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Unread 11-20-2010, 09:53 PM   #1
AbbyNormal
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Unhappy Benzo's and Sub

What have your Sub doctors told you about taking benzo's with Sub? I had to sign a contract promising I wouldn't take any. The nurse said it could kill me if I did.

I read the indications on the Sub website and it said if Sub is abused (injected) or you take benzo's not as prescribed it could cause side effects, even death. At least that's what I took away from it. Correct me if I got that wrong.

The Xanax does really tempt me and has been my biggest failure overcoming this addiction. Why I crave them I don't know. I never did abuse the medication, I think it's just that I want something to change my brain and that's all I got. Plus it does make me feel normal again and I can feel it doesn't mix well with Sub.

What'cha all think? Yes, I know I must stop taking my one small dose of Xanax daily. And I have gone weeks w/o it and then go back. Mostly I just feel shame.

I'd really like your input on this. I'm beating myself up pretty bad.

Thanks All,

Tom
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Unread 11-20-2010, 10:04 PM   #2
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Tom,

I think personally that like me, you may be wanting something to change your brain, you want to feel normal, find some relief. I have klonipin and I am allowed a half, .5 when I get a lot of anxiety.
There is no need to beat your self up about it. All of us, when we stop the opiate use, want to feel normal, because the suboxone does noto 'fix' us. We are searching for something to make us feel better. There is NO NEED to feel any shame about this, either.
You can bet you will get more posts on this and maybe it will make you feel better.
It is like they say, taking the medicine does not fix us. I woke up the next day thinking I would just feel great. But- nothing can replace the feeling the Hydrocodone gave me. It is hard very hard.
Maybe someone who knows more about this can speak to you about PAWS and other things.
Hang in there....I know this is hard because Hydrocodone was my friend for a long time.......

Take care.
Cynthia
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Unread 11-21-2010, 03:37 PM   #3
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Tom,

Yes, www.Suboxone.com does warn against use of Benzo's with Sub. Much of this comes from high-visibility publicity/notoriety from when students injected Bupe and benzo's and died from the combination. This is a long way from taking benzo's therapeutically, orally, and Sub sublingually under the care of your physician.

I think you should be properly diagnosed and get an Rx for Xanax if you don't already have one, and in my experience most Sub physicians will accept a patient's use of a small, stable dosage of a benzo under a doctor's care with a proper diagnosis.

The Suboxone formulation was designed to prevent IV misuse and many doctors require patients to sign an acknowledgement that they are aware that mixing benzo's and Sub could be dangerous.

I am on Sub, and my doctor had me sign an acknowledgement. He said he wasn't comfortable with me taking Ativan, but when I explained that I get it from my psychiatrist, take no more than three mg a day, and am compliant in every way, he has had no other issues with it.

Best of luck with this.

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Unread 11-21-2010, 04:50 PM   #4
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You shouldn't feel guilt and shame if you're prescribed benzos from a doctor for anxiety. If you're buying them off the street and don't have anxiety issues, then that's another whole matter, not that you should feel guilt and shame, but I'd look into what you're looking for from the benzo's, and try to find the root of the problem. Why you crave them, etc.
Best to you,
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Unread 11-21-2010, 07:16 PM   #5
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I got the script from my regular doctor before I started Sub. Was told that I HAVE to stop the Xanax if they are to treat me. I agreed. But after some time my anxiety did not improve but got worse so I refilled my script, told my Sub Dr., and got the third degree. They seem to think I'll have a seizure or some other overdose symptom. I don't think they read the information as well as we did.

The only reason I can think of that I crave it is because of my addictive nature. Anything to change my current frame of mind. And although the mg's are very low, it still makes me feel guilty because I broke my word. Catholic guilt, I suppose.

My script is out, and now I need to keep my word and not ask for a refill again. I was just really curious if the rest of you were told the same thing as I.

