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Starting Subs Tomorrow!
Ok, this is the first time I'm trying to get off Oxycodone. I've been on them since 2007, for back surgery and of course I got addicted! Ive taken between 8 and 15, 30 mgs a day, sometimes alot less due to finances.
Over the last few years I've told myself, ENOUGH! But of course that didnt work because I was doing it "cold turkey".
Well, I finally found a doctor that is going to help me using subs and counseling. I have an appointment at 6 tonight and Im getting very anxious! I have so many questions, and did alot of research online for the answers but the one question that Im not getting answered is, What are the withdrawls like when first starting out? How long do they last? So, if anyone can help answering those questions, I'd really appreciate it!
Thanks for listening!
Over the last few years I've told myself, ENOUGH! But of course that didnt work because I was doing it "cold turkey".
Well, I finally found a doctor that is going to help me using subs and counseling. I have an appointment at 6 tonight and Im getting very anxious! I have so many questions, and did alot of research online for the answers but the one question that Im not getting answered is, What are the withdrawls like when first starting out? How long do they last? So, if anyone can help answering those questions, I'd really appreciate it!
Thanks for listening!
I also just wanted to add that subs are a very long drawn out process to get energy back.
Not for everybody, some people take tyrosine which in the end i stopped taking because it didnt help me with energy. But others praise it.
My doctor told me i would get my energy back and return to normal at 3-4 months clean after detoxing subs.
Not for everybody, some people take tyrosine which in the end i stopped taking because it didnt help me with energy. But others praise it.
My doctor told me i would get my energy back and return to normal at 3-4 months clean after detoxing subs.
Hi, my story differs from every other comment on your post !!! ( with the exception of the advise nurse girl has given you )
I was on long-term Subutex maintanance because i could not quit heroin.
I did it correctly and under my doctors supervision. ( Next Step Drug and Alcohol Program )
I didnt have my own subs given to me, they were dispensed daily at my local pharmacy with them giving me my daily dose supervised.
We are recommended to use subs long-term for the benefit they were intended for.
By using them long-term ( 1 year-2 years ) it gives an addict the chance to see what life can be like when we are not using our drug of choice. I went about my daily routine and had a very clear head. I functioned as if i was normal everyday.
In my opinion and what is written in my subutex/soboxone info book given to me by my sub program, it is said if you are only on subs for a week, then you will not reak the benefit that sub was intended for and chances for relapsing your drug of choice is almost inevitable.
I slept 8 hours a night on subs, i had energy every single day.
When i decided to taper i did it in 5 months and jumped. The taper itself was hard because i tapered from 32mg. But i didnt start feeling uncomfortable until i got down to 4mg. I kept going and jumped at .08mg.
I had clonidine and valium from my sub program doctor for 10 days to detox. I took them respectfully and indured pretty much no withdrawals. I slept 8-10 hours a night on my detox with sleep undisturbed.
I took effexor 3 weeks before jumping to help in case there was depression or anxiety heading my way due to withdrawal symptoms. I experienced no depression and anxiety or sadness on my detox.
Now im heading to 120 days clean from subutex and 26 months with no heroin.
I have days with much energy and days with no energy and absolute exhaustion.
But my head is clear, no anxiety or depression and im getting energy back slowly.
I am not a horror story for you !!!
I did my program under constant supervision and did everything without taking short cuts so i succeeded and dont regret taking subs. I also had a great program and listened to what i was soposed to do.
The support network was fantastic with my doctor and i give him much credit for my success.
Yes, we are all different and react differently. I would only recommend subs if all other avenues have been tried and failed and your a long term drug abuser with no success quitting on your own.
I understand we do the program differently in Australia to how the u.s. and surrounding area does it. i.e. we dont take a bottle of subs home with us, we dose at the pharmacy everyday and the ladies watch us dose and make sure the subs have dissolved before we can leave. And our doctors recommend being on subs long-term so a relapse is slim. If we miss appointments and have a dirty urine test, we are automatically discharged.
We also only pay $4.00 Aus dollar, a day for our dose so its next to nothing and our sub program is free so this is what i mean about countries doing it diffetently.
I wish you the best of luck in your recovery, take care : )
I was on long-term Subutex maintanance because i could not quit heroin.
I did it correctly and under my doctors supervision. ( Next Step Drug and Alcohol Program )
I didnt have my own subs given to me, they were dispensed daily at my local pharmacy with them giving me my daily dose supervised.
