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An Awful Sub Situation

Discussion in 'Detoxing From Buprenorphine/Subutex/Suboxone' started by sandman1318, Mar 8, 2017.

  1. sandman1318

    sandman1318 Member

    I used to post regularly on this forum back around 2004. Anyway, most of you are probably unfamiliar with my story. And if by some chance you are, there have been some rather scary developments since that time.
    Anyway, I'm not a so-called addict (or at least I wasn't in the early 2000s when I was first put on Buprenorphine.) I used to have "treatment resistant" depression. So I began seeing a psychiatrist in Miami in 2001 who came highly recommended. He was known for trying unconventional methods for dealing with depression when nothing else would work. So the doctor prescribed the buprenorphine ampules and had me take one, sublingually, 4 x daily. I got a bit of a buzz from it and a bit of "a lift" which seemed to help me a lot so I stayed on it. HUGE MISTAKE!! I had no idea what I was getting into at the time. This doctor seemed rather conservative and he probably would have kept me at that low dose as long as I was doing well. But after seeing this doctor for about a year he moved back to his hometown up East. I had a lot of trouble trying to find another shrink who was willing to treat me since most of them didn't want to prescribe buprenorphine.

    I was finally referred to a psychiatrist who would treat me since he's also is an addiction specialist who works with buprenorphine. Shortly after starting to see him, he switched me over to Subutex. The initial dosage, though I can't recall it, was fairly low. But over the years he raised it a number of times. (Honestly, it was so long ago that I truly don't remember why he kept upping the dose.) But before I knew it I was taking 12 mg daily. Then, about a year ago, I periodically began going into withdrawal for some strange reason. When this would happen, taking an extra 8mg tablet would do the trick, and I would be fine for another few weeks until it happened again. But this began happening more and more often and at shorter intervals. The doctor's solution was to raise me to 16mg daily which did the trick for perhaps a few months. Eventually it began happening again and he raised my dosage to 24mg daily. But once again, roughly every two weeks I end up needing extra, as if to make up for a deficit of Sub in my system.

    I asked the doctor why this is happening and he just didn't know. He said he's treated hundreds of others with Sub, patients who have been on as large a dose and for many years as with me but he's never heard of this happening before. So I'm now on 24mg daily and the problem is happening again but worse than ever before. Rather than taking an extra 8mg tablet when I begin going into withdrawal, I now end up having to take two or more tablets, sometimes as many as six EXTRA over a period of three or four days! When I go into withdrawal, one of two things happen; I either get INCREDIBLY weak, I mean so weak that I'm not even able to pick up the phone to try calling the doctor, (as if that would do any good.) I pretty much am unable to even get out of bed. Or, instead of the weakness I get very VERY tired, an incredibly DEEP tiredness as if I haven't slept in weeks. Yet if I lie down to nap, I'll be too restless to even fall asleep. BTW, since this problem began, I always hold the sub under my tongue for a prolonged period of time to make sure it's all getting dissolved and going into my system.

    The last time I saw the doctor, I told him that 24mg of Sub daily is no longer working consistently and that I'm once again going into withdrawal every couple of weeks. So he gave me a choice; The first option is to go up to 32mg daily which sounds like a bad idea. I know it will work for a little while but what will happen if and when this problem starts up again? I assume he can only raise the dosage so much. He said the second option is to try cutting back on the dosage for a little while to re-sensitize my system. I chose the second option as it seemed to make the most sense. Well as good as it sounded, it just doesn't work! If I cut the dosage down even a little bit, say I just take 2-1/2 tablets, (20mg) FOR ONE DAY as opposed to taking 3 tablets, (24mg,) within two days I get week again. About five years ago I tried cutting down by 1mg over several days and got to week to continue. I know that for people who haven't been on Sub for very long, the weakness is just temporary until one's system gets used to it a day or two later. (and that worked for me many years ago.) But because I've been on Sub for so many years and at such a high dose, the weakness goes on and on but doesn't let up. My doctor even told me that it probably is not even medically possible for me to come off of Sub!! This is a truly horrendous situation.

    I'm a rather intelligent person and am normally extremely resourceful and good at problem solving. But this situation has me totally perplexed. I just have no idea what to do from here!! I guess I should probably get a second opinion from another doctor who specializes in addiction and buprenorphone. I live in South Florida but am willing to travel anywhere in the state, (or even outside the state,) to see the right doctor. I'm so worried about my future and I'm talking about the immediate future! What if at some point it will take even more sub when this problem occurs than it does now? I don't have an unlimited supply of the stuff and I'm sure the doctor can only raise my dosage so much. Has anyone reading this every had to the same problem? If so, what did you and your doctor about it? If anyone has any ideas or can recommend a good doctor who I can see for a second opinion, please reply! Thanks.

    sandman1318
     
    Last edited: Mar 8, 2017
  2. AumuA

    AumuA Well-Known Member

    Hello, welcome back. It sounds like you might be torn between a desire to leave this stuff behind, and some sort of idea of "cutting back" so that it "works again". I'm kind of guessing here, but does quitting for good sound like something you might want to do? Because that's what we can help you with. Tapering, detoxing, getting off the buprenorphine.

    As far as the other thing, experience has shown that it's a one way trip you're on. It doesn't get any better, only worse. So, you have a decision to make.
     
