Psycho-Babble Substance Use Thread 333744

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Re: Buprenorphine - I INSIST YOU TELL ME MORE!

Posted by bupe_fan on May 3, 2004, at 18:36:30

In reply to Re: Buprenorphine - I INSIST YOU TELL ME MORE! » bupe_fan, posted by Chuckie on May 3, 2004, at 13:06:36

I know alot about where you are coming from, as I was on poppy tea (very low doses - 2 giganthemum pods per day) for the last months before I got the bupe appointment. Yes, I found the bupe doc at http://buprenorphine.samhsa.gov and it took me over a month to get in (kinda sad imagining a junkie having to needle himself for an extra month cause of a delay in admissions).

Well I can tell you what to expect: Your first appointment you will likely NOT be given any buprenorphine, but instead asked very many questions and made to sign very many forms. I realise that you, like most people who find themselves with opiate dependancy are only trying to treat your depression, but unfortunately you'll be treated like an addict the whole way. Of course a doctors office once a month is much more humane than waiting in line every morning at the methadone clinic, but no matter how hard the doctor tries to keep his words stigma free, its truly impossible as they have not experienced what you have experienced. You might experience like I did a nurse asking "do you regret ruining your life?", to which I responded "Excuse me!?", and she says "Becoming a junkie and having to deal with all this bullshit", to which I replied "I am glad I discovered opiates as they helped keep me from doing something I regretted such as killing myself or others".

My advice for the first appointment is to be pretty honest about your situation, however be very careful about what you disclose, because the doctor is quite likely to paint a picture of you in his mind biased towards what he first heard. You know the expression "first impressions always last". For example I told my physician that I had been using roughly 10-15mg morphine equivalancy in poppy pods for the last couple weeks (calculating that there is 5-8mg of morphine per Giganthemum pod), but unfortunately this did not account for my previous Oxycodone usage at 40mg/day, hydromorphone at 8mg/day and fentanyl usage at 1600mcg per day. Due to this information he considered me to have an "extremely low tolerance" and prescribed me 2mg of buprenorphine initially and suggested that I use 1mg once I stabilize. I found myself to be somewhat comfortable at 2mg (certainly more comfortable than without), but when I tried to taper to 1mg, I found that I was unable to concentrate enough to function at work (I have a job which involves the use of my brain intensely for many hours), I also found that tapering lead to misery at home, and my discomfort caused some conflict with my fiance.

After a couple months or so at 2mg, I realised that I missed the "good old days" of being able to feel as comfortable as I wanted any day of the week and decided to tell my doctor that due to the pain I was experiencing in my hands and arms (various things wrong with them: carpal tunnel, ulnar nerve and shoulder) and due to cravings and poor functioning at work whenever I tried to taper, that I viewed the benefits of using buprenorphine outweighed all cons, but that I needed a higher dose to prevent these cravings because I felt that I did not reveal the full extent of my opiate habit during my initial visits. So after much pleading and reasoning as well as providing many studies about buprenorphine dosages and buprenorphine in the treatment of depression (www.google.com and PubMed are my friends) he increased my dosage to 3mg/day, which is certainly perfect. It is great because it gives me some leeway to adjust how much I take in a day, some days I take only 1 pill (2mg), while others I take a full 2 (very rarely), but all in all the average is right around 1.5/day.

You should however realise that much of the "torture" you were experiencing comes from protracted withdrawal symptoms, as well as the initial depression you had.

As you seem pretty set on bupe as the treatment for you, you should be aware of the possibility that you might not get it at all from your doc, if he evaluates you and for any reason (personal, moral, religious, who knows) decides that he doesn't want to put you on bupe, you'll likely end up on whatever drug the pharmaceutical manufacturers are paying him to promote this month. (Effexor seems to be a biggie these days - despite telling my doc that I absolutely refuse to try to "Treat" my ADD with an anti-depressant and a severe allergic reaction to the closely related Buproprion (Wellbutrin) a couple years ago, he kept trying to push effexor on me.) Aslo remember it is quite likely that you are not going to start on bupe right away, and also they will want you to be clean from other opiates for 24 hours. In all honesty there is some safety margin in those 24 hours, and I was only off opiates (I switched to hydrocodone due to its short halflife) for 12 hours, to mimize the withdrawals I experienced at work, and I was feeling better within 10 minutes of putting the suboxone under my tounge. If you really wanna be certain about what day he would dose you, call and ask what his policy is. They usually dose on the 2nd day because they require a whole buncha signed paperwork (thank you litigous people for wasting my time) and also require a driver to take you home (you probably won't need it, but liability rears its ugly head).

Some doctors will require a urine test during your first visit to make sure you are "honestly a junkie" and also to make sure you aren't a "polysubstance abuser", because that increases the amount of work they have to do.

You will also be urine tested every week/month (depends how good you are) to make sure you aren't "relapsing" (which is fortunately very difficult to do thanks to the 72 hour blockade caused by the buprenorphine - in my personal experience all other opiates are wasted when attempting to do them within 3 days of buprenorphine, although you will get very uncomfortable when going 36 hours without, so its pretty much impossible to last 72 hours off bupe to actually get high.) If you fail opiates or one of the other substances on the test besides opiates, your doc can do whatever he feels is neccesary, including reccomending methadone maintenance instead, tapering your dose or whatever other punishment is appropriate (I realise its not really a punishment in the doctors mind, it just has that effect). Personally I failed for benzos once and didn't get anything more than a lecture from the moralizing nurse. Of course the only reason I failed is because they have not prescribed me anything which actually helps me sleep yet.

If you have read anything on the net about how buprenorphine is "withdrawal free" or anything of the sort, its not entirely true. Once you have been on buprenorphine for a couple weeks or more (6 months in my case) it becomes extremely unpleasant to go without for 36 hours... If someone uses this drug to wean themselves off opiates in a period of 2 weeks it would definately be less unpleasant than using methadone or quitting cold turkey, and this is why the rumours about "withdrawal free detox" got started. While quitting is still very hard, the thing I've been impressed with about bupe is the lack of any creeping tolerance! 2mg still feels exactly the same as the first day I did it.

