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Day 2 Subutex Reduction
Hi friends
I am here in the UK and on a subutex script.
For 8 yrs. I was on massive amounts of dihyrocodeine - I guess a mixture of hydro and vicodin - powerful stuff. I had built up to about 40 x 30mg a day and it was killing me. Originally started taking it for pain for an old spinal injury and stuck to the 8 per day. But with all addicts we tend to have heavy baggage and kid ourselves we are taking it for pain but really we are taking it to block of all the bad stuff that has happened to us in our lives that we cannot deal with, or can no longer cope with. We like the euphoria, the energy and being able to block things off. So we end up addicts.
Beg. of Nov. started on 6mg of subutex. First 6 weeks no withdrawals and just felt normal but emotionally nothing.
Started taking vitamins and minerals, good diet and building up a good exercise regime which for me was walking - now 40-50mins. per day. Stopped taking valium at night. Then first 6 weeks of year felt fantastic! Was reducing at 0.4mg per week. 'Natural energy', or so I thought, tremendous peace of mind and a zest for life I had not felt in years. I thought I was winning all round - the addiction and all my demons. Night meant pain at night and sleeping on and off all through the night and temp. swinging up and down. But okay. Head was clear and I looked a million times better. Sussed!
Down to 3.6mg and breakthrough pain started so I was told to stay on the 3.6mg and that was 9 weeks ago then the depression started. And boy oh boy it has been a roller coaster of horrors. With subutex, people talk of the 'honeymoon period' of feeling great, and then falling down. Fall I did. Anxiety attacks, pessimism about the future, no hope, severe anger about the whole of my life, bitterness, hatred, real extremes - the demons truly came to visit, and real, deep, profound unhappiness. Depression personified. The odd days bearable inbetween. Started researching subutex and found this could happen to people who had mental health problems, had not had such a great deal in life through things happening to them such as traumatic car crashes changing their lives and **** childhoods(!), and history of depression. Had not chosen methadone to get of the pills as knew I did not have the discipline not to abuse it. So ... what to do?
The shorter time you are on subutex apparently, the easier the withdrawal at the end, and the less likelihood of PAWS from what I can gather. I just want off it. Have had 3 days of feeling okay mentally and want to be rid of it. The dihydro should be gone and now this stuff, yet another addictive chemical needs to **** off too!
Docs need to tell you about the negative sides of the drugs that help you come off your DOC when they prescribe them. Had I known what was in store ..... I would never have stopped reducing back in Feb. Have wasted 2 months letting the subutex get more of a hold.
Day 2 - am down to 3.2mg. Need to take into account the half life, storage of subutex in body fat people talk about. If I feel stable after 5 days I will drop another 0.4 mg. Get the tablets in 2mg and 0.4mg.
Prior to starting, I began taking vitamins and minerals and making sure I was on a good diet, which I had let slip during the bad depression, which is when you just don't care. Had kept up the exercise because my dog needed to still get out and she has helped me a lot. Taking her to the fields and woods has helped me think a lot of stuff out. When I don't want to go, I force myself to. Seeing her enjoyment as she hunts and plays brings me pleasure when nothing else does.
Would be happy to hear from others - good stories and bad, and those that want to take the same journey. I will always reply.
Take care all
- F
I am here in the UK and on a subutex script.
For 8 yrs. I was on massive amounts of dihyrocodeine - I guess a mixture of hydro and vicodin - powerful stuff. I had built up to about 40 x 30mg a day and it was killing me. Originally started taking it for pain for an old spinal injury and stuck to the 8 per day. But with all addicts we tend to have heavy baggage and kid ourselves we are taking it for pain but really we are taking it to block of all the bad stuff that has happened to us in our lives that we cannot deal with, or can no longer cope with. We like the euphoria, the energy and being able to block things off. So we end up addicts.
Beg. of Nov. started on 6mg of subutex. First 6 weeks no withdrawals and just felt normal but emotionally nothing.
Started taking vitamins and minerals, good diet and building up a good exercise regime which for me was walking - now 40-50mins. per day. Stopped taking valium at night. Then first 6 weeks of year felt fantastic! Was reducing at 0.4mg per week. 'Natural energy', or so I thought, tremendous peace of mind and a zest for life I had not felt in years. I thought I was winning all round - the addiction and all my demons. Night meant pain at night and sleeping on and off all through the night and temp. swinging up and down. But okay. Head was clear and I looked a million times better. Sussed!
