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Bupe Embeda and Suboxone

I think people are mostly confused because 30mg of morphine per day is such a low dose.

I mean... how much buprenorphine are you planning to take, anyway?

Because your opioid tolerance right now is in all likelihood much lower than it was back when you were on 3x8mg of suboxone.
Suboxone is usually employed to help people quit high doses of other opioids; if you were to take 8mg of suboxone, it would hit you way harder than your single 30mg Embeda.
 
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Hodor......thank you for being so kind. As I have said I'm very new to all of this. I was only going to take .25 of a pill of the Buprenorphine three times a day to get me through 3 or 4 days and I don't think I should start it until I have gone through 48 hours of being off the morphine just to be on the safe side. What I am really confused about is will I being going through withdrawal from the Suboxone and the morphine? I was weaned off the Suboxone over 4 days and that was 2 months ago. As I said, I don't know much about this. Thanks!
 
Hodor.........wanted to let you know I take Clonodine twice daily for my high BP and Gabapentin (300mg 3xday). Someone posted that these drugs help with withdrawal.
 
Sorry, my friend. I didn't realize how truly new you were ;) So, OP stands for Original Poster or Original Person or Original-Pawn-In-My-Twisted-Game. In this context, it stands for Original Poster. It's something you say when you mean to refer to that person, but want to do it quickly.

I wasn't fully aware of your situation and perhaps I should have been. So, if I'm understanding correctly, your hope is to go back to your doc and begin a different medication, as the Morphine is not working for you. Have you had Morphine in the past without the negative symptoms?

So if you're just trying to "bridge" yourself to your appointment, I think you're actually going about it in a pretty sensible way. As an addict, I've done this countless times, as one cheap tablet could potentially last me 2.5 days, even with a heavy habit. With that being said, the main takeaway for you is going to be waiting longer than 24 hours, until you are very sick and only then should you administer a small amount of Buprenorphine just to test the waters, then titrate.

Let us know if there is anything important that we have missed.
 
Thank you so much! Yes.....this is all VERY new to me. One person posted something about talking to my doctor when I am serious about getting clean. This is so foreign to me, I can't begin to tell you. I never judge anyone. I am 61 and my older brother who is 64 was a drug addict from age 13 well into his 50's. He did serious drugs that totally messed up his mind, LSD, etc. It breaks my heart because he now lives in a group home and just can't function in the real world. When we talk he can only talk about Woodstock, the Beatles, Jimi Hendrix and every time I hang up the phone with him I cry. So, seeing what happened to him has made me so afraid of any kind of drug and especially something that can be addictive. It sounds like you certainly know what you're talking about. I will wait 48 hours and see how bad the withdrawal is and if I feel I just can't handle it I will only take a tiny amount of Suboxone. Thanks again for your help.
 
Gabapentin is also a great way to detox a small habit. Likewise tramadol if there are not any contradictions. Or kratom.

Honestly though, with a habit this size, gabapentin is awesome. Especially if one isn’t already tolerant to it, it works very well for detoxing. Only issue is tolerance builds fast, but if you’re only using it to detox it’s a nonissue. Gabapentin is also super cheap and any doctor in their right mind would prescribe it for someone trying to get off morphine.

In terms of buprenorphine, if you’re not looking to get on maintenance, than yes it’s important to be careful how it is used. That said, if it’s all that you can get, it will work very well for this purpose.

Best part is that one 8mg pill or strip should see you through withdrawal. Try dosing 0.5mg ever 90-120 minutes, not going above 2mg/day. 2mg/day for four days will see you through acute withdrawal and won’t end up leading to dependency.

In the unlikely event 2mg/day isn’t enough, as long as the buprenorphine isn’t taken for more than a week there aren’t really issues with dependency. It is very rare for someone to become dependent on buprenorphine after just a week or use for detoxing. Just keep in mind buprenorphine is VERY potent. And less is more with this stuff when using it to detox.

