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Unread 01-07-2006, 03:50 PM   #1
cindyj
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Default Could use some help

Hi Everyone,
I could use help.... I started sub treatment on Tuesday. The doctor was confortable with gving me 4 mg. At first I felt light headed but within a few hours I felt absolutely wonderful. I took the Suboxone around 3 p.m. so I felt good for the rest of the day. In the morning I took 4 mg. again felt light headed but soon felt great, like I was meant to feel, I'm sure I don't have to go into detail to explain the peace and clarity I had. In the afternoon I mentally crashed and felt withdraw, my doctor advised to take 2 mg more, didn't work, so he had me take 2 more and then try 8 mg the next morning. It worked and I had that sense of well being again.

Thursday I woke up and took the 8 mg. I felt horrible, dizzy, weak and tired. I went to my appointment and told him how I felt. He instructed me to take 4 mg twice a day.

Yesterday morning I took the 4 mg, felt the usually light headedness, but never got the good feeling back. I took 4 mg in the afternoon, still no good feeling. Instead I felt very depressed and naseaus and even threw up. I had no cravings or pain, but could not think straight.

This morning is the same, again throwing up and feeling miserable. I have no physical pain, just mental. I had a glimpse of what I could feel like (when the sub was working the first couple of days) and now its gone.

I have tried calling my doctor on his cell, but no luck. I thought maybe someone has gone through this.

Thanks for listening.

Cindy
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Unread 01-07-2006, 04:41 PM   #2
Mike
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I'm not a doc...To me It sounds like either something unrelated like the flu, (is that possible) or some people as they stabilize and find their dose experience some discomfort and anxiety (can last 3-4 day)

To check to make sure you are not having break though withdrawal check your pupils against someone not on medication, in the same light. If you are getting enough Suboxone your pupils should be the same size or smaller, as the other person's. If yours are substantially bigger it means you are in some withdrawal, and your dose is too low.
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Unread 01-07-2006, 04:51 PM   #3
spanky
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Good advise from Mike about checking your pupils.Sounds to me like not enough Bupe to start.How much were you using and for how long??What were you using.Also some folks (like me for one)can't take Suboxone as it has Naltroxone(SP?)in it to make it abuse proof.It can cause nasaua.For me it caused swelling and itching.I had to be switched to Subutex the form of Bupe without Naltroxone(SP?)and I had no more problems.You should ask your Dr about it......SPANKY
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Unread 01-07-2006, 05:24 PM   #4
cindyj
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I don't feel like its the flu, I don't have body aches, just upset stomach. I checked my pupils and they are smaller than my husbands.

I started using vicodin about 2 1/2 years ago but not daily until last March when I broke my arm. Up to last Monday I was taking 6 - 8 Lortab 10/500 a day.

Cindy
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Unread 01-07-2006, 05:41 PM   #5
SomeDayBFree
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Hi Cindy!

A habit is a habit - however, yours has not been as heavy as most others. My personal feeling is that you needed the 8mg for the initial withdrawal from Lortab. However, you are now beyond that and I am inclined to believe that your dose is much too high.

Although our bodies and metabolism are unique to each of us, it makes sense to consider that higher amounts of Suboxone are needed for heavier habits. As an example, I was also using Lortab (the 10mg variety) at the rate of 25-30 tabs daily. For me, the effective dose was 8mg the first day, 12mg the second and 3rd day, then down from there. Within a week I was doing well at 4mg daily and that's where I am most comfortable now, 2 months later.

Maybe it might be worthwhile to try only 2mg this afternoon - or possibly skip a second dose today altogether, and then start out with 2mg in the morning and 2mg in the afternoon. My experience is that too much Suboxone can generate the nausea. Sometimes it takes a little finagling to come up with what works for each individual.

I am quite certain that you will find the best dose for you within a very short time.