Down to 3.6mg and breakthrough pain started so I was told to stay on the 3.6mg and that was 9 weeks ago then the depression started. And boy oh boy it has been a roller coaster of horrors. With subutex, people talk of the 'honeymoon period' of feeling great, and then falling down. Fall I did. Anxiety attacks, pessimism about the future, no hope, severe anger about the whole of my life, bitterness, hatred, real extremes - the demons truly came to visit, and real, deep, profound unhappiness. Depression personified. The odd days bearable inbetween. Started researching subutex and found this could happen to people who had mental health problems, had not had such a great deal in life through things happening to them such as traumatic car crashes changing their lives and **** childhoods(!), and history of depression. Had not chosen methadone to get of the pills as knew I did not have the discipline not to abuse it. So ... what to do?
The shorter time you are on subutex apparently, the easier the withdrawal at the end, and the less likelihood of PAWS from what I can gather. I just want off it. Have had 3 days of feeling okay mentally and want to be rid of it. The dihydro should be gone and now this stuff, yet another addictive chemical needs to **** off too!
Docs need to tell you about the negative sides of the drugs that help you come off your DOC when they prescribe them. Had I known what was in store ..... I would never have stopped reducing back in Feb. Have wasted 2 months letting the subutex get more of a hold.
Day 2 - am down to 3.2mg. Need to take into account the half life, storage of subutex in body fat people talk about. If I feel stable after 5 days I will drop another 0.4 mg. Get the tablets in 2mg and 0.4mg.
Prior to starting, I began taking vitamins and minerals and making sure I was on a good diet, which I had let slip during the bad depression, which is when you just don't care. Had kept up the exercise because my dog needed to still get out and she has helped me a lot. Taking her to the fields and woods has helped me think a lot of stuff out. When I don't want to go, I force myself to. Seeing her enjoyment as she hunts and plays brings me pleasure when nothing else does.
Would be happy to hear from others - good stories and bad, and those that want to take the same journey. I will always reply.
Take care all
- F
Best Answer
Try to give yourself a break. I have found that most addicts are really great people, so awesome in fact, they beat themselves up for not being perfect. The problems in the world and life seem to touch the addict in a personal way. You will have the rest of your life to make up lost time, you will have time to be the person you intend to be. I found that I am becoming a better person and living a better life than I thought I was capable of. Stay focused on recovery, all the rest will fall into place. Great work so far. Time heals all things.
Do you now what Weaver, it's a coincidence that you have addressed this issue - as I have been thinking along these lines too! My pain has markedly DECREASED since I overdid and was laid up a couple of weeks ago, yet carried on reducing.
After seeing my outreach worker today, it seems switching to bu trans patches from subs is 'complicated' and have to see a specialist drugs doc again to make the switch. That's in anor 3 weeks.
Meanwhile, i will just carry on reducing the subs. In a couple of days it will be 1.4mg. Steady as she goes. I DO want to be opiate free and look at the pain picture again. My whole outlook on natural therapy, steady exercise, limiting life (okay a pain in the arse but nothing I can do about) is better than being filled up with chemicals 24/7. And, mind over matter - that all powerful tool that can be utilised to certain degrees, but can be used.
Thank you for making me think. It helps everyone gain valuable insight too, and think of things that seem 'impossible'!
All the best
- Fee
After seeing my outreach worker today, it seems switching to bu trans patches from subs is 'complicated' and have to see a specialist drugs doc again to make the switch. That's in anor 3 weeks.
Meanwhile, i will just carry on reducing the subs. In a couple of days it will be 1.4mg. Steady as she goes. I DO want to be opiate free and look at the pain picture again. My whole outlook on natural therapy, steady exercise, limiting life (okay a pain in the arse but nothing I can do about) is better than being filled up with chemicals 24/7. And, mind over matter - that all powerful tool that can be utilised to certain degrees, but can be used.
Thank you for making me think. It helps everyone gain valuable insight too, and think of things that seem 'impossible'!