Thanks for the input,

Tomas
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Unread 11-21-2010, 07:21 PM   #6
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Sounds like you went off on your own....and realize it. Why not come clean with the doc, and ask about getting your anxiety treated in another way. There are alternatives. Even if a benzo were indicated, I doubt xanax would be the choice.
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Unread 12-04-2010, 05:06 AM   #7
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Originally Posted by AbbyNormal View Post
I got the script from my regular doctor before I started Sub. Was told that I HAVE to stop the Xanax if they are to treat me. I agreed. But after some time my anxiety did not improve but got worse so I refilled my script, told my Sub Dr., and got the third degree. They seem to think I'll have a seizure or some other overdose symptom. I don't think they read the information as well as we did.

The only reason I can think of that I crave it is because of my addictive nature. Anything to change my current frame of mind. And although the mg's are very low, it still makes me feel guilty because I broke my word. Catholic guilt, I suppose.

My script is out, and now I need to keep my word and not ask for a refill again. I was just really curious if the rest of you were told the same thing as I.

Thanks for the input,

Tomas
Tomas,
Not sure why they told you "you wil die if you take benzos..."; do they use any other scare tactics that are untrue?

I am prescribed and take 3 mgs of Xanax per day with 24 mgs of Sub and function normally. The reason for the Xanax is that I was a heavy drinker along with my hydro and oxycodone use, and have an underlying, separate, anxiety problem (which probably led to the drug problem to begin with!).

My point is that taking the benzo is not a problem and nothing to worry about - if and ONLY if you are honest with yourself and your doctor and you are taking it to help treat your addiction, and not to "feed" you addiction.

I'm worried when I hear statements such as, "I crave it.." that make me think you are addicted in some manner to the benzos. I've used benzos as prescribed on and off for 20 years and never had a problem with becoming addicted, but to each their own, some people find them highly addictive.

First, there is no contraindication with benzos and Sub, except for an overdose situation - just as with any other full-agonist opiod and CNS depressant...so the info about you having a seizure from the combo is incorrect (of course stopping the benzo too quickly can cause seizures, and if you are taking an SSRI style anti-depressant, that will lower your natural seizure threshold).

It's hard to tell in your case if you really need the benzo, and feel guilty and cravings because of the way they are treating you and the fact that you legitimately need it, or if you do have an addiction to the benzo and hence the craving.

Personally, opiates cause anxiety for me, so I actually need the benzo in order to counteract the induced anxiety from the sub...it complicates matters, but it works very well in my case - keeps me from drinking, keeps me happy and functional, I can excercise, etc., and I am slowly tapering both down at the same time (although I suspect in my case, I may be on a small dose of both for quite some time).

That's my personal experience. Have you tried getting a second opinion from a different doc? I had to search for a while before finding a sub doc that didn't have a hard-core regimine and would really design a program tailored to my needs...good luck, and maybe a second opinion would help....!

-S
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Unread 12-04-2010, 09:55 AM   #8
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My experience has been that some docs get really silly about this issue. When I went to rehab, I had drank to deal with opiate withdrawal and was in a hell of a shape. They gave me a small dose of suboxone, then when the alcohol WDs kicked in they informed me that they couldn't give benzos to someone on suboxone (of course no one had told me that ahead of time). After I got to shaking so bad I couldn't function, they finally switched me to benzos and said they'd switch me back to subs when I passed the alcohol WD. This helped some, until they started insisting on tapering the benzos after only 24hrs.

Later, I learned their policy was to only use low-dose suboxone for a 5-day taper. The4 place was flooded with young kids hooked on smack, most of whom had an awful time. With me, they had me off benzos after <3days, then refused to put me back on subs. Of course my symptoms worsened, and even though I kept telling them, they insisted I was "doing great"....until I had a seizure in the middle of a group! Now, they've changed their policy somewhat, so I felt like a guinea pig.

