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Starting Suboxone
  1. #1
    chrisgt46 is offline Member
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    Default Starting Suboxone

    I have been taking Oxycontin for three years, 80mg's three times daily. Thursday, two days from today I will be seeing a Suboxone doctor to begin induction. I have printed off a copy of Robert's method to take with me, and intend on following the .5 mg ,method he suggests. I am not sure what the doctor will say to me and if he will go along with that plan, but I'm going to insist upon it. I am hoping Robert will develop a plan for me. I have also bought all of the things that Thomas recommends for opiate withdrawal. Today I have taken 2 Oxycontin, and tomorrow I will take only one at about 10AM, to ensure I will be in severe withdrawal for my appointment the next day. I've been through opiate withdrawal before and I don't think I have it in me to do that again.
    Last edited by Anonymous; 10-21-2014 at 01:51 PM.

  2. #2
    Randy35 is offline Platinum Member
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    Robert has retired from the forum. But there are plenty of knowledgable and experienced members here that will help that have used Robert's plan. Some like myself are now off the sub and doing great, while others are in the process of inducting or tapering. Everyone will be able to help you in one way or another.

    Based on my own experience, and what many others have also said, i wouldn't count on your sub doctor being too experienced in sub therapy. And it's really a shame too. They take their 8 hour online course and then hand out the subs making it all about the money. Not all of course, but the majority fall into that group.

    Most sub doc's want you on the largest dose possible (8-24mg, even 32 mg in some cases) for the longest time possible. Many will say you need to be on subs for the rest of your life.

    Best thing to do is "suggest" to this doctor you want to stay at the lowest dose that gets you stable. Don't argue or tell them what to do because that won't accomplish anything in most cases. If you are inducted on a high dose, get as many subs as you can and come back here for advice and suggestions. If you are put on a real high dose we can get you down quickly and then slow the taper down to make things run smoothly. That's my suggestion anyway.

    If the doctor lets you take .5mg up to 1mg and see how you feel that's great, you are ahead of the game. If not don't worry. Just get the script and get out. Keep us informed. We can help. Good luck!

    P.S. Make absolutely certain you are in moderate to severe withdrawals by using the cows score. That will make sure you're ready for induction. I can promise you want no part of precipitated withdrawals by taking the sub before you're ready.
    Last edited by Anonymous; 10-21-2014 at 11:45 AM.
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  3. #3
    chrisgt46 is offline Member
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    Quote Originally Posted by Randy35 View Post
    Robert has retired from the forum. But there are plenty of knowledgable and experienced members here that will help that have used Robert's plan. Some like myself are now off the sub and doing great, while others are in the process of inducting or tapering. Everyone will be able to help you in one way or another.

    Based on my own experience, and what many others have also said, i wouldn't count on your sub doctor being too experienced in sub therapy. And it's really a shame too. They take their 8 hour online course and then hand out the subs making it all about the money. Not all of course, but the majority fall into that group.

    Most sub doc's want you on the largest dose possible (8-24mg, even 32 mg in some cases) for the longest time possible. Many will say you need to be on subs for the rest of your life.

    Best thing to do is "suggest" to this doctor you want to stay at the lowest dose that gets you stable. Don't argue or tell them what to do because that won't accomplish anything in most cases. If you are inducted on a high dose, get as many subs as you can and come back here for advice and suggestions. If you are put on a real high dose we can get you down quickly and then slow the taper down to make things run smoothly. That's my suggestion anyway.

    If the doctor lets you take .5mg up to 1mg and see how you feel that's great, you are ahead of the game. If not don't worry. Just get the script and get out. Keep us informed. We can help. Good luck!

    P.S. Make absolutely certain you are in moderate to severe withdrawals by using the cows score. That will make sure you're ready for induction. I can promise you want no part of precipitated withdrawals by taking the sub before you're ready.
    Thank you so much for the response. The first thing that made me question this doctor was the fact that he told me the appointment would last two hours max, so I probably will just try to grab what I can and get out. The appointment includes going to the pharmacy to get the induction dose, then coming back. Then I assume he gives me the script for however long I am supposed to go before the next appointment. I have 25mg, 10mg, and 5mg librium to help with any anxiety I might have during the withdrawal or taper. Again I really appreciate the quick response, thank you!
    Last edited by Anonymous; 10-21-2014 at 12:09 PM.

