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question regarding suboxone/subutex
question regarding suboxone/subutex
For those of you who haven't read any of my prior posts, I am 59 years old, was an IV >>>>>> addict in the '60's and '70's. Got on methadone in 1975 and just stayed on it, well it feels like forever, actually 33 years. I am one of those "lifers" they talk about negatively in other threads. I just try to ignore that because the methadone saved my life. I would have ended up with AIDs from dirty needles, dead, in jail or whatever had it not been for methadone so I don't pay attention to the ones who would call me a "loser". Anyway, I digress.
I have a serious question for which I need an answer. I got on the suboxone 5weeks ago, have gone down from 16 mgs. a day to 8 mgs. a day with no problems as far as withdrawal goes. However, I have been suffering acute anxiety and depression, mixed with each other. Robert had suggessted perhaps the nalaxone in the suboxone disagreed with me so today I got my doctor to write a perscription for subutex. I still have quite a bit of suboxone left which I of course won't waste considering the price and all. Will I have any problems if I mix suboxone and subutex? I will take the subutex for a few days to see if it has any affect on my anxiety/depression but then I want to use both til I use up the suboxone. Will that be OK?
Also, the suboxone doc gave me a perscription for celexa for depression but when the insurance company said I need preapproval and he would have to call he refused, saying "I will not call and sit on the phone for an hour". He is a general doctor at the hospital who is in charge of the methadone program and the suboxone/subutex people and he told me to find another doctor, perhaps a psychiatrist, to perscribe an antidepressant who would be willing to get the preapproval. Really nice guy, huh? I am hoping that the switch to subutex with no naloxone will help me with that aspect of my problem.
Thanks in advance for any advice or information you can give me.
Wishing you all health and peace,
Really beginning to hate the medical professionals.... what a jerk Bev. What I would do is ask you insureance company to call him or ask them to fax the preapproval papperwork to you ......... then you take it to the nurse at the clinic or where ever you go, she/he can fill out most of the papper work and then just get the doc to sign it.
I do this all the time, esp for manage care type insurance.
Good luck sweetie.
BTW, we began the sub at the same time.... so we are at the same place just about.. makes me feel better. How about you?
I have to admitt I have been having some, I guess, anxiety.... not sure cause I never had anxiety attacks before and not now either........ Just a bit nervous or jumpy inside my soul. I have to take quiet time and just meditate a bit every morning and a long fast walk mid day while at work. This seems to stablize me a bit... the depression, I have never really experience that either but I have been very tearfull the pass week. This may be depression but just not sure. Last night I finally gave in and just had a good loud cry. I cried for about two hours straight, loud and hardy. I had to close my windows so my neighbors didnt hear me.. I didnt really even have a reason. I slept very well and work up feeling a bit relieved this morning.
I am not saying this will help you..... but it did me. As I said I have no experience with either of these feelings. All new to me
think of you alot,
oh yes.......... the only difference between suboxone and Subutex is the narcan. I am 98% sure that there will be no negative effects if you mix them..... Your doc let you switch over without waiting a day, right? I see no reason why you cant switch back if there is no improvement.
Good luck hun,
Thanks, Robert. You are a darn sweetie. I'll let you know if the subutex makes a difference. Even if it does not, I still prefer it. I take so many medications, why do I need an additional chemical in my body? I'm happy he was willing to do it for me as they have a policy of NO SUBUTEX, only suboxone. I'm the only one he sees who he wrote subutex for. When I asked him why, he said it was for the protection of the patients. In my case, at least, that is ridiculous. I would not shoot subutex, or any drug for that matter, under any condition. I've been there done that and have no desire to revisit bad habits.
You may find that you are still alittle to high on your buprenorphene dose.I would do what Robert said and stick to the subutex for a week and see how you feel.If nothing changes then try droping your dose by 4mgs/day.Wait for a week and see if there is a change.