SomeDayBFree
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Unread 01-07-2006, 06:01 PM   #6
cindyj
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Hi
Thanks for the posts.
I finally got a hold of my doctor, at first he wanted me to increase my dose and take benidryl (sp?), when I told him I thought the dose was making me feel sick, he said to decrease it and take benedryl... I don't think he really knows.... But I will try 2 mg and the bendryl and see what happens.
Thank you all very much,
Cindy
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Unread 01-07-2006, 07:24 PM   #7
peachez
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Hi cindy-
Glad you're here...i too was a lortab lover: 25-30 10's a day. It takes a lot of courage to overcome an addiction and i applaud you for taking that step. You know, i never had the problems you are having with the sub. At first i thought the same thing that it might be the flu (tis the season!) or something like that. And now your doctor wants you to take benadryl with this? Did he say why and what outcome could come of taking those 2 together?? I am just curious...
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Unread 01-07-2006, 08:54 PM   #8
cindyj
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I have no idea why he would tell me to take Benadryl. I called the pharmacist and she didn't know either. Also the same doctor gave me a script for sleeping pills to take before I go to bed.... maybe he just wants me real sleepy so that I don't call him anymore


Peachez, thanks for the kind words.. has anyone gone to NA... I have realized that I probably do need some sort of conceling, I did go to one NA meeting, but sure if its for me.

Thanks again,
Cindy

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Unread 01-07-2006, 09:48 PM   #9
Janet T
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Cindy--

You poor thing! It sounds like you've been through hell.

I'm new too so I don't have the experience you're looking for, but I did want to say that you need a doctor who will call you back the same day, within a couple of hours. What he did (or didn't do) is criminal - you're in early withdrawl, you may be having some weird drug interaction...who knows. If you decide to look for a new doctor and don't know where to start, try this link: http://buprenorphine.samhsa.gov/bwns_locator/index.html

Also, SomeDayBFree may be right - you were definitely opiate addicted, but the amount was reletively low and the dose you started with may have been too high. However, dosing is very tricky and there seem to be a lot of different opinions (both professional and not) about it. Also, it's hard to know what symptoms are due to detox, what's due to the Suboxone, what's due to PMS...there are so many variables. I'm going to post a separate thing on this on the "New Members" thread on this topic as I'm having a hard time with it myself. Good luck to you, and keep me posted. --JT

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Unread 01-07-2006, 10:32 PM   #10
Phoenix
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Of everything I've seen Tony go through, this is NOT AN EXACT SCIENCE. When he told the doc that he was feeling weak, he wanted to boost his dosage. I asked if he might be getting too much, the doc was like "yeah, that could be it too!" It is crazy. Too little, too much, the only way is to make sure you're not in any type of withdrawl, then tweak your dosage based on how you feel. Do you feel better with less? Tony's stabilizing dose is 20mg all at once in the morning. He felt more weakness if he took any of it at night and went to sleep, in addition it also hindered his already screwed up sleep habit. Hope that helps somewhat.
Judy
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Unread 01-07-2006, 11:31 PM   #11
Robyn
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Cindy,
So many are so grateful to find a Sub doctor, it's hard to remember this is a very new medication with limited exposure. Add to it, no two people are alike, and that makes it tough going for the dosage. Try to keep that in mind, it may make things easier to tolerate.

I am sure some of the more experienced folks will pipe in here soon, but three immediate possibilities come to mind: dose too low, dose too high, or reaction to the Naloxone. I have read serious Naloxone reactions are rare, but do occur. Perhaps your doctor was taking a stab in the dark, but Benadryl is usually prescribed for itching and hives......never heard of it for nausea. FWIW, I would vote the dose may be too high. I was taking a large dose of hydrocodone, and the most I could tolerate was 8 mg. of the Suboxone. Within my first week, I was down to 4 mg. That said, we are not your doctor. Any changes you make to his orders should be discussed with him.

I would try to find a very nice (not being facetious here) to ask him how many patients he has treated and from there try to have a meeting of the minds regarding your dose. The success of your treatment depends on the two of you working it out. It's really tough to have patience finding the right dose when you are feeling so rough, but the success of your treatment depends upon it.

When many of us are inducted with the treatment, we appear at the doctor's office in mild, preferably moderate withdrawal. I was given 2 mg. and checked in one hour. Then I was given another 2 mg. This continued until all of my WD symptoms disappeared, and that was after 8 mg. total. I was there for over 4 hours. That was considered my target maintenance dose. How did your induction differ?

Unlike everything we have experienced, more is not better with Suboxone.