  4. #4
    Randy35 is offline Platinum Member
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    You're very welcome and I'm happy to help. When you take that first dose of sub make sure to wait a minimum of 1 hour before taking more. Sometimes it can work in 15-20 minutes, but usually it takes a full hour or longer to get the full benefit of each dose. Again, make certain you are in rough withdrawals.

    Another thing is you don't want to be taking any kind of meds that will make you feel better while you're in those withdrawals waiting for induction. That totally defeats the purpose. If you take a comfort med like the librium during that time it delays the progress you have made towards the required moderate to severe withdrawals. Hope that makes sense. In other words you have to get sick with symptoms before you feel better once you have some sub in you. Use that cows - it's a golden tool for induction purposes!

  5. #5
    chrisgt46 is offline Member
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    Quote Originally Posted by Randy35 View Post
    You're very welcome and I'm happy to help. When you take that first dose of sub make sure to wait a minimum of 1 hour before taking more. Sometimes it can work in 15-20 minutes, but usually it takes a full hour or longer to get the full benefit of each dose. Again, make certain you are in rough withdrawals.

    Another thing is you don't want to be taking any kind of meds that will make you feel better while you're in those withdrawals waiting for induction. That totally defeats the purpose. If you take a comfort med like the librium during that time it delays the progress you have made towards the required moderate to severe withdrawals. Hope that makes sense. In other words you have to get sick with symptoms before you feel better once you have some sub in you. Use that cows - it's a golden tool for induction purposes!
    Okay, I will avoid the Librium then. I have a couple of questions. There seems to be two types of medications, Suboxone, and Subutex? Which do I want, and then there appears to be two forms, strip and pill, which do I want? Thanks again!

  6. #6
    Iluv2smile is offline Platinum Member
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    Hi there!
    Did the dr give you the cows scale to use?
    That may be why he said the appt will take 2hrs.
    You have got to be to a least a 26 on the cows.
    Do not take any Librium while waiting to start the suboxone..
    You have to be in pretty bad withdrawals to start.
    Or you will go into precipitaded withdrawal..
    You will regret that for a long time..

    I am tapering off of sub myself from 24mg to now 1.25mg ..
    I was getting off a 10+ year methadone "treatment" from 100+mg and even then 24mg of sub was to high..

    Are you using the suboxone to detox from the oxy then getting off of the suboxone?
    Hopefully you will familiarize yourself with the COWS and the induction for now because who knows how the dr will do it..
    Most Drs have not done this themselves as an addict only have done it to others..
    I know more experienced people on here will come to support you!

    There is so much experience and success here with people who have walked in your shoes and will help you every step of the way..

    Welcome!
    Iluv2

  7. #7
    chrisgt46 is offline Member
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    Quote Originally Posted by Iluv2smile View Post
    Hi there!
    Did the dr give you the cows scale to use?
    That may be why he said the appt will take 2hrs.
    You have got to be to a least a 26 on the cows.
    Do not take any Librium while waiting to start the suboxone..
    You have to be in pretty bad withdrawals to start.
    Or you will go into precipitaded withdrawal..
    You will regret that for a long time..

    I am tapering off of sub myself from 24mg to now 1.25mg ..
    I was getting off a 10+ year methadone "treatment" from 100+mg and even then 24mg of sub was to high..

    Are you using the suboxone to detox from the oxy then getting off of the suboxone?
    Hopefully you will familiarize yourself with the COWS and the induction for now because who knows how the dr will do it..
    Most Drs have not done this themselves as an addict only have done it to others..
    I know more experienced people on here will come to support you!

    There is so much experience and success here with people who have walked in your shoes and will help you every step of the way..

    Welcome!
    Iluv2
    Hi, and thank you for the response, no the doctor didn't give me the COWS, in fact he told me to be in moderate withdrawal and not severe for the induction, which was the second thing that made me pause, so I have one 80mg Oxy left and I'm going to take that tonight, that leaves me with 36 hours of nothing, assuring that I will be in severe withdrawal. I have the COWS I found online to go by. I will be using the subs to quit oxy, then hopefully very quickly will get off the subs, as I do not want to become dependent on the subs. Thanks!

