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Unread 11-29-2005, 01:46 AM   #1
ratchet
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Default Quitting Buprenorphine

Hi Everyone,
I am also new here, and I have a question for anyone that might be able to answer it for me.
I started on Buprenex injectable back in Dec 1998, I was detoxed off of a high amount of oxycontin. Back then Sub was not available in the US and the Dr I went to for help at the time had the foresight to use the Buprenex (buprenophine hydrochloride .3mg amps) injectable for detox as an "off label" treatment for opiate dependence. It worked Great, I felt great for years, I switched over to sub about two years ago without any major crossover problems (it is the same drug after all)

Long to short-
I wanted to taper down to the lowest amount possible, I went down as low as .5mg to .25mg for 10 days.
I stopped on July 13,2005
The Wd symptoms were pretty mild compared to other Opiate/opioids it took my body about 30 days to physically feel better (no more chills/aches/sweats/rls/ect), However I still lack any kind of motivation or energy at all. My life can be summed up by massive fatigue.

I have tried ALL branch chain Amino's- addl 2000mg L-tyrosine as well
B-12 shots, Wellbutrin, Celexa, Provigil 200mg a day, caffeine, phentermine, all kinds of diet pills, red bull, quadruple espresso’s, pretty much exhausted every legal method I can think of. to gain energy again.

Does anyone have any idea why a normally hyper person with extra energy to spare, would suddenly have less energy than a bump on a log. Almost 5 months after quitting sub????
(I have no desire to use sub ever again so that is not an option for me, 7+ years was long enough)

Any help or suggestions would be greatly appreciated.

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Unread 11-29-2005, 11:35 AM   #2
Mary
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Hey Ratchet, Welcome. I don't have an answer for you, but hang in there. We have a couple of well informed, caring doctors who visit here, and hopefully one will have some input next time they visit! Hang in there. Mary
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Unread 11-29-2005, 02:14 PM   #3
ratchet
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Thanks Mary, for your response. I have been highly anticipating a response.

I just wanted to add that I stopped the oxy cold turkey and went through wd.on my own. After about 3 week of being clean I felt fine again, energy, no extended symptoms at all.(I got married during this "clean time" that is how I remember it so well. However, A month later I relapsed, due to financial problems. 2 weeks after that, I was detoxed with the Buprenex.

Meaning there was no long term damage to my receptors, prior to my introduction to the buprenorphine.

I also wanted to add that I still feel buprenorphine is a great tool to help fight addiction. I just happened to stay on it for a very long time.
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Unread 11-29-2005, 02:40 PM   #4
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Rachet, none of this should be considered 'medical advice', but the first thing I'd suggest is to have a complete physical exam and medical evaluation with testing to see if a cause for the fatigue can be diagnosed. Were you an injection drug user and have you ever been tested for HCV and HIV? What about your HBV status? Do you smoke, when was your last chest xray? With methadone, studies show an adverse effect on the HPA axis, and testosterone levels can drop. I am not aware of similar findings with bupe, but that could be checked too. Frankly, there are MANY medical conditions (eg anemia, hypothyroidism, diabetes, malabsorption syndromes, etc and etc...too numerous to list here) that can cause fatigue and your doc needs to sort it all out. Just a few of my immediate thoughts.
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Unread 11-29-2005, 03:20 PM   #5
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Caroline,
I have had extensive medical examinations and testing. My lungs were x-rayed recently due to small pneumothorax received over a year ago, they are completly healed with no neg findings.

Neg on HIV/HCV HEP-abc Lyme, and any other disease currently known, I am physically healthy, with the exception of a broken bone held together by a titanium plate, this has nothing to do with my fatigue because I can move around physically without any problem.

I have had EVERY blood test possible, even a CT scan of my brain, here are the findings-

Brain volume is symmetric. No acute effacement, focal edema,hemorrhage,herniation,hydrocephalus,midline shift,or extra-axial fluid collection. The ventricles are symmetric. Cisterns are patent. Visualized sinuses and mastoids are clear.

Impression: No acute intercranial abnormailty

In other words, I have exausted every possible physical explanation that my doctors can think of. However they have NO experience with buprenorphine, and they have also done some research and there are no specific findings on long term use that they could find.

I am certain that this is not permanent, I feel a little better every month. However at the current rate of improvement this will take at least a year or two. I dont think I can function this poorly for that long.
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Unread 12-01-2005, 02:54 AM   #6
Caroline
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Rachet, I have been prescribing Suboxone for almost 3 years and I have not had patients report excessive fatigue after stopping, but then again, I have not done 6 month follow-ups. So your question, your connection with fatigue and bupe, has inspired me to put together a simple questionnaire for patients, to be submitted 6 months after discontinuing bupe. I know I'll have very few responses, but the opportunity will be there for patients with significant post-suboxone symptoms to report their problems. The other thing I want to mention is that when people stabilize and are finally off drugs for a reasonable period of time, psychiatric conditions either disappear or become more diagnosable. I am wondering if you might have a bipolar condition. It is very important to treat bipolar with the proper medications. Antidepressants are not enough, A mood stabilizer is also required, used in combination with the antidepressants. I think a psychiatric evaluation would be in order here. You mention being a 'hyper' person and this could be a clue to an underlying bipolar disorder.
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Unread 12-01-2005, 03:05 AM   #7
leeglegle
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I'm going to bang my same old drum again.

Sounds like unipolar refractory depression related to a dopamine malfunction is at work here. Sub/bupe is a dopaminergic.