It seems strange that you are on xanax, one of the short half-life benzos that have a high abuse potential. The patients I've seen who get prescribed benzos while on sub always are taking one of the longer half-life drugs, usually klonopin, and always for a limited time. It seems like something to discuss with your doc.....it obviously concerns you since you took the time to ask.
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Unread 12-04-2010, 10:31 AM   #9
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Like Toms said it's been my experience to, that some doctors MAKE you stop taking benzo's. But we know that's just not possible in some cases. If you take them as prescribed whats the harm? If you take other than prescribed, more lets say, theres the bee in the bonnet. Ask your PCP to confer with your sub doctor and wean you from them so you can continue your treatment. Or even better, maybe your PCP or shrink or whomever prescribes them can convince your sub doc that you do indeed need them. Sub and benzo's can be a toxic combo IF YOU TAKE TO MANY. It just boggles my mind how they can be abused to that extent, I hated them when I was on them, and it took a long time to be weaned from three 2mgs a day to 0 and I was taking them as prescribed.
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Unread 12-04-2010, 12:15 PM   #10
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The problem with taking benzos and sub at the same time is that over time, it makes you feel worse and worse. I know from experience. I have taken 20mg of valium (a pretty low dose) for 4 years and tapered from 16mg of sub to 8mg of sub. My sleep varies now from 2-3 hours a night to 14 hours a night, and there is no in between.

For years it was all ok, I slept well and things were ok. The sub never really took away cravings for me like they said it would and I developed a huge benzo and soma habit on top of the sub, right after I started my sub maintenance/life destroying program. So I had to go into in patient to detox off the soma and benzos. I slowly got it down to 2mg of valium a day from 240 mg of valium per day. I cold turkeyed the soma at 1400mg per day.

I then went back up to 20mg of valium and stayed on 16mg of sub and its been like that for over 4 years. Well in January of 2010 I started tapering off of sub from 16mg to 8mg and have not been able to go below 8mg. When I do I totally lose the ability to sleep and it doesn't go away. Yes I had sleep issues before I ever got on drugs but it was nothing I couldn't live with.

So today I cannot work, I am severely depressed, and would cut off one of my arms to be able to sleep 7 hours a night just on most nights. I do also think about suicide which is something that horrifies me.

Before I started on sub and benzos I was a drug addict but could stop, suffer for about 10 days, then live life drug free and happy as I can be. Today I can't bring myself to cut the grass in the yard. I think its the sub mainly. The benzos also contribute a little bit. I don't shower much either, I simply do not have the energy to get in the shower. Before I started sub I was running 3 miles per day/5 days a week, bench pressing 3 times per week, and doing sit ups 5 days a week.

Long term sub use has destroyed this. Benzos have contributed a little too but I'm on such a small dose of benzos compared the huge dose of sub I tend to think its mostly the sub's fault given how many other people on sub complain of the same symptoms. There is literally 1.5 entire message boards dedicated to people suffering from long term sub maintenance.

I haven't seen one other drug, legal or not, that has an entire website/message board, and half of another, dedicated to people who have such a horrible time as is the case with buprenorphine. And no, I'm not counting this website because this seems to be a pro-sub website which is worse than having a pro-heroin website.

I would also cut off an arm to be addicted to heroin rather than sub right now but I would actually go into severe withdrawals if I switched from sub to heroin because of the long half life of sub compared to the short half life of heroin. If I tried the switch I would probably die of an overdose trying to keep myself out of sub withdrawals that last for months, with PAWS that would last for years.

Last edited by JamesContin; 12-04-2010 at 12:28 PM..
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Unread 12-04-2010, 12:41 PM   #11
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Hey James, just jump then. You've been bitching about this forever. So jump. Prepare yourself with comfort meds and just do it. Get it over with. Oh, did you stop snorting the sub yet? Did you go to therapy to figure out why you're so miserable. You can't blame it on sub when you abuse the hell out of it and sit around and do nothing. I've tried to help you like others have but you just go on and on bitching instead of ****ing doing something.

Get your shit together and either do stuff to get your life together or just jump and get it the hell over with. You say you're gonna suffer anyways.

Look, I did it with hardly any problems. No PAWS for years nevermind even a day. You could too, but you've convinced yourself it's all the sub's fault. Not like the benzos could have anything to do with it either? Whatever.

