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Unique problem encountered while trying to use Robert_325's taper
  1. #1
    firahs75 is offline Junior Member
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    Default Unique problem encountered while trying to use Robert_325's taper

    Hi Robert,

    I have no doubt that your tapering plan has help many, many people free themselves from sub. I am wondering if I am a non-typical sub user, as I have not read any threads with quite the same problem. Here is my situation:

    Started subutex almost 2 years ago, inducted at 12 mg, been tapering
    down since October 2011 and now I have been completely stable at 3 mg
    per day for the past several weeks.

    My goal is to get off completely. So, I recently tried a more conservative version of your taper, ie ~17% reduction every 7-8 days. After being stable for about 8 weeks at 3 mg once per day (in the morning), I have tried on a few different occasions to reduce my dose from 3 mg to 2.5 (a reduction of ~17%).

    By afternoon of the first day of trying 2.5 mg, I am pretty uncomfortable (chills, general feeling of being "off"). Day 2 is a bit worse (lethargy, chills, runs, anxiety, etc). Usually by day 3 I've had enough and I just go back to the 3 mg.

    I mean, WTH?? Do I have to resign myself to being a special case that is super sensitive to dose reductions? As I said before, I have been stable at 3 mg for quite some time. Why can't I tolerate such a low reduction? The symptoms I feel are very real and not imagined. I have to work and be around people, so I cannot afford to be feeling ?????? all the time.

    I feel like I will never be free

  2. #2
    Robert_325 is offline Retired
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    firahs ..... I don't know what made you come up with 17% as a reduction amount to use? Don't get uptight about this. Some people get hung up at a certain dose and we have to make a temporary adjustment. Change the reduction to 10% for a week. Get stable and then proceed. Often, once this happens one is able to proceed forward without any problems. You should have said something sooner. I am interested though as to why you chose a number like 17% when everyone does so well at 25%? If you'll talk with me regularly I can help you. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  3. #3
    firahs75 is offline Junior Member
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    Quote Originally Posted by Robert_325 View Post
    firahs ..... I don't know what made you come up with 17% as a reduction amount to use? Don't get uptight about this. Some people get hung up at a certain dose and we have to make a temporary adjustment. Change the reduction to 10% for a week. Get stable and then proceed. Often, once this happens one is able to proceed forward without any problems. You should have said something sooner. I am interested though as to why you chose a number like 17% when everyone does so well at 25%? If you'll talk with me regularly I can help you. God bless.
    Since I am cutting 2 mg pills, it was just easier to reduce by 0.5 mg (a quarter of a pill), which happens to be 17% of 3 mg. I figured that since it was a smaller proportion than 25%, it would be easier. I mean if I feel so rough trying to go down by 0.5 mg (17%), it is only logical to assume that it would be worse if I tried to reduce by 0.75 mg (25%).

    Perhaps 10% a week would be best? Can I really get off this stuff with minimal discomfort? The thing that really kills me about the sub withdrawals are the fatigue and anxiety.

    Now, I do have chronic pain that is pretty much covered by my low sub dose. Pristiq (an SNRI) also seems to help. If you had to choose between taking a low dose of sub or an SNRI for the rest of your life, which would it be?

    Many thanks for your feedback!
    Last edited by firahs75; 05-30-2012 at 09:28 AM.

  4. #4
    Robert_325 is offline Retired
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    After using drugs for 35 years, ten years ago (anniversary this Sunday), I found that after getting and staying clean for some time that I could make it without drugs. You owe it to yourself to get clean for a while, like several months at least, then judge your true problems at that time in a "fresh" state of mind. You may find the same thing that I found. I have a laundry list of health issues and used to be on over a dozen medications from legit drs. Our body takes care of itself for the most part if we take care of it, with the exception of some deathly illnesses or accidents. And I HATE antidepressants, used almost all of them at one time or another. Give yourself some time clean, then decide what is best for you. Addiction is painful in itself! God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  5. #5
    firahs75 is offline Junior Member
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    Quote Originally Posted by Robert_325 View Post
    After using drugs for 35 years, ten years ago (anniversary this Sunday), I found that after getting and staying clean for some time that I could make it without drugs. You owe it to yourself to get clean for a while, like several months at least, then judge your true problems at that time in a "fresh" state of mind. You may find the same thing that I found. I have a laundry list of health issues and used to be on over a dozen medications from legit drs. Our body takes care of itself for the most part if we take care of it, with the exception of some deathly illnesses or accidents. And I HATE antidepressants, used almost all of them at one time or another. Give yourself some time clean, then decide what is best for you. Addiction is painful in itself! God bless.

