[Angela H]

Hey, it's me again!
Okay, don't worry if you don't get a question in before that time because he said he would answer any tomorrow if anyone got their's in late. What I will do is print the ones that didn't get in before 8:30 and take them to him at lunch tomorrow. He will write down the answers and I will post the answers tomorrow. This is kinda cool, huh? The reason he said he would do it is because I was telling him about the horror stories I was reading on that site. He was so shocked that some of them are THAT uniformed. So, take advantage of this if you've got questions.

[LISA GIRL]

Question for the Doctor: NYMOMMY's experience which is detailed on page 146 of this forum has me a bit fearful of starting on the sub program. In your experience, are these common side effects, ie., the nauseau, blurred vision, headache, which will eventually go away or is this the result of too high a dosage prescribed ?Angela said the sub made her sick at first too. If it is a dosage question, would it not be best to start low and take more if needed rather than a higher dosage and finding it is too much? If it is an expected side effect, how long can one expect such symptoms to last?

Also. What is the difference between suboxone and subtex..and there is something called bupr?? (i won't attempt the spelling but I am sure you know what I mean) Are these just different names for the same drug?

I appreciate your help and your time. Very cool of you [8D]to take the time to answer our questions.

[LISA GIRL]

Another ?: Does the suboxone resolve or aid in psychological withdrawal issues as well as physical withdrawal?

Thanks again!

[nymommy]

angela..thats awesome..still not feeling great..i would like to ask him if its possibe it just wont ever agree w/ me, or does it take time for the body to adjust.if so how long do i give it..also ask since i have 5 days off in a row should i just go ct..my family thinks i'm sick and i have 0 pills in the house...thanks soooo much..whats up w/ the email

[Angela H]

Lisa, Hi, I'm Angela's friend...Doc K.

First of all, I want to say that I am not knocking the advice of your physician, only providing my insight. I have been treating patients (30 at a time, because I am not an addictionologst) for 3 1/2 years. I've been able to work with addicts from a small hydrocodone problem all the way to 10 year heroin users. So my experience is very broad spectrumed. Prior to treating with Buprenorphine (the generic name for Subutex), Methadone was the only option we had. It's still an option for extremely hard core opiate addicts (10 year heroin habit), but is extremely difficult to cessate.
Sub (I'll call this drug in all posts) is a very well thought out, planned out, extremely helpful treatment for Opiate addicts.
Subutex is Buprenorphine Hydrocloride .
Suboxen is identical to Subutex, but it has an ingredient called Naloxone (an antagonist) to guard agains misuse (especially snorting).
Lisa, about NYMOMMY, I can't exactly comment on the dosage because we don't know what it is. The tablets come in 2 mg and 8 mg. She said she took two over the course of the office visit. I'm assuming it was 2 2mg. tablets, which would be a total of 4. If I understand correctly, she was taking 5-7 Hydrocodone 10 tablets a day. Depending on how long she had been taking them at that quantity, I would have started her out on 2 mg. 2 hours later, monitor her and if she felf fine and no withdrawals, that would be her starting dose. In my opinion she was given too much. 45 minutes is long enough to see how this medication will affect a patient. I prefer to start patients on a small dose and work up. That way you avoid bad side effects. Why go through them if you don't have to?
The side effects she experienced were from much too high a dose. Angela's starting dose was 4 mg...she was taking 10 pills a day. See the difference? And she still got sick. She's tiny, so that could have been some of it.
Once a stabilized dose is reached, side effects are very minimal in my experience. Some might include dryness of the mouth, constipation and perspiration. I haven't had any report blurred vision.

[nymommy]

i didnt mean to be soo brief, but everyone here thinks i'm sick (as in stomach virus) so typing on the computer wouldnt seem sick...angela i really appreciate what your doing..lucky to have a doc/friend to walk you thru this..soo tempted to tell my hubby...my kids asking me every minute how i feel makes me feel like **** lisa~~~no pills that would take care of physical/ physco needs wouldnt that be great..i will say havent thought of taking a vic..could be cuz i'm sick to my stomach i'll be chking in later oh Angela..ask about the ambien @ nite..again thanks

