If you know anything about suboxone, please help me!

[leba]

Okay. I'm going to try and make this short.
I have been on Suboxone (8mg buprenorphine/2mg of naloxone) for the better part of 13 months. When I say the "better part", this means that I've relapsed a couple times. My longest relapse was 2 months, and I have now been morphine-free for over four months. I have always been taking a dose of 8mg.
In the past three weeks, I have noticed that my Suboxone isn't working very well. When I first started taking it, I could go for 3 days between doses without going into withdrawals. Now, I can't even go 12 hours, sometimes less, before getting sick.

This has happened to me once before, in October. I went cold turkey, and went to detox for 5 days but the withdrawals were unbearable (much, much worse than coming off morphine) and kept getting worse and worse as the days went on. I was in so much pain, I ended up getting morphine, using for two months, and that brings us to where we are now.

I want to know why this is happening, and if there is anything I can do about it.
I don't want to raise my dose. I've already been on this medication for far too long. I can't do it cold-turkey, because I estimate that I wouldn't be able to work for weeks afterward, and I am finding it so hard to continue on the way I'm going.

Please, if you have any advice, I'd love to read it.
Thank you!

[electrolingus]

There could be many reasons for tolerance issues with suboxone. SWIY will find answers to this question and many more at this site. http://suboxonetalkzone.wordpress.com/
Or: http://suboxonetalkzone.com/

Hope SWIyou find the answers SWIY is looking for. Welcome to the Forum.

[leba]

Electrolingus,

I've been looking through the two links that Swy gave me. I've only found mention to the problem I'm currently having. No concrete answers. I've tried contacting the author of both of those sites, and hopefully he will be able to shed some light on my situation.

Thank Swy.

Anybody else? Anybody?

[Breedlove]

Leba,

This is my second post and I'm half crazy now...it's day 5 of kickin' heroin so take whatever I say with a grain of salt. I really don't know about suboxone, but it's sold by the same people that sell methadone and that makes me leery. Methadone, in my opinion, is the most God awful shit I ever made tha mistake of taking. I never got off it without getting strung out on Heroin and then kickin' that. I should have done that in the first place, I guess.

[electrolingus]

Originally Posted by Breedlove

This is my second post and I'm half crazy now...it's day 5 of kickin' heroin

Stay with it. SWIY is so close to the finish line now, one can hear the roar of the crowd and see that checkered flag a flappin in the breeze.

This hamster who is a friend of a hamster I know is all too familiar with and sympathetic to SWIY's plight. Just remember to avoid self-incrimination in future posts. Welcome to the forum.

SWIwe now return everyone to the regularly scheduled topic.

[Spucky]

Now a few Day`s to late!
But is Swiny. drinking a lot of Alkohol?

Because there are some Reports about problems with the Naloxone and Alc.!

[chillinwill]

Leba, how are you doing now? Please post an update when you can

[leba]

To answer your questions,

1. No, I haven't been drinking any alcohol at all.
2. Things aren't getting better, they're only getting worse. I've been scouring the internet for information and have come up empty handed every time.
I saw my prescribing doctor yesterday, and told him of my plight. He basically gave me two options. Option number one, stay at my current dose.
Option number two, raise my dose.
Really, I'm not satisfied with either of these options. Right now I'm staying at my current dose, and I'm waking up sick every morning, coming home sick every day after work, and then doing it all again.
My doctor really had no clue what to do about this situation. He gave me some clonidine for when the WDs are making it hard to work/sleep/whatever. He's going to consult with some of his colleagues and hopefully he'll have an answer or a game plan by the next time I see him in 3 weeks. I am getting so frustrated with this. Honestly, I just don't know what to do. Day by day, week by week, it slowly gets worse and worse. I feel like the suboxone is only making it harder for me to stay clean. Being sick every day isn't really motivating to stay on the same track.

Swim is tempted to save up money to afford a months worth of eslons, and to taper off those instead of the subs. Swim already knows that it's much easier to get off the morph.

Please, if swiy has any insight into swims problems, swim would looooove to hear it.

[pinksox]

Personally SWIM would try increasing the dose every few days until they felt comfortable and then stabilize, then work downwards again.

SWIM admits knowing next to nothing about Subs however.

