I realize that your question is directed toward withdrawal; I will get to that, but first I want to say something about addiction in general...
Opiate addiction is a very tough problem to deal with; there are no simple cures-- in fact, there is no cure at all. Once the addiction is established, the brain pathways that are involved become 'learned' like any other information is learned; you can't just 'recover' any more than you can forget how to ride a bike!
For reasons that escape me, there are angry people out there who resent Suboxone; the medication can be abused, but as you know from your own experience, it is entirely different from other opiates as far as the effects that it has. Most people who become addicted to opiates know too well the endless cycle of using, stopping, getting sick, and then using again... I consider Suboxone to be an excellent treatment option for many people. We treat other illnesses-- and we no longer talk about the 'disease theory' of addiction-- the people who work with addiction day after day in treatment centers, or who design policies to deal with addiction, or who study the brain activity fo addicts... everyone who KNOWS addiction knows that it is a disease. Yes, it is affected by behavior-- almost every disease is affected by behavior. Some people with diabetes can get off medication by dieting. Some people with heart disease can avoid medication by exercising. Some people with opiate dependence can stay off medication by going to meetings. But for all of those diseases, medication is sometimes-- often-- required.
Sorry to go on a bit-- I was harassed a bit by the 'anti-Suboxone' crowd last night, and I am still a bit irritated.
If you did decide to go back to Suboxone, keep the decision between you and your doctor. One funny thing about addiction-- everyone who has ever quit anything fancies himself/herself an 'expert' on the subject, and suddenly has the cure for everyone else. It would be like a cancer survivor yelling at other patients to 'stop chemo, because it is killing you!' Your health is YOUR business.
Most people who become addicts have other things going on in their lives that drag them down-- depression, histories of abuse, anxiety disorders, ADD... they also can have personality issues that make life a constant struggle. The result is that when a person stops an addictive substance, life often doesn't work-- not until they make other changes. The twelve-step community has much to offer anyone with a history of addictions, and an active recovery program (meaning, just go to a bunch of meetings!) tends to make many things better, including a person's mood and energy level.
OK-- now for the simple 'neurochemical' part: When a person stops any substance that has withdrawal-- including the buprenorphine in Suboxone-- intermittent use will greatly prolong the withdrawal. So in your case, you will continue to experience withdrawal from the Suboxone as long as you continue to take the short-acting opiates. I have seen some pretty silly recommendations out there, suggesting that people take a short-acting (or long-acting!) opiate to deal with 'Suboxone withdrawal'. In reality, Suboxone is now used by many major sobriety-based treatment centers as an agent to 'step down' from pure opiate agonists. The withdrawal from Suboxone, despite what some people say, is much less severe than the withdrawal from other opiates-- we know that from using buprenorphine for over 30 years!
At this point, though, you are right back in the mess you probably left when you started Suboxone-- I'm not sure which agonist you are spelling, but 150 mg of any hydrocodone- related product per day is going to cause a great deal of misery.
My recommendation to you, and to anyone else who is wrapped up in the mess of taking this or that pill to stop taking some other pill-- is to take a good look at yourself and decide: When will this crazy life stop? If you are ready to stop, decide on a treatment plan-- which for opiates means residential treatment, a meeting a day, or Suboxone remission-treatment. Pick one, be grateful for the new life, and stick with it-- and don't let someone else talk you out of it!
I don't know where to start-- so much of what is written is so off-base that there is hardly grounds to engage in much discussion. There are issues to discuss related to Suboxone-- the issues ARE being discussed-- but the discussion here is based in... I don't know what it is based in! I'm sorry folks-- I treat addiction, lecture on addiction-- the issues you are tossing around are simplistic views of things that other people talk about, but your facts are all so mixed up that if you took your argument into a room of people who know the research on addiction you would be looked at like you are from other planets. That is about the nicest way I can say it.
Need guidance, the drug is dihydrocodeine-- with an O. The chemical structure is not the important thing; the potency and dose are. This is such a simple point-- the fact that you don't understand it gets to my problem with you and others trying to argue whether a person should take Suboxone. No, it is not 'overkill', to answer your question. Codeine's activity is because of it's conversion to morphine by G6PD-- codeine is essentially morphine.
As for tramadol, the analgesia is from a combination of mu agonist activity and serotonergic activity. That is the reason I mentioned the potential for the use of a partial agonist at the opiate receptor.
I tried to correct the 'opiate potency chart' in someone's journal-- it didn't take into account the nonlinear kinetics of buprenorphine, and so it was completely incorrect and misleading-- and was being used to make a point-- that was completely off base.
Eagle, you aren't taking into account the differences on addictive behavior, personality effects of addiction, loss of intimacy, etc between agonists and partial antagonists. Again, if you don't know the literature, I don't know where to start with you. To answer-- buprenorphine is more akin to naltrexone than it is to methadone, so your point in comparing the two is simplistic, and again, based on ignorance.
Do any of you know about the ATTC? Do you know about the NIDA/SAMHSA fusion project? If you are going to try to discuss this stuff, at least do SOME homework. I am here to answer questions based on the best evidence that we have-- not based on what I happen to 'think.' I hope other people who post will at least try to do the same.