I had refractory depression for over 25 years. Opiods/opiates relieved it momentarily due to their dopaminergic effect. Consequently, I ingested ever increasing amounts of opiates/opiods to seek momentary depression relief until I became psychotic.

My belief, formed with the help of an addictionologist, is that dopamine malfunction was my problem and sub/bupe resolved it immediately.

Take this for what it's worth. I'm no physician.
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Unread 12-01-2005, 04:24 AM   #8
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Thank you both so much for responding.
Would Bipolar disorder occur much later in life, like in my late 30's?
Or is it some type of chemical imbalance I was born with? When I said Hyper I just meant that I had excess energy, I saw plenty of psychologists and addictionologists in the past 20 years and they never once mentioned Bi-polar, nor did they ever find the need to put me on any type of A/D drug at all until after I quit the sub. I have always been a very upbeat person, never having dark thoughts. This is more like lack of energy and motivation. My brain wants to get up and get things done, yet at the same time I don't want to.

After I quit the sub, I went through some mild (compared to other opioids) wd' symptoms, and then just as the chills went away, I went through about a week of literally not being able to move. I would lie in bed all day gathering the strength to just get to the bathroom. This EXTREME fatigue stage only lasted 8 days and then things slowly got better as the months wore on.

Do you think that I should continue to try A/D meds to help me through this type of "slump". I just figured that after this much recovery time I would feel ok again. I looked into the HPA axis function that you previously mentioned, and that sounds like what is exactly out of whack. Will A/D meds help with HPA regulation? I have spoken to a few people that have told me that my symptoms sound very similar to someone who was getting off long term MMT.

I don't mean to whine so much, but this is really frustrating. I have 3 small kids that are growing up around me and I don't have the energy to play with them.


Thanks again,

Ratch
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Unread 12-01-2005, 12:37 PM   #9
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Ratch, I have to get to the office so this has to be quick. Bipolar Disorder tends to be misdiagnosed or missed altogether. With Bipolar I, you don't need to have depression and there is a high co-morbidity with Substance Use Disorder. There are many questions regarding your case that need to be asked and answered, and the internet is not the place to do it. So my best advice to you is to please make an appointment with your physician.
Caroline
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Unread 12-01-2005, 09:25 PM   #10
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ratchet and to some extent Caroline,ratchet I find your story very interesting.I checked into a Detox after abusing every type of pain med known for a long time.There they used Bupe to get me past the worst part of WD once out I managed to stay clean for about 70 days but all was not well!I continued to have issues, the most troubling was a massive lack of energy.I felt like someone cut off my foot and sucked the life out of me.I could not last a full 10 hour shift(more like 5 to 7hrs)It was a chore to do anything! I lacked motivation all of the things you describe.I also tried the Aminos and L-tyrosine but to no avail.It was suggested that I was suffering from P.A.W.S.(post acute withdrawal syndrom)I had finally had enough and since using again was out of the question I got in to see a Bupe Dr. and started on Subutex and PRESTO back to normal.I'm now afraid to ever stop taking it!It has also been suggested that the P.A.W.S. was caused by the damage to my receptors and my brains inability to produce the nessacary chemicals that it did so routiely before my use.I do know the fatigue you speak of and its crippling.I did read someplace that long term abuse affects the adrienal axis or something like that and this aurthor swore by using freeze dried adrienal extract sold as Adrienal Plus or something like that.He said he had used it to treat people comming off methadone(which I was using alot of)I never could find it to try it.Bottom line here if you find a answer PLEASE,PLEASE,let me know as that was my biggest issue and currently my biggest fear!I would like to dicuss this in more detail.I will admit though that since I've been on Bupe I've had no problems.Maybe someone else out there (like a Dr..)could shead some light on this for us.I also saw shrinks and Bi-polar was ruled out for me.Fatigue was NEVER a issue until I tried to clean up.Please post anything you find on this matter....SPANKY
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Unread 12-01-2005, 10:39 PM   #11
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Spanky,
I found a lot of stuff under the spelling Adrenal Plus. And I will gladly give it a try and post my results. I have exausted every avenue, and my Dr's keep telling me that they are unfamiliar with buprenorphine. They also have told me that I am not bi-polar. However, if medication to treat Bi-polar disorder will help me get out of this funk any quicker, then I will continue to try.

thanks
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Unread 12-01-2005, 11:16 PM   #12
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ratchet I saw a shrink when I got out of Detox you know recovery and all.I had to take this very long test which is supposed to show if you have any mental conditions like Bi-Polar or ADD , Etc.To my suprise my test came back normal.The shrink told me that he thought I was too smart for the test(whatever that means)and thought that I had a little ADD and Bi-Polar traits.He put me on stratera(SP?)I hated it however it DID mask the fatigue symtoms somewhat.I think the thing with the adrenal axis is more like what we're dealing with but how do you fix it??It may be somthing like a broken heart only time.I am hoping against hope that I will heal while Bupe but after your post I'm not so confident.
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Unread 12-02-2005, 12:21 AM   #13
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Ratchet and Spanky:

Thanks for isolating on the subject of the life-diminishing lethargy you previously experienced and which has now returned. I, too, am a hyperactive, triple A type of personality by nature; but I, as well, experienced this phenomenon prior to bupe therapy.

Once on sub, I instantly lost a leaden anchor I had been dragging around for many, many years. Toward the end of my addiction (and depression), I had been spending all the time I could, either lying on the couch or sleeping. I was socially withdrawn. I just couldn't function no matter how hard I tried. My mental acuity was equally leaden. I couldn't concentrate. As both my depression and addiction progressed, these symptoms advanced as well.

