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Oxy problem, plan to quit, Need help!!! I
  1. #1
    mr_c is offline New Member
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    Default Oxy problem, plan to quit, Need help!!! I

    Hi all:
    I posted a while back. Had 5 surgeries, ended up at pain center, now on 180 mg of oxy per day, all under dr care.

    Same Dr wants me to consider Sub therapy. He is willing to hospitalize me through first two days to get me on Sub, then fast taper of Sub.

    His plan is something like this:
    Day 1: Enter hospital, private room, still on Oxy, last dose at midnight
    Day 2 and 3: in Hospital, with meds to control withdrawal symptoms
    End of Day 3 or Day 4, start Sub therapy. Not sure how he decides when. Start at 32 mg
    Day 4-6: head home, rest for weekend.
    Day 7: drop from 32-26MG, Day 11: drop to 20 mg, Day 15: drop to 14 mg -- Hold for 1-2 months
    After 1-2 months: Fast taper to 2 mg, then slow taper off Sub.

    I read Robert's post (from 08) and am worried I'm starting on way too much Sub??
    I have good psychological counseling before, during and afterwards. We (my Dr and I) are planning this for late June.

    I'm really really scared. I'm going to do it. But, I am scared. Any input to the plan, any help, or just good thoughts appreciated.

    Thanks!!!!

  2. #2
    The Husband is offline Member
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    I have never taken subs but it sounds like way to much to me. I believe Robert 325 got people off up to 1000mg Oxy daily use and it didn't even take that much to get inducted. I would guess 8mg sub is more then adaqaute.

  3. #3
    Iwantoff2013 is offline Platinum Member
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    Hi there. Yes, 32 mg of sub is totally absurd and highly unnecessary. My guess would be that you could stabilize at anywhere from 4-6 mg at first...then start tapering. Robert's taper plan definitely works! It has helped countless people taper off of subs with minimal discomfort.

    Is your doctor willing to consider Robert's plan? How much sub will he prescribe at first (how many tablets/strips)?

    Kat

  4. #4
    mr_c is offline New Member
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    Hi:
    Thank you both for your comments. My understanding until I read Robert's note was that I HAD to go to 32 mg. That was the top dosage and was standard protocol for anyone on high dosage of oxy. In light of Robert's note, I will ask my Dr.

    Next questionsL How long does it usually take from last oxy dosage to first starting Sub? My Dr is saying 2.5 days, which sounds like eternity. Thoughts?

  5. #5
    The Husband is offline Member
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    2.5 days sounds about right to ensure you don't go into really bad w/d's... People have c/t from more Oxy and been successful but you would have 10 days of acute w/d.. But from what I have read no matter how low of a dose of sub you get to you are going to have w/d at some point. With all that said you need to score 26 on the COWS scale to be inducted on subs.

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    Iwantoff2013 is offline Platinum Member
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    The problem is that most doctors don't have a clue how to properly administer subs. Sad, but true. Even hard core hero1n addicts usually don't need more than 6-8 mg to start.

    As far as when to start subs after oxy, it's not a matter of time. You must be in moderate to severe withdrawal before inducting on subs. There's something called a COWS worksheet which measures your level of withdrawal. You need to reach a score of 26, then it's safe to start sub.

    The COWS worksheet is posted on this site. Take a look at it.

    Don't be scared...you will be just fine if you follow the taper plan.

    Kat
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  7. #7
    mr_c is offline New Member
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    Hi everyone, Thanks again -- it's really REALY soothing to find this group and to have you all responding so quickly. Thank you!!!

    With all your help (I've been lurking )I'm convinced that I can taper the Sub now. What I'm most scared about is the 1-2.5 days it takes to get to 26 on the COWS worksheet. Can I make it? I'm just flat our scared --

    My Dr wants me in the hospital, on monitors, with 24 hour care -- I think so they can drug me up so it's not so bad ... but I'm not sure ... We're going over it next month when i see him.

    Can anyone tell me what I should ask him to give me to make it not as bad???

