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Help coming off Suboxone

Discussion in 'Detoxing From Buprenorphine/Subutex/Suboxone' started by nesscal, Jan 2, 2004.

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  1. nesscal

    nesscal Guest

    Hi everyone. Wow, haven't checked in in awhile and everything is so different.
    I wanted to know if anyone had any experience coming off the Suboxone completely. My husband has been off for maybe a week (??), and is having joint pain and trouble sleeping. He's easily agitated so I don't know if that is part of it too. What are the symptoms, how long do they last, and is there anything you can do to ease some of the pain??
    He wants to be pill free and in doing so has also quit taking the Wellbutrin. Don't think that was a smart idea but I think he's reached the point where he's sick of being dependent on a pill for every part of his daily life. I'm just worried that doing this in too abrupt of a way might get him back to using. He was on 8mg twice a day and then slowly started tapering off. Once he tried breaking the pill in quarters, or thirds, is when he decided it was too much of a pain in the butt. I think he only broke the pills for about a week or two and then stopped altogether.
    Hope you all are hanging in there. I appreciate any info or advice anyone has. Happy New Year to you all!!!
     
  2. Bup4pain

    Bup4pain Well-Known Member

    How long was he on the Sub?

    FYI Buprenorphine has a 37 hr half life, and will take a few weeks to clear his system. Please post his results. Many of us are interested in this very same issue!
     
  3. nesscal

    nesscal Active Member

    He's been on the Sub since August of '03. He said he went a day and a half without taking one and then felt so bad he broke a small chunk off, less than a quarter of a pill, and then felt much better in 20 minutes. So he is back to taking a very small chunk a day.
    With the old posts I remember people talking about feeling pretty bad coming off of this. I'm wondering what the best approach is, do what he's doing now and take small amounts when needed, or just quit altogether and feel cruddy for awhile.
    Thanks again for any info.
     
  4. nesscal

    nesscal Active Member

    Oh, a question for you, what exactly does that mean when you say 37 hour half-life?? I kind of have an idea but just wanted to know for sure. And is it that the longer you take it the worse it is to come off, or is it the amount you were taking that affects coming off? Or probably both I'm sure.
     
  5. nesscal

    nesscal Active Member

    Well, hubby's latest pill was yesterday morning. Last night he had muscle pains and couldn't fall asleep. Tonight he felt worse, no pill today at all. He went to bed early and I thought he was sleeping, but I heard all this commotion. He threw everything off the bed and was thrashing around. He said his muscles hurt and it was driving him nuts. I gave him a massage and he said it helped a lot. So now all is quiet upstairs. He said to me when I walked up there, "I'm trying NOT to take a pill!!" He knew it would take away all the pains in a matter of minutes.
    Isn't that such a powerful drug? So much is packed into that little pill. Even breaking small chunks of it can ease the pain. It's so bizarre to me because just 6 months ago he was taking 25-30 pills a day plus a fentynyl losenge. Blows my mind.
    I'll keep checking in and let you know how it's going. Tomorrow should be interesting. Spending the day with his parents and brothers and their families. Usually that kind of day called for an extra Oxy and a couple of drinks for him, on top of everything else.
    So we'll see how it goes. Have a good night everyone!!!!
     
  6. Jon

    Jon Well-Known Member

    Hello nesscal,
    I don't have any magic bullet for you, wish I had. I too am coming off of buprenex; 38 hours since last dose. While I was on it for only a short time (2weeks) for the expressed purpose of detox, it can still be a bitch, the thing is. it's still a lot easier a detox than from herion or other opiates. The long half life , I've found really makes it easiere by giving you more control. Don't give up please! every succesful story makes it easier for someone else. What I'm trying to say is you've got a lot of people rooting for your husband and you. Listen to me I'm less than 48 houres clean and I'M ON YOUR SIDE. It can be done and a lot easier than in a jail cell with no help. As much as can be, we are here for you.
    If you can , have husband Try to get halves and quaters thrown away. Ask him when he has a buzz on. They aren't really helping and will only prolong this eventuality. Remeber.... you always have someone to talk with here.
    Love and good thoughts to you both.
    Jon
     
  7. Bup4pain

    Bup4pain Well-Known Member

    Jon...

    A little confused here. What do you mean by "ask him when he has a buzz on" I doubt he is getting ANY BUZZ taking 1/4 of a sub/bup pill! Even a whole one after 3 months! You make it should like he is snorting 80 mg of Oxy or something. [:I]

    If he was on 8 mg a day.. then tries to quit I thinking tossing his pills out is a BIG mistake. He should taper then quit.

