Silk Road forums

Discussion => Drug safety => Topic started by: mybodymychoice on August 16, 2012, 06:33 am

Title: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: mybodymychoice on August 16, 2012, 06:33 am
Hello all . Well first off I want to say THANK YOU from the bottom of my heart to all the people who may reply and possibly help aka "treat" me or think about me later on. This is my second time trying to quit Heroin by using Suboxone and now that I know what to expect I'm scared SHITLESS! Yes I am publicly admitting I'm a pansy. I dont care to be honest. Opiate withdrawal is something that I have ZERO tolerance for. It hurts me physically and more important mentally. My, sweet baby jesus does opiate withdrawal fuck with your mind, body and spirit. This is going to be the hardest tasks to accomplish that ive ever done. Including the 2 days of heavily pitocin induced labour that my spouse and I went thru with our first born!! SERIOUSLY people... Makes childbirth seem like a breeze. Seriously... This shit is heavy as they say.

Ok so im currently on around 200-300mg a day of very high quality, VERY PURE #4 Heroin. I was on 12mg of suboxone prescribed by my doctor previously but then I got a bunch of money that I was able to blow and like the dumb addict I am , I bought a bunch of heroin. Now ive decided that tomorrow i am going to induct myself back on suboxone and kick my habbit. hopefully for good this time. to my first question is :

- Do i have to go thru the suboxone induction process again? im assuming yes. i have been off subs for almost3 weeks now and been ONLY taking heroin.

Last time i was inducted i took my last sniff of heroin at 12:30am the night before. I took my first 2mg dose of suboxone at around 4:30-4:45pm the next day. This time around i took my last dose at 1am and I'm praying to the sweet baby Jesus, Buddha, Allah and the SR gods that I can make it to around 5pm which i plan to take 1mg follow by another 1mg either 30 or 60 minutes later. So my next question is:

- With the intention of avoiding precipitated withdrawals i thought that taking 1 mg instead of 2mg would more likely help me avoid any kind of prec withdrawls. im being cautious ... just cuz i didnt get precip last time doesnt mean i wouldnt this time. i feel like i might have taken more heroin this binge around, and especially on my las dose i think i took more then the first time.  So am I correct in thinking that taking 1mg will decrease my chance of precip? and if i did get precip w/ds would they be less intense with 1mg as opposed to 2mg?  Which leads me to my next question:

- If i did get a precip how long would it likely last at a 1mg or 2mg dose? will taking more suboxone help? what about if i took some heroin? some people say nothing helps including taking more H but ive also read that taking a double or triple sized bump or  two does actually help the precip w/ds.  can anyone comment on this? and if it does help does that mean it will undo the suboxone and i have to start over again or will the sub be bound to my receptors and i can continue induction and up my dose?  Which leads to my next question. Is there a maximum limit of sub i should take on my first induction dose? ive read not to take more then 8mg at first cuz it could cause withdrawal in the event that some small bits of heroin is still in my brain bound to my receptors? or can i just work my way up to my desired dose of 16mg once ive passed the 2mg induction "test" dose and i dont go into precip w/ds? i was thinking that after my first 2mg dose i should go up 2mg every hour up until my 16mg goal.. is this a good idea? or can i just take it all at once (take a 8mg tab and 3x2mg tabs to total 14mg)?

Ok so the firs time i was on subs the doctor underdosed me. i was feeling "some" relief but not what i should have been feeling. it took 4 days before he got me up to 12mg which SUCKED. but i did ask the pharmascist and another sub doctor if i would be able to take a small dose of H to cut the edge off. To my delightful surprise they said YES!! If absolutely necessary i could! So when i was on 8mg i took about 15mg in the morning and 15mg of H before bed and I felt a 1000x better! 2 small doses of H combined with the subs made me feel gold all day and night people!!! This may not sound like an accomplishment but at the time it was! Finally i got bumped up to 12mg but not before i had to go thru 3 days of small H doses. This time around im going to be at 12-16mg almost from the getgo. But if there is a max of 8mg that i can take in the first 24 hours of induction, then how long do i have to wait before I can take 10-15mg of H? The first time around i did it on my second day. This time around I want to do it ASAP . I have to function during the day with my kids and just as importantly i am at work for the first 2 days of induction. luckily i work pretty independently and dont have someone breathing down my neck!

My last 2 questions are regarding 2 other prescription medications which may help. My doc gave me  20x 0.1mg Clonidine pills to help with the W/d's i was having even at 8mg of subs. He said they would help with the excessive sweating i was having from being in 24x7 withdrawal due to being underdosed. My question is what dose should i be taking this clonadine at? And is there an alternative use for this medication at a higher dose? i read in only one spot (someones personal blog so not sure the validity of it) that clonidine can be used to ease anxiety at a slightly higher dose. does anyone know if this is true? im having trouble believing a medication which lowers blood pressure to ease sweating can somehow reduce anxiety. atleast that's how i think clonadine works - by lowering blood pressure or some sort of pressure. lol. i could very easily be wrong. i havent really researched this drug a whole lot yet. i will try to do that tomorrow to help pass time while im w/ding to be able to induct myself.

