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Trying to detox again, help and advice needed for rare case
  1. #1
    DancingZorba is offline Member
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    Default Trying to detox again, help and advice needed for rare case

    I first want to thank everyone here who has tried to help me in the past. I failed to kick my habit because I couldn't handle the pain...both the physical and emotional. I never had the guts....and still don't, to perform a complicated surgery that could leave me in a wheel chair. This fear and constant pain I have been living with, has ruined my life.

    I've pushed all those close to me away. I could not focus at work because of my pain and because of my medication. I pushed my wife away...I was always miserable and depressed. I never wanted to be social and do things a couple should do, and realized she deserved someone better. So now, I pushed all my friends and family out of my life. I have a dog. I have not seen my wife in 3 years...I don't know where she is. I spent the last few years taking my meds and doing PT trying to fix my back without an operation. The only light in my life right now is that after a few years of daily hardcore PT, I am confident I can live with less pain without an operation or pain meds. My docs also believe I can now stop my pain meds and live normally without the operation. I spent 3 years of my life, just trying to fix my back. I think I'm there.

    I started a new thread because my last one had some unanswered questions. This is honestly going to be the last and final time that I attempt to detox of my pain meds. I was on VERY high doses of hydromorphone, and I am now down to about 24mg 3X a day. I know it's still a lot....but it's a lot less than before. I was maybe on 3-4X my current dose in the past. I took as much as I needed to be able to walk, get out of bed, try to function. My dose went higher and higher over time and had to resort to other meds to kill my pain. Now, it's just hydromorphone.

    I have read so much over the years and there are a few questions I need help with before I try again. I got my hands on everything I think I will need, my primary problem has always been the induction phase and how to best do it. I have a severe panic condition and have been on high doses of benzos for the past 24 years. I am now on 6mg of clonopin ED. Yes, a heavy dose....but it was higher. I was once 245lbs...so perhaps my size had something to do with how much medication I was taking. Moving on....

    Last time I had some horrible gastrointestinal problems and some SEVERE depression. I thought that perhaps the nalaxone in the suboxone wasn't working well with me. However, the SEVERE vomiting and other sides were present while I waited to hit a 26 on the COWS. I waited about 24 hours last time, and I was almost certain I hit 26 on the COWS. Perhaps I was a few points off because I once again landed in PWD. A complete and total nightmare that I NEED to avoid at all costs. I can't do it again and have been studying everything under the sun/net to make sure it does not happen again.

    As I said, I'll be using subutex instead of suboxone this time around. I know that if I take the subutex too early, I can still land in PWD....but it might not be as severe. Still, point is to avoid it PERIOD. So, I am going to do my best and hold of until I am sure to be a solid 26 on the COWS. I will also be sure to wait at least a solid 30 hours. I will be looking at my COWS score, not so much the clock. I found someone to help me guage where I truly am on the COWS before I induct.

    I am more than familiar with Robert's plan and will be following it as close as possible....to the letter. My doc did suggest I start off with 4mg of sub for the initial dose since my tolerance is so very high. But again, I don't want to take 4mg and find myself in PWD. However, in case I do happen to induce early by accident....I have conflicting information on what to do next.

    Some info I gathered says this:

    What if you put yourself into precipitated withdrawal?

    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.



    This info was taken from these sources:

    TIP-40, buprenorphine treatment clinical guidance - government document 2004
    PCSS clinical guidance on buprenorphine induction- Buprenorphine induction - clinical experience
    Home induction of buprenorphine - study
    Anecdotal evidence compiled from several social media sites over a period of several years
    NAABT- Avoiding precipitated withdrawal published 2011


    However, some protocols suggest that you should wait a FULL 12 HOURS to take more sub if you happen to take it too early. I believe Robert's exact words were....

    "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."

    So, if I happen to take it too early....what to do? I have called many doctors and rehab centers, and everyone seems to have a different opinion. Some say wait 30 mins, 90 mins, 2 hours, 12 hours, etc. before taking more subs. There has to be a right and wrong answer here, no?


