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Sub induction question
  1. #1
    DancingZorba is offline Member
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    Default Sub induction question

    I think I am having a problem with my browser, I posted this question before and can't see it on my mobile app anymore so I am posting it again.

    I'll try and be as brief as I can. I have been using pain meds for a long time, and I did manage to stop once with the help of Subs. However, I was in a car wreck and they put me back on....since than, I have tried to stop 2X with the help of Subs, only to fail miserably.

    I can't seem to get pass the induction phase. I am on a large dose of hydromorphone and I take it 3X a day. My dose is a great deal higher than what it once was. I have some back problems that I was born with, I also have nerve damage done to my spine from two bullet wounds. I decided I will just live with the pain....I no longer want to use opiates and pain meds. I car risk an operation, but I was told it not only may not work, but I could very well become paralyzed.

    I get sick VERY quick if I miss taking my medication. If I go 10 hours without my medication, I have stomach problems and vomit a great deal. The last time I tried to induce, I waited about 24 hours. I was violently ill and nearly passed out a few times. My insides where on fire. I became so weak from the constant vomiting, I nearly called 911. I waited as long as I could before taking some subs.

    When I did, I didn't feel much of anything...so I assumed it was safe to take a little more. I followed Robert's plan as I had done the first time. However, I felt even more sick shortly there after.

    I considered going to a rehab facility, and was more or less told that there isn't much more they can do for me than what I am doing at home. Here is my question that I have about the induction process: According to Robert, if it doesn't work....I'm to do the following:

    If a patient finds themselves in precipitated w/d, the best thing to do is stop taking the subs immediately and redo the induction as outlined above. Wait until the sickness from precipitated w/d has ended and make sure you have reached the 26 again on the COWS worksheet before taking anything else. DO NOT attempt to take additional subs to cover up the precipitated w/d. You are asking for a hospital stay should you pursue this course of action.


    However, I also read this on a few places on line. It suggests that if I do find myself in PWD, that I should push forward with the Subs. It says:

    If you feel more withdrawal after taking the buprenorphine than before, then you are experiencing precipitate withdrawal. To fix it you take more buprenorphine. This might seem strange to some people because if some buprenorphine causes withdrawal won't more cause more withdrawal? No. Remember, the cause of the withdrawal is not enough opioid effect, and buprenorphine causes opioid effect, so taking more will eventually breach the threshold of withdrawal and suppress symptoms. Follow the same procedure and increase by 2mgs. every 30 minutes.


    I told myself last time, that I would try once more on my own before admitting myself to a rehab facility. When I called them and spoke to someone, they told me they would put me in a comfortable room for 24 hours before beginning the Sub therapy. Well....I can do that at home. When I asked if there is anything more they can do for me to help control the violent vomiting and other sides, the rep on the phone was unaware of anything.

    I wish I never started taking these meds. Had I known I would have to deal with this at the end of the road, I would never had allowed my doctors to give me these things. When I was injured overseas, I didn't know they were pumping me up with such dangerous drugs. I was in a coma for 4 days. When I awoke, I didn't know what was going on and I just kept taking whatever they were giving me. When I eventually left Germany and came back, it was only then when the doctors here told me that they had me on an extremely large amount of pain killers. In any case, if someone can please help me....I would very much appreciate it. I spoke to someone that went to a rehab facility here, and when she was admitted...they waited for her to get into a mild state of WD than fed her 8mg of Subs. And from what I was told here, that is far far too much. However, it worked for her and in 4 days time....she was OK.

    I read on other posts here that if you do find yourself in PWD, you should wait at least 12hrs before trying take more subs. The info I posted above directly conflicts with that. I know we are not all the same, and I know Robert said to wait for the PWD symptoms to leave before beginning to take more Subs again....put when I'm that far sick, I really don't know what is what and I am a total mess.

    Please, I really don't know where else to turn. Some say these clinics are a nightmare, other people say they are a God send. I think my specific situation is a bit different than most. I NEVER took these drugs for rec purposes. At this very moment, the only reason I currently take them (aside from my pain) is so that I don't get sick. God Bless one and all....



    DZ
    Ming23 likes this.

  2. #2
    Ming23 is offline Platinum Member
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    Default

    Hey Zorba!
    Sorry you're having such a bad time. I've also read Both versions of proper sub protocol. Well, i put myself into pwd the first time i inducted. Are u at 26 on the Cows scale?
    The next time i inducted, i did it in a hospital. You can too. Not a rehab. Up to you.
    Good for you that you've decided to quit. Good choice at a good time.
    If i were you, i would check your local hospitals for a sub detox. I stayed 3-4 days.
    Proud of u man!