Hang in there, you and your doctor will get it right!
Dixie
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Unread 01-07-2006, 11:49 PM   #12
TIM
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Cindy,
If you could find a way to suggest this to him without offending him...There is a mentor program set up for exactly this kind of thing. The link is: http://www.pcssmentor.org/

"The SAMHSA-funded PCSS is designed to assist practicing physicians, in accordance with the Drug Addiction Treatment Act of 2000, in incorporating into their practices the treatment of prescription opioid and heroin dependent patients using buprenorphine."
Tim

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Unread 01-08-2006, 02:02 AM   #13
leeglegle
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Sounds like it has possibly been precipitated withdrawl.

Good luck. With a litle time, you'll even out. Then, any agony will have been worth it.

Good luck.

Robert
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Unread 01-08-2006, 12:56 PM   #14
Debbie
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Good morning, Cindy. How are you feeling today?

Debbie
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Unread 01-08-2006, 03:56 PM   #15
cindyj
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Well this morning I woke up feeling ok (not great) but ok. I took only 2 mg and made it through church. I am definately not as clear headed as I was my first couple of days but am no longer sick to my stomach. About 4 hours after my first dose I started feeling very agitated and emotional. I just took 2 more.
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Unread 01-09-2006, 09:50 AM   #16
just-n-time
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Good morning Cindy!!
I noticed where you live. I'm about 40 min. away!! (by Lake St. Clair) I was on Norco (10/325), about 12 to 18 per day, for 1 year.
Also like you, I caught my addiction problem before it got to a point where so many here were taken. Believe me, read some of the peoples post here, it could have been worse. Not to lessen our level of addiction, however, I wanted to point that out. My doctor, who is in the same town I live, is wonderful!! My induction was identical to Dixies'. Very well supervised. I started out on my 2nd day (at my discretion), taking a total of 14mg sub. Next day, 12 mg. Next day 14mg. Into my 2nd week, I'm at 8 to 10 mg. per day. This was after my 2nd doctor's appt., where we discussed my dosage, and what he was shooting for, as far as dosage went.
I am also experiencing the "emotional" thing!! I want to bring a possibility to light. I think (as in me!!) I need to figure out the new life I have created today-with no emotional stabilizer to fall back on-the Hydro. I do think you have to work out the dosage. However, we have other issues we have to address. My problem, is trying to get used to this new feeling of-awareness. The pills helped "quiet" me, to be able to accomplish everything I had to do on a daily basis. Now, I have to figure out how to do that without the aid of my "crutch". I viewed the sub as a tool to get through the withdrawls. I too am trying to figure this whole mess out!! I am interested to hear your thoughts!! Let me know!! My blessings are with you!! Beth.
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Unread 01-09-2006, 10:35 AM   #17
Robyn
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Hi Cindy!
How is it going????? Is it getting any easier???? So sorry you are having a rough go. Hang in there........it IS worth it!
Dixie
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Unread 01-09-2006, 12:05 PM   #18
cindyj
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Hi Everyone,
Well today seems much better. Yesterday was kind of a roller coaster ride with many many crazy and impulsive thoughts. The good news is I do not have any pain (fibromyalgia and arthritis) and I do not have any cravings. I woke up feeling a little naseaus but feeling better now. I agree I have to get my dose right. This morning I took 4 mg and will take probably 2 later this afternoon, if I feel I need to.

My induction didn't go as well. My doctor is probably in his 80's I don't think he has much training in drug addiction. When I went for my induction I was probably 20 hours in withdraw. He wan't me to be a little more into a withdraw so he had me wait a whole 15 minutes. He gave to 2 mg and came back in 15 minutes to see how I felt. I didn't feel much different. He gave me 2 mg more and came back in 10 minutes. I told him the pain was starting to go away, but I still felt depressed. He said I should probably see a psychologist and told me to come back the next day. The 4 mg he gave me in the office were short acting so he gave me a perscription and told me to take 4 mg when I got home. I did end up feeling very good within a few hours. He told me he like to get his patients off of sub in about 2 months. I am looking into finding a new doctor, maybe a psychiatrist.

Is anyone experiencing forgetfulness?
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Unread 01-09-2006, 01:52 PM   #19
dodo
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Cindy,
I'm so glad to hear it's getting better for you. Fortunately, it looks like Beth lives very close to you and had found a good doctor. You two should hook up. I'm still waiting to see if anyone is from my part of the woods(suburbs of Phila.) but haven't had any luck yet. Sorry, I haven't been experiencing any forgetfullness. Actually, that has gotten better for me, I use to forget everything although I think I just didn't want to deal with anything at the time.
Doris
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Unread 01-10-2006, 12:48 AM   #20
Robyn
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Hi Cindy,
It sounds like you are doing better, not perfect, but doing better. I think in another week, you will be doing much better. But you are right, the writing is on the wall an it's time to look around.