All the best
- Fee
It seems like you are equipped with a lot of the knowledge you need to succeed. You have the right attitude as well. Now, you are tapering and trying to make plans to deal with the pain that remains. I don't understand how the doc thinks that a smaller dose of sub, the patch, is going to work better. If you weren't an opiate addict, I think it would work fine, I just don't see the logic in tapering down to 20mcgs and staying there. I just want you to consider rebound pain. The pain that is caused by a reduction or termination of opiate use. I usually suggest getting back to a base YOU, before going to the next treatment. My pain is far less, without opiates, even when I was on them. I think it has to do with being more aware of my body and when it's time to rest. I also feel the tension building and go to the chiro or do the stretches and exercises that help. Sometimes I need an OTC med, but rarely. Dealing with pain in clarity is much easier. I've had back pain since I was 11, so I've tried lots of things. I've yet to meet a person who says, "I found the perfect med and have had no pain for many years." Anyway, something to think about. If nothing else, the bupe will work better, after getting all the opiates out of your system. Oh yeah, all the nutrients, made a huge difference for me, in symptoms and healing. You're doing great.
Hi nursegirl
I was very interested (again!) in your detailed and helpful information - thank you!
Subs took away all of my desire to take my opiate DOC but then I was 100% ready to stop! I had hit rock bottom. So yes, psychologically that had a great deal to do with it naturally and I would not have dared to try. Also, I had tried to taper etc. etc. been forced to do CT and was absolutely terrified of the WDs (with an spinal cord injury (equina cauda syndrome with some damage to lower legs and feet, but ambulant, you can imagine certain things that were from pleasant too!)
Totally agree you do not take subs just to stop WDs! You take them to stop your habit and stop full stop! You have made a very important point there.
Personally, I chose to only drop 0.4mg this past 7 days when I got to the 2mg mark, to stabilize as the WDs, albeit moderate had started occurring 2 weeks ago. In a couple of days, another 0.2mg drop and so on. My 'outreach worker' advised 0.4mg every 2 weeks but i have beat the target of 1.6mg in 4 weeks and made a 2mg reduction. When setting the 'target', which I don't think she thought I could do(!) as we do not have a rapport, at no time did I receive advice on preparing for the reduction which I think is all important i.e. the vits, minerals, and amino acid protocol, which I found on here. That helped enormously to send WDs from moderate to min. and got rid of the awful depression.
I DO believe in the 'honeymoon period' followed by severe depression with subs for a significant number of people, purely down to the lack of information they are given about possible side effects. I have heard it from too many people now (on anor Forum too). It is not something my worker recognises and only the good medics and nurses such as yourself are fully educated about the power of this drug and the correct way to reduce etc. Some individuals are more vulnerable e.g. those prone to depression/have long history of addiction with a lot of baggage from the past. Subs give such a clarity of thought, and when someone has been in a long, long opiate haze, blocking stuff off it suddenly hits you all at once after the 'honeymoon period' is over. And you can crash badly.
Exercise all you can! (I can't run but I walk as far as I can and I built up my back muscles and forced myself mind over matter, pain be damned as far as I could from the beg. 6 months ago. My dog helped!) and drink at least 1L of water on top of other drinks like fruit drinks, tea. I love proper ground coffee but coffee dihydrates so people need to be aware of that even though it is still a liquid! .
And I cannot stress enough about being prepared with the right vits, minerals, looking at the amino acid protocol on here. L-Tyrosine has been wonderful! Will move on to 5HTP in the future too.
It is a gradual and slow process if you are aiming for success. I think if someone feels so darn awful, they can possibly relapse back to their DOC - and I know of this happening to some because they mentally and physically just cannot take it.
I wish you were attached to the clinic I went to! Your knowledge is invaluable and you are not only of great help to me - but to other people to reading this thread.
All the very best to you No. 1 nursegirl!
- Fee x
I was very interested (again!) in your detailed and helpful information - thank you!
Subs took away all of my desire to take my opiate DOC but then I was 100% ready to stop! I had hit rock bottom. So yes, psychologically that had a great deal to do with it naturally and I would not have dared to try. Also, I had tried to taper etc. etc. been forced to do CT and was absolutely terrified of the WDs (with an spinal cord injury (equina cauda syndrome with some damage to lower legs and feet, but ambulant, you can imagine certain things that were from pleasant too!)