As far as you all vouching for each other as far as the value of the discussions here, since coming on I was called a 'pusher' by 'worried'; I read a frenzied group of posts about whether I was a 'suboxone doctor'-- at least read my history before all the petty stuff-- then get petty if you must. I read a number of posts in the addiction forum; some of you are having fun, but if you take a look at the visits by people you will notice that many people come, get a barrage of comments, and then disappear. Where do you think they go? Do you even care? Addiction is a fatal illness; some of those people likely die. I have known people who died from their addiction to opiates; I lost a career and almost died myself. I consider it serious business.
Dear Dr. Junig
Wow you do have it rough out here and I admire your persistence, dodging bullets, and being slandered. Coming back to again give your personal and professional opinions. Although I don't necessarily agree with everything you say......You have taken a lot of flack and disrespect from members here, but You still come back, and hope you continue to do so.
Thank you for taking the time, and I hope you continue to do so. Addiction is "serious business" and a very hot topic. There is no question the "pills" are big business and like in every profession, there are always bad apples. Nothing new.
I enjoy reading your posts very much, and again, thank you for your time.
Admittedly my emotional reaction to MedHelp giving Worried878 a ban notice dramatically colored my response to your post. I think calling it ignorance is going a bit far, though. Regards the sub / meth thing - they are both tools that have a time and a place. Preferably prescribed through an office/clinic program and utilized with aftercare. Your position as a Sub Doctor suffers from the previous methadone doctors reputations. Not saying the drugs are the same at all ..... but saying that they affect perception of the treatment .......and that is probably not a good thing. Its too bad that legitimate sub Doc's get lumped together with a bunch of opportunistic greedy doctors. Both exist. My sympathy's on the loss of your friend to methadone overdose. I agree that he probably would have been better off with suboxone. You should at least derive some satisfaction from the fact that your personal efforts have been genuine and that you have made a difference.
I don't believe anyone on the addiction forum is against the Suboxone. Nor have I ever communicated with anyone angry about it. It was actually recommended to me at one point when I was really having a hard time with hydro. I've only met good people with a variety of good information. Since my time on the forum the old timers, the eagle,worried878, cathy etc. have never recommended subs as a rule unless everything else has been tried. Then they are the first ones to recommend it as a tool for recovery if akk ekse doesn't seem to be the answer. All in all they are a great group of people that think it is great tool for recovery when it is warranted. It should not be used for every instance. Re: Suboxone and Tram w/d... I have never heard of that nor can I find it on the web. I would like more information. I also have never gotten the impression the people on this site are know-it-all's just because they are addicts. They actually state the contrary and often say they are only giving their personal experience ans state they are not professional although some are professionals. I believe they can offer insight others cannot having never been addicted. They can tell you first hand what they went through and help you prepare for what you may experience. I will keep you in my prayers!
Also....Dihydracodeine is a synthetic codeine..not Hydrocodone...and twice as strong as regular codeine. Wouldn't Suboxone be overkill?
are you taking codene and sub.?
are you an addcit?
I have posted this twice.
The same content thou.
Why do you think its different lol.
Ive just stopped my sub scrip 7 days ago,t and taking df's to ease the withdrawal symptoms.
I'm not addicted to df's but the sub i'm finding hard to come off of.
lets get real folks.
i've been on (and off) this forum for over a year, and YES, there have been angry reactions to Sub use (maybe not you reading this) but there have been a few ANGRY people, and responses, generally from folks who haven't tried it. which boggles the mind ...
as well, there's been the "know-it-all's" too on this board. i did it myself when i first got on here. YES it happens.
everything the doctor said was spot on. we don't need to take it personal. unless you should, lol...
i for one am really glad to have this info. i just found it and can't wait to read more.
from one who is now weaning completely off and really glad I went this route...
ps - hi to all i haven't talked to in a while!!!!
Ok nice to know nearly everyone answer everyone else but my question.
I have used sub and was successful. No, no one answered your questions as I have seen so many times before. If I can be of any help, I will, but my knowledge is strictly based on my own personal experiences. My first go'round with sub was right after I lost my husband to an overdose. I was addicted to severly high amounts of Oxy Contin. I did NOT use a dr to help me with the sub treatment so I shouldn't classify it as "treatment". I was trying to minimize my w.d and went about it the wrong way. I too was duped into believing that I could by-pass w.d. And after 4 years of addiction and many, many attempts at quitting using everything detox method out there, have realized there is no by-pass to w.d. Anyway, my point, after almost 2 weeks of sub use I stopped because I ran out. And the w.d was bad. Again, I was not under a drs care and didn't follow a taper so I stopped the sub at I think 8mgs a day. I tried to use percocet every now and then to ease the w.d and found that it only prolonged it. If you are using an active opiate you are merely masking the w.d that you will inevitably endure once all opiates are discontinued. The brain can't distinguish which opiates are which. It can distinguish amounts and length of use. My advice, is to stop all opiates and just get through the remainder of w.d that is left. Do you have support at home to stop?
Thank you for answering my question, I find people who come onto threads and ignore the actually question so rude.
Has put me off this site tbh.
I shall not be coming back as have found a site where support is given.
I do thank the few people who have answered my questions, much appreciated but seems people on here just want to argue.
I also got asked why I was posting in old threads .
Excuse me but people do not have the right to say if its ok to post in any threads.
If I find something relevent or have an opinion then I am free to do that.
Thank you for your advice hun, I am now reducing the dhc as find it impossible to cope without them .
Hopefuly it won't be so bad once I cut right down.
I wish you all the best hun xx