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Unread 05-08-2010, 03:46 PM   #1
Phoenix Love
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Default Dosage Question

I'm reposting this from my thread in the welcome room in an effort to get an answer. A few hours after I posted how wonderful I felt I started feeling anxious. It was accompanied by yawning over and over with my eyes watering up like tears. I tried deep breathing and meditation to no avail. I slept pretty good and woke up still yawning with watery eyes (no anxiety though!!). This has gone away since I took my medication. I experienced this to some degree the night before but chalked it up to adjusting to the medication. I didn't give it a second thought because the next day after I took my sub I felt beyond incredible. Is it possible that my dose needs to be adjusted and while I am feeling so normal and great it is because one dose is overlapping on the day before (indicating that I may need to increase my dose) and I start feeling withdrawal symptoms when the overlap wears off? Also, after going outside for about 10 min in very hot and humid weather I feel lightheaded and nauseated. I did not swallow any of the "left-overs" from the suboxone. Any ideas??
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Unread 05-08-2010, 04:55 PM   #2
suboxfreedom
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Watery eyes and yawns are early & mild WD symptoms. You don't say your dosage or how long you have been on subs which is relevant
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Unread 05-08-2010, 05:49 PM   #3
Phoenix Love
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I've been on for four days and my dosage is two 8mg tablets once daily.
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Unread 05-08-2010, 06:00 PM   #4
Phoenix Love
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I'd like to add that today I am totally craving my DOC. I'm trying to keep busy and not think about it. I didn't have this problem the past three days. Ideas anyone??
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Unread 05-08-2010, 06:30 PM   #5
OhioMike
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Without knowing your daily dose, how you take it and your history, my best first response is that you are not getting enough Sub to stop cravings and WD.

I would up my daily dose by 2mg and phone your doctor right away.

Mike
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Unread 05-08-2010, 06:50 PM   #6
Phoenix Love
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My history is using 5-7 poppy pods a day for the past year and augmenting it with 8-10 10 mg lortabs when I could get them. I just added 2mg I'll let you know what happens. My doc isn't available until Monday. When I got the scrip on Wed. he told me that I may suffer on this dosage for a while but I'd adjust and in the end it would be less expensive and easier to wean off. He told me that in the meantime he wouldn't adjust the dosage until I see him this coming Fri. and gave me exactly enough to get me to Fri. I am screwed if he won't increase the dose because of the 2 mg I just took to stop withdrawals. If it works I know I need an increase daily so I don't backslide between now and then. I started to cry and freak out. I'm taking a deep breath and realizing that right here right now I have everything I need and there is no reason to be catastrophizing about something that truthfully hasn't happened. What happens on Monday can be dealt with on Monday.
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Unread 05-08-2010, 06:52 PM   #7
Phoenix Love
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I should add that the doc didn't really know how to quantify poppy pods and had never heard of anyone using them before. Both he and his nurse were a little incredulous to say the least and I'll bet they had something to talk about when I left.
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Unread 05-08-2010, 07:31 PM   #8
OhioMike
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I can't help much with the poppy pod history, but, taking it just from the Suboxone end, your doctor is correct in that it takes several days to build up enough Sub in our system. However, if I am correct you are well into or just past day three, so you should be getting a good half life of Suboxone going by now.

My bet is that your dose simply wasn't strong enough. Many of us might take a higher dose to begin with and then can lower it after the first week or two, to month.

The important thing is to stop the WD and cravings right away, as those are the things which place your recovery effort at risk.

Your doctor has to understand that there is no set beginning dose for any of us and that early on, we might go through several adjustments up or down, until we get it right and we level out. He also must understand that if you are in any type of Wd or experiencing cravings, then the process is not achieving it's goals and your at risk. Let alone the waste of money and time!

The induction process is just that, a process which can be vastly different for each person. Though there are some good guides, so we can find the correct dose, there is no way to really tell prior to induction and we must be flexible so we do not risk relapse. I hope your doctor understands this.

That is why I would phone him first thing Monday then and let him know what your doing, how your feeling and so on. WD and Cravings = Relapse!

There is some good information on this site geared for the doctors. I don't have the exact pages handy like Nancy does, but, maybe she can give you the links, so you can print some additional information for your doctor.

Hang in there!

Mike
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Unread 05-08-2010, 08:21 PM   #9
Phoenix Love
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Thank you for the information and support. After an hour 2 mg had no effect so I took an additional 2 mg and that did it. I hope the doc. is understanding. He said that I shouldn't adjust my own meds and that I must wait 10 days before I could know if I needed an adjustment. This is obviously false. Hopefully he'll understand.
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Unread 05-09-2010, 08:33 AM   #10
NancyB
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Hi Phoenix Love, even though your doctor told you that you had to wait 10 days (I don't know why he has that pre-determined amount of time to wait), I agree with Mike, just tell your doctor that you were at risk for relapse. Taking more Suboxone was the better choice than going back to the pods.

Here's a link to the PCSS, which is a mentoring program for Suboxone doctors. Your doctor can get help from them:
http://naabt.org/providers.cfm#PCSS

Also, this is from the precipitated withdrawals sheet:
http://www.naabt.org/documents/NAABT_PrecipWD.pdf

The goal of induction is to safely suppress opioid withdrawal as rapidly as possible with adequate doses of Buprenorphine. Failure to do so may cause patients to use opioids or other medications to alleviate opioid withdrawal symptoms or may lead to early treatment dropout.3 To achieve this, some physicians have found they may need to dose as high as 32 mgs. the first day with some methadone to Buprenorphine transfers.5

3 Dosing Guide Maintenance therapy for Opioid Dependence. Suboxone®/Subutex® www.suboxone.com/pdfs/DosingGuides.pdf

5 Physician Clinical Support System: www.pcssmentor.org Transfer from Methadone to Buprenorphine, Paul P. Casadonte, MD, PCSS guidance paper. 8/9/2006 http://www.pcssmentor.org/pcss/docum...neTransfer.pdf


How are you today?

Nancy
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Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. NEVER take any online advice over that of a qualified healthcare provider. Any information contained on AddictionSurvivors.org should only serve to inspire further investigation with credible, verifiable references sources such as your physician or therapist.
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Unread 05-09-2010, 02:01 PM   #11
Phoenix Love
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Hi Nancy,
I'm doing MUCH better today. Thank you. I am going to talk to the doc tomorrow. I'll let you know how it goes. Thanks again for being helpful and supportive.
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Unread 05-10-2010, 07:08 PM   #12
Phoenix Love
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I called the doctor today and was told that I had to come in to be evaluated and give another ua before they could alter my dosage. I got to meet the actual doctor instead of the P.A. He was incredibly nice. My dosage has been increased.
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Unread 05-10-2010, 07:40 PM   #13
NancyB
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Hi Phoenix Love, I'm glad you like the doctor! How do you feel with the increase? I hope that takes care of it.

Nancy
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Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. NEVER take any online advice over that of a qualified healthcare provider. Any information contained on AddictionSurvivors.org should only serve to inspire further investigation with credible, verifiable references sources such as your physician or therapist.
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Unread 05-11-2010, 12:31 AM   #14
Phoenix Love
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I feel great! The evening anxiety, hot and cold flashes and anxiety are gone. I am happier and don't feel like I want to withdraw and hide. Thanks for asking.
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Unread 05-11-2010, 07:35 AM   #15
NancyB
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Phoenix Love, that's such good news! I'm really happy for you!

Nancy
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Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. NEVER take any online advice over that of a qualified healthcare provider. Any information contained on AddictionSurvivors.org should only serve to inspire further investigation with credible, verifiable references sources such as your physician or therapist.
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