Slipped up while on suboxone , need ur help please!!!

[Freshmaker89]

Hi guys , I'm very new to this so apologies if I'm posting in the wrong section or what not I'm not very familiar with this .
ive been an iv heroin addict for a while now, I've recently started the suboxone program I've been on it for about 10 weeks now.. I've been getting dosed 24mg Monday , 24mg Wednesday , 32mg Friday so I've only been dosing 3 times a week , I think the doctor said same as 12mg daily but circumstances I'm in its easier hard for me to get the chemist on a daily basis , it was working absolutely wonderful for me except for excessive tiredness and fatigue , not high at all just tired , sleeping a lot having trouble getting things done and moving forward etc .
But other than that I had no cravings for heroin the thought of using rarely if ever came into my mind as a serious contemplation. .
ive renewed my script and asked to lower my dose to combat the tiredness . I'm now on 10mg daily, I attend chemist 3 times a week still , the same days too , but now I take 10mg there and get given 10mg take away .
after reading about suboxone and other users opinions etc I'm just wondering would I be better off with how I was doing it in the first place ? Only because I've found my self not even taking the takeaway dose so basically I've just been having 10mg 3 times a week , I felt the drop a bit but have adjusted , also taking as bit on weekend too . This weekend I found myself thinking about heroin and using for the first time since I've been on the program and that's been about 11 weeks now . I used 10mg Friday ,6mg Saturday , and 2 mg Sunday , I buckled and used heroin today for the first time in nearly 3 months , I wasn't expecting much of a result but I was surprised I got quite high,. I'm really wanting and thinking about going out and scoring again now , but I'm thinking I should just take a sub strip now just so I no I won't feel it anyway to get it out of my head , I injected about 5 hours ago , if I take a strip now will I feel sick ? Or is that only if I've been using heroin consistently and have a habit and then use sub to soon afterwards , will this one time shot cause me to be sick if I use sub to soon ? I just want to get the heroin thoughts out of my head and start strictly taking my 10mg every day starting from tomorrow so I don't slip up again I've been so happy I havnt been using yet I'm friending to have another shot right now I've already msg ppl waiting for a reply to try and get , I'm so sorry for writing such a long question I'm just not that informed about the workings of sub , thank you

 

[chugs]

Firstly you need to understand the cause of your addiction as to better manage and understand how to avoid "using". Read this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783351/.

It basically says that opiate use has nothing to do with the quality of your character or ability to say no. Your glia (the pink structural stuff that your brain sits in) creates inflammation molecules that bind to the TL4 receptor. This is what creates tolerance and the withdrawal feelings.

During early childhood (womb, first 12 months) your brain was effected by cortisone, a stress hormone produced by your mother when she is being stressed. This effected your brain, namely causing it to produce pro-inflammatory molecules that targeted the TL4. This increased as you engaged in behaviours that created neurotransmitters that binded to the TL4. Bad behavior, risk taking, socially acceptable addictions, whatever it took. You have always been dope sick. You just didn't know it. It also explains tolerance. You need more and more to get through to the TL4...breaking through those pro inflammatory products the glia is producing

How do we know this. The researcher in the aforementioned article created drug addicted animals from birth. He in turn cured it.

The withdrawal feelings range from subtle psychological effects to projectile vomiting psychological ones. That "desire" to use is the fact you have inflammation molecules that are still binding to TL4 receptors. Simple anti-inflammatory drugs like ibudilast and regular small doses of vitamin C can do wonders to hold off the withdrawals. Carry around a bag of green apples. I promise you they will take the edge off anything you'll feel. Once, funny story, i was in the middle of a corporate training session with a dozen senior managers when i started to go into withdrawals - hard fucked up withdrawals. The only thing that stopped it dead in its tracks was the green apples they had for us to munch on. I think people must have thought me weird but i ate a good half a dozen apples that day.

Long life opiates like buprenorphine (suboxone) are good at binding to the TL4 hence their use. But they aren't always effective for a variety of reasons. The duration of the drugs in your system is directly related to your metabolism. People think drinking lots of water clears drugs out but this is completely the opposite. Eating and physical activity are two biggest factors that dictate your metabolism. Eat less, do less and your dose will last longer.

If this isn't possible then you'll need to discuss with your prescriber daily dosing or better still takeways. Its clear that you must be working hence why your already at a chemist. Perhaps they'll be more flexible if you explain that your doses aren't holding you.

 

[footscrazy]

I injected about 5 hours ago , if I take a strip now will I feel sick ?

