Thread: detoxing from Fentanyl patch with/without suboxone

Hi everyone... I've been on pain medication for fibromyalgia and migraine (with chronic daily headache) for about six years. For the past three years I've been on the 100 mcg patch once every two days. Three years ago I had appendicitis and two years ago I broke my arm, and both times I had terrible pain that went untreated by the hospital system. I'm getting arthritis (43 years old--family history) and also have cancer in the family, and I've begun to be afraid of the high tolerance I've developed. So I went into suboxone treatment two days ago. The first day was an utter nightmare: precipitated withdrawal because I took the suboxone a bit too early (despite scoring properly on the withdrawal scale I found on the internet). I was in bed with RLS and sweats all day; my son thought--I don't know what he thought. I told him I was having a bad reaction to a new medicine, which was the truth, but Jesus, I never thought to go through something like that. It's a bit better now; I'm taking about 10-12 mg of the suboxone and at least can take some water and food, but my energy is gone and I feel depressed because I CAN'T DO ANYTHING!! Does anyone have any experience with this? Should I continue with the suboxone or just try to taper off the patch? Is it even possible for me to do without pain meds after having been on them for so long? Have I screwed up my brain chemistry? (I never though, having experienced severe child abuse, that my body produced enough endorphins anyhow; my PCP believes my history truly screwed up my adrenals permanently) ... Any insight would be appreciated. All good wishes, G.

Welcome to ODR guinevere......first of all there's a big difference in 10 to 12 mg of sub. You'll want to get to a stabile dose. But being in PWDs...you'll want to lower your intake and get stabile first....maybe even no sub for a time. Let the half life wind down.

Yes..you've most likely screwed you brain chemistry up....but it does heal once you're clean.

Yes..it is possible to do without the pain meds...no matter what time frame or dose you're on. AND it's very rewarding.

The sub is a good detox aid. It can help minimize the acute stage of the WDs. But it's best used short term to avoid yet another possible addiction and WDs.

What's your plan with the sub?

Jay

<center>You can't solve problems by using the same kind of thinking that caused them in the first place.</center>

My plan was to taper down over 2-3 weeks. I'm just not sure that's possible, having been on such a high dose of the patch. I just have zero energy. The reason I tried doing it at home rather than inpatient is because I'm a wife, a mother, a business owner, etc. I simply can't "disappear" for a couple of weeks or a month. Having disappeared for the past two days has caused havoc enough for my son and husband. But I'm supposed to have people coming over tonight I just don't know if I can do it. Last week I was painting my dining room, taking my son to camp and back, having his friends over, working on my own writing and artistic business. Today I am on my butt facing painting the baseboards, cleaning the bathroom and making supper for seven, and I don't know if I can do it. The last time I felt like this was when the fibromyalgia was just rearing its ugly head, before I went on pain meds. I feel like I've gone back six years. Maybe I'm supposed to be on them?? Are they OK for some people? If this depression/lack of energy carries on for much longer, I feel like I'll just have to go back on my regular medications. But if there's hope of it getting better, I don't want to go backwards.

I read that a guy named Slingblade might have some things to say. Any way I can get in touch with him?

Welcome to ODR!:)

Hun'...my best advice to you is to drop the superwoman act.

It will only lead to continued rationalization to use.

Arlene
Exodus From MMT;12-25-02
<center>THIS TOO SHALL PASS</center>

Arlene... I don't know what you mean by the superwoman act... Do you mean I'm just fooling myself by enjoying all the things I do, that I'm putting on some kind of "act", and that I should--what? BTW I haven't identified myself as an addict. Perhaps I'm on the wrong forum. If so, I apologize. I had hoped to benefit from the experience, strength and hope here. I am seeking a way to care for my body, with my own HP on my shoulder and in my heart--that doesn't mean I'm graced with perfect clarity 100 percent of the time. I appreciate all replies but those that mean to criticize or belittle... Thank you for your time and care... G.

quote:Originally posted by guinevere64
BTW I haven't identified myself as an addict.

Okay, my dear....if you're not an addict, please excuse my transgression.