I am sensitive about constantly returning to the subject of depression. I am starting to feel like a one-armed drummer. But, as I understand it, these phenomena meet many of the criteria for clinical, refractory depression. So, I raise the following questions.

Is it accurate that 100% of opiate/opiod addicts have abnormal dopamine function?

Is it accurate that suboxone stimulates the production of the brain chemical dopamine? Is it accurate to observe that opiate abuse overstimulates the production of dopamine, thereby in part producing the "high" addicts crave? Is is accurate that sub, as a partial agonist, isn't as potent a dopaminergic as full agonist opiates/opiods, but is a dopaminergic of a lesser degree?

Can dopamine malfunction lead to a sense of physical, mental and emotional leadedness? Can it cause a clinical refractory depression?

Is it possible that sub, as a dopaminergic of a lesser degree than full agonists, restore dopamine function to a more "normal" or "baseline" level?

And finally, could the dopaminergic qualities of suboxone explain ratchet's and Spanky's observations, as well as my own with regard to depression and/or lethargy? Could there be a nexus between dopamine malfunction and overwhelming lethargy and/or depression?

Ratchet, am I wrong, but it appears you wrote that so long as you were on bupe "you felt great" and that when you transitioned to sub nothing changed? But, when you tapered off sub, you felt "massive fatigue" and began to feel like "a bump on a log"? Could there be a connection with the cessation of bupe, and then sub treatment, with your overwhelming lethargy? As you observed: "(after all, it is the same drug)".

Spanky, in an earlier post you related that you had a terrible depression that resolved "PRESTO" upon your beginning sub therapy, and that, like me, you have no reservation about taking it for as long as you feel the need, possibly for the rest of your life. Does the above make sense to you?

In closing, ratchet I understand your strong aversion to continued sub use. Who wants to feel tethered to a drug? God knows, I detested my addiction to opiods. But is it possible that sub/bupe is, for you, like insulin is for a diabetic?

I strongly believe that, for me, sub is my form of insulin. It saved my life and restored my vitality. I will happily and without shame take it for the rest of my life.

Dr. Will? Caroline? Ratchet? Spanky? Anyone?
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Unread 12-02-2005, 04:16 AM   #14
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After being on the bupe for about 4 years the lethargy started before I ever even considered discontinuing usage. I adjusted dosage dramatically in both directions to try to counter the "imbalance". Switching over to the sub a year later had no real effect on this "fog" as I like to call it, and as the years wore on I became "foggier" mentally and more lethargic, all while still on bup/sub. My dosages ranged from 1mg a day up to 24mg a day with no change in mood, energy, or clarity whatsoever. I was put on wellbutrin, celexa, provigil, paxil, and many other a/d meds during this time. I spoke with many doctors and only one of them reached the best conclusion. He told me that many of his MMT patients also experienced this "fog" and lack of energy after years of MMT. He told me it was about time (post 7 years after my Oxycontin addiction) to quit the bup and try to correct the problem with a clear head and no additional assistance stimulating my mu receptors. Well. I took his advice and in the past 5 months my sense of smell/taste/and vision has dramatically improved. I feel clear headed and my thoughts run better that they have in years, My ONLY downside had been this fatigue and lack of motivation, which has very slowly been improving. For years bup gave me energy and kept me clean, that effect wore off for me. I still think bup is a great tool, HOWEVER the long term effects/effectiveness are NOT posted/published/proven in any study. So I am the lab-rat that has to put on the glasses and the white coat at night and try to figure out what is going on with myself.
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Unread 12-02-2005, 06:15 AM   #15
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Hi everyone my name is Sara and I am eager to join. I have taken suboxone for over a year now and would like some feedback. I feel I will need to be on this for the rest of my life. My lifee has changed! I never thought I would see the day I could stop using. This drug is amazing! Does anyone else feel the same. I encourage all feedback. Thanks first time user Sara
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Unread 12-02-2005, 12:22 PM   #16
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hi sara and welcome. it did work this time. i've been on bupe since june and it is truly amazing medicine. not sure how long i will be on, but if it is for the rest of my life, i don't care. it's a medicine treating a medical problem. peace- gwen
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Unread 12-02-2005, 07:58 PM   #17
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Hi sara and Welcome to the site where many like you sort through all things that our sickness presents.Yes like you I feel very NORMAL on this drug and have no desire whatsoever to use.I too feel as if I may have to take this drug for the rest of my days.I am concerned however that my Dr may see things differently.I hope not.Please keep us posted as to how you are doing as we like to know.We are all here at different stages of recovery and at different doses of Bupe.We all differ in our time and amount of useage so we like to hear from everyone.What dose are you on.What and how much were you using and for how long.Again welcome and post again soon............................SPANKY
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Unread 12-03-2005, 02:35 AM   #18
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Hello again! I was working when I wrote last night I am off work now for 2 nights. I thank all for your reply. It is great to know we all can share. My doctor is understanding about long term use and is ok if I am on it for my lifetime. But many in recovery feel this is the same as dope so I am glad you guys are out there. I am planning on starting a support group for suboxone, not a 12 step, but for education of those interested, but also for anyone taking suboxone and have questions. This will help me too. I have a close friend who is going to help, but we probably will not start till after the first of the year. Another question, can I remain on the page I submit my reply,to see if anyone answers? Thanks again Sara
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Unread 12-03-2005, 02:40 AM   #19
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Spanky, I used on and off for 30 years. I had a tremendous habit. I will have to ask my doctor how long Iknow it is over a year. I currently take 2/8 a day. Sara
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Unread 12-03-2005, 04:57 AM   #20
leeglegle
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Ratchet:

I have only a moment.

