Methadone, Bupe and gasp Codeine!

[Stiffeno]

Before i was put on the bupe my doctor and case worker mentioned a type of program where they would suddenly stop the codeine, and then treat the various symptoms such as the stomach pains, anxiety and so forth. Now would that still be an option now? or coz im on such a huge dose of bupe screwed me?

Another thing is one of the meds in the list i THINK was valium, or some kind of benzo, the problem is i fear that my doctor would just think im trying to get cheap prescribed benzo's to get high on (which isnt the case) i just wish to get off before im totally hooked for life!

Someone above said it would be hard for me to be prescribed things due to the additted drug use, however i never told my doctor at times i used recreationally. There were times yes when i did use recreationally, but the major part of my use was for the back pain, and in the end to stop the withdrawals. I just dont want my doctor to think im trying to get a cheap thrill from something he is gunna prescribe =/

 

[L3inad]

Firstly, I apologise for not reading all these thesis sized posts - but havent seen this mentioned yet.

Alright, so you dont want cravings, you dont want to head to the phamacist every day, dont want to dissolve pills, dont want to be able to abuse your meds AND dont want to be in pain..?

That looks impossible, but maybe not I've had fentanyl prescribed in a similar situation, as opiate maintenance (post painkiller filled hospital stay) and pain relief. Not post operative either.

This would come in a patch form for your situation, each patch lasts 3 days. So even if you didnt get take homes, you'd still only have to front up every few days. Good luck abusing these things to, I never really tried as it means 3 days of hell before your next patch...

Fentanyl is extremely effective for pain, and in the patch form also effective for maintenance.

Talk it over with your bupe doctor, you really need a solution. But like all opiates fentanyl also has tolerance, but being ~40 times more potent than heroin its possible to keep raising it indefinately, much like methadone. All good things come to an end though, and you'd still hit a max amount on this same as bupe or methadone.

 

[Christ!]

Before i was put on the bupe my doctor and case worker mentioned a type of program where they would suddenly stop the codeine, and then treat the various symptoms such as the stomach pains, anxiety and so forth. Now would that still be an option now? or coz im on such a huge dose of bupe screwed me?

Another thing is one of the meds in the list i THINK was valium, or some kind of benzo, the problem is i fear that my doctor would just think im trying to get cheap prescribed benzo's to get high on (which isnt the case) i just wish to get off before im totally hooked for life!

Someone above said it would be hard for me to be prescribed things due to the additted drug use, however i never told my doctor at times i used recreationally. There were times yes when i did use recreationally, but the major part of my use was for the back pain, and in the end to stop the withdrawals. I just dont want my doctor to think im trying to get a cheap thrill from something he is gunna prescribe =/

I think I remember you saying you've been on 24mg+ for a year? Unfortunately going cold turkey and treating the symptoms is no longer an option for you (by any sane doctor anyway) Let me explain -

Codeine withdrawals @ 300mg would have peaked at around 3-4 days, and after a week you would be well and truly over the worst of it.

With suboxone at the dose you're currently on withdrawals wouldn't even really start for around 3 days after your last dose. They'd progressively get worse for the next few weeks I'd guess, I don't have time to work it out at the moment but you'd be looking at months after that of not feeling well. It would slowly get better over the weeks after the WD symptoms peak. You're looking at months of withdrawal (not all of it severe) and then probably between 6 months and 2 years of PAWs - you probably won't have a huge problem with PAWS if you've only been on bupe a year.

They can treat your symptoms with the codeine because it's such short term...a couple weeks of benzos is no problem for most doctors if they view you as genuine. With the suboxone WD there's no way anyone is going to prescribe you benzos for months, and you wouldn't want that anyway - just like opiates they tend to work great for a while, but if you keep taking them regularly the benefits will diminish until they just make you feel 'normal' - if you don't take them the withdrawal will kick your arse.

The way to get off suboxone is to taper! Make it easy for youself...why go through all that pain? Man up and give tapering a try, it was honestly easier than getting off pot for me. The reduction from 32mg to 6mg will be literally painless if you stretch it out over 6 months. From around 6mg - 2mg is still pretty easy and it doesn't start getting difficult until you hit the really low doses.

Tell your doctor you want to give it a try, what do you have to lose? If you start to feel uncomfortable tell your doctor and I'd bet they'd have no problem bumping you back up to whatever dose you want.

Here are some graphs that will maybe help you picture bupes staying power -

 

[Christ!]

Firstly, I apologise for not reading all these thesis sized posts - but havent seen this mentioned yet.

