Been on Subutex too long!

[SerenityPlease]

I was a pretty major opiate addict. Up to about 30 Norco/day and couldn't put more than about 60 days of clean-time together before another relapse. It almost cost my my marriage and my life. Went to a doctor who told me about this wonderdrug called Subutex. He told me that it would help me kick the hydrocodone AND would block my opiate receptors so that if I relapsed in the future, I wouldn't feel the drug. Sounded too good to be true but I gave it a shot.. I had pretty much nothing to lose at that point in my life. I followed his directions and waiting until I was in pretty deep D.T.'s before I put that first Sub under my tongue and - - it was a god-send! I felt better within minutes! That was a little over 2 years ago and I'm still taking about 16 mgs of Subutex/day.

I want to get off the stuff so badly but everytime I go to low on the Mg.'s, I start to feel worse than any withdrawls I've felt before (and I've kicked pills, methadone, morphine, everything but Heroin before).

What's the deal? Is this stuff just another wolf in sheep's clothing? Is there a way off of it? Is it a forever proposition?

I'm happy to be no longer "using" but I'm having a hard time calling myself "clean" because of the Sub. I don't mean for this to be a rant... I have an actual question: Will someone please share with me their experiences kicking Subutex after a prolonged time taking the stuff? Any advice or help would be greatly appreciated. Also, does anyone know of any physicians who have hospitalized Subutex users for the purpose of getting them off the stuff? Like a medically supervised detox from the stuff that was supposed to detox me in the first place?

Thank you all!

[LogCabin]

Sounds like you need to work with your doctor to start weening off this med.

Here is a great website with good info. (I don't know anything about this medication myself...but I want to point you in the right direction.)


The entire article:
Drug Abuse Help: Suboxone/Subutex Information

"When patients no longer require buprenorphine, they should work with their physician to set a gradual taper schedule to avoid acute withdrawal.
Source:
Opiate Detox Heroin Detoxification Buprenorphine Buprenex Subutex and Suboxone Detox in California

Withdrawal:
Both Suboxone and Subutex can cause drug dependence which can result in withdrawal symptoms if the medicine is suddenly stopped. Since buprenorphine is a partial agonist, withdrawal is less severe than with full agonists. If a patient has a dependence on another opiate, he may experience withdrawal symptoms at the beginning of treatment. These drugs are not for irregular use and should never be stopped without first consulting your doctor. Generally, doctors will gradually reduce the dose to avoid or minimize withdrawal symptoms.

Buprenorphine is a partial agonist at the mu-opioid receptor and chronic administration produces dependence similar to the opioid type, characterized by moderate withdrawal upon abrupt discontinuation or rapid taper.
Sources:
http://www.suboxone.com/Suboxone/phys/20021008.htm
Suboxone medical facts from Drugs.com

Treatment:
To avoid severe withdrawal symptoms, chronic Suboxone/Subutex users should taper down slowly under a knowledgeable physician�s care. Dependence resulting from even a few weeks of regular use can usually be handled under a physician�s supervision with minimal discomfort.

However a person chooses to free themselves from the clutches of a drug, there is one constant each needs: Support. Narcotics Anonymous remains a successful choice for many addicts, with world-wide availability. The "information age" has produced numerous on line support forums, popular with many recovering addicts, useful to some addicts as their sole means of support and for others, as adjunct therapy. Drug addiction is treatable, with help out there for everyone."

[kj3880]

Hi,
I'm weaning off the sub slooowllly. I tried to go real fast one time, and didn't feel at all well, like a flu. So I'm decreasing by .5 mg about every 8 days or so, whenever I adjust to the last decrease. Right now I've gone from 16 mg down to 2 mg.

I was gonna decrease some more starting tomorrow, because it is day 8 on 2 mg today, but now I have strep throat, so I'll wait until that clears before I fiddle with my doseage again. My weaning is voluntary, my doc was OK with whatever I decided, staying on longer or going off of it. It has taken me about 2 months to go from the 16 down. I suggest doing it more gradually than you would think--.5 mg at a time or even less.

Just as long as you decrease some even if it takes a whole month between decreases, you will make progress. There isn't any reason to do it all at once or quickly, is there? You don't want to relapse. So what if it takes 16 months to get off it? I feel OK about me as long as I'm making progress. I think you can do it, if you go more slowly.

