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Oxycodone addiction, Suboxone taper advice,
  1. #1
    mr_c is offline New Member
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    Default Oxycodone addiction, Suboxone taper advice,

    Hi:

    First, a BIG thank you to all of you. Not just for answering my questions and encouraging me to step forward. But to all of you who make this forum a great resource.

    Here's where I am:

    I decided to go with the new Dr -- the one who is an addition psychiatrist. Some of you might remember, I got into this mess cause of 5 very painful surgeries over 3 years resulted in me being on a very high dose of Oxycodone (toped out at 500 mg/day). After 9 months of tapering with the pain Dr and much suffering, I got down to 175mg /day. But I'm miserable with the Oxy taper.

    Here's the plan:
    Increase me back up to 200 mg/day till induction day. This is so i'm comfortable as the drop from 200 -> 175 was tough and I never settled well at 175. Induction day is May 8th. Between now and then, I am to experiment talking last dose of Oxycontin (60mg) at 8 pm, the 7pm then 6 pm ... till at 8 am the next am I am at between 11-13 on the COWS scale. This is reasonable because I process the meds so fast now, that I have to take Oxycodone every 90 minutes to stay our of withdrawal and I start to feel withdrawal after 4-5 hours from Oxycontin.

    May 8th, Induction day!
    Arrive at his office at 8. Immediately take 4 mg of Suboxone, wait an hour and see how I'm doing. If not well, add 4 mg, wait another hour, if feeling good, wait another hour and see how I'm doing. He repeats a process of giving me more Suboxone till after 2 hours the symptoms stay stable. At some point before 2 pm, he tries to send his patients home. then he's checking in with me every 2 hours on the 8th, and every 4-6 hours on the 9th, 10th, 11th and 12th. He expects me to feel 'ok' Friday and over the weekend and back to normal by Monday (12th). He expects me to top out at between 8 mg and 24 mg. Most of his patients top out closer to 8 mg of Suboxone.

    Suboxone taper:
    Every 14 days, taper 25%. Below 2 mg can start skipping days at 2mg, 1 mg or .5mg.

    I am very excited to go through and complete this process. I know there have been several protocols published here. I've read all of the ones i could find. I would love to hear any specific thoughts, comments, encouragement, similar experiences.

    It's going to get HARD before it gets better for me. Thank you all for the help and encouragement.

    Mr_C

  2. #2
    ashamedmom7 is offline New Member
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    Don't do suboxone! God please no! I became an addict and I was taking 200 mg a day of oxycodone ,the withdrawals were awful so I went to a Dr and I was perscribed 24mg of subutex a day,I have tapered down to 12-16 mg a day but it's taken me FOUR YEARS! I've tried twice to do a quick taper and cold turkey and by 7 days without a single mg of subutex/oxone I was laying on the floor,inthe shower ,trying to cut my wrist to end the pain...! My husband had to fight me to get the knife away...I begged him to strangle me,break my neck...it was the WORST pain I've ever been through...the restlesslegs,the yawning and cold sweats,the chills and stomach pains..puking and pooping all over myself then becoming so dehydrated my kidneys started shutting down...I lost about 13 lbs those 7 days. .I went back to 12-16 mg of subutex...look I'm a stay at home mom of 7, I can't lay around,immobile,too sick to move for months and months..my oldest is 12 and I have 3 ages 3 and under...suboxone saved me but it trapped me...I've met many ppl ,talked on so many forums and we are not lying when we tell you that the physical withdrawals last up to 3 months...maybe longer and then the depression that follows is the worst...if the withdrawals don't kill u the depression will! I will honestly admit that when the day comes that I'm forced off the program or forced to stop the suboxone...I will off myself....call me selfish and weak ...but I am ashamed as it is,I let my beautiful children down...I can't imagine them seeing me so sick like that...and buprenorphine binds to your receptors differently than any pain pill or methadone...it can take DECADES to completely cleanse the bupe from your brain receptors ,yes I said decades....now..with that being said ...if you can use suboxone/utex for about 3 weeks and do a super quick taper...u will do beautifully...but please be realistic too...u will suffer some sort of discomfort...physically and/or mentally ...it's part of it...but if you can use the sub for a short time,just the time it takes ur body to withdraw and you DON'T GET ON A LONG TERM PROGRAM you should do great...BUT if you don't do away with the sub after 3 weeks,you will find yourself in another vicious cycle and if I had known 4 yrs ago what I know NOW ,I would've NEVER TOUCHED SUBOXONE! EVER,I would've done a slow taper from the pain pills then substituted the last week with subutex...or just suffered the withdrawals from the pain pills for a week and been done with it...trust me....it's no mind over matter! Mind over matter does NOT work in this situation/addiction ....it's HELL AND U CAN SUFFER WITH PAWS (POST ACUTE WITHDRAWAL SYNDROME) WHICH CAN LAST INDEFINITELY...LOOK IT UP..and my thoughts and prayers are with you which ever method you use! Xoxo