  8. #8
    Iluv2smile is offline Platinum Member
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    I tried to edit my previous post but couldn't.
    Subutex is only buprenorphine
    Suboxone is buprenorphine and naloxone an opiate blocker
    Most Drs will only prescribe the suboxone because they think It can not be abused.
    The film is easier to taper with .
    These are only my opinions.
    That I have learned the hard way..
    If you could get the 2mg films I think that work the best..

    You are going in prepared!
    Knowledge is power especially with this drug it is a great tool but it is a very strong opiate..

    They will help you here.
    Every step of the way!
    Keep checking in please..

    Iluv2

  9. #9
    Iluv2smile is offline Platinum Member
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    You can google the cows..
    I put my self into precipitaded withdrawals and called 911 to go to the emergency room in the hospital where I am a RN and have worked for 20+ years..
    My point is that is how bad it is..
    It immediately knocks any opiate you may have left on your receptors off and puts you into withdrawals immediately..
    Some Drs will disagree but they have never done it to themselves.
    Google precipitaded withdrawals..

    Just like Randy said above they take a class..
    Clearly it is not enough..
    Randy is one of the people helping me too.
    We are Team Taper!
    There are 4 and sometimes 5 of us all tapering together.
    Although we are at different doses it is so. nice to have the support.
    You are welcome to join us!
    We have Kat,Alex and Randy helping us !
    Take care!


    You were posting when I was too!
    Glad you found the cows!
    Last edited by Anonymous; 10-21-2014 at 12:47 PM.

  10. #10
    chrisgt46 is offline Member
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    Quote Originally Posted by Iluv2smile View Post
    I tried to edit my previous post but couldn't.
    Subutex is only buprenorphine
    Suboxone is buprenorphine and naloxone an opiate blocker
    Most Drs will only prescribe the suboxone because they think It can not be abused.
    The film is easier to taper with .
    These are only my opinions.
    That I have learned the hard way..
    If you could get the 2mg films I think that work the best..

    You are going in prepared!
    Knowledge is power especially with this drug it is a great tool but it is a very strong opiate..

    They will help you here.
    Every step of the way!
    Keep checking in please..

    Iluv2
    Okay then. I'll go for the Suboxone strips. I'm not sure what dosage they will be as it sounds like this guy doesn't know what he's doing having people come in there in moderate withdrawal. I feel sorry for the people who are not a 26 on the COWS, it sounds like that's a recipe for big problems. I'm trying to get as much input as possible here so I have a better chance of success. The odd thing about this doctor is that he is directly next door to an AA club. That sucks in a way because there are always people hanging out in front of the club and uif I go to AA, I don't want them seeing me get Suboxone. Anyway thanks!

  11. #11
    chrisgt46 is offline Member
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    Quote Originally Posted by Iluv2smile View Post
    You can google the cows..
    I put my self into precipitaded withdrawals and called 911 to go to the emergency room in the hospital where I am a RN and have worked for 20+ years..
    My point is that is how bad it is..
    It immediately knocks any opiate you may have left on your receptors off and puts you into withdrawals immediately..
    Some Drs will disagree but they have never done it to themselves.
    Google precipitaded withdrawals..

    Just like Randy said above they take a class..
    Clearly it is not enough..
    Randy is one of the people helping me too.
    We are Team Taper!
    There are 4 and sometimes 5 of us all tapering together.
    Although we are at different doses it is so. nice to have the support.
    You are welcome to join us!
    We have Kat,Alex and Randy helping us !
    Take care!


    You were posting when I was too!
    Glad you found the cows!
    I hope that the 36 hours off of Oxy is enough to get me to severe then, I'm pretty sure it will be because I've read the indications on the COWS and I'm familiar with what it would take as I often run out of meds. Knowing that this was coming I've been taking 6 Oxy's a day leading up to today where I will only have the three. I know that isn't a smart thing to do, but that's what I did. I didn't start doing research I into this until yesterday and I'm so glad I did! How do I join team detox?

