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Old 03-18-2010, 10:39 AM   #1 (permalink)
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Question skipping days on suboxone

OK, so now per docs instructions, three days before my appt. on monday. I am on 14mg and he thinks it ok to skip days... I know how long of a half life sub has, so Im wondering.. does anyone have any experience with this, and since it has such a looong half life, has anyone ever skipped like three days? I read from most peoples w/ds from subs, they really dont start to hurt until days 4 or 5. I think I remember BV telling someone that.. I am really all of a sudden starting to look forward to being off of them. Probably will be fully off in June. I just wondered if anyone else doc had them do this, and if anyone had the experience with the three days.

I am wanting to do that, to show my mind that I can DO THIS.. I plan on hitting meetings twice daily during those three days.. I know there will be SOME discomfort.. the legs, maybe my tummy.. So, what does anyone think of that? Im not trying to rush it. i will be on just 8mg per day starting Monday, I just want to be able to know that I can WILL myself when I am done with them. I dont think that it should hurt anything. And like I said, will hit meetings hard and will no way in hell pick up..

Hope everyone has the beautiful sun that we have here today!!
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Old 03-18-2010, 11:21 AM   #2 (permalink)
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Sounds like progress to me!! Great to see you with a desire to live a better way of life and doing what you can!!
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Old 03-18-2010, 12:22 PM   #3 (permalink)
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Did your doctor say what the rationale is for dropping from 14 to 0?
Did he say to reestablish your dose if you experience w/d? I would think the precipitation of w/d only to resume sub in three days would be risky. But there may well be an established precedent and appropriate reason.
I have not heard of this in my dealings with suboxone patients, and my personal experience was only 5 days.
I am very interested in hearing from people who received the same directive from a doctor, so I (we?) can be helpful to others in the future.
Thanks for posting this, it's a totally new one on me.
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Old 03-18-2010, 12:22 PM   #4 (permalink)
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I went three days. Why are you doing that again? Im sorry I just dont understand what the purpose of that is (not being rude at all, just asking).
When I did it, I did start withdrawaling some, but my biggest issue was THINKING about the subs. It didnt give me a buzz or anything, but its a pill so I felt like I needed it.
I would try and post alot during those three days and keep yourself busy.
ALSO, I know personally some people who used the liquid taper method. They literally had almost no withdrawals doing this. If you need info on that let me know.
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Old 03-18-2010, 01:56 PM   #5 (permalink)
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Thank you for all your responses.. He wanted me to start skipping days, since i balked at any reduction last time.. He was firm about it.. The way he explained it to me was that say I took a dose of 8mg... (just my morning dose) then the next day I would still have 4mg in me, and the next would have 2mg in me, and so on,so a day or two would be good. He thought that by Monday, it would still be in my system, and we could go from 14 to 8mg safely. Then at the end of the month (or sooner if I wanted) to do the same thing. I was really scared before of getting off subs, but now a change of heart for some odd reason.. I want to will myself, and to know that when the time comes, that I am strong enough to do it.. testing the waters?I dont HAVE to skip three days... i just want to, to prove it to myself.. he did want me to skip some days, tho... does that term make sense here? When i see him on Monday I will still have some sub in me, and then the drop to 8mg will be easier.. I dont really know his reasoning, but he is a pretty smart guy and I trust him fully.

Nalla, I am curious about the water method when I do begin tapering off? I have never heard of that one, but it sounds interesting..When you went three days was it to completely get off of them, or just to skip days? when did you first start to feel bad? after a day or two? I do NOT want to make myself sick, or to the point where I would crave (i am not going back to that no way in heck) I am just curious as to when you began to feel bad.. I have heard after 2 days, and after 3 days, i have even heard of people going 4 before feeling bad (BV I think?)

Thanks again guys, and I look forward to your responses..
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Old 03-18-2010, 03:06 PM   #6 (permalink)
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Becky...I think you should listen to your doctor because, well, he IS a doctor. I know for me, I went from 16mg to 8mg with no problem physically....then, from 8mg to 4mg...really no problem physically...then for 4mg to 2mg, no problem. However, emotionally I've kinda been up and down. Once I get to 1mg, I'm gonna stay there for a little while. Just take it easy, and follow through with your plans. You'll do fine. Honestly, these nightmare stories about withdrawl...I haven't really experienced it...yet anyway. And, most importantly, with my taper, I honestly haven't craved any opiates....this is why I've said that I believe the subs are a great recovery tool and taking them just to avoid withdrawl in the beginning of your recovery, then jumping off just isn't a good idea. You have to have a strong recovery in place while on subs...yeah, being able to stop taking opiates is a good thing, but having on going recovery without relapses is even better...I know for me, the subs have helped me so much and I thank God that I've had the opportunity to be on them.

