Suboxone withdrawal advice needed..

[dontgodownthisroad]

Ok so this isn't my first, second, or 10th rodeo. I'm actually an old user from the forums who lost my old account, but anywho, I've gotten clean from the grips of Suboxone before by using what I call "the ladder method" - in which Suboxone is one of the stronger opiates and in order to get clean without losing your mind, you take strides and start "stepping down the opiate ladder" to sobriety. "Stepping down the ladder" means using less potent/lasting opiates to deter the withdrawals from the stronger opiates.

So, in this instance, I need to kick a Suboxone habit that I've had for the better part of a decade. I've done this before, but the circumstances were different.

So, as of right now, I'm 2 weeks clean from Suboxone, but I've been using oxy's to manage the withdrawal symptoms. Well, this gets extremely expensive because as of right now it takes at least 3 30's to get me through the day, but every day I can feel myself healing and getting better.

I have two strips and am wondering, after 2 weeks no use, do you think I could stop taking the oxy and use the sub for the next couple days (because I'll inevitably feel like shit) , or should I stay away from the Suboxone altogether?

Also, for anyone wondering the steps after this, once I adjust all the way and Oxy becomes too much, I "step down the ladder" to hydro's (only taking maybe 1 lortab 10 in the morning and 1 at night, then taking less) and then after hydro, I hop off and become clean and if I *still* can't manage, I'll find Kratom, which I've yet to have to do.

So, stay on the Oxy's after a 2 week break from Suboxone, or cut the Oxy's and use the Suboxone I have sparingly and see how I feel?

I know this is pretty specific, but any advice is welcomed. Thanks, guys!

 

[Greymare]

" stepping down" really has more to do with MG's I would think? it's a little dicey to assume that taking 90 MGs of OXY is In some way a better or less harmful way to keep withdrawl at bay .

And kratom has alkaloids very similar to morphine in strength! Just be careful and don't thibk switching from one thing to another is benifical unless the actual amount of opiod your taking is decreasing. Stay on subs! they have a ceiling dose ( you can't get higher and higher) long half life and antagonist properties..
Good luck

 

[Moreaux]

I was kind of thinking the subs would be the best option as well, and am confused as to why you would want to step down to something with such a short half life comparatively speaking? Like Greymare said, subs are self limiting so they do seem the more logical choice.

In the other hand, you've been off subs for two weeks, do you feel comfortable moving forward in you plan and transitioning to the hydros? I get the feeling that subs are a major issue for you, so maybe moving on to the hydros would be best.

Are you ready for the stepping off point- do you have a plan for when you totally quit?

Kudos on your three weeks!

 

[Swimmingdancer]

I was kind of thinking the subs would be the best option as well, and am confused as to why you would want to step down to something with such a short half life comparatively speaking?

That is the point. The withdrawal syndrome from a shorter-acting opioid is shorter. I used morphine to get off methadone. Taking Suboxone again at this point defeats the point of the ladder method. What I did personally was just skip switching from morphine to a weaker short-acting opioid like hydrocodone and just tapered the morphine with the help of some non-opioid meds.

 

[Greymare]

i don't think that's true??? Half life of a drug doesn't correspond directly to duration of withdrawl symptoms? I could be wrong I don't know
but if that were the Case then suboxone would.be a lousy choice as replacement therapy right? . It has to do with altered chemistry in your brain and body

But it sounds like you don't like subs. The other part of getting off drugs though is the actually " use"part , and subs, having such a long half life don't require hourly or even daily administration,
Pyschologically speaking anyway, I would think it's better to use less frequently so your not still thinking about and taking pills, taking pills, stashing pills, thinking about when your gonna take your next dose etc...you know what I mean. It's all that time and mdvral energy we devote to drugs.. Eliminating the rituals and behaviors surrounding their use is a HUGW part of getting clean too.
I hope whatever you choose works out for you!! It's just a tough thing to do alone and any opiod is an opiod is an opiod

 

[Swimmingdancer]

i don't think that's true??? Half life of a drug doesn't correspond directly to duration of withdrawl symptoms? I could be wrong I don't know
but if that were the Case then suboxone would.be a lousy choice as replacement therapy right? . It has to do with altered chemistry in your brain and body

Methadone and Suboxone being used as replacement therapy has zero to do with the duration of withdrawal syndrome.

They are used partly because of their long duration of action. But anyone with experience will tell you the withdrawal from methadone or buprenorphine lasts longer than the withdrawal from any other opioid. I have not actually seen a medical research paper etc on the subject of whether or not this is due solely/directly to the drug's half-life or duration of action (not always the same thing) and I doubt one exists. No one wants to spend money on showing that long-acting drugs have any disadvantages over shorter-acting drugs. But I thought it was well known that shorter-acting drugs generally have a faster and more abrupt onset of withdrawal symptoms and shorter-lasting withdrawal syndrome, and vice versa for longer-acting drugs? My doctor didn't question that concept. I believe it's due to multiple factors. A long half-life drug will take longer to leave your body, which affects withdrawal syndrome. It may also have something to do with consistent use of long-acting drugs altering your receptors more, since they are usually near-constantly being flooded, as opposed to a shorter-acting drug where you may have less consistency (like most people are not going to take an oxy every 3-4 hours all day/night every day).

Now, I'm not saying it's necessarily a good idea to switch from a longer-acting opioid to a shorter-acting one in preparation for stopping opioids completely. What the OP is doing is different from what I did and what I did is not something most people seem to be able to do effectively. Although, getting off Suboxone or methadone after years of use and transitioning to no opioid use is not something most people seem to be able to do period.

