[SickOne]

Let me preface this by saying that I've tried to read the suboxone sticky without much luck as my brain is in a fog.......

I'm having problems starting on suboxone, and looking for advice. I'm not real confident in my doc's abilities at this point, I don't think she's real experienced with suboxone, so that's why I'm here asking questions.

DOC - 11 tramadol a day, 50 mg

Doctor gave me a script for 2mg 3x a day (with no instructions on what I was to do....thank goodness I've read a bit about the suboxone).

I waited 20 hours before taking the suboxone, 2mg. Took a second 2mg. Second day, I took 2 + 2 + 2 as prescribed. I felt dizzy and tired most of the day. Finally felt "normal" after taking the last pill in the evening.

Third day, yesterday, took my first pill and felt tired and light headed. I developed a bad headache and started throwing up. In the afternoon, I ended up taking 4 2mg pills because I thought maybe I wasn't taking enough --it helped my headache, but seemed to make the vomiting and tiredness worse. Evening I took 2 more 2mg pill....for a total of 14 mg.

I called my doc yesterday and got no answers from her. Today I'm at a loss on how to go forward. What should I take? Back to the 2+2+2?

I actually don't feel half bad today, but I don't know what I should be taking now. And I'm afraid to even take a suboxone because that seems to be what precipitated the vomiting yesterday.

This is confusing.

[Robert_325]

Originally Posted by SickOne

Let me preface this by saying that I've tried to read the suboxone sticky without much luck as my brain is in a fog.......

I'm having problems starting on suboxone, and looking for advice. I'm not real confident in my doc's abilities at this point, I don't think she's real experienced with suboxone, so that's why I'm here asking questions.

DOC - 11 tramadol a day, 50 mg

Doctor gave me a script for 2mg 3x a day (with no instructions on what I was to do....thank goodness I've read a bit about the suboxone).

I waited 20 hours before taking the suboxone, 2mg. Took a second 2mg. Second day, I took 2 + 2 + 2 as prescribed. I felt dizzy and tired most of the day. Finally felt "normal" after taking the last pill in the evening.

Third day, yesterday, took my first pill and felt tired and light headed. I developed a bad headache and started throwing up. In the afternoon, I ended up taking 4 2mg pills because I thought maybe I wasn't taking enough --it helped my headache, but seemed to make the vomiting and tiredness worse. Evening I took 2 more 2mg pill....for a total of 14 mg.

I called my doc yesterday and got no answers from her. Today I'm at a loss on how to go forward. What should I take? Back to the 2+2+2?

I actually don't feel half bad today, but I don't know what I should be taking now. And I'm afraid to even take a suboxone because that seems to be what precipitated the vomiting yesterday.

This is confusing.

SickOne ..... first of all you have never been stabilized yet. You don't take a little dose of sub throughout the day. It should be taken twice a day, some people even do it once, but most do better with two doses. More than that is addictive behavior which you are trying to stop.

Plus you're coming off a pretty high dose of tramadol. I wish your dr would prescribe you some depakote or dilantin which are anti-seizure medications. Tramadol detox can cause seizures and you having the depakote would make me feel lots better for you.

I personally think you started taking the subs before you were in serious enough w/d and you're putting yourself into precipitated w/d. How long did you wait from your last dose of tramadol before your first dose of suboxone? I'll wait for your reply and then I'll advise you farther.

I know how to do this if you'll trust me. I wrote the suboxone therapy sticky, sorry you had a tough time with it. Post back and answer my questions and we'll move forward. God bless.

[SickOne]

Thank you so much for replying.

I waited 20 hours before taking the suboxone.

My doctor at first didn't even want to prescribe suboxone because to her the 11 tramadol a day "wasn't that much". She spoke to the drug company though, and then changed her mind.

[SickOne]

Originally Posted by Robert_325

I wrote the suboxone therapy sticky, sorry you had a tough time with it.

My brain's not firing on all cylinders right now, that's the only reason I had a hard time with it.

[Robert_325]

Originally Posted by SickOne

Thank you so much for replying.

I waited 20 hours before taking the suboxone.

My doctor at first didn't even want to prescribe suboxone because to her the 11 tramadol a day "wasn't that much". She spoke to the drug company though, and then changed her mind.

