Please Help: Suboxone induction problems...
Sorry if this is a little long, but please read.
HELP!!!!
I'm helping my partner switch to Suboxone today from a 64 mg a day IV Dilaudid habit -- but things don't seem to be going too well -- despite the fact that we waited
18 hours after his last shot to administer the first 4 mg of Sub.
We also used the COWS opiate W/D scale to make measure how sick he was.
But the Sub seemed to make him sicker, though he's not in the "Worst WD" of his life, where he's shitting and puking and all that stuff. He just says he feels worse.... "can't sit still," all of that.
With some folks, relief is instant with Suboxone, I'm told.
With others, it takes several doses or even more to get relief.
I don't know what to do.
I REALLY need to counsel or advice about what I'm doing here.
I am educated about Suboxone -- or thought I was -- and the probability of precipitated W/D if the Sub is given too early before the person has gone into bad enough W/D/. We did this on our own, without a doc's help -- not such a good idea, it seems.
HERE'S WHAT"S GOING ON:
He took his last shot at 2:30 am. Sunday.
He woke up at 12;30 a.m.. but the COWS opiate W/D/ scale test indicated he wasn't even close. He was just having anxiety attacks -- the prelude to the madness.
After the COWS test said it wasn't time, I gave him 20 mg, Valium, 30 mg Restoril or Temezepam, some Clonodine and a Soma. He slept for two hours.
When we awoke, at 2:30 p.m., he was still not in the COWS range to give him the suboxone. So we waited some more.
Finally, at 7:30 p.m. --18 hours after his last shot -- he scored a "23" on the COWS test, which is just one point below "moderately severe W/D " -- the second worst ranking, so I figured it was safe to give him the first dose.
The plan was to give him 4 mg every 30 minutes until he started feeling better.
But after the first dose he almost immediately complained that he was feeling
worse. I suspected then that he was having a panic attack -- because it's easy to think you've taken it too early AFTER YOU TAKE IT and then you start playing mind games with yourself -- you all know the drill, most likely.
He laid down for a while longer and when I checked on him, he said he felt even worse than before -- and that a NEW "restless leg" symptom which wasn't there before I gave him the sub.
He said he can't "stay still" or stop moving his legs -- a common W/D symptom.
I know this symptom well, and it's one of the worst. However, as I write, he IS laying still in my bed, not pacing the floor, so I don't know what he expects.
DID THE SUB CAUSE THIS?
I'm pretty positive he was in enough W/D when I gave him the first dose.
Sweat poured down his face; his blood pressure and pulse was low, but I i attributed that to the Valium. But he could barely walk or stand. He scored higher on restlessness. He was so agitated that it was hard to get him to finish the test.
He couldn't stop sneezing. In fact he sneezed at least four or five times a minute -- the highest score for that category. His eyes watered. He's chilling.
At 8 p.m., I gave him 3 mg more Sub -- because I recall a doctor advising that when you're in this "
no man's land zone of sub W/D" -- where you don't know if you did it right, but you're not in the worst W/D of your life: puking, shitting, wanting to die, you should
KEEP TAKING IT UNTIL THE SYMPTOMS SUBSIDE...
But he seems to be getting worse with every dose, so for now I've stopped giving him anymore. But it's too late to turn back now, isn't it? I've got methadone here, but I'm not about to put him back on that shit unless I really fucked this up.......That is not an option at this point.
Since his blood pressure rose back to normal when I gave him the second sub - weird huh? -- I gave him twenty mg more of Valium for the anxiety.--
I know this is dangerous to mix the valium with Sub -- he's fairly Valium tolerant and very opiate tolerant, so I'm not too worried. I NOT giving him any more Valium till things improve. Plus I read that the ODs with benzos and sub usually happens when people inject them together (REALLY DUMB)
We're on pain clinics and get a bunch of different opiates each month.
This is kind of strange, but
HE TAKES 60 mg of Methadone a day for 1/2 the month, then stops for a day and starts shooting 16 4 mg of Dilaudid a day the last half of the month. (We're on pain clinics) --
I was thinking there may be some methadone left in his blood -- but he's been off his 60 mg a day for
12 days......That didn't seem to concern me, I figured 12 days was long enough. In fact, he mentioned Friday night that his "rushes" were getting REALLY strong because the Methadone leaving his was gone.
I don't want to sound hysterical. But I'm concerned.
Again, I could really use some assurance, or guidance or advice or counsel from someone who knows this shit and knows what they're talking about -- I know a lot of you do, because I've seen these types of "help me" freaked out Sub posts before and lots of folks respond with great feedback.
PLEASE DO THE SAME FOR ME.
Either post it or send it directly to
my private messages.
***Edit: Don't give out your email address on a public forum. - Mr Blonde***
Thanks a lot
greenwire
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")