[Budman]

nymommy how long were you withdrawling? When I started the suboxone I also took it 3 times a day, 4mgs. each.The Dr. weened me off within a month. 2mgs. each time. The Dr. I used has been doing this about 3 yrs. also. Did he or she leave you there cell #?. I had no problem at 1st. He gave me 4mg. 1st and then 20 plus minute later another 4 mg.I was on the **** for 7 plus yrs. I was just exhausted from the withdrawls from the night before. While on the sub. I also slept great. I know everyone is different on this stuff. But I am totally for it My last vic was July 5 3:00 pm, Started sud July 6th 1:30 pm (I was jonesing!) Last sub Aug 6th. I admit there has been some tough days. But there is no way I could have done this without the sub. Beleive me I tried at least 4 times but always went back. This time I have no desires. Angela H I think that is awesome your Dr. is willing to help answer ? nymommy hang in there. Call your Dr. Hang in ther Mommy

[Angela H]

Hi NYMOMMY, Dr. K here.
Ambien CR is probably okay, but I would suggest trying to sleep tonight without it. Your post said you called in sick tomorrow, so if you are having trouble sleeping you could take one after you've been in bed for a while and not falling asleep. Or, preferably try to sleep on your own tonight. If you sleep fine you won't need it, if not, take it tomorrow night.
I'm so sorry you felt so bad. BTW, what dose did you take today?

[LISA GIRL]

On average I take between 5-6 percocet 10s per day during the week.. The weekends are probably 8-12. What do you think is a good starting dose for me.? I am sure the doctor will tell me what to take, but I am now worried about initially taking too much. I will be getting the prescription and starting on my own (not IN the doc's office) so I will have ultimate control. I am also TALL (5'11) and overweight (thanks in part to the percs curtailing my workouts) Will that play in to dosage?


Does the sub really help psychological w/d? You may have already answered that before I get this posted.. If so please disregard. Thanks!

[Angela H]

One more thing, NYMOMMY,
The reason I said try not to take it tonight is because most people do not need a sleep aid while on Sub. Most of my patients say they sleep very well while on this medication.

[Angela H]

Lisa,
From reading your post, I would initially start your dose at 4 mg.

Percocet is Oxycodone,whereas Lortab, Vicodin, Lorcet, norco are hydrocodone. Oxycodone is stronger than Hydrocodone, so that alone in my opinion is enough to start you out a little higher. 4 mg seems to be the majic dose for some reason, for Percocet and Oxycodone addicted patients. If you are in control of your meds, you can monitor it. Take initially what your doctor prescribes (or half of that if you're apprehensive). You can always increase, but once you're up too high, you're there for a while.
Also, from what I'm hearing, some patients are being advised to take 3 times a day. They are misinformed. This drug has a long half life, meaning some patients don't need to dose again for 48 hours.

[LISA GIRL]

Dr K. One more question (it was a high perc night and these things always make me chatty in word or in print) [)] An obvious concern is the w/d from the sub.I don't want to be substituting one w/d for another. (I have done the cold turkey previously.. not fun but not horrific other than inability to sleep and restless legs) If one tapers down from them quickly will there be any w/d symptoms? From my dosage (posted above) how long do you think I am looking at being on the sub treatment?

Thanks again both of you. This was a great idea A.H.!!!

[Angela H]

Lisa,
The thing about Sub treatment is simple...get on it, stablize, and then get off. The maximum time most of mine stay on is 3 months...and that's the maximum. Hydrocodone addicts-usually 6-8 weeks. Oxycodone addicts-8-10, maybe 12 weeks.
Withdrawals from Sub are very minimal if the stay on it is short. They are NOTHING compared to Opiate Pain Pill withdrawal. However, patients that stay on it more than 3 or 4 months will have a harder time coming off, but it's still not as bad as the one we are treating. I would not reccommend anyone staying on it longer than 6 months except for extenuating circumstances.

[nymommy]

dr. k thanks soo much, really amazing you would share your knowledge and time w/ a group of strangers...i'm taking your advice and not taking the ambien...in the doctors office i started w/ one 2mg..and felt good...the doctor was suppose to come check on me, but got busy..so on my own i took the second one..thats when i felt horrible..i waited 6 hrs and took one more..i threw up soon after..i will try tommorrow starting w/ one..wait as long as i can then take another..does that sounds right?? i am also tiny in height and weight..thanks again

[Angela H]

Angela said it was okay to call you Mommy, so
Mommy, my advice to you would be to not take any Sub tomorrow until you feel that you need it. The doses you took today will still be in your system this time tomorrow. I don't think you will even think about wanting one, but if you feel like your jonesing (which I doubt you will be), try taking half of a tablet instead of the whole and see how you feel on that.
On this drug, you should not feel groggy or spacey. If you do, you've probably taken too much. Sub should just make you feel fairly normal, but good. Most report energy like they haven't had in a while and a lifting of depression.