It may be overkill in terms of potency, but if only a little is used buprenorphine will work well for this purpose. Honestly I wouldn’t recommend going in patient for a detox like this. Inpatient detox have a lot of issues, especially cost. Unless the OP feels they can’t do this on their own, they’re probably going to be better off just taking care of themselves at home.

Love seeing threads like this with so much quality feedback :) keep doing what you’re doing folks!

Edit: after looking more at the OPs posts, it seems like maintenance might be a good idea. Have you ever considered methadone OP? That works very well for pain of pain is also something you are dealing with, and generally if you’re on disability methadone is very cheap (depends on the state, but if you’re on CA’s disability insurance you get your methadone for free).

Something to consider. Methadone has a lot of stigma surrounding it, but most of it is bullshit. It’s a highly effective treatment if you’re likely to continue dealing with issues related to opioid use or pain and will require ongoing care. Plus the clinic provides other service, more than most buprenorphine doctors (less than an IOP but more than a private physician). Methadone isn’t something to be taken lightly, but neither is buprenorphine, morphine, or really anything else we are suggesting.
 
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PW2244 said:
Prescottdave, No, I was on Suboxone for two years which my doctor prescribed for back pain that I've been living with for 20 years. I have been seeing the same doctor for two years and two months. As I said, the Suboxone helped with the pain for a while but it only took the edge off. What I am asking is: Will the fact that I was on Suboxone for two years and then MSContin for a month and Embeda for 2.5 weeks bring on very bad withdrawal? PLEASE do not judge me and talk about getting clean. I have never abused drugs in my life. This site is very new to me and I am surprised at all of the posts about people who do abuse drugs, but I am not here to judge anyone. I am just trying to reach out to someone who knows much more about these drugs than I do. You try living for 20 years with 6 hernaited disks, degenerative disk disease, spinal stenosis, scoliosis and arthritis in my spine, hips, knees and hands. It's not easy, but I chose to stay away from any opiates for 18 years and I finally gave in because the pain became unbearable. This is all very new to me.
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So you have been on opioids for over two years as buprenorphine is a strong opioid. No judgement as I am also on opioids buprenorphine to be exact. It is just good to understand the reality. So for doing painkillers/opioids for two years I would say the WD will be hard. Unfortunately sub for 30mg morphine habit is overkill. If you are serious about getting off opioids or transitioning back onto suboxone I would speak with a trained professional such as your doctor.

This is also important due to the several serious pain conditions you live with given the WD will be extremely uncomfortable.You say you are new which is cool. Just so you know buprenorphine is an extremely strong opioid so yes it will effect your hopeful transition off the morphine.

I believe if a person is serious about getting off their pain medication it is important to do it under the care of a doctor. This is a common suggestion made to many people such as yourself who are in your position. Just because I may be suffering from chronic back pain does not mean I will not seek out medical oversight for an opioid detox.
 
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Prescottdave said:
So you have been on opioids for over two years as buprenorphine is a strong opioid. No judgement as I am also on opioids buprenorphine to be exact. It is just good to understand the reality. So for doing painkillers/opioids for two years I would say the WD will be hard. Unfortunately sub for 30mg morphine habit is overkill. If you are serious about getting off opioids or transitioning back onto suboxone I would speak with a trained professional such as your doctor.

This is also important due to the several serious pain conditions you live with given the WD will be extremely uncomfortable.You say you are new which is cool. Just so you know buprenorphine is an extremely strong opioid so yes it will effect your hopeful transition off the morphine.

I believe if a person is serious about getting off their pain medication it is important to do it under the care of a doctor. This is a common suggestion made to many people such as yourself who are in your position. Just because I may be suffering from chronic back pain does not mean I will not seek out medical oversight for an opioid detox.
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Great post!

Might be a relatively small habit they’re dealing with, but if they’ve been on opioids for that long it’s important they take things carefully.

It also makes me think buprenorphine or methadone is viable, probably methadone over buprenorphine as it works better for pain and can be cheaper with disability.
 
