June 30, 2008 - 12:03pm
Hi everyone. It's been a while since I posted. I've been working and haven't had much opportunity to get on line. Getting back to work was tough, and has taken some adjustment because I have to figure out when the best time is to take my meds so I can drive safely and stay alert at work, but not be too much pain since that effects my concentration. So far so good and my boss is aware of my condition and is very understanding. Okay, enough about me, but this is where my question comes in. I have continued to read the posts about using methadone or suboxone to get off of other drugs, and I am wondering if it would be better for me to just try to taper down on the pain killers that I take now, and deal with the withdrawal, or to go on methadone or suboxone to try to kick the pain killers completely. Won't I have to go through WD from methadone or suboxone too? Is that easier than tapering off the painkillers to begin with? Will either of those help me manage pain while I am tapering? I posted earlier that my husband and I are hoping to start a family soon, and even though some posters said it was okay to be on certain drugs while pregnant, that worries me too much. Now that I have been working I feel a little better and can manage my pain better because my mind is occupied most of the day. It is harder on weekends and at night because I am tired when I get home and I try to recover on the weekend. I don't want to discuss this yet with my pain doc because i am afraid he will just reduce my meds. Any ideas? Thanks.
June 30, 2008 - 12:27pm
#2
methadone
hey roxie, whats up. i am on methadone maintenance, and have been for almost 2 years. Prior to that I used opiates for about 10 or 11 yrs, and then kicked them, then got hurt at work, so that obviously caused a relapse getting painkillers legally ...what was i gonna say, no? i should have, but i didnt. that just led me to the bottom a few more times and then for the final time. i went into a detox, and then got into a mdone clinic, which has saved my life.
As for u, i dont know what u are on, or the dosages, if i knew that it would be easier to give advice. There are a lot of variable factors when it comes to quitting. Are you wanting to quit because you are abusing the meds? or just sick of being on them, and u are able to deal during the week like u said? IF IT WAS ME, and i had not been using very long , like a year or so, i would prob try to ween off the meds i was on, and just deal with it. BUT since i dont know what were dealing with here for time, or what meds, I cant really give accurate advice, but ill do my best. IF YOU HAVE GOOD INSURANCE that will cover suboxone, that would certainly be easier than doing an mdone clinic. As fro pain relief from it, Ive heard both ways, it helps and it doesnt. Methadone on the other hand would definately manage your pain, whatever it is. If you have been on these meds for a number of years, I would try the clinic, it is a longer process to actually get totally clean, but it will hurt less as far as withdrawals....unles they kick you off for some reason and you are on 150 mgs a day! then u are bummin.
If you have been on like percocet or vicodin, then I would just ween off them, but if you are on oxys or dilaudid, or fentanyl patches, u know..the heavier stuff, then you will DEFINATELY need some type of help. Like i said sub would be easier, but i dontknow how it would do for your pain. Methadone u would have to go there everyday, but the pain relief would be better (just dont say thats why you are there, for pain). Also if you are a good little patient you could apply for take home doses, so u would not have to go there everyday.
This is just advice, im not telling you to do one or the other, esp. since i dont know specifics. But if u want to send me a priv. msg. I can answer more questions or whatever. I have a LOT of experience being an addict and a dependant for pain, i have neck issues, thats what happened to me when i got hurt. I also have a lot of exp. with wdrls, and weening off etc, so im sure i can help u. Just curious, where are u located? on the off chance its the same area as me, that would help even more.
So if u want to pm me thas fine, if not fine 2.
June 30, 2008 - 1:23pm
#3
Methadone withdrawl/verses?
I was so emotionally addicted as well as mentally to opiates..I never imagined waking up and going to work with out them..I was at 1 loritab 10mg a day when I met a girl and she turned me on to Diludid..The lifestyle I obtained during my usage was pitiful,I had my house in default and my lawnmower in the pawnshop and a bunch of users all around me..It was disgusting..
I heard of the clininc and stayed there for 5 years..Looking back now, I wish I could have kicked the pills,,But mentally it was a strong hold,,,With methadone it is soooo physical..my roots of my teeth ached my legscrawled it was tough to come off of it,, at only 20mg a day.Emotionally mentally and physically..
