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Unread 08-09-2010, 08:24 PM   #1
rphoke
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Unhappy rphoke - moved from another thread

I have been excessively tired lately, lethargic, a little depressed and I wake up every night between 3o AM and 6:00 AM with anxiety and
I have to dose between 4 mg and 8 mg to snap out of it. I am currently
at 24 mgs a day (I've been in treatment for seven months). After reading
most of these posts, I believe I am on way too high of a dose.

What say you ?
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Unread 08-09-2010, 08:34 PM   #2
Sub-Zero
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Could be, by now your tolerance has probably decreased effectively making the sub more potent. Which would cause the symptoms you have. Check your pupils, are they pinned all the time? If so, your dose is probably too high. But you shouldn't need to dose during the night, in fact at your dose you should be able to stop sub for 48 hours without feeling any withdrawal at all. Did you have anxiety before you were addicted?
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Unread 08-10-2010, 01:38 AM   #3
Salgoud
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First of all, welcome rphoke to the forum that pulls no punches.

A person cannot blame everything on Suboxone. First of all, tell us all the medications you are on. You may have an interaction problem.

Were you taking benzo's or Ambien, Lunesta or Sonata previous to getting on Suboxone?

If knowing if you are or were on anti-depressents, benzo's, or the Z-drugs, it might explain your anxiety.

I personally am hyped up all the time, always doing something, by 2 or 4 AM I go to sleep. Then wake around 8 AM or 9 AM depending on what dumb ass junkie calls and wakes me up asking me if I can get this to trade for that. I say "hell no". Now let me sleep, you friggin' idiot.

Are you only on Suboxone? Tell the truth and you might find an answer that might surprise you. Recently I was given Venlafaxine (Effexor) for my depression. I didn't sleep as good, I had anxiety, and I felt more depressed that when I was on Suboxone alone. So I stopped taking it, before I got dependent on it. One week was enough to tell, it was not for me. Now I'm back to the good old me. I feel great. I sleep great. I dream again. However, when I wake up, it takes about an hour before I want to interact in Society. I need Blue Mountain Coffee.

Good Karma
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Unread 08-10-2010, 11:06 AM   #4
rphoke
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I had anxiety before suboxone and I believe some of that anxiety was from constant
withdraw (and/or taper down) from hydrocodone that I was in and out of for about
three years. I take two .5 mg of Xanax ER everyday (one at 6:00 AM and one at 6:00 pm) for a total of 1 mg per day as prescribed by my family doctor with the
blessing of my suboxone doctor because I apparently do have some anxiety issues
that are unrelated to medication. When I was using hydrocodone I would always
have to wake up somewhere along the line in the middle of the night and dose. I
am SLOWLY decreasing my daily intake of Suboxone. In a few days I will be down
to 2-1/2 8mg tablets per day and in a month, down to 2-1/4 (18mgs/day). I hope
that at least the fatigue eases up but what I wouldn't give for 8-10 ten hours
of straight, totally relaxed sleep. Does your tolerance actually decrease the longer
you are on Suboxone?
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Unread 08-10-2010, 01:04 PM   #5
Sub-Zero
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Quote:
Originally Posted by rphoke View Post
Does your tolerance actually decrease the longer
you are on Suboxone?
It did for me. I found I felt better as I lowered my dose over time. I would start to feel medicated, lethargic, a little spacey, or just unmotivated, and that was a sign that I could lower my dose. Once i did I felt better, but it takes a few days to feel the full effects of a decrease because it lasts so long. If I were you I'd try dropping to 16mgs right now and se how you feel in 4-5 days. I garrenty you won't go into withdrawal. To prove it to yourself keep checking your pupils, they get really big if you start to go into withdrawal. You might find you need as little as 8mgs/day???

opiates cover up some anxiety, so as your tolerance goes down and you need less sub some of the anxiety that it was covering up could show up. Tell your doc and he might need to up your Xanax a little at least temporarily.

I think once you find your right dose you'll feel pretty good.

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Unread 08-10-2010, 01:12 PM   #6
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Here's something else that might interest you. Its a PET scan of brains showing available receptors, somewhere between 2mgs and 16mgs almost all of the available receptors get filled up so any more sub doesn't do anything (except maybe make you feel medicated and lethargic) http://www.naabt.org/images/petscan.jpg

one thing to note is not everyone responds exactly like this guy did in the PET scan, but it gives you a general idea.
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Unread 08-10-2010, 01:42 PM   #7
Mike
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My tolerance went down too. I think just about everyone needs less as time goes on. We've seen people come here who stayed at a high dose for a long time and most have the symptoms of being medicated, unmotivated or some other symptoms that's consistence with too high of a dose. On other sites it happens too but people don't know why and say things like "the sub turned on me" or "it isn't working like it used to" -its counterintuative to think that you'd need less so if no one tells them than they think its the sub changing or something.

Your tolerance won't go to zero until off completely, but you'll probably be able to get down to 2mgs without any trouble at all just with small decreases as you start to feel medicated.