KJ

[SerenityPlease]

Thank you all for your advice and support. I keep telling myself I'm going to start the weening process but for some reason, I always find myself needing a refill at about the same time each month. It's just something that I need to do once and for all and the thought of doing it gradually is MUCH more palateable than abruptly stopping it.

I'll start tomorrow morning and keep you updated on my progress.

Thanks again!

[bvaljalo]

I can't give out medical advice, but I can tell you this ... I honestly know from experience that you don't need NEARLY that much subutex on a daily basis ... unless perhaps you are like only keeping it in your mouth for like 3 minutes before swallowing/spitting it out?

I had a similar sized opioid habit to yours for many years, 'cept I was sniffing oxys rather than gobbling vikes. My experience on subs was that after the first couple weeks at 16mg, I went down to 12mg for about 5 months, then I dropped to 4mg a day OVERNIGHT, did that for a month, then I did 2mg a day for about 3 weeks, then I quit taking it. It was a pretty rough for about 96 hours (days 3-7 without subs), but it was manageable. I did it under my mom's care, at her house. I've now got over 13 months completely clean and sober. So, I'm here to tell ya, it can be done.

These 'withdrawals' you think you're feeling from taking less ... unless you are DRAMATICALLY dropping your dose overnight, I can almost guarantee you are imagining them. Perhaps since you've gotten off methadone you have this preconception that it's going to be worse than it actually is?

I basically experienced zero discomfort from any of the reductions I made in my dosages, not even the drop from 12mg to 4mg, which as I say, I literally did overnight. If you want to get off the stuff, talk to your doctor, and get on a weaning schedule, and then stick to it. It's *honestly* not that hard to wean off of it ... it's when you quit it that it sucks. But if you get your dosage down reasonably low, it's not really *that* bad. Not nearly as bad as, like, coming off of 300mg/day of hydrocodone, that's for sure.

Good luck, and keep posting

[hairgirl]

I have been on Suboxone for almost a year.I have done as much research on it as possible.The only thing I can tell you is that, maybe it is not time to want to quit.I know how you feel, but think about how long you were taking Norco's and the amount.This place we are all in such a hurry to get to, well, how long did it take to become addicted?
The taper should be very slow, like dropping a couple mg's every two months or so.I am no doctor, we are all different, but I have seen it to be much easier when the taper is done over six months to a year.Your brain controls it all.If your brain is not ready, you will feel worse than if it was ready.Give your recovery the time it deserves.I know all too well how rushing through can lead to mistakes.

[illbeback]

I feel you, Serenity! One question though -- why not try switching to suboxone? I don't know much about this stuff, but I think it has something in it that better helps block the opiates.

I've been back & forth on these things for about a year and found a great rapid-detox guy. This system is NOT for everyone, but the pricipal behind it may work. Talk to the doc about switching to suboxone, then try tapering down by 1/2 a pill every couple weeks. You may have a day or two of an "uneasy" feeling when you first taper down each time, but's it's almost nothing compared to the alternative.

I took my last one Monday morning and am not feeling good by any stretch, but infinitely better then going cold turky from the vics (which I went through more then enough for the rest of my life). BE STRONG!!

[SerenityPlease]

Thank you , thank you and thank you! Everyone. Actually yesterday I went from 16mg down to 12mg and didn't even feel the difference. If anything, I slept better than I have for a long time because what I did was skip my 4mg dose right before bed. This stuff keeps me from getting into a deep enough sleep to be restorative you know? I find that if I take it right before bed, I'm up in an hour eating for some reason. Anyway, my plan is to stay on 12mg for a few weeks then drop a bit more. I like the idea of doing it very slow! Thank you all again! I'll keep you updated.

[illbeback]

Great job, Serenity! I had 2 docs that I went to -- one went with a rapid detox which didn't work for me very well (relapsed quickly), the 2nd kept me on subs for about 6 monts (8mg per day).