    I also need to know if taking immodium while I wait is a good idea or not. I can see taking it after I induce....but what about while I am waiting to hit the number 26 on the COWS? Will the immodium throw the numbers off? Will my high doses of bezos throw the numbers off? I can't stop taking my benzo....I could very well start having seizures and die. All my docs told me not to stop my benzos, some did....and those that did were more or less clueless about other questions I had. One rehab place I looked into said they would not let me have my benzos, even though I have been using them for 24 years. I came to the conclusion that using a rehab clinic is a roll of the dice and I am probably better off doing it myself. I have heard such horror stories at these rehab centers.

    This time....and for the first time, I have clonodine to work with. Actually, I am going to post a list of what I have on hand. I know it's a lot of stuff, doubt I will use it all....still doing research. Nonstop.

    •Fish Oil
    •Tagamet
    •Prilosec
    •Vitamin D
    •Multivitamin
    •Clonopin
    •Immodium
    •Gabapentin
    •Magnesium
    •Calcium
    •Potassium
    •Passion Flower (liquid and caps....to make a tea)
    •Tumeric
    •Zantac

    I'm sorry for the long rant. And I didn't mean to mention my personal issues, I know that has nothing to do with my detox. I was just venting and trying to explain where I'm at....both in body and mind.

    So if anyone has anything to throw at me.....please, let me know what you think. And again, thank you to everyone who has helped me in the past. God Bless....


    Z

  2. #2
    DancingZorba is offline Member
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    And here....I can't understand why some say that "To minimize the risk and damage of precipitated withdrawal, buprenorphine should be started when the withdrawal symptoms are still mild (a score of 5 or 6)."

    A score of 5 or 6 on the COWS before starting sub? There is just so much wrong info out there! I've seen this advice posted several places....and many say there is no need to wait 24 hrs.

    http://americanaddictioncenters.org/...ed-withdrawal/




    Why would they say this?
    Last edited by Anonymous; 08-03-2017 at 02:08 AM.

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    Randy35 is offline Platinum Member
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    Hey Zorba -

    Glad to see you back, but sorry it's under these circumstances. You seem to have a firm grasp on how subs work, intended to work, and our sub plan here so I just basically have a couple things to suggest...

    Whatever you do make absolutely certain you're at an honest score of 26 on that Cows before taking the first dose of sub. That's takes all the guessing and worry out of PWD's happening. No negotiating on this. Get to an honest/accurate score of 26 and the worst part is over and you'll never have to do it again.

    Second, if, and I say IF you do happen to go into PWD's the absolutely WORST thing you can do is to take more sub hoping it will get you out of it. It will NOT!!! It will only make things worse. The very BEST thing to do is exactly what Robert325 suggests, let the PWD's subside, then redo the induction.

    Lastly you don't want to take 4mg as your unitial dose at induction because you'll never know if less would have sufficed? The overwhelming majority of sub doctors just don't know how to prescribe this drug. They get their info from the pharma reps and a simple 8 hour class. I HIGHLY recommend your first dose be between .5mg and 1mg and waiting one full hour giving the sub plenty of time to work. It works slower/faster for some than it does others. The goal is to be on the LOWEST effective dose, just as Robert suggests.

    After the initial dose of .5mg to 1mg the following doses should all be .25mg every hour until you're stable with little or no wd symptoms. The only change to the dosing would be if you were coming from Methadone and strong drug with a long half life. You add small doses until stable and that's how you find your lowest effective dose.

    If you follow these suggestions you'll have a very positive sub experience.

