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question about subs
  1. #1
    Ben39 is offline Junior Member
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    Default question about subs

    I have a few basic question. How do you switch from oxy to subs if you are taking high dose of oxy? Do you switch immediatelly? How do you know what is the right dose? And how likely is that doctor would perscribe it?

  2. #2
    zebra1961 is offline Member
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    Default Ben

    You should consult a Dr. about amounts,and you need to wait before starting subs until you are in wds from the oxys . Look up the COWS withdrawal scale to determine when you are far enough in wds to start subs, otherwise you could go into precipitated wds. Ask a DR for help to be safe. He/She may not even suggest subs or methadone, He/She may tell you to taper from oxys or go cold turkey. Look up the Thomas recipe to help with wds when you quit,hot soaks really help when you quit,and exercise really helps All we can do is give tips and tell you about our experiences and what helped us!! But a Dr. should be used for dosages and which way to go that is best for you. I am not a medical professional but am willing to support and help any way i can good luck and let us know what happens.
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  3. #3
    Ben39 is offline Junior Member
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    Thanks Zebra. I wouldn't do anything on my own I just wanted to get familiar with subs. Thomas' recipe contains stuff that my pharmacist told me that shouldn't be mixed with my meds. I also take antidepresants and benzos. I am scared to mix stuff from health store or over the counter because pharmacist said they don't know what herbal stuff really contains and there is no information if they can be taken together with my meds.

    I don't have any vitamins because I buy a lot of ensure. I drink 3 bottles a day and they contain multivitamins
    Last edited by Anonymous; 02-06-2017 at 10:13 PM. Reason: add

  4. #4
    zebra1961 is offline Member
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    Default Ben

    glad to hear your dr is involved! Here we go,subs i was on them 2 1/2 years you DO NOT WANT TO ON THEM ANY WHERE NEAR THAT LONG!! They are just as addictive as other opiates, they are supposed to be used short term,like maybe two weeks to help with the withdrawals from other drugs. I have been on both oxys and subs.This is what happened to me when i quit the short acting opiates i.e. oxys hydros percs, the wds were intense for 2-3 days then subsided to nothing in 5-7 days in a couple weeks i was back to normal other than still having cravings I quit them several times lost count. The cravings took about 2 months to subside but still had them but they where weaker and more father apart as time went by.When I started subs they kept the wds and cravings away, but i was kept on them far too long, who's fault is that? Mine and my dr he did not tell me they where addictive and i didn't educate myself about them.So if you use them use short term or you will have another addiction. When I quit subs I jumped at a high amount 6-8mgs a day,the wds where intense for 5-7 days it was about a month before they subsided, that is the physical wds the depression lack of energy, not enough sleep, the anxiety the mental part last a lot longer. I did not mention i slept about 6 hrs in the first 21 days after quitting.So all that being said use subs short term only and rapidly taper down and quit!!! The only thing i liked about subs i did not crave subs or opiates after i quit them thats my story. You mentioned your on benzos careful very addictive and hard to quit So in a nutshell subs help you quit the wds are very lite or you may have none if you use for two weeks and after the first week rapidly taper down so you are on a small dose when you quit. Other wise if you are on them long term even at small dose they are tough to quit because the wds are rough and last longer because of the long half life of the drug so use wisely hope i helped you sorry about blabbering so long.

  5. #5
    Ricky71 is offline Advanced Member
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    Quote Originally Posted by Ben39 View Post
    I have a few basic question. How do you switch from oxy to subs if you are taking high dose of oxy? Do you switch immediatelly? How do you know what is the right dose? And how likely is that doctor would perscribe it?
    Hello again Ben. I see that you have a lot of threads started and I can also see that you are really struggling as well. I've replied to a few of your threads in the past to offer my advice and support.

    I don't have a lot of time right now but I wanted to leave you a quick reply regarding your sub questions. Subs should only be used as a last resort after repeated failed attempts at tapering and/or cold turkey from your current med/meds! Subs also have to be inducted on and taking correctly in a very structured manner or they can cause more harm than good! I'm gonna leave you a link to Robert's sub therapy/taper plan for you to look over and study? This is a very successful plan if followed correctly! I'm also going to leave a message for Randy to stop by your thread here, he can give you all the ins and outs of suboxone/subutex and how to properly and successfully use Robert's plan. Please wait for his reply before going any further with the subs! I wish you the best of luck... God bless us all!