  3. sandman1318

    sandman1318 Member

    AumuA, thanks so much for the reply! Right now, I'm not taking any options off the table. But as far quitting altogether, it's hard to fathom doing that when I can't taper down at all right now. Many years ago when I had been on a much smaller dose and for only about two years, I tried tapering down with the intention of going off it completely. I followed my doctor's instructions and cut down my daily dose by 1mg every week. But I eventually threw in the towel as I was so sick and tired of feeling so sick and tired! But I tried again a few years ago and had very different results. After cutting back by 1mg, I would feel crappy a day or two later but I wouldn't stabilize after a few days as I did before. The feeling would persist and just go on and on! And this was before I was having any of the problems I'm having right now. If I could start tapering SUCCESSFULLY again, without having to feel really horrible every single day, then I would seriously consider going off it completely.

    AummuA, how would you suggest I taper down the dose? Have you (or anyone here) ever heard of anyone in my situation before, where the sub doesn't work as well as before and the person keeps going into withdrawal? What's the best course of action at this point? I'd also like to know, has anyone else has ever been on such a high dose, (currently 24mg daily,) for so many years and has successfully tapered down and jumped off the stuff?
     
  4. AumuA

    AumuA Well-Known Member

    A few suggestions: think long term. You have been on this stuff for a long time (how long?), so consider a taper plan that's some significant percentage of the time you've been on it. I don't have an exact taper plan for you, but there is information on this site of how to make one. A plan is essential! Written out. You might consider drop times on the order of months rather than weeks, it all depends on the individual. Generally you go down more per drop at first, and then you slow down as you get closer to zero.

    You're gonna feel uncomfortable, for an extended time. That's just the bottom line. I suggest getting in the mindset that this is just something you got to go through, but you only got to go through it once. Support is essential, whether that's meetings, counseling, or therapy of some kind, family and/or doctor on board is good also.. or even posting here on a regular basis. You don't have to do this alone, and the truth is that it's difficult or impossible to do alone for most people. Your fellow travellers here (and out there), we know where you're coming from.

    You might look at Ibogaine, if you have ~$7500 to burn, and are able to switch to a short acting opiate before undergoing the treatment. There are others who can tell you about that. I don't mess with that stuff. I attend meetings, and it works just fine, and it's free.
     
  5. sandman1318

    sandman1318 Member


    Much of what you said, I had learned years ago from being on this board. But some of what you said, like about the Ibogaine, is something I've never heard of before. Money would not be an issue but from what I just read, I would definitely like to know more about it. It sounds like parts of the Inogaine treatment are very painful emotionally not to mention safety concerns. And at 64 yrs. old, I don't know how much agony I want to put my self through. But I still need to learn more about it aside from the little I read by Googling it. Oh, and to answer your question, AumuA, I've been on buprenorphine for about 15 years! To make matters worse, I'm on an incredibly high dose, 24mg daily!

    So here is the conclusion I've come to after reflecting on your two responses. I can think of very good reasons to both discontinue sub completely as well as good reasons to stay on it. But one thing I feel I absolutely MUST do is taper down the dosage, that is if I can stabilize first and not be going into withdrawal every two weeks as I am now. Considering the high dosage I'm currently at, I imagine that jumping off completely, (should I decide to,) is quite a ways off anyway, right? That said, there is no reason why I must decide right now as to whether or not I'll ever do it. Is there a thread you can stear me toward that can give me the info I'll need to plan a taper? And who can tell me more about the Ibogain? Thanks so much for your two responses. I really appreciate it!!
     
  6. sandman1318

    sandman1318 Member

    OK, I absolutely have to go off bupe due to recent developments. Because I've been going into withdrawal frequently,
    (while taking 24mg sub daily,) my doctor wants to raise it to 32mg daily. But now I'm running into problems with the pharmacy due to it being such a high dosage of a controlled substance. This is the very last problem I need on top of everything else. (Or perhaps it's a blessing in disguise that I can't get more.) So I've been researching Ibogaine and really thought it was a viable option until I read they won't accept anyone for treatment who is on more than 8mg at time of arrival. My problem is that I've been unable to taper at all! If I continually go into severe withdrawal while taking my regular 24mg daily dosage, how am I supposed to taper? If someone could suggest a way to do this I sure would appreciate it. I am truly up the creek without a paddle!! :(
     
  7. peacenik

    peacenik Administrator

    hi sandman. Yes it's a real difficult problem - seems hopeless, yet I can tell you there are those of us who have gotten free. I felt just as trapped as you do. So, realizing this is a good first step. From here you need, I think to get a plan in place and stick to it.
    A hospital detox even ibogaine is not usually available to someone on suboxone or methadone. So you are just going to have to find a way to taper and to deal with the symptoms. Not fun for sure but you don't really have any other choice.

    So you do some of the things that help you get through it. You give over your supply of suboxone to someone who will follow your detox schedule and not sabotage it by giving you extra. I was in no way capable of detoxing myself so don't think it is an insult saying that you might not be able to stand firm without help.

    Get yourself down to a low dose and then you have other options, like detox and rehab which would be my suggestion. I'm not a fan really of ibogaine mostly I guess because it is illegal in this country and costs so much money :) Anyway this whole process is best looked at as a series of baby steps. The first one is choosing a plan. The next is putting it in place. Telling your Dr that you want your meds reduced on whatever schedule you've chosen.

    Oh and btw, what you have been experiencing - going into withdrawal every so often is nothing mysterious at all. It is the process all addicts go through as your body no longer is happy with the amount of drug you're getting, so you take another 8 mg, or get an increase from the dr. It's just addiction. Increase the dose - its what we do.

    Best of luck. Let us know how you're doing OK
    Dave
     
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  8. sandman1318

    sandman1318 Member

    Thanks so much for the feedback, Dave. I'll be sure to let you know what I decide to do and how it goes.

    -Neal
     

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