  8. #8
    alexnt is offline Platinum Member
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    Hi mr_c welcome to the forums. I see where your Dr wants to do this starting in June. So thats still 3 months from now so since your not planning on starting on subs for some time now real quick here is what i think of your Drs plan. The plan he has outlined for you in my opinion is a terrible plan. I am not a Dr and do not claim that i know more about suboxne then your Dr does first of all. But sadly this a pretty well known fact and i am sure there are several members of this site that will agree to me on this. A very high % of Drs that prescribe suboxone are almost clueless about suboxone. Drs just need to take a 8 hours online quiz i think it is to prescribe subs and they just go by what the pharmacy companies tell them. Big Pharma is interested in only 1 thing and that is making as much money as they possibly can. As for how long between your last oxy dose and as to how long before you first take subs there is no set in stone answer to that. It depends on how long it takes to get to 26 on the cows worksheet. Starting you out at 32 mg is ridiculous as no one needs even close to 32 mg to start out at. Then the fact he has you holding at 14 mg for 1 to 2 months is crazy. You said you read Roberts plan and are worried you are starting on way to much subs and you are correct there. While 180 mg of oxy is a pretty good amount of use per day i have seen people with much higher daily useage then 180 mg a day get clean here using subs as a detox tool get clean. Check out threads on here in the sub forum and you will see that starting doses at low amounts is what most have used. When i say low doses i am talking about 4 to 6 mg which is by no means low doses but is if you compare it to 32 mg. Subs are a great detox tool to get off of opiates but are just that and that is a tool. There is a saying about using subs and the saying is less is best. It made no sense to me when i first read that but in the case of subs it is true. Your Drs schedule has you on to much subs for to long of a period of time also. The lower you can induct at and the less time you are on subs the better off you are in the long run. Since you arent planning on starting this right away do research this topic and i think you will come to see your Drs plan is not very good. Best wishes to you

    Alex
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  9. #9
    alexnt is offline Platinum Member
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    Quote Originally Posted by mr_c View Post
    Hi everyone, Thanks again -- it's really REALY soothing to find this group and to have you all responding so quickly. Thank you!!!

    With all your help (I've been lurking )I'm convinced that I can taper the Sub now. What I'm most scared about is the 1-2.5 days it takes to get to 26 on the COWS worksheet. Can I make it? I'm just flat our scared --

    My Dr wants me in the hospital, on monitors, with 24 hour care -- I think so they can drug me up so it's not so bad ... but I'm not sure ... We're going over it next month when i see him.

    Can anyone tell me what I should ask him to give me to make it not as bad???
    Are there any underlying issues as to why he wants you hospitalized to start this? Not that i read every thread that is posted on this site but being put in the hospital to start subs is something i dont recall reading about. You said you take 180 mg a day. Is this what you are prescribed a day? Do you take extended release or immediate release and what is your normal routine in how much you dose at a time and how many times a day? Without trying to offend you i guess i am asking if you abuse them or take as directed by your Dr. Myself i am just a addict plain and simple. I used to get high and it had nothing to do with needing meds for pain issues. sorry for the questions but it might determine your waiting time.

    Alex

  10. #10
    mr_c is offline New Member
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    Hi Alex:

    I had 5 major knee and shoulder surgeries. After the last one, I ended up on close to 400 mg of Oxy per day -- a mix of ER at night and IR during the day. I have never taken Oxy except as proscribed by my Dr (thought I do tend to take a little too much). From the day after the last surgery he has tried to coax me into switching to Subs and then a fast taper off. I asked to try to taper of Oxy and have reduced from 450 mg to 175 mg a day. But it's getting too hard.


    While he may be starting me too high on Subs, it is me that it terrified of the 2.5 days of withdrawal and it is me that wants to go slow on the Sub taper and take long breaks. I have a super demanding job, with a lot of people and investors counting on me and we are trying to minimize my down time, while returning me to health (the most important part!!!!).