    Here's a link to Robert's sub therapy/taper plan - https://www.drugs.com/forum/suboxone...apy-66109.html

  6. #6
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Ben39 View Post
    I have a few basic question. How do you switch from oxy to subs if you are taking high dose of oxy? Do you switch immediatelly? How do you know what is the right dose? And how likely is that doctor would perscribe it?

    Hello Ben -

    Ricky asked me to take a look a this thread and I'm happy to do so.

    To answer your question, you can make the switch to subs from oxy at any dose. Even if your dose of oxy is very high. as the others mentioned what's most important is that you completely stop the oxy and wait for wd's to set in. Use the Cows to determine when it's safe to induct to aviod precipiatated wd's. You'll be feeling terrible for 24-36 hours or so, but once you take some sub you'll be feeling much better shortly.

    Once you hit the 26 score needed on the Cows you should begin your induction with very small doses taken every hour or so. Usually it's between .5mg and 1mg as your initial dose, depending on your drug of choice and tolerance. The gola is to be on the lowest effective dose, not the highest. Most people are completely stable on 3-4mg per day, sometimes a bit more, sometimes less depending on the person.

    Sadly many, if not most of these sub doctors don't have any idea how subs really work. Just a 8 hour online course is all they are required to take and they're then able to prescribe the subs. Then the pharma reps come in and advise these sub doctors to prescribe huge amounts to unsuspecting patients. And they instruct the doctor to keep them on it for years. Makes me so mad. If you find a sub doctor that actually knows subs you've hit the jackpot. Just doesn't happen very often I'm afraid. If your sub doctor says you need anything over 8mgs per day you most likely have an uneducated sub doctor. Most use a one-size-fits-all approach and that's completely wrong. I guarantee you I'm right about this.

    Taking subs for ONLY 2 weeks isn't going to do much either. I'm not saying stay on them for months and months, or years, but you need time to curb your addictive thoughts and behaviors. The sub plan used here, Robert's sub plan, takes about 6-8 weeks give or take and that's usually the right time frame for most. Once you find the right induction dose you remain on that dose for about a week then begin the taper process by reducing your dose 25% every 4 or so days. Read the plan, it's all there.

    All the horror stories you'll read about subs are always for the exact same reasons...
    Inducting on too high of a dose.
    Improper induction.
    On sub for years.
    Jumping from way to high of a dose.
    Tapering much too quickly.
    Tapering by too many mgs.
    Not tapering low enough.

    Theres several other reasons too. If you follow the plan closely you'll be another success story. And you'll be off in a timely manner with very few, if any problems. The plan really does work.

    Hope this helps Ben. Do this right and it only needs to be done once.

    I'm here if you need me. Take care.

    Randy


    Randy
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  7. #7
    Ricky71 is offline Advanced Member
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    Quote Originally Posted by zebra1961 View Post
    glad to hear your dr is involved! Here we go,subs i was on them 2 1/2 years you DO NOT WANT TO ON THEM ANY WHERE NEAR THAT LONG!! They are just as addictive as other opiates, they are supposed to be used short term,like maybe two weeks to help with the withdrawals from other drugs. I have been on both oxys and subs.This is what happened to me when i quit the short acting opiates i.e. oxys hydros percs, the wds were intense for 2-3 days then subsided to nothing in 5-7 days in a couple weeks i was back to normal other than still having cravings I quit them several times lost count. The cravings took about 2 months to subside but still had them but they where weaker and more father apart as time went by.When I started subs they kept the wds and cravings away, but i was kept on them far too long, who's fault is that? Mine and my dr he did not tell me they where addictive and i didn't educate myself about them.So if you use them use short term or you will have another addiction. When I quit subs I jumped at a high amount 6-8mgs a day,the wds where intense for 5-7 days it was about a month before they subsided, that is the physical wds the depression lack of energy, not enough sleep, the anxiety the mental part last a lot longer. I did not mention i slept about 6 hrs in the first 21 days after quitting.So all that being said use subs short term only and rapidly taper down and quit!!! The only thing i liked about subs i did not crave subs or opiates after i quit them thats my story. You mentioned your on benzos careful very addictive and hard to quit So in a nutshell subs help you quit the wds are very lite or you may have none if you use for two weeks and after the first week rapidly taper down so you are on a small dose when you quit. Other wise if you are on them long term even at small dose they are tough to quit because the wds are rough and last longer because of the long half life of the drug so use wisely hope i helped you sorry about blabbering so long.
    zebra - you left a post earlier today on the following thread - https://www.drugs.com/forum/need-tal...ilm-57730.html
    I left you a reply there, I didn't know if you would go back to that thread so I thought I'd give you a heads up here? Take care... God bless us all!

