New to site, need help

[Alphadog73]

Ok so before surgery about 6 months ago I was taking around 200 MG a day of oxycodone just to get by for pain relief. Since surgery I've been trying to wean myself down, every time I do feeling crappy for several days. I'm now down to about 80 MG a day. The same person who gets me the meds also gave me some suboxone 8 MG strips and told me I could use them in a jam or if I wanted to quit. He said that suboxone itself is very addictive so if I was going to use it to quit, to tske it for a week and then throw the rest away. I understand it binds to the same receptors as the opiates. What I don't understand is this: if it binds to the same receptors as the opiates, when the week is done of using suboxone and I stop taking it, am I not going to go through the same hell I would go through as if I just quit the opiates without even using the suboxone? Please help, I really want to quit but don't want to be in the fetal position for a week or more over it.

 

[herbavore]

I'm going to move your thread to Sober Living where I think you will get some good advice.

 

[simco]

Suboxone is a medicine that is often used to help people recovery from opioid addictions. Suboxone (or more accurately, one of its active ingredients, buprenorphine) is itself an opioid, and it is often used during opioid replacement therapy much like methadone is. However, unlike methadone (or Oxycodone, heroin, etc.) buprenorphine is a "partial" opioid receptor agonist, which means among other things that it has a lower potential for abuse than other opioids.

I think what your friend was suggesting was a rapid suboxone detox. The principle here is basically that you stop using your oxy. When you being to feel withdrawals coming on, you take your first dose of suboxone...enough to stave off the worst of the withdrawals. Over the next few days, you incrementally taper your suboxone dose down. There's a bit of finesse needed here...you want to taper fairly quickly, but you want to 'soften your landing' in terms of withdrawals as much as possible. Ideally, after ~4-5 days, you'll be able to jump off the suboxone and be done with the oxy as well.

This kind of rapid detox will not be much fun. But it is, for many people, far preferable to cold-turkeying off oxy. Likewise, the reason the suboxone is helpful is that many people find suboxone much easier to taper than they find fast-acting, full-agonist opioids.

Other folks on this forum will be able to give you better advice than I can about dosages, tapering schedules, etc. But I'll also mention that this is something that a suboxone doctor can help with. As always, my advice is to consult with a doctor.

Let us know if we can help with other questions, advice, etc.

 

[twang]

You will definitely feel shitty after you stop taking suboxone. If you are having success tapering with the oxy, I would keep doing that as long as you feel you are not going to cheat. Because oxy is faster acting, the WD symptoms will not last as long as suboxone will. However, with either, if you can correctly taper slow and steady, you can minimize WD to almost nothing. I've never had the self control to do that with full agonist opiates (oxy or heroin) but if you do have that self control, there's no reason to switch to suboxone unless it makes sense financially. Suboxone, in my case, has always been way cheaper on the street than Oxycodone. I know we're not allowed to post pricing, so I hope this isn't breaking the rules, but what I pay for 8mg of suboxone would get me the equivalent of 10-15mg of oxycodone. And 8mg of suboxone will keep you well waaaaay longer than than 10mg of Oxycodone would. If weening down on OC isn't breaking your bank, and your self control is good enough not to wake up one day and decide you wanna take 150mg of OC to get high "one last time", then just keep doing what your doing. I would wager for nearly all opiate addicts, this usually ends unsuccessfully, but I know an addict whose self control was the most ridiculous thing I've ever seen. So it's not impossible to ween off OC completely. It's just very hard for most because as long as you still have OC in your possession, the addict inside is usually screaming "take some! Take some!" however with your OC tolerance right now, it would be possible, and very likely you would get high on the suboxone too if you took to much. I knew plenty of addicts back in my early days of using before everyone switched from OC to heroin and there were OC addicts that would buy suboxone, not to get off OC, but to get high off it when they were broke. When your tolerance isn't through the roof, which imo yours isn't, you could just as easily fuck up with suboxone and end up taking more than you need because it can get you high if you take too much.
If you decided to switch to suboxone right now to complete your weening process and wanted to do a quick taper with it, I would start with 2mg and work your way down from there by .5mg a day the first few days (so 2mg day one, 1.5mg day two, 1mg day 3, .5mg day 4) and once you get down to .5mg take that day 5 as well, and then .25mg day 6 and 7, and after that don't take anything on day 8. See how you feel. Because of the super long half life of suboxone you'll still have a little suboxone in your system from the 2mg you took on day 1. So after a week I would not take anything on day 8, then take another .25mg on day 9, nothing day 10, .25mg on day 11. If you feel stabile at this point, start skipping two days between taking .25mg, or just stop altogether if you can.
That's just me, I'm sure there's people who have more personal experience with bupe than I do. I've done a taper with suboxone once and I was able to go from a gram of heroin a day, to 8mg suboxone a day, to .25mg suboxone a day within two months and it was completely painless. I was also VERY highly motivated at the time, more so than I ever have been in my life, including right now, and I think that motivation to leave my shitty past behind and looking to my brighter future helped a lot.
Getting off opiates is so much easier when you have something to live for and better your life for. In my case it was a financial opportunity that I ultimately fucked up because I relapsed.