    I will definitely talk with him about the lower dosage!!! It would be GREAT to start at 4 mg and taper in two to four weeks -- I can't tell you how much hope this discussion has given me. Please don't rant too much about my DR. He's trying to get me off the meds. Maybe he's not got it right, but he is a good person and a super smart guy and I'll see what he thinks. I'm also meeting with two other drug rehab guys. So I'll go with what seems best!

  11. #11
    alexnt is offline Platinum Member
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    mr c oxy has a fairly quick half life if they are IR ones. If you used those as you got ready to begin taking subs it would cut down on the time you would need to wait I think. If there ER then I don't know about the half life as opposed to the IR. I know the clinic I went to told me not to use any opiates for 24 hrs and that I could start subs then. They started by giving me a 4mg dose and to wait an hr and see if I thought I needed more. Maybe the 2 drug rehab guys you are meeting with can suggest starting you at a lower dose. Best of luck to you

    Alex

  12. #12
    Bungalobiggsby is offline New Member
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    I was at 1300mg oxy per day. I'm on day 5 of sub taking 8mg per day....that first night I took 12mg, but I got pr. Wd and it was hell...but that is way too much sub, I want off em soon as poss so I'm doing the taper plan. Anything over 12mg a day is overboard

  13. #13
    Bungalobiggsby is offline New Member
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    I was off oxy for 36 hours b4 takn subs, time is irrelevant, it's based on ur wd
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  14. #14
    iloerose is offline Platinum Member
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    The point is that you need to be at a 26 on the COWS or clinical opioid withdrawal scale. If you start your sub before that time you risk precipitated w/d and that is NOT fun. There is not set TIME contrary to what another poster said: it could be 36 hours it could be 48. That does not matter it's most important that you are in moderate to server w/d: hence the 26 is non-negotiable. The best thing to do if you are going to do this yourself is to piece out your subs in either .5mg. or 1mg. portions and when you hit that 26 take .5mg or 1mg. and wait for at least an hour and a half and see how it goes: in either case increase by .5mg. You want to induct at the lowest effective dosage. Here is robert_325's taper plan:

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

  15. #15
    mr_c is offline New Member
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    I like the idea of starting on a MUCH lower dosage. Question: I have a rather demanding job -- I'm a CEO of a fast growing Start up in California. I am hoping to take 3-5 days off to switch from Oxy toSubs. Then take a break, then when I have slow weeks, taper for 7-10 days to wherever I get, take another break and stay on a consistent level of Subs, then taper again when i have slow weeks. The plan is to start this over the July 4th week, so I will get several "Slow" taper weeks in the summer and would like to get 100% off by Labor day weekend. So that's two months on Subs.

    Can such a plan work?

  16. #16
    iloerose is offline Platinum Member
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    The point is to induct at the lowest effective dose that will keep you out of w/d. 32mg. is way too much, 16mg. is way too much. I'm guessing that you could induct around 6-8mg. tops. You should feel normal and you're right this may take around 3-5 days to begin. But you should feel normal on the inducted amount. This means that you are stable at that amount. When you are stable at that amount, you decrease your dose by .25% around every 4-5 days. You should be fine doing this with very minimal problems, if you encounter any at all. Read Alexnt's thread on the suboxone board. If you trust the process and let your body tell you what to do, you should be done before labor day. The worry you put yourself through will be the worst thing for you. You cannot just taper willy-nilly when the time suits you. The best thing is a slow and deliberate taper which gives your body time to adjust to each step. If you hold for weeks then drop suddenly for 7-10 days you are putting yourself at risk for w/d. If you can induct at the lowest effective dosage you will be fine, and I would guess that that dosage would be somewhere around 6mg. or even less. 32mg. and even 16mg. is way, way too high and may cause you more complications as far as how the sub makes you feel. Have you read the induction and taper protocol? Many in your situations have come off of subs without the w/d. The worst of it is going through the w/d period to induct on the subs. There is nothing set in stone as far as drop timing. The point is that if you are stable on a dose, you need to drop your dose. If you run into anxiety or problems at a drop, the taper is not set in stone and you can hold at a drop a bit longer, but there is no need to go weeks before a drop, if you are stable at a dose. You may experience some discomfort dropping, but nothing that would be debilitating to the point that it should interfere with your life. 6-8 weeks is the optimal time on subs but what you are suggesting is dropping way too fast at certain times, when you could drop just as easily doing it deliberately and on schedule.

