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Bupe High-Dose Suboxone Not Helping Withdrawl/Cravings... help?!

S

spade082

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Joined
Jun 19, 2012
Messages
18
Hey there. I am currently taking suboxone at a done clinic for an addiction/dependance problem stemming from severe everyday chronic pain. I had been using opiates for years, mainly Oxycontin, percs, vicodin, methadone, u name it. needless to say, I used to have to take promethazine after i started taking something every day pretty much all day for 2 years, just so i could get an effect. In the last month ive started getting suboxone for bad withdrawl and and the real bad cravings i get.. plus i cant afford getting pills off the street anymore.. Anyways.

Gradually they bumped me up to 24mg of suboxone, and it worked well for the first two weeks. But after that, the effects became more and more limited. For the past 2 or so weeks i havent sleep well at all, been in cold sweats all day, very irritable, trembling uncontrolably and having intense cravings to get more oxys and just rail those b*tches upp.. Ohh, have i mentioned the horrible dry-gags and vomiting all day? .-.

I've talked to my counciller and will see me Doc. about this soon. But till then, does anybody have any idea why this might be?
I even started taking prometh. with the dose, as well as holding the sub under my mouth like 45 minutes until its flavorless.. but still I feel like absolute shit, like I did before I came in to the clinic. And no matter how I take it, even when in full w/d it is like taking a placebo pill.

I used to get methadone on the street for my w/d's and boy did that help. Although I needed 40-60mg. Which, frum what peole have told me is much stronger than suboxone and if you need a dose that high of 'done, suboxone wont be effective. I will discuss this with my doc;
but does anybody have any ideas?! I'd appreciate it so much, im SOO confused. :(

-utterly confused
 
Sounds like your tolerance on the subs went up, hence they are becoming less and less effective.
 
It's hard to know what is going on... Is it possible that the symptoms are not actually withdrawal symptoms? Are they constant and seem to be not affected by the Suboxone at all? Or do they get a bit better for a while and then get worse when it's been a while since your last dose? There are a number of different possibilities: Perhaps your tolerance to opioids may be too high for the Suboxone to be effective, but it seems strange that it would work for 2 weeks and then stop - tolerance to Suboxone's withdrawal-alleviating effects should not go up that rapidly. You might be sensitive to Suboxone and getting side effects. Or perhaps you metabolize Suboxone differently than other people (and/or even differently than you did at the beginning). Other possibilities are that you are taking/eating/drinking something that decreases the effects of the Suboxone, or that you are allergic to something in the Suboxone (even an inactive ingredient).

If you needed 40-60mg of methadone solely to eliminate withdrawals (not to get high), then it is very possible that your tolerance is too high for Suboxone to be effective. I would definitely talk to your doctor about this. He may suggest raising your dose to see if that helps. If it doesn't, then you might want to consider switching to methadone if you found it more effective and think you will have trouble resisting using other opioids while on Suboxone. But be warned that you are still going to get cravings, you will have to learn how to cope with cravings without feeling compelled to act on them and to cope with and/or treat the reasons you were using opioids in the first place (pain, anxiety/depression etc).

One last question, have you been taking any drugs aside from the Suboxone while you have been on it? If so, that could definitely be a factor.
 
I started out at 16mg and went all the way up to 32mg. I experienced a lot of the things you did. What I think you should do is take less. IME buprenorphine gives extremely dysphoric effects at those high doses, if you drop 4mg every week until you are down to 4mg I bet you would feel a lot better. Suboxone is counterproductive to most other opiates.
 
Well things sorta jump around. One day ill take my dose and let it all absorb for like 30 minutes.. and I could feel it for a while and then it goes down and I start withdrawling again. But then Ive taken it and (most days) it's like taking 3 big ol' placebo pills... Ive waited some days until Im withdrawling again to take it (and yes the effects ive been feeling are w/d for sure) , taken promethazine, split the doses up, taken more at once. Nothing. Nada.
This has been sum of the worst weeks of my life. Im in incredible physical pain as well as mental & emotionally. its hard.
Yes I will talk to my doctor about this friday but since im not quite of age yet they might not even consider methadone. All I know is when i took done i was pain free, withdraw free and stopped craving pills, but I did have to take 40-60mg. About 40mg will take the withdraw away and a little more will help on a bad day with pain.
I got that good opiate feeling as well, but not like a euphoric high. Thats not what im going for anymore.

The only other meds I take are Celexa (anti-dp) Gabapentin (nerve pain) and alprazolam (anxiety/panic).
my doc doesnt want me to take xanax cuz of the possible interactions, and I only take it when i need it.
Other than that I dont take anything else besides a little pot here and there.

Does it seem normal that i would need more than 24mg to stop withdraw? Everyone Ive talked to needs like half a strip-to one strip, and the highest ive heard of other people taking is usually 16mg... so why would I still be sick and in pain ? Why would it stop working after 2 weeks when Ive raised the dose?