It sounds like your dr doesn't have a clue! I hate when drs start doing this and don't know what they're doing. When was the last time ( the exact time as you recall) that you took any suboxone? Reason I am asking is that one of two things is happening. Either you went into precipitated w/d or esle you're reacting to the naloxone that is in the suboxone. The precipitated w/d is more likely. I'll wait for your answer. Be as exact as you can with the time. God bless.

[SickOne]

It's been about 15 - 16 hours since I took a suboxone.

Right now I feel a little light headed, but otherwise okay. I've been able to eat this morning without vomiting.

[Robert_325]

Originally Posted by SickOne

It's been about 15 - 16 hours since I took a suboxone.

Right now I feel a little light headed, but otherwise okay. I've been able to eat this morning without vomiting.

In the suboxone therapy link that you had trouble with it explains the INDUCTION process. During the induction it's imperative that you reach a severe level of w/d prior to the induction. To determine that level we use what is called the COWS ( clinical opioid w/d scale) worksheet. Here is a link.

http://www.suboxone.com/pdfs/OWR.pdf

What you do is pull up this link and score your w/d symptoms according to the worksheet. There are two pages. When your accumulative score reaches a 26 or above you're ready to begin the induction. If you start too soon you'll get sick just like you've described.

I want you to score yourself now. Don't be too lenient on yourself. Just relax, settle down and do this. Then tell me what your score is. The worksheet is self-explanatory.

What I'm thinking here is that we need to do the induction over again and get you stable the right way. Then I can tell you how to take the subs properly so that it will go smoothly for you.

Let me know if you have a problem with this and let me know your score. I'll be waiting here to see your reply. Just relax and don't be uptight. I've done this countless times and I KNOW what I'm doing. I've got some things to do this afternoon so let's get after this. I'll be waiting. God bless.

[SickOne]

I used the COWS before I took my first suboxone on Monday. I don't remember the exact number I had, but it was on the low end of the moderate rating.

I honestly don't have to look at the chart now to tell you my current number: 0. I don't feel any withdrawal symptoms right now except a bit of a headache / lightheadedness.

[SickOne]

Originally Posted by Robert_325

Just relax and don't be uptight.

Easier said than done...lol. I have two children and no one to call for help if need be. I thought the suboxone route would be a fairly simple route after the first day or so.

Sorry, just really terrified and ticked that my doctor doesn't have a better set up.

[Robert_325]

Originally Posted by SickOne

Easier said than done...lol. I have two children and no one to call for help if need be. I thought the suboxone route would be a fairly simple route after the first day or so.

Sorry, just really terrified and ticked that my doctor doesn't have a better set up.

It's totally understandable that you're both ticked at the dr and terrified about your future. You wouldn't be very smart if that weren't the case. This is serious and you haven't been receiving the support you need from the person who is supposed to be telling you how to do this.

I have seen SOOO many people here during my years on the forum that get totally jerked by their suboxone drs. There are obviously some great drs out there, I totally support them. But there are some drs prescribing subs that have no idea what they're doing. That is very sad and it makes it tough on people like yourself who are struggling trying to do what is right.

Here is my suggestion. First don't take any more of the subs today at all until you get to that 26 score on the COWS worksheet. Talk to me first before taking anything. I want to be sure for your benefit that you're really at the right place and actually ready to be inducted again.

If you'll stay in touch with me closely today I will personally walk you through the induction over again. I promise that if you'll do as I ask that I will get you totally stable and you'll feel great once the re-induction is over. Then I can advise you about the proper way to move forward with the subs. Just reply back to me and let me know if you want to do it like this so I'll know.

I've been doing this a long time and I've worked with lots of people. I know how to do this the right way if you want to do what I'm saying. It needs to be all or nothing though. I can only promise you success if you go along with me to the letter. I'm not saying my way is the only that can work. But I am saying that I guarantee my system will work. Let me know what you think. God bless.

[SickOne]

Originally Posted by Robert_325

Just reply back to me and let me know if you want to do it like this so I'll know.

Yes, I would like to do this. I'll post when I get to 26 on the COWS chart. Thank you for your help -- it is very much appreciated.

[Robert_325]

Originally Posted by SickOne

Yes, I would like to do this. I'll post when I get to 26 on the COWS chart. Thank you for your help -- it is very much appreciated.