    The point is to taper slowly and deliberately. You only hold at an amount until you are stable. This cannot be set in stone.

    Peace,

    Iloerose
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  17. #17
    mr_c is offline New Member
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    Everyone: This is really really encouraging. I am feeling much better to have all of you and your knowledge as a support group. THANK YOU!!.

    I do like my Dr and believe if i get him information he can review, ever anecdotal, he will look at it. I know for sure, if he feels comfortable about starting me at 6mg, he will. If there are studies, that's best, please point me to those. If not, I know Robert's taper plan and will review Alexnt's thread, pointing mr Dr to both of them. And will point him to that. Are there any other reviews of the process? Perhaps with personal testimonials about how well it worked? One of the reason I am asking is my Dr. has an office full of pain patients, many of whom would like off the Opioids and mr Dr is ALWAYS searching for ways to improve. And please, no bashing -- I know many many Dr's and this guy is a good one, very open, very young, very smart, very dedicated.

    Also, I am working with a psychologist and she is going to intro me to several other Dr's to talk to to get other opinions, plus she will provide long term support after with her and several support groups she is getting me hooked up to.

  18. #18
    iloerose is offline Platinum Member
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    I am not clear that there are any formal studies on Robert's taper protocol, all I know about this protocol is that it has worked here for 1000's of people. Subs were relatively new when robert wrote the plan and he specifically wrote it for people who were coming off heavy duty opiates. What he found, over a period of time that the shorter taper, around 8 weeks or so, helped to keep people from becoming dependent on the sub: suboxone IS in opiate and an extremely strong one. Often times we see people come here who actually get ill on the high levels of sub, 32 and even 16mg. You will see many people say with subs less is more and that they actually feel better at the lower doses. 32mg. is absurd. People have come here on high levels of sub and tapered quickly down to around 6mg. or 8mg. because 16mg. is even too much. Because of the build-up of sub many do not feel this drop. Most docs like to follow a patient's progress through the w/d or even have the patient come in when they are in w/d before beginning sub. then they start them at a high amount of sub, way too high and have them hold there for much longer than necessary. One thing though about induction we do not believe you should NOT TAKE ANYTHING at all as a "comfort" med as it only defeats the purpose as you WANT to reach that 26 as soon as possible and you do not want anything masking the w/d because if you still have a significant amount of opiate in your system you risk precipitated w/d, which while not life threatening, is hell itself according to people who have been there and these are addicts used to running into c/t w/d. No one here is trying to bash doctors, it's just that there is much that they don't know about subs and what they do know they learn from the pharma companies who manufacture suboxone. And the process can be costly for those who can't afford the sum the docs ask for when they go to a "certified" sub doctor and then the doc keeps them on high doses way too long. They tend to use sub as a maintenance drug like they used methadone (don't even go there). If your doctor is truly open to purely anecdotal information, which is all we have on this board, he would be among the first to be accepting of this protocol. Although I believe some people have worked this protocol with an accepting doc, but I do not evidence of this. None of us here are doctors. We never claim to be. We just help people based on what Robert has done and found that it works. I don't know if anybody has actually pointed a doctor to this site, we don't encourage this, as so many docs are adamant that their protocol is what is sanctioned by license in sub protocol and by the AMA. What we do here is help addicts and we've been using robert_325's protocol since around 2008.
    On another note: the idea of w/d is scary, scary, scary. It's the idea more than the reality and the brain knowing you are going to take away the drug it has become dependent on that stops people from moving forward. There is NO magic pill or guarantees that there will be no symptoms whatsoever. However, through reading the suboxone board you will see that this can be done, with minimal symptoms. Keep in mind that lately there are many people detoxing sub that have been on for years and this is a perhaps a more difficult situation as subs are strong and have an extremely long half life, so keep that in mind as you read.