Alternatively, stabilize back onto methadone again at a dose that just makes one feel "well" and not "high." Stabilize and that meds for several months and then attempt Suboxone induction at a higher starting dose. Could it be that their starting Sub dose was too small to begin with?

If SWIY if uncomfortable to the point of "sick" and getting worse, something is not working obviously. SWIM doesn't see where anything is to be gained by waiting 3 more weeks(feeling like crap) until ones next appt. Call and get something done(one way of another) now.

SWIm would think either a bump up or temporary switch back to methadone would be preferable to possibly going back to Heroin.

[Spucky]

Do Swiny-San know the concentration of Suboxone in her Blood-Plasma after 12 Hours?
Try to speak with swiny`s Doc about a Check-Up.

If Swiny think about to snort it will be much better to increase the Dose,
swiny have to change her behaviour, Snorting is a behave like a typical Drug-Addict!

Please be very carefull with Clonidine, this is a very prolematic Drug,
not easy to calculate!

Edit: What do swiny not undertsand in the Pharmacokinetics of Suboxone?

[ex-junkie]

please dont snort the subs. this will do nothing to improve swiys situation, and will only make matters worse in the long run, because it will not hold swiy for as long. if swiy isnt adequately held now, then expect to feel more shitty than swiy does now.

[kailey_elise]

have you thought about split-dosing yourself? perhaps give it a try on a weekend...you're already feeling shitty, maybe taking half the pill in the morning and the other half 10-12 hours later might hold you a bit better?

I've heard anecdotal reports that the more times you use buprenorphine, the less effective it is at preventing withdrawal symptoms and relapse. taking that information, in addition to the fact that your per-dose usage went up upon each relapse, into account, I actually would agree that the correct response would probably be a dose increase to where you feel stable, then slowly decreasing from there once you have had a period of, well, stability.

If you choose to increase, don't go up by a whole 8mg tablet or anything! Try 1-2mgs at a time and work up from there; buprenorphine is far more potent than most people realize (not saying *you* don't know this, I just wanted to put out a standard disclaimer).

Good luck, and keep fighting the good fight!

~Kailey_Elise

[Spucky]

Originally Posted by kailey_elise

I've heard anecdotal reports that the more times you use buprenorphine, the less effective it is at preventing withdrawal symptoms and relapse. taking that information, in addition to the fact that your per-dose usage went up upon each relapse, into account, I actually would agree that the correct response would probably be a dose increase to where you feel stable, then slowly decreasing from there once you have had a period of, well, stability.

My Cat have the same Experience, something is really strange with Bupre.
Many Times she used Bupre. and Heroin together,
but suddenly she get extrem Withdrawal!
Something changed insider of her Brainchemie!

Bupre. is really unsuitable to Switch in between!

[kailey_elise]

Originally Posted by Spucky

My Cat have the same Experience, something is really strange with Bupre.
Many Times she used Bupre. and Heroin together,
but suddenly she get extrem Withdrawal!
Something changed insider of her Brainchemie!

Bupre. is really unsuitable to Switch in between!

Yes, TIK have had similar experiences. Guess that's what happens when one tries to "work" the system!

Oh well.

~Kailey

[Sib]

SWIM would only use sub for 3 weeks due to it's strength.

[Spucky]

All Swiny`s are different,
swiny can`t say; "oh, it is soooo fu..ing easy for everyone to stop Bupre."!

[dyingtomorrow]

Originally Posted by Spucky

All Swiny`s are different,
swiny can`t say; "oh, it is soooo fu..ing easy for everyone to stop Bupre."!

Compared to full opiate agonists, yes you can.

The only problem occurs when you stay on Suboxone for too long, like a couple months. Then the withdrawals are pretty bad. If you taper down and get off within like 1-3 weeks, they are like NOTHING compared to full opiate withdrawals.

Doctors really should not be prescribing Suboxone for long term tapering. It might be the only way to do it with methadone, but it actually makes it worse with Bupe.

[crizzle]

hey OP, When swy says "the last 3 weeks"... sis swiy start up again after using a full agonist opiate? going back and forth from subs to other full agonist opiates, from swims understanding, can increase youre tolerance.

In that case, swim would suggest increasing swiys dose a little, maybe to 12 (4mg 3x/day) and see how that goes. stabilize, and then take it from there.

[nick23]

With subs less is definitely more and 8mgs is a large dose,taking more shouldn't be required.

