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Bupe Switching to Subs (need help)

appleguy

Greenlighter
Joined
Jun 15, 2012
Messages
36
Hello. My last attempt was unsuccessful. I was on subs for a bit and had some bad pain, had to stop the subs and start perks again.

Now they've gotten away from me again. I'm taking 200-400 mg daily. My paid has subsided and I'm ready to stop. I want to use subs to help. The last time I did it I had some nasty WD in the first day. I can't afford to loose much time at work and have a family at home. They're unaware of my issue.

What is the best way to switch to subs. Best...as in I want to have the least amount of withdrawal symptoms. How long should I wait. How much should I take etc.

I also have tramadol. In the past that has helped ease WD but that was before my problem was this bad. I'm wondering if I can take them to stave off early WD and THEN take sub a few hours later. Any help is appreciated.
 
Hi
I would have to say that I would take some of the tramadol for a day or so before starting the subs. I actually did this and it was pretty smooth. The best tip is that u should take the trams when it would be time to take ur hydos dose. The key for me was to take the teams BEFORE you start to have WDs. Once on the trans, I would take the subs 24 to 36hrs after ur last hydo dose. I would start off w just 2mgs of sub. Less is best one it comes to subs. After taking the first 2mgs of sub, if in an hour u still feel bad wds, take another Mg.... I don't think ur wds should be too bad if u keep up on the tram doseing
good luck!
 
Thanks for the response! I haven't been able to find much help anywhere online about tramadol. So you're confident that I can take the tramadol right up until the time I take the subs and they won't react with subs and force preciptive WD?

Last time I was took last perk around 8pm. Took a few tramadol in the morning, felt fine, even felt GOOD. Then took 1-2mg sub around noon. Actually they made me worse! The day got bad after that. Around 5 I felt horrible...tried to go out with the family, got upset stomach at dinner, had to leave, came home with dry heaves and all. HORRIBLE! I want to do whatever possible to avoid having that happen again.
 
Thanks for the response! I haven't been able to find much help anywhere online about tramadol. So you're confident that I can take the tramadol right up until the time I take the subs and they won't react with subs and force preciptive WD?

Last time I was took last perk around 8pm. Took a few tramadol in the morning, felt fine, even felt GOOD. Then took 1-2mg sub around noon. Actually they made me worse! The day got bad after that. Around 5 I felt horrible...tried to go out with the family, got upset stomach at dinner, had to leave, came home with dry heaves and all. HORRIBLE! I want to do whatever possible to avoid having that happen again.

cant comment on the tramadol, but as far as sub goes...wait 24 hrs from your last percocet dose and start with.02 mgs of sub and you will feel like a new man...hope this helps..good luck


olskool
 
Can't cut it shorter than 24 hours? That's going to be painful for a good while. What do you do in the mean time? How about valiums....do they help in the in-between period?
 
Can't cut it shorter than 24 hours? That's going to be painful for a good while. What do you do in the mean time? How about valiums....do they help in the in-between period?

Depends on your metabolism.. everyone is different. You need to take the suboxone when you are in full withdrawal.. if that happens for you after just 12 hours (like it does for me) than that is a safe point to take it... the longer you wait the better, obviously.. but it isn't always a necessity for everyone to wait the full 24 hours.. (of course some people with a slower metabolism need to wait even longer than that) It also depends on how long you've been using every day for consistently.. the longer your body has been used to your drug.. the harder it is to switch to the suboxone and the longer it takes. But if you follow this rule, FULL withdrawal then start dosing the suboxone slowly.. you'll be fine.
 
What is full WD? How do I know when I'm there? How can I get to that point and hide it?
 
Last edited:
I went into Full withdrawal, when going from methadone to subs. I took a 8 mg subs 4 days after my last dose of methadone. I curled up into a ball on hard floor and put a blanket over me. I had a panic attack feeling for 30 min and gradually felt better after 1 hour. However, it was 30 minutes of hell. I don't understand how you can be in withdrawal all day long!