Totally agree you do not take subs just to stop WDs! You take them to stop your habit and stop full stop! You have made a very important point there.
Personally, I chose to only drop 0.4mg this past 7 days when I got to the 2mg mark, to stabilize as the WDs, albeit moderate had started occurring 2 weeks ago. In a couple of days, another 0.2mg drop and so on. My 'outreach worker' advised 0.4mg every 2 weeks but i have beat the target of 1.6mg in 4 weeks and made a 2mg reduction. When setting the 'target', which I don't think she thought I could do(!) as we do not have a rapport, at no time did I receive advice on preparing for the reduction which I think is all important i.e. the vits, minerals, and amino acid protocol, which I found on here. That helped enormously to send WDs from moderate to min. and got rid of the awful depression.
I DO believe in the 'honeymoon period' followed by severe depression with subs for a significant number of people, purely down to the lack of information they are given about possible side effects. I have heard it from too many people now (on anor Forum too). It is not something my worker recognises and only the good medics and nurses such as yourself are fully educated about the power of this drug and the correct way to reduce etc. Some individuals are more vulnerable e.g. those prone to depression/have long history of addiction with a lot of baggage from the past. Subs give such a clarity of thought, and when someone has been in a long, long opiate haze, blocking stuff off it suddenly hits you all at once after the 'honeymoon period' is over. And you can crash badly.
Exercise all you can! (I can't run but I walk as far as I can and I built up my back muscles and forced myself mind over matter, pain be damned as far as I could from the beg. 6 months ago. My dog helped!) and drink at least 1L of water on top of other drinks like fruit drinks, tea. I love proper ground coffee but coffee dihydrates so people need to be aware of that even though it is still a liquid! .
And I cannot stress enough about being prepared with the right vits, minerals, looking at the amino acid protocol on here. L-Tyrosine has been wonderful! Will move on to 5HTP in the future too.
It is a gradual and slow process if you are aiming for success. I think if someone feels so darn awful, they can possibly relapse back to their DOC - and I know of this happening to some because they mentally and physically just cannot take it.
I wish you were attached to the clinic I went to! Your knowledge is invaluable and you are not only of great help to me - but to other people to reading this thread.
All the very best to you No. 1 nursegirl!
- Fee x
Hi there! Sounds like you have a good plan in place.
A few things I wanted to address, just for clarification purposes...Sub is actually not a full agonist, it is a partial agonist opiate. That's the main reason people are mostly unable to get high on other opiates while on sub, it has to deal with the way sub fills the opiate receptors. When a person has been stabilized on sub, their receptors would be filled to a high precentage, up to about 95%, which basically doesn't leave room for anything else. When a person tries to take another opiate while on sub, they won't feel the high from that med because there isn't enough room left for that opiate to hit the receptors in the same way it would to cause a high (without the sub). That's actually the way sub blocks other opiates. many people thinks it's the opiate blocker nalaxone, but that only has a very small effect on the blocking of other meds. It acts more as a psychological deterrant more than anything.
Also, unfortunately, sub absoutely can be abused, people do it all of the time. Not with the same level of frequency as full agonist opiates are abused, but it does happen.
I would never recommend methadone as a way to detox off codeine. I think even Suboxone most of the time would not be the most optimal choice to recovery from codeine addiction, but that's an indivdual decision everyone has to make for themselves. If a person is looking into any replacment med treatment (sub/meth) as just a way to get around w/ds...then it's the wrong decision. There IS no way to completely avoid w/ds (as you know). Whether it's w/d'ing off the initial DOC, or the Sub, it's something the addict has to face at some point. It's extremely rare for someone to experience no w/ds.
