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  • Wanting to start Subs detox.

    Alrighty....let me make a very long story as short as I can. I'm a firefighter/paramedic that injured myself in two separate incidents 10 months apart contributing to the same injury that I have been off for, for the almost 3 years. I originally fell and fractured my lower back which wasn't found until the second injury when I was lifting a heavy patient and the fracture spread apart by a few millimeters. The pain I was having though was due to a disc that herniated and was pressing the S1 nerve root between itself and a bone spur. Workers comp gave me their normal runaround until I finally decided that it was time to get it fixed with my group health and continue fighting them in the meantime. All this led to a physical dependence on opiates. I have never enjoyed taking and being tethered to these drugs...but they were a necessity because without them, I could hardly walk. Through some sort of miracle...the surgery that I just had last week was a total success even though the surgeon wasn't optimistic due to the length of time that the nerve had been impinged. Over the past 3 years I have taken pretty much everything (nucynta, vicodin, percocet, dilaudid, tramadol, generic morphine, avinza and I'm sure a few others). I would take them until they stopped working effectively and then ask to be changed. I learned pretty quickly that I was physically addicted when I decided to not take my nucynta because I felt pretty good pain wise one day. I was drenched in sweat, freezing, shaking, nauseous. My wife was trying to talk me into going to see a doctor when it dawned on me what it might be...took a pill and within 30 minutes I felt normal. Lol...that was a wake up call. Anyway....fast forward almost 3 years and I had my surgery last week and miraculously my back pain and leg pain is about 95% gone and I am ready to start physical therapy and get back to work. I came into 4 8mg/2mg Suboxone strips. My buddy has told me that if taken short term...it is a miracle drug...and if taken long term...it is a nasty demon from hell. I have read hours of posts about it and how you should take it. I've read Robert_325's posts. I've read everything from people taking it for only 4 days for up to 6 weeks....and obviously I've read the horror stories of people being on maintenance doses for years. So here is the gist of the question. At this point...I am still taking my generic morphine 30mg twice a day. I have quit taking all breakthrough meds but can't cut the ER morphine into smaller units. I want to start the Suboxone tomorrow but am willing to wait another day or two to get this nailed down. I have enough to last through next weekend. I have 4 of the 8mg strips and am pretty sure that is plenty to get thru this. As far as addictions go...mine probably sounds pretty minor...but addiction is relative and to me...it's the worst I've ever experienced. I don't know if Robert_325 is still around or if anyone has been thru this that was taking approx. the same amount of opiate when they kicked. Almost all of the posts I've read on here...the person kicked from a much higher amount. What would be a good starting point?. My tentative plan is to start at 2mg. I know Robert says that is too high...but IMO(and I've never done it)... .25mg just seems way too low. My buddy that has done it recently went from 2mg twice a day for a few days...down to 2mg once a day...to 1mg twice a day...to 1mg a day down to .5 twice a day to .5 once a day to .5 once every other day. The whole process took place over two weeks. He said once he quit completely...he had some yawning, lethargy, and runny eyes and nose for a couple of days and that was it. That sounds like heaven to me compared to what I have been through before when I have ran out of my opiate earlier than I should have. Does this sound realistic? Is anyone going through it now or that has been through it recently that was taking around the same amount of morphine when they quit and took suboxone to kick it with? I'm just curious. I'm open to any suggestions and helpful past experiences. Any and all help would be appreciated. Thanks a lot in advance and I wish you all success with whatever struggles you're going thru.