As for actually dosing, pick a time when you've got 15 minutes without talking to anybody (due to sublingual administration), and take 2/3rds of your daily dose when you first wake up, and 1/3rd about 12 hours later... This provides the best balance of feeling comfy when you need it most (morning and night), and the body actually gets more use out of such a dose, due to the partial agonist nature of the drug.

Lastly remember bupe is not a magic cure, although it definately helped me with my depression, ADD and bipolar disorder, I still work hard every day to find better ways to cope with my natural limitations. Excersize and diet are the most important ways to combat depression. And I highly reccomend DLPA and L-Tyrosine for a little boost in the morning and Melatonin at night. Proteins are the only way to get a lift without a subsequent crash.

Yes, so sad about GHB, I have commented to my fiance that if I had a steady supply I would be able to wean myself off bupe and experiment with living without (my original plan), but a wedding, a full time job, and a housing search have prevented the taper.

Good luck! and don't be scared of the docs! they really are trying to help! They're doing their best but they're only human and motivated by profit (after all medicine is a BUSINESS). Read up on opiate addiction at one of many harm reduction related sites such as www.bluelight.nu and www.at-watchdog.org (I provided this link earlier).

> Sorry for insisting, and so emphatically, but this is my life in the balance.
>
> I admitted myself to the hospital a few weeks ago for detox. I was there for four days; they gave me decreasing dosage of methadone and then said well there you are. I spent the following week sick, in a spiral *much* more destructive than the drugs. After a week i should have been better but the fact was i was worse and on my way out. Couldn't take the torture anymore and now i'm back on the poppy and approaching my old dosage.
>
> You say these things, and they raise questions which i hope you're kind enough to answer after i shouted at you:
>
> >>The doctor said no way would he let me continue on buprenorphine for any longer than 10 days,<<
> >>If the doctor ever tries to taper me I will raise hell about how much better I am doing now...<<
>
> What sort of doc did you see? And why is he reluctant? I thought bupe was a maintenance medication.
>
> I want to avoid your sort of situation. It doesn't sound much more workable than the old go-to-the-doctor-and-be-in-pain strategy for obtaining Vicodin or whatever. IOW, it can and likely will be taken away from you before you're ready to have it taken.
>
> I ask, because tomorrow i have an appointment with a certified buprenorphine type doc. I'm nervous as hell because my only other options are continuation of the poppy, or methadone. The flower is illegal and makes me ill at the dosages i take. The nearest methadone clinic is a 45 minute drive from here, and i'd have to go every day until they decide i don't. And i don't want to be addicted to methadone.
>
> This geographical area of the U.S. has only two buprenorphine docs listed in the gov't directory; the one i'm going to see, and the one i can't get hold of.
>
> Of course i'll do whatever needs done, but the buprenorphine sounds like the thing that *should* be done. I want to get my body back in balance... start eating right again and get back into the gym, etc. And my wife is taking me to see a holistic practitioner; dietary plans and acupuncture and whatnot. I'm skeptical because it's my nature but i'm also open because that's my nature too. But i need a *somewhat* balanced place to start from.
>
> Sorry. I'm likely rambling because of my nervousness. Bleh. Want my life back.
>
> One of my more important questions: What is the bupe costing you? The receptionist told me that their visits start at $95 and go up, but that Medicare would pay "some portion." I have no idea what the medication costs around here but i've read official estimates of around $250/mo. This sucks, but the poppies were getting to be about $150/mo. and my ultimate purpose is to get de-drugged eventually so the cost is somewhat of a motivator. I just don't want to be priced out of treatment entirely.
>
> Thanks for the info about GHB. I had sorta figured it out, i just hadn't figured "no way in hell." Oh well. Thanks to my government for protecting me so well.
>
> >>I think you put the Doc which you saw into a situation where he only had one thing to reccommend.<<
>
> Dangit, which thread am i on? I forgot what i said, and where. If you're talking about the intake person who tried to shanghai me, then no, she had no right nor justification for that whatsoever. You might be correct about the kickback but i think it had more to do with her bad day, her need for control, and the approaching 5:00 hour.
>
> I'm still angry about that episode, can you tell? ;)
>
> *cough*
>
> Erm anyway like i said, thanks for ANY further info, comfort, advice, etc. you can provide. I get all worked up. Really feels like tomorrow's appointment is life or death in the balance. I'll not give up if it turns out badly, but it gets so very hard not to give up when things *keep* turning out badly. Ya know?
>
> - Chuckie
>

 

Re: Buprenorphine - I INSIST YOU TELL ME MORE!

Posted by arrie on May 3, 2004, at 19:37:06

In reply to Re: Buprenorphine - I INSIST YOU TELL ME MORE!, posted by bupe_fan on May 3, 2004, at 18:36:30

Thanks for all the bup info. Now heres what happened with me. I too looked at the "gov" website to find out what docs in my area had this med. After many exasperating calls, many of the listed docs referred me to just one who works in a University hospital meth clinic setting. I went in, upper crust house wife look and all, forced myself to talk to them. They WOULD not give me Bup unless I signed my life away to them, I was pissed. They wanted me to get in line every day like i was getting meth, attend groups and have mandatory counciling with them once a week, for only the first 90 frickin days. They are the only game in town, my city is almost 800,000 in population. asked how drug was working out they said " oh youre our first one". In other words they are doing a poor shit ass job of helping anyone. I walked out.

 

Re: Buprenorphine - Thanks! And... » bupe_fan

Posted by Chuckie on May 3, 2004, at 19:38:29

In reply to Re: Buprenorphine - I INSIST YOU TELL ME MORE!, posted by bupe_fan on May 3, 2004, at 18:36:30

That was beautiful, just beautiful. Thank you.

I just have a couple more questions, if you have the patience.