    Peace,

    Iloerose
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    alexnt is offline Platinum Member
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    mr c its getting late and I need to get to bed and will talk with you later on some things I would like to share but real quick I just wanted to point out to you that Rose advise to you is very good advise as she always give I want to share a expert sub Drs point about the use of subs and the great tool it is to detox and he believes strictly in using it as a detox tool and never a maintenance drug.

    Alex

  20. #20
    alexnt is offline Platinum Member
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    mr c there is a Dr in Fla with the last name >>>>>>> and I have read some articles of his about using subs. He himself became addicted to fentanyl and used subs to get clean. He points out about how great subs are used as a detox tool and how almost all Drs over prescribe it. He detoxes people with oxy habits running between 300 to 600 mg a day. He also detoxes people who have been on subs for long periods of time and says that its harder and takes longer to detox them then the ones with bad oxy addiction. His goal is to introduce someone new to subs and get them off as soon as possible. He points out that after more then 3 months on subs that's when it becomes more difficult. he does not outline his taper plan for someone new to subs but tries to do it in less then 30 days and uses other meds. Your Drs plan has you at 14 mg for a long period and that would make it that much harder to wean off. one of his articles talks about how 16 mg of subs a day is ridiculous and not needed. Just wanted to pass that along to you.

    Alex

  21. #21
    mr_c is offline New Member
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    yup, i agree with you all. am talking to someone with newer methods shortly. Initial call he said, no hospital and way less sub and shorter.

    Will keep you posted.

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    mr_c is offline New Member
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    I got the appointment for this Thursday. Crossing my fingers that he is the amazing guy I've been told. Im getting very very busy at work and really need to end the up down of the meds. I want off all Opioid meds!

    All I know so far is he's got a not too hard way to get onto the Subs, then likes to see an 8 week taper off the subs.

    Question: I also take 2 mg of Ativan at night for sleep, as prescribed by my GP. My pain Dr. knows this. My GP does NOT want me to taper off the Ativan until I am at least on the Subs, and preferably off the Subs. I have tapered off Ativan twice before with little problems.

    Do any of you think the new Addiction Specialist will have a problem with the Ativan plan to taper off after I am off the Oxy? I have never abused the Ativan.

  23. #23
    TightRope is offline Junior Member
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    mr_c,

    Just quit all Pills, (Ativan too) that cause the Ills,
    Your going to do some time to get Kleen,
    get help from Green? Now mean Green isn't a crime.?

    I'm just getting over a week of Detox now. It does feel bettter.
    (I feel like I'm cheating with the Weeds.?.?..)
    I would suggest, you only do this once and do all them Dam Pills!

    'Keep walking the' -TightRope.

  24. #24
    alexnt is offline Platinum Member
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    Quote Originally Posted by mr_c View Post
    I got the appointment for this Thursday. Crossing my fingers that he is the amazing guy I've been told. Im getting very very busy at work and really need to end the up down of the meds. I want off all Opioid meds!

    All I know so far is he's got a not too hard way to get onto the Subs, then likes to see an 8 week taper off the subs.

    Question: I also take 2 mg of Ativan at night for sleep, as prescribed by my GP. My pain Dr. knows this. My GP does NOT want me to taper off the Ativan until I am at least on the Subs, and preferably off the Subs. I have tapered off Ativan twice before with little problems.

