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Questions about Suboxone induction
  1. #1
    DangerLuvr is offline New Member
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    Default Questions about Suboxone induction

    Hey everyone! First off, I just wanted to say thank you to the senior members who look out for newbies like me. I've read these forums for a long time, and am now ready to do this myself. I've read Robert's post, and I was a critical care nurse before throwing my life away for drugs.
    I have a pretty significant history of PTSD that started me down the path of addiction. I began diverting IV narcotics and ended up losing my nursing license. This was 5 years ago. I began a program for nurses in recovery and was promised a lot of things that never came true. Story for another day. My longest clean time was 18 months. The major problem I have is that I have a pretty significant history of arthritis and also stenosis of the spine as well as scar tissue build up. After that 18 months, I couldn't take the pain anymore of living without something to help the chronic pain of arthritis, and I kept screwing up. I ended up getting kicked out of the program, which means if I do go back for my license, I will have a discipline on it for life. All info from the time I entered the program until I left is public information. I struggle with that a lot. Anyway...sorry...I'm getting off topic.
    I've never been someone who had a lot of "connections" to get drugs, so if I couldn't find it I went without. For the last 10 months or so, I've had a connection for suboxone (8s) It's helped my pain a lot. I have a friend who sees a Dr here where I live as well who is extremely well versed with regards to suboxone treatment, and because my connection has gotten sparse, I decided to go to the Dr myself. Herein lies my dilemma. My connection can't get me anymore subs, my appt isn't for another week and a half, and I'm in full on withdrawal now. I'm at about day 10, and earlier this week was of course the worst. The problem is even at the peak of my withdrawal, my COWS score was nowhere near a 26. I haven't taken anything for support except Immodium, and massive amounts of ibuprofen (yes, I know the dangers). I've never, ever had a lot of those symptoms that COWS looks at...specifically tremors, yawning, and watery eyes. I do get hot/cold flashes and piloerection, but not to a significant degree. As you guys know, I feel like >>>>. My friend who sees this Dr is kinda in the same boat as me...significant history of arthritis but is an addict and can't take pain medication as prescribed. He has told her that she can stay on suboxone for the rest of her life if needed. I know this is a heated topic, as many don't believe in suboxone treatment for pain OR long term...but for people like me who have had over a year sober and still in unbelievable amounts of pain...it leaves us stuck between a rock and a hard spot. If my arthritis pain isn't treated, I will continue to use. I know that to be as true as the fact that the sky is blue. I know I'm long winded, but just trying to give a good history. I guess my question is what's going to happen if I am so far out from last use at my appt? I know I will have a lot of pain still, this is an everyday thing for me if I'm not on something. Right now it's a lot worse of course. I ended up finding some old Neurontin in a drawer like 5 min ago that I used to take for sleep when I was sober. I am taking that to help with the symptoms, as I have to work while also going through withdrawal and I have a 48 hour shift starting in 5 hours. This is going to blow. Anyways...thanks for reading, and any input would be greatly appreciated. Thanks guys. -DangerLuvr

  2. #2
    Randy35 is offline Platinum Member
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    Hi there DangerLuvr, welcome to you! Love the name! Sounds like me! Lol.

    I would first suggest you move this thread to the Suboxone forum. You'll receive many more replies than this one. More traffic there than here. Of course you may leave it here if you choose to do so. And secondly I will inform you the both Imodium and Ibuprofen can many times alter the Cows score by delaying any progress made in Wd's. Especially "massive" amounts of Ibuprofen. Imodium is opiate-based and anything that makes you "feel better" that's taken when trying to reach the 26 score can slow down the severity of symptoms. Ideally we recommend taking absolutely NOTHING and allow Wd's to hit hard so that score gets there quickly, or as fast as possible. I think if you stopped taking any kind of med or supplement that has any kind of feel good effect your score will rise to the 26 needed for a safe induction. I went into PW's TWICE and I promise you want no part of that nightmare!

    You're certainly in a dilemma with your addiction and pain issues. We don't promote long term sub use here on this forum. Buprenorphine is an agonist, albeit a partial-agonist, but long term use can lead to dependence and even addiction in some cases. Never a good idea. I guess one could say it's better being on sub than the previous drug of choice. I'm personally of the opinion one should remain on sub long enough to get past addictive actions, behaviors, and thinking, but not so long as to begin liking it too much. Our sub therapy plan of 6-8 weeks seems to be ideal for most. I spent around 9 months on sub coming from Methadone and that was maybe too long, but it was honestly what it took for me to change my thinking process concerning my addiction. I'm now clean and free over 10 months.

    My first thought is to forget the sub and try to deal with the pain problems in another more natural manner. You have 10 days clean and taking sub may compound the problem. Bupe has never been a good pain reliever for most, but if you believe it works for your pain then taking sub for that reason alone has to be YOUR decision to make. I think it would be beneficial to explore every other opportunity for non-addictive pain meds before using sub in that manner. MY opinion only here.