We are recommended to use subs long-term for the benefit they were intended for.
By using them long-term ( 1 year-2 years ) it gives an addict the chance to see what life can be like when we are not using our drug of choice. I went about my daily routine and had a very clear head. I functioned as if i was normal everyday.
In my opinion and what is written in my subutex/soboxone info book given to me by my sub program, it is said if you are only on subs for a week, then you will not reak the benefit that sub was intended for and chances for relapsing your drug of choice is almost inevitable.
I slept 8 hours a night on subs, i had energy every single day.
When i decided to taper i did it in 5 months and jumped. The taper itself was hard because i tapered from 32mg. But i didnt start feeling uncomfortable until i got down to 4mg. I kept going and jumped at .08mg.
I had clonidine and valium from my sub program doctor for 10 days to detox. I took them respectfully and indured pretty much no withdrawals. I slept 8-10 hours a night on my detox with sleep undisturbed.
I took effexor 3 weeks before jumping to help in case there was depression or anxiety heading my way due to withdrawal symptoms. I experienced no depression and anxiety or sadness on my detox.
Now im heading to 120 days clean from subutex and 26 months with no heroin.
I have days with much energy and days with no energy and absolute exhaustion.
But my head is clear, no anxiety or depression and im getting energy back slowly.
I am not a horror story for you !!!
I did my program under constant supervision and did everything without taking short cuts so i succeeded and dont regret taking subs. I also had a great program and listened to what i was soposed to do.
The support network was fantastic with my doctor and i give him much credit for my success.
Yes, we are all different and react differently. I would only recommend subs if all other avenues have been tried and failed and your a long term drug abuser with no success quitting on your own.
I understand we do the program differently in Australia to how the u.s. and surrounding area does it. i.e. we dont take a bottle of subs home with us, we dose at the pharmacy everyday and the ladies watch us dose and make sure the subs have dissolved before we can leave. And our doctors recommend being on subs long-term so a relapse is slim. If we miss appointments and have a dirty urine test, we are automatically discharged.
We also only pay $4.00 Aus dollar, a day for our dose so its next to nothing and our sub program is free so this is what i mean about countries doing it diffetently.
I wish you the best of luck in your recovery, take care : )
To answer your questions on what to expect. The RIGHT way to start a suboxone program is as follows:
First, there should be an info gathering portion, where you will either fill out forms, or tell the nurse/doctor about everything from your medical history, to any medications you're taking, and of course, detailed info about what opiate you're trying to get off, how long you've been taking it, what dose, and how much you're taking daily. They will also ask you about any legal issues, and other social history questions (married, home life situation, employment, etc...typical demographic info). You should be asked to consent to a urine tox screen (and a good sub clinic will require those at every visit, or close to every visit moving forward).
Then, the doctor should do a thorough examination, which should include your vital signs and an assessment of where your current w/ds fall on the COWS scale. That's an assessment tool used to determine if you're experiencing significant enough w/ds to start the sub. It's VERY important to note that if you're not having at least moderate w/ds, it's too soon to start subs, and there will be a risk for precipitated w/ds, which makes regular w/ds look like a walk in the park. When did you last take the Oxy?
Once the assessment is done, the doc will discuss the program with you, and what's to be expected on both ends (this will probably also be laid out on paper, many will require a signed contract where you're agreeing to abide by their rules). The doc will formulate a reasonable induction dose, which would be your starting point, taking into consideration WHICH medication you were abusing, how much you were taking and for how long, in addition to the severity of your w/d symptoms.
IMO, the best sub docs do the induction right in the office to see how the patient does, to determine if the dose is sufficient. Like the others have said, with sub, less is more, it's a very potent opioid medication, and most people are easily made comfortable on fairly low doses. Your usage is pretty significant, but not off the charts like it could be. The length of time you've been on the Oxy is pretty significant as well. If I read your OP correctly, you've been taking up to 15 30 mg tablets, correct? That's 450mg of Oxy a day, which is pretty significant. That may mean that your induction dose starts out a bit higher, but optimally, the induction dose should be dropped pretty quickly, within 2 weeks of starting the sub. It's at that point, after about 2 weeks, where the adjustment from the full agonist opiate (Oxy) to the partial agonist opiate (buprenorphine) will be mostly complete, and that's when it's reasonable for the doc to try to get you to a more reasonable maintenance dose. That's not the same thing as tapering you off, but it's an adjustment to avoid patients being kept on excessively high doses of sub, and to get you on a more "doable" dose.
