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Unread 12-11-2007, 04:49 PM   #1
dan32
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Default I Start Tommorrow

My appointment tommorrow to start is @ 9:00 am. I took my last perc @ 11:00 am today. Does anyone think i will have any problems with waiting around 22 hours before my induction ? Right now this is my biggest concern.
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Unread 12-11-2007, 04:55 PM   #2
Pearl
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Hi there dan32, good for you!! I believe you will be pleased you did it now, rather than wait. I wanted to wish you well and say congratulations!! This is the scariest part, I think. I also believe 22 hours is a bit long, but more power to you if you can do it!! I'm rooting for you! Someone who knows how to post the links will be along shortly, I am sure, to give you the information on that soon. (My husband showed me, but that was at least a week ago, how am I supposed to remember??!)

Take a walk if you get anxious, or a long hot bath and 9:00 tomorrow will be here before you know it!! Keep close and many here will help you through it!!

Elizabeth;}
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Unread 12-11-2007, 05:09 PM   #3
dan32
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Thanks Elizibeth. I aready have the info sht. on p.wd . I just don't want to stop to late or go through unnessary extended wd symtoms. thanks for your kind words.
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Unread 12-11-2007, 05:34 PM   #4
Indy
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That's great Dan,glad your starting asap.Your blessed not to have to do the whole 36 hrs.You will do the remainder of today and Weds standing on 1 foot-no problem.
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Unread 12-11-2007, 05:39 PM   #5
mikejacks
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The longer you wait, the better the sub works, and the better you will feel. If you wait till tom, and dont take anymore you will feel great within about an hour.
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Unread 12-11-2007, 06:00 PM   #6
Smith
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I mostly used H, and I allmost allways waited at least 24 hours, before starting sub. So I don't think 22 hrs is to long, Everyone is different though. Did you talk to the doc, and when you come in is he going to give you the sub then? If so then great, should work well. My doc likes me to come in well, then he gives me a script, I fill it then start the 24 hour wait. I always thought the first 17 hours are the easist, and remember it is a one time thing, if you stick to the program, so you can do it. From what you said, I would expect a great result for you. Hang in there.

Dr.Smith (Not an MD)
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Unread 12-11-2007, 06:05 PM   #7
NancyB
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Hi dan32, congratulations on starting tomorrow. You can probably judge how you're feeling from when you've gone into withdrawals - or started to go into withdrawals - before.

You only need to be in mild to moderate (as is on the precipitated withdrawals sheet you've read) to start.

Let us know how you're doing.
Nancy
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Unread 12-11-2007, 06:59 PM   #8
Chuck
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You are going to feel a bit fatigue for the first 24 hours when you beging induction, and the next day you should be feeling okay. Good luck, I know it it torable the intial disconfort. Knowing that in a few hours you will be feeling okay. This medication, for me has been a miricle, eventhough I know in my head that it is a techinical advance. It is ammazing. Again good luck and let jus know how you are doing.
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Unread 12-11-2007, 07:15 PM   #9
down2zero
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dan32, the good thing is you have an appointment first thing in the AM so you can see the physician right away. I imagine you will be fine and within short order, a day or two, start to being to feel normal. Hope all goes well and you induction goes smoothly. d2z
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Unread 12-11-2007, 09:33 PM   #10
go75
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dan that is awesome you decided not to wait until january.

how you doing right about now? i heard 12-24 hours from folks and i waited 24 myself though i never actually asked the dr what i had to - 22 hours should be perfect. you should be able to make it through tonight ok, if you have a rough time post for some advice.

come let us know how the dr visit went and how things go tomorrow, i've learned a ton about sub and ive only been on it for 6 days.
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Unread 12-12-2007, 12:05 AM   #11
Cally
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dan32

Congratulations on your decision to start taking suboxone.

It's good that you have a 9AM appointment. You can start start taking suboxone first thing in the AM any any discomfort you may be feeling will vanish in the doctors office.

I know these next few hours are a scarry time. I was in mini-panic mode the hours leading up to my induction. I left my doctors office feeling great and you will too.

Stay on this board tonight if you need to. Do whatever you can to get your mind off your worries.