    Heavy

  • #2
    Originally posted by HeavyFD View Post
    Alrighty....let me make a very long story as short as I can. I'm a firefighter/paramedic that injured myself in two separate incidents 10 months apart contributing to the same injury that I have been off for, for the almost 3 years. I originally fell and fractured my lower back which wasn't found until the second injury when I was lifting a heavy patient and the fracture spread apart by a few millimeters. The pain I was having though was due to a disc that herniated and was pressing the S1 nerve root between itself and a bone spur. Workers comp gave me their normal runaround until I finally decided that it was time to get it fixed with my group health and continue fighting them in the meantime. All this led to a physical dependence on opiates. I have never enjoyed taking and being tethered to these drugs...but they were a necessity because without them, I could hardly walk. Through some sort of miracle...the surgery that I just had last week was a total success even though the surgeon wasn't optimistic due to the length of time that the nerve had been impinged. Over the past 3 years I have taken pretty much everything (nucynta, vicodin, percocet, dilaudid, tramadol, generic morphine, avinza and I'm sure a few others). I would take them until they stopped working effectively and then ask to be changed. I learned pretty quickly that I was physically addicted when I decided to not take my nucynta because I felt pretty good pain wise one day. I was drenched in sweat, freezing, shaking, nauseous. My wife was trying to talk me into going to see a doctor when it dawned on me what it might be...took a pill and within 30 minutes I felt normal. Lol...that was a wake up call. Anyway....fast forward almost 3 years and I had my surgery last week and miraculously my back pain and leg pain is about 95% gone and I am ready to start physical therapy and get back to work. I came into 4 8mg/2mg Suboxone strips. My buddy has told me that if taken short term...it is a miracle drug...and if taken long term...it is a nasty demon from hell. I have read hours of posts about it and how you should take it. I've read Robert_325's posts. I've read everything from people taking it for only 4 days for up to 6 weeks....and obviously I've read the horror stories of people being on maintenance doses for years. So here is the gist of the question. At this point...I am still taking my generic morphine 30mg twice a day. I have quit taking all breakthrough meds but can't cut the ER morphine into smaller units. I want to start the Suboxone tomorrow but am willing to wait another day or two to get this nailed down. I have enough to last through next weekend. I have 4 of the 8mg strips and am pretty sure that is plenty to get thru this. As far as addictions go...mine probably sounds pretty minor...but addiction is relative and to me...it's the worst I've ever experienced. I don't know if Robert_325 is still around or if anyone has been thru this that was taking approx. the same amount of opiate when they kicked. Almost all of the posts I've read on here...the person kicked from a much higher amount. What would be a good starting point?. My tentative plan is to start at 2mg. I know Robert says that is too high...but IMO(and I've never done it)... .25mg just seems way too low. My buddy that has done it recently went from 2mg twice a day for a few days...down to 2mg once a day...to 1mg twice a day...to 1mg a day down to .5 twice a day to .5 once a day to .5 once every other day. The whole process took place over two weeks. He said once he quit completely...he had some yawning, lethargy, and runny eyes and nose for a couple of days and that was it. That sounds like heaven to me compared to what I have been through before when I have ran out of my opiate earlier than I should have. Does this sound realistic? Is anyone going through it now or that has been through it recently that was taking around the same amount of morphine when they quit and took suboxone to kick it with? I'm just curious. I'm open to any suggestions and helpful past experiences. Any and all help would be appreciated. Thanks a lot in advance and I wish you all success with whatever struggles you're going thru.

    Heavy
    Hi there. Welcome! I know what you're going through as far as the awful opiate addiction. I could be mistaken, but I don't think you have enough sub to do a proper taper..at least not the one most people follow here which is a 25% reduction every 4 or more days until u reach .25 mg. Someone with more experience with this will be along shortly to help you. Best of luck! My first sub dose reduction is tomorrow. I'm very excited to be on a journey towards sobriety! Take care. Will check your thread to see how you're doing.
    -Katherine

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    • #3
      Heavy, if you are still taking your pain pills daily, you do not want to start suboxone yet. You should go at least 24 hours after having any kind of pain meds, and be in pretty bad withdrawals before you start. Otherwise, if you start taking the suboxone too soon after your last pills, you run the risk of what's called 'precipitated withdrawal'. You will want to do a google search for 'COWS worksheet', and print out a copy once you find one so you can assess yourself after you've had your last pain pill. You will want to have a score of at least 26, and have gone 24 hours without pills. Once those 2 things have happened, you can start with the suboxone.

      You mentioned you've read the taper plan written by Robert, who unfortunately no longer posts here. Here is the link to the taper plan:

      https://www.drugs.com/forum/featured...apy-50887.html

      It may be helpful to read it again or even print it out, as it can answer many of your questions. It addresses the induction phase, where you start with a small amount and wait 90 minutes, assess any withdrawal symptoms you may be still having, and if needed take a smaller amount, and repeat the process every 90 minutes until you feel like you've stabilized. You may find that you will be able to get stable at less than 2 mg, and since you only have 4 strips, that couldn't hurt.