Give us some hard science, not just anecdotal fears. There is far more compelling anectodotal hope on this site than your lonely anectodal fears. Dozens, if not more, of others on this site disagree with you.

In the absence of hard facts, I think you are being reckless. Let's hear hard, quantifiable science from those qualified to provide it.

Frankly, unless you can back up your assertions with facts and hard science, you are doing a disservice to our community. If you have read the huge number of posts on this site, you will see that you are a lonely voice who is (excuse me), pissing into the wind and spreading fear.

Give us facts, not your unscientific, unsupported, anectodal and isolated fears. Suboxone is all about revolutionary hope, not regressive, repressive thinkng.

If you detect a tone of anger in this response, you are accurate.

This site requires facts, not wholly unsupported speculation. It is your sort of unscientific bias that retarded the miracle of legal buprenorphine treatment to the rest of us, while it served you so well before FDA approval.

You were one of the fortunate ones while others suffered. You were incredibly fortunate to have had such a brave physician to treat you "off label" while the rest of us waited and suffered.

I will await the views of the scientists who unselfishly give their knowledge and time to this site.

In the interim, please cool your unsupported rhetoric. I will not amplify on my thoughts until I am better informed. I am not qualified to do so. I suggest you do the same. In the interim, let's stay in a positive frame of mind and await the input of those more knowledgeable than you and I.

I wish you well. Please keep an open mind and don't be your own worst enemy. Most important, don't spread fear until you (and we) have hard scientific facts.

Spanky: Reserve judgement and keep the faith until we have more information. You're doing fabulously. Your personal experience belies Ratchet's assertions. Don't let your faith be shaken by unsupported observations. Let's all cool it until we know more.

Ratchet: Thanks for starting what I hope will be a spirited discussion.

All the best.
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Unread 12-03-2005, 08:34 AM   #21
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leeglegle, You have quite a way with words! Although I am the new guy, I would like to comment. I noticed everyone is talking about the lack of motivation with sub use. Sometimes I can truly sleep my 2 days I am off work. If it is the sub it is a small price to pay for the countless sleepless nights I experiencwd while using heroin. It allows me to socialize again with a community of people I had hidden from for so many years. I do not mind getting up and and doing the daily things that need attention, and not focus as to where the money will come from today. I can honestly say I am proud of the life I live today. I still wonder about the extreme amount of time I sleep, but I like you, will wait for scientific proof that this can be in anyway bad for me. I have waited years to find this help, and a doctor with the guts to take on a group of addicts and give us the life we all so desperately want today. Sara
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Unread 12-03-2005, 11:47 AM   #22
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hi sara, kudos on starting the bupe group! an alternative to a 12-step is certainly needed in many areas. especially when the 12-step groups i found were against any medical assistance. about your lack of energy. have you told your doctor about it? not being a doctor, myself, but maybe after a year it might be time to adjust down a little? i had the opposite effect. i had to stop taking it in the late afternoon/evening because it interefered with my sleep. i'm now on 12 and don't feel any difference with cravings, etc. from the 16 i started with. just a thought. peace- gwen
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Unread 12-03-2005, 05:07 PM   #23
ratchet
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I really don't want to be the town "Crier" with white signs on my back and front spreading the word of doom and gloom over Buprenorphine. It really did help me through a rough time, and I, just like a lot of people on another website thought bup was the greatest drug since sliced bread. It took me almost 4 years before I started to realize that " wait a second" I am not as "normal" as I thought I was. And I could tell you this with some certainty. When most of us start bup/sub we are coming from a lot of other drugs and our perception of "normal" is actually a lot different than what "normal" really is. Granted, we don't get a "buzz" but we do get a bit more energy and a extra dose of well being. (there is nothing wrong with that at all) except for the fact that its NOT REALITY! I am in reality right now, and the feeling that bup gave me most DEFINITELY was not this. If a drug makes you feel good/great forever and you can function on it perfectly/flawlessly forever, I also see no reason to stop taking it. Bup just was not that "magic" drug for me, or a lot of other long term users. Many long term (+3/4 year users have reported multiple problems regarding effectiveness) my 2 close friends that started the EXACT same time that I did, also would LOVE to quit due to the "fog" and the lethargy and fatigue. However, they continue to use it because of my 5 month story. So I am not some lone wolf, there are others.

Its like driving down a highway, and there are some warning signs ahead. Right now the road seems smooth, no traffic. Yet these signs keep telling you that there is a bumpy road ahead...maybe WAY ahead, but still rough and bumpy. Will you ignore these signs? Or at least check them out on the car radio/internet a bit? I have no reason or interest in posting "false" road signs, and neither did the others before me. I would have loved to stay on the sub, and avoided all this misery. However, I wake up every morning, I take nothing at all, and life isn't some blurry fog, my kids are no longer growing up around me anymore. Time will heal my symptoms, and I feel better every month for the most part. Its a long bumpy road and here I nail up another sign.

PS- I am also an addict, I know exactly what you are all going through and how awesome and good sub initially makes you feel. It seemed like a miracle to me. (My Dr. failed to tell me that it is also an Opioid derived from Thebaine the EXACT same part of the poppy as oxycontin) But it worked! I wasn't high, and I was happy and getting my life together... Why would a sane person who has worn your shoes tell you that there are long term difficulties? Why would I ever want to take something that seems too good to be true away? Because time AND Science has proven that ALL opioids begin to lose their effectiveness on dopamine functions after a certain amount of time, how much time have you got?