Yes, I think there's a strong chance taking sub 5 hours after a shot could put you into precipitated withdrawals and make you feel sick.

Or is that only if I've been using heroin consistently and have a habit and then use sub to soon afterwards , will this one time shot cause me to be sick if I use sub to soon ?

You've still got a habit, it's just you've been maintaining it with sub rather than smack lately. If you're at a point where if you don't take anything you'll get sick (ie you have a habit), it's not going to make a difference how often you use heroin, if you take suboxone to soon after it (or any other full agonist opioid) it'll put you into precipiated withdrawals. I think as a general rule you should wait 12hrs after a shorter acting opiate/opioid to use sub (oxy, heroin), or 24 hours after something like poppy seed tea. Or if you're starting to feel dope sick, you should be ok. I've started to be less strict with how long I wait...I've taken sub probably 10 hours after my last dose, when I haven't been feeling sick, and I haven't experienced precipiated wd's. Everyone is different though, and from everything I've heard, it's something you really want to avoid.

Where are you located though, what country? I just ask because your dosing regime sounds quite unusual for Australia or New Zealand. Also, as you've experienced, I think that sometimes there's benefits to taking more suboxone than you would need just to make you feel well. There does seem to be many people reporting a reduction in cravings with higher doses. I have also found, like you, that when I'm on a higher dose of sub it discourages me from using because I know I won't feel anything, and it'll take quite some time until I could. Whereas on a small dose, even if I don't feel sick, I find myself being tempted to use because I know it might work.

 

[Crankinit]

^ Pretty much everything she said. Except I find I need to double those times if I want the suboxone to actually work. 24 hours for heroin/oxy/morphine, etc. 16 - 18 if I eased into it by making my last dose a CWE.

 

[footscrazy]

^ So Crankinit if you take it sooner than about 24hrs later it doesn't hold you..? I'm interested in this because I've experienced something that sounds the same. The first day I take sub after using heroin for awhile, it often doesn't hold me no matter how much I take. I will still feel mildly to moderately dope sick. Sometimes the sickness only lasts a day or two and then I'll settle into my dose, other times, it seems to continue on and the sub doesn't get better at holding me at all. In those cases I've usually switched back to smack for at least a few days consecutively and then when I switch back to sub, for whatever reason, it will sometimes work again. Whether or not sub works for me, and at what dose, is all over the place with me...I suppose the switching back and forth really doesn't help.

 

[Crankinit]

Yeah I think it's the switching back and forwards which makes things get worse over time - I mean each time you skip off subs to get high you basically put yourself through withdrawal twice, and as withdrawal seems to get worse the more you undergo it, it makes sense that you'd get less relief and need longer to settle into the dose as you skip off more often.

I think time is also a factor - I found it a lot easier to go back to subs after only a day or two of getting high than the times where I went for 4 or 5. And of course half life - heroin and morphine last longer than oxy, which lasts a lot longer than fentanyl. That's why I'd sometimes end those suboxone breaks with a dose of codeine - the shorter halflife meant less time of a wait time.

But yeah, I remember there used to be a bit more variability when I first went onto sub, able to take it 18 or even 16 hours after my last dose, but later on, especially the last few times I did it, I found I'd have to wait a full 24 hours, and even then it wouldn't give full relief. Like you described I'd still feel partially sick, sometimes it would feel like it was getting worse for an hour or so before it improved at all (possibly slight precip. w/d, possibly just placebo from fear of it - had it once and wouldn't wish that on anyone). But usually it would be enough to allow me to sleep, although even then the next day I'd still feel off, maybe a little sore or sweaty, and it would only be the day after I'd feel back to baseline again.

God what a pain in the ass

 

[footscrazy]

^ It really is a pain. I've felt the same feeling of sickness after taking sub too - I often feel a short flush of withdrawal shortly after taking it, which I've wondered might be precipitated withdrawals or even the naloxone, though it's not meant to have an effect. It is really annoying that it takes awhile to settle in to the sub and it always tempts me to just stay on h - it really is attractive how much more comfortable I feel on it rather than the slightly shitty, cold sweat/hot flush way I feel on sub. I suppose it's no news that h feels better than sub though. Thanks for the reply

 

[Crankinit]

On the flip side, once you stabilize back onto the sub, the thought of going through that whole mess of a process again is a pretty huge motivation to just not bother.

As for the naloxone, I'm certain it has some effect. It certainly did when I IV'd and IM'd bupe, even though everyone and their mum says that the bupe overpowers it. I guess it's just one of those 'everyone is different' things.