      I am one of those poor souls who was stuck at a large maintenance dose for years. I am at the start of my taper, about a week in and at 8mg a day. Therefore I can't answer your specific questions about what others have experienced in circumstances similar to yours, but there are people here who have been where you are, and have successfully used suboxone to end their years of heavy duty pain pill usage. I'm sure you will hear from some of them soon.

      In the meantime, please consider doing your induction using the guide provided in the link. If you google 'the Thomas recipe for opiate withdrawal', you will find a host of ideas and tools to treat your withdrawal symptoms which will allow you to take the least amount of suboxone to met your needs. However, in order to bring your COWS score to 26 as soon as possible, you might not want to use anything mentioned in the thomas recipe while you are waiting to go into withdrawals after your last pain pill.

      Comment


      • #4
        hey, Heavy, you've been on a nasty ride with the opiates. Congratulations on getting down to only two 30mg. morphine tablets. However, I do have some concerns with the amount of sub that you have: 4 8mg. strips give you only 32mg. of sub. Subs are very potent medicine. Despite what you have been told subs are NOT a miracle cure. I don't believe that that amount is going to quite get you through the taper. You want to taper no more than .25% around every 4 days.

        Make sure you read Roberts sub plan thoroughly. You want to start on the lowest effective does. Therefore, I wouldn't start out at 2mg. Cut your sub, or at least one of them until you have some .50mg. pieces. (you can google cutting sub). It is imperative that you are in moderate to severe w/d before beginning the sub. You can google a COWS worksheet and try to score at least a 26 before you begin your induction. When you begin your taper, start with .50mg and wait around an hour, if you are still having symptoms try another .50 mg., wait awhile and take another .50mg. and so on. You should be able to stablize around 2mg.

        You can also start with 1mg. and wait around 1 to 1/5 hours and then take .50 mg. doses in increments around an hour apart until you feel "normal". Again, I think you should be able to induct at around 2mg., perhaps less.

        Once you feel stable, you can start cutting your dose by .25% every four days. Do not get in a hurry with this. Robert felt that most people are successful in weaning off subs without becoming addicted, as long as they tapered within 6-8 weeks. That is an estimate. The taper is not set in stone, you need to listen to your body and taper accordingly. It helps to post here and people will help you as you go. One thing you might want to do is to post in this in the "suboxone therapy" section of the boards. There are many who can help you there, particularly Alexnt.

        I wish you all the success in the world!

        Peace,

        Iloerose
        Last edited by Anonymous; 09-30-2013, 09:35 PM.

        Comment


        • #5
          Sorry about recommending the sub board, Heavy, you are already here! LOL. Been a long night.

          rose

          Comment


          • #6
            Thanks for the replies. Yeah I have read the Thomas recipe and unfortunately I know myself and am not that organized...lol. I had also read that about getting into pretty heavy withdrawal before starting the subs. I just didn't want to believe that it was very important. I haven't heard of "precipitated withdrawal" before though and will be googling that as soon as I get done with this. The reason I only got 4 of the strips was because my friend had done it with 3 and I figured I would get an extra just to be safe. I can always get more if needed but I was hoping not to need it. I didn't want to wait to be into heavy withdrawal to start because I have a young son and it is so hard to take care of him while feeling so >>>>>> as I'm sure some of you know. But if I have to...I have to. Whatever is gonna work the best. I guess I will start with the .25 and titrate up...it just really seemed like too small of a dose since my friend had said he started at 2 and it wasn't enough. I know everyone is different but a difference of 800% seemed like way too much of a difference....idk. Looks like I should probably put it off a couple more days...one day for more input...which is coming I a lot faster than I expected (I appreciate that) and a second day of not taking anything to get my system ready for the suboxone. Alright....time to look up precipitated withdrawal...I'm just glad I started looking into the specifics a week out from running out of my meds...thanks again

            Comment


            • #7
              Originally posted by iloerose View Post
              Sorry about recommending the sub board, Heavy, you are already here! LOL. Been a long night.

              rose
              Lol....no worries Rose....I thought I was but you had me double checking