Ratch
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Unread 12-03-2005, 06:07 PM   #24
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Ratch...Spanky here Hows the adrenal plus working???I think your concerns are very well founded.I personally don't want to deal with that fatigue issue ever again but your story has me somewhat bothered.So much so that I think I will begin my exit from Bupe although I will do it ever so slowly.First off I want to quit smoking and anything else I do thats bad for me.Then I want to begin a exercise regimine and start eating a better diet and then lastly I will again begin the vitamin regimine that I was on to include L-tyrosine,aminos,Glutamin,and Adrenal Plus.I want to have all this in place before I start a snails pace tapor.My thinking is get the body in its best shape and the brain a kickstart and tapor on down and finally just pray like HELL.This process will probility take a year.There,s another guy on here who I have spoken with personally and hes been on it for 3+ years I believe and he has the oppisite view.His name is leaglegle and his phone number is posted throughout this site.I lost that other sites address.....THANKS SPANKY.....PS maybe some of the pros on this site will chime in reguarding your post.I just don't want to make my condition worse than it is...Know what I mean???
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Unread 12-03-2005, 08:05 PM   #25
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Ratchet,
Naltrexone is also a Thebaine derivative, yet is not an opioid.

Buprenorphine does not increase ones tolerance. In fact there is some evidence that tolerance actually decreases with time. That means that your friends who report feeling "foggy", is expected, and they may have a lowered tolerance and require a lower dose. Most of my long term patients periodically ask for dose decreases. In the vast majority of cases longer treatment terms, and more gradual medical taper result in less withdrawal and higher rates of abstinence.

Buprenorphine may mask symptoms of depression or other disorders, perhaps what the person was attempting to medicate when the drug misuse began. This is why it is important to find the reason someone became addicted in the first place.

Many "complaints" people have when discontinuing buprenorphine are the results of changes to the brain from the initial addiction. It can take many months for the brain to get back to endogenous opioid equilibrium. Sometimes this system is permanently damaged. (In which case they would feel low level withdrawal indefinitely, without medication) There is no evidence that long term buprenorphine use is anymore difficult to discontinue then short term (in a properly treated opioid dependent person) In fact the evidence points to easier discontinuation with longer, slower treatment periods.
W
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Unread 12-03-2005, 08:10 PM   #26
Caroline
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Ratch, Regarding research citations on safety and efficacy of Bupe/Suboxone check out Science and Practice Perspectives, Vol 2, No. 2, 8/2004, 'Special Focus: A New Medication For Opioid Addiction.' This is a publication put out by NIDA (National Institute on Drug Abuse), and there are probably around 150 references to published articles relating to buprenorphine at the end. Don't know if this is what you are looking for. If so, have fun!!!
Caroline
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Unread 12-03-2005, 08:26 PM   #27
Jake
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Thanks Caroline and Dr.Will, here's a direct link to that article:
http://www.drugabuse.gov/PDF/Perspec...-Practical.pdf (it can also be found on the links page of this site)
Here are the reference articles: http://www.drugabuse.gov/perspective...html#practical

Ratch, I was on Bupe for years and felt normal the whole time, I slowly tapered off, has some trouble sleeping then a little sensitive to pain. I was told to expect it and it slowly disappeared. It was the easiest detox of my life, but if I never expirienced anyother detox I might have complained more.
Jake
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Unread 12-03-2005, 10:24 PM   #28
Phoenix
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I have some serious questions about this post about fatigue, weakness, fog.
That scares me. Tony went off of Naltrexone because he was having severe weakness. He is an energetic, vibrant person who can take our 15 stairs 2 at a time, with Naltrexone, he couldn't make it up without a break midway. He couldn't work effectively, etc. etc. Please tell me this isn't going to happen again. I have read everything and none of the stories are like his Naltrexone one, but is this site biased? I haven't read anything, anywhere indicating it is, but I'm scared. He can't feel the same way or he will abandon bupe. He hasn't started yet, but weakness is his main fear. Any words of wisdom here?
Judy
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Unread 12-03-2005, 10:45 PM   #29
gwen
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actually judy, i had the opposite effect. i had more energy. from reading these posts, it may be something to look for after longer term maintenance. but for now for me - since the beginning of june - i haven't had symptoms of fatigue. as a matter of fact, i had to stop taking the bupe in the late afternoon or evening because i would have trouble sleeping. hope this helps. love, gwen
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Unread 12-04-2005, 12:11 AM   #30
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You always do Gwen. Thanks, gotta go get ready. Whoo Hoo!!!
Judy
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Unread 12-04-2005, 08:40 AM   #31
lenny
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ratchet!
DO NOT FREEK!! My addiction was rather large. When I first
passed the physical addiction my head played scrabble for some time.
Six or Seven months later I realized that I could actually have
17 pockets full of any opiates and wouldn't have one craving
to swallow 2-5-9-19-32!!! BELIEVE ME IT WILL HAPPEN!!!!!!!!!!!!!