Why don't you just jump from the sub or check into a rehab and get off both and quit bitching about it. -Mary


edited to add:
April 22, 2010
Quote:
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...Does that mean that when I started snorting the bup and went to the doctor asking him to up my dosage by twice what it was at the time, I was not then addicted to the drug buprenorphine? Tim, when the doctor approved my rise from 16mg per day to 32mg per day, and I started to snort between 24 and 32mg of bup every day after being on 16mg taken under the tongue for over 2 years, does this not fit the profile of an addict?
http://www.addictionsurvivors.org/vb...7&postcount=43
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Last edited by Mary; 12-04-2010 at 12:44 PM.. Reason: added stuff
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Unread 12-04-2010, 01:19 PM   #12
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Wow, this thread really took a turn sideways.

I stopped the Xanax but am having a different problem now. It seems the only time of day that I crave a change in my mental state is when I get home from work. The last week minus one day I took an extra Sub (2+1=3 total) after work. It sure helps get rid of the anxiety but I feel guilty for taking more than I should. Obviously I can't keep doing it because I only end up with a few left over at the end of the month.

And yes, I did discuss both the anxiety and extra dose with my doctors nurse. She suggested other things to help like yoga, walking, etc. Today, considering I'm off work, I will do my best to not take another one. Only have about 8 as extras anyway.

The Xanax discussion did come up again and she once again said that the Here to Help program forbids it and they could get in trouble unless it's medically necessary, which in my case is not.

Once again, it's just me being the addict. But I do ask myself if it's really that awful to take another dose? I'm not abusing, taking Xanax, or drinking. Only Sub is in my system. Funny thing is, I feel slightly hungover in the morning when I take more. Sub is a very strong drug IMO.

Still feel sleepy, even on 16mgs. And I know I'll feel better going down in dosage like I did going from 24 to 16.

I'm going on too long now, and it's getting fragmented so I'll stop here. Thanks everyone for your help. It really is nice to talk to others who know about this drug.

Tom
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Unread 12-04-2010, 01:38 PM   #13
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I have no idea what is up with you, Tomas.....you take an extra to "feel better", then talk about "knowing you'll feel better if you do another drop". Basing how you feel on your dose seems counter-productive, and as you've mentioned, you have several issues medically. Hopefully you'll work these out with your doc, rather than independently tinkering with your dose.

Sub, to me, is much like working any Program, in that searching for the minimum amount that will get you by could easily lead to a relapse.
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Unread 12-04-2010, 01:59 PM   #14
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AbbyNormal~
Have you tired other non-benzo's for anxiety? I ask b/c I was on many different benzo's for a long time and I swore to myself, anything besides a benzo would never work for me! Of course I was in my active addiction at the time, and the more drugs I could get a hold of the happrier I was! I do have anxiety problems, I've suffered from panic attacks, have insomnia, ect. Once I was put on Sub, my Sub doctor would PREFER me not to be on a benzo, and I would prefer the same. I've tried 3 or 4 different medications for the anxiety thru these past 10 months on Sub, some have worked, some not, some for only a small abount of time. Anyway, I was just wondering if you've tried with any of these?

The only way to find out the truth, is to call Here to Help, and ask them yourself. Many doctors don't want to give benzo's to people with past addiction problems, b/c IF they happened to get addicted to the benzo and started taking more then prescribed, there's a lot of consequence's there.

There are also a lot of methods out the to help control anxiety. I wasn't always as open minded as I am now. I never wanted to try yoga, meditating, acupuncture...any of that stuff, but I am now open to anything that has the possibility of helping me and making my life better!

If you think you need to go back up on your Sub dose for a period of time, then speak with ur doctor about it (not the nurse or receptionist) and find out what your doctor thinks about it. The last thing you want to end up doing is running out of Sub, having to adjust your dose to get you thru until your next refill, and possibly finding yourself back stepping instead of continuing to move forward!

Anyway, just wanted to throw those things out there for you.

On another note, I find it sad that all these anti-sub people keep coming around here preaching their stories about how they are using the medication wrong and because of that it's a horrible thing to be on and it's not helping, and bla bla bla. Yes, this board is FULL of people who've choosen to use Sub in the RIGHT way and better their life. There are a lot of people on here who have already completed treatment with Sub and are now living their life better then they ever have before! Suboxone is not right for everyone, and everyone is not right for Suboxone. That doesn't mean that it can't do what it's meant to do, and that it's a horrible medication that people get addicted to.