    So, a 10% a week reduction would work well you think? When properly tapered, can subutex really be stopped with minimal discomfort? The thing that really gets me about bupe withdrawal is the fatigue and depression.

    I went through a very traumatic and painful (mentally, emotionally, and spiritually painful, as well as physically) experience with cancer (in remission now, thank God), and sometimes have severe bouts of depression. I struggle with depression and lethargy even when I am at a stable dose of bupe. So, if I can minimize the impact of bupe withdrawal by tapering very slowly, that would be great.

    Please level with me, are you sugarcoating it to encourage people, or can bupe really be stopped with minimal side effects?
    Last edited by firahs75; 05-30-2012 at 12:28 PM.

  6. #6
    Robert_325 is offline Retired
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    Quote Originally Posted by firahs75 View Post
    So, a 10% a week reduction would work well you think? When properly tapered, can subutex really be stopped with minimal discomfort? The thing that really gets me about bupe withdrawal is the fatigue and depression.

    I went through a very traumatic and painful (mentally, emotionally, and spiritually painful, as well as physically) experience with cancer (in remission now, thank God), and sometimes have severe bouts of depression. I struggle with depression and lethargy even when I am at a stable dose of bupe. So, if I can minimize the impact of bupe withdrawal by tapering very slowly, that would be great.

    Please level with me, are you sugarcoating it to encourage people, or can bupe really be stopped with minimal side effects?



    Sorry about having to deal with the cancer, but think about this logically for a minute. Do we know each other except for the couple sentences we've written back and forth? I don't even know your name! What could I possibly have to gain "sugar coating" ANYTHING to you about this? I don't get paid a commission for people who get clean.

    I've been on this forum for years and I do it for personal reasons. I don't get paid, I receive blessings that are between my God and myself. And I'm not preaching to you. I was a piece of trash scumbag for a long time and I'm just trying to give back some for the hurt I caused others during my reign of insanity and terror over the 35 years I was an addict.

    I'm not going to lie and say this will be like "mai tais and yahtzee" getting clean! You would know I was full of it! But if you listen to me, don't go backwards and keep making progress you'll end up clean. I suggest tapering 25% about every four days. So what happens if you can only do it by 10% every six days? It will take you a little longer to end up with the same result!

    I don't believe in torturing people. You are tapering off drugs and SHOULD expect some discomfort or you're not being aggressive enough. But I am not one to insist that you plunge forward when you're sick. Subs are to help you get clean without all the pain of a cold turkey detox. But everyone is different. We all metabolize drugs at a different rate, we have different activity levels and other health conditions. So as long as you shoot straight with me and follow the suggestions I give you I've never met anyone that stuck it out that I couldn't get clean. But you have to be willing to do the work, even if it's at a slower pace than what we normally do. Main thing is that you finish the race! I'm here if I can help you. God bless.
    Last edited by Robert_325; 05-30-2012 at 12:52 PM.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  7. #7
    firahs75 is offline Junior Member
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    Dear Robert,

    Thanks for replying. I will try tapering 10% every 6-7 days. I am not in a rush. Took me a year and a half to get here, so I can't expect to get off scott-free in a few weeks. ANyways, I really appreciate what you are doing here.
    Robert_325 likes this.

  8. #8
    Halloweenhead is offline Member
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    firahs, I just posted a comment in my thread today about long term sub use. My personal opinion is that a person that has used sub long term should expect a long taper if they want to minimize their discomfort. This opinion is based on limited experience but, think about it, if you've been using sub for two years, your body has been inundated with a long half life drug...a stacking effect from doses that were actually way higher than they needed to be. It is common for many to have difficulty getting below 2 mg. I have been in your place...the hard truth is that you will be required to experience some discomfort to get your dose down. The discomfort will subside after your body stabilizes on the lower dose...then you reduce again. Please don't think that you are doomed to be stuck on sub. You will adjust and you will begin to heal. I got in that negative frame of mind over a year ago and it's just not true. Stay positive and fight this thing! Robert has tons of experience in getting people off this stuff...keep posting and follow his advice. Stay comfortable but not too comfortable.

  9. #9
    PatrickB is offline Member
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    Just wanted to share with you a little bit about my experience and I hope you progressed through the last week well. I had a tough time tapering when I was on pills and also right about where you're at now. Two things that helped me personally get through the road block at 4mg.

    The point of this I think is a reminder that everyone is a little different and you have to find something that works for you. I strongly believe that Robert's plan is pretty much exactly the right level for remaining mostly comfortable. I wish I had found all this info earlier although being the junkie I was at the time I dont' know that I cared about myself at that point.

    Anyway two things that worked for me.