  12. #12
    Iluv2smile is offline Platinum Member
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    Just keep sharing!
    We just call it that cuz we been supporting each other for awhile through this..
    It is comforting..
    I guess that is one good reason to have run out of meds in the past . Lol
    Now you know how your body reacts..

    Kat always tell us
    Do this right and you will only have to do it 1x...
    The films come in 2mg,4mg and maybe 8mg .
    This is a more is less drug for sure..
    That is a hard concept for most of us to grasp.
    I have always thought the more the better..
    I think we would all agree we feel better at a lower dose!
    I will check back tomorrow
    Take care!
    Iluv2
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  13. #13
    chrisgt46 is offline Member
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    Thanks, I will just have to wait and see what dose he gives me after induction.

  14. #14
    chrisgt46 is offline Member
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    I'm worried about not being in severe withdrawal by Thursday morning, so I'm going to skip this last pill. Which means I need to flush it to prevent a moment of weakness.
    Last edited by Anonymous; 10-21-2014 at 04:07 PM.
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  15. #15
    Iluv2smile is offline Platinum Member
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    I think that was a smart move..
    You definitely want to be in withdrawals.
    Precipitated withdrawals can effect your induction and taper.
    Just try to stay busy while you wait to go to the . Doctor.
    As I am sure you know a lot of this is mental.

    Make sure You drink lots of water.
    Try to exercise even it is walking around the block.
    Just keep moving.

    I don't know if you have, considered any 12 step programs.
    I did not want to go but I have met some fabulous women there.
    So I attend an AA workshop on Sundays.

    One of the things they suggest in our mission to stay clean is that we change our behavior.
    Get into new habits!
    I even changed the, side of the bed I get up on.
    I had some really rigid routines and my brain was on autopilot 99% of the, time.
    In order to change the way my brain works and recovers we have to start small.
    I am developing some healthy habits!
    It is kinda exciting!

    I am going to bed.
    I will check on you tomorrow!

    Bet/Iluv2

  16. #16
    Randy35 is offline Platinum Member
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    Quote Originally Posted by chrisgt46 View Post
    I'm worried about not being in severe withdrawal by Thursday morning, so I'm going to skip this last pill. Which means I need to flush it to prevent a moment of weakness.
    That will be a very smart move as Bet said. No sense even taking the slighest chance at pw's. Bet gave you very good info about the subs. I agree that the films are much better. They seem to dissolve quicker, taste a little better, and are by far easier to cut into smaller doses at taper time.

    Yes, the 2mg films would be a wise choice also in my opinion. Even easier to cut smaller.

    Some insurance plans won't cover the films because they only come in brand name thus they are very expensive. Suboxone comes in generic pill form and of course they are priced much less. I imagine the doctor would have no problem giving which you would want. You might check on advance (if you have insurance) and see if the film is covered by your plan? Call your ins company or your pharmacy for that info.

    Heres a real good cows shart link for you -

    http://www.naabt.org/documents/cows_...flow_sheet.pdf

    Just make sure you score yourself honestly. It's very easy to cheat a bit on the scores when you're in the middle of withdrawal symptoms. If you can have someone else score you it would be even better.

    The induction can take a few days actually. You may need to adjust your sub dose a tiny bit during that time. Read as much info as you can up until your appt time. Go in prepared.

    You should be able to get completely stable on 3-4mg or LESS!!! If it's more it's more - don't worry too much. If the doctor tells you that 16-24mg would be better for you say "ok doctor" and get the script. You MAY not have to see this doctor again if he gives you a months worth of subs and tells you to come back then?

    Relax - things will go smooth because you have been researching properly! Talk to ys later.
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  17. #17
    chrisgt46 is offline Member
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    I don't think I'm going to be a 26 on the COWS by 10AM tomorrow. I'm going to call and try to push the appointment back till Friday.

  18. #18
    iloerose is offline Platinum Member
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    When was your last pill? Also ask yourself how you felt when you detoxed the last time and hit your second day. I'm assuming this is your first full day? It can be very difficult sometimes to get an appointment with a sub doc. Did you take your last pill last night or flush that last pill? Sometimes you just have to relax a bit and let nature take its course. You are going to be fine.

