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Recovery Over 3 months on Suboxone - no major WD symptoms

T

tjmothy

Bluelighter
Joined
May 4, 2016
Messages
139
Hello,
I thought it would be helpful for myself and others to share my experience and get feedback from this community I've been lurking & learning from for a few years now. I've used and abused opiates for 7 years. WD'd a few times, some CT, some with suboxone. The times I have used suboxone was only for ~2 weeks.

Started suboxone this time around to get off of a oxy/PST habbit. It's been over 5 days (over 120 hours) since my last dose of suboxone and I've yet to experience any major withdrawal symptoms. Now, I know this isn't considered a long time or a high dose, but I've been on sublingual suboxone films for a little over 3 months.

[TABLE="class: grid, width: 300"]
[TR]
[TD]Dosage[/TD]
[TD]Duration[/TD]
[/TR]
[TR]
[TD]4mg[/TD]
[TD]5 days[/TD]
[/TR]
[TR]
[TD]2mg[/TD]
[TD]1 month[/TD]
[/TR]
[TR]
[TD]1mg[/TD]
[TD]1 month[/TD]
[/TR]
[TR]
[TD].5mg[/TD]
[TD]3 weeks[/TD]
[/TR]
[TR]
[TD]2mg[/TD]
[TD]4 days*[/TD]
[/TR]
[TR]
[TD]1.5mg[/TD]
[TD]1 day*[/TD]
[/TR]
[/TABLE]

* No science behind upping the dose just lack of judgement)

I have WD'd CT from a 2 year 150mg oxycodone habit so I understand what major symptoms feel like and what I'm experiencing isn't even close. The only symptoms I have experienced are minor aches in my joints, 4-5 hours of sleep, and spurts of anxiety/tiredness. I have ambien (prescribed) but haven't used it yet. Let's be honest, anything over 4 hours is incredible.

Potential contributing factors:

  • I workout at least 4 days a week for the past 4 months
  • Healthy diet - good balance of proteins, carbs, and vegetables
  • Multi vitamins, fish oil, protein shakes (with BCAAs)
  • Kratom - was skeptic of this plant at first but I actually really enjoy it after finding the right dose for me

My Arsenal (haven't used yet):

  • 3 8mg suboxone films - Most likely won't come to this.
  • Ambien (Zolpidem) for sleep (used this on night 4, slept like a baby and woke up feeling great)
  • Ativan (Lorazepan) for anti-anxiety

I understand the long half life of bupe, and while unlikely, I know there's a chance it could still hit me, but at what point can I start feeling like I'm out of the woods?

Thanks for reading.
 
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Given how long you were taking buprenorphine and your taper, it is unlikely you'll be in for too tough a time.

Generally by day four one has a good sense what the acute withdrawal from buprenorphine will be like. The acute withdrawal itself shouldn't take longer than 7-14 days, even in the worst cases. If you're feeling pretty good at day five, it is unlikely it will get any worse. If anything the symptoms you're experiencing now will just take a while to completely subside.

With the kratom, zolpidem and lorazepam you shouldn't have any problems with this whatsoever. Try not to take the kratom for more than two weeks, as you can develop a dependency on this as well. Likewise, take the lorazepam and zolpidem sparingly, only when necessary. After two weeks try and avoid any meds that aren't absolutely necessary (but don't force yourself to suffer unnecessarily).

I'd suggest you pick up some melatonin or valerian root to help with insomnia. They are pretty harmless in terms of sleep aids (although not as potent as something like zolpidem or lorazepam, they do help). Your circadian rhythm will return to normal eventually, the more you distance yourself from opioid use.

I wouldn't say that you're out of the woods exactly, but you're in them well enough already to have a good sense of what getting out will entail. If it isn't too bad right now, run with it. I would be very surprised to hear of your symptoms getting any worse.

How long have you been taking kratom and how much do you use each day?
 
Thanks for the feedback toothpastedog.