  8. #8
    Ben39 is offline Junior Member
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    I have an appointment with my doctor tomorrow for other reasons but I will mention subs to him. I will see what he says and I will reply to your posts. Thank you all. You are my big and only help guys.

  9. #9
    Ben39 is offline Junior Member
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    Zebra, you gave me some good info about subs. That is the point of my thread, to get some help from people who were/are on it. What do you mean you slept 6 hours 21 days after quitting? I hope you mean 6 hours per day.

    Ricky, I am always glad when you reply. I will take your advice to see if I can wean off oxy first. I like your last sentence in your every post, the God bless us all. Without prayer it would be much harder for me. It helps.

    Randy, Thank you for your clear explanation. Thank you for offering support when I need it. I do have this question though. Does the dose of opiods matter much for the sub dosage? From 300 mg oxy is 4 mg of sub sufficient? Also, what do you mean by score 26 needed on the COWS...(And I know nothing about COW scale)


    Now my short story. I went to my doctor (my very new doctor) for some physical issue and I mentioned subs. He said, almost yelling, "suboxone is for junkies and talk to the doctor who prescribed them to you".

    Well, that is why I need to know if sub dose matters comparing to opioid use.

    Thanks everyone

  10. #10
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Ben39 View Post
    Zebra, you gave me some good info about subs. That is the point of my thread, to get some help from people who were/are on it. What do you mean you slept 6 hours 21 days after quitting? I hope you mean 6 hours per day.

    Ricky, I am always glad when you reply. I will take your advice to see if I can wean off oxy first. I like your last sentence in your every post, the God bless us all. Without prayer it would be much harder for me. It helps.

    Randy, Thank you for your clear explanation. Thank you for offering support when I need it. I do have this question though. Does the dose of opiods matter much for the sub dosage? From 300 mg oxy is 4 mg of sub sufficient? Also, what do you mean by score 26 needed on the COWS...(And I know nothing about COW scale)


    Now my short story. I went to my doctor (my very new doctor) for some physical issue and I mentioned subs. He said, almost yelling, "suboxone is for junkies and talk to the doctor who prescribed them to you".

    Well, that is why I need to know if sub dose matters comparing to opioid use.

    Thanks everyone

    Hi Ben -

    That so called "doctor" should be reprimanded for saying that. Unbelievable??? I would have loved for him to say that to me. He would have gotten an earful that's for sure. He has no clue, and no compassion.

    To answer your questions....Does the amount of opioids matter as to what the sub dose would be? No, not at all. Doesn't matter one bit. Doesn't matter how much opiates someone is taking, how long, or how severe the habit, the subs work the same. Most addits are stable on 3mg to 4mg of sub. But it can vary, especially when coming from Methadone. Might take someone on Methadone 6-8mg to become stable. The induction should be performed the same for everyone.....start with small amounts and build up the dose until stable. The goal is to be on the LOWEST effective dose.

    What is the Cows? The Cows (clinical opiate withdrawal scale) is a chart used to determine when it's SAFE to take the first dose sub. The Cows gives numbers to a variety of wd symptoms. You add up your score and once you hit a score of 26 or higher you know it'sok to take that first dose of sub. Take the sub too soon and you could go into precipitated wd's in which wd symptoms come on almost immediately, and are the WORST symptoms you'll ever experience I promise. They are HORRIBLE and you'll be sicker than you've ever been. I've been through them twice and landed in the ER. They can do nothing for you either. Just have to let them pass, and the time varies. You want no part of PWD's.

    After completely stopping your drug of choice you'll want the wd symptoms to begin and be moderate to severe. You'll hear some people say they waited 12 hours, or 24 hours, or whatever "time" they waited before taking the sub. That's just a guessing game. The Cows takes all the guessing out of it. Once you hit the honest and accurate score of 26 you know for CERTAIN you can then take the sub. Here's a link to the Cows so you can take a look at it below -

    https://www.drugabuse.gov/sites/defa...rawalScale.pdf

    Here's the link to Robert's sub therapy plan that Ricky provided earlier and we follow closely here -

    https://www.drugs.com/forum/suboxone...apy-66109.html

    If you haven't already read it over carefully.

    I will tell you that subs should always be the very LAST choice made when wanting to get clean. Try cold turkey first, try it again and again if necessary. Try tapering you drug of choice if possible, Try that again too. If all methods fail then subs may be right for you? Suboxone saved my life, but I was at the end of my rope. I relapsed over and over. I was at rock bottom. I had no other choice but to try subs. It was the best decision for ME.