    1. I started taking half of the dose in the morning and half after work. OR I would take 3/4 of it in the morning and save 1/4 for work. I don't know why but the comfort of knowing that I hadn't taken everything for the day to stick to my plan gave me a sense of comfort.

    (**please note this was MY experience, I am not telling you to do this.**)
    2. I actually had days in there where I didn't stick to Robert's schedule. For example (kept a daily log of how many mg) it looked like this. I did 3mg for 10 days straight after failing to drop down. What I actually did is take 4 mg, followed by 2,2,2 and then I did 4,2,2,2. Which is about a 17% reduction but for some reason it worked for me. Please also note I NEVER increased the dose more than 1 day and never more than 25%.

    3. Timing can be important. After that 4,2,2,2 I dropped to 1.5 and was actually okay with SOME discomfort that was timed for the weekend. Try and plan those uncomfortable times for periods where you have limited responsibility but also have STUFF TO DO. Keeping busy was so important for me, I can't stress that enough.

    4. Having support. This forum, family, loved ones.

    I don't know whether others would agree with me but it was a lot easier for me to do a taper with the film than it was with the pills. What I would do is basically continue to cut it in half (usually very carefully with an exacto knife and tweezers). So you'd have 2x4mg, 4x2mg, 8x1mg, 16x.5mg...etc. Can go down low enough so you can combine different size piece like .5 and a .125 or .25 or whatever you need.

    Again, just my experience. Good luck to you.
    Last edited by PatrickB; 06-05-2012 at 09:30 AM.

  10. #10
    clevername is offline Member
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    Quote Originally Posted by Halloweenhead View Post
    if you've been using sub for two years, your body has been inundated with a long half life drug...a stacking effect from doses that were actually way higher than they needed to be.
    I just want to say I've never quite understood this idea - a longer half life mean there is _more_ in your body than just your daily dose, but it doesn't cause some sort of unbounded stacking over time. Think about it - a half life is the amount of time it takes for _half_ of the medication to be gone. "half" gets bigger the more that is there. This means that if you have a 36 hour half life and you dose 1mg every 36 hours, your "steady state" amount of drug in your system will be 2mg... because every 36 hours you lose half of 2mg (1mg) and take another 1mg (to get back to 2mg). It doesn't just continue to stack. So if the halflife of sub is 36-72 hours, and you dose every 24 hours, then your steady state dose is 3-6 times your daily dose.

    Once you reach that plateau, extra time isn't going to make more build up in your system. I think there are other issues from long-term receptor stimulation from just being constantly on long-acting opiates for years, but it's not really the half-life that gets you (with sub at least - things like valium can have half-lives of hundreds of hours so it really takes a long time to stack up).

  11. #11
    rxqueen83 is offline Member
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    Half life can be a complicated issue. Especially when you consider people have very different metabolic rates and some excrete drugs faster than others. I have been helping an old friend from childhood taper from suboxone and he's started using an Excel Spreadsheet to see just how much sub is really in his system. That's the whole point of regularly spaced and quantified doses though. To keep your body STABLE because of the factor of drug half life. Also, different drugs I believe have different half life's. Example, Xanax has a 12 hour half life. While Sub has a 72 hour half life I believe.

  12. #12
    clevername is offline Member
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    Yea half life is totally different depending on the drug and body characteristics. Usual numbers for Xanax are 6-8 hr and 18-36 for subs I think.

    Ps. Characteristics meaning things like liver function and especially body fat pct - most drugs dissolve into fat.
    Last edited by clevername; 06-07-2012 at 03:17 PM.

  13. #13
    Robert_325 is offline Retired
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    Quote Originally Posted by clevername View Post
    Yea half life is totally different depending on the drug and body characteristics. Usual numbers for Xanax are 6-8 hr and 18-36 for subs I think.

    Ps. Characteristics meaning things like liver function and especially body fat pct - most drugs dissolve into fat.


    Usual half life numbers for xanax are 4-6 hours, and it can be up to 72 hours or longer for subs. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  14. #14
    clevername is offline Member
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    Sry I'm an idiot and was thinking "36-72" but wrote " 18-36". I need to keep my big mouth shut lol

  15. #15
    Robert_325 is offline Retired
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    Quote Originally Posted by clevername View Post
    Sry I'm an idiot and was thinking "36-72" but wrote " 18-36". I need to keep my big mouth shut lol


    I think you are being a little hard on yourself! LOL You're not an idiot! I was merely making a correction in case someone who didn't know better got the numbers wrong. No judgement made on your intelligence or knowledge and I would hardly say you're an idiot! Cut yourself some slack! God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

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