This sound like either too little or too much rather then a reaction to nalaxone......Good luck...Dave
Having a reaction like you could be having is very uncommon with suboxone. In fact if you ask most sub drs they will tell you that no such side effects as you describe even exist with the naloxone. I would not say the symptoms could be due to the naloxone if it weren't for communications with several people on this forum and another forum I post on occasionally. I have seen a few people who have reacted the exact same way and the switch to subutex helped them. So while it's a very uncommon side effect it is a real possibility that this is what is causing at least some of your problems.
The reason your dr gave about shooting drugs is obviously why drs don't usually prescribe subutex. They are dealing with opiate junkies like us. They don't know who will abuse and who won't. And we are all still using when we begin treatment so they just don't trust any of us right or wrong.
I agree with Dave that some of your symptoms could still be due to the dose. I know that it's a fact that dropping from subutex is a little easier than with the suboxone. It was such a piece of cake for me that I am always shocked to hear how some people have so much trouble. So picking up with your taper should be easier now. I think subutex should be used ALWAYS unless someone is an IV drug user. No reason at all to use suboxone if you are not shooting drugs.
I certainly hope this works for you. Your outcome with this could prove to be a very beneficial study for the others here who end up with the same symptoms as you are having. I'm very curious to see how this works out. Good luck bev.
Last edited by Robert_325; 08-22-2008 at 09:35 AM.
Thanks, Robert and Dave. At age 59, what could be better than getting the attention of not 1, but TWO men . Dave, as far as dose goes, I want nothing more than to get lower than 8 mgs. As you may know from my prior postings, I've been on methadone for years and years and years (idiotically, I might add - should have at least attempted to get off 25 years ago but on a meth program there is no encouragement to do that. I suppose its a money making business so it's good for them to keep patients (clients?)). I am not knocking methadone, I believe it saved my life way back when. This is before people knew about about AIDS but were catching it just the same, not to mention the possibility of jail or death..... But because I've been on opiates for so long, I am very afraid. I want nothing more than to get down to 4 and then 2 mgs and then 1 mg. But I'm afraid of the brain chemistry thing, PAWS which I had never heard of before coming to these forums, or whatever. I have gotten this crazy thing in my head that all my years on methadone and >>>>>> before that have negatively affected (destroyed) my brain chemistry (the natural ability people have to produce painkilling chemicals) and I will suffer greatly without enough of something. Of course, I do realize it would be worth it to try to wean. I can always crawl back up in dose if necessary. I started on 16 mgs. and got myself down to 8 three days ago on my own without my doctor's knowledge. According to him, I should just stay where I started indefinitely, but he is also the methadone doctor so he has that "forever" mindset. I am going to go to 6 tomorrow than 4 next week. I do realize you both are right about less being better because when i started this stuff, I instantly couldn't sleep til I adjusted the timing of my last dose per Rob's advice. It's a wierd narcotic. Rather than getting more "down" the higher your dose, it seems to work the opposite. What other narcotic prevents you from sleeping? It's benefit is that it did take away all the classic withdrawal symptoms of getting off methadone. If it weren't for the anxiety/depression, I would be 100%. I'm starting subutex today and I am going to get myself down to 4 before I leave for Virginia which is Sept. 3. If that goes well, I'll go to 2 mgs. in Virginia. Then I will probably STOP weaning for a little while. As far as my present thinking, I am too afraid to try for zero but I'm working on my fears. Thanks for your input and help.
I wish you peace and good health
I started out 7 years ago on methadone and in the first 1 1\2 years I went to 400mgs a day.I stayed there until a little over 2 years ago when I felt in my gut that I could come down.I am a chronic pain\addict so I wasn't sure about pain issues but so far so good.
I'm now at 160mgs and am doing fine.I see no reason for me ever to stop treatment as I know I would be back to taking handfulls of morphine and or >>>>>>.
I was actively addicted for 23 years and had never missed a day without abusing opiates.I have never been in withdrawls either and I hope never to be.
So I guess what I'm saying is that I don't have a problem with being on ORT (Opiate Replacement Therapy) for the rest of my life.