    If you do go the sub route make certain you use them the right way. All the horror stories are for the reasons I mentioned earlier. Used correctly they do work. Just remember that getting clean is easy, I did it many, many times. Remaining clean takes an enourmous amount of effort and willpower. I use meeting of NA and AA to help keep me clean. I'll have 3 years in July. Just keep that in mind about outside support whether it be meetings or counseling. Can't do this alone Ben.

    Randy
    Last edited by Anonymous; 12-13-2017 at 07:36 PM.
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  11. #11
    Ben39 is offline Junior Member
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    Thank you Randy. So going from 300 mg of oxy to 3 or 4 mg of sub is OK. I will look for a doc who is willing to prescribe it (I still am attempting tapering). I will print the COWS chart and carefully observe myself (if I go on subs).

    I know that by point 26 I would be ready for ER. But, after I take my first dose of sub, what happens. How soon the WD symptoms go away? What other symptoms might I experience while on subs.

    I might soon run out of my opiods. If I happened to go cold Turkey, if i survived, I would develop PTSD and chronis post withdrawal syndrome because I know my seld and how weak I am mentally. I developed GAD/Depression in my early teens in war and they just grew in me instead of going away. I felt good when I started oxy but as you know, eventually I use them just bc my body needs it to function.

  12. #12
    Ben39 is offline Junior Member
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    Since my doctor left I have seen 2 so far. First one said sub is for junkies and will not take over my file. Today, the second one said "a doctor needs to have a special license to prescribe suboxone". But he has license to prescribe narcotics???? And he said come in a few days so we can talk to see if I am able to treat you.

    WTF? What is there to see. I may need referrals for my physical issues and he can decide in 2 minutes if he is willing to take over triplicate file from my old doctor. So sick and tired of these doctors.

  13. #13
    Iluv2smile is offline Platinum Member
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    It's true the only Drs that can prescribe sub
    Are the ones that go through an 8 HR class..
    that's makes them an expert on the drug..

    Subs is not just for junkies.

    Subs are for people who have no where else to go..
    Many because of a opiate addiction that was started by a legitimate pain issues.

    I really think that Drs get so defensive sometimes because a lot of people that end up addicted
    Starting by going to the Drs for real pain issues.

    I am a ICU RN and work with doctors everyday for the last 27 years
    And they hardly ever if ever admit they had a part in this epidemic or are they wrong..

    I am glad that their behavior is not distracting you on your mission to get clean!

    You sound very determined with or without their help!

    That's what it takes!

    Carry on!
    You are doing great!

    Bette
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  14. #14
    Ben39 is offline Junior Member
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    So, now I have to ask if the doctor has sub license when I look for a new one. He can prescribe morphine but no suboxone. Oh God.

  15. #15
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Ben39 View Post
    Thank you Randy. So going from 300 mg of oxy to 3 or 4 mg of sub is OK. I will look for a doc who is willing to prescribe it (I still am attempting tapering). I will print the COWS chart and carefully observe myself (if I go on subs).

    I know that by point 26 I would be ready for ER. But, after I take my first dose of sub, what happens. How soon the WD symptoms go away? What other symptoms might I experience while on subs.

    I might soon run out of my opiods. If I happened to go cold Turkey, if i survived, I would develop PTSD and chronis post withdrawal syndrome because I know my seld and how weak I am mentally. I developed GAD/Depression in my early teens in war and they just grew in me instead of going away. I felt good when I started oxy but as you know, eventually I use them just bc my body needs it to function.


    Hey Ben -

    I know this stuff can be a real nightmare sometimes. It gets your head messing with you and makes your mind wonder about all kinds of scenerios. Take a deep breath and know that everything will be ok. You just have to want to be clean. Really want it bad. You have to want it more than anything else. And yes you can do it. I know you can.

    IF subs are your choice then please use them the right way. Induct properly and eventually taper the right way as the plan advises. I realize that getting to a 26 score on the Cows is certainly no fun. And yes, you might feel ike a visit to the ER is in order. It may feel that way, but you don't have to resort to that fact. You only need to do it once if you do it right the first time. Waiting in wd's to be able to induct on the subs is the worst part to sub therapy. Waiting in wd's while adding up your Cows score takes enourmous strength and willpower. Again, you only have to do it once.

    After you hit the magical 26 number and take a dose, maybe two of sub you'll alomst instantly begin to feel better. Much, much better in fact. As you add small amounts every hour or so you'll feel as normal as normal can be.