    Do any of you think the new Addiction Specialist will have a problem with the Ativan plan to taper off after I am off the Oxy? I have never abused the Ativan.
    mr c i do not know how your new Dr will feel about you taking Ativan while putting you on subs. Different Drs feel different about the use of benzos while prescribing subs. Im only guessing here but he might want you taper off Ativan before putting you on subs or have you start weaning off the Ativan once your put on subs or perhaps have you start the subs and wen you off them and then have you wean off the Ativan. I really don't know what he will suggest and those are just guesses on my part. I like the fact that you have found a sub Dr that looks like he is one in a few that appears to know how to put a person on subs and also has a method to get you off of subs using a taper plan. There are far far to many sub Drs out there who know how to place a sub patient on subs but if you say to them ok fine you are putting me on subs now how are you going to get me off of subs. Most of them are clueless as to this question. Or i have read this from quite a few members that there answer is you will probably need to stay on them for life. This is the answer i got from my councilor at the clinic i was going to. I was prescribed 16 mg of subs a day and i just let them think i was taking 16 mg a day. My plan was get as much as possible and build a stash so i could spend as little time there at $90 a week plus the cost of subs out of my pocket as low as i could. I wasn't aware of the taper plan here until i had been on subs for almost a month. I started tapering on day 4 once i got my script from the Dr at the clinic. My first 3 weeks were at a rather slow taper but i didn't know much at that point. Anyway I was a little over 5 weeks into my taper and was taking 8 mg a day and was getting ready to drop to 6 mg about 3 days later. I was having a meeting with my councilor on Friday and had another appointment to see the DR on Monday and get my 2 week script and knew i would then have plenty to taper off with Roberts plan by then. we had about 10 minutes to kill befor my session was over so i just asked her how long they would probably want to keep me at 16 mg a day before i would be able to start reducing. Here answer was it depended on the individual and that they would reassess me probably after a year and then maybe i could be able to start reducing. And to never try to reduce on my own without there ok. Im sitting there taking 8 mg a day which they think im at 16 and in three days im planning on dropping to 6 mg. By now i am familiar with the taper plan here and i felt like busting out laughing in her face. Anyway i went in Monday gave then a UA sample and the Dr wrote me a script for 28 8 mg strips. I dropped to 6 mg that day and 2 days later realizing i had more then plenty to taper off with wrote a letter to the clinic and thanked them for there help and told them to remove me from there patient list and give it to someone who was on there supposed waiting list. You appear to have found a sub Dr luckily that is not on of those who places a patient on a ridiculous high amount and just keep them on that dose for years. It does happen way more often then not. As for the reply that Tight Rope sent you that advises you to quit all pills. I am not one of those people on here that claims to be any sort of expert on things and i don't like to dispute people but when i saw what he replied to you in my opinion he has no business telling you to just quit all pills. I don't know what his history is as far as benzo useage but sudden stopping taking benzos cold turkey especially if you have been taking them regularly for a period of time can be quite dangerous It can lead into seizures so this is something to go over your DR with. Why he would post that to you is beyond me so i myself would disregard his message to you. Best wishes on your Dr visit and will talk to you later.

    Alex
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  25. #25
    Stigmata is offline New Member
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    You want to make sure you are going through withdrawal symptoms for sure!! If not the sub will only make you go into the worst part of withdrawal. Whatever you do, stay away from methadone as an alternative!!!

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    Stigmata is offline New Member
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    Alex is right about the benzo situation. Try to only open 1 can of worms at a time. I've tried to quit my benzos before and it was an insomnia nightmare. If your Dr. tries to tackle both the Oxy and benzo problem at once, make sure you stockpile like you did the subs because they'll be needed if you've been on them for any considerable amount of time. Regards,
    Mike.

  27. #27
    iloerose is offline Platinum Member
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    I am chiming in with Alex on the ativan: if you have been taken it regularly and for a period of time, you should not just go c/t from the ativan: that needs to be tapered. (I am basically writing this for others who might be thinking of jumping off a benzo drug c/t) Ativan can be dependence producing pretty quickly and should always be tapered. Just quitting a benzo drug, particularly if you are taking it regularly can cause seizures and even death. It is irresponsible for anyone to suggest c/ting a benzo drug while not under a doctors care.

    Mr. C: my advice is to wait until you've tapered the sub to begin on the ativan. Of course this will depend on what your doctor says. Hope everything is going well.

    Peace,

    Iloerose
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  28. #28
    alexnt is offline Platinum Member
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    mr c was wondering how the Dr appointment went Thursday? I am not sure if it was for this past Thursday or next Thursday.