Anyways, keep doing what you're doing if it's working for you. If you feel like you need to switch to suboxone because you don't trust yourself having Oxycodone around or you need to for financial reasons, I'm sure someone else can give you a more detailed and thorough plan of action

 

[Jabberwocky]

If the OP switches directly to buprenorphine form their current dose of oxycodone it is highly unlikely that 2mg of buprenorphine/naloxone will hold them. I would be surprised it they needed more like 16mg to stay well for the three or four days of the worst of acute oxycodone withdrawal.

Taking buprenorphine for seven days alone isn't going to lead anyone to become dependent on it. If one experiences withdrawal after those seven days of buprenorphine (at any dose), it will be the tail end of their primary opioid's acute withdrawal, which in cases with high dosing can last for 10-14 days even with short acting opioids like oxycodone.

In the case of the OP, how they should use buprenorphine depends what their goals are.

Interested in learning how to live without using opioids to get stoned? ORT actually can really help with that, in which case seeing a doctor or going to an outpatient program to get prescribed that medication can be very useful.

In a sticky situation and just need to kick until you can get more junk? If the goal is just to make it through the acute withdrawal, without regard for what will come next, seven days of buprenorphine should make a rather huge difference.

Other crucial withdrawal comfort medications: clonidine, gabapentin, diazepam or clonzepam, IBU, etc. These make a much larger difference than most people imagine before trying them.

The lower the OP can taper on the oxycodone, the "easier" the withdrawal with be, but the difference in kicking 80mg versus 60mg or 60mg versus 40mg probably isn't going to be all that huge (40mg would certainly be a bit more manageable than 80mg however).

But the main point is, taking buprenorphine for one to two week isn't going to lead to one having to then kick buprenorphine. Dependence takes longer to develop and requires chronic use (so for most people dependency starts to really begin setting in after week 2-4, at the very earliest).

If you have a limited supply of buprenorphine you're working with OP, you can use the stuff (if it's in pill form) intranasally (snorting) to increase the BA. If it's in strip form you can wash your mouth out with Listerine (or any ethanol based mouthwash) directly before popping it under your tongue (not only will it dissolve like butter on a hot pan, but it will also increase the BA a bit). Increasing the BA allows for less of the drug to have more of an effect, in essence - so this isn't necessary if you've got more than just a few 8mg doses to work with (as you'll like need more than 8mg to see yourself through the acute withdrawal from 80mg of oxycodone).

Do try to find some other comfort meds. Any doctor in their right mind would prescribe gabapentin and clonidine (and a non-narcotic sleep aid for that matter) to someone trying to kick opioids. Sadly there aren't a whole lot of doctors in their right mind with all the shit they have to deal with.

 

[twang]

Agree to disagree I suppose. 16mg of bupe is a fuck ton, imo. And it will be harder to come off of. If the point is to do a quick taper it's going to suck in the short term, but in the long term the lower amount of bupe you start with the easier it will be for a quick taper. You'll be in discomfort but I wouldn't say you'd be in the "fetal position"
According to the Conversion chart, bupe is 40x stronger than morphine, therefore 2mg is about the equivalent of 80mg of morphine which would require you to go through some discomfort if you decided to jump right now from 80mg Oxycodone. If you're not having to go to work a physically/mentally demanding job or go to school, you should be able to manage starting with only 2mg of bupe and when you start to taper down from there it won't take as long and therefore won't drag out the WD process as much.

 

[Alphadog73]

Forgot I posted. Thanks for all who posted. Good advice. I fucked up and used 8 of my 16 MG of suboxone once, then used again after 4 easy days of feeling fine, then didn't have enough left to do it right. 8 MG just wasnt enough to get through a week or a little more. So I'm on day 5 of cold turkey. No turning back now. Wish I would have saved all 16mg of the suboxone for when I was really ready. My hope is that it's all gonna be better soon. Hope so!