Bupe Suboxone or not?

[Juc]

Hey guys. New here.
If I was the op, knowing what I do now, I'd seriously try and avoid going on the suboxone program to kick a codeine addiction.
I've been using codeine as my doc for approx 10 years. Before that I used H and morphine sporadically but fortunately without developing a habit. Just loved opiates I guess. These days I only use codeine because I drive a truck and I wouldn't keep my license if I used other opiates. It's also been so easy and cheap to get.
I first went on suboxone about 4 or 5 years ago. My codeine use at the time was 90 to 100x 12.8mg nurofen + pills per day (no CWE - straight from the packet to the stomach). Usually 30 at a time, 3 times a day, at which point my tolerance ceilinged out. The prescribing Dr put me on 16mg sub. After 8 months on the sub I ended up in hospital with impacted bowel (went 6 weeks without shitting) and when I got out of hospital I tapered off the sub. Quickly got down to 8mg, then 4mg and then 2mg, no probs (the doctors prescribe way too high doses of sub imo). Eventually tapered down to .10mg and I thought I could jump off from there. Couldn't do it. I went back on the codeine, built my habit back up, and then went back on the sub program. Same story. Tried to taper, jumped off at the lowest possible dose, but couldn't stand the long wd process. It felt like it was never going to end. Back on the codeine, and this is where I am now.
So these new laws have forced me to cut down on the codeine. I've cut my dose from 90x pills per day (so about 1000mgs codeine) to 26x pills per day over the last 3-4 weeks. From here I'm going to drop 20% per week. Withdrawals are mild to hard (not severe), and I can function. I plan to taper right down to zero and then do the 4-7 days of cold turkey. For me, this is going to be much easier than stopping suboxone. That bupe just seems to hang around forever. For me the constipation was ridiculous and I could find no relief. The humiliating visit to the chemist twice per week, waiting with others for the dose, getting treated like a junkie, dealing with clueless doctors, just not worth it. Not saying suboxone isn't a good drug for some, but I would never recommend it. Do the hard yards of opiate withdrawal. Taper down if you need to. I find it best to buy one packet of nurofen plus each day, use what I need (26 per day this week in 2 doses of 13) and throw the rest away. Don't stock up. It's too easy to use more than you need if it's around. There are still enough chemists in NSW that will sell without ID (much harder to get in Victoria now but still possible in a few of the "lower socio-economic" type suburbs). Next week I'll be down to 20 per day and I'll do the same and maybe when I'm down to 15 I can stash the other half packet til the next day.
Everyone's situation is different of course, and I accept that for some people bupe has been a life saver, but I would do all I could to discourage a person from using the stuff, especially when it's replacing such a low dose that the op is currently using.
I would suggest spreading those 40 tabs out over the whole week (say 10 per day to start) maybe getting a friend to hold the packet, and then tapering from that.
Good luck.

 

[Zerwas]

Well if you only take it 2 days a week Subs would not only be overkill but a certain way to develop a much worse physical addiction to opioids.
Also Buprenorphine does not sedate that much, it is more of an activating opioid so if you especially like the sedating part of codeine you will most likely not be satsified with low dose subs. Also because it is only a partial agonist and lots of people miss that full agonist feeling and don't like Subs.

So in your case I would NOT touch Subs with a ten foot pole. You may feel bad now on the days without codeine but going on Subs will only make that worse in the long run trust me.
I have done it after a somewhat small addiction to Tramadol/Tilidine/Kratom/DHC etc and I regret it very much. Even low doses like <1mg are a fucking bitch to come off and nowadays it even makes me depressed and feeling void when I am on it.

So yeah, don't go on Subs. It will make things worse for sure and it will skyrocket your tolerance to the point where Codeine will do nothing for you anymore.

 

[Prescottdave]

I was under the impression that codeine has a ceiling dose. I don't even know how people handle doses above like 250 mg. At that rate it made me have a full on histamine reaction. Upon second thought Zerwas is correct about Sub being somewhat stimulating. I had a terrible time trying to sleep properly on 16 mg per day after the honeymoon phase. I actually lost over 30 pounds since being on Suboxone. I eat extremely well. I'm a skinny person to begin with so this side effect has been devastating for my health.