    Peace,

    Iloerose
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  19. #19
    chrisgt46 is offline Member
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    I didn't take the pill last night. I'm at a 10 right now. Because I have been taking such a high dose, it's going to take longer. This appointment is all I can get, so I'm going to go. I just have to hope that it goes okay.

  20. #20
    Randy35 is offline Platinum Member
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    Quote Originally Posted by chrisgt46 View Post
    I didn't take the pill last night. I'm at a 10 right now. Because I have been taking such a high dose, it's going to take longer. This appointment is all I can get, so I'm going to go. I just have to hope that it goes okay.
    You are going to be ok. Just be sure NOT to take ANYTHING that might make the symptoms better. Try to RELAX and things will go ok. If you keep scoring yourself every hour or so on the cows hoping the score rises it puts way too much pressure on you then the anxiety and stress begins. I suggest you leave the cows alone until tomorrow morning. As Iloerose said - Let nature take it's course and by the time your appt get here you should be plenty ready to induct. Your tolerance was high, but I've seen much, much higher. You will be just fine so please try to relax and stay busy.
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  21. #21
    Iluv2smile is offline Platinum Member
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    Good morning!
    Well you may increase your symptoms quicker if you are drinking water too.
    Not only is that important for the well being of your body it also helps flush the other drugs out.

    Like Randy and Rose said just relax and you will be ok
    And it could take a couple of days after you start the sub to be stable ( comfortable)

    The only thing I would watch and question is if he offers to high of a first dose..
    It is usually after they make sure you do not go into precipitaded withdawals they start adding doses.

    But these are my experiences some others will add to this through out the day.

    Like Randy said if he does start you to high then he will write you a script for that too.
    You may not have to see him again..
    You can just say ok get the script and go!

    I will check back later!

    Bet/iluv2

  22. #22
    chrisgt46 is offline Member
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    Thanks, I have to walk away from the COWS, I'm stressing big time with it. I'm drinking water. I'm just gonna chill out for the rest of the day and if tomorrow I'm thrown into precipitated withdrawal, I'll have to deal with that. Thanks everyone!

  23. #23
    Iluv2smile is offline Platinum Member
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    Great idea!
    Forget about it for now!
    A lot can happen in 24 hrs!

    Iluv2

  24. #24
    chrisgt46 is offline Member
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    I forgot to mention I had a surgical procedure today and because of the anesthesia I am now at zero. Unless this wear off I'm screwed.

  25. #25
    chrisgt46 is offline Member
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    I'm freaking. I don't even know if Suboxone is going to help me with the PWS. I've gone a month without and the symptoms don't get better. If I don't get the Suboxone tomorrow, then I don't know when I will get it. Maybe I'll get lucky and the precipitated withdrawal will kill me. That's where I'm at. I've about had it.

  26. #26
    chrisgt46 is offline Member
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    The Propofal is now starting to wear off and I'm back to a 10. Maybe I'll get there in time. I never thought I would be wishing to be in severe withdrawal.

  27. #27
    iloerose is offline Platinum Member
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    Try to stop stressing, part of your stress is probably not taking the oxy. There is nothing you can do tonight. You tell that doctor tomorrow exactly where you are at with this surgical procedure and the anesthesia. Be up front and honest about what you've taken when. You have no idea what this doctors intentions are. He may give you a script and instructions for starting them. That's why you need to be upfront with him. Don't be confrontational, just be up front. I've read through your thread and have seen some of the horror stories and yes, some of them are true. I've also seen people who have only waited 24hrs. and not gone through precipitated w/d. How much oxy are you detoxing from?

    Peace,

    Iloerose

  28. #28
    chrisgt46 is offline Member
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    400mg's a day for the last week and 240mg's prior for 3 years. Thanks for the advice.

  29. #29
    iloerose is offline Platinum Member
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    O.K. Yeah, that's a pretty heavy habit. Hang in there. You've got support here!!

  30. #30
    chrisgt46 is offline Member
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    I'm back and feeling good. Unfortunately the doctor wouldn't listen to me and inducted me at 16mg's. I have 21 8mg strips now. I'm not sure what to do now. Can I just take 2mg's tomorrow? Will that be okay, or do I now have to taper from that huge dose??? Please HELP!

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