You have made a very wise decision.
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Unread 12-12-2007, 12:48 AM   #12
angipooh
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Welcome dan,

Like everyone has saud before, this is a great place to read and discuss your questions and problems with Suboxone/Subutex. I was in major withdraws when I started the Sub. I started feeling it within 2 hours. I took 16mg at once and then another 8 mg before I went to bed. The next day I felt "normal" and just had to take 16mg all day. I've had no problems with taking the sub but everyone is different. I'm also on an anti-depression med and I just wish that I had started that sooner too. I've battle depression for 7yrs or more. Enough about me...I just wanted to wish you good luck tomorrow and take it day by day...

Angi
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Unread 12-12-2007, 02:01 AM   #13
gotoffmdone
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I believe you will do just fine coming from Percocet to Sub. This time tomorrow if you are not on too high a dose you should be feeling better than you have in a long time.

I am pulling for you. Good luck and best wishes.

Wayne
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Unread 12-12-2007, 12:17 PM   #14
dan32
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I made it through the night pretty well. At 6 last night I decided to go to bed. I took a valum and roserum for sleep and it knocked me out. I slept until 6 am today . I have quite a bit of anxity today. Im up driving around passing time before the doc shows. About an hour or so left. Ill let everyone know how the induction goes and how i feel afterward.
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Unread 12-12-2007, 12:30 PM   #15
Indy
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Keep up the good work.
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Unread 12-12-2007, 12:37 PM   #16
NancyB
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Good luck dan32 and let us know how it goes!
Nancy
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Unread 12-12-2007, 05:46 PM   #17
dan32
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its been around 2 hours since I left the doctors office. She gave me a total of 12MG . I.ve still have a lot of anxity. I feel like i waana take my DOC. I don.t know if I didn't take enough or what. we.ll see how it goes
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Unread 12-12-2007, 05:55 PM   #18
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Hey Dan, good to hear that you've made it this far. Are you feeling any withdrawal symptoms other than anxiety?? Also, how much did your doctor say you could take? If it's not against your doctor's orders, then you probably ought to take more until you're feeling alright. I know you've probably done your reading on how this all goes, but remember that it's gonna take a while before things really get going. You're still probably gonna be a little off today, then it'll probably take you a week or two to stabilize.

If you have any problems, feel free to ask for help on here, but if you're having a lot of trouble with anything, you need to talk to your doctor as well.

Good luck, and I hope you start feeling better.

-Stephen
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Unread 12-12-2007, 06:17 PM   #19
NancyB
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Hi dan32, Stephen gave you some good advice. I just wanted to add that bupe is only indicated to alleviate WDs and cravings at the right dose. It may not help your anxiety. Also, you've been through a lot the past day or so - having to go into wds and worrying about the new step you're taking. So try to relax, the worst is over now, it'll only get better from here.

Nancy
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Unread 12-12-2007, 06:43 PM   #20
dan32
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I called my doc tod her about my uneasyness . now she thinks im precip wd . i dont think so. i just think she didnt give me enough to cover me. what does everyone else think
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Unread 12-12-2007, 06:55 PM   #21
JStephen
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honestly, I think that if you were in precipitated withdrawals, you wouldn't even be able to get on the computer and type, they can be very severe. Like Nancy said, sub is only to treat the withdrawals and cravings, anything else is just a side effect. If you're still having symptoms then you're probably gonna either need to take more, or you're gonna have to wait to be a little more stable. But, before you do all that, make sure about your symptoms, if it's just anxiety and no new cravings or anything, then you probably just need to relax and find something to do. This is a rough time for you and your body so you can't really expect to be totally normal in a couple of hours. If you find that you are still having significant cravings and/or withdrawal symptoms and your doctor didn't give you enough sub, then just explain to her that you're feeling better than before, but not quite all the way better. She should understand, in my experience, I've had to take more the first day or two to get myself going.

Also, if you feel that you're up to it, go to a meeting or something like that, they can be very helpful when going through rough times. Tomorrow night we have chat on here at 730pm eastern time I think. We're gonna be talking about ways to prevent relapse, and how to get past it if you do, but you can get "the floor" if you need help.

-Stephen
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Unread 12-12-2007, 07:11 PM   #22
Pearl
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Hi there dan32! ~rough start, no? BUT, it will get better. I'm always hesitant to give specific suggestions, so this is only my 2 cents.. My thoughts are you were in sufficient withdrawal, your last dose of your DOC was over 20 hours before you took your first Suboxone, correct? So, precipitated withdrawal is probably not the case. JStephen is more likely correct..your body and emotions have been through a lot. Also, you are this doctor's first patient, no? At this juncture, you probably know just as much about Buprenorphine as he/she does, if you read the material here. I would give it a little more time. Try and take a walk or a hot bath or do something you find relaxing. I know this sounds lame, but it really helps when I am stressed. Try it, it can't hurt, ya know? Also, don't stop the benzos without a taper. Did your doctor discuss that? Stopping those abrubtly can be deadly, so please be careful!