Prescottdave.....thank you for all of your advice. No one, including my doctor, ever took the time to explain to me that Subxoxone is a strong opiate!! He knew I was nervous to try narcotics like Percocet, etc. and that is when he recommended Suboxone. I have learned much on this site and thank you again for your help.
 
Thank you so much for all of your advice. I really am so grateful to everyone who has written to me. I really have been in the dark! My doc never took the time to explain that Suboxone is a strong opiate. He just knew I was very much afraid of trying things like Percocet, etc. because I have a brother who became addicted to serious drugs when he was very young. From now on I will do a lot of research if a doctor recommends something that I know nothing about.
 
Just saw your post about previously taking suboxone for pain management, PW2244. That really does complicate things, and honestly I think your doctor really fucked up by advising you to do that. For one when buprenorphine is used for pain, especially since you weren't already highly tolerant to opiates, you should have been taking Temegesic, which comes in doses of .2mg not 8mg, thats correct point 2. And by instructing you to take 24mg of bupe daily he not only fast tracked you to dependence but also jacked up your tolerance so no opiate would work the same ever again. He should have known better.

Luckily, it seems you were able to switch back to a low dose of morphine seemingly with ease and have been stable from there, so I'm not sure how much this changes things from a functional standpoint. Although I am less optimistic about the ease of which you will be able to stop taking your medication. I still think you may want to give cold turkey a shot and see how it goes. If not well, then you should proceed to taper.

You can do this with or without your doctor, but I suggest you do it with. You can either break your pills in half, then quarters, morphine SR will mostly remain SR even after being broken in half. Or talk to your doctor and get him to script you a lower dose. You could also consider switching to the oxycodone 5mg, but given your inexperience with narcotics this may be a little more difficult or at least a more lengthy and research intensive proposal. It would look something like taking 5mg every 4-6 hours for a day or two, then breaking them in half, maybe still take 5mg in the morning, then take 2.5mg every 4 hours(or longer if you can manage it), and then either breaking them into quarters, or cutting out one of the doses each day. I am also not sure how your pain is going to play in here.

Well since you already take clonidine I don't know how much help it will be, some I assume, but maybe not as much as it could have been. And I cannot myself advocate increasing the dose on your own, even temporarily, although this may be a valid idea. But its good that you are already familiar with gabapentin, GP can be a great med for opiate WD. We call meds like these "comfort meds" you may want to use the search engine and google and check out the mega thread for more info on "comfort meds" and see which ones you think will be of the most help to you. But for the gabapentin, tell your doc you are stopping your opiates and you want to up your dose of gabapentin so it will provide some relief during WD. Assuming there are no medical barriers, given your history and temperament you could probably ask for a couple weeks worth of valium as well, as far as comfort meds go it doesn't get much better than a benzo(such as valium, klonopin, restoril, xanax).

edit: and only you know your pain, and what you can handle, but you should be honest with yourself about your quality of life free of narcotics. I understand the urge to not be on these drugs forever, but if living a full life just isn't possible without some opiate don't let the stigma surrounding them force you to live in pain. Although, chances are you will be forced to return to them later in life, and when you do they will work better if you have 10-15 years opiate free before going back on them. But if it just isn't possible then you should explore why you want to stop taking them and work with your doctors to create a sustainable pain management regimen that addresses those concerns. I believe someone suggested methadone(from your doc, not a clinic), thats not a bad idea, highly analgesic, and very long half life to avoid repeated dosing and probably a less noticeable effect on your psyche.
 
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Hey Coolwhip! I totally appreciate where your heart is at and love the compassion that you're showing the OP here, but I don't want us to be giving outright medical advice to people here. What I mean is deliberately suggesting which medications are or are not appropriate for a certain person is out of our purview. If someone needs advice regarding how to withdraw from a drug in comfort, sure, we can throw out some helpful suggestions, because withdrawal is something we really know.