  3. #3
    DancingZorba is offline Member
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    Quote Originally Posted by Ming23 View Post
    Hey Zorba!
    Sorry you're having such a bad time. I've also read Both versions of proper sub protocol. Well, i put myself into pwd the first time i inducted. Are u at 26 on the Cows scale?
    The next time i inducted, i did it in a hospital. You can too. Not a rehab. Up to you.
    Good for you that you've decided to quit. Good choice at a good time.
    If i were you, i would check your local hospitals for a sub detox. I stayed 3-4 days.
    Proud of u man!
    Ming......I decided to stop a year ago. You actually chimed in to help me a few times and gave me some advice. I was born with some back issues and got injured overseas in the military. Not sure if you remember.

    I would be fine doing it at a hospital. Can I ask you, what did they do for you for the sides? I get VERY VERY violent sides....I begin to vomit non stop. My insides BURN and I have nearly fainted a few times. What more can they do for me in the hospital? Can they help me with the nausia and vomiting? There must me something more they can do for me. I called and they told me they would put me in a room and have me wait 24 hrs. before giving me any Subs to take. I asked what they will do to help me....they couldn't answer me. I was told to call a doctor. Can they do something more for me that I can't do at home? Thanks again, Ming!



    DZ


    PS....do you know if you are supposed to push through using MORE Subs or not?? What is the correct method?

  4. #4
    DancingZorba is offline Member
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    Any truth to this about vomiting??

    For vomiting i would recommend trying a OTC anti-nausea drug first such as dimenhydrinate or meclizine. If those don't work go see a doctor. I would recommend trying the following drugs for nausea and vomiting related to opiate withdrawal:

    1. Promethazine which is OTC in some countries and is a anti-histamine that is supposed to work rather good for nausea

    2. Metoclopramide which is a strong D2 antagonist that also empties out your stomach contents quicker. Only take it for as long as you absolutely need to though because it can cause tardive dyskinesia if taken for a long time.

    3. Prochlorperazine (trade names Stematil, Stemazine, Compazine, etc) is a old typical anti-psychotic now almost only used for nausea and vomiting.

    4. Chlorpromazine (trade names Largactil and good old Thorazine ) was the first anti-psychotic on the market and is a phenothiazine like promethazine and prochlorperazine but half as potent in it's anti-psychotic action as prochlorperazine. I have found it to work fantastic for nausea and vomiting caused by anything including opiate withdrawals. It has stopped my nausea when nothing else has. Doctors often use it in ER settings along with morphine or some other opiate to stop the nausea from things like migraines and to increase the effects of the opiate. It's also rather sedating so it will help you sleep.

    5. Methotrimeprazine aka Levomepromazine (trade name nozinan) is a weak typical anti-psychotic that is about half as potent as Thorazine in it's anti-psychotic action. It is mostly used these days to treat severe insomnia and nausea and vomiting. It works very well for me but it is hands down the most sedating drug i have ever had. It makes seroquel look like dextroamphetamine by comparison . 15mg's which is not even close to the dose used as a anti-psychotic will knock me out for about 12 hours.

    6. Scopolamine a drug that is a very strong anti-cholinergic that is derived from the Belladonna and Datura plant. It is available in Canada anyway OTC in a transdermal patch called Transderm-V. The patch lasts for 3 days and it does work pretty damn good.

    7. zofran or ondansetron


    Any experience with these during induction, anyone?

  5. #5
    UncleLeo is offline Advanced Member
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    How are you doing DZ? In the hospital they can pump you full of Zofran for the nausea. And there's a couple other ones you mentioned that they gave me as well.

    Mine was so bad that they finally caved and had to pump me full of dialadid so try to avoid that But that was when I was actually coming OFF the subs. So maybe subs aren't the right solution for you either?

    There's also the very fun Phenergan suppositories if you can't even hold the Zofran down Had to use those several times as well...

    There's also an older med - Donnatal that actually works pretty well for some people - it helped me. And Reglan can help also.

    Keep us posted.

  6. #6
    DancingZorba is offline Member
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    Zofran can help?? I wish I had known that.

    Would it be best to go to the ER while doing doing the induction? This way I get immediate attention and don't have to plan something, and maybe schedule a day or whatever where my insurance may or may not pay for??

    The Subs did work for me the very first time. I just don't think I am waiting long enough....I wait as long as I can before I am just about ready to pass out. I wait until I can no longer barely stand on my feet and ALL of my insides are on FIRE. I can't swallow much less feel my ears or throat. It's the most ill feeling I have ever felt and I'm really really am beyond scared to death of it.

    I will make a list of these items to tell the doc....is the ER the best way to go???

    Thank you!!!

  7. #7
    UncleLeo is offline Advanced Member
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    Why do you need to induct? Sounds like the subs don't agree with your tummy.

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