  3. #3
    alexnt is offline Platinum Member
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    mr c do you know how long this Dr has been using this method with patients and what his success rate is using this method? Have you spoke with any patients of his that he has treated this way and discussed with them how it worked using this method. If your using 200 mg of oxy a day then I really cant say I believe he should try inducting you at lower then 4 mg. I know that the less time your on subs the easier it is to get off subs. I see where he has you reducing with 25% drops which sounds good but I don't like the fact he keeps you on a dose for 2 weeks before dropping. That is usually what people who have been on subs for long periods of time might need but not for beginners of using subs. I did not know of the taper plan on here my first month of subs but I found it and at 8 mg I used mostly a 6 day drop schedule sometimes 4 or 5 days but never more then 6 days at a dose and reduced 25% with my drops and never felt any of my drops. Having you stay at each dose 2 weeks will result in you being on subs longer then I really feel you will need to be on and make getting off of them harder then needed. You said until your appointment on May 8 you are to experiment with how long you can go time wise as far as making it till 8 am. That gives you a little over 3 weeks so I would suggest you test it and see how long you can go before you are really hurting bad. I don't understand how he will be able to tell if he puts you into PWD on the 8th or not. I suppose he can tell by your symptoms if he puts you into PWD or if you need more because at 4 mg your dope sick. Also if 4 mg is not enough which it may be enough to hold you then I wish he would try to add 2 mg instead of 4 mg and see if that works. Anyway those are my thoughts and hope to hear back from you and see how you are doing time wise with your evening dose while you experiment with it.

    Alex

  4. #4
    mr_c is offline New Member
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    Alex:

    First of all, thank you for the thoughtful response. I know my Dr believes that 4mg will not be enough. He believes I'll stabilize somewhere between 8 mg and 20 mg total per day. In his mind, lower (closer to 8) is better, but I stabilize where I stabilize. That being said, he's prescribed me "SUBOXONE 8MG/2MG DISSOLVING FILM". I'm not 100% sure what that means, but I assume that I have a 2 mg dose and he may very well go with 4 mg then increase in increments of 2 mg. He indicated to me that the first day is a long slow day. I should expect to work with him pretty much the whole day till we get me to a good dose -- Then he will check in with me every few hours fro 2-3 more days (except from 12 midnight to 6 am).

    Taper:
    His fundamental believe is that it takes ~14 days for your receptors to stabilize each time you lower the dose. Regardless of how you feel, he feels strongly that 14 days is the min. You can take longer (thought he discourages this unless you are quite sick). I do understand your Robert's theory -- but for my Dr, it's 14, rather than 4. He is not seeing too many patients getting stuck, though he does have a few who are stuck at .5 mg a day. He expects me to be on Subs for 2-3 months, max. Is that a terrible worry?

    Last question:
    He's planning on having me take the Suboxone films. I am a very healthy 51 years old male. But I am somewhat chemically sensitive. For example, I can't be anywhere near new paint or solvents -- the higher the VOC the worst it is. But as long as I avoid very very new renovations, I'm fine. Also, there are certain medications that i can't take, not many, but, for example, I can't take SRII's. On the other hand I take an array of blood pressure and cholesterol meds with no problems at all.

    Do you know how many folks really have a problem with the naloxone in Suboxone? I understand you don't absorb it into your blood >>>>>>, so it's hard for me to understand how I could have a problem, but because i read about the odd person here and there having problems with naloxone, I thought I'd ask. FYI, My DR knows about all this and has instructed me to have enough oxy for a week supply so we can stop the induction if i react badly to the naloxone. (my pain Dr is on board and will help). If I do have a bad reaction, we will try with a generic buprenorphine the next week. He really feels like the strips are such a good delivery system that it's worth the tiny risk for me to do it this way.

    Thoughts?

    Thanks everybody!!
    MadMax03801 likes this.