During the 5 years, at my iniital intake they started me at 20mg , I then stabilized at 70mg in a coupla weeks,,I had no desires for drugs, drinking.. . after 9 months I got weekly take homes,,at 3 months you will get 2 take homes and then 6 months @ 4 then at 9months clean, you recieve weeklys...I had complete fullfillment and yes I am a chronic pain sufferer..
If you can do it,,Don't go to methadone,,Go for the suboxene,,I haven't ever taken it but researched it and feel that it is a much better medicine..It actually repairs your pain receptors.., Methadone damages your receptors..
Alot of clinic patients will top off with drinking and zanax and use the mmt program as a legal place to cop. It's all in what YOU want out of life,,
Your newborn will be born addicted, but...It's better then being in the streets..There is alot of love hate with the clinic,,After being strapped down to them, your fog clears and some people leave with out the proper tools..
There are plusses and negatives,,Methadone addiction is a nightmare at its best,,It is a great way to get clean, but alot of people tend to be life long methadone users.SImply out of fear of the withdrawls,,Which are far worse then most street drugs...
If you can get help and maintain, follow a program and change friends and stop dr. shopping YOU can make it..
June 30, 2008 - 5:44pm
#4
thanks for all the feedback
ok. to answer few questions, i do not believe that i am an addict because i only take what is prescribed for me. after my accident i did "borrow" extra pain killers from friends and family because i was not getting enough relief but i have not done that in a while. the strongest prescript is fentenyl and i get usually get those in the lollipops so i can use them more easily when i am out somewhere and i need slow and steady relief. i do not use those often anymore and mainly use vicodin and percocet. i have had oxy in the past, but rarely take those now. i think i have learned to live with my pain and manage it better than i did at first because i have accepted that i have limits now on what i can do. i do think that i have a "mental" connection to the drugs now because i am afraid to wean off of them - i am afraid of the pain and of the withdrawal symptoms. i am not sure if this is addiction or not. i do want to be drug free before i get pregnant because i am more worried about the possible damage to my baby if i am taking anything while pregnant. so that's pretty much my story -
June 30, 2008 - 7:42pm
#5
private message
Mdonia -i've never sent a pm - only replied to one that i received. how do i send one to you? sorry to be so dense but i don't see how the pm thing works.
June 30, 2008 - 7:47pm
#6
Hi Roxie
Just go up to the bar that says who's online and click the users name that u wish to message. Once you click the users name it gives you the option of sending a private message.
-JpD
July 1, 2008 - 12:30am
#7
Suboxone
Suboxone is your best bet in my opionion as a professional. Mainly due to the dosing schedule and availability of it as 30 day take home dosing from a pharmacy as opposed to MMT clinics. I have read forum posts from people claiming that Suboxone was not doing anything for them, but I have never had a patient of my own tell me that it was not effective. In fact, I haven't had any negative responses to it as of yet, when it comes to pain management. I have found that the people who "don't like it as much as other opioids" are the ones who are expecting a mental high / rush / whatever. Suboxone will provide marked analgesia (pain relief) but with little to no psychotomimetic effect as is seen in full opioid agonists (Oxy, Hydro, MS, Fent, etc). If you don't expect to get the mental effects, Suboxone is a great option, and a physician with a DATA2000 waiver can start you on it in a day or two (called induction) without the need for you to taper your pain meds yourself (it will be a guided induction). He/She will give you instructions on your last dose(s) of what you are on now, then start you on the Bupe - total time 1-3 days from first visit to getting a take home 30 day script depending on your last opioid dose and the doc (I usually do 2 day induction, Day 1 - evaluation/treatment plan; Day 2 - induction with Subutex/Suboxone and a take home script, titrated up from there as needed). If you are induced rapidly (similar to how I like to do it), you probably won't have any ill effects, or at least not strong symptomatic withdrawal.
As for the pregnancy, I wouldn't recommend being on anything you don't absolutely need, including pain meds. Although there have been no reports of teratonegicity, no in depth studies have been conducted regarding Buprenorphine and pregnancy. It is advised only if the benefits outweigh the risks. Some neonates have been found to experience dependence symptoms if the mother was on Bupe during pregnancy. Buprenorphine DOES pass in to breast milk, and should NOT be used by mothers while intending to nurse an infant. This is true for all opioids to the best of my knowledge.