Firstly you didn't tell me how much this costs. I have some resources at my disposal, but i did lose a contract over all this and so money is tight. I only have Social Security and some miscellaneous odd jobs. And credit cards, lots. :D

Secondly what means "polysubstance abuser," to a doctor of this sort? I've been on clonazepam for fifteen years, and i'm not about to even try to give that up at this time. It helps me out a great deal as my depression is triggered by stress. I handle it much like you do the buprenorphine; adjusting it to circumstances to maintain balance. My script is for 2mg/day, generally i take 1 to 1.5mg. Do you think such usage makes me an "abuser"?

Good grief i can't imagine the pain of having to quit that too. For no good reason either, since it does no harm and in fact helps me.

You realize, you know, that you've reinforced just about every fear i have about my appointment tomorrow? But i guess i needed to hear it. It's just strange, and wrong, that such judgements should be passed in a practice specializing in harm reduction. Or that there should be any question about the propriety of buprenorphine maintenance, when the alternatives are illegal substances or methadone.

Here's what i plan to say, for lack of anything else; see what you think:

1) I took the opium for depression, after every conventional AD had failed me.
2) Opium turned out to be a mistake.
3) Detox put me in Hell. (I honestly don't remember what sort of Hell it was. I remember a few Bonanza episodes, otherwise the only objective information i have is what my wife observed. All i know for sure is i couldn't take it.)
4) I don't want to continue doing opium because it's illegal and unhealthy. I don't want to do methadone because it's impractical hour and a half driving per day, and i don't want to be addicted to it.
5) My current dosage is 12 level tablespoons/day (~ 3/4 cup) raw product. (I equate this to approx four 750mg Vicodins, i have no other reference. Sound right?)

My whole point, as i think i said, is to be in a balanced state from where i can accomplish things. I have a plan in place for my mind and my body, however when i'm so wildly imbalanced i'll never get a damb thing done and i know it.

In any case, thank you very much for the descriptive picture. I hope my experience to be a bit more copacetic, but now i understand some the potential pitfalls and i'll tread lightly. If you have any further advice based on my specific plans, please share.

Thanks Again. Really.
- Chuckie

 

Re: Buprenorphine - W00T!

Posted by Chuckie on May 4, 2004, at 21:17:16

In reply to Re: Buprenorphine - Thanks! And... » bupe_fan, posted by Chuckie on May 3, 2004, at 19:38:29

Well i have some good news, and some good news.

I saw the doctor today. I was a half hour late because of traffic jams, but the staff was friendly and understanding. The clinic is actually a family practice; in fact it's housed in a comfy converted residence.

The doctor was all smiles and helpfullness and REAL. None that clinical distance and uncomfortable feeling of being sized up for to pass appropriate judgement. He's a family doctor with a background in methadone clinics.

We talked for about ten minutes. He asked me to approximate my current poppy usage, in terms of Vicodin, and i told him i thought about four 750mg pills/day.

Then he called in my prescriptions.

No pee tests. No counseling. No judgement. And apparently i can call the pharmacy for my monthly refills.

To top it off i now have a GP for my family. One who will also refill my clonazapem and wellbutrin scripts, should i need them, without concurrent whinging about my 'substance abuse.'

This is almost too good to be true. But, the scripts are called into the pharmacy. It actually happened, already. The pharmacy doesn't have any, but they're supposed to have them by tomorrow afternoon.

The only downside is the cost. Of course i'll pay whatever it takes to get started on my new life, but wow. Something like $90 to get started on Subutex, then $360?/mo. for suboxone maintenance.

Although he's got me at the 'target' dosage of 16mg. Judging from anecdotal stories like from ^bupe_fan, who is comfy on 3mg, i should think i should be able to live with at least half or third of my prescription. So in theory, half to a third of the cost.

The other downside is i guess i have to be dopesick before i can start the bupe. Hopefully this happens by tomorrow evening. If not, i'll just stay up until it does. And hopefully i judge properly how sick i should be before taking it. I mean i hope the runny nose and the shattered nerves are sick enough, since if i call it wrong i guess i could make myself even sicker. But even that should pass, after all i will be getting opioid medication into my system.

That's my only real criticism of my experience. I think the doc could have been a bit more detailed about how to proceed. But then, his original plan was to have me off the flower for TWO days and then start me on Suboxone, so maybe he feels everything be OK with the gradual introduction of Subutex instead. I also note the lack of an office visit for my first dose, as seems traditional, and the lack of actual verification of my dependence. But here again, buprenorphine is a poor choice for abuse, so maybe he skips the formality based on experience. I mean he probably doesn't have a lot of people traipsing in to bs him for a fix, esp. considering the cost.

All in all, a great day for Chuckie. I'm feeling a bit sad for all the stories i hear of less fortunate situations. But... after 40+ years of suffering in one form or another, i think it's about time i get a chance at a life. I mean before it runs out entirely.

SO...

This is probably my last comment on this thread, unless someone asks for more commentary. I'll post my progress on new thread(s?), as i'm embarking on a new life now.

Thanks All. Just for being here.

- Chuckie

 

Re: Buprenorphine - Thanks! And...

Posted by bupe_fan on May 4, 2004, at 22:21:48

In reply to Re: Buprenorphine - Thanks! And... » bupe_fan, posted by Chuckie on May 3, 2004, at 19:38:29

Chuckie: Regarding the cost, I have very expensive health insurance through my work (a health industry related business) and thus all I pay is $10 copay + $30 for the Urine tests (for some reason insurance won't cover those!)... I've read elsewhere that the 2mg pills are $2 each while the 8mg pills are $6 each.

I think in the doctors eyes benzo use is abuse if its not prescribed, and if it is prescribed, he may have his own reasons for wanting you to quit them. I do know that in the physicians manual at http://buprenorphine.samhsa.gov it says to excersize caution with mixing bupe and benzos due to some overdose deaths caused by IV benzo+bupe usage in france in the 1980s... Some physicians take this a little too far and are overcautious to the point of not prescribing benzos to bupe patients (even though the deaths were from massive dosages IV)... I have no idea how your doctor will react in your specific situation.
Good luck!

 

Re: Buprenorphine - Thanks! And...