PLEASE REMEMBER:
When taking this drug, less is more. You will find that after a few days on it.

[nymommy]

budman..i was off the vics for 15 hrs..he said i needed to be off @least 12 hrs

[Angela H]

Dr K signing off!
I enjoyed being here. I hope I've been of some help.
If anyone else needs anything, let Angela know tonight or tomorrow, and I'll do the best i can to help.
Good Luck to all of you. As I said, the shorter time on this drug makes for a much smoother transition. That's not saying that if your personal case requires you to be on it longer (some just take longer, but don't beat yourself up over it), stay with it as long as your doctor feels it's okay.
And remember this:
It's much better to be on this a little longer, than to quit too soon and relapse. Be proud of yourselves. You're taking a giant leap in your recovery and this says to me that you are serious and You WILL beat this. Determination and a positive attitude are the best traits and addict can possess!
Good Night y'all.

[Lazer]

Angela, I'm at 13 Darvocets a day, a lot of Tylenol but not a strong opiate. What do you think my course should be. I am really addicted to these things and have been at this high dose for about 10 months. Thanks.

[Angela H]

Lazer~
This is Angela. He left about 10 mins ago.
Because you're on a lower strength opiate (and that's what this treats, not the tylenol), your dose would be fairly low I would think. I will run that by him tomorrow and get back to you.
Even though you're taking a lot of them, you're still not getting THAT much opiate. That's just my opinion and I think he would agree.

[livelife21]

nymommy - how are you? I read your posts back a week or two...Similar postion here. anyway, I am trying as of this evening to STOP taking hydro...5 hours now, but who's counting? haha. I posted a topic under "need to talk." Anyway, I have taken exactly 5/day for the last week or so...and 6/day max for the last year. My only options are to stop on my own, with help of Church and this board, or not stop at all. supply is not an issue for me, I just gotta WANT to quit! i think you should be on the suboxone for a very short period of time...it seems (i could be wrong) that the amount of hydro that you were taking is just a nagging amount, just like mine! Our real battle is going to be WANTING to quit!

[livelife21]

Angela H, Lazer, LisaGirl, I am also following your posts as of about 2 weeks ago? Just responded to nymommy and wanted to also say hello to yall also. now I have my official posts on this topic I dont have to keep skimming back and getting lost, I just need to look for replies since this reply...and just like that, Im in the mix!
God Bless All of you for being here and helping! -pj (male)

[nymommy]

angela/dr thanks again..got a pretty decent nite sleep w/o the ambien..taking dr. k's advice and not taking any sub till really needed..woke up feeling good .actually emptied the dishwasher, got the kids off w/o thinking of pills..that feels real good! have the appt. w/ the shrink today..maybe she can give more insight as well~~~~~~~~~~~~~~livelife(newbie) welcome.it's good when you finally jump in..w/ the small amount your taking sometimes its even harder to let go, but unless your ready, nothing will change...signing on shows your definitly ready for something

[LISA GIRL]

Livelife21..Welcome! As far as the options you listed I vote for #2 but you have to be ready. If you have been reading my posts you know that I have been strugging with the desire to quit issue. But I will quit. I know I need to. My sub appt is next Thursday though I doubt I will start until the next week. If you have never tried to taper (decrease dosage by one per week until done) then you might try that first, but some people can't do that. Whatever you decide, glad to have you here. This is a great board for information and support. There are active users here (like me), some recent quitters(like Mommy,Kaidog and others) and some with a fair amount of clean time (like Angela)..checking in here will def help you get motivated.

NY MOMMY...Interested to see how the therapy goes. My sub doctor is a psychiatrist so who knows.. maybe I'll try that too. Hope you feel better today.

[Kaidog]

DAY #9:

nymommy: I am so jealous that you are able to sleep at night. I don't covet the nausea but a bit of sleep would be nice.

Again the restless legs and not much sleep was problematic last night. Really sucks. I'd kill for a good night's sleep. Other than that, my energy level is returning to normal.

Closing in on two weeks.

[LISA GIRL]

quote:Originally posted by Kaidog

DAY #9:



Again the restless legs and not much sleep was problematic last night. Really sucks. I'd kill for a good night's sleep.