Good luck, hope that helps some.
/Xtrasystole - BS.Bio, MS Anesthesiology, Pharm/M.D.
Always check with a physician/pharmacist licensed where you live before taking medication. My license does not extend past the state of my practice.
July 1, 2008 - 12:40am
#8
Well until Methadone was
Well until Methadone was resticted to clinics I would have recommend it. I personally wouldn't recommend suboxone for a few reasons. The first is that it is still an opiate and is very difficult to quit. Second, I personally don't think it has very good pain killing properties. Third when you get a 30 day supply to meds and aren't in a restricted climate the chances of relapse are fairly high. If you can get a doctor to prescribe methadone then I would suggest this as it helps a good deal with pain. However, both options x*#& as you are just replacing one thing for another, so I recommend a taper-as it will be a shorter process then tapering from methadone or suboxone. Good Luck.
Check with a licensed MD before you take any suggestions!
July 1, 2008 - 8:17am
#9
pm
yes u can do what jpd said which is easy, or u can go to where it says view inbox, and go to where it says write new message. either one.
July 1, 2008 - 8:59am
#10
wow - so much information
Thanks for all this information - I have a lot to think about with the different options. i have heard/read a lot that suboxone does not help with pain but i hear what you are saying too about the high/rush. that's not what i am about - not that i am not sympathetic to people who have gotten into that because i can see how it happens. can you tell me this? if i started on suboxone now how quickly could i taper down to nothing to see if i can manage and how long would i have to wait before trying to get pregnant to be sure the drugs are out of my system?
July 1, 2008 - 11:27pm
#11
Suboxone / Taper
Pertaining to tapering from Suboxone, the answer really depends on how medicated you are now. The higher doses of opioids you take now, the higher the initial doses of Suboxone would be, thus requiring a longer taper. Assuming you are near maxed on opioids, you would probably end up on 16mg-24mg Suboxone QDay, which you would be titrated up to over a few days. After about a week, you would probably want to establish yourself on a stable dose for at least two more weeks before tapering down. At about 21-30 days, if you feel comfortable with it and you and your physician do not suspect abuse/relapse to short acting opioids, you could theoretically taper down relatively fast. I have seen patients taper from Suboxone 16mg QDay to zero in as little as 3 days, though this is usually in preparation for a surgical procedure. In actuality, you would probably be more comfortable tapering by 2mg every other or every third day, bringing you to a low 2mg dose within about 10-14 days, at which point you could either discontinue, or dose on alternate days for another week to further avoid the chance of withdrawal, craving, etc...
Bottom line, if you really ramped up the dose, got established at a high dose, then wanted to come down as quickly as possible, about 45-60 days would be the minimum I would recommend (assuming you max out on the dose). At 60 days, you should have no difficulty in discontinuing if tapered properly (other than the return of original symptoms, ie pain). For a smaller max dose, say 8mg QDay, it could be done in a month or so from start to finish, but would be a constant change in medication dosing and frequency.
If you want to just "check and see" how you would handle it without the Suboxone and other pain meds, you could do a 3 day taper (after a few weeks of being established on a stable dose) similar to patients who are preparing for a surgical procedure, but you should advise your physician you are interested in this so that they can advise you of any deleterious effects or contraindications regarding your specific case. In addition, you should be prepared to resume Suboxone in the event that your initial symptoms (pain) persist to a significant degree and should have enough readily available to you to restart therapy and continue on your previous dosing schedule until your next appointment / refill date.
Regarding systemic clearance; once you taper off completely, you should have minimal to no unchanged drug or metabolites in your system (assuming normal metabolic, hepatic, and renal function) in about 4-5 days following the last dose (the half life is about 72 hours). In other words, after a few days you should be fine as far as considering pregnancy.
Best of luck, and I hope this helps!
/Xtrasystole - BS.Bio, MS Anesthesiology, Pharm/M.D.
Always check with a physician/pharmacist licensed where you live before taking medication. My license does not extend past the state of my practice.