    A small decline in his daily dose for a few weeks will help in the severity of the symptoms of the W/D. When he is down to a tiny bit every day (.5 mg or less a day) Then he can quit and go through what ever is left for w/d. Fatigue, and insomnia seem to be the most prevalent.

    I did a 30 day taper and the last bit was still a bitch, but NOTHING like quitting at a full dose w/o a taper!

    If he feels he is through the worst of it than maybe stick it out, but if he gets bad... take a 1/8th of a pill (crush and divide with a razor) That would be 1 mg take that once a day for 3 days.... Then take 1/16th (.5 mg) for 3 days. Then even 1/16th (or less) every other or every 2 days for a while. THEN quit.

    But stepping off at 4 mg a day is to much IMHO.

    Yes, buprenorphine IS a powerful drug, and it lasts and lasts.

    It however dose not get you high. A 1/2 a pill will not give you a "buzz"!
     
  8. cgdg

    cgdg Well-Known Member

    I'm w/you Bupe...taper down to as little as possible before getting off...the whole principle behind utilizing Subutex/Suboxone is to *avoid* discomfort...

    When yer uncomfortable, you CRAVE...when you have cravings, your thoughts turn to using. Not that you *won't* crave when tapering down to miniscule amounts, but you certainly won't crave as *much.*

    If you step-off at a high(er) dose of Sub...you'll suffer a LOT more than at a lower dose...which IMO defeats the purpose of getting on the Sub in the first place.

    *I understand how stressful it can be spending time w/ones family...that used to be *my* "Oxy-time" as well...it takes a period of adjustment to get used to 'socializing' again, but give it time...
     
  9. Jon

    Jon Well-Known Member

    Well,
    I guess I really misspoke here. First off BupeJohn, pardon my use of the common vernacular. I can see how it can be misconstrued. I of course didn't mean when he was "stoned" but only that the best time was when he had just taken SOME bupe and would be more aimable to reason. AS far as my statement to get rid of the pieces; the 1/4's and other pieces, I stand by it. It is an accepted protocol used many, many times with sucess. I realize that is not the method you are using cgdg, and I respect whatever works for you. In reading case histories however it is shown time and again that trying to "detox" to nothing is unnesasary for most patients and in fact prolongs the WD. Like it or not, most patients step off at 1 to 2 mg. and it works.
    And Bupe, I never said to quit at 1/2 his dose of 4 or 8mgs or even not to taper down. Just that a taper past 1mg does LITTLE good. cgdg I am glad it is working for you, but I am of the OPINION, (just as Bup has his OPINION about the reletive IM and sub method of taking Bupe) that for MOST people walking off at 1 mg or even 2 works best.
    I didn't advocate "taking" the mans drugs when he is "high". After almost two days off this stuff I am well aware that 1/2 a pill won't make you "HIGH" and there was no need to make such an issue of it in this self-serving remark you repeated several times as if this would make your foolishness more meaningful. Spend more time reading your own F.A.Q.S espescialy where you missunderstand the statement and I parapharse here: "Bupe taken PO (or swallowed) is 10x as efficent than taken IM. However Bupe taken SUBLINGUAL shows a bioavailability of 25 percent as opposed to that of IM which has a rate of 71 to 75 percent." A rate of aprox 3:1 not this 10:1 you keep throwing around this board, which applies ONLY if the drug is swallowed. Back off me friend. Thank you
    So I misspoke, but yes I really am happy for you cgdg. I told you I am really counting on your making it....And I am. BUT I stand behind the facts of what I say. "it is medicaly easier to get off a 1mg dose than to prolong it" You my friend are a wonderful exception! Just read about ALL the other people who kept stretching out that detox, stretching it out 'till they were down to a "LOW" enough dose. MOST ARE STILL ON IT ONE, TWO YEARS LATER. You can't avoid ALL the pain. It's a question of are you ready to stand what you must to be clean. Thrn make it as easy as you can. Belive me; it will never be painless.
    I didn't mean to offend and hope I didn't, but after about 48 hours or so dealing with my own detox. I do have my own issues and don't like to be picked on, not when I have been living it as well as researching the issue. Two days so far, some cramps,cranky and I miss my daughter,
    Peace,Jon
     
  10. Apheana

    Apheana Well-Known Member

    Hello All- we all have our own apinions and thats ok here. I can honestly say that coming off bup is PAINFUL, I have been on it for 2 months. I made it through 4 days after taperinf down to about 1mg a day. I had to take another 1mg after 4 days and I wa so mad at myself. I am an emotional addict. Along with the joint pains and the muscle aches and the stomach cramps (you DO withdraw from bup and do not let anyone tell you differently) It is worth the chance to learn to live BUZZ free. I do not get a buzz but within minutes it seems like all those awful feelings go away with one little piece. This stuff is amazing!

