and suffering, as well...
 
not to get off track, but trunk, where are you at in your w/d and what's the plan? you can pm me if you'd like... just curious.

yea, you could take the sub now, I just like to see people torture themselves a little when they're doing this sort of thing

OH THE PAIN IS SO DELICIOUS
 
The pain does remind you to stay on track!

Oh, I used to take about 200 mg morphine and 90 roxy a day. I used to take 2 8 mg suboxone, they cut me down this month to 1 1/2 strips a day, but it's complicated. I'll PM you.
 
Thanks guys. Yeah sorry about not editing, I'm at work and for whatever reason my archaic work browser won't allow "edits" to post when I hit the button. I have to type in the response box it won't send. Heh.

Yeah, I'm going to wait until later on tonight to take the Bupe although I like to torture myself and I brought the Sub strip with me in my shirt pocket, sitting there like a little devil of temptation.

I can handle the WD right up until the cramping and extreme RLS symptoms begin. That's when, in the past, I'd begin blasting my body with hundreds of MGs of Lyrica and 150mg of Tramadol or so to ease the symptoms. Believe it or not, for lower MG/day amounts of Oxy use (I'd say in the 30-90mg region, just shy of where I'm at) Lyrica for WD can be amazing. The last time I withdrew it was from 4 months of 60mg / day and I WD cold turkey with Lyrica and Tram and I never vomited once, nor did I have any sleepless nights. It was a godsend. Although at almost double the daily amount I'm leery of just relying on the Lyrica again, although I'm certain it would still help, I'd rather be on the Bupe.

It's just been nearly impossible for me to stay clean for any real length of time. I have a back condition so severe I can take my MRI into any pain clinic and walk out with a handful of blissful medications (which believe me, I've needed desperately to even have a chance at normal functioning, I have periods of pain so severe it's completely debilitating), and more recently acquaintences around me have come into massive quantities of opiates, so I can pretty much get whatever whenever. Not condusive towards sober living.

If I so chose, I'd be prescribed Oxy round the clock for years to deal with the pain, but I made a conscious decision not to rely on opiates as a crutch, which I've done so many times for both emotional and physical pain. If I didn't enjoy Oxy so much, maybe, but being given constant access to it almost guarantees I'll take more than prescribed and abuse it, which is the primary reason I'm trying to live cleanly. If the pain becomes unbearable (physical), I relapse for a bit until it calms down. That's how I've resorted to living my life.
 
I've gone through the cycle of dependence and full W/D about 4-5 times this year alone. This however is my first real experience with Bupe to help me get off, because this is the highest daily amount of Oxy I've ever been on.
 
Sorry for yet another post in a row (see above post for the reason why I can't edit in), but I just had another thought.

What about if I were to get prescribed Suboxone for long term treatment? Wouldn't that make sense since I've heard Bupe can be a strong painkiller, which I still need, and have the added benefit of me not being addicted to Oxy? What do you guys think of something like this? Living completely without any medication for me is unrealistic given my condition, I'm just having moral objections to depending on Oxy any longer in part because I simply like it too much and rely on it for much more than physical pain.
 
Well, I've heard it both ways, actually. My first suboxone doctor told me it doesn't work for pain. My second suboxone dr. said it does relieve pain just as well as methadone or vicodin, and tried to convince my mom to drop her opanas and roxies for it. (yeah right, she never will)
 
On it's own, Bupe is not ideal for pain management. However, it is still a very powerful opioid, and frankly, if one was on bupe long term for pain and addictiom (which it really sounds like you'd be the perfect candidate for OP, given your history), and also had access to IR Tramadol for breakthrough pain issues, well, I think that would be ideal.

OP, although this is a big commitment to make, it really sounds like you'd be best advised to seek out a suboxone maintenence program.

If you're pain isn't totally debilitating, which is sounds like it isn't, the bupe AND tramadol should work well for you, pain management wise. Let us know how things go. And best of luck my friend!!!!
 
You can take Tramadol and Suboxone together with no problems. The suboxone, however, will diminish any opiate effects you'll normally receive from tramadol. Sometimes, though, believe it or not, they do seem to have a synergy, minus the snri and epinephrine aspect.
 
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