Addiction Survivors

Notices

Reply
Unread 01-01-2008, 06:00 AM   #1
CocoRosa
Junior Member
 
Posts: 5
Default Trying to start Sub tomrw

Hello all, I am new to this forum, but have been reading here and there for about a month or so. Dober, a member of the forum, is my boyfriend, and he's told me that he's gotten a lot of support and advice from you all. I need to start Sub tomorrow, and could really use some feedback.
I was in rehab for 6 weeks and got out in November. Long story short, I relapsed, and am trying to get back stabilized on the suboxone.I have used buprenorphine off and on for a few years, so I am somewhat familiar with how it works for me. But I still have been having a hard time figuring out how long exactly I have to wait from my last use until my first dose of Sub. Heroin is my DOC, and the stuff I've been doing lately is so strong it seems I have to wait a lot longer than I have in the past for my first dose. Is 20 to 24 hrs a normal time to have to wait?
I guess my main question is, can I get some tips for waiting out the time before the first dose? My problem is sticking out those hours where I am sick, anxious uncomfortable, but not sick Enough to take the first 2 mgs. I've had such bad experiences with precipitated WDs; my impatience with the waiting always seems to get the best of me.
I appreciate all help. I hope this post was articulate enough; Dober keeps chattering in my ear and tickling and poking and distracting me because we like to bug each other like that.
CocoRosa is offline   Reply With Quote
Unread 01-01-2008, 02:13 PM   #2
NancyB
Administrator
 
Posts: 25,466
Default

Hi CocoRosa and welcome.

It's not the amount of time that matters, it's your withdrawals. Please give the precipitated withdrawal sheet a read. On page 2 of the PDF is the COWS (Clinical Opiate Withdrawals Scale). You should be able to tell where you are withdrawals by that. Remember, it's only mild to moderate withdrawals. NOT on the floor writhing in pain and vomiting. Also remember, anxiety can have the same symptoms as withdrawals, so you can always check your pupils in regular light to see if they're pinpoint or dilated.

http://www.naabt.org/documents/NAABT_PrecipWD.pdf

Try keeping as busy as you can, hot showers/baths, have dober give you backrubs.
This thread has some tips also.
http://www.naabt.org/forum/topic.asp?TOPIC_ID=3268

You should feel some effect of the bupe in 15 to 30 minutes. Full effect is 1 to 2 hous (all depending on the person). More bupe is needed if you happen to have preciptitated withdrawals.

Let us know how you're doing when you can.
Wishing you and dober a great 2008.
Nancy
NancyB is offline   Reply With Quote
Unread 01-01-2008, 03:28 PM   #3
Mike
Senior Member
 
Posts: 2,425
Default

CR,
I was taking heroin too and only had to wait 4 hours before the withdrawal set it, but everyone is different. If you follow that sheet that NancyB linked to you should be fine. Heroin transfers to sub are among the easiest, so you should feel good the same day. Good luck!!
Mike is offline   Reply With Quote
Unread 01-01-2008, 03:43 PM   #4
werdna
Senior Member
 
Posts: 527
Default

Rosa welcome! Hang with us, stay close to the board, make friends and read the stuff Nancy gives you to read! You can and will do it this time!

Happy New Year and make it a drug free year!

werdna is offline   Reply With Quote
Unread 01-01-2008, 11:20 PM   #5
CocoRosa
Junior Member
 
Posts: 5
Default

Thank you all for the support.....Still waiting for a higher COWS score to take my first dose. Happy New Year.
CocoRosa is offline   Reply With Quote
Unread 01-02-2008, 12:17 AM   #6
endzonewife
Member
 
Posts: 92
Default

CocoRosa, hello and welcome! I just wanted to congratulate you on your decision to start sub. I know that for me, it has been one of the best decisions of my life and I hope it will be for you as well. Happy New Year! Please keep coming here. The people here are amazing and you will find the answers and support you need.
Michelle
endzonewife is offline   Reply With Quote
Unread 01-02-2008, 04:18 AM   #7
CocoRosa
Junior Member
 
Posts: 5
Default

First, it is so nice to be so welcomed here!
About 18 hrs after my last use I scored a 6 on the COWS and took 2 mgs of bupe. I should've waited till I had a higher score; the dose ended up making me feel worse that I did before. I ended up using on top of the 2 to take away the PWs. This is very embarrassing to admit, but being honest & having people to be accountable to helps me in the long run.
Even though I screwed up today, I am still planning to try tomorrow. Nancy, you recommended being in mild to moderate WDs, so that would be around a 13 on the COW scale?
I really want to do this. As my disease progresses, I find it more and more difficult to get on the Sub on my own, as opposed to being in an in-patient setting. But because that is not the case for me right now, I need to just do what I need to do, with the situation I'm in. Even though I have done this on my own before, part of my problem is that sometimes I don't believe in myself enough....but I have to do it, I can't take this lifestyle anymore.
Thanks for all the advice.....
CocoRosa is offline   Reply With Quote
Unread 01-02-2008, 01:02 PM   #8
NancyB
Administrator
 
Posts: 25,466
Default

Hi CocoRosa, sorry you had a rough time.
From: http://www.naabt.org/documents/NAABT_PrecipWD.pdf

"Short-acting Opioids
(Heroin, Crushed OxyContin, Percocet, Vicodin, Oxycodone and others)
Prior to induction, patients must abstain from all short-acting opioids for 12 to 24 hours and/or have objective withdrawal symptoms sufficient to produce a score of 5 to 24 on the COWS."