    Alex

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    mr_c is offline New Member
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    Thank you for all the great comments and good thoughts. I can't tell you how much it means to log in to the forum and see all the great, thoughtful, comments. Thank you!!!

    The Dr: He is a board certified Psychiatrist, specializes in addiction medicine, been doing addiction medicine for ~30 years. Follows the research and the boards. He's very easy to talk with, listens and will consider any ideas. All references to the Dr. mean this same guy.

    1) On the Ativan: Talked it over with Dr. We will wait till after the Sub onboarding and probably after the Sub taper to taper the Ativan. He has a slow, reasonable taper plan for Ativan.

    2) On Boarding to the Subs (from Oxy): Overall goal is the same, shift you from any opioid drug to Subs, the lowest possible dose. However the process to get you onboard the Subs is vastly different. Note this process I am reporting is for patients who are on meds prescribed by a pain management center or surgeon. He takes patients from other backgrounds --but the process is different. Here's what he is planning for me.

    a) First, using your total dosage of meds/drugs you are currently on, he calculates the Max Sub dosage. You may or may not get to the this max, but you will not go over. Mine is 20 mg - -Though possible, he does not expect me to ever get to 20. He simply wants to make sure the patience always has enough

    b) He has you keep a journal for a week or so -- All the meds you are taking, and how you feel when you wake up

    c) Assuming you can sleep after last dosage (I can), he has you move the last dosage the night before he does the onboard to Subs, earlier evening by evening until you are waking up the next morning at between 6 and 7 on the COWS scale. He wants you in his office 2 hours after you wake up, i.e., 2 hours after you hit 6 or 7 on the COW's scale.

    d) in his office, he administers 10% of the max dosage calculated above. If symptoms don't go away, add second dosage of 10%. , If symptoms still don't go away add a third dosage of 10%,. Keep repeating till symptoms go away. Add up the mg of Subs, and this is your first dose. Goal to to have symptoms go away after one or two dosages. Once symptoms go away, wait two hours and check symptoms. If no symptoms, wait two more hours. If you have symptoms run 10% process again till no symptoms. This is your second dosage. Now wait two hours, like before. Once you've waited a total of 4 hours with no symptoms, you can go home. The whole process usually takes 6-8 hours. But if it takes 24 hours, he stays with you till you are stable. The goal is to get you in a little bit of withdrawal, stabilize, let it happen again, stabilize until it stops happening. Research shows that letting folks get into a little bit of withdrawal, then stabilizing with Subs, does not put you into precipitated withdrawal. He claims to have done this with 100's of patients, of all kinds of backgrounds.

    3) Taper Subs to zero meds. He follows the 25% method, but has you stay at each level for 10 to 14 days, rather than 4.

    All in all, he is a great guy, seems to know what he is dong and claims that this is just much easier than letting you get to 26 on the COW's scale.

    Note, I have only talked about the switch to Subs and then the Sub taper. obviously there is my parallel treatment plan to deal with addiction. It's really late, so i'll outline that in another note.

    I know everyone here (including me) believes intake 26 number on the COWS scale. But this does make sense. And if right, it sure beats the 2.5 days of hard W/D I'm facing in the other plan. method.

    Please send me your thoughts!!! The Dr is active in the research community .. very smart, very nice, very kind and I got a killer reference for him from someone in the know!!!! Gotta go to sleep ... looking forward to hearing everyones thoughts!!!!!!! Thanks you again!

  30. #30
    alexnt is offline Platinum Member
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    mr c ver interesting to read what your Drs approach is. If he has been doing this with other patients and had good results then he must know what hes doing. To be honest I don't know why he would have you tapering as slow as he does as you are going to be new to subs and I have always thought the less time on subs the better. But I am not a Dr nor any kind of sub expert so there is no way I would tell you not to follow his advise especially considering the fact that he is a Dr that has a taper plan for you. I have never heard of an induction like he is doing with you but if hes done it with 100's of patients with success it must work. Hope he can get you stable at a fairly low dose so that you can get on and taper in the least amount of time as possible. Best wishes to you and talk to you later.

    Alex

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