    Randy

    P.S. Here's a link to one of your other threads.....
    https://www.drugs.com/forum/suboxone...ain-72534.html

    It's always best to stick with one thread as your info is already there and it can get confusing if you have more than one going.
    Last edited by Anonymous; 08-03-2017 at 07:00 AM.
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  4. #4
    DancingZorba is offline Member
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    Thanks for your reply. My last try, when I went into PWD....I was so beat up I didn't know how long it would last. I didn't know how long to wait before trying to take more again. I tried to wait another 12 hrs. I think, and it just didn't happen.

    I read a few studies, and the one I outlined in red above came from clinical studies. They suggest to keep using the subs until the PWD is gone....

    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'm really really hoping I don't have to deal with this, but I might just have to.

    As for taking 2mg or 1mg to see where I'm at.....all I have are 8mg subutex pills. How can I cut them smaller than 2mg? That won't be easy. I do have several 2mg SUBOXONE strips....but I want to avoid using them at first because of the nalaxone. I can cut those strips into little pieces if need be though.

    What sups can I take NOW to help with the nausia and vomiting that is going to come. The worst sides I get are not being able to sit still and the constant vomiting.....ugh....

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    DancingZorba is offline Member
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    Any suggestion on clonodine dosing? I think I can start using that now??

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    DancingZorba is offline Member
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    And I read a study that said using clonodine with passion flower can be a big plus....I'm just not sure if it's ok to take PRE-SUB? Again....thank you again for trying to help me. One and all. I have to get this right this time...I have to...

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    DancingZorba is offline Member
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    Forgive me for throwing all these questions out there again....just really trying to do all I can here. I'm all alone with just a laptop so I hope I'm not being out of line.

    I had someone I know suggest that I begin a regimen of testosterone and/or perhaps some other anabolics. I'm a former body builder and I know that opiates kill free testosterone levels, and testosterone can also help produce endorphins. Just throwing that out there.

    I'm more concerned with the clonidine and when/how much to take with passion flower though....

    God Bless you all....thanks again....and AGAIN. Talk about Déjà Vu....

  8. #8
    Randy35 is offline Platinum Member
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    Quote Originally Posted by DancingZorba View Post
    Thanks for your reply. My last try, when I went into PWD....I was so beat up I didn't know how long it would last. I didn't know how long to wait before trying to take more again. I tried to wait another 12 hrs. I think, and it just didn't happen.

    I read a few studies, and the one I outlined in red above came from clinical studies. They suggest to keep using the subs until the PWD is gone....

    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'm really really hoping I don't have to deal with this, but I might just have to.

    As for taking 2mg or 1mg to see where I'm at.....all I have are 8mg subutex pills. How can I cut them smaller than 2mg? That won't be easy. I do have several 2mg SUBOXONE strips....but I want to avoid using them at first because of the nalaxone. I can cut those strips into little pieces if need be though.

    What sups can I take NOW to help with the nausia and vomiting that is going to come. The worst sides I get are not being able to sit still and the constant vomiting.....ugh....


    You can do as you please, but IF you do happen to go into PWD's I would NOT take more sub. I would wait until it passes. Up to you. If you use the Cows, and you get to an honest and accurate score of 26 or higher then you have nothing to worry about in the way of PWD's.

    As for breaking the 8mg pills we suggest the crushing method. Either use the back of a spoon to crush the pill or get a pill crusher available at most any pharmacy. Crush the pill into a fine powder. Separate into equal piles to get any dose needed. You can usually cut an 8mg pill into 4 pieces that are 2mg each using a single edge razor blade. Did it mnay times and if you're careful you can do it. Then crush one of those 2mg pieces into powder. Making 4 piles out of 2mg will be .5mg each. Half of one of those will be .25mg and so on. You can get any dose using this method.

    As for the Clonidine and other things....when you're waiting in wd's to induct on the subs you DO NOT want to be taking ANYTHING that will make you feel better as that defeats the entire purpose. You want to be sick in wd's so you can safely take the sub. If you take anything in the way of comfort meds it will probably delay you getting to the 26 score and make you suffer longer than you need to.

    As I always say....do this right and you'll ponly need to do it once.