Keep in touch and you will get through this!! Let us know how you are doing, okay? You have taken the most difficult step. I realize it doesn't feel like it right now, but it will get better!

Elizabeth;}
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Unread 12-12-2007, 07:17 PM   #23
dan32
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I talked with my doc she said its a two day process and to take somthing for my anxiety. I tried to tell her that every thing ive read suggest that I need more. she said we will take care of that tommorrow. so im in a delima . Im going to try to stick it out till tommorrow .
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Unread 12-12-2007, 08:23 PM   #24
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Hey dan32, are you having any WDs? Are you sure the cravings aren't just anxiety? Try to chill out, and not over think it. If it gets really bad, then just keep calling her until you're ok. Whatever you do, don't take your DOC. It'll be blocked and it'll just mess you up. Beams! -Mary
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Unread 12-12-2007, 08:40 PM   #25
Indy
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Dan-good job,I was exactly where you are only last week.I have kept a log of doses and symptoms but the 1st day I didn't log.But my 2nd day I logged at 20 and now I'm at 24.I knew if I started to sweat,have leg pains,fluish and didn't want to smoke,eat,drink then it was wd's not just me.Anytime I called my doc he said take 4 more-but I always called.From what I've been reading that is very normal to start low and go up.Probably sticking it out is a nice way of saying your hands are tied-but by the sounds of it you will get relief tomorrow.I agree with keeping busy even if you don't feel like it.I think this board is a godsend,but when I was in my first couple of days I don't think it helped me keep busy-it kept me very focused on it.I sat and read and read so much so that it was all I thought about.
My advise is to keep a log.It was very helpful when seeing my doc I just passed it to him.Sorry you have to break your doctor in,but it is a very good thing.
You did a very good thing-congrates.

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Unread 12-12-2007, 09:39 PM   #26
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Is it me or does this doc sound like a moron? First I want to say congrats on taking the step.

Now, I remember a week ago when I started WD's and it was a NIGHTMARE. Something I never want to go through again but when the sub arrived at the doc office and I took my first 8mg dose, within minutes my anxiety lifted and I was starting to feel better. He then gave me another 8mg tab, totalling 16mg, because I was having such WD's and I ended up falling asleep on his office floor waiting for time to pass so he could re-evaluate me. I was feeling fine and went home and was instructed to take another 8mg later that day.

He left me at that dose for 3 days until I stabalized.

The thing I find strange with you is that the doctor told you to take something for anxiety. I thought that was bad and I was specifically told NOT to take something for anxiety. At least not a Benzo (valium, zanax, klonopin..etc). I hope you didn't take her advice and if you did I hope your ok.

Hopefully she allows you to take a little more sub and she realizes that you may need it. I would say if you went the full 22 hours without using than I doubt you are having precip wd's. My DOC usage was out of control taking approx 20 pills a day and I probably could have gone on sub within 12 hours because I was in ROUGH shape. He almost admitted me to the hospital when he saw me. I think it was mostly anxiety because I just could not sit still. I was off the walls almost fainting from breathing so heavy.