(I am getting so weary of all the hearbreak...first finding a doctor for help and then the doctors wanting to get patients off the Suboxone too quickly....medicine finds the treatment, yet the government has created a monster...if you can't afford it, you are screwed. Sorry, will get off soapbox).

As far as a psychiatrist, if you are willing to accept other meds for treatment, go for it. Otherwise you may just want to locate a good therapist. I just recently sent an email to someone about that very subject, so I have done a quick cut and paste to help you look.

Ph.D./M.S. These are therapists - psychologists (i.e., LP), family therapists (i.e., LMFT, LMC), social workers (i.e., LCSW, LSW), nurse practitioners (i.e., ARNP, APRN), and clinicians (i.e., LMHC) - who primarily use talk therapy to help you assess the difficulty you are experiencing and identify solutions.

M.D./D.O. These are doctors who have a specialty in Psychiatry or Addiction Medicine. In addition to diagnosing problems and treating them through talk therapy, an M.D. or D.O. can prescribe medication for behavioral health problems if necessary. Many psychiatrists also have subspecialties such as: Children and Adolescents; Geriatric; Addiction Medicine, etc.

Clinic. This is a group practice that may have all levels (see above) of providers in the service location.

Here is a list of abbreviations often found after behavioral health provider's names:

Types of Degrees:

MSW Masters Social Work
MS Master of Science
MA Master of Arts
RN Registered Nurse
PHD Doctorate of Philosophy - Psychology
PSYD Doctorate of Psychology
EDD Doctorate of Education
ARPN Advanced Registered Nurse Practitioner
MD Doctor of Medicine - Psychiatry
DO Doctor of Osteopathy - Psychiatry

Types of Licensure:

LISCW Licensed Clinical Social Worker
LCSW Licensed Clinical Social Worker
CCDC Certified Chemical Dependency Counselor
LMFT Licensed Marriage and Family Therapist
LCP Licensed Clinical Psychologist
LP Licensed Psychologist
LPC Licensed Professional Counselor
MD Doctor of Medicine - Psychiatry
DO Doctor of Osteopathy - Psychiatry

Many states have different names for licensures; these are usually master's level counselors. Some of the abbreviations include: CCSW, LPCC, CADC, CCSW, LCPC, CCPC, CICSW, CPC, MFCC, LMHC, CMFT, and CMHC.

Here is one of the better sites for http://www.4therapy.com/consumer/abo...20of%20Therapy finding a therapist. I had a bad experience with one that I found, right out of the phonebook, at barely 24 hours after detox. I didn't know the right questions to ask, so I just went on in and it wasn't until about 4 or 5 visits that I was stressing over the therapist. Luckily for me, my doctor saw it was not a good match and let me off the hook. My problem was due to the fact she had zero experience with Suboxone. She was clueless about this treatment plan and was pushing me harder than the doctor to wean off of it. It takes time and energy to find the right person...time I don't have and my energy needs to go elsewhere.

Sorry, didn't mean to write a book
It's been happening to me a lot lately,
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Unread 01-10-2006, 11:07 AM   #21
cindyj
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Thanks for the info, it is aggrevating trying to find a doctor who really understands this program. I am going to get a list from my insurance company of mental heath providers that they cover. Then compare list to see which of these doctors would be on the suboxone doctor list. I need to find a doctor who understands that this drug not only is helping me with the withdraw from pain killers but is controling my pain from fibromyalgia, giving me clarity which could be a form of adult ADD or fibromyalgia, and depressesion. The whole idea of being off sub in two months (which my doctor is suggesting) is causing me to panic..... I have an appointment tomorrow and hopefully will feel a little better about my treatment. I am now taking 4 mg in the morning and 4 mg in the afternoon. I have more enegry than I have had in years.
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Unread 01-10-2006, 11:59 AM   #22
dodo
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Cindy,
Glad to hear your feeling better. Dixie gave you some great info! Just keep looking for another doctor. Good Luck!
Doris
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