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I was also addicted to fentanyl. And from what you wrote about inducting onto the sub....it sounds like fentanyl, like methadone and some of the black tar heroins take longer to clear off the receptors and one has to wait more than usual to induct.
OK....a big difference between the fentanyl and all the other short-acting opiates I had to detox off of (usually CT) was that the fentany took almost 2 weeks...the first bad and the second one maybe a tiny bit better. It always took me one week to detox off things like oxycontin or heroin.
Now, one problem with the suboxone is that it's much stronger than people think and you may actually be raising your tolerance. Sub can work very well as a detox tool....but that has to be limited to an extremely low dose for only a few days...like 3-5.
But....once you use it longer than that, you have signed on for some degree of PAWS....you've read about that here, haven't you? If not, I can explain it. And many here think the PAWS was not worth getting out of going through the acute withdrawal
Now...one of your choices is to do a taper....do you use the duragesic patches or the mylan patches? It would be much easier with the mylan patches as they can be cut down with scissors. The duragesic...the problem with them is that there's a rather big jump between doses....as they come in 100 mg....75 mg....50 mg. and 25 mg., right. Now I have heard that they now have a 12.5 mg. patch which would be really helpful for a taper.
If I missed this, I apologize....but are you looking to totally get off the pain meds or just to significantly lower your dose and thus, have lower tolerance?
BTW, this doctor? this detox guy? He's a frigging hero in my book. You should see the folks who come to his office. He has healed more people than are in the phone book. He's just an ordinary guy who looks like Mr. Rogers. No white coat. But these hardcases kneel before him like he's a saint. And he IS. He gave me his cell phone and returned all my calls within 5 minutes. Where can you find a doctor like that these days? --But I'm not letting him put me on suboxone maintenance. I'd rather taper off the patches like someone else on this forum did (I forget her name). A long-half-life partial-agonist mystery-drug is not for me. ... G
Dee... How kind of you to write so late in the day. I've read about PAWS today and this is why I'm keen not to stay on the suboxone longer than the 2-week taper this guy is putting me through. Do you think 2 weeks is too long? ... I don't know what else to do; I'm seeing my pain doc on 9/10, and I'll be able to get more patches then, but I chucked the rest of my patches because I knew it would be too hard for me to quit a taper if I had them. (I've been in withdrawal before: when I broke my arm, they didn't give me enough pain medication no matter how I told them that I was an opioid-tolerant chronic pain patient, and the pain was unbearable, and I used two extra patches to get through that week and I ran out four days too soon and went through a hellish withdrawal.) ... Anyhow... I get the Mylan patches. The brand-name are too big to fit on my body. The only place I can wear them is on my pelvis, and sometimes on my buttocks; all the other places on my body, they just fall off because the skin stretches and the patches blister. (And BTW? I never "nickname" my medicines; the patches have always been "patches", the pills have always been "pills.") My doctor has encouraged me to wear them above the beltline but I've tried to explain to her that they just fall off everywhere, especially when I do yoga or exercise and work up any amount of sweat. She would not like to imagine me cutting patches at all, but I have read that the Mylan patches can be cut to any size, which I suppose would make it easier to taper. But they have never lasted more than 2 days with me--I don't know whether it's because I just don't have a lot of body fat or what. I wish I could get them to last longer. ... One thing I loved about the patches is that I could just forget about them. I didn't have to constantly think about dosing myself with this or that. They just worked. Also, I'd been on Kadian, and my period had gone; but on the patch, my period came back! I felt like I had a semi-normal life. ... I can't see how I could possibly be raising my tolerance on the suboxone right now. I'm yawning, sneezing, feeling generally weak and crappy, irritable, and not sleeping at all. Waking up sweating in the night. Sounds like withdrawal to me. ... When I started with this doc, my only thought was that my HP was leading me to him and I would do what he said. He said he didn't know whether I'd be able to get totally off the medications, since I'd been on them so long, and that he was willing to help me have a go and see. At this point, at 10mg/day, I'm really afraid of tapering down because I can't imagine how I'll ever move to work or be a mom. But I'm seeing him again Tuesday and I'll cross that bridge when I come to it, along with my HP. I'm going to have a discernment time with my husband and see what he thinks too, and talk with my sponsor, but at this point if I could just lower my tolerance so that I could get on a lower dose of the patch and either regain some equilibrium there for a bit and then taper, or taper right away--whatever my HP seems to want--I'd be happy. ... When you said it took you two weeks to detox off Fentanyl, did you mean you went through two weeks of acute withdrawal after you totally stopped taking any, or that it took you two weeks to taper? There was someone else on this forum who said they managed to taper off the patches without too much trouble, but I forget her name. I'm not kidding myself: I know this is a total *****; I'm not looking for a way to do it easily, I just like to know what to expect, but that said, everyone's body chemistry is different. ... Finally, doesn't PAWS come with EVERY opioid, not just suboxone? I mean, can't I expect to suffer years of PAWS, having been a pain patient for years? Or is it much worse with suboxone? if so, why would that be? ... Thanks again, Dee, and to everyone, for replying. Take good care... G
Dee, I see now that you said you CT'd off fentanyl (for which you deserve much more than a medal: my heart goes out to you). Jesus, how ever did you manage? Anyhow, now I know you meant that you went through two weeks of acute withdrawal after CTing. (right?)... G
G....there's a huge difference between being on the sub 2-3 weeks and a maintenance. The PAWS simply means you're healing. The Paws from sub is different in some ways then the short acting opiates...but not a big issue with a short stay.
Don't let fear rule the plan. There are some stickys on PAWS...plan for it,understand them, but know that it means you're healing...one day at a time.