    Randy

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    DancingZorba is offline Member
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    Thanks again for the reply.

    My last attempt, I think my biggest issue while waiting to hit 26 was the violent vomiting. I was told to use zofran to help with this. I did ask my doctor if it was OK to take BEFORE taking the subs, and he did say yes....as well as the clonidine.

    It really is frustrating getting different answers from everyone, even from doctors. I know that my benzo will mess with my COWS score just a little....and I really can't do much about that. I did take what my doc told me to take....being the clonodine, zofran, gabapentin. I guess it may take a little longer to get to a 26, but if that can be done without my insides burning and the non stop vomiting....so be it.

    But regardless....I will not induce until I am SURE to be at a score of at least 26. For some reason, the last thing that happens is my pupils dialating. I'll report in with progress.....last time I could hardly see the screen much less type I was so messed up. I pray it won't be as bad.....

    God Bless.....

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    DancingZorba is offline Member
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    10 hours in. Just woke up. 14 hrs. or so left. I think the clonodine knocked me out....not sure. Stomach is in knots, face is wet, eyes are dripping tears....but I'm no 26 yet. Going to try and focus on some TV, take a few walks, maybe read a bit. I have my suit cases next to my bed....if this works, I'm packing them and am leaving. Kinda a motivation tool I guess. My friends from abroad are all waiting for me....they keep sending me pics and telling me to come. I can't tell them why I can't just yet....and it's killing me that I'm still here. My dog can sense I'm not well and she is all scared....I'm more worried about her than myself.

    I think I should start cutting the subutex powder up because later, I'll have the shakes and won't be able to do it...

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    DancingZorba is offline Member
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    Almost at 15 hours and to be honest, I really don't feel that bad. I really think the clonodine and gabapentin I took is preventing me from the violent vomiting I had last time.

    I have a serious question. What if when 24 hours comes....I'm still not at a 26 on the COWS? Do I wait longer? Or is the clonodine / gabapentin going to prevent me from getting to a 26? Shouldn't my receptors have flushed out everything by that time??

    Please chime in....thank you!!!

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    DancingZorba is offline Member
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    I need to take my benzo now....I tapered off a bit but my body is asking for it.....I think. Everything is fuzzy and I can't think straight. I just don't want to take the subs too early and land in PWD. I need to figure out when to drop the subs because I don't think I can depend on the COWS due to my benzo, gabapentin, and clonodine....UGH!!

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by DancingZorba View Post
    I need to take my benzo now....I tapered off a bit but my body is asking for it.....I think. Everything is fuzzy and I can't think straight. I just don't want to take the subs too early and land in PWD. I need to figure out when to drop the subs because I don't think I can depend on the COWS due to my benzo, gabapentin, and clonodine....UGH!!
    As Randy has already mentioned, you should not be taking the gabapentin, clonidine or any other comfort meds while waiting for your COWS score to hit 26 or higher. You should only be taking your benzo as prescribed by your doctor!

    Please go back and read through all of your old threads, all the information you need to do the sub induction correctly has been explained to you many times. If you are asking for help here then you have to start trusting what we are telling you and follow our advice! Here are the links to your old threads -
    https://www.drugs.com/forum/suboxone...ase-70091.html

    https://www.drugs.com/forum/suboxone...ion-72922.html

    https://www.drugs.com/forum/suboxone...ain-72534.html

    I wish you the best of luck... God bless us all!

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    DancingZorba is offline Member
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    I have been following what everyone has said. My doctor told me to take the gabapentin and the clonodine. I won't take anymore and just wait to hit 26 I guess....

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by DancingZorba View Post
    I have been following what everyone has said. My doctor told me to take the gabapentin and the clonodine. I won't take anymore and just wait to hit 26 I guess....
    Okay, I get that your doctor told you to take those meds but I can tell you that the doctor most likely isn't well informed on subs or sub induction.