Posted by rianna on May 5, 2004, at 18:29:27

In reply to Re: Buprenorphine - Thanks! And..., posted by bupe_fan on May 4, 2004, at 22:21:48

> Chuckie: Regarding the cost, I have very expensive health insurance through my work (a health industry related business) and thus all I pay is $10 copay + $30 for the Urine tests (for some reason insurance won't cover those!)... I've read elsewhere that the 2mg pills are $2 each while the 8mg pills are $6 each.
>
> I think in the doctors eyes benzo use is abuse if its not prescribed, and if it is prescribed, he may have his own reasons for wanting you to quit them. I do know that in the physicians manual at http://buprenorphine.samhsa.gov it says to excersize caution with mixing bupe and benzos due to some overdose deaths caused by IV benzo+bupe usage in france in the 1980s... Some physicians take this a little too far and are overcautious to the point of not prescribing benzos to bupe patients (even though the deaths were from massive dosages IV)... I have no idea how your doctor will react in your specific situation.
> Good luck!

I've been reading your post Chuckie and Hope things work for you. Do be careful with that klonopin. It is my living nightmare...And thanks for your comments on my post.

 

Re: Buprenorphine - Thanks! And...

Posted by Chuckie on May 5, 2004, at 19:17:10

In reply to Re: Buprenorphine - Thanks! And..., posted by rianna on May 5, 2004, at 18:29:27

Thanks Rianna,

Not feeling so good right now, as i'm unsure how long i'm supposed to wait before i take my medication. If i wait long enough, it will make me feel better. If i don't wait long enough, it can make me feel worse. At least as i understand things.

I wish i understood things better. :(

Hey, if it's any consolation i've been reading about benzo dependence as well. I can't find the link ATM, but i know i read something very encouraging about ditching the stuff after the last bit of tapering.

Here's a FAQ i found:
http://www.benzo.org.uk/FAQ1.1.htm
... looks like lotsa good info.

Also, although i only did it once, i *did* taper myself organically, simply owing to living a healthy lifestyle. I was down to .25mg clonazepam, from a high of 2mg. I hardly noticed the taper, and if i'd had any sense i probably should have stopped entirely because i probably wouldn't have noticed that either.

I'm saying it can be done, so don't give up. Of course this is just my experience, but from that experience i think the best angle at it is to get healthy and happy, so you don't need the drug so much.

That's my plan, anyway. :)

GL
- Chuckie

 

Re: Buprenorphine - Thanks! And...

Posted by Festus on May 5, 2004, at 22:54:31

In reply to Re: Buprenorphine - Thanks! And..., posted by Chuckie on May 5, 2004, at 19:17:10

I,too,have just gotten absorbed in the "Will Chuckie make it?"saga,and I think that ,combined with a bit of luck and plain honesty,the Dr. you found was willing to help you without all the usual BS one would get in this situation.A"Good Doctor",as this one,knows you,ve already got BS up to your ears,as it is,so I,m real glad for you.Please wait till you are steady and sure from the opiate stoppage before trying to dis-continue the Klonopin.Gettin off that stuff is dangerous,sometimes.I,ve heard of some using Xanax to stop the Klonopin,then weaning from it.I wondered if you had any Chronic Pain issues?I take Methadone because of Chronic Pain that keeps me from being able to work without meds,and also because it,s cheap(no insurance).I don,t like taking it,but I don,t have much choice.At one time,I was on 640-720mg. of Oxycontin a day,I was very relieved to go to the Methadone.The Oxy was $1,750.00 a mo.without insurance.The Methadone is 50 bucks a mo. and does a better job controlling my pain.I take Dexedrine for ADD,also,so between the 2 meds,I,m able to keep a clear enough mind and able body to run a business,but I wish I did,nt have to depend on the Meds.I,m grateful that I have a"Good Dr.",too,that will give his patients what they need,not what he feels"safe"giving them.Good-Luck,Chuckie!Festus

 

Re: Buprenorphine - Thanks! And... » Chuckie

Posted by rianna on May 6, 2004, at 19:11:54

In reply to Re: Buprenorphine - Thanks! And..., posted by Chuckie on May 5, 2004, at 19:17:10

thanks your support is great. keep yours up! you can do it. You have gone through a lot to get help so don't give up. Your info has been very inspiring for me and many others.

 

Re: Buprenorphine - W00T!

Posted by arrie on May 6, 2004, at 23:56:05

In reply to Re: Buprenorphine - W00T!, posted by Chuckie on May 4, 2004, at 21:17:16

Great news Chuckie on getting the Bup. Keep us posted. How did you find this Doc, was he on that government sponsered web site? I am still confused on this very important point, can any qualified Dr prescribe this, or only a certain few? Please tell me what you know, if any Dr can prescribe it, I will get the yellow pages out again, anyone out there know? Anyway congradulations and please keep us Bup wannabes posted on your progress.

 

Re: Buprenorphine - W00T!

Posted by bupe_fan on May 7, 2004, at 0:45:41

In reply to Re: Buprenorphine - W00T!, posted by arrie on May 6, 2004, at 23:56:05

Any doctor who has taken an 8 hour training class and received a certification enabling him to prescribe suboxone and subutex is allowed to prescribe this. See http://buprenorphine.samhsa.gov for more on this and many other subjects.