Anyway, I hope you are doing better now and like said, wait until a week passes. I feel better each day and I compare myself now to last week and it's a 180 turn. I feel so great right now. Still adjusting, still having weird side effects but emotionally I feel like my head is getting itself together and I'm becomming alive again.
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Unread 12-12-2007, 09:49 PM   #27
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Dan32, Have you been taking a medication for anxiety before sub? Have you been diagnosed with an axiety disorder? If not the anxiety you feel is probably from the withdrawal, or just from starting a new therapy. Try and relax as best you can and write down any other symptoms you might have to show the doc. Try and distract yourself with something too.
Sub-
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Unread 12-12-2007, 09:54 PM   #28
dan32
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Thanks everyone . yes my doc is green but no moron. She just has a policy of induction over 2 days . for some reason. I am doing ok now that im home i just wish i had the option to take more. And yes she did tell me to abstain from benzo's. I'll be fine tonight and be looking foward to tommorrow when i have more control. When I arrived at her office today she said I wasn't ready , I was a 12 on the COWS. I finally talked her into treating me though ..
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Unread 12-12-2007, 09:58 PM   #29
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What is your COWS score now? In particular how big are your pupils in low light?
Sub-
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Unread 12-12-2007, 10:02 PM   #30
HateBlueDemons
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Glad to hear it!!! Each day will get better and better. You might hit an off day here and there but that is part of the journey to addiction remission.
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Unread 12-12-2007, 10:13 PM   #31
dan32
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I think the 12MG I had today has a pretty good handle on WD for now. I would like more but can deal without. thanks guys I really apprech your imput. My back pain is a notch or 2 away from being imbearable though. Hopefully higher doses tommorrow will help with that.
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Unread 12-12-2007, 10:19 PM   #32
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Hopefully you'll be able to get pain relief from the suboxone. The way to go about getting the most pain relief out of it seems to be to take small doses about every four to six hours b/c the it's pain relieving effects tend to wear off in about that time. I've personally had good results doing the dose splitting and taking 600 to 800mg of ibuprofen for my back, although I don't have serious back problems, just the muscle pain caused by an accident a few years ago.

-Stephen
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Unread 12-13-2007, 01:14 AM   #33
Cally
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dan32,

I just logged on to check how you are doing today. You started today and I am so happy for you.

The next couple of days are days that your body will become adjusted to the suboxone. Take good care of yourself now, drink a lot of water, eat a lot of friut.

I have a plate in my neck so I have back pain. (That's how I started taking pills in the first place.) Your pain will get better, give it time. Ibuprofen will help a lot. Warm baths will help your muscles relax. I know it's cold outside but walking just a little bit will also help.

Keep in touch with you doctor like you are doing, tell your doctor everything. Keeping a log is a great way of keeping track of how you are feeling so you can see your progress.

Keep posting your updates. You sound wonderful and everyday will get better.
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Unread 12-13-2007, 12:55 PM   #34
dan32
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I slept like a champ last night . i feel much more relaxed today. Yesterday was tough but it wasn't so bad . My next appointment is at 11 today . Im looking forward to talking mith my doc and having freedom from there. thanks everyone. Ill stay in touch and let everyone know how the next few days go.
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Unread 12-13-2007, 01:13 PM   #35
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Hi dan32, good to hear that you slept well last night.

About the benzos, please just don't abruptly stop them - benzo withdrawal can be severe and could be lifethreatening (seizures, etc.). Here's a link to a site that has taper information:
http://www.benzo.org.uk/

The 2-day induction could be from the TIP40: http://www.naabt.org/links/TIP_40_PDF.pdf
pdf page 78:
"...The total amount of buprenorphine administered in the first day should not exceed 8 mg."
pdf page 82:
"Patients who return on Day 2 experiencing withdrawal symptoms should receive an initial dose of buprenorphine/naloxone equivalent to the total amount of buprenorphine/naloxone (or buprenorphine) administered on Day 1 plus an additional 4/1 mg (maximum initial dose of 12/3 mg). If withdrawal symptoms are still present 2 hours after the dose, an additional 4/1 mg dose can be administered. The total dose on Day 2 should not exceed 16/4 mg. Continue dose increases on subsequent days according to the induction schedule shown in figure 4-2 up to a maximum of 32/8 mg per day."

That has pretty much changed:
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"

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

5Physician 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

Good luck this morning and keep in touch.
Nancy
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Unread 12-13-2007, 05:28 PM   #36
dan32
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I am so glad I started this treatment. It has been about an hour since I left the doctors office. I have no anxiety or ill feelings except for a slight headache. I would definetly advise anyone who is comtempating this to do it. I will stay in touch and try to help others who are about to start this process. Thanks from the bottom of my heart to everyone who replied and tried to help me. you all were the only people who I could talk to about my endever and it helped alot to get everything off my chest. If anyone has any questions feel free to ask.
Danny
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Unread 12-13-2007, 06:23 PM   #37
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Congrats Dan32 !! I'm glad you are doing great now. It will, like other have said, get even better every day.
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Unread 12-13-2007, 09:25 PM   #38
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Danny,
Congratulations!! Sometimes the anticipation of the treatment is harder than doing it. Looks like your induction went perfectly. Nancy gave you some great links that have tons of info in them. Good luck with the next phase, changing lifestyle and repairing damage caused by addiction.
Tim
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