That sounds good. I'll be more than happy to help you. Based on where you are right now you're likely looking at least tonight. I don't see you having bad enough w/d in the next few hours if you're not feeling anything major yet right now.

Melinda that posted to you on your other thread is my fiance. We will be leaving for about two hours in another hour. Have some personal business to take of but then we'll be back. So don't worry if you post and I don't reply right back. I'll return shortly. If I tell someone that I'm helping them you can bank it that I'll be there for you. We just have to work together around each others' schedules and commitments.

Want to make a suggestion. There is another guy here who I did a re-induction with not too long ago like we are about to do. His dr had made a total mess of things. I suggest that you read this guy's thread and some of the posts and replies. His name is Henry. You can ask him questions too and he will be happy to help as well. Henry is within days of being done totally and being clean. Here is a link to that thread where you can find Henry and read some. I'm taking you right to where we started the re-induction. Have fun reading. There are lots of pages before you get from Henry's induction to where he is now. So you can always jump ahead to today on the thread and ask him anything you want. Henry loves to share with others.

http://www.drugs.com/forum/need-talk...tml#post254695

You just made a big decision and we're going to get you clean! God bless.

[kidmonster]

Good luck , sickone. Just keep posting and you'll make it. I have been on Subs for 3 years and as of today am totally off of them for about a month. Good Luck

[SickOne]

Wow. 36 hours since the last suboxone and I am at 0 zero 0 withdrawals. ::insert happy dance::

I slept completely through the night except I woke up once shaking uncontrolably. It wasn't uncomfortable though, just a strange shaking.

I prayed for God to help get me started on the suboxone and get away from the tramadol, and I think He's answered my prayer in a way I never, never expected.

It's going to be way different than I expected though -- combating cravings and dealing with emotions a lot sooner than I expected -- but one day at a time.

Wow.

[Robert_325]

Originally Posted by SickOne

Wow. 36 hours since the last suboxone and I am at 0 zero 0 withdrawals. ::insert happy dance::

I slept completely through the night except I woke up once shaking uncontrolably. It wasn't uncomfortable though, just a strange shaking.

I prayed for God to help get me started on the suboxone and get away from the tramadol, and I think He's answered my prayer in a way I never, never expected.

It's going to be way different than I expected though -- combating cravings and dealing with emotions a lot sooner than I expected -- but one day at a time.

Wow.

I'm happy for you. This is the main reason I ask people to wait until they reach that 26 number on the COWS worksheet. If you don't experience very significant w/d symptoms there is no reason to start on the subs. So at 36 hours I would say the odds that you'll ever reach a 26 are slim to none.

Now you just want to do things like hot baths/showers before bedtime to help with a little relaxation prior to going to sleep, get some exercise like going for a good walk to help with endorphine production (helps with your overall well-being), and you speak of prayer which I'm a firm believer in too.

Continue doing the other things you're doing. I am flying to Houston during the day today. I'll check on you later this evening when I get to my destination. But I really would be surprised if you need to take the subs at all from this point forward. Keep us posted. God bless.

[SickOne]

Thanks Robert for your help. Just knowing that I was talking to someone here who was knowledgeable helped me from going into panic mode.

Thank so much

[shellister]

Robert_325, just want to say how awesome you are for being so knowledgeable and helpful to all of us hopeless addicts. I too have tragic stories of opiate and then suboxone abuse (due to doctor's orders, had I any idea-would've never gotten to this place!!). So I thank you, makes me feel hopefull in human-kind again. I have read quite a bit of your threads, posts, etc. and am starting suboxone induction/stabilization today--again! I wasn't even too heavy of an opiate addict, went to sub Dr. and he gave me 30 8mg subs a week, to take 4 times a day. Did this for almost 2yrs., never weened me down or anything. It got to be way too expensive, so I began to ween myself. I told him I couldn't afford, he just said that I need them and need to have family help with cost. Well, like all addicts, have put my family through enough-wasn't willing to do this. So, I weened down to 8mg a day, maybe every other, then nothing. Well, 3 days later I felt like I was going to die, worst opiate w/d's ever! I did 1st and easiest thing I could do to alleviate the torture-could find roxys cheap (at first) and no problem. Well, 4 months later I'm full fledged opi-addict again, lost job, losing daughter possibly, miserable, you know the drill. I am looking for some support and encouraging words, possibly some advice too. You definitely seem like the guy. I am hoping that since I have been off subs for so long that once I start to taper, I won't w/d from subs like last 2yr stint---makes sense to me, is this true. Well, as I said, I think what you do here is awesome and I wanted to introduce myself and problems and hope to get a response from you soon. I am starting subs tomorrow and will follow COWS sheet for sure---any other pointers??