    I think the way to begin is to induct safely and properly and go from there if that's what you want. Stop taking comfort meds. get to the 26 score and begin tkaing very small doses of sub until stable. Keep posting letting us know how you're doing. Amazing people here willing to help and support. I'll check on you later and I'll help you as much as I can. Take care and all the best to you DL!

    Randy
    Last edited by Anonymous; 05-15-2015 at 07:51 AM.

  3. #3
    DangerLuvr is offline New Member
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    Hey Randy!
    Thank you so much for the reply! I wanted to post there but I don't know how.. Can you guide me through moving it? Also thanks on the name... It's been my "handle" since I was 14. I just turned 32! Haha!
    I unfortunately am in a bind where I can't take any time off work... In fact, the only reason I can afford to go to the clinic is because I now have enough money to go. I should also say I haven't done IV in 5 years. With my arthritis there's no way I can go without ibuprofen or Immodium. I'm doing the induction in his office over 3 days. I will not take my ibuprofen the day before or the morning of my appt so that I can show how much pain I am in. I guess even as a nurse I don't understand PWs... If I haven't had anything for the two weeks before my appt is there a chance I can go into them when they start? Or if I'm not at a 26 since I'm 14 days out will they turn me away?
    As far as alternatives, I've tried everything under the sun. I really have. Unfortunately, the only drug that helps a little that isn't a narcotic is toradol, and you can only be on it 5 days at a time and not very often. I've actually had several Dr's refuse to give it to me at all because of the black box warning on it.
    I'm on a 48 hour shift now and there isn't a bad enough word to describe how I feel.
    Thank you so very much for the help!
    DangerLuvr

  4. #4
    crazyfrog is offline Banned
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    Have you tried a very high dosage of Loperamide ? Like 36mg. Might help you.

  5. #5
    Randy35 is offline Platinum Member
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    Quote Originally Posted by DangerLuvr View Post
    Hey Randy!
    Thank you so much for the reply! I wanted to post there but I don't know how.. Can you guide me through moving it? Also thanks on the name... It's been my "handle" since I was 14. I just turned 32! Haha!
    I unfortunately am in a bind where I can't take any time off work... In fact, the only reason I can afford to go to the clinic is because I now have enough money to go. I should also say I haven't done IV in 5 years. With my arthritis there's no way I can go without ibuprofen or Immodium. I'm doing the induction in his office over 3 days. I will not take my ibuprofen the day before or the morning of my appt so that I can show how much pain I am in. I guess even as a nurse I don't understand PWs... If I haven't had anything for the two weeks before my appt is there a chance I can go into them when they start? Or if I'm not at a 26 since I'm 14 days out will they turn me away?
    As far as alternatives, I've tried everything under the sun. I really have. Unfortunately, the only drug that helps a little that isn't a narcotic is toradol, and you can only be on it 5 days at a time and not very often. I've actually had several Dr's refuse to give it to me at all because of the black box warning on it.
    I'm on a 48 hour shift now and there isn't a bad enough word to describe how I feel.
    Thank you so very much for the help!
    DangerLuvr

    If it's been 14 days since you've last taken anything of an addictive nature like narcotics I HIGHLY doubt you'll experience any PWD's. If it were me in your shoes I would feel safe inducting even if the Cows score never hits a 26. Your case would be the exception to the rule because of the time passed since you last used. I went into PWD's twice because I didn't use the Cows the first 2 times, and because I got in a big hurry to induct on subs. I paid the price too. Precipitated wd's are no joke. Thought I was gonna die I was so sick and ended up in the ER because of it. Only thing that helps is for it to pass on it's own. Might take a few hours, may take a day or two. It totally and completely sucks!!! But I honestly believe you have nothing to worry about. I think if you weren't taking Imodium of Ibuprofin you would be at a 26 score. Have no worries is my advice.

    I often advise Toradol as an alternative to addictive substances because it's helped me in the past. But it's not a long term solution as you mentioned. We have several RN's here as members. Hopefully they will say hello to you soon. I have the utmost respect for nurses.

    I'll provide you with the link to the Suboxone Forum in a minute. And I'll copy and paste these posts there for you also. Give me a few minutes and I'll let you know right here that's it's been done. I'll let you know how to proceed too so hang on….

    Randy
    Iluv2smile likes this.

  6. #6
    Randy35 is offline Platinum Member
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    Ok, heres the link to starting a new thread in the Suboxone forum….

    https://www.drugs.com/forum/newthrea...newthread&f=40

    Click on the link I provided and name your thread as you did before or with a different name if you choose. Once I see it up I can copy and paste all the posts from here to that one if you like if you're not certain how to do that.

    Randy

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