During the first week, if your induction dose isn't sky high (please express to the doc that you don't want to be put on a super high dose, anything much over 16mg is just extra dosing with no real benefit, btw, as sub has a ceiling effect), you may experience some VERY VERY mild w/d symptoms. That's normal. It's to be expected, and it wouldn't be anything that isn't tolerable, no worse than a very very mild cold. If you do have symptoms during the initial adjustment, usually OTC meds like Tylenol or Motrin is enough to take care of them...your doc will tell you more.
One of the common misconceptions of sub is that a person should ALWAYS have ZERO w/ds when they start sub. Let me just say this, you will be experiencing moderate w/ds at least when you go in, and after your first dose of sub, the w/ds should be GREATLY reduced, if not completely eliminated, within a mere 20-30 minutes, if not faster. There's still that adjustment period though, so you can expect to feel a little off for the first week (and you may not, it depends). If your sub dose is too high, you'll feel overly drowsy, probably nauseated, "spaced" out, and you may have a headache. You should feel "normal" on the right dose, not high, not experiencing uncomfortable w/ds.
Of course, sub is a very controversial topic, so be prepared to hear all kinds of opinions from both sides of the fence. I've seen many people succeed on sub, and I've also seen many people make a small habit/addiction a much bigger one. Just be sure that you educate yourself and understand that this isn't a miracle cure. Sub CAN be a helpful TOOL in recovery, but if you don't do all of the WORK on your addiction you need to, it doesn't matter if you're on sub or not, you'll be in the same spot down the road, only you'll then have to taper off subs, which isn't easy for a lot of people. A proper taper can make it more manageable, but you have to realize that you're not going to avoid w/ds. You will face them at some point.
A typical sub program is about a year in duration. That gives people time to stabilize, get some "clean time" under their belt and get some normalcy back in their lives while they do the work on their addiction (the most important part). While some people DO do well on a fast tracked sub program (a few weeks), it really isn't optimal, as to get the full benefits of sub and do it the right way, one must allow for adjustment periods and stabilization periods. Also, for someone with a long history of addiction, it's crucial to put some time between their active use and their sobriety. Also, and probably the MOST important, for sub to be properly tapered, it takes a GOOD bit of time, it's not a process that can be rushed. So, unless a person does a sub program that lasts no more than 2-3 weeks, there's no real benefit from rushing the program. I don't recommend that people plan to stay on for years on end, but it's not wrong or unreasonable for a good sub program to last a year or so. Some can complete a program in 6 months, some need longer.
There are pros and cons of subs, and my best advice I could give you is to ASK questions, and learn as much as you can about it. You want a GOOD doctor that's not going to keep you on super high doses indefinitely, one that's going to insist on accountability within the program, which will come in the form of regular drug tests, and required counseling (private and/or group therapy). You also want a sub doc who is going to always be moving you forward, always talking about your next step....encouraging you to try tapering down at a pace that works for you, and one who is supportive of that process, as it's probably the biggest thing people in sub programs are fearful of. A sub doc who allows a patient to remain stuck with no discussions of goals and progress isn't a good one, IMO.
I wish you the very best, please feel free to PM me if you have any further questions or just want to discuss something related to subs off the forum. Keep us updated, okay?
First, there should be an info gathering portion, where you will either fill out forms, or tell the nurse/doctor about everything from your medical history, to any medications you're taking, and of course, detailed info about what opiate you're trying to get off, how long you've been taking it, what dose, and how much you're taking daily. They will also ask you about any legal issues, and other social history questions (married, home life situation, employment, etc...typical demographic info). You should be asked to consent to a urine tox screen (and a good sub clinic will require those at every visit, or close to every visit moving forward).
Then, the doctor should do a thorough examination, which should include your vital signs and an assessment of where your current w/ds fall on the COWS scale. That's an assessment tool used to determine if you're experiencing significant enough w/ds to start the sub. It's VERY important to note that if you're not having at least moderate w/ds, it's too soon to start subs, and there will be a risk for precipitated w/ds, which makes regular w/ds look like a walk in the park. When did you last take the Oxy?