I need to work on my brevity I don't blame you for not reading the massive posts.

It's just frustrating, but I guess that's the nature of trying to help people that have drug problems. I'm sure I was the same.

A quick check on a conversion calculator - 32mg of bupe = 8mg of fentanyl. Not familiar with fent but I believe that's a large dose, and I think it has a short half-life so re-dosing would be necessary?

 

[L3inad]

I need to work on my brevity I don't blame you for not reading the massive posts.

It's just frustrating, but I guess that's the nature of trying to help people that have drug problems. I'm sure I was the same.

A quick check on a conversion calculator - 32mg of bupe = 8mg of fentanyl. Not familiar with fent but I believe that's a large dose, and I think it has a short half-life so re-dosing would be necessary?

8mg? As in Milligram or microgram?

Milli would be very lethal, Micro probs wouldnt do much.

It comes in the form of a transdermal patch that you chuck wherever on your skin for 3 days. Releases constantly over that time, so half life & redosing isn't a issue. Keeps you effectively not high but not sick for that time. Depending on how heavy your patch is.
They measure them by how much fentanyl gets absorbed per hour. ie. 50mcg/hour patches.

I think the OP could do well to consider this option and at least ask for his doctors opinion as to whether it would be more suited. Doctors I have talked to regarding this, pain specialists included are of the opinion that the fentanyl patches are completely unabusable. Now while this isnt 100% true by any means, them thinking it is makes it something they're more comfortable to precribe.

 

[Stiffeno]

I was reading up on fentanyl and it seems there have been a number of cases where some transdermal patches malfunctioned and caused a number of ppl to die due to over release of the drug =/, sounds scarey!

I will probably talk to my bupe doctor in a few weeks and see what he says, he will probably think im just trying to get stoned seeing as how strong fentanyl is.

EDIT: But something needs to be done, right now my back is so fucked up its killing me...and there is NOTHING i can do to stop it right now

 

[L3inad]

I was reading up on fentanyl and it seems there have been a number of cases where some transdermal patches malfunctioned and caused a number of ppl to die due to over release of the drug =/, sounds scarey!

Malfunction? This is not possible with the silica matrix type patches we currently have in australia. Previously patches had a 'gel resovoir' that contained the goodies, this could potentially malfunction and was easily abused. Those patches are no longer available - so not an issue

He will not think you just trying to 'get stoned' as you've already been put on bupe and as stated previously he will likely think they are non-abusable and be comfortable prescribing them. Hell, he gave you bupe for a tiny codiene habit and thats abusable?8( You work it out... Wanting whats best for you and discussing this with your doctor is in no way a drug seeking behaviour and wont ring any alarm bells.

EDIT: But something needs to be done, right now my back is so fucked up its killing me...and there is NOTHING i can do to stop it right now

Well do it? Indecision leads no where, and if the stupidly high dose of bupe isnt doing it for you then as you said something needs to be done %) The fentanyl patch makes far more sense in that it would actually treat your pain, not just the addiction you've gained from trying to treat your pain yourself. Any half-witted doctor can respect that reasoning.

 

[Stiffeno]

Ok i will speak to my bupe doctor about it after i get the xrays done, should be getting em done in next few days, been busy with my son over.

 

[Stiffeno]

Went to get my dose today and the doctor has allowed me to switch back to the Sublingual pill form rather then the pain in the arse films, which is great .

Reasons why i hated the films for the record:
1. Very often the wrapper wuld either break off to early, or just not be rippable without using scissors.
Just to elaborate a little, the films come in a special child proof packaging. In order to open it you must fold along a dotted line, and start ripping at a little nick (a tiny slit) in the plastic. This would very often not be slit enough, or just plain old wouldnt work!
2. I found it extremely difficult to place the films under each side of the underbelly of my tounge. The first time i tried one of the films banked up and got stuck to my bottem teeth. I had to start carrying a small mirror with my while i went to get dosed due to the ease of placement while seeing what you are actually doing!
3. I found the films didnt hold me as well as the pills did.
4. The films, while advertised as being faster to dissolve, actually took LONGER to dissolve then the pills. I found that even when pre-wetting my mouth with water the films would turn into a toffy like sludge (which is by design to prevent possibility of diverting the med) which would actually cause my mouth to become very dry.
5. Nearly 1 in 3 films were either cracked in half, or virtually crumbled within the packaging. This was probably due to the fact they are extremely thin and dry.