I am proud to say that Sub has saved my life and given me another chance to become a mother and a wife. I chose to use it the way my doctor and I find fit for me, and I have yet to have a problem. I also don't abuse is tho, which can help a great deal with it being able to do what it's meant to do!
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Unread 12-04-2010, 05:03 PM   #15
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Tom S

It really is just my addiction that drives my behavior. My anxiety needs to be dealt with w/o any drugs. I do know how sick my thinking is, as I'm a recovering alcoholic who sobered up in 1987 and hasn't had a drink since. AA was my means to that end so I have been involved in recovery for many years. In truth, I stopped going to meetings many years ago but still remember how I was able to function just fine with no drugs at all in me.

So I apologize if my rants seem a bit disjointed. I'm beating myself up over relapsing and my lousy addictive thinking has been sabotaging my recovery from opiates. I do know what it takes. It takes just NOT ingesting any drug other than my doctor approve dose of Sub. No Xanax, no extra Sub because I feel anxious. I just need the time under my belt and my thinking will follow later. You know the saying, "bring the body and the mind will follow". That's what's needed for my recovery.

TLG

Yes, I plan on doing exactly what you suggested. Yoga, meditation, etc. I just tend to procrastinate, that's all. Typical addict behavior. I have to remind myself how far I've come since induction. No more high quantities of Norco, Soma, & Tramodal. (with the occasional Xanax) My wife is so much happier that I'm back. No more nodding off to TV at night, or embarrassing her in front of friends. I also got rid of a nicotine gum habit. That one actually caused me to go to Urgent Care, not knowing I was going through nicotine withdrawals! It was really bad.

So I have come a long way, and I have to start appreciating it.

Thanks All,

Tomas
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Unread 12-04-2010, 06:26 PM   #16
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Tomas~
I know what you mean. I also tend to put things off as long as I can~ I am aware that it only makes things worse majority of the time, and it's one of those addictive behaviors I have yet to be able to completely overcome. One thing I've realized, is that I can't continue to use my past addiction as a reason or "excuse" for the way I am and the things I do now! I have got a lot better at it, but on occasion I still find myself doing it. A lot of these things, these behaviors, were made over years of being in active addiction, so it's no wonder that after 10 short months of working on getting my life back, it's still a battle to overcome some of these problems. Although everyone is different in many ways, the one thing we all hold in common is that we suffer from the same disease, and exhibit many of the same behaviors. I may not be able to sit here and say I understand everything anyone says just because we share a disease in common, it helps me to relate with those things. In doing so, I can often see things in which others are still doing and have yet to change, and then I realize that I too am in the same boat.

Anyway, I got way off subject with that, lol. Maybe you could make a list of things you have been procrastinating on, and work on checking off at least one of those things a day. I found that doing that helped me out a lot! In fact, I haven't done it in a while, and I think it's about time to get started on it again.

Also, many places that offer yoga and things like that, will offer a free session so you can get a feel for what it's really about, and see if it's something for you. I also have made myself a kinda "rule" of at least trying something 3 times before I say it's not for me. IMO, it's really important to really give it some effort, because in the past I was always so quick to judge things, and never even gave them a try. Again, it's all part of the progress in changing the way we use to do things and the way our brain use to think.

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Unread 12-06-2010, 10:33 PM   #17
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Wow, this thread really took a turn sideways.

I stopped the Xanax but am having a different problem now. It seems the only time of day that I crave a change in my mental state is when I get home from work. The last week minus one day I took an extra Sub (2+1=3 total) after work. It sure helps get rid of the anxiety but I feel guilty for taking more than I should. Obviously I can't keep doing it because I only end up with a few left over at the end of the month.

And yes, I did discuss both the anxiety and extra dose with my doctors nurse. She suggested other things to help like yoga, walking, etc. Today, considering I'm off work, I will do my best to not take another one. Only have about 8 as extras anyway.

The Xanax discussion did come up again and she once again said that the Here to Help program forbids it and they could get in trouble unless it's medically necessary, which in my case is not.