    Remember time is not the determining factor on when to start the sub induction, only an honest COWS score of 26 or higher is! The longer you wait and the sicker you get the better the sub induction will go! Do you remember and understand the dosing schedule for the induction? How much to take and how long to wait in between doses? I know it sux but make sure you don't start the induction process too early! Hang in there, like Randy said, do this right the first time and you'll never have to do it again! I wish you well... God bless us all!

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by DancingZorba View Post
    Almost at 15 hours and to be honest, I really don't feel that bad. I really think the clonodine and gabapentin I took is preventing me from the violent vomiting I had last time.

    I have a serious question. What if when 24 hours comes....I'm still not at a 26 on the COWS? Do I wait longer? Or is the clonodine / gabapentin going to prevent me from getting to a 26? Shouldn't my receptors have flushed out everything by that time??

    Please chime in....thank you!!!


    If 24 hours passes and you're not at the 26 score required then YES you wait longer until you are at the 26. And YES, the Clonidine and Gabba will most likely slow down you getting to the 26 score as I previously mentioned. Anything that makes you FEEL BETTER will slow down the Cows score.

    Waiting to induct is the hardest part to sub therapy. It really does suk as Ricky said. I know, I've been there. Those hours you're in wd's are horrible and will definitely test your patience and resolve. That's when people get in trouble with precipitated wd's, they get in a hurry to induct, maybe not use the Cows, or give themselves a score higher than they really deserve and then the PWD's hit. Then it's too late.

    But I'll tell you something else....as soon as you do take that first and maybe the second small dose of sub you'll begin feeling better and better. I'm gonna suggest you begin with a 1mg dose of sub when you do hit the 26 score. Wait at least a full hour because sub can work slower for some than it does others. Then add .25mg doses every hour until you're stable and the wd's have eased up.

    The benzo is the tricky part to this. If you've been taking one under a doctors orders for a while then you should definitely keep taking it. If you stop the benzo it can be dangerous, and will also put you in a different kind of wd, and make you miserable. I don't know what dose of the benzo you're taking, but if I were you I would take a little less than is prescribed until you get through the induction process. Won't hurt a thing. After you're safely through the induction you can resume the prescribed dose.

    Randy

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    DancingZorba is offline Member
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    im 25 hrs in and feel awful but am no 26....guess i waiit longer.....

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by DancingZorba View Post
    im 25 hrs in and feel awful but am no 26....guess i waiit longer.....


    I know it's a rough situation, but keep pushing through. Just curious what your Cows score is now? Just for info purposes, but you may not have all the symptoms listed on the Cows. Just score the ones you do have correctly and you should be able to get to that 26 score soon I would expect.

    Randy

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    DancingZorba is offline Member
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    Quote Originally Posted by Randy35 View Post
    I know it's a rough situation, but keep pushing through. Just curious what your Cows score is now? Just for info purposes, but you may not have all the symptoms listed on the Cows. Just score the ones you do have correctly and you should be able to get to that 26 score soon I would expect.

    Randy
    Well.....I guess it worked. I never got close to a 26 on the COWS, and I blame that on all the comfy meds I took. However, I waited 30 hrs. I went to the ER in fear of dehydration....got some fluids but kept vomiting. I'm still vomiting a little and feel nausa. I have some bad stomach burns. None the less, I think I did ok. I don't want to jinx myself. I ended up taking 12mg....I might take another 4mg before I go to bed. Than taper.....

    I love you all...thanks for helping me. I hope this is over....

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by DancingZorba View Post
    Well.....I guess it worked. I never got close to a 26 on the COWS, and I blame that on all the comfy meds I took. However, I waited 30 hrs. I went to the ER in fear of dehydration....got some fluids but kept vomiting. I'm still vomiting a little and feel nausa. I have some bad stomach burns. None the less, I think I did ok. I don't want to jinx myself. I ended up taking 12mg....I might take another 4mg before I go to bed. Than taper.....