July 2, 2008 - 8:58am
#12
No offense but as far as I
No offense but as far as I know you wouldn't titrate up to that dose, then stabalize, then taper, atleast not in that time period. Most of the time you either do a simple 7 day detox using suboxone to become opiate free, or you do a fairly long maintainence program for atleast four months to a few years. The problem I see with a lot of doctors and people is the belief suboxone is easy to get off of. Suboxone contains one of the strongest opiates around and although it doesn't physically feel like it, the physical withdrawals are pretty bad. I would again recommend a quick taper with either hydrocodone or suboxone.
Check with a licensed MD before you take any suggestions!
July 2, 2008 - 12:12pm
#13
subutex or methadone
I did a three month detox using subutex . I was started on 16mg daily ,dropped after 2 weeks by 2mg, then it was tapered down until i got to 0.4mg. I stayed on 0.4mg for about a week , then after that time just stopped. I was given some ibuprofen to take as needed, felt like i had flu for about three days, not heavy but uncomfortable, got hot and cold sweats but the britlofex helped with that (sorry should have mentioned britlofex earlier) then it was all over . So physically , when monitored , it was"nt all that bad to come off. I found once i was clean that was the hardest part, staying off the illegal stuff ! this story will continue another day .... thanks.
July 2, 2008 - 1:13pm
#14
Suboxone
None taken, and none intended likewise. The OP was requesting info on what some options are though, and I outlined several regarding Suboxone, including a short 3 day taper after becoming established on a stable dose (I have never ordered an intentional 7 day transfer to and then immediate taper from Suboxone, or any other form of Buprenorphine; that isn't really how it is intended to work - for opioid dependence or pain management). Short acting opioids are used for short term therapy like 7 days, which is what the OP is already on. Plus, this isn't a dependence detox case per se, it is a transfer of pain management meds, which at some point the OP may want to discontinue for personal reasons, eg planned pregnancy. Buprenorphine is no easier to "get off of" than any other opioid, but its affinity for the Mu receptor (one of the highest affinity profiles for that site of all opioids - its so called "strength") doesn't have as much to do with how long it takes to "come off of it" as it might seem. Mu affinity is more related to short term issues, such as the ability for it (Bupe) to displace opioids with a weaker affinity from Mu sites when administered concomitantly, or within the bioactive time period of another opioid. Systemic metabolism, primarily hepatic through the 3A4 isozyme of the P450 Cytochrome system, is the major factor in determining the half life of Buprenorphine and thus elimination of the drug from the body. Due to a relatively long half life, tapering Buprenorphine is genreally tollerated much more consistently and with better results (fewer problems) when compared to short acting opioids; this due to the fact that the body is more gradually tapering itself naturally, due to the longer elimination time. Indeed, physical withdrawal symptoms can be as bad as any opioid (I have experienced Suboxone withdrawal), but if managed correctly, and guided by a qualified physician per my previous post, there is rarely any issue in discontinuing treatment with regard to withdrawal.
I would not recommend a single week of therapy on Suboxone based on the information given (both in my experience as a patient and practitioner), but again it is the choice of the patient and physician attending, which I am neither. In a 7 day time period, by the time you establish a steady state plasma concentration (a few days), you would be tapering off already. This would not (in my opinion) allow enough time for the OP to make the decisions that are being proposed. Longer therapy, followed with a gradual taper would be far more effective in allowing evaluation of both the therapy as pain management, and how well the possible lack of narcotic pain management might be tollerated in the event it is decided to discontinue opioid PM. The time tables I mention are what I would set as minimums from the information given, if I were managing the case. I don't know what time frame is in which the OP is wishing to become opioid free, but if it is soon, then 30-60 days would be my starting point for Suboxone therapy. Without the need for a discontinuation of opioids that rapidly, I would go to a 3-6 month therapy schedule (or longer) from induction to discontinue, based again on information that isn't readily available to me - primarily the patients concerns regarding pregnancy, MHx, FHx, SHx, etc, and the possibility of relapse to short acting opioids (evaluation of abuse risk).
/Xtrasystole - BS.Bio, MS Anesthesiology, Pharm/M.D.
Always check with a physician/pharmacist licensed where you live before taking medication. My license does not extend past the state of my practice.