    Its worth it for people on H and oxi's but I really think they should rethink it for people on shorter acting opiates (Lortab/Vicodin etc). I think it may be more powerful than what they need and I think people are going to end up with a higher tolerance in the end. My opinion. I was on a mix and Oxi was my drug of choice. I also was getting heavy into coke. For me its what I needed to function to get through the day and apparently it still is. EVEN 1mg...[V]

    ***Live, Laugh and Love***
     
  11. cgdg

    cgdg Well-Known Member

    Hi Jon...
    I've said it before...there's *no* set protocol for detoxing on Buprenorphine. Probably never will be...not unless we end up living in a world of clones :D.

    Too many variables...1-2mg may be fine for you, but for me...I'd rather walk off 1/4mg. Will it be easier? If I had to guess...I'd say YES! [:p] Putting off the inevitable...w/o a doubt...but I'm much "better prepared" to deal w/it now.

    But hey...that's me.

    My doctor advocates 28-35 days...they've had a *very* high success rate w/their protocol...but again; everybody is different. I think there are a LOT of people who get stuck in the 2mg range...while STICKING at any particular dosage for more than 6-8 days makes dropping more difficult.

    Makes sense to me...whenever I found myself becoming "really comfortable" on a particular dose, I KNEW it was time to drop.

    So from my experience, a taper below 1mg does a LOT of good...

    No matter what method you choose, as long as you SUCCEED...then who cares? That's what we're shootin' fer ;)!

    "Offend?" Nah...we're all on the same side here pal. You know I'm pulling for you home-slice!
     
  12. Bup4pain

    Bup4pain Well-Known Member

    Jon,

    Sorry to ruffle your feathers. It was not meant to be that way. I was not the only one who misread your post. Easy to do with typed conversations.

    Also, it is probably because we are sensitive about people saying we are getting a "buzz" from sub/bup since it has been used as a way for the anti buprenorphine folk to hinder approval here in the US for 10 years. (The methadone folks mostly, and the anti maintenance people) We need to be careful what and how we say it.

    I agree with your feeling of a prolonged taper. There is a point of diminishing return. That point is much different for a SHORT term user of bup than a LONG term one. Your experience has been with short term usage. Even a 30 day taper for a long term user can be difficult. The clinic I went to said at LEAST 30 days at under an amp a day (.3 mg IM) . They even recommended dilution with sterile water, and even every other day dosing at very small doses!

    Just as short term usage with methadone is MUCH different then long term in regard to w/d. I feel that bup is similar in that account. Maybe the long ? lives has something to do with it.

    If her husband was on 8 mg a day for 6 months, a quick taper would be painful. Since she was saying his symptoms included leg and joint pain, it sounded like to quick a taper. Telling her he should toss out his meds was a little harsh. If he went from 8 mg to 4 to 2 in a week he NEEDS to do more of a taper. Unless he wants to suffer, and would suffer more than a short term user of bup like yourself. Trust me his w/d is a LOT different than yours.

    I tapered early on my bup usage and it was fairly easy. I tapered again at a year. It was much different, and than again recently. After 2 years the w/d was just to much and I chose not to do, and switched to morphine. I have experienced the different levels of addiction to this drug and it's associated different w/d at each level.

    FYI, the FAQ I posted here was the "opium poppies org" and was written by a long term heroine user who just switched to buprenorphine. It was written back in 2002, and most of it was data from back in the late 90's. It is a collecting of "Stuff" + Opinions. Some of which I strongly disagree with, some of which I agree with. It, by no means, is 100% accurate, or complete. Parts are already outdated.

    Re dosing.

    There is a huge disconnect in the sublingual #'s. FYI the absorption rate of sublingual liquid compounded buprenorphine is 50% more than a sublingual lozenge The % varies drastically between subjects. This is well documented.

    When comparing IM dosage, and effects biased on real life usage and sublingual lozenge usage the 1/3 - 1/4 rate vs the 1/10 the rate disconnect is apparent.

    If the max IM effective dose for the buprenex is at 6-8 amps IM (2.4mg) than at 10x would equate to 24 mg sublingual in lozenge form. From most sources that 24 mg dose sublingual is the max. So the 10x fits.