And my final question... regarding another medication... BENZO's! Everyone loves their benzos. And i have a legit prescription of 0.5mg lorazapam , My doc told me no benzos, even Atavan if it was prescribed. Well he doesnt understand the anxiety i normally get on a day to day basis. let alone the hell i will have tomorrow. but ive read that people have taken benzos and suboxone at the same time perfectly safely as long as they took it as prescribed. So for me thats 1 to 2x 0.5mg pills. i should be fine right? lol. i am pretty drug tolerant normally. i can take a pretty high dose of H and not die or even come close and ive taken up to 4 of these ativans at a time with alcohol &  H before so im hoping i'll be fine with 1 or 2 ativans when needed... thoughts?

Well i think that just about does it. I would REALLY REALLY appreciate EVERYONE who can contribute their experiences to share and offer me advice/support.

Thanks again everyone. Thank you for your time consumed reading my questions and  even more thanks and good vibes for answering my questions. I really need some suuport here and my doctor has failed me in that regard - not taking my anxiety seriously & making me ball n chained to his vile clinic even though im there willingly, unlike some of his felon patients. God i hate pissing in a cup . I'll tell u willingly what its going to say ! Ugh.

Anywho. Going to bed now. Hope i can sleep. Im dosed up good on H right now but im anxious about the morning and entire day without H and Im nervous about the possibility of precipitated withdrawals! ahh!!!

Take care friends. Eagarly awaiting your support and replies! :)

MBMC
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: Black Sheep on August 16, 2012, 07:45 am
How long do you plan on taking the subs? Do you plan for a quick taper or to use them as a maintenance drug? What's your reason for quitting? Is it the life style or that you just want to be sober?

If you plan on quitting all opiates for good, I'd honestly say just cold turkey it. I've used opiates for almost 2 years and I've only withdrawn once... I've been using poppy pods the whole time and H for like 5-6 months. When I withdrew I thought I'd be able to get mass amounts of codeine where I was going but could only obtain very small amounts. I also had a few hydrocodone pills... Only 5 mg ones. I was 10,000 miles from home... I basically cold turkeyed it... The worst was over in 3-4 days. Now I will definitely agree it sucks but the mental aspects of it were much worse than the physical parts. Point is it's going to suck no matter what. Why draw it out? It'll be very acute but at least it'll be done with. Exercising and staying active helped a lot. I guess it released my natural endorphins? Keep your head up and it'll be over sooner than you think... I believe you're building it up I your head and giving it more power than it deserves. Keep your head up and be STRONG!!

If you plan on using subs as a maintenance drug, maybe consider a long acting full agonist. Methadone is the obvious choice but poppy pods could work. At least it will give you a glow and take care of cravings... You'll most likely save money and get away from the up and downs if you've been having a problem with that. Fight the battle you can win. It'd better to obtain a smaller victory than not one at all. You know yourself better than I do though... It really just depends on what you want and for what reasons... Honestly fuck what people and society thinks, do what's best for you. Even if that's just drastically reducing your heroin intake but still using it...

My thoughts are kind of scrambled right now... I'll try for s better response in the morning...

You CAN do it.
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: wasta on August 16, 2012, 12:27 pm
Looks simple to me...

You have to come down to 0.05 gr of number 4 or less then 0.2 gr of a nr 3 grade.
You will have to do so in a matter of a few days.
If you do such and take your time, you will not have the strength anymore when it really comes down to it.

After you have come down on your dose, you switch to methadone for a few days.
20 mg first day, 10 the second, 5 the third and 2,5 (half a pill) the fourth day.
Take twice a day half that dose.
The fifth day a quarter.
Try to save the last 1/4 pill of 5 mg, in-case you will be breakdancing in bed, through the night.

Now you are at the point that your body has done without heroin for 5 days and is not fully used and addicted to the methadone.

Stop the methadone and switch to temazepam take 40 or 60 mg temazepam for the night.
Go to the suboxone and a sleeping pill (or two) for the night
Some other sleeping pills will do so too.
Or combine the temazepam (That's for falling  asleep) with a other sleeping pill that is working longer to help you to get some sleep.
The first 5 nights without a opiate are the worse.

Take the temazepam in, when you are about to get some sleep, on the edge of your bed.
Better if you are already in bed.
The time window is short.
When it is starting to kick in, you have to take advantage immediately.

When you follow this guideline, you will be able to sleep.
You will be able too, to do some little things like going to the supermarket and riding your bicycle.

I went on my mountain-bike and cycled of the road in woods and other nature.
Long bicycle trips will help to keep your legs still at night.
You have to feel a little muscle-pain.
You wont know, if you are feeling your legs because of the withdrawal symptoms, or that is is just the muscle pain from the bicycling.
During cycling, go off the road.
Take a gear that's make's you sweat.
That will speed up detoxification.
The nights will be long.
Be glad with 2 hours of sleep.
Some nights you wont sleep at all.
Take a shower twice a day.

Try to do something.
Do not lay in bed all day.
Do not smoke marihuana. (You do not have enough strength already)
Do not use sugar. ( that will only support the feeling of withdrawal)
Eat pasta's, they will provide sugar too, but releases it slowly.
Pasta itself does not contain sugar, but your body will convert the pasta.