[Robert_325]

Originally Posted by shellister

Robert_325, just want to say how awesome you are for being so knowledgeable and helpful to all of us hopeless addicts. I too have tragic stories of opiate and then suboxone abuse (due to doctor's orders, had I any idea-would've never gotten to this place!!). So I thank you, makes me feel hopefull in human-kind again. I have read quite a bit of your threads, posts, etc. and am starting suboxone induction/stabilization today--again! I wasn't even too heavy of an opiate addict, went to sub Dr. and he gave me 30 8mg subs a week, to take 4 times a day. Did this for almost 2yrs., never weened me down or anything. It got to be way too expensive, so I began to ween myself. I told him I couldn't afford, he just said that I need them and need to have family help with cost. Well, like all addicts, have put my family through enough-wasn't willing to do this. So, I weened down to 8mg a day, maybe every other, then nothing. Well, 3 days later I felt like I was going to die, worst opiate w/d's ever! I did 1st and easiest thing I could do to alleviate the torture-could find roxys cheap (at first) and no problem. Well, 4 months later I'm full fledged opi-addict again, lost job, losing daughter possibly, miserable, you know the drill. I am looking for some support and encouraging words, possibly some advice too. You definitely seem like the guy. I am hoping that since I have been off subs for so long that once I start to taper, I won't w/d from subs like last 2yr stint---makes sense to me, is this true. Well, as I said, I think what you do here is awesome and I wanted to introduce myself and problems and hope to get a response from you soon. I am starting subs tomorrow and will follow COWS sheet for sure---any other pointers??

Here is the link for how I suggest using subs. Pay close attention to the INDUCTION section. You should be able to get stable on 4-6mg following this plan. I will check in on you to see how you're doing and make suggestions. I'm flying out of town on business today but I'll continue to check on you as I can. Just follow the plan and there will be lots of others on the site who've used the same process that can also provide assistance. I'll be talking with you. Just relax, don't freak out. Stick to the plan and you'll be fine. God bless.

http://www.drugs.com/forum/featured-...apy-50887.html

[SickOne]

Robert, I'm going to bow out of this thread now as I think I am in the clear for the withdrawals. I know I have a lot of work ahead -- I am sure the relapse rate is higher doing this kind of flip flop in such a short amount of time, but it is what it is.....I'll just have to remember to go one day at a time.

Thank you for your time and expertise.

[shellister]

Thanks soo much for your timely response Robert. I reviewed link you suggested and am actually surprised at the low dose for induction--and, yes, still scared---let me restate, petrified! I don't even know how I got here, was never like this. But also know this is everyone's story and have to walk through it. So, last opiate was at noon today (btw-was taking 10-15 30mgs roxys a day) so, hope to sleep through till bad w/d's and then start subs. Will do as your post suggests and definitely let you and everyone else know how this goes. Am scared to death because there are soo many elements to w/d--physical, mental, spiritual, etc. and am trying to put my life back together at the same time. No time to be a depressed lunatic-have an awesome job interview on Monday. So let us all pray that this will work out!! Thanks again and God Bless, till next post!

[shellister]

Well, day 1 on suboxone--again, and well, woke up at 3:30am dying, tried to hold out little longer. Think it was 5amish that I finally took 2mgs of sub, and nothing. Waited hour intervals and didn't get any relief till I got to 8mg-hope that's not too high because I know you suggested 4-6mgs. But, whatever...so been a while since any more sub and still achy, achy, achy!! Plus stomach not the best (but could and has been way worse). No energy and eyes are watering like crazy. I don't want to use any more sub today, 8mg should be stabilization for next 3 days---just hope I feel better tomorrow. Can't really eat, but know this could be worse. Also taking OTC med for achyness (back is just killing me!). Well, that's all for now, just wanted to keep everyone posted!