Anxiety can sometimes cause symptoms that mirror withdrawal symptoms. Checking your pupils is a good way to see how far in WDs you are. The bigger the pupil, the more in WDs you are.

Also, 2mg may have not been enough. From that same link:
"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

This is from the TIP40: http://www.naabt.org/links/TIP_40_PDF.pdf (pdf page 78)
"Patients who are experiencing objective signs of opioid withdrawal and whose last use of
a short-acting opioid was more than 12-24 hours prior to the initiation of induction can receive a first dose of 4/1-8/2 mg of the buprenorphine/naloxone combination (buprenorphine monotherapy for pregnant women). (See figure 4-1.) If the initial dose of the buprenorphine/naloxone combination is 4/1 mg and opioid withdrawal
symptoms subside but then return (or are still present) after 2 hours, a second dose of 4/1 mg can be administered."

Have you thought about going to a doctor who will do the induction in his/her office? There are people who can't do it at home and there are some people who prefer doing it at home. You may just need to feel more secure about what you're doing.

You can do this. Please let us know how you're doing.
Nancy
NancyB is offline   Reply With Quote
Unread 01-02-2008, 02:14 PM   #9
lookingup
Senior Member
 
Posts: 313
Default

I have heard rumors that the black tar type takes a lot longer to clear your system. I have no first hand knowledge, but have read that enough times to reccommend that you do some research if that is the type you use.
lookingup is offline   Reply With Quote
Unread 01-07-2008, 11:58 AM   #10
NancyB
Administrator
 
Posts: 25,466
Default

Hi CocoRosa, just checking in to see how you're doing.
Nancy
NancyB is offline   Reply With Quote
Unread 01-07-2008, 02:25 PM   #11
OhioMike
Senior Member
 
Posts: 11,335
Default

lookingup
Senior Member


170 Posts
Posted - 01/02/2008 : 10:14:45
--------------------------------------------------------------------------------

I have heard rumors that the black tar type takes a lot longer to clear your system. I have no first hand knowledge, but have read that enough times to reccommend that you do some research if that is the type you use.


************************************************** ************************************************

I have a person who I work with who had a hard time making the switch from H to Bupe. I tried a couple of different things with him and we still had some issues. Something was wrong, as he was reacting more like a person switching from Methadone. I spoke to Nancy to try and problem solve this. she recalled one substance which H can be cut with which has been known to cause some issues during induction. I regrouped as he kept failing and treated him more like a person switching from Methadone and during induction we kicked things up a bit and went for a breakthrough dose of Sub. this worked and he was able to make that time, but, it still took him a little longer to level out than most who switch from H.

Just something I have personally experienced.

OMike
OhioMike is offline   Reply With Quote
Unread 01-07-2008, 03:25 PM   #12
lookingup
Senior Member
 
Posts: 313
Default

Thanks Mike,

I have no knowledge of H, but have read about this particular problem enough times that I thought I should mention it. I hate stating something on rumor, but it is all I have. Glad to hear it from someone else.
lookingup is offline   Reply With Quote
Unread 01-08-2008, 12:04 AM   #13
aussiemommy
Senior Member
 
Posts: 186
Default

Coco, how are you doing today?? I really hope you gave Sub another try.

Are you getting your Sub from a doctor?? If not, I highly reccommend going to a Sub doctor. They really ARE helpful in finding the right dose for you. It sounds like you really need to take more than 2mg of Sub. I have never done Heroin. My DOC was Vicodin (and my habit was not at strong as many on here), and still, I needed 16mg of Sub a day. So I would definitely say you need more.

If you havent tried the Sub again yet, I would say try waiting 24 hours from your last dose of H. Then start out taking 4mg and if you dont feel better in 30 min, take another 4mg. Again, I really suggest going to the doctor. And I found it really helpful to do my induction IN the doctors office, so that we could find the right dose. Also, if you have a Sub doctor, he may be willing to give you comfort meds to get through the WDs til you can take your first dose of Sub. My doctor gave me Clonodine, Phenergan and Seroquel...but I didnt really take them. I got through it. I took and Ambien and slept through my WDs.

You CAN do it and I reallllllly hope you stick it out this time. Like someone said above, stay close to us on the board. We will help you through it. Please dont give up. This could save your life, and it IS worth it. Your life is worth it.
aussiemommy is offline   Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off




All times are GMT -4. The time now is 11:17 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2019, vBulletin Solutions, Inc.
© 2014 Addiction Survivors