I tapered down to 0.5 mg then stopped only to find my self in rather painful WD's that should last a good 30 days with months of PAWS. I remember codeine WD was much easier. My doctor acted surprised that I was having WD's stating, "Tapering should be smooth and when you finally come off a micro dose it will be like stopping a homeopathic vitamin. You know like mostly just up in your head."

 

[crzydiamond]

Truthfully, and you may not like this, subs are overkill. You don't have a physical habit/dependence. You would be, in essence, signing up for one

And you may like this even less--if you want to get rid of the psychological cravings, urges, etc that you suffer the "other 5 days", you should really stop taking codeine the 2 days that you do. All you're doing is feeding the cravings just enough that you'll never be free of them. You're not dependent. So take a month or two *completely* off. THEN you will allow your body time to adjust to none--and allow your brain some freedom from it....and your life will no longer become about 2 days with 5 "others" spent focusing on obtaining codeine for those 2 days

And I don't say that lightly. I have, over the last 22 years had bad heroin addictions, time on methadone clinics, and also long stretch of clean time. I've been there; I know the psychological hold it can have. To the point that's all you think about

Which is why I tell you that the way you're doing it you won't ever be free of the obsession. But I also think getting on subs is a much worse choice --an awful choice for a nondependent individual. Give yourself a chance and skip the next "pill session". Lie to yourself if necessary---keep telling yourself "next weekend". But don't do any for a few months. Then and only then will that obsession lift....


Like I said you may not like it. But you've got 3 options
1. Continue as you are
2. Maintenance (and you don't have a habit so this is a big fall down)
3. Take a long break.

When you look at it that way it sort of makes sense, doesn't it??

 

[Zerwas]

^Listen to this. crzydiamond is absolutely right. You will dig yourself a deeper hole if you go down the maintenance road.
When I did this ~3 years ago I was already physically addicted and just wanted to have a safe supply to be able to work and continue my life in a somewhat normal way.
Now after 2 harsh withdrawals, relapses and countless attempts to taper off I am at the point where it seems nearly impossible to even quit my ~1mg/day habit. You don't want that, believe me...

However unrealistic it is the best would be to completely stop. Or just take Codeine like once a month even if that is wishful thinking.

 

[WARDMAN3]

I agree with the sub being overkill.. I certainly do not want to minimize your habit as you are obviously concerned and seem to be well informed of the dangers but with codeine and the amount you are taking, I, too, feel that suboxone may be too much. If you do decide this route, you should start on the lowest dose possible and maintain while tapering off it sooner than later... There are many pros and cons to suboxone and you have to weigh all those options along with one's individual needs and usage of opiates.

 

[cornflakes]

Well I went to the drug place and according to them I qualify for suboxone. But the feeling I'm getting here is that it'll be too much. Is it something I can just *try* for say, two weeks?

 

[Prescottdave]

Well I went to the drug place and according to them I qualify for suboxone. But the feeling I'm getting here is that it'll be too much. Is it something I can just *try* for say, two weeks?

You could try heroin for two weeks. Heck you could even try methadone for two weeks and yes you could try suboxone for two weeks. All of which will help progress to a lifetime of opiate dependency. I don't think you are going to get the answer you want here so really it's up to you. It would be a shame to get on opiate replacement therapy for such a small 2x/week habit. Stay safe and what ever you do or take try and keep your doses low. Really anyone can qualify for Suboxone treatment as long as they can piss dirty. Some places do not even check to see if your using. You could also do a quick suboxone taper under the care of a doctor but what would you be tapering from exactly? Using codeine twice each week. Thats just crazy talk or more like addict talk.

 

[keeping]

so cornflakes, could you clarify for me - do you want to stop using opiates entirely, or rather do you want to go on a maintenance program indefinitely?