Suboxone saved my life along with my family and company!
My breakfeast was one 80mil up the snoz around 9:00 a.m.
10:30 I was ready for round 2! An hour later I would have brunch
with a 40mil meth. Around 1:00 I sniffed another 80 greenmeenie
followed by a yeagerbomb or three for lunch. I would examine the rest
of my day (AT WORK!!!) with a rather interesting outlook;
Mostly non-coherant at times.I am not resonding to give my opiate quest but to reply the truth to the soulful use of an addict.
I have respect to every addict that is willing to give their words and advice to all of us that need answers. I TRULY LOVE all of you very much! Look at yourself and change your future! Stand in front of the only LIFE that was chosen by the one who understands forgiveness.
Normal lives do exist! I actually awake with hope and actually
cut my own grass and most of all STAY MOTIVATED!!!

Mr. Leegegle has spoken with me about my venture into the
medical-based suboxone rehabilition world. I'm hoping to be
fully functionable in 2 months! Be strong Ratchet!!!!!
The Strangest feeling is being sober. kinda weird statement
but really true.
lenny's my name! this is my second or third
venture into the discussion world!

HEY JAKE!!! YOU DOIN O.K.?
PEACE and HAIR GREASE Dr. Robert (Leegegle)

Keep taking the vitamins and all the good things that keep
the bad boys away! One month or two months was a mind funck for
me! I have a 1966 volks bus that needs a RATCHET!! STAY STRONG!

NEED TO TALK! CALL (304-374-7016) east time

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Unread 12-04-2005, 10:14 AM   #32
purple
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I quite horien 8 years ago cold turcky and havnt touched it since. I had lingering withdrawel sysptoms for almost 2 years
After the intial 3 or 4 months of horror the lack of energy,slepless nights and leg spasms took about 2 years to all go away.Mind you i was also taking my owm methadone maintance at the time
I am not saying all this to scar anyone.I am on suboxone for pain managment for about 5 months. I am expecting to go through SOME KIND of discommfort when i do stop taking it. Being a addict i dont like to feel any pain at all And i have NO TIME TO BE SICK.
My point is that if you stop taking antidepressants,or even sinus over the counter stuff we go through some discomfort
I am going to stay positive about stopping Bup.[TRUST ME I AM SCARED] but little by little day by day i will get better
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Unread 12-04-2005, 04:38 PM   #33
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G'Day y'all:

Interesting discussion going on here. Ratchet, thanks for getting it started. I'm looking forward to posting tonight. I don't have time until later this evening, but for now, I am compelled to observe what follows.

I am concerned that the posts of the professionals on this topic are not being given the weight they should and are being obscured and undermined by Ratchet's wholly unscientific assertions. So, let's slow down a bit and reflect on recent posts.

The distinction of this website is that we engage in rational discussion backed by hard facts. We're not here to swap drug stories of yesteryear, but to live in the present, look forward, and support each other. There are many regulars who are wonderfully supportive and generous with their time. God bless them and all of us. We are also fortunate beyond measure to have the active participation of the Dr. Wills, the Carolines and numerous other professionals.

I feel compelled to post this message now, when I don't have time to fully express myself, because of my good friend Spanky's remark (made before Dr. Will's and Caroline's posts) that he is "somewhat bothered" by Ratchet's story, followed shortly thereafter by the concerns expressed by Phoenix.

Spanky, I am confident that further debate will remove your concerns. For all I know right now, the posts of Dr. Will and Caroline have already erased them.

Phoenix, your post truly worries me. I would have waited to post until later, but for your statement: "That scares me" concerning Ratchet's post about "fatigue, weakness, fog".

Ratchet, words are powerful and are not to be used lightly. Once they leave our lips, they no longer belong to us. Respectfully, you are being reckless. All I have heard from you is verbiage that borders on propaganda. No hard facts. You referenced another website. What is it?

There are a bunch of negative sites out there, many of them supported by the enormous drug rehab industry that is scared of the miracle of suboxone. The money involved in drug rehab is staggering. I am personally acquainted with the billionare owner of over twenty mental hospitals here and abroad that have rehab units. We sit together on the rare occasions I go to my synagogue.

In the mid-nineties, I was in one of his hospitals when I was introduced to buprenex, the injectible form of bupe that Ratchet was injected with for many years until sub arrived. Subsequently, I was in numerous other hospitals all over the United States and remained desperate and in agony until I commenced my now almost three-year journey with sub.

If my memory serves me, TIM straightened me out on a post when I referenced a website that I thought was interesting. That site is largely, if not entirely, supported by the Weissman Institute (sp?), a very profitable business that offers some forms of medically supervised rehab and detox. Suboxone has the potential to wipe them out. They have a vested interest in undermining sub thereapy.

To the point: Ratchet, be careful with your words and references. People's lives are at stake here. You've made unscientific and factual errors in your posts. Where did you get your Thebaine information that Dr. Will had to correct? Have you visited and absorbed the sites to which you were directed by Jake? Your statements have been quickly proven to be false. I'll have more questions for you later.

A large part of the mission of this site is to disseminate, accurate facts and scientifically sound information. This topic is an excellent example of the necessity for this site and our active participation.

Have a great day! Life is good!
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Unread 12-04-2005, 05:19 PM   #34
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Well put Robert!