    I love you all...thanks for helping me. I hope this is over....
    12mg is too much my friend! Do not take anymore sub, let's see how you feel tomorrow night and we'll go from there?

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    DancingZorba is offline Member
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    Hey.....the only side I have is nasuea and vomiting, occasional blurry vision. Zofran isn't helping.....but the vomiting is insane. What to take???

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    DancingZorba is offline Member
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    Anyone have an idea???
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    Catrina is online now Diamond Member
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    Quote Originally Posted by DancingZorba View Post
    Anyone have an idea???
    I'm sorry you're vomiting. UGH. I don't know of anything else that you could try to get some relief. Sorry. I think that maybe you've taken too much sub. One of the side effects of too much is that it will make you nauseous. Did you take more after your reported you had taken 12mg? That's a really high dose. To try and put some perspective on this, the estimates are that sub is around 30 times stronger than morphine. If we go with that estimate. you took what may be an equivalent to around 360mg of morphine all within a very short period of time. I was able to gobble enormous amounts of short acting opiates but if I had taken that much at once, I know for sure that I'd have been vomiting too.

    Remember too, that the half life of subs is long and with each dose, it's stacking. Can you back off your doses and get them down to a more reasonable amount? You have enough in you right now that you could easily go the next 24 hours without dosing again without having to worry about detox symptoms. If you could do that, it would allow some of the sub you've taken to dissipate and if you begin to feel better, then you'll know it's the size of your dose that is making you sick and I think it's a very good possibility. It also doesn't surprise me that your vision is being affected. No way to know for sure unless you get your dose down but both these symptoms are telling me it's because you took too much sub.

    What have you got to lose? Try to go for at least 24 hours without dosing being sure not to take any other opiate either so that when it's time to dose the subs again, you won't have to worry about having anything else in your system. I would go one step further than that and wait long enough until you begin to get withdrawal symptoms and re-induct the correct way. By this I mean to begin with a very small dose of the sub, say 1/2 or 1mg and then add only 1/4mg at a time once an hour until your symptoms have subsided. I don't think you'll need anywhere close to 12mg.

    Let me know what you think.

    Peace,

    Cat

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    DancingZorba is offline Member
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    Quote Originally Posted by Catrina View Post
    I'm sorry you're vomiting. UGH. I don't know of anything else that you could try to get some relief. Sorry. I think that maybe you've taken too much sub. One of the side effects of too much is that it will make you nauseous. Did you take more after your reported you had taken 12mg? That's a really high dose. To try and put some perspective on this, the estimates are that sub is around 30 times stronger than morphine. If we go with that estimate. you took what may be an equivalent to around 360mg of morphine all within a very short period of time. I was able to gobble enormous amounts of short acting opiates but if I had taken that much at once, I know for sure that I'd have been vomiting too.

    Remember too, that the half life of subs is long and with each dose, it's stacking. Can you back off your doses and get them down to a more reasonable amount? You have enough in you right now that you could easily go the next 24 hours without dosing again without having to worry about detox symptoms. If you could do that, it would allow some of the sub you've taken to dissipate and if you begin to feel better, then you'll know it's the size of your dose that is making you sick and I think it's a very good possibility. It also doesn't surprise me that your vision is being affected. No way to know for sure unless you get your dose down but both these symptoms are telling me it's because you took too much sub.

    What have you got to lose? Try to go for at least 24 hours without dosing being sure not to take any other opiate either so that when it's time to dose the subs again, you won't have to worry about having anything else in your system. I would go one step further than that and wait long enough until you begin to get withdrawal symptoms and re-induct the correct way. By this I mean to begin with a very small dose of the sub, say 1/2 or 1mg and then add only 1/4mg at a time once an hour until your symptoms have subsided. I don't think you'll need anywhere close to 12mg.

    Let me know what you think.