I thinks SZ's right and you could probably drop to 16mgs and feel fine, but you have to make sure the placebo effect doesn't trick you, the mind is powerful especially with an anxiety issue. Using the pupils only to know if what you feel is withdrawal is a good way rule out anything in your head.
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Unread 08-10-2010, 04:19 PM   #8
rphoke
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Thank you so much, everyone. You certainly haven't heard the last of me and for now, I may take a day or two to sharpen up my courage and then drop to 16 mgs
a day. My doctor claims if you taper too quickly it may jeopardize treatment
because it is important to maintain as much balance as possible to encourage
adherence to the treatment and that bouncing your dose around too much can
throw everything in a state of flux that can be hard to regulate. He obviously favors
slow and steady, at least in my case. I hope it's not just erring on the side of caution.
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Unread 08-10-2010, 04:50 PM   #9
Mike
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Your doctor's right, and you're right to listen to him, you certainly don't want to do something someone on the internet said, but it might make for a good conversation with your doc and maybe you'll both come to the decision to give a lower dose a try. I agree that slower is better, especially at lower doses, but at the doses you are on, you are probably above your ceiling dose, so it doesn't matter how fast you taper down to your ceiling dose...but the rub is there's no way to know your ceiling dose before tapering. But for most people its around 8-16mgs.

Bouncing around with your dose is bad, I agree, finding the lowest dose that stops withdrawal and cravings and sticking with it is a good plan. Good luck please keep us informed on your progress!
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Unread 08-13-2010, 12:19 PM   #10
rphoke
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Default Working towards 16 mgs a day

I am still taking 22 mg's a day but am going to drop down to 20 mg's
this weekend and see how that goes. What I now think I'll try is
give that a week and then drop to 16 mgs a day and see if I can
tolerate that. I truly believe 16 mgs a day will result in less fatigue
and less middle of the night anxiety and I hope that is not too quick
a taper. Man, the heat (which has been mid 90's almost every day)
is tough to endure on this medication. I am so looking forward to
Autumn weather which is beautiful here in South Carolina.

I hope all of you are doing well !
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Unread 08-13-2010, 10:53 PM   #11
Mike
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Sounds like a plan. I think you could drop straight to 16mgs and not feel any different whatsoever. the difference between 24mgs and 16mgs is virtually nothing if both are above your ceiling dose, which they probably are. The PET scan sub-zero provided shows that ceiling is even lower than 16mgs.Keep busy after you drop to lesson the placebo effect or false symptoms. good luck.
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Unread 08-14-2010, 01:22 AM   #12
Salgoud
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I used to lived in Sumter. S.C. I went a school that was 90% black. I guess thats why I get along with all races pretty good. Then I went to Camden Military Academy in Camden, SC ( I did something bad and got sent there by my DAD when I was 15.)

Everybody is right, once you stablize you'll be able to come down to a decent dose, like 4mg to 8mg, then to 2mg. I did it, and felt better on 2mg than 16mg. I guess everybody is different. Where do you live in SC.

Good Karma
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Unread 08-18-2010, 12:16 AM   #13
Salgoud
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Default Benzo's

rphoke,

Remember, even if you take benzo's as prescribed they lose there effectiveness after 30 days. It's is a good idea to skip a day here and there, so the benzo's stay active. They have such a long half-life, going one day without a Xanax ER, might help you sleep better and help with your anxiety. However, it seems you've fled the scene so I hope I'm not talking to myself. Also, 2 1/4 8mg Suboxone's is only 4mg. So are you taking it four or five times a day like that.

Buprenorphine's antagonistic effects are very strong. It acts somewhat like Naltrexone and decreases your tolerance to opiates significantly. When people quit Suboxone for three to four days, then do a large quantity of opiates they are used to doing, they are playing with fire. You have a minimal tolerance and many people I know, have almost OD'd from doing strong agonistic opiates, after quiting for three days, then doing a blast or a lot of Oxycontins. Even though Suboxone does cause dependence and is an opiate and will cause withdrawal symtoms it also is a powerful antagonist. It is in a class of it's own. If a person happens to OD on Subutex, not even Naloxone will bring them back. It is a Bentley Compound, and they are known for there strength of agonistic properties. Etorphine is a Bentley Compound like Suboxone. If a drop gets on your skin, you will die unless you have a strong tolerance to opiates. Suboxone is not nearly as strong as Etorphine, but it is a powerful opiate, because it metabolizes into a pure agonist, norbuprenophine. Norbuprenophine would probably kill someone if taken in the pure form, but because Buprenorphine is still in the system, it prevents that from happening. The more you take, the more Buprenorphine stays in the system which does not metabolize into the agonist norbuprenophine. Thus, the ceiling effect. Chemistry is fantastic. Knowledge will keep you alive dealing with these powerful chemicals.