    Yes, doctors have to have a "special" license to prescribe subs. As Bette mentioned they only need to take an 8 hour online class and they are then able to begin prescribing it. Sadly many, if not most of these sub doctors are in it for the easy money to be made. most of these sub docs place patients on huge doses (8mg - 24mg per day) and plan to keep them on it for years. Absolutely the opposite of the way it should be. You want to be on the lowest effectice dose, get stable for about a week, then begin the taper process. If you do that you'll experience very few, if any problems.

    Do everything in your power NOT to use the subs. They should be the very last choice made. Try tapering and CT and give those an honest effort. If you just can do it that way then subs may be the way to go. I'll be more than happy to help you on and off the subs if you do choose them. Google "sub doctors" in your area and many should pop up. Call the closest ones first and try to find one accepting new patients.

    If you do go to a sub doctor and he or she puts you on a large dose of subs try not to let it worry you. Just get as many subs as they will give you and come here for advice. We can get your dose down quickly with little problems.

    Think it over carefully what you want to do. We'll help and support no matter your choice.

    Randy
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  16. #16
    NikkiLP is offline Junior Member
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    Ben

    Dropping by to let you know my experience on how it felt hitting the COWS score and induction. Please know I am a chronic pain patient and that's how oxycodone got introduced. After 2.5 years..I went through the 120 pills in 2 weeks. It got bad the last few months and I was buying.
    I tried tappers. Many months of promising myself it would be different. I would have skip days..I made and broke dozens of promises to myself. The writing was on the wall..I was just to scared to read it.
    I am seeing an addictionologist and a therapist. It's true the market is flooded with Dr. Who take an 8 he class and get a special DEA number to prescribe. These dr.s usually only take cash and it's 500.00 then 175. Every 2 weeks. Just check the prices it does vary..and to me explain who uses it to pay for their vacation house. Wanting to keep you on it for a long time as a cash cow.
    I read that you are taking high doses of gabs to help with withdrawal and left you a comment on that thread.
    So the COWS score is downloadable..google COWS score..clinical opiate withdraw scale..Randy provided a link.
    I needed 120 mg to feel normal and function. No high.
    No comfort meds Ben..no Xanax, Tylenol or Gabapentin..it masks your symptoms and makes hitting that score much harder mentally. I was induced on Thursday..I went to the Dr Tuesday. There was a problem with my insurance and it took until Thursday for me to pick up. I took my last oxy at 4 pm Tuesday. So I was sobbing by Thursday. I couldn't trust myself to be honest with myself ( just take 3 oxy today..lol..nope..it was 8) and had my husband score me or I would have put myself in PW..It is a mind game mostly..I had chills then hot..pouring sweat..goosebumps. Skin hurts bubble guts..no appetite..runny nose..pupils became dinner plates..I ate 4 mg. My BAD..opening and seeing this tiny film..my drug brain was convinced it wouldn't help. The film is already scored into 2 pieces..I put 4 mg under my tongue and waited an hour..felt 80 percent..took entire other half..8 mg.
    The Dr said up to 12 mg. By doing it the way I did..I did NOT learn my minimum effective dose. Today is my 2nd day at 6 mg..Catrina nudged me to begin tapper. SHE is right.
    I waited the entire day for withdraw to come back. It didn't..I feel great. Like in the last 6 days since starting subs..I have done more for my daughter husband and myself then all of last month. I feel like Nikki. Me..I am laughing and crying..it feels great to be me. I understand that there is still opiates in my system and they need to be out in a few months or they will turn. Oxycodone turned on me..jerks. But I spent the entire weekend waiting to be sick..it never happened.
    I had physical therapy today..in water and I am sore..but I don't know if this is my true pain level or oxy sending signals for more. Giving it at least 1 month. Took Tylenol..used Voltaren gel and lidocaine gel.
    Getting to 26 took me 32 hrs..I was so close to eating another pill because my insurance needed pre auth. The only thing that stopped me was knowing if I used..I would have to start all over to hit that 26 again.
    Unknown if people come on here with the no man it is okay to take it after 12 hours..are trying to D**k size or what. It's your body and your health at risk. It sucks to hit 26 on the COWS score. It's hell not taking anything to hit it. But if you do it right you only have to do it 1 time.
    If you get the strips..trust the process outlined here. My drug brain would not be convinced that .5mg would do anything. I doubted 4 mg could help. In the end I started higher and have to get lower..I added time..
    Wishing you well Ben. Promise I went 40 plus hrs..with nothing and I am a baby. Don't let your mind trap you. Know that 1000 Have walked before us..post if you need too.
    Blessings
    Nikki

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