 

[cornflakes]

Yes I'd like to stop eventually, just not right this minute. Dammit, it's complicated. Look, I wake up most mornings around 5am whether I want to or not. My heart rate immediately jumps to around 120bpm (I wear a fitbit wrist monitor), and often the anxiety hits so bad that within 10 minutes of waking up I'm retching in the toilet. Then it's on to the business of the day, sitting hunched and shaking over a laptop watching movie after movie because I just can't bear go outside. The only relief I can currently count on is the couple hours of slight relaxation I get from weekly codeine. Yes, I know, it's pathetic, I should just stop. But my daily life is hell and I just can't keep going like this.

 

[FLA]

Thanks for the replies. If I was being honest I'd say it was more of a psychological addiction to the codeine - I am only able to access 40 tablets a week which I eat in 2 days, leaving the next 5 days with nothing (before my access was restricted I'd take 20 every day, but I haven't been able to do that for about a year). So in reality, I'm not taking much. The thing is though, I'm in a really bad place emotionally and mentally, and I crave codeine for its relaxation effects (I'm self medicating - I don't drink or smoke). When I dont have it I constantly think about it. I am anxious and shitty ALL THE TIME. And because of my addiction problems my GP will NOT prescribe anything for my anxiety. Prick.

So would suboxone be overkill for such a small habit? Or might it help level me out and get rid of these constant cravings?

Also, what is it like being on suboxone? Will I be able to relax on it?

Why do you have to throw up first thing in the morning and your "business" involves watching movies all day long? Not sure I understand. Why don't you go out and take a walk or something?

Mine started with codeine too, hydrocodone wasn't even around in the US in the 70's. After going thru this craving, scoring, using, repeat pattern since way back then, I decided to try give Buprenorphine a try because:

Obviously I have some kind of brain disease and this pattern would keep playing out indefinitely.

Buprenorphine keeps it in remission. End of story for me! Obviously everybody's situation is different.

For the most part I am not restless, irritable and discontent, as the AA saying goes to, to which you have alluded.

No one seems to want to talk about the possible costs of not being on opioid replacement therapy. Buprenorphine definitely saved my marriage and may have saved my life! The people on here that trash it don't know for sure that they will never return to opioid use. One thing is for sure, not being on it keeps their options open.

Belbuca is what I take now because it comes at those low doses and has no naloxone. Don't know if it's available in Australia?

 

[crzydiamond]

Yes I'd like to stop eventually, just not right this minute. Dammit, it's complicated. Look, I wake up most mornings around 5am whether I want to or not. My heart rate immediately jumps to around 120bpm (I wear a fitbit wrist monitor), and often the anxiety hits so bad that within 10 minutes of waking up I'm retching in the toilet. Then it's on to the business of the day, sitting hunched and shaking over a laptop watching movie after movie because I just can't bear go outside. The only relief I can currently count on is the couple hours of slight relaxation I get from weekly codeine. Yes, I know, it's pathetic, I should just stop. But my daily life is hell and I just can't keep going like this.

That sounds more like you have generalized or social anxiety. I'm not sure I'd compound that problem by introducing an opiate dependency?

What about treatment for your symptoms? If your regular doctor won't help can't you see a psychiatrist or different doctor? Having had addiction issues shouldn't preclude you from help for anxiety. Especially anxiety that's so debilitating that it keeps you indoors?

 

[cornflakes]

I've initiated contact with a psychologist. I have a long history of depression and have been diagnosed with general and social anxiety, as well as ptsd and borderline personality disorder. I'm pretty messed up right now. That's why I thought suboxone could provide some stability with regards to my addiction, so I could work on everything else. But it's looking like I won't be doing that now, it sounds like just another addiction...

 

[mad man]

i dont know ur back story but it isanother addiction without a doubt I have been on box for 12 years now and i tried twice to quit once by going back to straight opiates. now I feel i will never kick this it henders alot of people if u try to subscribe to twelve step programs cause then u feel ur not really clean well most people on it feel that way at meetings where im from n the old timers c u as an addict still getting dope which u r but it doesnt get u high if it does u didnt need it in the first place. I will say the first time i took it in a clinic i was withdrawing hard n i did get a lil high man i wanted that drug then parents were on board then it stopped making me fel anything but well it is hell to quit and even if u go a month ull still b sick 2 months u may feel better but for me wanted the damn box just so i wouldnt fuck up my then relationship with my ex wife by getting high like i use too so i take the box n now i battle not to take other shit that i like that i can do on box its not a miracle drug as some put it its a miracle im alive n it is part of that but i guess the price u pay is forever being dependent on what the dr gives u not the dope man

