Bupe Please Help On Sub & Relapsed

[trying]

Hi. i was a straight up opiate junkie and in oct. of 2010, checked myself into detox and then went directly to six months of rehab.

i have been on Suboxone for 6 months and my doc (because I am a chronic pain patient as well) had me up to 32 mg per day.

Over the past two months, I have weaned myself down to 8mg sublingual strip a day.

I graduated from rehab 3 weeks ago, and the directors have been really mean to me because I wouldn't stay and pay 800 a month plus food for sober living when others in our house were relapsing constantly.

I came home to get my own place and ran out of Sub and my pharmacist had to order.

I was w/o sub for 48 hours and took some oxy - hate myself for it and wish i could take it back but i'm taking it as a Prolapse - i know now that I NEVER want to use that way again.

now that i did oxy last night at 10.30 p.m. (and barely felt shit), when can i safely take Sub without PCWD? I found two 8mg strips in my Journal.\

I don't want to be a junkie, without the Sub the cravings were just more than I (thought) I could bear. Now, I want to get right back on my Sub without precipitated withdrawals.

Am I safe now? My pharmacist will have my rx tomorrow....so these 2 i found could get me through today if I'm safe.

Can anyone help me? Thank you in advance. Life in the real world is so much different than living in a rehab house * another thing that pushed me over the edge was a huge fight with my Grandma.

I'm taking full personal responsibility, I could have toughed out a few days w/out Sub, but I made a mistake.

I just don't want to get sick taking the Sub after the oxy last night.

Thanks.

trying (so hard!)

 

[psychedelicious]

hey trying,

Been there, done that. You should wait about 24 hours after taking the OC to take more suboxone. 18 hours would *probably* be OK, but precipitated w/d suck soooo hard, I would just play it safe and wait til 24 hours.

I'm not sure if you've figured this out or not, but with suboxone, there is a cutoff point in doses where more drug only gives you unpleasant physical symptoms and no high/good feeling. You don't need to take a lot to completely stave off withdrawals, and after taking suboxone for like a year, I realized that I was taking wwwaayyyy more than I needed to just stay normal.

Suboxone is a bitch and a half to drop, you should taper down to about .5 to 1.0 mg bupe before dropping off totally, otherwise you might feel some of bupe's hellishy long withdrawals. 0.5 mg is one sixteenth of an 8 mg pill, or one quarter of a 2mg pill. It's a very small amount of powder and the junkie in me always thought "there's no way in hell that tiny amount of drug is going to hold me" but it always did.

Good vibrations for you, soon-to-be-fellow-ex-junkie

edit: Don't worry about relapsing so much...Well, I don't mean to say that it's OK to relapse! But I mean to say that cold turkey is really difficult, even with suboxone it's tuff to get off the horse, and so if you relapse it's not like you have just lost all progress... It's not binary, it's not on/off or junkie/normal person. It's a spectrum of varying qualities and quantities of addiction, and you can't go from junkie to normal person usually in one fell swoop. I don't even think it's a good idea to try cold turkey as it only discouraged me because it was so difficult. I guess I'm saying, hey, you just relapsed one time, and how long had it been before then that you had gotten high? Odds are you are doing way better than you were a month or so ago. So take this as a learning experience, don't hate on yourself cause that won't help, don't be afraid to love yourself even though you relapsed, cause you are making progress. It's hard to type out what I am trying to say or convey to you, trying, but hopefully you can figure that out. Keep up the good work

 

[psychedelicious]

One more thing - I started on 16 mg suboxone and I should have just started at like 4 mg. I thought I needed way more sub than I actually needed. I never felt bad if I took less sub than normal, so long as I took about 1mg. Towards the end I felt fine even if I only took .5 mg. So your two suboxones should be able to last you a couple weeks even! Just take way less than you think, don't take more til it's been an hour or so and you can really gauge how much the subs will help.

 

[trying]

thank you so much...

for both your words of information and of support.

My Doc had me on 4-5 8 mg strips per day. i have gradually tapered myself down to 1 strip per day...i have many chronic pain/degenerative diseases including fibromyalgia, lupus, osteoarthritis, osteoporosis....just to name a few, and i've had cancer 3x and most of my guts removed.

i don't know what i'll do for pain but i know that i can't stay on sub forever.

i just saw a pain management specialist that my sub doc/addiction specialist sent me to, and he said that sub only "takes the edge off" where pain is concerned...and that since i now, in my early 30's, have six crushed verterbrae because they're just degenerating, i'll eventually HAVE to do something different for my pain.

but i don't want to abuse again, to need it, for my life to revolve around it. i want to be happy joyous and free!!! and i have been for almost 7 months....and then this.

thank you, i will try not to beat myself up this bad....i'm so MAD at myself i should have called my sponsor or something.

but like i said, i'm looking at it as a prolapse, b/c it showed me I DON'T WANT THAT FOR MY LIFE ANYMORE...UGH!

thank you for talking to me

 

[Cane2theLeft]

With buprenorphine, as a partial agonist, there is a ceiling to the analgesic effects it can produce. For most people, they reach this ceiling around 2mg (sometimes around 4) and doses beyond this amount do not produce any further mu opioid agonism hence no superior analgesia. In the treatment field, doses above this ceiling have clinical relevance because they can produce a more substantial and longer-lasting blockade effect. This ceiling is equivalent to about 30mg of methadone so no matter what dose you're taking, you're not going to get more analgesia than about 30mg of methadone a day.

There are lots of ways that you can manage pain that don't rely on opioids - other non-opioid medications can synergize with/enhance the analgesia provided by the bupe such as tramadol, tricyclics or more targeted SNRI's, muscle relaxants, anticonvulsants, NSAIDs, local anesthetics, etc.

Aside from pharmaceuticals you may benefit from interventions such as epidural steroid injections or nerve blocks.

Aside from these you have options such as physical therapy, meditation, biofeedback/neurofeedback, counseling, massage, acupuncture and many other mainstream and alternative ways to manage pain that you shouldn't discount that many people find tremendous relief from.

I was using opioids daily for around 4 years and then I started to abuse them and realized at my age it was unsustainable so I stopped. I've been managing my pain for over 18 months now and although I'm sure its not as severe at yours, there is reason to be hopeful and options to explore so you aren't JUST resigned to insufficient relief on bupe or going back into full-blown addiction.

On top of having some experience with chronic pain, I've been studying addiction counseling for the last couple years so if you ever want to talk, feel free to private message me anytime.