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Old 03-18-2010, 03:55 PM   #7 (permalink)
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Becky,
I have been on subs twice, with two different doctors. I have also done a ton, and I mean a TON of research. I know a sub doctor who is a psychiatrist and an addict. He was on sub as well so he is the perfect person, in my opinion, to presrcibe subs. I truly believe many sub doctors are really underqualified to prescribe it. I even had one tell me that I shouldnt expereince withdrawals if I come off at 2mg. WRONG
He highly reccommends the liquid taper. I know many people who this has worked for. In fact, these are the ONLY people that I have ever talked to that experienced little to no withdrawals while coming off subs.
In my opinion, it would be better to take 2.5mg a day, than skip three days. In your theory, the highest concentration of the drug is in your system for the first day, less the 2nd, and even less the 3rd. Then, IF you repeat the process, then its the same thing all over again; thus you are going up and down, up and down. I think if you are going to spread 8mg out over 3 days, it would be better to take 2.5mg a day. Just my opinion.
About the liquid method... its like if everyone says the sky is blue, then it must be true, right?
If you want to go from 1mg to .8mg, its too hard to cut the pill accurately and know exactly how much you are getting. BUT many people have proven that slow and low is the way to go with subs. So, if you are going from 1mg to .8mg, here is what you do:

Crush an 8mg pill and dissolve it in 10 ml of water, so every 1ml of water would contain .8 mg (800mcg) if Suboxone. Use an oral syringe that meaures in mls (available at pharmacies, used for measuring kid's cough syrup, etc.) to dose yourself with a half a ml in the morning and half a ml at night. Keep the solution in an empty pill bottle in the fridge so it doesn't get funky (shake before each use).

Keep the amount of water low so that the solution would be fairly concentrated, and it works really well. Hold it under your tounge just like you would the sub pill.
The drop from 1mg to.8mg produces only the mildest symptoms, some restlessness and a little irritability. Much better than trying to go from 1mg a day to 1mg every other day.

Then you may go to .6mg, then .4mg, then .2mg, then jump off. To go to .6mg, you would take 3/4 of a 8mg pill (or three 2mg pills) and dissolve in 10ml's of water, keeping in mind that each ml would thus contain .6mg. You are supposed to drop down every 4-7 days.

It all seems really tedious I know. Oh, and when I skipped 3 days, once it was to quit and once it was for tapering. I found the daily reduction much easier phyisically and mentally than skipping days. But thats just me.
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Old 03-18-2010, 04:05 PM   #8 (permalink)
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Becky

I agree with Penny - the best course is always to speak with your own doctor about your fears and concerns and questions. They know you, they know your history, they know your level of health, and they know your circumstances....and unless you're really unlucky, they know their stuff (in which case, if you are unlucky, vote with your feet).

If you don't entirely trust your doctor then maybe you need to look at finding a new one.

The advice you read here might be good - or it might not.
I'm not a doctor and I assume no-one else here is either.

That's basically why we have the no medical advice rule.
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Old 03-18-2010, 04:43 PM   #9 (permalink)
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Maybe you could speak with your doctor about the liquid taper. A good doctor would at least listen to you. Some sub docs dont know about it or may not think its necessary, but there is no harm in asking if its ok and if you think it will help with your recovery and detox. Sub is a hellava drug to come off of- Ive done it twice, once the wrong way, and once the "right" way.
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Old 03-18-2010, 05:41 PM   #10 (permalink)
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Ok to me, the liquid tapering sounds like the Cold Water Extraction I did sometimes with pain pills. Toooooooooo creepy for me!
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Old 03-18-2010, 05:46 PM   #11 (permalink)
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Oh and I think I felt bad day 3, but only a little.
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Old 03-18-2010, 06:51 PM   #12 (permalink)
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Beck,

I agree with the consesus.... if the doc says it's ok, go for it. I will add however, that I have also done a sh!t ton of research about this medication and have come across A LOT of positive reinforecement in regards to the liquid taper method. I have seriously been considering it for my own drop below .5mg. Sorry Court, I don't have any experience with this prior to reading about it in regards to subs, but I understand your fear regardless.