Kaidog... I have read bananas and tonic water (not necessarily together) help with the RLS. Have you tried either? Also AMBIEN is a miracle drug IMO. YOU WILL SLEEP... and no hangover!!!

[Angela H]

Hey everyone~
You guys are awesome. Doc enjoyed doing that last night...made him feel good. He even called this morning to check on Mommy.
Lazer~
I asked him about you and the Darvocet. He said your recovery should be a piece of cake, as the actual opiates in your system are not that much. One interesting thing he said is that the high amounts of Tylenol you're getting is cause for the sweating. Not sure why? Anyway, he said he wouldn't be surprised if you could start on 1 mg or less of Sub.

Kaidog!
Way to go dude! You're my hero. To do this ct takes some serious guts and you've shown such strength through this. One thing I was gonna ask is if you had ever tried Trazadone for sleep? It's an old tricylic anti-depressant that is prescribed for sleep. It's non addicting and is supposed to really help.

Mommy~
Glad you didn't need the Ambien last night...you prob won't. I haven't had any problems sleeping at all...in fact, been sleeping better that I have in a long time. Also, I wouldn't be surprised if you don't need to dose again with Sub until tomorrow. You took 6 mg total yesterday...I would think that would hold you for a while. You also said you had not thougt about taking a pain pill...awesome, isn't it?
Keep us posted...you're doing great. Also, seeing a counselor of some kind is very helpful. I've been seeing a psychologist for over a year and now I'm glad I have.
Hope everyone is well today. Will keep you all in my thoughts.

[Kaidog]

Angela: I've done the cold turkey thing 3X before and its never fun. I know from prior experience though that, after day 3, it gets better with each passing day. I'm somebody's hero??????[:I] Awe, shucks.

livelife: Welcome to the group. I don't think I read if you are a current user or are clean. In either case, it is a helpful forum and it has been theraputic for me to post here, sorta like a diary.

[livelife21]

nymommy, you are GOLDEN! dont look back. you are done with hydro, the sub is going to help you but remember the hardest part is WANTING to stop. for good.

lisa girl, how come you vote for option two (not quitting) ?? it is dificult but not impssible? you are here for a reason....make it your primary goal to do something every day that helps, even if it is only taking 1/2 or a quarter of a pill less! or even if it is just writing a post on here...DO NOT FORGET ABOUT IT. It will creep up on you and 10 years will go by!

kaidog, I am a user of 5 per day. trying to quit. thank you for the reply....I know somebody probably half my size taking 5-6 per day, i'm 6'1 220lbs and these little yellow tictac sized bastards control me!! ??? amazing how fine tuned our brains and bodies are eh? that something so small can make a difference. I mean seriously, I take bites out of a hamburger larger then the amount of hydro that i take in a whole week! geeez these things are powerful, whether we feel high or not anymore!

livelife21, you are doing a good job! keep it up. haha, ok i'm posting to myself. anyway, I got to about hour 17 and took ONE. didnt really do much for me..I want to take a few more at a time, but i'm not going to. I got to resist!

thank you everybody for the posts.

I WANT TO FEEL!!

[nymommy]

[][][] feel much better today..went to the shrink, who i likes immediatley, my sub doctor recommended her..her specialty is drugs and alcohol.didnt take my sub till 10:00, called my doc 1st, he said to take 1/2 and try to sretch that for at least 6hrs...he says we now determined my tolerable starting dose to be 1/2..angela, he didnt say anything about skipping a day..also the shrink swears by sub; actually called it a miracle..she's been in this field for 15 yrs and say's this has been a god send..she told me not to even think about doing this w/o it. (seems for people like me ..low dose not many yrs using..it has been very effective) i went food shopping (which would always require 2 vics) came home cooked..now thinking about the gym!.but i havent thought about pills AT ALL~~~~~~~~~~~lisa i put up the smiling faces for you..c'mon you can do it..i forgot, how many yrs. in total have you been using?~~~~

[Angela H]

Kaidog....My Hero!! You are something else! Wish I was as strong as you. I guess little girls are weak and need help! LOL!
No, seriously, I do admire what you've done and are doing. CT is probably really good for the self-esteem cuz you can say "I did this all by myself." No crutches...and...probably a lot less likely to relapse because no way in hell are you gonna want to go through that again. Sometimes I feel kinda guilty for using a crutch...but hey...whatever works, right?
Keep up the good work and start counting those weeks. Before you know it, you will be counting the years!