Then, I decided it was time to stop because, like you, I was tired all the time and...well, something inside told me it was the right time. My current doc was out of the country for a couple weeks, so I went back to the rapid-detox guy and went from 8mg per day down to ZERO in about 6 weeks with very minimal discomforts. In fact, the only real problems started when going from 2mg to 1mg (and that was actually pretty mild -- just lack of energy) and then a bit worse from 1mg to .5mg, which was more of a mental thing...and stupidly, I didn't do it the way the doc suggested and basically only did .5mg for 2 days, then down to zero as of Monday morning.

Everyone is different! Do this while working with your doctor and as you're able to handle it. But, I will say from my experience, you may feel even better still going from your 12mg dose down to 8mg over a few weeks. Again, work with the doc. I think this stuff stays in your system a long, long time (like a week), so that helps cut down the issues associated with tapering.

I do confess, the past 3 days have not been the best, but nothing at all like my experiences of going from 200mg vicodin to nothing overnight. I also had to get a 2-week script for Lunesta because the sleepl problems are the worst for me -- I just can't function if I'm not well rested. If you can get a decent night's sleep, everything else is just that much more tolerable.

So, hang in there! Make a plan, stick to it, and you'll be OK.

[bvaljalo]

Just for the record, there's *no* difference between suboxone and subutex when used sublingually as directed. The extra ingredient (naloxone, aka Narcan) in suboxone is inactive unless the pill is injected (or maybe snorted), the narcan is there purely as a safeguard against improper use of the active ingredient, which is buprenorphine in the case of both subutex and suboxone.

Illbeback, congrats on getting clean I just want to mention, when I stopped the bupe, the worst of the w/d's didn't kick in until day 4, due to the long half-life of the drug. It may be different for you since you tapered much lower than I did, but ... just a head's up. Be prepared for the possibility of feeling worse for a little bit as opposed to better. If it happens, it's normal, don't worry. If not, then count your lucky stars

And SP, congrats on successfully starting your taper. Honestly, I felt best when I was on about 4mg/day of the stuff. Go about tapering in a reasonable way, and you really shouldn't have any real discomfort. What you do have will be mostly mental, your addict mind tellin you 'you need MORE', but if you really stop and think for a moment you'll realize it's much more a 'want' than a 'need'.

[illbeback]

After reading a ton of posts about subutex withdrawls (including many, many terrible experiences), I guess I realized that, for me, tapering led to about 3 weeks of almost daily mild withdrawls. I had no energy, never really felt good, and was probably pretty depressed. But I was tapering down faster than most suggest. I can only assume that going through all that made the last 3 days much more mild than they could have been. Woke up on day 4 feeling pretty darn good!

When I quit cold turkey from Vics, the physical stuff wasn't nearly as bad as the mental anguish. By using Subutex, I've had months to develop new habits and generally get my life together. So, going through the Sub withdrawls has been tough, but compared to cold turkey it was like starting out on week 2 of the process. Mentally, anyway.

Anyway, Serenity, my point is this: you can do it!! I think fear is one of the worst parts of the healing process. You'll feel bad and wonder if you'll never feel better; you'll be afraid of things getting worse; but when you start to feel scared, take inventory of how you feel at that moment, and chances are it's not as bad as you think. You may feel worse sometime later, but deal with that when it comes and don't let fear control your life.

[13thStep]

Iv been a Heroin addict for going on six years. Been to a few rehabs,
losta psycologysts and psyciatrists so iv done my rounds. The most
clean time iv had at once was almost a year. Other than that its only
been a few months inbetween.

Been realy serious about comming clean so went to the doctor and he
put me on 8mg of subutex, 30mg of Serapax and 15 mg of dormicum.
Iv been on this for about seven months now.

Iv just recently moved and the place that iv moved to none of the
Doctors or Pharmacies have any, iv been of the subutex for three days
now and im withdrawing realy badly, cant sleep, massive depresion, feeling
weak, hot and cold spells etc..the doctor told me it will take about a week
for them to order it but i realy dont think i can wait that long.

He perscribed 1mg of Buprenorphine a day until the Subutex arives. But it
is doing absolutely nothing to help with my withdrawal symtoms. Can anyone please help me with any suggestions about the Buprenorphene or if there
is anything else out there that will help.