Once the assessment is done, the doc will discuss the program with you, and what's to be expected on both ends (this will probably also be laid out on paper, many will require a signed contract where you're agreeing to abide by their rules). The doc will formulate a reasonable induction dose, which would be your starting point, taking into consideration WHICH medication you were abusing, how much you were taking and for how long, in addition to the severity of your w/d symptoms.
IMO, the best sub docs do the induction right in the office to see how the patient does, to determine if the dose is sufficient. Like the others have said, with sub, less is more, it's a very potent opioid medication, and most people are easily made comfortable on fairly low doses. Your usage is pretty significant, but not off the charts like it could be. The length of time you've been on the Oxy is pretty significant as well. If I read your OP correctly, you've been taking up to 15 30 mg tablets, correct? That's 450mg of Oxy a day, which is pretty significant. That may mean that your induction dose starts out a bit higher, but optimally, the induction dose should be dropped pretty quickly, within 2 weeks of starting the sub. It's at that point, after about 2 weeks, where the adjustment from the full agonist opiate (Oxy) to the partial agonist opiate (buprenorphine) will be mostly complete, and that's when it's reasonable for the doc to try to get you to a more reasonable maintenance dose. That's not the same thing as tapering you off, but it's an adjustment to avoid patients being kept on excessively high doses of sub, and to get you on a more "doable" dose.
During the first week, if your induction dose isn't sky high (please express to the doc that you don't want to be put on a super high dose, anything much over 16mg is just extra dosing with no real benefit, btw, as sub has a ceiling effect), you may experience some VERY VERY mild w/d symptoms. That's normal. It's to be expected, and it wouldn't be anything that isn't tolerable, no worse than a very very mild cold. If you do have symptoms during the initial adjustment, usually OTC meds like Tylenol or Motrin is enough to take care of them...your doc will tell you more.
One of the common misconceptions of sub is that a person should ALWAYS have ZERO w/ds when they start sub. Let me just say this, you will be experiencing moderate w/ds at least when you go in, and after your first dose of sub, the w/ds should be GREATLY reduced, if not completely eliminated, within a mere 20-30 minutes, if not faster. There's still that adjustment period though, so you can expect to feel a little off for the first week (and you may not, it depends). If your sub dose is too high, you'll feel overly drowsy, probably nauseated, "spaced" out, and you may have a headache. You should feel "normal" on the right dose, not high, not experiencing uncomfortable w/ds.
Of course, sub is a very controversial topic, so be prepared to hear all kinds of opinions from both sides of the fence. I've seen many people succeed on sub, and I've also seen many people make a small habit/addiction a much bigger one. Just be sure that you educate yourself and understand that this isn't a miracle cure. Sub CAN be a helpful TOOL in recovery, but if you don't do all of the WORK on your addiction you need to, it doesn't matter if you're on sub or not, you'll be in the same spot down the road, only you'll then have to taper off subs, which isn't easy for a lot of people. A proper taper can make it more manageable, but you have to realize that you're not going to avoid w/ds. You will face them at some point.
A typical sub program is about a year in duration. That gives people time to stabilize, get some "clean time" under their belt and get some normalcy back in their lives while they do the work on their addiction (the most important part). While some people DO do well on a fast tracked sub program (a few weeks), it really isn't optimal, as to get the full benefits of sub and do it the right way, one must allow for adjustment periods and stabilization periods. Also, for someone with a long history of addiction, it's crucial to put some time between their active use and their sobriety. Also, and probably the MOST important, for sub to be properly tapered, it takes a GOOD bit of time, it's not a process that can be rushed. So, unless a person does a sub program that lasts no more than 2-3 weeks, there's no real benefit from rushing the program. I don't recommend that people plan to stay on for years on end, but it's not wrong or unreasonable for a good sub program to last a year or so. Some can complete a program in 6 months, some need longer.
There are pros and cons of subs, and my best advice I could give you is to ASK questions, and learn as much as you can about it. You want a GOOD doctor that's not going to keep you on super high doses indefinitely, one that's going to insist on accountability within the program, which will come in the form of regular drug tests, and required counseling (private and/or group therapy). You also want a sub doc who is going to always be moving you forward, always talking about your next step....encouraging you to try tapering down at a pace that works for you, and one who is supportive of that process, as it's probably the biggest thing people in sub programs are fearful of. A sub doc who allows a patient to remain stuck with no discussions of goals and progress isn't a good one, IMO.