  5. #5
    alexnt is offline Platinum Member
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    Quote Originally Posted by mr_c View Post
    Alex:

    First of all, thank you for the thoughtful response. I know my Dr believes that 4mg will not be enough. He believes I'll stabilize somewhere between 8 mg and 20 mg total per day. In his mind, lower (closer to 8) is better, but I stabilize where I stabilize. That being said, he's prescribed me "SUBOXONE 8MG/2MG DISSOLVING FILM". I'm not 100% sure what that means, but I assume that I have a 2 mg dose and he may very well go with 4 mg then increase in increments of 2 mg. He indicated to me that the first day is a long slow day. I should expect to work with him pretty much the whole day till we get me to a good dose -- Then he will check in with me every few hours fro 2-3 more days (except from 12 midnight to 6 am).

    Taper:
    His fundamental believe is that it takes ~14 days for your receptors to stabilize each time you lower the dose. Regardless of how you feel, he feels strongly that 14 days is the min. You can take longer (thought he discourages this unless you are quite sick). I do understand your Robert's theory -- but for my Dr, it's 14, rather than 4. He is not seeing too many patients getting stuck, though he does have a few who are stuck at .5 mg a day. He expects me to be on Subs for 2-3 months, max. Is that a terrible worry?

    Last question:
    He's planning on having me take the Suboxone films. I am a very healthy 51 years old male. But I am somewhat chemically sensitive. For example, I can't be anywhere near new paint or solvents -- the higher the VOC the worst it is. But as long as I avoid very very new renovations, I'm fine. Also, there are certain medications that i can't take, not many, but, for example, I can't take SRII's. On the other hand I take an array of blood pressure and cholesterol meds with no problems at all.

    Do you know how many folks really have a problem with the naloxone in Suboxone? I understand you don't absorb it into your blood >>>>>>, so it's hard for me to understand how I could have a problem, but because i read about the odd person here and there having problems with naloxone, I thought I'd ask. FYI, My DR knows about all this and has instructed me to have enough oxy for a week supply so we can stop the induction if i react badly to the naloxone. (my pain Dr is on board and will help). If I do have a bad reaction, we will try with a generic buprenorphine the next week. He really feels like the strips are such a good delivery system that it's worth the tiny risk for me to do it this way.

    Thoughts?

    Thanks everybody!!
    mr c I know that some people don't tolerate the naloxone in the suboxne strips well for some reason. I believe its just a small % of people though. You said he is prescribing you 8mg/2mg strips and you did not know exactly what that meant. The strips contain 8 mg of buprenorphine and 2 mg of naloxone. I still don't think you need to wait 14 days before each drop though. Roberts taper plan of 4 day drops was just something he used himself and he did this on his own as it was several years ago when he developed the plan on his own. While maybe 4 days is dropping may be a little quick if your new to subs as will be your case I just do not agree my self on having you stay on a dose for 14 days befor dropping. I have seen a lot of people on here with daily use higher then yours and 6 mg tops usually is what they can get stable on. You said he expects you to be on subs 2 to 3 months tops but that will not be possible if he has you dropping 25% while spending 2 weeks at a dose. Lets assume you are able to stabilize at 8 mg. Here is what your taper would be with using a 14 day drop at 25%.
    first 2 weeks 8 mg a day
    2nd 2 weeks 6 mg a day
    3rd 2 weeks 4.5 mg a day
    4th 2 weeks 3.375 a day
    5th 2 weeks 2.5 mg a day
    6th 2 weeks 1.875 mg a day
    At this point you will have been on subs for 12 weeks and your next drop would be to around 1.4 mg a day and you would still have a ways to go. The math doesn't add up if you see what I am talking about. I would like you to google Dr Steven >>>>>>> and check out some of his articles about suboxne use. He is a sub Dr who himself became addicted to fentanyl which is the king off opiates and used subs as a tool to get clean. While I like the fact that you do have a Dr who isn't one of those Drs who know how to put a patient on subs and has no idea how to get you off of them at least your Dr does have a plan but I see flaws in it. Let me know what you think of Dr >>>>>>> and also post on how your experiment is going on how long you can go with your pm dose and how long you can make it till 8 am next morning.

    Alex

  6. #6
    mr_c is offline New Member
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    Alex:

    Thank you. I will look up Dr >>>>>>> tonight. I am trying my experiments this weekend and will let you know.

    Thank again for the support. It's been very helpful.

    A

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