Not to mention the fact that withdrawal is by definition, a temporary process. For this reason, we can feel comfortable helping people fill in the gaps in terms of addiction knowledge between them and their doctors. Often, doctors know much less regarding addiction than addicts who have experienced it first-hand. For this reason, we provide this kind of advice. It's just that we can't be giving straight-up medical advice to people, as this can get us in trouble.

No worries man, just wanted to put that out there!
 
Sorry, definitely didn't intend to do so and would advise anyone to discuss all these options with their doctor first before taking action. The only thing I suggested you could perhaps pursue on your own was tapering off morphine, that did not apply to any of my later suggestions although I could see from the wording how it could have been taken as so. I just know gabapentin is a very safe drug, very effective for WD, with an extremely high TI and thought since the OP is already taking it then it would make a lot of sense to utilize it in quitting narcotics. But definitely talk to your doctor first before taking more than your prescribed dose, and per my last post don't screw around with your BP meds on your own.

It is as Keif said, most doctors who don't specialize in this sort of thing won't be able to give you as helpful of advice for navigating WD as you can get here but you still need to talk to them first to make sure its safe for you to pursue any options we offer. In my head I imagined you were currently taking somewhere around 300-900mg per day of gabapentin, and you could perhaps increase that by ~50% for your WD period, but for all I know you are already taking 3,000mg a day, so don't act too quickly on any suggestions I make. Or you may want to avoid using gabapentin in that way altogether, because you don't want to risk changing its effective in treating your nerve pain hereinafter.

And for anything you find via the mega thread or search engine concerning comfort meds, if they aren't OTC make sure you are only taking them with your doctors approval. In my earlier post I did just throw gabapentin/clonidine out there without any info or the stipulation that you talk to your doctor before utilizing them for this purpose, which I should not have done. And in case I forgot this caveat anywhere in my later post, talk to your doctor before changing your prescription regimen or taking any RX drugs other than for their prescribed purpose.
 
Thank you so much for all of the information. I really appreciate the time you took to explain everything so well. Unfortunately, I have capsules, not pills, and I only have 2 left. I was supposed to see my doc today, but I don't have the money for the copay. So.....it looks like I have to get through the withdrawals on my own. I'm a little nervous because I guess it's going to be really tough. I think I am going to be forced to use Suboxone to get through it. I will wait 48 hours after my last Embeda and take .25 of an 8mg Suboxone pill. I know to only use a tiny amount of Suboxone to get me through 4 days. I'm assuming after 4 days that I can stop Sub and I will feel ok. I know my pain will be through the roof, but I will just have to live with it.
 
Keif Richards.........I just read your post to Coolwhip. I totally understand where you're coming from, but I really appreciate so much the feedback I have gotten from everyone. At this point I am going to tough it out and go through withdrawal and I will most likely need to use Suboxone if I'm really feel miserable. I know to only use a tiny amount of Sub each day and I guess 4 days will be long enough. I will wait 48 hours after my last Embeda and see how I feel. I have gabapentin and clonodine because I have been on both for a few years. I don't know how much they will help because I've been on them for a while. I honestly wish I never got into all of these meds, but my pain is just so awful 24/7 and I felt desperate. I did not know that by taking Suboxone at a high dose for 2 years no opiate would work on my pain. The Embeda barely touches my pain. Thanks so much for everything!
 
No worries.......I am taking 1200mg of gabapentin. I would never adjust the dose on my own.
 
toothpastedog...........I am only allowed to send one message. so, I can not find your really long post to me. I think it may have come through this morning. I have looked everywhere and don't see it.
 
I have capsules so I can not do as you suggested. I only have 2 capsules left. I was scheduled to see doc today, but I don't have the <snips> for the copay.
 
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PW2244 said:
toothpastedog...........I am only allowed to send one message. so, I can not find your really long post to me. I think it may have come through this morning. I have looked everywhere and don't see it.
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Do you remember around when I had send you the message you mentioned?

What info did you need again specifically? I’ll probabky just start from scratch with whatever I’d suggested earlier. You’ll get essentially the same info.
 
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