In no way was it meant to belittle.

We addicts are different. We abuse pain meds to continue to tell ourselves the lie that we can be "functional" addicts or that the opiates give us a quality of life otherwise not found in sobriety.

So, if I misperceived you as an addict, accept my amends. I read this forum from an addict's standpoint and as a woman who thought that she too could be all things to all people by using.

My strength is not with chronic pain patients. My strength is with a straight up junkie or an addict who once believed that they were chronic pain patients.

So that being said, I will bow out knowing that there are others on this forum far more equipped to help you.

G-d's speed.:)

Arlene
Exodus From MMT;12-25-02
<center>THIS TOO SHALL PASS</center>

I so didn't mean to offend or upset. I value all people's experience, strength and hope, but take what I like and leave the rest. I am a 10-year member of a 12-step program for families and friends of alcoholics, having both been sponsored (by a loving woman since my fifth meeting) and having sponsored others, so I deeply understand the 12-step approach and the reality of addiction. I lost both parents at young ages to the legal addictions of drinking and smoking. It is my understanding that addicts use substances to get away from their feelings and responsibilities. I saw this with both my parents, neither of whom would ever go to therapy or get psychological help of any kind. ... The reason I've used pain medications is to participate more fully in life--and I have done so, successfully. I'm just worried about being in bed every day and being depressed, like I was before I got treatment at the clinic. There is something about the medication that allows me to have energy and not worry about the pain. But I'm also seriously worried about being dependent on these drugs till my dying day. It's a kind of catch-22. I can't believe there's nobody out there who understands what I'm talking about.

Hello G and welcome to ODR. I am around your age and identify with the "superwoman" you are. If you check my thread you will see that I suffer from chronic back pain, arthritis, migraines, a number of other things. What I can say to you about the migraines is that in women, they are mostly hormonal. I have used Imitrex many times and it is a life saver. Headaches and migraines are different and what you are doing with the pain meds is masking the problem. Check your hormones and go that route. The Fentanyl patch - Im not familiar with - but may I ask what pain, other than arthritis is chronic for you today? The apendix op shouldve left you pain free by now, and shouldnt be of issue today. The broken arm as well. For arthritis, you should look to take an anti-inflamatory as in mobic and the like and look into steriodal injections. Why dont you check my thread and see if you can relate to any of the non- opiate avenues of pain relief Ive posted. I will be glad to help you in any way I can if you identify with issues. One thought though, as I am unfamiliar with the sub mg as it transfers to the fentanyl mg. you are taking, Im inclined nonetheless to say that 10-12 mg of sub is much too high for you to be taking. 2-3mgs may be more in line. There is a taper schedule on the sub section of this forum and I suggest you check that out as well. We are ALL here for you, and our perspective comes from journeys but the main theme is that we all know that living on drugs whether they be prescribed or otherwise is not an answer. The lethargy you are feeling is normal and will be for some time as you WD from the meds. It will pass. As you read other threads here you will see that it all gets worse before it gets much better. I know you like to do all the things you talked about. Arlene's suggestion to not be superwoman was a way to say that, in this situation, you need to take on much less for awhile while your body heals as it WDs. Which in effect, coming off the drugs, is what it is doing. You wont be at full capacity and if you do less, the lethargy will feel less. I hope you understand what we're trying to say. Again, welcome.

As a cronic pain patient,I would simply ask what do you do in the next 3 yrs when your tolerance(and it will) has brought you up to 200mg or more. With perhaps a fruit bowl of breakthru meds?
No philosophy involved....nut's and bolts sort of thing with opiates.

There's a reason you choose the suboxone route. That's between you and your Higher Power. If you want the nuts and bolts answer....you took too much sub too soon. And you're not at a stabile dose..ie your 10-12mg.

You won't feel much better B4 the dinner is served,or the paint is dried. But if you want to physically get stabile, start with a 2mg dose in the am. Wait at least 90 minutes to see IF you need to dose again. Your goal should be to get stabile at a split dose. My best quess is around 2-4mg in the am and the same 3-4 hours B4 bedtime.