I want to emphasize that I believe the symptoms people like ratchet are experiencing are real. I also believe that there are too many variables to conclude that buprenorphine is in anyway responsible for them. Every methadone patient I have ever treated that has been through a medical taper to abstinence reported similar symptoms for months and sometimes years after last dose, long before buprenorphine was available. I believe the "rapid detox"industry has led people to believe that addiction is not chronic but a condition that can be flushed "out" overnight. This year rapid detox was proven ineffective and unsafe.
(see JAMA, http://www.medicalnewstoday.com/medi...p?newsid=29619)
Addiction causes changes in the brain that take months or years to correct. Partial agonists like buprenorphine show promise because they can be used to treat without causing the patient to become more physically dependent. The only way to know what course of treatment is best is to separate the science from the speculation and build on what we know.
W
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Unread 12-04-2005, 05:59 PM   #35
purple
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Sorry you feel i was swaping drug tales of yesteryear I think you missed my point
As small as it may have been recieved by you , it may click with someone else.
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Unread 12-04-2005, 06:18 PM   #36
Mike
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Purple, I don't think the comments were directed toward you.
Mike
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Unread 12-04-2005, 06:18 PM   #37
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No actually Dr Will did NOT correct what I said. He simply said that Naloxone is also made from Thebaine and that particular drug is NOT considered and opioiod.

Buprenorphine IS AN OPOIOD it is not some miracle pill that completly replaces opioids. It is a partial agonist that stimulates the mu receptors. Please read the FIRST paragraph of the article that Dr Will or Caroline was reffering to. The first line in it says that Buprenorphine IS an opioid. Granted the longer half life and the milder wd symptoms do make it ideal for treatment. However, please do not call a dog a horse. I am not trying to start an uproar by any menas but simply state the facts and my own personal experience. Take off the "miracle drug" blinders for just one second and do a little bit of Objective research. Granted this site is a Pro- buprenorphine site and it is mostly funded by Reckitt and Colman (makers of bup) however if you used reference materials that are slightly more non biased you might surprise even yourself. Again even after all the abovementioned, I still think its a great drug, however the long term effects have yet to be documented in ANY study yet done.
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Unread 12-04-2005, 06:25 PM   #38
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Hello All,

Interesting debate here. As one of the original 'lab rats' during some of the studies of bupe in early 90's (Burlington VT...2 trips through the fun house there) and, unfortunately, a current suboxone patient I'll try to contribute soon.

But for the now: leeglegle requested to know what site ratchet referred to in some of his posts.

I invite you to visit here: http://www.heroin-detox.com/default.asp
and join the discussion.

Jim
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Unread 12-04-2005, 06:31 PM   #39
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I don't think anyone is disputing that buprenorphine is an opioid. It should be acknowledged that a partial agonist is not the same as a smaller dose of a full agonist and the properties of one cannot be inferred on the other. I'm not paid by Reckitt and am only here because I have seen how this medication has helped many of my patients that did not respond to any other treatment. I think it's a good idea to stick with the facts, and not speculate, do you disagree with that?

Rachet: What "objective research" are you referring to? I would like to read it.
W.
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Unread 12-04-2005, 06:37 PM   #40
Mike
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That's a good place to go for non-science expiriences and where those kinds of discussions should be.
Mike
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Unread 12-04-2005, 06:39 PM   #41
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hi ratchet and everyone, ratchet i think the reason you may find this forum pro-bupe is that the people here have had good experiences on it. i'm fully aware of what it is, what it does, but for me right now it is helping me overcome my 5-year oxy addiction. as i was reading about your statement about the funding, let me just put this here to keep the honor of posting facts to back statements up. I found it in the 'About Us' section:

Funding for this organization began with the two co-founders self funding and soon additional funding was given by anonymous donors whose lives were saved by buprenorphine treatment and were willing to contribute to the cause. Reckitt Benckiser Pharmaceuticals, Inc., in Richmond VA, is also a contributor. We were very reluctant to seek funding from a pharmaceutical company in fear of being seen as an arm of or cover for a drug company. We eventually accepted limited funding in the form of an "Unrestricted Educational Grant" Unrestricted in that there are no "strings" as to how the funds are used, there are no restrictions on the content or mission of this site. Reckitt is currently the only FDA approved maker of a buprenorphine based product for addiction. We are a source of information and a tool for helping patients connect with physicians. Once our 501(c)3 status is approved we plan to seek funding from government grants and though other sources.

As for the long-term effects/studies, i'd be anxious to see those also, as i am month 6 on suboxone. and if i had anything negative to say about my experience i certainly would as it may be helpful to others.
peace- gwen
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Unread 12-04-2005, 06:56 PM   #42
crazed
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Quote:
quote:Originally posted by Mike

That's a good place to go for non-science expiriences and where those kinds of discussions should be.
Mike
Hi Mike,

Your post doesnt make a whole lot of sense to me but thanks for the reply. I was just pointing out the web site ratchet referred to.

Just a question: Is my experience in a controlled bupe testing environment, which I have been in, more valid than my current outpatient treatment experience?

Regards,

Jim



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Unread 12-04-2005, 07:09 PM   #43
Mike
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Personal experiences are interesting, but may not be representative of what most people will experience. There are too many variables, such as addiction history, coexisting problems. I think much of the problems/symptoms people have are blamed on Suboxone when there are many other factors to consider. What one person experiences should be weighed differently then what 100 people experienced in a controlled scientific study. To answer your question I think they are both equally valid.
Mike
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Unread 12-04-2005, 07:12 PM   #44
crazed
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Mike,

Thank you for the clarification.