              Comment


              • #8
                Ahhhhh....ok....precipitated withdrawal...I've done it to many patients in a >>>>>> overdose when I give them narcan...didn't realize that's what it was called. I'll tell you one thing this whole process has taught me...I'll be a lot gentler when pushing narcan...lol...I have a lot more sympathy now for withdrawal symptoms

                Comment


                • #9
                  I just wanted to add, when you do actually start taking the subs, make sure you place it under your tongue either off to the left or right side. Allow it time to dissolve completely, at least 5 to 7 minutes. During that time, do not swallow, spit, talk, eat, drink, or smoke. Suboxone absorbs in the capillaries under the tongue, so you must allow that to happen in order to get the full benefit of what you are taking. Once the time is up, swallow all the saliva that will have accumulated in your mouth.

                  Also, I know that the doses being suggested probably seems like an insanely small amount to start with, but suboxone is a really strong medication. It is prescribed in Europe for pain at doses of less than one milligram.

                  Comment


                  • #10
                    Oh....I just had a thought...I have had a lot of luck with gabapentin stopping withdrawal symptoms. If I was to take that all day tomorrow....since it's not an opiate...it should help me not feel like >>>> all day. That wouldn't have any effect on taking the subs the next day right? What are y'all's thoughts on that?

                    Comment


                    • #11
                      The thing with that, is that it will probably prolong your wait to get to 26 on the cows sheet. I have no experience with it, but IMHO, the faster you can get to 26 and get started, the better off you'll be. Maybe save the gaba for when you are tapering and starting to feel icky because of that.

                      Comment


                      • #12
                        Well...decided to take the gabapentin last night and this morning. When it wears off...it does so pretty quickly compared to the ER morphine....didn't wanna gradually slip into withdrawal...lol....no way would I make it...starting to feel it now...should be what was it...a 26 on the COWS sometime tonight and will be able to start....ahhhhhhh this is fun.....got a thermal on under a shirt with a sweatshirt on over that in a house that my wife thinks is too hot...haha...love feeling this way...not

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                        • #13
                          The 26 is non-negotiable. You need to be in w/d before you take the sub. I've seen too many people here slip into precipitated w/d and you are on a heavy opiate. PW is NOT fun. Do NOT start at .25mg. start at at least .50mg. or even 1mg. Follow what I told you to do. I know you are afraid of the w/d. Everyone is. DO NOT take anymore gabapentin.

                          This is not meant to be easy. But once you get stable on a dose, you should feel "normal". I will look for you in the morning. I do not have a lot of time. You must be ready to do this and to do it right. Do it right the first time and you will never have to do this again.

                          Peace,

                          Iloerose

                          Comment


                          • #14
                            Yeah...gonna wait for the 26...or close enough...I know I won't be in any mood to read the form and tally up a score...just by going over it though I'm pretty sure I can estimate it. I feel like >>>> right now but I'm not even at a 10...so I'll wait and starting at .5 sounds better. I re-read Roberts plan and I must have misread it at first. I think I read where he said you can go up increments of .25 every 90 minutes and confused it with the initial dose. I wanna cut it now because I know how shaky I will be later...but don't wanna open the package till I have to. I'll get thru it...no worries. Just wanted some info on doing it right and y'all have provided it for me. I really do appreciate that. The good thing is that I have no mental ties to this drug so I won't have to get over that...just the physical. I had a bad addiction in my early 20s to something much different than opiates so I know how that goes...just glad I never felt that way about these. Starting to sweat pretty good as I write this...it's so weird how it comes in waves...I will feel totally >>>>>> for 10-20 minutes and then my body will seem to just start regulating my temperature and I feel better for a little bit...then it returns....etc...thx iloerose...I'll report back in the morning. I'm central time zone just fyi....I was hoping this would hit me faster and I could do it tonight...but it's not looking like its gonna cooperate...ah well...talk to you tomorrow

                            Comment


                            • #15
                              Took the subs last night around 9:30...talked myself into it when I was feeling pretty icky...anyway...no PW...ended up needing 2mg to feel normal...but had an awesome night....took .5 at 9:30... .5 at 10 and then 1mg at 10:30 cause I ran out of patience....finally normalized around 11-11:15...didn't need to take it again till about 11:30am...took 1mg...but started feeling worse...so I put in another 1mg at 12:30....it's dissolving right now...we'll see how that works out.

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