[kidmonster]

Hi Shellister, how did you make out today, I have read some of u posts and good luck sticking to 8mgs a day! That's seems to be the best starting point in your case

[shellister]

Good to hear from you, kidmonster--nice to see so much support on this site. Well, as previously posted, not too great, but also know at the same time could be way worse! I am still sooo achy, back and shoulders is where I get it, like knots and constant spasms. No energy, depresseed--all and all ok. I am just hoping to be a normal human being by Monday for job interview. I am sooo sick of this ********!!! Sounds like we have lot in common with the over abundance of sub scripts! Need class action suit against these 'so called docs'. But no energy to be so vindictive now. I just hope to sleep and wake up better tomorrow. Thanks again for checking in and would love to hear from you again!!

[kidmonster]

I hear you, especially on the no energy part, I wanted just to crawl under my covers and stay there! But I couldn't even sleep, so I would take a tiny bit of suboxone to sleep, then feel bad like I cheated. But hang in there, great job landing an interview, and go get'em Monday.

[shellister]

Yeah, I wish we could just sleep through the whole detox! I actually took Advil PM--helps with the aches and sleep. Just worry about taking/depending on anything anymore! I still feel very sluggish (which I hate, why I like the opiates soo much to begin with--ENERGY!), but know this could be worse and have to remember this. Also, I may be more sluggish because of the AdvilPM....don't think I will take tonight, if possible. I need energy for the interview! So how long was it before energy came back for you? I'm also struggling with depression, makes it hard to walk into new job. One day at a time, right!

[kidmonster]

The energy part /lack of, took like two weeks, not two weeks of torture, but too weeks of , not wanting to do anything. . Then slowly you find that the morning cup of coffee is all the energy I need, but it's hard, no doubt. Talk to you soon..

[kidmonster]

Originally Posted by shellister

Yeah, I wish we could just sleep through the whole detox! I actually took Advil PM--helps with the aches and sleep. Just worry about taking/depending on anything anymore! I still feel very sluggish (which I hate, why I like the opiates soo much to begin with--ENERGY!), but know this could be worse and have to remember this. Also, I may be more sluggish because of the AdvilPM....don't think I will take tonight, if possible. I need energy for the interview! So how long was it before energy came back for you? I'm also struggling with depression, makes it hard to walk into new job. One day at a time, right!

Me personally think taking Advil PM is okay, I used to soak in baths,showers for ever to relieve the aches when I couldn't sleeep.

[shellister]

I am soo grateful for this website---don't even think I coulda done this without. But, over 30 hours without roxy!! Thank you kidmonster for the responses, they really keep me going! I have just been living in a bubble last few days to get through this. However, real life starts tomorrow--1st with job interview, then I have a whole other issue with my daughter (she's only 3 and family keeps me away as much as they can). I was doing soo good (I thought) while on the subs, "clean" (if you can call it that, don't think so anymore) for over a year and family still gave me hard time, but was doing really good. Anyhow, am rambling at this point, but just life stuff is getting to me and know that I can't rush any of this. Well, thanks again for your words and support.....Robert_325 is amazing too.

[kidmonster]

Originally Posted by shellister

I am soo grateful for this website---don't even think I coulda done this without. But, over 30 hours without roxy!! Thank you kidmonster for the responses, they really keep me going! I have just been living in a bubble last few days to get through this. However, real life starts tomorrow--1st with job interview, then I have a whole other issue with my daughter (she's only 3 and family keeps me away as much as they can). I was doing soo good (I thought) while on the subs, "clean" (if you can call it that, don't think so anymore) for over a year and family still gave me hard time, but was doing really good. Anyhow, am rambling at this point, but just life stuff is getting to me and know that I can't rush any of this. Well, thanks again for your words and support.....Robert_325 is amazing too.

Crazy this sub is,, But my paxil and POT use are the next things to tackle... I did not have too much trouble cut out alcohol... Good Luck and Great Luck on your Job Interview.
Russ S

[shellister]

Alcohol's a @@tch!! So, no easy going there---however, heard that paxil is tough withdrawl. I know that I need wellbutrin and lexapro to be "right", but no insurance, yet no exuse. Please be careful with the paxil---was never one for the POT! Wish I was, seems the most harmless! Anything I can do to help....am here kidmonster, you were here for me!!