 

MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by sofarsogood on June 20, 2004, at 20:42:03

In reply to Re: Buprenorphine - Thanks! And..., posted by rianna on May 5, 2004, at 18:29:27

I HAVE BEEN AN DAILY ABUSER(OTHER THAN WHEN I COULD NOT GET THEM AND FELT LIKE SHIT
) OF OC 80-160 MG AVERAGE .THE OLD CRUSH AND SNORT FOR NEARLY TWO YEARS. I HAVE PRIOR TO THAT ABUSED JUST ABOUT ANYTHING YOU CAN NAME I . I lived the seeker life style. Keeping IT FROM WIFE AND FAMILY AND COMING UP WITH SOME REALLY GOOD REASONS MONEY WAS DISAPEARING.HAD A PART TIME JOB FOR PILLS. ANY WAY THE REASON I AM POSTING IS I HAD ENUOGH.AFTER MUCH RESEARCH, I WANTED TO DO A MEDICALLY ASSISTED W/D.I WENT TO A DONE CLINIC AS A FEW OF MY FRIEND HAVE WITH FOR THE MOST PART POSITIVE RESULTS .(LITTLE SLIP UPS HERE AND THERE )THEY ALL WISH THEY DIDNT . CLAIM ITS REALLY HARD TO GET OFF. I WAS INTERESTED IN BUPE. BUPE IN A DONE CLINIC IS LIKE BEING ON DONE. AM. DOSE DAILY @CLINIC. BUT MUCH MORE MONITERD REGIMENTED AND THEY ARE REAL QUICK TO KICK YOU OFF THE PROGRAM.DOC MEETINGS ONCE A WEEK.TWICE A WEEK IN THE MIDDLE OF THE DAY YOU MUST GO TO A MEETING OF SORTS.AND @ NIGHT GROUP MEETINGS WITCH MIGHT BE GOOD FOR SOME .ZERO FLEXIBILITY IN ANY OF THIS. MY CAREER DOES NOT ALLOW ME TO DO ANY OF THIS AS MUCH AS I STILL WAS INTERRESTED. THE INTAKE COUNSELER WAS COOL. RECOVERD SMACK ADDICT. SO HE WAS ABLE TO SEE WERE I WAS COMING FROM. I ALSO HAD THE PLEASURE OF SOME OTHER ASS HOLE WHO APPARENTLEY IS IN CHARGE OF THE BUPE PROGRAM COMING IN THE ROOM. AFTER HE BELITTLED ME FOR "NOT BEING READY TO GET OPIATE FREE"DUE TO ME NOT BEING ABLE TO MEET ALL THE REQUIREMENTS HE TOLD ME TO COME BACK WHEN I AM READY. I ALMOST TOLD HIM TO PISS OFF.THEN THE COOL GUY TRIED TALKING ME INTO DONE SO I TOLD HIM THANK YOU AND LEFT. AFTER MUCH RESEARCH I FOUND THE BUPE LIST GOOGLE SEARCH YOU CAN TOO.OF DOCS WHO DO IT IN AN OFFICE OUT PATIENT SETTING.I LIVE IN A POPULATED AREA SO THERE WAS A SHIT LOAD. MANY WITH REQUIREMENTS SIMILIAR TO THE DONE CLINIC(THEY WERE DONE CLINICS OF SORTS). MANY LISTED AS TAKING MY HEALTH INSURANCE BUT NONE WOULD. SOME(THE MORE AFFORDABLE) SEEMED NOT SO ON THE UP A FEW PLACES GIVING 3 DAYS OF TAKE HOME INJECTIONS AND NO SUPPORT,NICE HUH. MOST ON THE LIST WERE NO LONGER DOING BUPE,OR NOT TAKING NEW PT. EACH QUALIFIED DOC (8 HOUR CLASS) AND A PIECE OF PAPER CAN ONLY TREAT 30 PT.IN THE US. AT A TIME. I LUCKILY FOUND A PLACE REAL CLOSE TO HOME WHO SPECIALIZES IN RAPID DETOX,ADDICTION THERAPY,PHYCOLOGY AND BUPE .1ST YOU MUST BE IN W/D I WAS ABOUT 60 HRS(ONLY CAUSE THERE WAS NOTHING AROUND) I DIDINT LOOK TO HARD EITHER I FIGUERD IN TWO DAYS I WAS PUTTING MY PLAN TO QUIT INTO ACTION. RECOMMEDED AT LEAST 24 HOURS BY COUNSELER.THE FURTHER YOU ARE THE BETTER YOU FEEL WHEN YOU GET THE BUPE. WENT THRU ONE BAD DAY .DAY 2 BUT STILL SWEATY, ANXIOUS,RUNNY NOSE ,AGITATED BLOWN PUPES THE HOLE NINE FOR MY APPOINTMENT .I SIGHNED IN AND TOOK A SEAT LIKE A REAL DOCTOR OFFICE.THE INTAKE GUY WAS VERY RECEPTIVE EXPLAINED IT ALL TO ME ASKED ME A TON OF Q'S AND HAD ME SIGN A FEW PAPERS.NOW THE KICKER $2000. I KNEW THIS THOUGH BUT FOR MANY PEOPLE OUT THERE THIS IS NOT A FEASIBLE AMOUNT OF MONEY AT ONCE TO PAY . ALTHOUGH I WAS SPENDING $600-$800 MONTH ON OC PLUS 60 PRESCIBED BY DR FEEL GOOD PERC 7.5.AND WHATEVER ELSE CAME DOWN THE LINE IT WAS ALL ADDING UP AND JUSTIFIABLE IN MY EYES . I WAS GOING TO MAKE THIS WORK. BRIEF CHECK UP WITH DOC . DOC CALLED IN BUPE. WENT AND PICKED IT UP. CAME BACK TO OFFICE AND I WAS ADMINISTERD 16 MG SUBUTEX. FELT BETTER IN 30 MINUTES OR SO THEN HE ASKED IF I WANTED ANOTHER . I TOOK 4MG MORE. I WAS NOT HIGH BUT FELT GOOD A LITTLE CHEERY MABEY BUT NOT OC HIGH. HE TOLD ME THE FIRST WEEK 8MGS AM 8 MGS PM.IF MID DAY W/D TAKE A LITTLE PIECE.