Once again, it's just me being the addict. But I do ask myself if it's really that awful to take another dose? I'm not abusing, taking Xanax, or drinking. Only Sub is in my system. Funny thing is, I feel slightly hungover in the morning when I take more. Sub is a very strong drug IMO.

Still feel sleepy, even on 16mgs. And I know I'll feel better going down in dosage like I did going from 24 to 16.

I'm going on too long now, and it's getting fragmented so I'll stop here. Thanks everyone for your help. It really is nice to talk to others who know about this drug.

Tom
Tom, did your anxiety come about after you stopped the Opiates? Increasing your Sub HELPS your ANXIETY? Is that what I hear you saying in this post?
It is so weird how we seem to feel after we stop the opiates.
It is real rough.........
Thank you,

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Unread 12-06-2010, 10:42 PM   #18
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I hear and feel the lower the dose the better. My dr said lower for pain. anyone else hear this. I know I feel less tired on lower dose.
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Unread 12-06-2010, 11:36 PM   #19
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Cynthia, yes, I did say I had anxiety and took an extra Sub to deal with it. But it really was just my addiction wanting something, anything, to change my brain waves. Much better today though.

Mister, you are correct. It is said that the lower the dose, the better it works for pain. That one I can't figure out because we took soooo much Hydro to get it to work like the first time. I guess they are right.

Tom
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Unread 12-07-2010, 07:25 AM   #20
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I hear and feel the lower the dose the better. My dr said lower for pain. anyone else hear this. I know I feel less tired on lower dose.
Hi mister, buprenoprhine, the active ingredient in Suboxone, was originally developed as a pain reliever over 30 years ago. In the US it was available, mostly in a clinical setting in an IM injectable formulation. In Europe, they have Temgesic - a sublingual pill - but in 0.2mg and 0.4mg. Some people do get pain relief from Suboxone, others, not so much. Any analgesic effects tend to last 4 to 6 hours and people taking it for pain generally dose smaller around 2mg doses in that every 4 to 6 hour time span. The ceiling effect on the buprenorphine also holds for the analgesia. So the more you take, won't really help. More on the ceiling effect: http://www.naabt.org/faq_answers.cfm?ID=2
"The agonist effects of Buprenorphine increase linearly with increasing doses of the drug until it reaches a plateau and no longer continues to increase with further increases in dosage. This is called the "ceiling effect."

http://www.naabt.org/glossary.cfm#C
Ceiling effect:
Because of the limited intrinsic activity of buprenorphine at the receptor and the finite amount of receptors, there is a limit as to the opioid effect one receives. The increasing effects of partial agonists reach maximum levels and do not increase further, even if doses continue to rise. With most patients this occurs at about 12-16mg of sublingual buprenorphine. As the dosage is increased beyond the ceiling no difference in euphoria, analgesia, or respiratory depression will be felt.

Taking Suboxone, pain withstanding, rule of thumb is to take the lowest amount of Suboxone that stops cravings and withdrawals. As the patient goes through the recovery process, that amount generally decreases.

I hope that helps.

Nancy
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Unread 12-07-2010, 07:29 AM   #21
NancyB
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Quote:
Originally Posted by AbbyNormal View Post
Cynthia, yes, I did say I had anxiety and took an extra Sub to deal with it. But it really was just my addiction wanting something, anything, to change my brain waves. Much better today though.

Tom
Hi Tom, please take a peek at this thread:
http://www.addictionsurvivors.org/vb...ad.php?t=25583

Ed found the CBT (Cognitive Behavioral Therapy) link very helpful in looking at his thought process. Might be something worth giving a try to see if that helps with when you have that 'need to take something'?

Just a thought.

Nancy
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Unread 12-07-2010, 07:54 PM   #22
mister
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Thank you. This does help. I have been takin as small a piece I can cut off the film and it does still work for pain so far. its hard to adjust the brain says thats to small why bother but it does work
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Unread 12-07-2010, 09:50 PM   #23
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Nancy,

I did check out that link back when it was posted although I now forget exactly what the process is. I'll do a re-check.

Thanks,

Tom
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