Also, wanted to agree with Penny in regards to my tapers so far.... I've had absolutely NO problems physically as I've tapered to about 1.5 mg's daily. I have suffered some emotional distress.... a little weepy and some situational depression. Nothing I haven't been able to deal with though.

Good Luck!

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Old 03-19-2010, 09:08 AM   #13 (permalink)
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I'm sorry, are you serious??? I don't get how no one else is saying this but WTF???? This sounds incredibly sketchy to me and I'd question the doctor (and his license) again. I realize that any type of ORT is going to be subjective to to the person, and I'm not calling you a liar, but at that high of a dosage??? I sure as he!! I wasn't 'skipping days' or weaning myself down really low unless I was out of pills early due to over use, just being honest here. I've heard of skipping days when you're trying to come off altogether and are on super low doses, but at 14 mg?? Skipping 3 days sounds like a set-up for the quickest way to relapse!

I don't have any clue why your doctor would tell you to do this, and frankly, I think it's reckless and irresponsible, esp. considering your history with addiction, Beck. I guess it makes sense theoretically that you'll still have sub in your system due to the half-life...but you're probably going to be at the least, uncomfortable, at the worst, hard core jonesing for a damn pill! (whether it be physical or mental.) And not giving you ideas, but you could def. use over that (whether or not you'd feel anything is a diff. story.) I just don't understand that at all. I could see him having you slowly go down, like asking you to wean to 12mg or 10 mg first, but going off the pills altogehter??? Irresponsible and completely defeats the purpose of the REPLACEMENT therapy!!

The point is to keep you comfortable while you work a recovery - learning the tools you need and setting a support system in place so you are ready for the inevitable taper off the medication. 'Willing' yourself to 'not' take suboxone off of 14 mg is flat out useless in my book, and this puts your recovery into SERIOUS jeporady. Messing with doses like this seems completely contradictory to ORT and if I were you I'd get get real honest with myself real quick - if this is truly something recommended to you byu your doctor??? than I'd get another doctor, and ASAP!
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Old 03-19-2010, 09:21 AM   #14 (permalink)
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Sorry if that was, uh, heated - I didn't mean to offend you Beck. It just makes me mad when drs do stupid $hit. You know how you hear these 'horror stories' about people coming off of Suboxone and Subutex? Man, I've heard it time and time again. People feel good and 'normal' on ORT, they're working their recovery - it's all fluffy and bunnies and cupcakes and rainbows. They decide 'hey, I can do this! I don't need this stuff!" or some idiot on some forum somewhere tells them they are NOT sober on SUB and they are still tied to the dope man. (or some dr tells that to test themselves by skipping 3 days, cough. Seriously, WHAT?!) And then the person jumps off from doses that are way too high without being weaned/tapered properly, or they start trying to mess with doses or 'skip' days to 'test' themselves...all of a sudden, they're in the same pain they were as coming off their DOC and BOOM...relapse. Wash, rinse, repeat - there's your horror story. ORT CAN WORK SUCCESSFULLY if you choose to work it successfully. Just SAYIN! (jumpin off high horse now, my butt hurts!)
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Old 03-19-2010, 09:56 AM   #15 (permalink)
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Hi Shell, no I understand and no offense at all. I still have pills left, he just wanted me to do that (honetly i SWEAR it) and then Monday go to one 8mg tablet a day ,spread out in two doses.. He reasoning I posted above after Bears I think.. I have never even felt like abusing them, they do their job and that suits me just fine. I dont see how over using them would do any good? I KNOW people do, (maybe its just the act of taking a pill?) and lots of them, but for me I have never felt any reason. Im def. not going off them all together yet, no WAY am I ready for that. But what you said about wanting to use scared me. I thought the way he explained it there would still be subs in my system. And I even asked if it would hurt me, and he explained the long half life thing above. I do NOT want to set myself up to use, but thought what he said made sense, and that I would then be ready for Monday and the 8mg. I am a little skeptical now.. I really do trust him, and he has not steered me wrong thus far, but I will not, cannot go back "out there"...