 

[Opiatehell85]

Just been catching up, no I don't think you should take subs for a 400mg a week addiction. I'm truly shocked that they have even offered you them. I know it sounds shitty as its all u think about etc etc but if I was you I would try a taper instead then go Drs for an antidepressant or something. If u take subs you'll never be able to get high from codeine again, it totally frazzles your receptors and highers your tolerance, it's approx 50x stronger than morphine sulphate so I don't even think they could prescribe to cover 200mg of codeine, if you get what I mean. It would be like a quarter of a 2mg sub. I was taking atleast 8,500mg a week of codeine, I had a big problem, I made myself bankrupt from buying off internet pharmacies etc etc. Please just give in now before you get any worse. I promise a few days of no codeine and it will all be over, in your case I really do think it's the mental side of it. Take care.

 

[Opiatehell85]

I've initiated contact with a psychologist. I have a long history of depression and have been diagnosed with general and social anxiety, as well as ptsd and borderline personality disorder. I'm pretty messed up right now. That's why I thought suboxone could provide some stability with regards to my addiction, so I could work on everything else. But it's looking like I won't be doing that now, it sounds like just another addiction...

honestly I think you will be disappointed with suboxone, it is a slight mood lifter but once you get into it, say a week later, it stops working like that, so you'll just end up with a dependence to something even bigger. I know it was hard being addicted to full opiate painkillers, but I've heard that when I do have to drop off my subs, it's not gonna be easy. I definitely wouldn't be depending on opiates to try and stabilise your mood hunnie, there's other drugs that are a lot safer for that xx

 

[cornflakes]

Well shoot, looks like I won't be going the suboxone path. Which means I'm kinda in a shit place. Until my anxiety is under control I'm going to keep on using the same pathetic way I have been, because I *need* that relief I get for those few hours each time.

Thanks for everyone's input. I feel I've made the right decision with regards to going on suboxone.

 

[Prescottdave]

You have a diverse range of options. You could seek medical treatment for the anxiety. CBT, group therapy, exercise, meditation, diet, acupuncture the list goes on and on. Do you have insurance or access to healthcare? You also have options in the ways you use your mild opiates. You could use less, taper or spread the codeine dose out over several days.

Obtaining other mild opiates to supplement your current weekend warrior habit is a desperate option but is better then liver damage. Now i'm really encouraging you to use less opiates less often but in terms of harm reduction you may damage your liver if you keep on taking over 5 grams of APAP in a 24 hour period. As far as I know that maximum dose has been lowered recently. Try kratom or tieneptine legally instead of your current dose. Try and obtain some tramadol. Usually unscheduled and not hard to find.

Maybe something that interacts with NMDA such as calcium magnesium, memantine or low doses of DXM. When I used only a few times each week I would also use small doses of DXM in the days between taking the same drug you are using. It worked rather well for a number of years. Low doses of DXM like 30-75 mg 1x/week. Try moderate doses of immodium in the 12-20 mg range. It would be much safer then taking over 5 grams of tylenol. If you are suffering from anxiety opiates are not actually the first line of pharmaceutical treatment nor the best.

Heck gabapentin works amazingly well for opiate WD and anxiety. Gabapentin also has some recreational value. Clonadine helps and could lessen your cravings. Your psychological addiction is telling you that opiates are your only option. This is not true.

 

[cornflakes]

Unfortunaty opiates *are* my only option, most of those alternate drugs you mentioned are illegal in Australia. I've tried importing benzos and codeine but it gets caught by customs every time.

 

[Prescottdave]

You could get some addiction treatment that does not involve more opiates. When you start feeling desperate enough you could come back and re read this thread. Try some brief meditation and gratitude exercises and talk to a family member, loved one or friend. Maybe they may have some better advice. Sounds tough what your going through. Hope it gets better.