Good Karma, hey where did you go. Post so we know we are talking to you. So many people come and go. Especially the newbies. If you stick around, you may learn a thing or two on how to get off Suboxone when the time comes. That is the most important time in ones recovery, jumping off Suboxone. Later on brother.
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Unread 08-18-2010, 12:42 AM   #14
vhappy
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Salgoud,
I have a question about the 4mg to 8mg and then to 2mg, This is all very interesting to me, but confusing to. Just wondering if that was a typo, or a way to really reduce?
thanks,
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Unread 08-18-2010, 04:58 AM   #15
Salgoud
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Default Typo

I meant to say 16mg, to 8mg, then to 4mg then to 2mg. I did that at six months. I did it in about a two month period. Once your body is saturated with Buprenorphine, it really is easy to do. Most people think Bupe is a regular opiate. It's not. The taper is not the same, it is sort of different.

With a half-life of 20-70 hours. Some people metabolize certain drugs faster or slower than others.

I metabolize methadone quick. I need split doses, I never got them though.

Suboxone I metabolize slowly for some reason. The 37 hour half-life is a mean. A mean is different than an average. It is calculated differently. I remember that from Statistics. So you, may metabolize half the Sub in 20 hours, I may metabolize half the Sub in 40 hours. Anyway, it builds up in your system after awhile. And it is very easy to get to 2mgs, for me anyway. What is hard is going from some Sub to NO SUB. That is the hard part, and needs to be done nice and slow, skipping days, taking little pieces. Remember, Buprenex is 0.3mg. How much of a 8mg Suboxone do you think that is. Well you can do it by weight or by dissolving in water.

For example, the pill has buffer in it, so it weighs about 250mg. And 8mgs is 27 times 0.3mgs. Divide 27 into 250 and you get around 9mgs. So if you have a very good scale weigh around 9mgs of Suboxone pieces and you will have 0.3mgs. Want 1mg, it would be around 30mgs. I don't know what a Suboxone actually weighs, you would have to weigh it first then do the calculations. This is just a what if!

Dissolve a 8mg tab in 2mls (2grams) of water and do the same thing. However you will still have to know the weight of the Suboxone and add it to the 2 grams. Then put the liquid Sub in your mouth and try not to swallow it. It works much better in solid form.

What I'm getting at is, a person can get down to 0.3mg or less and then quit. 16, 8, 4, 2, 1, 0.8, 0.6, 0.4, 0.2 and then stop. Do it slow at the end. Going from 16 to 2 is easy. Going from 2 to 0 is harder.

Get my drift,

Good Karma and good night, sleep tight
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Unread 08-18-2010, 10:16 AM   #16
Sub-Zero
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I used the 25% -30% decrease method until I hit 1mg then did 1mg everyother day, then every 3 days, then nothing. With that method someone can go from 16mgs to 12mgs to 8mgs, 6mg, 4mgs, 3mgs, 2mgs, 1.5, 1. That gets you down fast and spreads out the end. Some people, can get down to 2mgs faster, but everyone should go by how their body adjusts and nobody should even start to taper until the addiction part is fixed.
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Unread 08-18-2010, 09:46 PM   #17
rphoke
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Salgoud, I meant 2 whole 8 mg Suboxone plus a 1/2 of an 8 mg Suboxone. This is
20 mg a day, correct ? Anyway, that is the dose I am now taking daily and my goal
is to have that down to 18 mg a day (2 whole tabs plus a 1/4) when I see my doctor on 9/7/10. I have been incredibly busy the last several days and plan to make several
more posts over the next several days. I live in Simpsonville, just outside of Greenville. I have lived in SC since 2001 after I moved from PA. Love it here.

Actually, would love to be down to 16 mgs by 9/7. Still debating whether to shoot
for it.
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Unread 08-19-2010, 12:33 AM   #18
Salgoud
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Cool

rphoke,

How long have you been on Suboxone? It is unlike any other opiate. I only did 8mg today, and did 16 yesterday, and I feel great. Detoxing off Suboxone is not like detoxing off Oxycontin or Norco's or any other agonist opiate.

It is in a class of it's own. Like I said your body builds up Suboxone in your body. If you quit now, you wouldn't feel bad for about 2 weeks.That's why you can get away with dropping from 20mg to 16mg without feeling a thing. You may get a little bit of a runny nose, but that's is about it.

Tell your doctor what you what to do. I don't because, again I don't trust doctors. They may come up with anything to drop your ass. It's good to have a little supply just in case. People will say, "That's dope fiend behavior, however, to me it just makes good sense. Cold Turkey is a killer, and screws our immune system up, and makes us depressed. Why go through it when you don't have to. Your doctor could get up an move, he could stop his practice of Suboxone therapy, anything could happen. It's always good to have some just in case. IMO. Best of luck to you, and don't worry about doing less, if you feel bad you can always take some more. Just keep the doc in the dark, otherwise he will give you less. And saving some will be impossible. Thats my story and I'm stickin' to it.

Good Karma rphoke, and do what you are gonna' do.
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