    Peace,

    Cat
    Hi.....yes, I think you were right about the sub dose. I pulled back on the subs, have not taken any in almost 20 hrs. and the vomiting and nausea have dropped a great deal. I was able to eat some jello and some extra fluids without bringing them up. So I guess too much sub was the problem. Doc told me to keep taking some until I felt "stable"....well, it's now day 3 I think. My head feels like it was hit by a truck....everything is cloudy and fuzzy. Double vision is also now gone, so that's good.

    Guess what I need to figure out is how much sub to take tomorrow.....or maybe I should just not take any unless I experience WD? I think the clonidine has helped me relax as well as my clonopin. I have had some freaky nightmares of war....and I really thought I was there. Scared me to death. I just hope tomorrow is a little better...

    GOd Bless one and all...
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  25. #25
    DancingZorba is offline Member
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    I think I need some sub now......feeling weird.....dose?

  26. #26
    Catrina is online now Diamond Member
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    Quote Originally Posted by DancingZorba View Post
    Hi.....yes, I think you were right about the sub dose. I pulled back on the subs, have not taken any in almost 20 hrs. and the vomiting and nausea have dropped a great deal. I was able to eat some jello and some extra fluids without bringing them up. So I guess too much sub was the problem. Doc told me to keep taking some until I felt "stable"....well, it's now day 3 I think. My head feels like it was hit by a truck....everything is cloudy and fuzzy. Double vision is also now gone, so that's good.

    Guess what I need to figure out is how much sub to take tomorrow.....or maybe I should just not take any unless I experience WD? I think the clonidine has helped me relax as well as my clonopin. I have had some freaky nightmares of war....and I really thought I was there. Scared me to death. I just hope tomorrow is a little better...

    GOd Bless one and all...
    Yes. Just as I suggested, don't take anymore sub until you are in withdrawal again. While Robert's Plan in theory agrees to continue to take doses until you are stable, it's important that those doses are very small and you give an hour between doses to give it time to take full effect. That's the step that you didn't pay enough attention to when you inducted.

    Cut a tablet/strip in advance into pieces so that you have one 1/2mg piece and the remainder into .25mg pieces. Start with the 1/2 piece and then wait at least an hour and then if you're not stable, take a 1/4 piece. Repeat that until you are stable. This is the only fool proof method to land at the lowest effective dose. Take too little and you'll be symptomatic but take too much and that will make you sick. I would be mighty surprised if you don't land significantly lower than the 12mg you took.

    I also think that there are a lot of people who aren't quite sure how they're supposed to feel when they are stable. Stable means that most, if not all of your withdrawal symptoms will go away. You should just be comfortable. I can only imagine that because you have multiple medical things going on and you are on other medications that effect how you feel both physically and mentally, it might be a little harder to determine if you're stable. Hopefully you'll just go slow enough inducting this time that you will recognize it when you do become stable.

    Seriously. You have taken enough sub that you should easily be able to go at least 24 hours and probably more, before you go back into withdrawal. Be patient and allow some of the sub to dissipate and try again. Having tried to induct your way made you sick so you've got to take a leap of faith here and try to follow Robert's Plan to the letter this time. You've got nothing to lose to give this your best effort. The more days in a row that you dose the sub, the more it is stacking making it longer before you can get on the right track.

    Good luck.

    Peace,

    Cat
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  27. #27
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Catrina View Post
    Yes. Just as I suggested, don't take anymore sub until you are in withdrawal again. While Robert's Plan in theory agrees to continue to take doses until you are stable, it's important that those doses are very small and you give an hour between doses to give it time to take full effect. That's the step that you didn't pay enough attention to when you inducted.
    Good luck.

    Zorba -

    Cat said it perfectly.....you didn't follow the induction plan correctly. That's one reason poeople get in trouble with sub therapy. It's EXTREMEY important you take small doses every HOUR until you're stable. If you do that you'll become completely stable on 2mg to 6mg of sub and not the ENOURMOUS 12mg you took.

    You gotta do this right Zorba to have a successful and positive experience with the subs.