 

[Stiffeno]

Just a quick question, what about Cannabis for my pain managment? I mean im going to be seeing a pain managment clinic and i need some ideas, do these type of clinics prescribe things such as Marijuana? Im not a smoker so i dont think i would ever use more then i needed (as smoking hurts my lungs).

EDIT: And i hear that out of most drugs Cannabis is the least damaging on your body, and...err isnt addictive? My family also has a history of Glaucoma so it would also double by lowering pressure in my eyes to possibly prevent its onset.

 

[Christ!]

No they won't prescribe cannabis I don't think There's some cannabis related drugs whos name I can't think of at the moment, I've got no idea if it's available here.

Some people find it very effective for pain, you'd just have to try it and find out for yourself. It's definitely one of the least damaging and addicting. It can still be abused though (so can chocolate cake), and some people have issues with anxiety and de-motivation. Some who start using it chronically find they don't like to go without it, or feel they -can't- go without it. There's a withdrawal but it's extremely mild compared to opiate WD.

Good luck with the x-rays.

8mg? As in Milligram or microgram?

Milli would be very lethal, Micro probs wouldnt do much.

Yeah milligram

According to that calculator someone who is on 32mg of bupe would need 8mg of fentanyl per day. So around 300µg per hour. If patches are 50µg/hour then he'd need 6 at least. Keep in mind these calculators aren't always perfect, especially when concerting to or from bupe.

Not sure if they prescribe such large amounts of fentanyl.

 

[Stiffeno]

Given all the information posted in this thread im really not sure what the pain clinic is gunna suggest =/, needing 6 fent patches a day would probably cost a heck of a lot of cash to keep up with....if they even put me on it in the first place.

 

[Crankinit]

Honestly, I highly, highly doubt they will, any history of substance abuse generally excludes you from being prescribed opiates except in cases of severe acute pain or chronic pain with an obvious and highly visible cause.

You might luck out and come across a more trusting and open minded doc, but honestly, the chances are low.

 

[Stiffeno]

Honestly, I highly, highly doubt they will, any history of substance abuse generally excludes you from being prescribed opiates except in cases of severe acute pain or chronic pain with an obvious and highly visible cause.

You might luck out and come across a more trusting and open minded doc, but honestly, the chances are low.

So what do you wreckin they will do for me?

EDIT: What about those Rapid Detox programs that are around?

 

[Crankinit]

Well I'd say they'll look at non-opioid treatments, and possibly swap you to methadone and increase your dose.

 

[Stiffeno]

Minor setback today, it seems my mother put my pants in the wash and i had my xray referral paper in it, now its a blob of mush on the table, my mother called the xray place the other day and they said we an just "walk in" anytime we want, dont really need an appointment so i guess i can just tell them what the paper said "Full spinal Xray" and my doctors name and hopefully they will do them. Dont wanna have to see my GP again coz the waiting room takes forever =/

 

[Verybuffed]

Minor setback today, it seems my mother put my pants in the wash and i had my xray referral paper in it, now its a blob of mush on the table, my mother called the xray place the other day and they said we an just "walk in" anytime we want, dont really need an appointment so i guess i can just tell them what the paper said "Full spinal Xray" and my doctors name and hopefully they will do them. Dont wanna have to see my GP again coz the waiting room takes forever =/

Call your GP, tell them what happened and have the receptionist fax a new copy of the referral to the imaging clinic. The details would have been recorded on file at the doctor's office.

I am sure that sort of stuff happens all the time.

 

[Mr Blonde]

^ That's the best idea. The referral form means that the X-Ray will be covered by Medicare; here in QLD, if you go to QScan they bulk bill the whole thing whereas other places will make you pay and you then need the referral form to claim a rebate. If you call the GP's office they will be able to fax a copy to the X-Ray clinic you plan on attending and they will also post you the proper form.

 

[Stiffeno]

Ah good news about the referral thingo, turns out it wasnt what went threw the wash and became mush paper, turns out mum found the refferal and pinned it up on our notice board in the kitchen :D...but now i dunno wtf DID get wrecked in the wash :S.

Also about the 32mg Sub not working great for me, at 4x8mg pills that is putting 8mg of Naloxone into my system per dose, could it be possible that the Naloxone is counter acting the bupe at those doses? I know Naloxone is mainly to stop shooting up, as its absorbed in IV, but i read a study that said Naloxone can be absorbed via Sublingual....and if thats the case it might be affecting me?

 

[Mr Blonde]

^ Naloxone is hardly absorbed sublingually. The reason for the lack of pain relief is that buprenorphine is only a partial agonist, not a full agonist at opioid receptors.