Regards

[princezz07]

13th step, that sux, what a bad situation, i cant believe your doc even let that happen.
If you can it maybe worth ASKING the doctor for Clonidine or Lofexidine ASAP they are both non addictive prescription only BP meds, that can help hugely with opiate w/ds.
I know many peeps who have used one or the other to come off methadone, sub, heroin, opiate pain meds......myself included.
This is just MY experience im sharing with you, please ask doctor.

Serenity,
congrats on reaching out and making the decision to head in the right direction, keep up the good work, im also trying to get clean and sober myself, i know how painful it can be.

[13thStep]

Thanks Princezz, ill do that. Have an appointment in two days, gotta
ride it out till then but will let you know how it goes.

Also, i just wanted to you in your personal oppinion cos iv
heard of clonidine and lofexidine but never heard of anyones progress
on it, would you say it will help more with my withdrawal than maby
asking the doctor to up my dosage of the Buprenorphine? (Doubt he Will)


Look forward to hearing your advice.

[kj3880]

I'm not a doc, but IMO if you want to go the suboxone route you need a very experienced doc. I've had a great experience detoxing with suboxone. Check my threads on the subject. According to my doc. 1 mg is the end dose, not the start dose. Check your area on the internet for an experienced addictionologist that has been working with suboxone patients for a while. I've never heard of anyone starting on 1 mg. Normal, according to my doc, is to start at 8-16 mg, and he works us down monthly .5 mg at a time. Until then, suck on the pills that you do have for at least 20 minutes before you swallow your spit. The medication is absorbed by the tissues in your mouth, not your stomach. You can do this, with the right doc.

Hey, make some NA meetings, too, cause suboxone doesn't cure your spirit, just detoxes your body (but for me, I needed the help of suboxone just to get started. I couldn't kick cold turkey, I tried it a lot of times). PM if you need more questions answered. Love from:
KJ

[bvaljalo]

What format is the bupe in, 13th? Is it a shot? Well, I don't know too too much about dosing that way, but I would think that if you've been bangin your subutex, you'd probably need somewhere in the neighborhood of the mg dose of bupe you were doing before in subutex. If you were taking it sublingually, as prescribed, I'm not actually sure how much of the original 8mg of bupe was hitting your bloodstream, so it'd be hard for me to gauge. But in any case, bupe shots should work the same as the sub pills, provided you get enough of it. 1mg a day sounds awfully brutally low, esp. since you went off the stuff for 3 days, so your blood concentration of bupe is getting pretty low at this point. Dunno, talk to the doc some more is all I can suggest. Don't do any dope. Good luck my friend, hang in there ...

[13thStep]

Im taking it in tablet form. It isnt helping at all, this is almost like withdrawing
from Heroin all over again. I understood when he told me that they didnt have Subutex in stock and had to order it but i couldnt believe that he put me on 1mg of bupe a day of all things.

Bvaljalo do you get bupe in liquid form? Would it be worth asking about that as well as the Clonidine or Lofexidine? Because iv still got four days till my Subutex arives.

Thanks Bv
Regards

[13thStep]

Hey B

Thanks for the advice, im in desperate need of any advice or help i can get at the moment. Seing as the Doctors didnt have Subutex there probably isnt a good chance but do you think its worth asking for Clodine or Lofexidine in the mean time?

I was originaly on 16mg of Sub and managed to drop to 8mg's, how many Mg's of bup if they have nothing else would i need just to take the withdrawal away for the next few days until my Sub arives?

Kind Regards.

[kj3880]

We aren't allowed to tell you how much you need, but I can tell you I needed 8 mg a day at first.

[13thStep]

Just thaught id let you ladies and gents know whats happening. I still dont
have my Subutex, iv already gone through just about a week of withdrawels
and i know with me when i used to shoot up and try come clean i would
sometimes withdraw for up to two weeks..was suposed to get my meds
yesterday but now the doctor tells me tommorow.

Iduno if i should just ride out the rest of the withdrawels and take the 50/50
chance that ill be ok or if i should go back on it and wean myself off properly?

[13thStep]

Finaly got my meds, just wanted to say thanks for the help
and advice.

Im looking for a little bit of help and advice, i am taking a lower
dosage of subutex now, i think im moving the dose down to
quickly but i have heard things like if you keep it in your mouth
longer it works better, etc..is this true? And if so is there
any other things i can do that might help?