    Lets reverse the #'s IF your 1/3 # is correct take 32 mg x .33 = 10.5 mg IM. That's 35 amps at .3 mg each. For anyone who has been on Buprenex they know 6-10 amps in a day if the most you can take w/o problems. I would not want to even think of how *35 cc* of buprenex would feel! OMG! [:0]

    Posted ceiling for sublingual is at 32 mg sublingual and less than 3 mg IM (10 amps = 3 mg but the ceiling is at about 2.4 mg which is 8 amps) Again that supports the 10x number.

    Let's look at clinic recommended doses for IM buprenex for maintenance. 2 amps a day with the most recommended being 3 amps a day. At the 10x that would be 6 mg SL to 9 mg SL, which matches the experience of the people here who found the effects peaked in that range. After that the effect per mg drops drastically and eventually will reverse it's self. Again the 10x # fits

    This board is an experience based forum. We also post a lot of info from printed literature. We have found a lot of it to be bogus biased on our experience. MD's have posted here saying how we know more than a LOT of MD's about this stuff.

    Let's
     
  13. pinkie

    pinkie Well-Known Member

    Long time no see,

    Ships log, one Monday early in the year of Bugs Bunny 2004: Still furiously paddling in an effort to escape the holiday doldrums, hope to have clear sailing by the end of the week. Will post more soon. Glad to see you all doing so well without my infinite, obsessive, annoying, self serving, narcissistic dribs and drabs of what I like to think is wisdom. But careful, 'cause I've still got my eye on all of you from up here in better-than-you land (safer for children than Neverland, but considerably more dangerous for junkies).

    Here's my stinkin' two cents...
    Taper as quickly as you can using the least you can. Then hold your nose and dive in.

    I stepped off at 2mg after 2 weeks, worked fine for me. Bf stepped off at 2mg after 2 days. That's not to say everyone will feel the same, just my experience.

    I was cranky and irritable and particularly touchy for a week after kissing my little pills goodbye, so maybe in the future, when we know someone is within a week or so of last dose, we can approach them and their "unusual" posts with some compassion and patience. Maybe some of you will disagree, but I maintain that I saw a substantial change in WDartmore's (disappeared, hmmm.) demeanor as he was down to bare minimum. I know that I was weird, (still am for that matter), if only I had my old posts, I would be more than willing to embarrass myself to prove the point.

    Anyway, good work Jon (we're landsmen y'know) and the rest of you. Keeps your eyes on the prize.

    Oh yeah, there was one other thing I've been thinking about. Used to be after a weeklong binge (before my daily habit stuck) I would get my hands on 5 mg tabs of Methadone. When I took one or two for a day or two after using H., I found that I had a really easy letdown. Maybe Methadone when used this way, in small dosages over the course of a week or so might work nearly as well as a short detox using Bup. The difference being a slow leak rather than a hard crash, (or like the Mars landing, just bouncing around for a while until finally coming to a complete stop). Positive rattle in my riddle cortex. What do you guys think?
     
  14. Jon

    Jon Well-Known Member

    Bup4,
    I bow to your far greater experiance and chearful outlook. I do reseve a debate for a later time on some of the technacl data as I belive I could show you how it proves my idea that MDs are experemting on addicts with much higher than needed doses and subtly convincing them that they need them. For now let me break bread with the group and pray feathers do no ruffle again. I acknowledge that my stepping off has engedered some odd notes, but meant well. Pinkie in a nutshell (if you fit) I have always said you were my hero and now I find you're a member of the tribe too!!!
    Bup4 Of course we're ok there is really only one greater pleasure than two men debating and Ah, I will let your sexest brain work on that one
    I'll keep hoping for a few more days before the cheere. My daughter is staying with my sister for a few more days untill I can really cheer.
    Be well,
    Jon
     
  15. Apheana

    Apheana Well-Known Member

    I strongly agree with the statement that docs experiment on us. I am scheduled for an apt tonight, I was going to cancel because I am
    A) paying cash and B) trying to step off this med. My doc is going to try and convince me to continue to take it. I only wish he would prescribe me something to help. I am cold then hot then I am crying then I am laughing. I feel insane. This is after 2 months folks. I am on nothing else at this time although I do have some hydroxyzine for anxiety (i am an addict get real that DOESNT work for me) and Trazadone for sleep. Some nice non-addictive substances to help me. Wish me luck! (i have taken zero today and I am at work functioning- the good thing in this is that I dont want to even smoke ciggies cause they are making me sick) [xx(]

    ***Live, Laugh and Love***
     
  16. nesscal

    nesscal Active Member

    Hi everyone. Sorry I didn't check in for awhile.
    Well, hubby went 3 days and today had to take a little piece. He said he uses his fingernail to get a little piece.