Today is day 6 and I'm feeling 99% and really no symptoms. Went out and had a few drinks last night so I didn't notice any RLS or sleep issues. I did wake up very early this morning, especially for the weekend, but got around 7 hours of solid sleep. Trying to use all meds seldomly as possible, which I am except for the kratom.

With the kratom, zolpidem and lorazepam you shouldn't have any problems with this whatsoever. Try not to take the kratom for more than two weeks, as you can develop a dependency on this as well. Likewise, take the lorazepam and zolpidem sparingly, only when necessary. After two weeks try and avoid any meds that aren't absolutely necessary (but don't force yourself to suffer unnecessarily).
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I've yet to use the lorazepam, haven't really had any anxiety. Zolpidem I've used once, and honestly I was reluctant due to the sleep walking horror stories. The time I did take it I got very nice sleep, woke up feeling refreshed, and had that "wake up and conquer the world" type energy.

I'd suggest you pick up some melatonin or valerian root to help with insomnia. They are pretty harmless in terms of sleep aids (although not as potent as something like zolpidem or lorazepam, they do help). Your circadian rhythm will return to normal eventually, the more you distance yourself from opioid use.
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I have some melatonin but that seems hit or miss for me. Maybe the dosage I have is too high, 5mg. From what I've read 1-2mg is more the dose I should be taking.

How long have you been taking kratom and how much do you use each day?
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Started kratom the day after my last bupe dose, so today is the 6th straight day I've taken it. First 3 days I dosed only once, since then twice a day at 10g a dose. Once in the morning and once at night, totaling 20g/day.
 
Sounds like the kratom is what is making the most different with this, other than your positive attitude (never underestimate a positive, healthy attitude when it comes to over coming challenges we face!) of course. I doubt you'll experience too much in the way of challenging withdrawal symptoms as you take the kratom.

I'd try and start reducing your use of kratom gradually around the 14 day mark of abstinence from buprenorphine so that you avoid picking up a new habit using it. Some people find kratom type maintenance use helpful though, so take things as they come. Trying to reduce your use before your body has time to become dependent on it is a worthwhile experiment regardless though (if for no other reasons so you can get a better feel for how your particular disposition is affected by this particular new substance).

Your experience on zolpidem sounds pretty normal, most people don't experience the horrible side effect that can be associated with it (perhaps other than dependency when used long term - but this doesn't sound like it will be an issue given how you use it). I often found that 5mg of zolpidem worked just as well as 10mg, so perhaps you can try that if you get concerned.

Regarding melatonin, yes it can be hit or miss. It isn't necessarily more effective at lower dosages, it's just that it doesn't tend to be more effective as you increase the dosage either. If it isn't helping I'd suggest saving it for when you don't have something more effective like zolpidem around. I found that once my body gets used to melatonin it is slightly less effective than it is when I only take it once in a blue moon.
 
I agree, a positive attitude can go a long way. That's what I'm curious about, if I never took kratom how would my WD symptoms be? Reading all the bupe horror stories I was sure to have at least some moderate symptoms but the entire time I've been just as productive as when I was on bupe, if not more. IDK, some things are better left unknown.

I'm really enjoying kratom, more than I expected, which makes it a bit dangerous for me. I like experimenting with different strands and the inexpensiveness accompanied by online availability makes it that much more appealing. But the last thing I need is another dependence so taper and discontinuing it is. Maybe after a while break I can periodically take it when I need it, we'll see.

5mg zolpidem is actually what I'm prescribed and that's how much I took. Worked great. I've always been a naturally sound sleeper so getting the zolpidem (and lorazepam for that matter) was just in case of severe WD symptoms. I have a limited supply.
 
If you never took kratom your symptoms would be more noticeable, but I doubt they'd be all too severe. Kratom can be a great aid in withdrawal, though its effects are limited. Three months isn't long enough to develop an intense habit with buprenrophine - it anything it is just long to develop a habit at all (not that this would make the withdrawal any less unpleasant, just perhaps not as intense as if you'd been taking I t for years).

As with all things opioid tolerance, dependency and withdrawal, each individual's millage will vary.
 