Thanks for all your replies, and Nalla, when I do go off in July, I am DEF asking my doc about the liquid taper, it sounds like a winner. I dont see that he will have any problem with it. Love to all you guys! ((Court)) ((Marsh)) ((Dee))((Shell)) and ((Nalla)) I really appreciate all your feedback!! Its gorgeous here and hope its the same for all of you!
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Old 03-19-2010, 10:14 AM   #16 (permalink)
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Um, is this water taper thing something developed by doctors or is it an addict's "recipe"?
I read that and it made me really uncomfortable. It appears to be like a detox recipe. If so, it has little place here. If I'm wrong, I stand corrected.
I checked with my co-counselor who has worked with three sub doctors. She was not familiar with anyone recommending stopping subs for a few days, especially at 14 mg. The only reason she knew of people skipping subs was when they were out of meds or needed to use opiate medication.
I agree with Shells post above, the most unsuccessful folks on Suboxone are those who mess around with their dosages, either up or down. People do experience exaggerated senses of well being at increased dosages.
This is all posted for information only, Becky, it is not intended as a reflection on what you are doing. The discussion had sort of branched off into other things and I wanted to comment on those.
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Old 03-19-2010, 10:20 AM   #17 (permalink)
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Maybe you could just call the doctor to discuss this again, make sure you understood him correctly?...Seriously, print out the thread and read it to him and see what he thinks! (wouldn't be the first time - I always bring my p-doc SR threads to discuss. He reallly loves me Calls me 'colorful.')

No, we are not Drs, but we are addicts with 'field' experience. What I posted above was my gut reaction, based on experience, that's all. I didn't mean to freak you out, and it's not the end of the world, but pretty scary I think. Honestly, if this doctor wants you skipping 3 days of medication NOW, coming off 14 mgs ??? Not only is he very clearly jeapordizing your recovery, but I'd be anxious to find out how is he intends to handle your taper later on when it really comes down to the nitty gritty? You know how you notice 'warning signs' or 'red flags' from an addict when there is dangerous behavior going on? Well for me, and this is completely just my opinion, this would be a big old waving red flag that this doctor either has little to no experience with Suboxone (not sure if he's a sub dr specifically, a p-doc, addictionologist, what have you) or is just plain ol' irresponsible. Don't know about you, but I had enough irresponsibility and 'testing' myself (in that way) during my active addiction, I don't need it in my recovery.
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Old 03-19-2010, 10:36 AM   #18 (permalink)
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I've heard about the liquid taper for when you get down on the super small doses, but I gotta go with Bear on this one-- the people I've heard this from are other addicts. More specifically, I've seen liquid taper plans discussed in great detail on most of the harm reduction websites I've been to, and IMHO, it's better left there. Only b/c, I def. think the method and discussion of it could trigger many, depending on their individual experiences. For the record though, I've heard this is quite effective in getting off sub. Never heard this from a doctor though. I know for me, this much activity, ritual and preparation surrounding a medication would be verrry dangerous, for me.
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Old 03-19-2010, 10:52 AM   #19 (permalink)
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thanks again you guys... I think I may in fact call the doc to make sure I understood him, but I was pretty sure I did? Of course I have been wrong a LOT in the past, lol.. He is a regular doc too, but I have felt good with him, i thought he knew what he was doing? I REALLY dont want to jeoaprize my sobriety maybe I shouldnt skip and then talk to him Monday? I feel really skeptical now, I do have the pills to take, and now Im a little freaked. Is 14 to 8 a dangerous jump? Maybe I should find another sub doc. I dont want to go back. no, i CANT go back. I sincerely appreciate all the feedback, and I may just make that call, but it was my understanding that he was available for sub related calls, visits, etc. Mon, Tues, Wed... Well, crap..
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Old 03-19-2010, 11:01 AM   #20 (permalink)
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Becky, if you can't get ahold of him before Monday --- if it were Me, I'd stick with my dose and reassess when I see the doctor again. (Monday's your next appt, right?) I don't know if I'm allowed to say that, b/c I know the dr told you different - but you just stopping the medication right now honestly scares that cr@p outta me. As far as going to 8, I think it's sort of weird he doesn't have you going to 12 or 10 first, but you probably won't even feel the drop to 8. Honestly, many addicts are started at 8mg or lower (not that it makes a difference at this point.) Plus, 8mg is still enough that it would block any opiate usage as well. You split doses right, so you'll probably do 4 in the AM 4 in the PM? Bet you won't even notice, but if you're worried, why not ask him to slow things down?

Is there a reason for the July deadline? Is it self-imposed for financial reasons? Other than that, it seems pretty quick for an ORT, given your drug history. Sorry, there I go again, I'm not a doctor. Honestly though Beck, please consider at least talking to another dr or getting another opinion. It just seems like what this guy is saying and the info you're getting doesn't quite jive, ya know? Just b/c he's an awesome family dr or PCP doesn't mean he's the world's greatest addictionologist. I do think it's cool that any dr can RX the suboxone for times when you can't find an addiction specialist, but if you can find one - even better, right?!
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