<center>You can't solve problems by using the same kind of thinking that caused them in the first place.</center>
It sounds like you are very tiny. Why they recommend that the patches go on the upper torso is that the fentanyl gets into your system via the peripheral blood vessels. And due to there being quite a bit of fat on the lower torso of females....so the issue is that there is way less peripheral blood vessels in fat...so you get much better absorption if they're on the upper torso.
Now...as far as tolerance...just to give you some idea. I was shooting up (injecting) fentanyl IV and took 3-4 times what is in your patch daily. So while 100 mg. is certainly not a low dose...I've seen cancer patients wearing 2-3 of the 100's at the same time.
As far as the sub goes...the only people I've seem totally have no PAWS (besides one case) the situation was always that they would get maybe 2 of the 8 mg. subs off the street and couldn't get any more....and during the entire detox, they would take nibbles of the sub tabs. Of course, this only takes the edge off during the acute detox and if you have more, you are tempted to take enough to keep you comfortable.
The PAWS after using sub for only 2 weeks would be mild but annoying at most. I did the sub maintenance and also the short-term, low dose stints.....and of course, the PAWS after the maintenance was SO much worse.
But..and trust me, I totally understand. Been there and done that SO many times myself....but here is what is likely to happen. For starters, you have a doctor who will keep you on sub for longer than 2 weeks, right? And you're on 10 mg. sub. Only 2 weeks means you'd have to really do a fast taper before you jump....and then you'll feel like relative crap and will go back to this sub doc who's perfectly willing to keep you on sub. OR, you'll have half a bottle of sub left at home, sitting right there....but once the uncomfortable stuff starts.....let's face it....you've got half a bottle of almost instant relief sitting there.
I don't know but I'm thinking I'd probably just cut really small pieces off the mylan patch....keep that dose thru whatever mild symptoms you have and then, when you are feeling normal again...cut a little bigger piece out of the next patch. This way you keep re-setting your baseline. The slower you taper, the less discomfort you have.
I did a cold-turkey detox off the fentanyl and it was a nightmare....probably worst than the acute methadone withdrawal...but not nearly as long. But I had no choice at that time.
Now, I do remember a gal on this forum...maybe around a year ago who was tapering the patches....however, she didn't do the jump here so we have no idea how it went. And from reading thru alot of the archives....I believe the other gal was named Moanettie....from a few years ago....who basically went thru almost the same acute detox I did.
A week ago I was at 5mg. I visited my suboxone doc and we worked out a schedule where I'd cut dosage once a week, jumping in late October. Then I read more about PAWS and decided I really didn't want to drag it out any longer than necessary. Janice's post about the fact that she could have tapered faster if she hadn't been so afraid of taking a pill was real helpful too.
However, all last week I could not sleep. Two hours max before I'd wake up, wide-eyed, unable to shut my eyes. By Thursday I was down to 4mg and by Saturday I was down to 3mg, still feeling the only real problem was insomnia. My son's BD was on Friday and on Saturday we had 14 boys over for a party. By that night I was just desperate for some real sleep. My suboxone doc had given me 75mg caps of Lyrica. He had told me to take one when I was in precipitated withdrawal, and I remembered how it allowed me to sleep for a few hours. So I took one. And I slept for 5 straight hours, falling asleep again for another two. Woke feeling pretty good, no rotten smell in my nose, able to eat. Sunday I got down to 2mg, and I was able to take my son to his soccer match and enjoy watching him in the game.
I've been warned off Lyrica because it's a scheduled drug, and I'm suspicious of it because it "worked" so well. But this morning I visited my PCP (the one who referred me to this fabulous suboxone doc), and she also said she trusts it, and just to take it as it goes, easy does it. I figure two sources I trust, I'll take the info at face value from my HP.
I faxed my suboxone doc the news about the big taper this morning and we've been playing phone tag. Pending his recommendations, I figure I'll stay at 2mg for today and maybe tomorrow, hang out here till my body gets used to this low of a dose. A 3mg-cut in one week is a heck of a cut--like coming down from 15,000 feet to about 6,000 in five minutes. Ears popping, etc. I think this last bit will be the hardest part of the ride but I'm trying to get through the clouds land the plane with as few bumps as possible. Keeping an open mind. Dreaming about being free.
Still exercising every day, maxing out on vits/fish oil/supplements. Visited the physical therapist to start weight-training.
To think I've cut my dose by as much as 4/5 is
It blows my mind.
Thanks everyone for your encouragement... --G
"What you don't have you don't need it now
What you don't know you can feel it somehow
What you don't have you don't need it now
Don't need it now
What a beautiful day" -- U2
I read in another thread where you were having trouble lately. I just wanted to come to one of your threadfs & bump it back up. And send ya well wishes through the bump in the road you've hit. Hang in there. I'd love to take time & write nore, but am on my way out the door here in a bit. Still, just wanted to let ya know you're in my heart & I'm pulling for ya.
You're my hero! Burning that script. Empowering, HU? You go girl, <me jumping up & down> you're trully an inspiration. I'm sure there will be many more trials in the days ahead, but you got through this one. Savor it, be proud of who you are & the strength you showed. I think that's alot of what this board is about, not just getting clean & drug free, but dealing with day to day life & learning how to handle what life throws our way, coping instead of using a substance to deal. Please continue to post & journal. I hope you spend more time keeping your thread updated.
Information in this forum is not monitored or provided by a medical professional. The information reflects member opinions only. Do not act on advice from these forums without first consulting a qualified medical professional. All content is copyrighted and protected by Aelius Group.