October 29, 2008 - 4:16pm
#15
a
Get the ???$* off the pain meds..
I'm on suboxone now, & it works wonders.
go to suboxone.com to see...
it gets you off everything very easily...
October 29, 2008 - 4:21pm
#16
a
FOR ROXIEHART Get the ???$* off the pain meds...
I'm on Suboxone now and it works wonders...
Go to suboxone.com to see...
It gets you off everything so easily...
October 29, 2008 - 4:58pm
#17
Hey
Hey, It all depends on the dose of narcotic you are on and the extent of the usage. In alot of cases it is much easier to ween yourself off of the drug you are using than Suboxone or Methadone. You have to remember will the side effects/Withdraw from Suboxone/Methadone be more beneficial to you in the long run than tapering your current dose.
July 27, 2009 - 6:49pm
#18
Suboxen
I am starting Suboxen tomorrow. I want to make sure how long I should wait after taking my last Percocet to start on the Suboxen. I have been on Percocet 10/325 for 4 years and need at least 180mg a day to keep going. I was in a car accident that resulted in 2 herniated discs. I have read alot of messages concerning Suboxen that make this transition encouraging. I am a little nervous about the transitition. I do not want to go into withdrawel when taking the Suboxen. The Dr. is starting me out on 8/2 twice daily. I am wondering if I should start with 4/1 and see if that works before taking the full dose. Any advice would be great
July 27, 2009 - 8:01pm
#19
suboxone
I have gotten off methadone in detox and it was pure ???$* for a month. I would like to hear from someone who has detoxed from suboxone, which I am on now.
July 28, 2009 - 1:15pm
#20
kell44
I am skeptical about your claim of taking 18 ten mg Percocets a day. If I were you I would be more concerned about liver damage (from the 5850mg of Acetaminophen/day), than switching to Suboxone.
Wait until you are in withdrawals (24-36 hours) from the Percocet, first, before taking any Suboxone, otherwise you will go into severe withdrawals.
Always take your medicine as the doctor prescribes.
I am not a doctor. Always seek the help of a professional.
July 28, 2009 - 2:45pm
#21
SUBOXONE
Suboxone can be taken for a very short period of time to get off of ther opiates. Your doctor will want you to stay on it for a longer period of time and do a long taper. I can't recommend this for anyone as, I am not a doctor, but I have gotten off of methadone and other opiates by using suboxone for 5-7 days and, going through the insomnia and anxiety stages after. I started at 8-12 mg of suboxone and tapered down quickly so I didn't become dependant on it. The only symptoms that were noticeable were insomnia and anxiety. I took a light dose of benzos for that and I was done with all of it within 2 weeks.
Like I said, I am not a doctor, this happened to work for me because I was determined to get off of opiates. I think that it is much easier to do this if you are dtermined to do it.
July 28, 2009 - 3:49pm
#22
I had blood work done. All
I had blood work done. All is good. My pain tolerance over the years while on percocet grew stronger. The problem with Percocets is that it is a short acting pain reliever. My goal is to get off of the Percocets and get proper pain management for my herniated dics without taking medication.
July 28, 2009 - 3:53pm
#23
suboxene
Did the Suboxene work well for you? I have 2 herniated dics and was wondering if it helps at all with pain.
I am supposed to wait 8-12 hours before I start the Suboxen. I am starting tomorrow morning. I am waiting till I start to have withdrawel symtoms. I just want to stay on the Suboxen until the Opiates are out of my system and then ween off of the meds alltogether. How did you feel the first day after taking the first dose of Suboxen?
July 28, 2009 - 3:54pm
#24
suboxen
I am starting Suboxen tomorrow. How well did it work for you the first day.
If anything it would be harder to taper off and the withdrawals will probably be worse withthe longer acting methadone or suboxone. If you feel you dont need the pain meds or dont want to be on them and are still getting a script I would just taper yourself off. Methadone or suboxone is usually for people who are getting meds by other means and severely abusing them and cant get enough to keep them out of withdrawals so they go on the maintenance programs so they get the dose they need to prevent withdrawals and then slowly taper off later. If you are still getting the scripts and dont run around buying every pill you see from your friends or w/e then just set up a taper schedule and stick to it.