Jim

edit/ I would say that many of the sub/bupe experiences shared are quite similar. I'll end the cross board talk now.
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Unread 12-04-2005, 07:20 PM   #45
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Ratchet, and all,

I agree with the pro-bupe statements here because buprenorphine is another treatment option that does give hope to many with opioid addiction. There are more than 810,000 addicted persons here in the USA, at an annual cost of $21 billion. Before suboxone came along, opioid stabilization with medication such as methadone was available to only 15% of the addicted population. (Drug and Alcohol Dependence 63 (2001) 253-262. Buprenorphine for opiate addiction: potential economic impact. Rosenheck and Kosten.) There were never enough treatment slots for all the addicted people who needed help, but with the surge of prescription opioid addiction in recent years, the need for more treatment availability became even more urgent...and buprenorphine seems to be an answer. With any drug there are always some who will experience adverse reactions, but if you weigh the good against the bad, many studies show that buprenophine is a plus in the treatment of opioid addiction. To take Rachet's side for a minute, yes, more long-term followup studies do need to be done. We should always be questioning, and for that I do give Rachet credit. I did go the the 'OTHER' web-site and read some of the incredible posts there, where people prefer to do their own treatment and have an aversion to doctors who prescribe bupe. In general, that is not a good idea, and if you are truly interested in helping fellow addicts, telling your doc about any adverse effects, which the doc then can report to the FDA's Medwatch, will only benefit others who undertake bupe treatment.
Caroline

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Unread 12-04-2005, 09:45 PM   #46
ratchet
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First off, I just want to thank everyone for being objective and keeping an open ear. As most medical professionals are aware when it comes to taking ANY type of medication, the best course is the LEAST most effective dose. The 8hr course that most Dr's take to become certified to treat with sub,and the majority of literature seems to suggest that normal maintenance treatment has a range of 16mg to 24mg (and up to 32mg) a day for effective sub treatment. These high doses might be effective for induction dosing.(first week) It has been shown time and time again (on the other site in hundreds of posts) that most people are comfortable at 4mg to 8mg a day. Why should anybody take more when they dont have to? This is the majority of (going against the Dr) that goes on over there at the other website.
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Unread 12-04-2005, 11:23 PM   #47
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No one has ever said to take more suboxone than needed. I prefer my patients to take less if that's possible. But you have to remember the route of administration...sublingual...there is only about 50% bioavailability by this route, maybe a little more or maybe less, which means that it does not all get abosrbed. So the amount of liquid bupe used in the past is not equivalent to the amount of suboxone that is administered sublingually. My feeling is that if patients opt to chose Suboxone as a form of treatment, they should have enough to stop cravings and withdrawal symptoms, a big reason for relapse....whatever it takes until they feel comfortable for a sufficient length of time to allow a change in drug-using habits, and normalize (that is, stop the highs and lows from stuff like heroin). The other thing I want to mention is that most of my patients are poly-drug users, most commonly cocaine and marijuana (in conjunction with opioids), with a little benzos thrown in. These other drugs also affect neurological functioning. In cocaine users, the amygdala (a part of the brain structure) shrinks. (I'll have to get that citation later if you really want it, but that's the latest). And although everyone thinks marijuana is a 'safe' drug they are wrong, and I can get you a million citations about that too. If you are still using these other drugs, you are putting yourself at risk...and could be a reason for your difficulties in adjusting. Ratchet, have you been a cocaine user?
Caroline
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Unread 12-05-2005, 12:16 AM   #48
ratchet
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Caroline,
I was not referring to any specific Dr's at all. I am sure your protocols are more than adequate. Probably awesome in fact. I was merely referring to a comment made about an aversion to Dr's on the other site. Actually as far as Dr's treating patients with Suboxone goes, you and Dr Will really do care about your patients and everyone's well being, and you both do additional research above and beyond what is required. As you are well aware, most of your colleagues in the field of medicine would rather play a round of golf, or go fishing on the weekend. Instead, here you are responding to some crazy guy who had a rare experience. Not only am I taken aback, but you should be commended.

As far as cocaine use/abuse goes. I had my fair share in the late 80's. I was clean for years (from everything) after without any adverse reactions. Actually after a 2 year crack habit, when I quit, I never experienced a second of physical discomfort, the cravings were there for about a year. )I have not used coke in over 16 years, not even a flake) But after stopping energy levels and motivation were just fine. ( I have not smoked pot in over 22 years) Now I don't even think about it. Like I said previously, I was clean 2 weeks prior to my initial bupe treatment and I felt great, a relapse due to financial troubles got me back on the oxycontin again. As soon as had the time, I rushed right over to the Dr for my initial bupe treatment. So in my case, the receptors were just fine prior to my 7+ year treatment with the bupe/sub, every month it gets a little better. I refuse to believe I have done any permanent damage, its just like Dr Will said, it might take a year.
I know I seem like a bit of a black sheep, but I just wanted you medical professionals to know, its Dr's like you that go over and above that make all the difference.
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Unread 12-05-2005, 12:29 AM   #49
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The textbook dosing (or worse), and the "more" is better philosophy regarding sub. No knowledge of mu or kappa receptor functions and the partial agonist properties, rx'ing high amount of benzo's, not warning about drinking. These are the kind of mistakes that many patients from the "other" website have reported regarding their Dr's.

Sadly, there are Dr's that sleep through the 8hr course and just add suboxone to their "buffet" of services right along with the Botox injections.

These are the Dr's that might be contributing to the darker side so to speak.
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Unread 12-05-2005, 12:43 AM   #50
ratchet
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Caroline,
The published sublingual absorbsion rates vary, however going from IM to SL I had a pretty good idea that the documented rates in between 2.5 to 4.1 absorbsion were dead on accurate. However the published detox dosing is for suboxone and subutex only. Treatment with buprenex is still only approved for pain only, however my average doses never really exceeded the 8mg SL or 1.2mg IM buprenorphine dosing range.
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