I've been on kratom daily, dosing multiple times, but I haven't been taking the other meds (zolpidem, lorazepam). Planning next week for a single daily dose then discontinue completely. Working out, combined with a healthy well balanced diet, is probably one of the most effective weapons for me. This weekend I've had a good amount of drinks and kratom so its hard to tell if I've had any

In case anyone is curious, I've been enjoying maeng da and green vein indo during the day for energy and either red bali or baik bali at night for a relaxation.
 
Update: The Kratom was working great but I ended up relapsing on oxycodone for 4 days. Not the end of the world but it was still a pretty shitty feeling. Hopped back on suboxone for about 5 days and currently dosing Kratom once daily. Besides the money and the fact of relapsing I've been feeling good. All this time I've kept up with my gym regimen and eating healthy.
 
tjmothy, you're doing awesome. A relapse is always a bummer, but if we handle them right I think we usually come back to a stronger base of recovery than we had before. And it sounds like you handled this one great.

Keep it up. Man, I'm jealous of your gym regimen...I really gotta get back there myself.
 
Thanks simco, appreciate the kind words. I agree, the way you respond to a relapse can help you become stronger through this journey.

The gym/exercise is such a strong weapon. For me, it's like a chain reaction of positives start. Healthy diet, less drinking, better sleep, focus, energy etc.
 
It's been a while so I figured I should post an update. To sum things up, relapsed for 2 months, went on suboxone for 10 days, relapsed again for 2 months, and now currently on suboxone.
When I used, it was strictly oxycodone, doses ranging from 150mg and ending at 210mg. Today will be my sixth day on suboxone and I'm feeling good, slight insomnia is all. Here is what my suboxone dosages were:


Day 1: 8mg (induced at 4mg, redosed 4mg more an hour later and felt fine)
Day 2: 6mg
Day 3: 6mg
Day 4: 4mg
Day 5: 4mg
Day 6: 4mg


The plan is to dose 2mg for the next 4 days, then reduce by half every 4 days after that, and finally use kratom upon cessation of suboxone. I know every time is different but this strategy has worked for me in the past so I have an idea of what to expect. In addition to using kratom at the tail end I also have lorazepam (ativan), zolpidem (ambien), and clonazepam (klonopin). They are all prescribed PRN so I use them very seldomly and my tolerance is virtually non-existent. I really only use them for peaceful sleep, I never really ever noticed any other effects from benzos.


Overall I'm feeling good and optimistic of the future. Hope you all are doing well, especially you simco. Been keeping up with your journal and I know you've been having some ups and downs as of recently so hang in there and let's do this.
 
Hey timothy... I also used kratom to come off subs. It works really good but of course now I'm addicted to kratom instead. There are pros and cons to that.. kratom is cheaper... but it doesnt last as long and redosing can be tedious.

Sounds like relapsing is an issue for you. Have you considered staying on subs and tapering down slowly ( even over a year or more) to avoid w/d symptoms that lead to relapse??
 
Hey - I was surprised how well kratom works and once I found the right dose it was quite enjoyable. I have considered long term sub treatment but I'm very reluctant. I really don't want to rely on another drug in my everyday life when the goal is to be completely drug independent. Usually a relatively quick taper of 6-8 weeks gets me past all oxy WD and I've yet to experience WD from the subs (maybe due to kratom). I'm always amazed how well sub works. Typically for me about a week in when I get down to 2mg I start feeling really good. Not euphoric just a feeling of well being with focus and energy.


How long were you on subs for? Do you have any plans for quitting kratom?
 
tjmothy said:
Hey - I was surprised how well kratom works and once I found the right dose it was quite enjoyable. I have considered long term sub treatment but I'm very reluctant. I really don't want to rely on another drug in my everyday life when the goal is to be completely drug independent. Usually a relatively quick taper of 6-8 weeks gets me past all oxy WD and I've yet to experience WD from the subs (maybe due to kratom). I'm always amazed how well sub works. Typically for me about a week in when I get down to 2mg I start feeling really good. Not euphoric just a feeling of well being with focus and energy.