I wouldn't get hung up about being on methadone to long or taking to much suboxone ect.The main thing is you are under control and living your life the way you want and your healthy and happy.If that means you have to place a pill under your tongue everyday then so be it.A heck of alot better then chasing pills around all day.Good luck and hang in there......DAve
I couldn't possibly agree any more with Dave than I do. If given the choice between ORT and any other drugs the choice is obvious. You and sister and I have talked before about the fact that we were all abusing heavily before most of the people on this forum were even born. Most people haven't been using for 35-40 years. So for people like all of us, well the rules kind of change a little I think. The priorities change as well.
While we all want to be totally clean and free of ALL chemical substances we have to place things in the proper perspective. In comparison to where our lives have been in the past using suboxone or subutex or even methadone for that matter is okay >> the alternative. If I had to take methadone to keep me off opiates I would do it in a heartbeat.
I am obviously thankful that I managed to use the subutex and then stop that as well. I am doing wonderfully today opiate free for the first time since childhood and I am extremely lucky for that. But it doesn't mean that you are a failure if it turns out that you do need ORT for longer than what you had hoped for. Even if it's forever you are not using drugs and are not living out addictive behaviors. That is the important thing, or at least it's the most important thing for me.
I think it's safe to assume that you, sister, Dave and I all agree that returning to opiates is probably a death sentence for each of us. Anything is better than that. Let's just pray that this works out with the subutex for you just as you are hoping and that you are able to move forward with everything just as you originally set out to do. Do the best you can without torturing yourself and that is really all you can do within reason. Things most always work out the way they are supposed to.
These thought make me feel better............... I have so much fear about getting off the sub completely that I think I may just stay on .5 till I am so sure I will not pick up, or talk my private MD to give me nacan for daily use. He is just not getting it. He thinks my using was an accident. LOL, he is so young.
Last night I forgot to take my evening dose and slept like a baby without waking up. I feel great today. Going to work on boat a bit and short sail with a ole friend. He is using right now and wants to chat. I will be able for the first time since the beginnin of the sub life share with a real live person...... hoping he wants to get clean and I have just the thing for him.
So today is your second day without the narcan...... how are you feeling? The narcan has very short life.... infact, by mouth has little effect (meaning about blocking narcs) I am hoping your starting to see some light here chic. Let me know.
You know ROb...... For me, I was glad to know I couldnt fire the sub without putting myself in wd.. I was so sick for starting the sub too soon that If the narcan was not in it I know I would of tried to cook it up and get some relief. SO for me, it was a blessing. There is reasoning to there thoughts.
Sis, you are doing so well, it makes my heart happy for you. Rob and Dave, I can't thank you more for your advice and input. I'm thinking about something and puzzled. Robert, you, sis, Dave and I and in the same age group and have been on opiates for so many years. You took sub for a short period of time and got off and you feel fine you say? Does that not blow my "brain chemistry is destroyed" theory out of the water? I'd love to believe that its at least possible to someday have my endorphins working properly (or whatever goes on in the brain). I have reread Dave's post about methadone and forever. I am getting over my woe is me, I have to be on something long term, thinking. It's ridiculous. I was on methadone for 33 freaking years and not worrying about it then so why worry now? It's like I was just looking to give myself a reason to feel bad about myself. When I was shooting drugs, I was a really bad junkie. I was a >>>>>> pig and my life was out of control and it's a miracle I lived through that. Believe me when I say that. I have been places and done things I can't even believe myself anymore. I am now a grandmother of two, trusted to move to Virginia to be their primary child minders. I am a legal assistant who held my last job for 7 years and 7 years at the job before that. I have 2 good kids, one a court officer in NYC, the other a career military man. I did a good job with them. My grandkids are 16 and 13 and they are the best. Now....... I just have to keep reminding myself of these things over and over and stop this BS self pity party. Suboxone is legal, methadone is legal. I don't get "high" on either. I function well. So, if it becomes necessary to stay on sub for a long time, it is what it is. Thank you to the 3 of you for helping me see things more clearly. These forums have been wonderful to me. I have learned so much, especially from the 3 of you. Sis, just keep hanging in there.