However Subs are also very subjective.So,all I can suggest is maybe try snorting your dose.

[Spucky]

Originally Posted by nick23

However Subs are also very subjective.So,all I can suggest is maybe try snorting your dose.

This will not help
Also the Half-life Period will decrease!

[nick23]

Originally Posted by Spucky

This will not help
Also the Half-life Period will decrease!

In theory,but in practice this works for many folks.I wouldn't suggest it if the op's dose was 2-4mgs,but at 8mgs a day and considering the 37 odd hour half life snorting(which means definite absorption) is possible.

I'd be interested to know the dose of opiates that Swiy was taking prior to using 8mgs of subs.

[leba]

yay! so many replies!!
okay, a couple things that may be useful:
Swim has never been on methadone, and never done heroin.
The first time Swim started taking suboxone, swim was using 40mg of oxy IV daily. swim was on suboxone for 5 months, then relapsed.
the second time swim started taking suboxone again, swim was using 50 - 100mgs of morphine IV daily. swim was on suboxone for 3 months, then relapsed.
the third time swim started taking suboxone, swim was using 100 - 300mgs morphine daily IV.
swim has now been on suboxone without using ANY other opiates for 5 months as of today.

swim is leary of snorting the subs.. however, swim has IV'd the subs before. surprisingly, the naloxone included in the preparation did NOT send swim into wd's as is stated in all of the patient literature. swim experienced the normal effects of the suboxone, except the half-life was a little shorter. another fun fact is that even though she injected the subs, she could still taste the lemony flavour immediately after injecting! swim hasn't shot the subs for 3 months, after her veins began to close.

swim's doctor has given her clonidine in the mean time to help with the wd's from the subs that she is still experiencing daily. she finds that the clonidine doesn't help much at all.

swim is seeing her doctor in 2 weeks, wondering what will come of this.
still feeling like shit every day, twice a day, like clockwork. swim can't wait until this ordeal is over.

any more suggestions? swim will try ANYTHING!!! swim is seriously considering ceasing the medication and tapering herself with morphine IV. this could cost a lot of money that swim doesn't have, and swim would like to avoid this if at all possible. swim is also considering trying to find a doctor in her town that might know a thing or two about addiction treatment and subs, instead of having to wait another 2 weeks and drive an hour away. swim lives in a major city, so this should be possible.

please help a girl out.

thank swiy all so much for your suggestions thus far! keep em coming!

also... swim has checked out several of the most popular websites/blogs about suboxone use and has found dick-all.

[dyingtomorrow]

Originally Posted by nick23

With subs less is definitely more and 8mgs is a large dose,taking more shouldn't be required.

However Subs are also very subjective.So,all I can suggest is maybe try snorting your dose.

Snorting increases the effectiveness by a huge percentage - this can be an option.

[Spucky]

Originally Posted by dyingtomorrow

Snorting increases the effectiveness by a huge percentage - this can be an option.

But it will be very uneasy to stop the snorting.
Much Smarter it will be to speak with the Medic,
to check up the plasma-level and maybe to increase the dose!

My Cat (Schroedinger) told me also in reallity snorting is a kind of waste,
to much stuff will flood away from good spots of absorbation.
It really depend on the Technic, but trust her: to absorb 8mg. Bupre.
via your nose you need more stuff than one pill and one pill is already a
lot of stuff because of all the fillings!

sublingual bioavailbility is ca, 30%
snorting bioavailbility is ca. 75%

can someone check the weight of one pill please?

[dyingtomorrow]

Originally Posted by Spucky

But it will be very uneasy to stop the snorting.
Much Smarter it will be to speak with the Medic,
to check up the plasma-level and maybe to increase the dose!

My Cat (Schroedinger) told me also in reallity snorting is a kind of waste,
to much stuff will flood away from good spots of absorbation.
It really depend on the Technic, but trust her: to absorb 8mg. Bupre.
via your nose you need more stuff than one pill and one pill is already a
lot of stuff because of all the fillings!

sublingual bioavailbility is ca, 30%
snorting bioavailbility is ca. 75%

can someone check the weight of one pill please?

That's not true ... suboxone is easy as fuck to come off of compared to other opiates. It's a disgusting feeling drug and SWIM can't see how anyone would want to be on it for long; especially not if they had been on IV heroin.