Also, the 'less is more' theory has been debunked. There is no evidence that suboxones activity decreases at higher doses, but instead; it levels off and doesnt increase. A dose of say 2-8mg doesnt cover very many mu-receptors, but from 8-16mg theres a big change. but thats all i know
 
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what? uhm he knows that and thats why he said dont take it. he doesnt know i still take it is the reason.
 
pardon, the way it is worded looks like he prescribed you alprazolam because he does not want you taking xanax. anyhow, if he didnt want you taking it why the heck would he prescribe it? and i myself only need a quarter to a half a strip a day, and i had a big habbit....goodluck, you will find what works best for you.

you know, alot of dr.s are dipshits, and nothing surprises me anymore
 
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The "less is more" theory has not been debunked, your own personal experiences are highly subjective and there's a reason that you're not feeling effects from low dose or high dose buprenorphine.

If you're going to use the sublingual route, use an alcohol based mouth wash prior to SLing the tablets, see if that makes a difference.

I wouldn't normally recommend this, but if that doesn't work, you could try some mixed into a solution for nasal administration, it's got almost double the bioavailability that way.
 
dude 24mg of bupe is massive. The withdrawals from that are going to be like 180mg methadone daily lol. I would start lowering ASAP. Bupe is a partial agonist and the cravings will only truely go away with time. Godo thing is though is at 24mg theres no way in hell your gonna get high on a full agonist without waiting 3 days lol.
 
@ tricomb ; since i take it everyday, the intranasal thing is no better than sublingual. and actually, the less is more theory HAS been debunked; im not basing this on my experiences. I can show you a few links if you'd like to read up yourself. There are pictures as well that display the empty opiate receptors, which begins to darken every 4-8mg delivered. (thermal imaging.)
@MisfitChick ; no I am prescribed the xanax by a psychiatrist. ive had anxiety/panic issues since i was young. the sub doc doesnt want me to mix, but i only take it when i need it.

and @Swain ; yeahh i know it sounds like quite a bit. but ive been trying to taper down, which is only making the w/d worse. and yea i know you have to be clear of opiates before starting something else.. but the fact is that the sub is not helping me in the first place, ive been in w/d since i last went to the doc 2 weeks ago.

I used to take 30-40mg of oxy multiple times a day, and when I had methadone I took 40ish mg and felt so much better. no sickness at all. but this sub thing is reallly tricky... its not like anything ive taken before. and yes i know its not supposed to get me 'high' but thats not what im going for. Im trying to numb my pain enough to get through the day and not w/d or be daydreaming about pills all day.... i go to doc tmrw but im still s confused as to why such a 'massive' amount is like taking placebo pills...
 
Could it be because I used so many full-agonists constantly (like all day every day) that the partial-agonist sub isnt working? Like I seriously feel like I could throw up all day. Im getting no relief from it... god damn i want to be on methadone again...
 
Sound like theyre working quite a bit more than you imagine, considering you haven't done any opiates since you got on them.

Cravings are a normal part of recovery whether on suboxone or not. How long were you abusing opiates for again?

I do think you should be on a lower dose though. I think its more side effects youre experiencing than withdrawals. Sometimes I get what FEEL LIKE w/d from the sub but its just like a hot flash and a bit of w/e for a bit. I think once you get stabilized you will have much less of those effects.
 
There are days where it's like you're saying, like hot flashes and minor wiithdrawl... BUT. There are also days where its not helping me at all. Not only am i craving the pills, Im thinking about them ALL day. I even dream about getting high... The only reason ive been off pills is because I cant afford to pay the clinic each week AND go get pain pills... but if suboxone doesnt start helping me better I might end up back where I was... The problem is i havent had relief in the past 2 weeks... so I dont understand why if it was working the first 2 weeks and then stops, how lowering my dose would make me feel better? Wouldnt I feel worse, like when I would take 30-40mg of oxy instead of the usual like 60-80mg a day?
Also, Ive been taking pain meds for like 2 1/2 years.. but about a year and a half of all-day, every-day use of high doses..

I've tried tapering down this week since i tried taking an extra half one realll bad day... but it only seems like im getting worse. I know you're not supposed to taper without dr. approval so im still taking what im supposed to take but I have the A/C on freezing cold and Im still sweating like a pig and have an enormous headache...

I just dont understand why it works for almost everyone else Ive talked to, and people look at me like Im crazy and this is all in my head? !
If I wasnt dopesick I wouldnt be complaining! And I have been sick enough to know how to distinguish it from other nasty side effects...
 
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bump.. :?
Im going to Doc tommorow so Ill know for sure, but If anyone has any more ideas please let me know!
-desperate : (
 
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People can say the less is more theory is debunked but I can say that in my personal experience, which is extensive, there is such thing as too high of a dose. I was at 32mg at one point and felt all kinds of terrible, when I started tapering I felt no difference from my dose except for gradually feeling less crappy.