I agree that you should not worry at all about this. Who cares how long you are on the subutex??? It doesn't matter all that much. Yes it would be nice to get off, and when you are ready you can do it then. Until you are ready I think it would be a mistake. It's certainly not worth the chance of blowing it.
I can only give one reason for my success with stopping subutex so easily after using so many years and not EVEN considering using opiates again. Most people don't like the answer I give and that is ok. I only give it when I am asked.
About the time I was doing my subutex taper I had an experience that truly changed me. My "want to" has changed, it's been re-directed. Not to sound corny but my wants have changed because I have developed a personal relationship with Jesus Christ. That is not in the medical books or on this forum. But I have relapsed numerous times over the years. Every time it was worse than before. I have been dead on the table twice following relapses. I have had two years clean, three years clean, but this time it's different. I just don't want any dope and I don't think I ever will again.
I know what worked for me will work for others. But it's a thing that each person has to do what they think is best and make their own decisions about. I don't push my beliefs at all. But if anyone asks me, I will testify in a heartbeat as to what has changed me and helped me to be successful with this.
Last edited by Robert_325; 08-24-2008 at 08:44 PM.
Sis, please don't get off the sub until you are actually ready. Its funny, I worry about getting off myself and feel bad about it, but when I look at you I know the right answer. That answer is stay on until you have total confidence in yourself staying clean. You have done alot with your life, kids or no kids. My sister is a nurse so I know how difficult a job that is and you have to be a responsible person to do that also. So you are doing fine. I just don't want to see either of use back to chasing a bag of dope (or a pill or a cup of methadone). It's a game for young people. I take that back. It's a game for NOBODY but especially not us. Don't rush yourself.
Robert, I really envy you your religious convictions. I was raised in a very non-religious home. I was actually raised as a non-observant Jew and I don't follow that at all. I have searched different religions over the years, especially during the past several years, and tried to get into it, but so far it hasn't worked for me. I actually got involved with a group called Jews for Jesus at one time until I realized you cannot be both. You are either a Jew or you believe in Jesus so I dropped out. I am definitely a spiritual person. I believe in the Higher Power (call Him what you may). I am just so envious of people who have total and absolute faith. I can see that those people are happier in their lives. They are able to accomplish things other people can't. (your recovery). Perhaps one day I will be able to have such faith. I do know it works and I envy anyone who has it.
Back to sub..... I can't tell you how much better I feel on the subutex. Thank you so much, Robert, for the suggestion. Maybe it's all in my head, but my anxiety level has decreased so much. The doctor told me to take 150 mgs. of Seroquel (I was taking 100) and the combination of that and the lack of nalaxone has made a world of difference. I have read online that the nalaxone has no effect, but I also read an article where they say it is rare but possible to have the effects I had. All I know is I feel better, thank you God.
Everyone has to decide for themselves about spiritual convictions. I was never ready until it just happened. I wore a shoulder holster for years and was no way a Christian. I wasn't even looking for Christ. If it happens for someone else like it did for me there would be no way a person could deny the experience. It truly saved my life.
Drs mean well for the most part. Although some are on ego trips and think they know it all and people like us know nothing. I really don't care what any professional says .. I have as much or more experience with buprenorphine than lots of them. So do others on this forum. We can make suggestions from experience that work, just like the side effects (although rare) with naloxone. I know the switch to subutex helped you. I was really pretty confident that it would. Just do this as long as you need to. If it's working now then that is all that matters. Doesn't matter what the books say about the side effects of naloxone. You know how you feel.
I believe the 150mg of seroquel is a good dose for people like us. I used 200mg and while that might knock out someone else all it did was put me to sleep. So just continue to do what works for you. None of the other stories from people really matter. If it's working for you that is what counts.
Whatever you do DO NOT start yourself on celexa for your depression. I used it for months and it worsened my depression badly. I know everyone is different but celexa is horrible. Try to get a different one.