    He said he was feeling pretty bad and just couldn't go any longer. Today he came home early from work and went right to bed. He's up now and wanting another massage. (Taking it for all he can :)) He thought he might be coming down with something but then figured that he wasn't getting a cold, just still feeling the w/d. He couldn't really explain how he felt today, just crummy.

    He said that it's easier to deal when he is busy. Nights are tough, but I don't think he was as bad as the very first two days he tried to get off. Maybe he's knowing what to expect.

    He said he is hungry all the time. And I notice he is still very cranky. I've got high energy kids and I'm on edge sometimes when they get a little out of control because I am worried he's going to blow.

    I do agree that every person is different. And the doctors don't seem to know what to tell their patients because it's like it's still in the experimental stage. Maybe in 10 years the people who will unfortunately go through this will have more answers thanks to all of you here.

    I have a feeling that there will be more talk about this drug because it is absolutley amazing. How could a fingernail scrape of Sub make you feel better after taking 25-30 pills a day. Maybe more people would attempt to get off the pills if they were made aware that there is a pill out there that can help you do that.

    I admit, I was so bummed out when I learned my hubby would still be on a pill to get off the pills. But now that I have learned more about it, I am so glad. It is very difficult for me when I'm not in his shoes.

    Well, good night to all. I'll check in later when I have something new to report. V
     
  17. wdartmore

    wdartmore Well-Known Member

    You have incorrectly defined 'half life'

    A half life works like this.

    today you take 12mg of subutex. In 37 hours (plus or minus) you will have 6mg. 37 hours later you will have 3mg, 37 hours later you will have 1.5mg and so on. Obviously at some point it gets so low your body clears it all but half life means exactly that. Half life. Not it's gone it 37 hours rather half of it is gone.

    So if you take 12mg on day then day two take 12mg you would have a effective dose of 18mg then take 12mg on day 3 and you would have an effective dose of 21mg.

    Dose one has 2 half life to 3mg
    Dose two has 1 half life to 6mg
    Dose 3 is at 12 mg

    Eventually if yo keep the same dose it will level off. But that's what half life means.


     
  18. wdartmore

    wdartmore Well-Known Member

    Hey that's my line. :)

    She's right. I ****ed around for an extra month because I just....what didn't want to, kept finding reasons (some even good) to drag it out. But in the end get your ducks in a row, cut to a .5mg do that for a few days and then just go for it. Keep lots of clonodine and a few benzoz around and anyone can manage to do it.

    God now I can't wait to just feel good and normal again. My fatigue is very very profound. Nothing like my wife went through.

    W.


     
  19. kevin

    kevin Active Member

    How much clonidine did you take? Is there a certain amount when using it during detox?


    Thanks.
     
  20. JaH

    JaH Well-Known Member

    From my own experience, there comes a point at which either long slow tapering -- or chipping a little "piece" of a subutex every few days -- is equivalent to "death by a thousand cuts."

    Better to taper as low as you can within a 10-14 day period or so, then jump off.

    There's no way around it -- you absolutely will feel bad. The worst of it, in my opinion, is the profound lethargy and depression -- the kind that leaves you slumped in a chair staring at the walls (and probably crying) for what seems like hours.

    The good news is, you will feel crappy but MUCH BETTER within a week to 10 days at most. Some people feel better in 4 days. It'll keep getting better until after several weeks to a month, you realize you haven't even thought about feeling bad all day. That's because you actually no longer feel bad. You sometimes even feel like doing things again.

    This was one of my greatest disappointments -- to learn that there really is no free lunch. But if it helps any of you coming off drugs, including Bup/subutex/suboxone, please try to remember all those poor souls dealing with terminal cancer, or agonizing debilitating pain. Day after day after day.

    Remembering that sure helped me get through the first week or two of Bup withdrawal. I still cried; I still whined; I still felt like **** a lot of the time in that first week.

    But hell, I knew even a wimp like me could endure a week or two of insomnia and leg-shaking and depression to get my whole life back again. And so can all of you stronger folks.

    No pain, no gain. And trust me, the gain is like being reborn.

    (A slow rebirth, to be sure, but none the less sweet.)

    By the way, I know this isn't exactly AA or NA protocol, but I found smoking a joint here and there improved my mood greatly.
     
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