I wish you the very best, please feel free to PM me if you have any further questions or just want to discuss something related to subs off the forum. Keep us updated, okay?
Im not as familiar with subs.. but I agree with the other comments(thats assuming methadone and subs are similar to come off of) About 2 years ago I was addicted to norco so my doctor put me on 50mg methadone daily, for about 6 months. Thats actually a pretty low dose but the withdrawal was something I cant describe and lasted 3weeks to a month, and my energy took even longer to get back. Unfortunately, I got back on norco and Percocet, I'm on day 5 off and I'm already feeling somewhat better. Day 5 off those stronger drugs are when it got really really intense! I was still shaking/sweating, couldn't sleep for weeks. Pure Hell!! Id say go the week or so getting off oxy and skip the subs, but thats just my opinion. Best of luck to you with whatever choice you make!! And congrats on getting sober:)
I would not recommend this route. i was taking about 10 perc 10s a day and after just one sub i realized how it was so much stronger than any amount of percs i did and way longer lasting. i took 1 2 weeks ago and last night threw the rest down the toilet. think long and hard before you take those. im at 2 and half weeks clean and feel great. on those subs it could be months or years to get to where i am now. i say drink water take baths and ride it out after tapering to as little as u can. in 4 days i went from 10 a day to nothing ( now i dont recommend doing that it was terrible) but after 2 weeks im going to the beach again and hanging with sober friends. i didnt want months of anything else. just something to consider. prayers for ya
Be aware that you're going on a much stronger drug than Oxycodone to get off a much weaker drug, and if you think withdrawals have been too tough to deal with coming off Oxycodone, they will be much worse if you get addicted to Suboxone and have to go through withdrawals.
Personally, I think it's a big mistake and am firmly against people going on Suboxone or Methadone to come off things like Hydrocodone, Oxycodone, etc. They rarely ever truly know what they're getting themselves into and end up in a far worse predicament than they would have been coming off their initial addiction in the first place. That's where the Sub horror stories come in the picture.
If you go ahead with your plan to go on Sub to get off the drug you're on now, it should only be for a very brief period to get over the worst of the withdrawals you would have gone though, then stop the Sub and deal with the tail end of Oxycodone withdrawals.
If you stay on Suboxone too long and get addicted, you'll regret it and become just another person with a horror story, one who was forewarned.
Personally, I think it's a big mistake and am firmly against people going on Suboxone or Methadone to come off things like Hydrocodone, Oxycodone, etc. They rarely ever truly know what they're getting themselves into and end up in a far worse predicament than they would have been coming off their initial addiction in the first place. That's where the Sub horror stories come in the picture.
If you go ahead with your plan to go on Sub to get off the drug you're on now, it should only be for a very brief period to get over the worst of the withdrawals you would have gone though, then stop the Sub and deal with the tail end of Oxycodone withdrawals.
If you stay on Suboxone too long and get addicted, you'll regret it and become just another person with a horror story, one who was forewarned.
Okay I have been a user of all kinds of opiates and have had a very high tolerance but for the last almost 7 yrs I've been on suboxone because at first I thought they were a blocker and a mood stabalizer! A week later that's when I did my research and found out it basically is an opiate because it tricks your receptors into thinking its an opiate! Its an opiate antagonist! Please stay on a very low and I mean low dose! Maybe 2mg if u do! Because I was taking 2 -8mg a day or 1mg a day and sometimes or actually most of the time just 4 mgs because u know what I discovered it didn't matter to me how much more I took the 4 mgs kept me able to functiom everyday! It wasn't getting me high nothing! I was glad to be able to function! I believed it was my miracle drug because my daughters father passed away from od using needles and I couldn't turn up like him that wouldn't be anymore fair to my daughter! I'm now his age when he passed and I swore id be off everything by then! I'm now 16 days off suboxones and it is something not so easy at all! You don't sleep for at least 2 weeks if not more! I'm not! Uh you are so weak and run down with absoluteley no energy for some people months a year! Please stick to a very low dose if none at all! They are harder to get off of! So isn't methadone! Only I hear methadone really gets in your bones! I've been to the clinics and have had friends that swear its the devil! But I wish u the best and I hope one day u can be free from this addiction just as I do for myself!
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