(THIS WAS MY INSTRUCTIONS THRUOUT THE ENTIRE PROCESS). IT WAS WORKING NO CRAVINGS NOT FEELING LIKE SHIT . WASHING MY TRUCK DOING STUFF WITH OUT HAVING TO DO SNOOTERS. WE HAD A TAPER OFF PLAN .AFTER A LITTLE MORE THAN A WEEK I SWITHCHED TO SUBOXONE.TAPERING DOWN OVER I GUESS ALMOST TWO MONTHS DOWN TO 1 MG DAILY .5 AM .5 PM. I ALMOST FELT LIKE IT WAS IN MY HEAD @ 2MGS DAILY .THAT THIS LOW DOSE WAS WORKING SO I SKIPPED A DAY AND A HALF. IT WAS WORKING. ONLY PROBLEM WAS SLEEP. I ALWAYS HAD SLEEP PROBS. WE TRIED TRAZADONE? 2 NIGHTS ADJUSTED DOSES. MADE ME FEEL WEIRD FELL ASLEEP BUT WOULD WAKE UP IN THE MIDDLE OF THE NIGHT . NEXT ELAVIL BASED ON THE POSSIBLE SIDE EFFECTS I TOLD HIM I DID NOT WANT TO TAKE THIS MEDICATION. FINE NO PROBLEM. I ASKED FOR AMBIEN . AMBIEN HAS A HIGH POTENTIAL FOR ADDICTION HE SAID NO. I ASKED FOR JUST ONE I WAS A WEEK INTO THIS AND HAVE NOT HAD A GOOD NIGHT SLEEP. HE CALLED ME IN 5 RESTORILL? THIS STUFF IS GREAT. IT IS A BENZO SO IF YOU LIKE THE BENZO THING MABEY SKIP THIS PART . IM NOT INTO IN THEM I NEEDED SLEEP.BACK TO THE WALK OFF ,THE END. .5MG AM .5MG PM.ON MONDAY. TUESDAY NOTHING AT ALL I HAD TO GO TO WORK.I FELT OK BUPE HAS A LONG HALF LIFE.I WAS PERSCRIBED CLONIDINE .2 6-8 HOURS FOR W/D SYPTOMS THIS STUFF WORKED FOR ME GREAT.10MG VALIUM EVERY 8HRS AS NEEDED FOR ANXIETY.AND SOME MORE RESTORILL.I TOOK ALL AS PERSCRIBED . I SLEPT MOSTLY FOR WENDS,THURS,FRI.SAT I FELT EXTREMELY TIRED BUT WAS FUNCTIONING. DOWN TO .1 .05 CLONIDINE IF NEEDED 6-8 HRS FOR W/D SYMPTOMS. AT THIS DOSE YOU CAN FUNCTION AND 5MG VALIUM IF NEEDS BE. PLUS THE SLEEP AID.7 DAYS OPIATE FREE. ALOT OF NERVOUSE ENERGEY AND MAJOR TENSNESS? 5-10 MG VALIUM UPON ONSET WORKED.ABLE TO FUNCTION BUT TIRED. I WILL TAKE OCCASIONAL .1 MG CLONIDINE IF I FEEL I NEED TO . DOES NOT PUT ME OUT LIKE IT DID IN THE BEGINING. FOR THE MOST PART IM COMFORTABLE.ALL THESE MEDS IF ONE DOES NOT HAVE INSURANCE WOULD BE NEAR THE, I WOULD GUESS ,$600-$700 RANGE.I LET MY WIFE IN ON MY LITTLE SECRET SO I WAS ABLE TO SHELL IT OUT AND SHE WAS SUPPORTIVE.THANK GOD. FEW FRIENDS HAVE HORROR STORIES.ANYWAYS IM ONLY 13 DAYS OPIATE FREE.I AM EXPERIENCING WHAT I THINK MIGHT BE DEPPRESSION IE TIRED ANXIOUS,A LITTLE CRANKY,ANXIETY AND JUST NOT HAPPY OR HIGH. THIS IS GOING TO HAPPEN TO ANY LONG TERM OPIATE ABUSER. IT TAKES THE HUMAN BRAIN THREE MONTHS TO GET BACK TO PRODUCING ALL THE CHEMICALS THAT MAKE PEOPLE FEEL THERE NORMAL AFTER LONG TERM INTENSIVE DRUG ABUSE.WE ARE NOT GOING TO ADDRESS THESE ISSUES YET IM GIVING IT 3-4 MORE WEEKS.THAN I MIGHT TRY SHORT TERM PAXIL.MABEY A GOOD TALKING TO WOULD HELP.WHO KNOWS. I GOT AN APPOINTMENT WITH THE SHRINK AGAIN. I ALSO HAVE A COUNSELER THAT I CAN CALL PRETTY MUCH WHEN EVER FOR WHAT EVER AND HE DOES HIS BEST TO HELP ME AND HE HAS GUIDED ME THRU THIS PROCESS.ALL FOR THE AMAZING LOW PRICE OF $2000 (ME TRYING TO BE FUNNY.)SOME SURGICAL FINANCE COMPANIES WILL GIVE LOANS IF YOU CAN QUALIFIE. NOW THE HARD PART KEEPING OPIATE FREE.WISH ME LUCK I HAVE NO ADVICE ON THIS AS I AM TRYING NOW TO DO IT MYSELF.I FEEL A GREAT ACCOPLISHMNET KICKING THE SHITTY HABIT AND I HAVE REMOVED MYSELF FROM THE SEEKING LIFE STYLE. DRUG FRIENDS CERTAIN PLACES VARIOUS TRIGGERS. THIS I FEEL IS A MUST.I JUST WANT TO ENJOY LIFE WITH OUT HAVING TO HAVE A SUBSTANCE OR SOME OTHER OUTSIDE INFLUENCE. GOOD LUCK I HOPE I WAS HELP TO AT LEAST ONE PERSON AS THE INTERNET HELPED ME LEARN ALOT ABOUT BUPE,DRUG ABUSE AND HOW TO GET OFF IT .