    If I were you I would not take anymore sub and allow wd's to get as severe as you can stand them. Then you do the induction the right way. Basically redo the induction.

    Randy

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    Thanks fellas. Well, there is no doubt that it was the subs that are causing the vomiting. After I chimed in here, I called my doctor and told him that I'm in a "catch 22". If I don't take the sub, I the nausea and vomiting go away. However, several hours later I start to feel some WD coming on. I told him the zofran was not helping with the nausea, and suggested that perhaps his suggested dose of 4mg might be to high and is overpowering the zofran. He than said to try 2mg if I wanted.

    I made the mistake and took his advice and took 4mg this morning. Within 20 minutes, my nausea and vomiting were back with a vengeance. The WD was not as severe as it was when I first induced, but I could feel it crawling up on me. I will follow your suggestion and hold off on the subs for as long as I can and take .5 mg than .25 mg.

    Now, he just called in a script for some other kind of nausea medication for me. Do you think .5mg or .25mg will bring back the nausea and vomiting? Thanks for the help once again.....it really is sad that professional medical treatment and advice is so wrong and off. This should be criminal. You guys rock....thanks so much. Love to all...



    Z

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    DancingZorba is offline Member
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    Quick question about my doses. I do have a bunch of SUBOXONE 2MG strips on hand. I had some nausea last time and I thought it might be the nalaxone, so I asked for generic subutex that didn't contain it....and that's what I've been using.

    Getting .25mg from an 8mg pill is not going to be easy. Perhaps I should switch over to the strips I have? I can cut those much more accurately....I'm just not sure if throwing nalaxone into the mix is a good idea? Thoughts?

    Again....thank you

  30. #30
    Randy35 is offline Platinum Member
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    Quote Originally Posted by DancingZorba View Post
    Quick question about my doses. I do have a bunch of SUBOXONE 2MG strips on hand. I had some nausea last time and I thought it might be the nalaxone, so I asked for generic subutex that didn't contain it....and that's what I've been using.

    Getting .25mg from an 8mg pill is not going to be easy. Perhaps I should switch over to the strips I have? I can cut those much more accurately....I'm just not sure if throwing nalaxone into the mix is a good idea? Thoughts?

    Again....thank you


    On some rare occasions, and I do mean RARE, there are those that have a reaction to the Naloxone that's in Suboxone. Less than 5% will ever experience this. And it usually causes some stomach issues if that does happen to be the case. But I'll bet the farm your problems (nausea/vomiting) are because you took WAY too much sub at induction. People just don't understand how powerful sub really is. It's about 30X stronger than Morphine to give you an idea. Yes, very, very strong.

    I know how it is....you try to induct correctly and you take that first dose of sub and wait for it to work like maybe some narcotic pills or other addicitve substances have in the past. When that doesn't happen in a few minutes you think you need more sub to do the job and take more to hopefully help. Before you know it you've taken way too much sub and feel the strength of this med.

    What you need to do is allow as much of the sub as you can to dissipate or leave your system and basically start over. Go as long as you can without taking any sub. Allow wd's to hit again and when you just can't stand it any longer take .5mg to 1mg of sub and wait a FULL HOUR. It can work very slowly for some. Then begin taking only .25mg doses every hour until you're stable. You should be completely stable on 2mg to 6mg of sub.

    The doctor doesn't have a clue on how to advise you. Sorry, but it's true in most cases. They just don't understand how Suboxone works, how to prescribe it, or how to successfully taper someone off. Not all sub doctors fall into this category, but the majority of them do.

    To get small doses from 8mg pills you can crush those pills into a fine powder using the back of a spoon or with a pill crusher available at most pharmacies. Crush the pill and separate into equal piles. For example 4 piles would all be 2mg each. Separate one of those 2mg piles into 4 equal piles and they will all be .5mg each and so on. You can get any dose needed using this method.

    I've given you my best advice. Up to you now.

    Randy

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