You do not need to take a dose higher than 8 mg subs. In addition, i would try and get subutex , the subs strips gave me a wicked headache. You just need to get used to the sub feeling. I have weened myself down to 1 mg of subutex and I still get weird feeling from it.

Also, I would go and get some blood work done. 200 - 400 mg of Percocet contains a lot of acetaminophen. The tramadol is fine before and after the sub intake, it won't stop withdrawals. . Valium is fine. Take it slow, lower your dose every 12 days.

Not sure by your post who knows about your addiction. I would definitely tell your spouse and if your not married tell your family. Get a support structure, . Also, you should attend some NA meetings, it will help and there every where all the time. Good luck!
 
I have both the pill and the strips. Which is better to take in the beginning?

Will valiums eliminate or tone down the WD symptoms?

I'm just confused....I'm thinking I can take valiums and/or tramadol to help keep the WD symptoms at a minimal. Will that work? And if so how will I know when a good time to start the subs is?
 
What mr.Scagnattie is saying is that you have to wait until you are actually experiencing withdrawal to take the buprenorphine. It can't be when you just start to feel uncomfortable. It really has to do with the half life of the opiate you are taking as well as how you metabolize the drug. For example, when switching from a long acting narcotic like methadone (24-48 hour half life) you must wait much longer than when you are on a shorter acting one like morphine (4-5 hour half life).

As for your personal situation, I would really only recommend using the Tramadol if you can keep the use down to a bare minimum. Due to the fact that it is also an SNRI, it can cause seizures at dosages above (though sometimes below) 400mg. I would think that with your tolerance, the amount of Tramadol that you would need to take care of withdrawals would be too high to safely consume.
 
Okay, I would first stop with the oxycodone (Percocet). When you feel some wd symptoms coming on - tearing, runny nose, aches and pains, and/or a feeling of significant uneasiness due to lack of the opiate, start with a dose of the Valium and the Suboxone/Subutex. But, make sure you are definitely feeling "poor" because of the oxycodone's absence - that is the key, along with some of the first wd effects like teariness and runny nose, and a feeling of unwellness/sickness. When you do the first dose, I would begin with 5 mg Valium orally (assuming you have no benzo tolerance), and JUST 0.5 mg Suboxone/Subutex under the tongue. I would continue with the Valium at 5 mg, taken four times a day (every six hours) after the first dose. I would, then, continue just the same with the Suboxone/Subutex, and keep at either 0.5 mg four times a day (every six hours), or increase to up to 1 mg four times a day (every six hours). The lower, more frequent dosing of the Suboxone/Subutex should help more in actually acting as an opioid agonist, which is what keeps you well - the frequent dosing allowing for accumulation of the drug in the system and a total dose enough to take care of the dopesickness as the wd's continue to ensue and peak. I would say NO MORE than 4 mg Suboxone/Subutex daily should be needed, and I seriously would take it as frequently as four times daily, even though that is not the norm, each dose being 0.5 mg - 1 mg. The less Suboxone/Subutex in each dose, the better for helping to ease wd's, and not just totally throw you into a Suboxone/Subutex trap. With the Valium, taken four times a day, too, at 5 mg, you should experience a good deal of relief in muscular aches/pains and tension, anxiety/nervousness, general excitability, nausea, and insomnia. Like I said I am assuming you have not got a benzo tolerance. 5 mg Valium four times a day (every six hours) would allow for good accumulation of the drug, too, like with the Subutex/Suboxone, and the effect would continue to build in strength as the wd's got worse, allowing you to ride them through more easily. At first, 5 mg Valium might not seem to do much, but if you dose as I suggest here, it should definitely exert effect at 20 mg/day in total. As for the tramadol, I would not necessarily take it UNLESS it helps you seelp, in which case, I would take 50 mg, then another 50 mg an hour later - this staggered dosing will provide more o-desmethyltramadol to be metabolized and thus more of an opiate feel due to more opioid receptor agonism, and relief of wd's. But, with the tramadol do not go much above 100 mg in one dose, in this case, and DO NOT dose it throughout the day - you have it, and it could potentially really help with sleep - let it be a nighttime extra, if you will, allowing for more comfort, and a better chance at sleep. Just my suggestion. It can be stimulating, but with the Valium and Suboxone/Subutex, and during wd's, it should help more than anything - just DO NOT use too much, for that could lead you into a tramadol dosing pattern very counterproductive to getting off opiates with ease. I do not even think the tramadol is necessary, but if you have no seizure history, I would say 100 mg, in a split dose form, would be okay to take at bedtime either every night or as needed, depending on what you needed.