And btw I had read not about this less is more thing as it was in 2006, so I didn't have any pre-conceived notions about the process.
 
Of course youre going to be thinking about using drugs, suboxone or not. You used dope for HOW LONG? Sorry to say popping a gross orange pill aint the end game. Suboxone does not change your thinking.

I always try and convey this message: suboxone is NOT some miracle pill. You do not simply take a suboxone and Presto! All better! What it does do is give you a safety net so if you fall off the tightrope, you dont break your face and have to start over again. There is a LOT of shit you have to work on, those abhorrent thoughts being a small piece of the giant puzzle that is your problems (which cause you to use).

But clearly the subs are working more than you think, because despite all of those fucked up thoughts, you have NOT USED!

Sorry to say its not some miracle cure, you have to put in a LOT OF WORK: mentally, emotionally, spiritually, even physically.

Not what you wanted to hear, I know, you wanted to hear "Oh on suboxone everythings peachy! I have no more thoughts of getting high, i have no problems, everythings great!" Not even close. You are going to have a lot of problems, ones you might not even know you had because you were doping yourself for so long and shoving them to the side. Whatever emotional baggage you have is all going to float to the surface, all of those problems/emotions you shoved under yourself, are going to be there. And you are going to want to get high as a result. No other way to split it. The suboxone allows you to tackle these problems.

You SHOULD be uncomfortable. You SHOULD want to get high, you SHOULD have all of these fucked up thoughts/feelings, its called being able to feel again.

Its normal. It takes awhile, for some WAY LONGER than others, and its fucking hard as hell. As I tell everyone constantly: it is (most likely) going to be the hardest thing you have ever done. Sorry to say, but if its easy, you're doing it wrong. Everyone wants to hear that it'll be super easy to quit, even with suboxone.

Everyone wants it to be as simple as taking a drug to fix a drug problem 8)

If you keep at it though and dont get discouraged about it simply because you "want to get high"? You'll get there.

EDIT: And FYI the less is more theory has NOT been debunked. While you are talking about a "ceiling effect" what we are saying is that at less than 2-4mg it has the most agonistic function that it will. Of course you will get more blockade/withdrawal cure/side effects from taking more, but you wont get more "feel good". Therefore, taking TOO MUCH suboxone will simply make you feel shitty as it kicks in those side effects I discussed (hot flashes/bouts of nausea/possible migraines/etc).

Also: DONT FUCK WITH YOUR DOSE! Take it as prescribed. Youre wondering why its having all these weird effects when youre fucking around with your dose, skipping some days, adjusting the amount you take, etc. And you wonder why its having weird effects? Comeon man, you gotta make it consistent and not fuck around with it. No wonder you think its not working, youre not even close to doing it right.
 
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I don't appreciate the tone of that message, DoomMod. I am not expecting a miracle cure, and yes I know people with struggle with these cravings for a looooong time. I get it. I need something that will KEEP ME STABLE. That's what im going for. Yes I have cravings for other pills, but when the Subs were working well the first 2 weeks, I was withdraw free and for the most part pain free. That's what I need. I need to function so I can go to fucking Tech college , and go to work without feeling like Im dying. The subs gradually have become ineffective. And it's quite easy to judge through a computer screen, but I ended up hooked on these pills due to extreme chronic pain. Every. Day. Of my life. On top of being dopesick... sounds fun dont it? But regardless of my exact situation, I just need something that will help me through the day, and the subs arent. When I tried Methadone I was completely stable. I just dont know if theyre ready to do that.
Also, I tried a different dose a week ago. Ive been on schedule with my meds since. Im not fucking it up. Must you be so condescending? :p
I am only here asking for help, not to be judged and treated like a crazy junkie.

And you can believe what you want. I think the 'less is more' thing is taken a little to literally. But I do admit that Bupe is a complicated drug, and theres all sorts of things we dont really know about it.

But Here is a post by Project Narco about this misunderstood phrase. It shows thermal imaging of the brain with different doses of suboxone, with the bright colors being empty receptors, and the darkened areas binded with Buprenorphine. Go ahead, take a look for yourself. You'll learn a bit.

http://derekwmeyer.blogspot.com/2011/07/followup-to-less-is-more-buprenorphine.html

And just to quote: "Again, there is no solid evidence in humans that buprenorphine's intrinsic activity actually DECREASES at higher doses , rather than simply level off with no further increase. "
 
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@ dopiate (nice name btw) what dose did you taper down to? I went up to 24 because I was still feelin icky at 16 after 2 weeks.. ugh.
But i still feel nasty on 24mg... i dont know if I should go up, or go down or just change meds altogether.. but I guess the doc will know tmrw...

All i want is to be stable so I can actually live my life. But alot of people prefer to look at me (and other clinic-goers) as stupid junkies who just want to get high.
the whole reason im in the clinic is to be stable and not going crazy and having my life revolve around pills. But I seem to face much opposition with some of these people.
 
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