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by arrie on June 21, 2004, at 17:32:33

In reply to MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by sofarsogood on June 20, 2004, at 20:42:03

Congradulations Sofar, are you and Chuckie the same guy by any chance? I am so glad you posted your story.Going to go for Bup on 7/9, tried like you when I went to a clinic. Live in the midwest, city of almost 1 million, they put me through such an ackward experience at the clinic I almost ran out. The whole purpose of this med is to make the person come forward for help, in a private confidential manner, not to have these smart alecks pull your pants down and spank you. I was so excited, then they basically told me about their program, asked how many they were treating, told me "no body yet", I see why, left.
Got back on the Samsa site and found another doc. An Arab in the middle of nowhere, but he went to Harvard and will be thrilled to treat alittle city girl like me, I'm sure.
I have used about 100-150 mgs of opiates for about 3-4 years. They helped with fibro and depression. I dont EVER buy illegally, but the gap is closing in on me, I am always out. I get so sick, you know the drill. THINK ABOUT THAT REAL HARD before you use agin, that awful drill, it is not worth it. Tell yourself maybe in a few years when you are really over, if you cant bear the thought of not having it again.
Are you on the Bup at all now, or completely off? Can you stay on this med long term for depression, pain control etc. You know I did alot of research and interesting thing is any doc can prescribe this off label for any reason like they do Botox, it is just they dont know much about it and it has the stigma. Anyway good luck and thanks for your account, I will read it again. Oh, and all the papers you had to sign, does that mean your name is on a hot list with local pharmacies or what? I am wondering why I hear so much about the papers???
Bye Arrie

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by arrie on June 21, 2004, at 17:46:50

In reply to MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by sofarsogood on June 20, 2004, at 20:42:03

And just in case you didnt hear me, remember the awful drill, the cycle, how crappy you feel, so stay off em dude. You should be proud, you pretty much did it on your own, so dont throw it away.

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by sofarsogood on June 22, 2004, at 0:21:22

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by arrie on June 21, 2004, at 17:32:33

Suprised someone read my saga cool. Today was a good day. Only 10 mg valium mid-day (it doesnt seem to have any negative affect and helps with cravings)and an extremely productive one at that.For arie , No longer on any bupe . What suprises me is I have a few left and I Thought about taking them when I first came off but I didnt. I might give em to a friend who wants to get off done. I have a full script of clonidine left as well. I have read about getting to a real low dose of done like 20-30mg and kinda use the clonidine for mid-late day w/d . This however is a 4-7 day process at most.I would almost guarantee he would be down and out for a few days.He would have to be extremely determined and I recommended some valium or xanax(with he would have to get off the street as well. He can not afford the $2000 but yet pays $70 weekly for done for like three years now????If he would quit his job and have a few children his done would be free.I dont get it . Help should be made more available to people for this thing . Its nasty.well 14 days now....no slip ups.I hope you can find something that works for you.The part about not having to seek is a plus at least you dont go thru that nonsense. It was a MAJOR reason I was so determined to quit.By the way im not chuck:}

 

Chuckie doesn't yell at people... (nm) » arrie

Posted by Chuckie on June 22, 2004, at 9:58:05

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by arrie on June 21, 2004, at 17:32:33

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by arrie on June 22, 2004, at 9:59:09

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by sofarsogood on June 22, 2004, at 0:21:22

Reading your post was very beneficial. See, it does have merit to pour yourself out like water on these sites. it is a nasty problem, and I can only surmise that it may well become epidemic with the way it all works now. The remedy is not within reach, face it, unless you are determined and go thru alot of ropes. Recently, on our local la-la news the health editor told me "EEEwwww docs just treat you like garlic if you have an addiction" I had called her about my bup experience(inaccessable) after they did a segment on a 35 year old mom that OD'd on pain meds. I was disgusted, like stick to the pig hearts in babies stories lady. I guess I have alot of contempt because I begged them to treat me with the bup in the "other" office the doc had, which he could have done but was just too much of a ninney or didnt understand the waiver himself. He admitted clearly I knew more than him about it all. thats ok, I will go see the Eygptian, this is typical of my life, I am like Samantha on sex in the city, but have Vic for sex, not men. Maybe I can turn that around, ha ha. At any rate, keep it up, I found it really profound that you stated you got to the point where you were feeling it was all in your head. Thats great because it shows there is an end to the physical aspect.I am down now to about 70 mg of Vic from 150, I visualize myself as a 747 going thru a turbulent lengthy landing, I am cruising at mid altitude now looking down, cant see the runway yet, that is a few weeks off. Anyway, glad you posted and reinforced this bup thing, I was having doubts, but now I'm sure. that Chuckie disappeared, which annoyed me because i wanted to get finale on him, but you provided. Godd luck, and good luck.

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by Chuckie on June 22, 2004, at 10:14:10

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by arrie on June 22, 2004, at 9:59:09

> that Chuckie disappeared, which annoyed me
> because i wanted to get finale on him, but you
> provided. Godd luck, and good luck.

I don't like to annoy people. I'm sorry if i missed something. I thought i had wrapped everything up.

You wanted a verdict on buprenorphine? Cuz i don't really have a verdict quite yet, i'm still working on me. And i'm not sure how much of me has to do with anyone else at this point.

Anyway sorry if i got confused and failed to do something i should have done. I do that in real life too, even when i'm relatively well. I was mis-wired at birth.

-Chuckie

 

Chuckie- you misunderstood

Posted by arrie on June 22, 2004, at 11:26:22

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by Chuckie on June 22, 2004, at 10:14:10

I had only been very interested in learning how things went for you on the buprenephrine regime. I am sure you can understand...remember at one point you had some urgency " I INSIST YOU TELL ME MORE", well, others are hanging in the balance as well.
Anyway to the point, how are you and how is it going? Are you still on bup? Is the dr still being cool with you and are you going to continue the medication? Fill in the gaps when you are up to it. You sounded pretty optimist in the begining and hopefully you are staying the course. Take care

 

Re: Chuckie- you misunderstood

Posted by Chuckie on June 22, 2004, at 12:56:01

In reply to Chuckie- you misunderstood, posted by arrie on June 22, 2004, at 11:26:22

OK, i'm sorry again, still, if i missed any direct questions. Please forgive me, my medication issues are not my only issues, or even my most troublesome issues. I really didnt mean to leave anyone hanging.