 

[Greymare]

yeah I know why subs are used and all about half lives and affinities and all the different receptors and nalexone and antagonists and agonists etc ....and I guess it does make sense that a long half life would result in a longer withdrawl

i don't recall having a worse or longer withdrawl from subs vs other sruff. My experiences have all been the opposite but thads prob due more to the low dose then the drugs action.
And doesn't prolonged use actually grow "extra" receptors ...complicating shit even more? I am pretty sure I read that in a text book at one point

 

[Moreaux]

That is the point. The withdrawal syndrome from a shorter-acting opioid is shorter. I used morphine to get off methadone. Taking Suboxone again at this point defeats the point of the ladder method. What I did personally was just skip switching from morphine to a weaker short-acting opioid like hydrocodone and just tapered the morphine with the help of some non-opioid meds.

True, but it helps to keep withdrawals at bay longer so your not dosing as much when going through a taper. I would expect that if using a longer acting opiate, the taper would be slower and one would go further in dose reduction to get the body reading for the stepping off point. I think longer acting opiates probably need a much slower taper than what is traditionally done, but that's just my opinion.

I see the logic in both ways, and with respect to the OP's situation, I think subs are a specific issue for them in. If that is the case, then either staying the course or proceeding forward with the original plan may be the best course of action for them.

 

[MrRoot]

Isn't 90mg oxycodone equivalent to 8mg buprenorphine?

I have once tapered down from 250mg daily oxycodone habit with buprenorphine and I started with 16mg per day and dropped 2mg per week and after hitting hitting 8mg per day I tapered 1mg per week until I hit 4mg per day and started dropping the dose by ~10% per week and finally stayed on 0.1mg twice a day for a month. No acute withdrawals at all.

Recently I tapered down from +160mg oxycodone with 10mg drop per week and jumped off totally last wednesday and had only some very minor withdrawals.

I would say that t doesn't matter if you taper off from oxy or bupe if you have a good tapering schedule which isn't too rapid. Cold turkeying and too rapid taperings had lead me into relapsing very soon.

 

[Swimmingdancer]

yeah I know why subs are used and all about half lives and affinities and all the different receptors and nalexone and antagonists and agonists etc ....and I guess it does make sense that a long half life would result in a longer withdrawl

i don't recall having a worse or longer withdrawl from subs vs other sruff. My experiences have all been the opposite but thads prob due more to the low dose then the drugs action.
And doesn't prolonged use actually grow "extra" receptors ...complicating shit even more? I am pretty sure I read that in a text book at one point

Yeah, dose and length of use are important factors.

Do you mean prolonged use of any opioid or of buprenorphine specifically? Exactly how prolonged opioid use affects receptors is complex and poorly understood, but basically it generally causes receptor downregulation, meaning receptors become less sensitive and decrease in number (at least for the main subtypes of receptors). Here's a strange dramatically-narrated animation about the process: https://www.youtube.com/watch?v=W2QjbdYfakg

Isn't 90mg oxycodone equivalent to 8mg buprenorphine?

I have once tapered down from 250mg daily oxycodone habit with buprenorphine and I started with 16mg per day and dropped 2mg per week and after hitting hitting 8mg per day I tapered 1mg per week until I hit 4mg per day and started dropping the dose by ~10% per week and finally stayed on 0.1mg twice a day for a month. No acute withdrawals at all.

Recently I tapered down from +160mg oxycodone with 10mg drop per week and jumped off totally last wednesday and had only some very minor withdrawals.

I would say that t doesn't matter if you taper off from oxy or bupe if you have a good tapering schedule which isn't too rapid. Cold turkeying and too rapid taperings had lead me into relapsing very soon.

Using a short buprenorphine taper to get off another drug is very different from trying to get off buprenorphine when you've been taking it for years. The OP said they've been on Suboxone for the better part of a decade. That definitely affects the withdrawal syndrome.

 

[dontgodownthisroad]

test i posted a reply and it didn't show

 

[dontgodownthisroad]

ah fuck you gotta be kidding me. well, i wrote a long message and it's lost to the void now.

attempt #2

it's nice to see all of you noticing the effects of these drugs and how ravaging they are, despite lack of research and what-not. it's good to know the community is informed and experienced, as usual.

anywho, i woke up feeling fine which was pretty damn unusual..i usually wake up feeling some kind of w/d symptom after 12 hours of any opiate use, even suboxone. anywho, i took the suboxone (2mg strip) and felt a little better and things were goin' good and i was stoked, all the sudden i felt horrible and I've been in this place before, i was w/ding from the oxy's...so I did a 30mg to curb those feelings until about 7-ish hours later when i felt like i needed to re-dose my sub (2mg strip).

So all in all, I think it was a stupid move and I could've had a better day if I just took less oxy. I might stay on subs for another day just to give my receptors a break and then try again with the oxy, this time with more self discipline and spacing out when i dose as long as possible.

All in all, I feel like I shouldn't have gone backwards and I could have done better managing the oxy's I had. I'm gonna have to take less and really buckle down on that. Time to keep trying!

Thank you guys for your time and your replies. They're very appreciated.

 

[dontgodownthisroad]

Ok so I don't want to bore you with details, but I believe I have my taper straightened out now.

Does anyone know of any good suboxone success stories? I could use those right now!

 

[Swimmingdancer]

Glad to hear. I am a success story in getting off methadone after a decade and I know someone who got off Suboxone after a few years. It is definitely possible. It does get better and easier with time! Hang in there and stay focussed on your goal.