Opioids Help please!!! Help about suboxone. Couldn't find in mega thread.

[chuckster11]

I looked in the bupe thread and couldn't find the answer. Yesterday I was gonna start subs but I couldnt get them in time so I took a 60mg MS Contin ER to help with feeling shitty and then I got a few oxy ir 30s later on in the evening and I just took my last 30 at 8am and I got the subs but I don't know if I have to wait longer than normal to take the sub than usual because I took that MS Contin ER cus I know how if you take methadone you need to wait alot longer to take a sub. This was the first time I took MS Contin and it didn't really do much but upset my stomach. I usually wait about 16-18hrs to take a sub cus that's when I start feeling real bad but since I took a 60mg MS contin ER will that make me PAW?? Thanks, I'm kinda scared cause I'm staying at my families place right now and last thing I wanna do is go into bad PAW.

 

[Law]

If you took your last Roxi at 8AM today, I would wait a good bit of time before dosing your suboxone. I would honestly wait until you start to feel mild withdrawals coming on, and THEN dose. But start your dose small, one milligram or two. Just so that way, if you go into PAWS, it won't last as long as if you took say, eight milligrams.

Cause I mean, if you took your sub right now, you'd be taking it an hour and a half AFTER taking the oxycodone. Some people can do that, but a lot of folks can't. So, your best bet, is to just chill out, let the Roxi do it's thing & once you feel it wear off, and then feel the withdrawals creeping in.... Go ahead and dose. But remember, START SMALL!

I mean, if you start small, you could come to find out that's all you need. A low dose goes a long way, man. But either way, good luck bro. I hope you don't go into PAWS, and you get this shit sorted out.

Edit: A good "rule" to follow, is to usually wait at least 24 hours after your last "DOC" dose, to dose your subs. But if you said you wait only 16 or so hours, I would wait that amount of time & THEN dose your subs.

[sorry for the long-ish post.]

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[stray cat]

sorry, i know y'all know what you're talking about, but this is just bothering me:

paws= post acute withdrawal syndrome, the bad stuff that can last for months/years after acute phys. w/drawal ends

pws= precipitated withdrawal syndrome, aka what you risk getting if you take sub too soon after a full agonist opiate.

 

[Law]

Oops, my bad Stray! Thanks for pointing that out bro. I mean that in a serious manner, not in a mocking way. +1.

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[chuckster11]

The only part that I'm mostly concerned about is the MS Contin I took yesterday before I took the roxis. I know people who take methadone usually have to wait 48hrs cause of the half life and i didn't know if MS is the same. The last time I tried taking a sub I waited until I started feeling shitty and I took 1mg of Xanax and slept for a few hrs then I'd wake up feeling worse and then I'd dose my sub but this MS Contin ER is what's mind fucking me now. I hope this time is the last time I go thru this but we all know it's easier said than done unfortunately.

 

[happygoluckygal]

Quit worrying about time frames...like law said above...the easiest way to gauge when it is time to start the sub is to listen to your body. When you start feeling w/d's...then dose! It's pretty much as simple as that!!!

 

[chuckster11]

BTW there use to be a good WD chart to go by on here but can't seem to find it anywhere on here. You know the one that tells you how severe your WDs are.

 

[jazzyhope]

Clinical Opiate Withdrawl Score- you want 25 or moreResting Pulse Rate: (record beats per minute)
Measured after patient is sitting or lying for one minute

- 0 pulse rate 80 or below
- 1 pulse rate 81-100
- 2 pulse rate 101-120
- 4 pulse rate greater than 120

Sweating: over past ½ hour not accounted for by room temperature or patient activity.

- 0 no report of chills or flushing
- 1 subjective report of chills or flushing
- 2 flushed or observable moistness on face
- 3 beads of sweat on brow or face
- 4 sweat streaming off face

Restlessness Observation during assessment

- 0 able to sit still
- 1 reports difficulty sitting still, but is able to do so
- 3 frequent shifting or extraneous movements of legs/arms
- 5 Unable to sit still for more than a few seconds

Pupil size

- 0 pupils pinned or normal size for room light
- 1 pupils possibly larger than normal for room light
- 2 pupils moderately dilated
- 5 pupils so dilated that only the rim of the iris is visible

Bone or Joint aches.
If patient was having pain previously, only the additional component attributed to opiates withdrawal is scored.

- 0 not present
- 1 mild diffuse discomfort
- 2 patient reports severe diffuse aching of joints/ muscles
- 4 patient is rubbing joints or muscles and is unable to sit still because of discomfort

Runny nose or tearing Not accounted for by cold symptoms or allergies

- 0 not present
- 1 nasal stuffiness or unusually moist eyes
- 2 nose running or tearing
- 4 nose constantly running or tears streaming down cheeks

GI Upset: over last ½ hour

- 0 no GI symptoms
- 1 stomach cramps
- 2 nausea or loose stool
- 3 vomiting or diarrhea
- 5 Multiple episodes of diarrhea or vomiting

Tremor observation of outstretched hands

0 No tremor
- 1 tremor can be felt, but not observed
- 2 slight tremor observable
- 4 gross tremor or muscle twitching

Yawning Observation during assessment

- 0 no yawning
- 1 yawning once or twice during assessment
- 2 yawning three or more times during assessment
- 4 yawning several times/minute

Anxiety or Irritability

- 0 none
- 1 patient reports increasing irritability or anxiousness
- 2 patient obviously irritable anxious
- 4 patient so irritable or anxious that participation in the assessment is difficult

Gooseflesh skin

- 0 skin is smooth
- 3 piloerrection of skin can be felt or hairs standing up on arms
- 5 prominent piloerrection

Total scores

Score:

5-12 = mild;

13-24 = moderate;

25-36 = moderately severe;

more than 36 = severe withdrawal