I would begin stopping the Suboxone/Subutex regimen after about 5 - 7 days, with a QUICK taper (1 or 2 days) by lowering the dose, but not the frequency till you are ready to stop completely. With the Valium, I would suggest going down to 2.5 mg from 5 mg four times a day, after about the same amount of time, but giving a little bit of time at 5 mg four times a day after you stop the Suboxone/Subutex completely (allow for maybe 24 hours more of 5 mg Valium four times a day after the Suboxone/Subutex is stopped altogether). At 2.5 mg four times a day of Valium, take a few days to a week, to cut down the dose of the Valium daily till you are ready to be done with it, and then you can stop. I assuming you are NOT benzo-dependent while thinking of this plan. With the tramadol, I would use it only while using the Suboxone/Subutex, for best result, and again only at night at 100 mg in a split-dose.

Hope this helps.
 
Thanks for the advice everyone. All very helpful.

I think I should be a little clearer. I've done the transition two times before. After the 2nd day I'm fine. What I'm struggling with is the first day. I'm trying to keep the WD symptoms at bay as much as possible. The first time I did this it wasn't too bad, however my use was significantly less. The last time my use was the same as it is now. I used tramadol in the morning and that helped. I started subs around noon. I had off/on WD symptoms all day after I started subs. Until around 5/6:00. Then they got HORRIBLE. Dry heaves, completely sick in stomach, Inabikity to focus or concentrate, cold sweats, body aches. I don't know why they happened hours AFTER I started the subs. I think I did something wrong. After that, the second day and on I just took subs...maybe started with about 4-8mg a day and tapered down to 1-2mg after 3 weeks.



So now I really just want a plan to run with on the first day. What is the best way to do this to eliminate as many WD symptoms as possible. Any more help is appreciated.
 
I'm planning in making tomorrow be my last day. If anyone can chime in that would help.

I'm a little scared. Looking for help in two areas:

1. Any suggestions on specifics to do on my last day taking perks?

2. What is the BEST way to make day one keep WD as minimal and as much at bay as possible?
 
As for question 2, just follow my advice about LOWER doses of Suboxone/Subutex (0.5 mg - 1 mg SL), for it will feel "better", but re-dose MORE frequently (4 x daily - every six hours) to allow for a constant level of buprenorphine, which will rise as it needs to with the wd's increasing severity, and allow for better control of the dosing of the drug, too. In this way, it should feel much more as an agonist, like any other opioid of recreation, than an antagonist - that is better to take away from dopesickness and the feelings that come with it. Also, use the Valium as I recommended, I'd suggest, if you have no benzo tolerance.
 
Ok. So tell me if this sounds like a good plan:

Take last Percocet around 7pm tonight.

Before bed (11pm) take 10g tramadol

Wake up and take another 50mg tramadol (8AM)

When I start to feel some symptoms above irritability take another 50-100mg tramadol and 5mg Valium. (I have no history with Valium, so tolerance is low)

Then every 2 hours take another 50mg tramadol

Every 4 hours take 5mg Valium

Then take first dose of sub (1mg) at least after 2pm. And when I feel like full WD would be set in. It'll be more difficult to tell due to tramadol and vallum masking symptoms.

Then take another 1mg sub every 6 hours.


Please let me know if that seems like a good plan.
 
so your taking your first SUB after 17 hours of your last opioid dose of Oxycodone

how much Oxycodone in your Last Dose, at 7:00 PM
 
Well it's now 17 hours since last dose. WD was really uncomfortable and anxious this morning. Started taking valiums and tramadols and WD have been manageable. Not too bad at all.

Wondering if i should take subs now or if I should wait more. Anyone?
 
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