I think that Bupe will be a good thing for me to use to get off opiates and leave them alone. I've almost given up the idea of using opiates for depression. I mean they work, very well, but they are problematic for me. On my first impression of buprenorphine, the stuff seemed so strong that i thought i'd only be taking maybe 4mg/day. My prescription is for 16mg/day and i've slowly worked my way up to that even though that wasn't my intent. Now i'm having to work my way back down again. So anyone hints that it isn't habit forming, they're wrong. But OTOH when i do cut down my dosage, it's not a crisis type thing and i don't miss it a lot.

I haven't seen my doctor again. I just call the pharmacy for my monthly refill and they call him.

Suboxone seems to cost approximately $4.00 per 8mg tablet, no matter where you try to get it. That's a big motivator for cutting it down to the minimum necessary dosage. Right now it costs $250/mo. for me, and i can't keep doing that for very long. So i'm shooting for a maintenance dosage of 1/2 tab per day, and eventually to quit.

Aside from all that, i'm doing pretty OK. I'm still not working because i been messed up in the head, but i don't think that has anything to do with buprenorphine.

Overall, i think it's a very good medicine. I certainly recommend it in place of pain medication s and/or illegal substances. But it's certainly not an innocuous medicine to play around with. It's very strong and it's made of the same stuff that gets some of us in trouble.

-Chuckie

 

Re: Buprenorphine - Thanks! And...

Posted by sofarsogood on June 22, 2004, at 19:38:04

In reply to Re: Buprenorphine - Thanks! And..., posted by rianna on May 5, 2004, at 18:29:27

Cost even with decent insurance . BCBS can reach 40.00 per script (as this is a non covered med). I reccomend if you have insurance to request that the doctor give you @ least your first months supply of the suboxone @ once to avoid paying $40 for the first week $40 for the second week or so then so on .As for the subutex your kind of stuck paying as you are prescribed(THE FIRST WEEK OR SO OF TREATMENT ,FOR ME ANY WAY).I had to pay several 40.00 co-pays just for the bupe it self. MabeY they do this to prevent you from taking too much. It does no good to take more than you are suppose too so dont WAST YOUR EFFORTS.GOOD LUCK TOO ALL WHO ARE THINKING OF TRYING . IF YOU REALLY DONT WANT TO STOP, BUPE AINT GONNA WORK.IT HELPS YOU GO THRU W/D AND GET OUT OF THE RUTT ,NOT THE NEED TO HAVE OPIATES .DONE MAY BE THE ANSWERE IF YOU STILL WANT TO GET A BUZZ EVERYDAY OTHER THAN THE HAPPINESS YOU CAN FIND FOR YOURSELF.

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by sofarsogood on June 22, 2004, at 19:45:52

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by Chuckie on June 22, 2004, at 10:14:10

CURIOUS .HOW LONG HAVE YOU BEEN ON THE PROGRAM ? ARE YOU ATTEMPTING TO TAPER OFF OR ARE YOU LOOKING FOR MATINIENCE? EITHER WAY HOW IS IT GOING ?ANY SLIP UPS?

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP

Posted by arrie on June 22, 2004, at 20:18:07

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by sofarsogood on June 22, 2004, at 19:45:52

Thanks to both Chuckie and Sofar, ya know I dont need the buzz, really dont get it anyway anymore, but I like the numbed up feeling because dah, I have a chronic pain issue, so I hope as a narcotic it still delivers. Gads, it must be strong because i dont think I am doing that much in comparison to what you guys have recorded. I am at about 100-150 mgs vics to really get pain control and well a bit of a buzz. This past week down to 80mgs on some hydro duds. I hurt and feel sort of ick, but I am OK. So what will my habit translate into, do you think about 4mg of bup a day, fyi no insurance at all but for everything else theres Mastercard. I am still very encouraged by what you both have reported. Chuckie, dont think so much its bad for you, just go something to get out if possible!

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP » sofarsogood

Posted by Chuckie on June 22, 2004, at 20:30:40

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by sofarsogood on June 22, 2004, at 19:45:52

Please don't talk to me in capital letters. Thanks.

I'm not trying to kick at this time. I have posts about it all over this board but the upshot was that i wanted opiates to treat my depression. Originally, i actually wanted buprenorphine because of all the stuff i'd read about it. But it seemed impossible... couldn't find a doctor, and surely couldn't talk one into prescribing for that purpose. So i got an illegal poppy habit. When it got out of control, i tried detoxing in the hospital and couldn't take it and went back to the drugs. After which i found a doc to prescribe bupe for my chemical dependence. Heh, so i couldn't get it for my depression so i got it for my bad habit instead. %)

I've been on it about two months now and i still feel like i'm adjusting to it. Or adjusting it to me, or something. I'm taking more than i intended to, although not more than i'm prescribed. I'm going to cut it back down again. Like i said, i have no specific plans to quit at this time, i'd just like a lower maintenance dosage and decide from there what i'm gonna do next.

I don't know for sure because i haven't tried, but i understand it's impossible to "slip up" when on Bupe because your regular drugs won't work for like three or four days after you quit the bupe. So it doesn't make any sense to do that, unless i'm wrong.

 

Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP » arrie

Posted by Chuckie on June 22, 2004, at 20:43:31

In reply to Re: MEDICATION ASSISTED W/D W/BUPE 2 THUMBS UP, posted by arrie on June 22, 2004, at 20:18:07

Arrie,

I'm confused about your dosages. Or mine, or something. Aren't the big fat Vicodins 750mgs? And i thought the regular ones were 500mgs?

I told the doc my poppy habit was approximately equal to four big fat vics per day. That was after detox, when i was trying to keep it contained. Before detox i don't have any idea... six... ten? I could easily take that many vics without a problem.

Anyway, what i told him is what he translated into the 16mgs/day of bupe. Which i now come to find out is a pretty hefty dosage, although i think the max is 32mgs. In any case, i'm sure i'll be fine when i taper back to 8mgs, and i think you would be too.

Someone else around here was taking two or three mgs and being OK with that. So i'm gonna keep tapering until i get too uncomfy.

-Chuckie


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