How long were you on subs for? Do you have any plans for quitting kratom?
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I was on subs for a year and a half. And yes, I am going to get off kratom on March 20th... I'm waiting a while because I have a lot of shit to do this month and that might be hard while in withdrawals. I am, like you, determined to get off everything.

Best of luck!
 
The thing is you will have to suffer a little bit no matter what, get off it now while you can. I got off 2 months suboxone my first time after 160mg oxy and occasional H with almost no symptoms. But the relapses will make it harder every time. I'd recommend lower kratom dose a bit. I'm coming off 2mg sub after 2 years and 10mg Kratom gets me feeling high and better than I ever felt on sub.
 
You are doing great timmaay!!!
I want soooo bad to be able to try Kratom.
Unfortunately I am in a state where it is not allowed.
I Wonder if I was to drive 30 minutes across the state line and bought it legally would it be illegal to take Home?
 
Today is day 7 and I took 2mg suboxone around 8am (6 hours ago) and I'm feeling good. Actually have energy and a mindset of being productive today. I've also been diligent about taking my vitamins, eating healthy, and getting at least 6 hours of sleep. I plan on going back to the gym next week so things are going great right now.

Pickled - good luck with quitting kratom. Not sure of your exact strategy but I've found tapering on kratom to be the easiest.

JVC - The plan is to only be on subs for about 6-8 weeks then use kratom if there is any discomfort towards the end. I too have found 10-12g of kratom to be my optimal dose.

beenbetter - Thanks! Kratom is nice and it's great having different strands to get your desired effects. I'm not sure about your question of carrying kratom over state borders but is there a specific reason you want to try kratom, or just simply curiosity?

Best of luck to all of you!
 
Day 8. Took 2mg of suboxone in the morning along with a small amount of clonazepam (.25mg). My sleep schedule hasn't been too great but I doubt it's related to WD or subs. One noticeable difference is my libido has definitely increased. Besides that, I feel pretty much the same.

I remember the last few times I've gotten down to 2mg or less it seems to make me feel even better, hard to describe. Apparently at a dose that small it gets metabolized as norbuprenorphine which is strong? I'll do some googling but if someone could explai that to me and why norbupe is, for lack of a better word, stronger, it would be much appreciated.
 
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Actually it metabolizes into norbuprenorphine at all the doses but at sub 2mg doses it is possibly that the lower affinity of norbuprenorphine to mu opiate receptors works better as there aren?t that much of buprenorphine when compared into norbuprenorphine as equal amount gets converted into norbuprenorphine in the liver no matter what the dose when it is over 2mg.

I mean that for example if your liver methabolizes 1mg of buprenorphine into norbuprenorphine per day then on the dose of 1mg you actually have mostly norbuprenorphine some time after the dose and therefore there isn?t much of buprenorphine blocking norbuprenorphines action and as norbuprenorphine has lower affinity (meaning stronger effects) to MOR (not sure if it actually is agonist for MOR instead of being partial agonist like buprenorphine) and therefore you feel ?better? than with larger doses but your WD symptoms might not agree that so therefore it is needed to use over 2mg doses when inducting subs.

Have you figured out any ways to help prevent relapses yet? It has been the biggest issue to get through the PAWS for me to staying sober instead of getting just past the acute WD symptoms and I am wondering how this time ends up as I haven?t had any cravings or other post acute withdrawal symptoms yet and it is currently day 14 without opiates for me.
 
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Thank you for the explanation.

I have not. For the past 12 years I have been on/off opiates, on for up to 3 years, and off for over a 1 year. Trying to keep myself busy as possible and always keep in the back of my mind the destruction opiates caused. I for sure have some underlying issues that I have never talked about in a professional setting so that might be something to try. I have never actually needed opiates for pain it was just to mask my inner issues, so for me it's a mental battle.

Congrats on 14 days! Interesting how you haven't really experienced PAWS this time around. Did something change? How long were you using? Did you do any kind of ORT? Either way, stay strong.
 
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