Also, there is a common misperception that the longer someone in on subs, the longer and tougher their w/d will be. That's typically not true, once the body has adjusted to the subs, w/d will be inevitable in some respect. Psychologically it can be harder if a person was on subs for many years, but the physical w/d part shouldn't be extended, not by any significant amount of time. The reason there are so many horror storues coming off subs is because a lot of times, the taper process is not done correctly. It's taken too fast, with little to no stabilization period, and people try to jump off from too a high a dose at the end. Many people think it's reasonable to jump off from say 2mg of sub. SOUNDS like a low dose, but in the world of sub, it isn't that low. The doc I worked with recommended that patients taper down to at LEAST 0.5mg/day before making that final jump. Those people did better, although even at that low dose, most of them still had to contend with some level of w/ds.
One of the biggest benefits of sub therapy is to allow a chronic relapser to get some "clean time" under their belt, alowing them to be fully functional while working their recovery, while building their self esteem. That of course is the most important part...working on education onseself on what brought them to addiction, what their triggers are, what will place them at risk for relapse, and how to handle it if they recognize that they are in early stages of relapse. Without the aftercare factor, they are no better off then when they started.
Glad to hear that you're educating yourself, that is so important. Just be cautious, as there is a lot of bad info out there about subs. A LOT of misinformation.....some of that comes from the very clinicians who are managing sub programs.
Good luck...keep on trucking! :0) We'll be here, cheering you on!
A few things I wanted to address, just for clarification purposes...Sub is actually not a full agonist, it is a partial agonist opiate. That's the main reason people are mostly unable to get high on other opiates while on sub, it has to deal with the way sub fills the opiate receptors. When a person has been stabilized on sub, their receptors would be filled to a high precentage, up to about 95%, which basically doesn't leave room for anything else. When a person tries to take another opiate while on sub, they won't feel the high from that med because there isn't enough room left for that opiate to hit the receptors in the same way it would to cause a high (without the sub). That's actually the way sub blocks other opiates. many people thinks it's the opiate blocker nalaxone, but that only has a very small effect on the blocking of other meds. It acts more as a psychological deterrant more than anything.
Also, unfortunately, sub absoutely can be abused, people do it all of the time. Not with the same level of frequency as full agonist opiates are abused, but it does happen.
I would never recommend methadone as a way to detox off codeine. I think even Suboxone most of the time would not be the most optimal choice to recovery from codeine addiction, but that's an indivdual decision everyone has to make for themselves. If a person is looking into any replacment med treatment (sub/meth) as just a way to get around w/ds...then it's the wrong decision. There IS no way to completely avoid w/ds (as you know). Whether it's w/d'ing off the initial DOC, or the Sub, it's something the addict has to face at some point. It's extremely rare for someone to experience no w/ds.
Also, there is a common misperception that the longer someone in on subs, the longer and tougher their w/d will be. That's typically not true, once the body has adjusted to the subs, w/d will be inevitable in some respect. Psychologically it can be harder if a person was on subs for many years, but the physical w/d part shouldn't be extended, not by any significant amount of time. The reason there are so many horror storues coming off subs is because a lot of times, the taper process is not done correctly. It's taken too fast, with little to no stabilization period, and people try to jump off from too a high a dose at the end. Many people think it's reasonable to jump off from say 2mg of sub. SOUNDS like a low dose, but in the world of sub, it isn't that low. The doc I worked with recommended that patients taper down to at LEAST 0.5mg/day before making that final jump. Those people did better, although even at that low dose, most of them still had to contend with some level of w/ds.
One of the biggest benefits of sub therapy is to allow a chronic relapser to get some "clean time" under their belt, alowing them to be fully functional while working their recovery, while building their self esteem. That of course is the most important part...working on education onseself on what brought them to addiction, what their triggers are, what will place them at risk for relapse, and how to handle it if they recognize that they are in early stages of relapse. Without the aftercare factor, they are no better off then when they started.
Glad to hear that you're educating yourself, that is so important. Just be cautious, as there is a lot of bad info out there about subs. A LOT of misinformation.....some of that comes from the very clinicians who are managing sub programs.
Good luck...keep on trucking! :0) We'll be here, cheering you on!
Oh yeah i am thrilled she disnt have to go through any wds! And iam healing well, and i couldnt ask for a better baby! She is so content and the sweetest thing! She sleeps very good! She only wakes up 2 times during the night and the only time she cries is if shes hungry or has gas, i mean she is just perfect! And she has been smiling since we left the hospital! She smiles all the time, it just melts my heart! Thank you again for all the support! :) <3
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