Two days of that, and you can determine your plan. 5 days of that and a small taper, you minimize the acute WDs from the patches. Your pain will increase during that time period(sub makes a lousy pain releiver for most) and then start to level off. At which point you can taper off the sub,find alternative pain control, or simply SLOWLY unregulate back to the patches.

If you go the sub route...don't jump off the sub and go right back to your normal patch dose. Don't use the sub as a bridge between patches, or as a PRN med.

Godspeed in your plan and quest

Jay

<center>You can't solve problems by using the same kind of thinking that caused them in the first place.</center>

quote:Originally posted by guinevere64

The reason I used pain medications is to participate more fully in life..There is something about the medication that allows me to have energy and not worry about the pain.

Hi again, G. You posted before I finished my last reply to you. These 2 lines concern me because it feeds into the lie of the opaites. There are alternative meds, non-opiate solutions to deal with chronic pain. Yes, they may not take away the pain as an opiate would. But guess what, it is the better alternative. And why do I say that, because of what Jay said prior. What will happen when tollerance gets higher? It is an inevitable scenario. As tollerance gets higher, pain meds change and become stronger, whether dependent or addicted the end is the same. You do not want to be waiting for your next dose or fix or whatever you chose to call it. You dont want to look at the clock and say I need it now...living around the pain meds is no way to live. This is not about the steps, and understanding them or working them. In your case Im glad youre intimately knoweledgeable with them and the support is immesurable. This is about making the right long term choice for your pain issue, some of which may not be as chronic as you think now since opiates have a way of amplifying pain as it wears off. I just realized you said you were suffereing vrom FMG - there is a thread here, probably on page 2 about FMG and meds for it. Keep us posted and have a safe Labor Day weekend.

Jay... Thanks... you're understanding why my HP led me this way... Fentanyl is such a controlled drug; the hassles I go through in order to have enough for when I go overseas to visit family, etc., are just a nightmare. Forget lost scripts (I've never done that, but for a day or so this summer I thought I had--can you imagine??). If I want to apply to an artist's colony for a month, how am I going to time that to work with the patches? My doctor says they can deliver them via DHL or whatever, but I can't imagine sitting in an artist's cottage at the other end of a DHL delivery route and hoping the cell phone doesn't crap out because I can't track down my medication. Being physically dependent on this stuff makes me nervous all the time. It has been affecting my serenity. I have been at a stable dose for 3 years, but that can't last forever. That's why I thought, why not try to either get off, or lower my tolerance? Which makes me ask, what do you mean when you say "don't jump off the sub and go right back to your normal patch dose. Don't use the sub as a bridge between patches, or as a PRN med"? I never imagined using suboxone as a PRN medication. But as to the former point, do you suggest that going back to my normal patch dose would be unwise because I'm lowering my tolerance? That would be good news! If I were to go back to the patch, or to some other medication (in consultation with my doctor), I would hope it would be at a lower dose. God, I would hope!

As for today, I've been forcing myself to just get up and about. I'm painting the baseboards, and listening to good music, and enjoying the kids watching Naruto in the room next door, and thinking about the book I want to write. (That's how I lulled myself back to sleep a thousand times in the night: sentence by sentence---and I remember a lot of them today, and plan on writing them down.) And talking with my HP. Who reminded me that today is all that matters, and that more will be revealed. And that I don't run the show.

I'd still be interested in hearing more advice.... Thanks, everyone... G

G ~ I would like to suggest something here.

There is a phenomenon known as hyperalgesia...aka rebound pain. Many a chronic pain patient has found herself trapped in this cycle and upon cessation of all opioids for a given time period make a startling discovery. Their pain levels either disappear altogether or dissipate significantly. To the point where alternative pain management methods work.

Take a look.

http://en.wikipedia.org/wiki/Opioid-...d_hyperalgesia

Arlene
Exodus From MMT;12-25-02
<center>THERE IS NOTHING SO REMARKABLE AS BEARING WITNESS
TO THE TRANSFORMATION OF THE HUMAN SPIRIT</center>