Just try it yourself (once).
When you are able to sit down and watch television and sit still, take some sugar.
You will be bouncing again in no time.

This way as described above has been for me the right way (several times).
I tried to stop to quickly and I have taking my time.
The best way for me is something in between as I wrote above.

It is not going to be easy.
But what a difference it is, when you are able to lay still and get some sleep and still be able to function through out the day.

Stick to the schedule.
If you tweak the schedule, tweak for the better.
I wouldn't touch it, but it's your ""party"".

Let the methadone take the worse hit from the heroin withdrawal.
Quit methadone before you are used to and only take it for the withdrawal symptoms of heroin , so for 5 days and nights max!.
Your body is now at this point, through the heroin addiction withdrawal, and not yet addicted to the methadone.
Soften the opiate / methadone withdrawal with sleeping pills.
The day you stop the methadone you switch to suboxone.
When you are switching to naltrexone, be sure not receive sleepingpills. other then benzo´s.
Now your receptors in your brain can't be touched by heroin anymore, because of the ""naltrexone"".

When you do as I described, you will feel like shit too.
But it does not come close by what you have to go through as if you are doing this ""cold-turkey"".

Compare it with a strong flue.
 You want to stay in bed, but you will be able to function and prepare yourself a meal and so on.

After these dark days, that lay in-front of you, the sun will show up and make you shine.

I wish you a lot of strength these days.

Within 3 weeks you will be as good as new and good to go.

Good luck, Wasta
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: mybodymychoice on August 16, 2012, 04:15 pm
thanks guys for the replies. ive read them... and maybe its the early onset of withdrawals that im starting to feel (it's 11:55am and i last dosed at 1am. i am about 11 hours since my last dose and starting to feel the fluttering, anxious feeling in my stomach. ugh!!) but u guys didnt quite answer my questions. your suggestions  are  greatly appreciate though, dont get me wrong. i dont want to sound unappreciative because i do really appreciate you replying. i just dont see those suggestions working for me.

i want to get back on suboxone to help detox from H and then get off them within a 3-4 week period by stepping down a few mg at a time. my main concerns were the questions regarding induction... for instance im very curious if there is a max dose i can take on my first induction dose? i read somewhere 8mg but not sure how true. does anyone know?

i also am not interested in going on methadone. ive heard too many side effects, and getting take home doses is impossible. also, my plan is to go back to the suboxone clinic that i was previously at once i've re-inducted myself and can piss clean. i was doing good with the subs i just was an idiot and fucked up and decided to go on an H bindge. id like to try to get back on track to where i was before.

i also wanted to comment on wasta's post. have u actually tried what u suggested to me or this just a theoretical approach that sounds good to you? cuz i see one HUGE problem that im sure everyone will agree with.. you mentioned: "Stop the methadone and switch to temazepam take 40 or 60 mg temazepam for the night. Go to the suboxone and a sleeping pill (or two) for the night" but if someone did that they would go thru agonizing hell as methadone has a 3 day half life. you cannot take suboxone within atleast 3 days of your last dose of methadone. thats why alot of doctors will switch a methadone patient to a short acting opiate like hydromorph or morphine for a few days while the methadone gets out of your system completely, then they let you wait up to 24 hours to go thru te standard suboxone induction . alot of methadone users have trouble apparently because by the 3 day mark they are crawling in their skin and it has been found more effective to keep the patient on short acting opiates for a few days then switching to subs.

only have about 4.5 hours left before i am going to be starting my induction test dose... anyone got any input on my idea of starting with a 1mg dose to lower the chance of precip withdrawal? if i cannot take more then 8 mg in the first day im going to need a tiny dose of H before bed to help me sleep so im curious how long after taking suboxone is it safe to take a short acting opiate? i realize most of the H will be blocked but im not trying to get high at all. i only want the small dose to cut the edge and help me sleep. once inducted and the suboxone has bound inself to your receptors it is safe to take small amounts of H. i just dont want to take it too soon and interfere with the induction process. i read somewhere that waiting 2,4 or 6 hours after taking suboxone is a good time to wait before taking H. i cant remember which of those 3 it was.. i feel like it might have been 4 hours. but not sure if that applies to the induction period or only after you've been completely inducted.

ahh the clock is ticking... suboxone experts please chime in : )

thx. MBMC       
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: InkIndulgence on August 16, 2012, 06:00 pm
I only read like 30% of everyones posts, but wanted to share what knowledge I have.

Suboxone has a ceiling of 32mgs, that means that 32mg is the highest dose you can take before it does no more.

I go back and forth from full opiates to sub all the time, and you going from 1am to 5pm is not needed to wait, almost all opiates (heroin included) have a half life of about 3-5 hours, which is NOT very long so waiting as long as you did was not necessary. The longest a doc has ever told me to wait before dosing on sub was 12 hours, and even then I only waited about 8 and I was fine.

If you do for whatever reason start to feel like you are going into precip after you dose on sub, do not take more heroin. Keep taking more and more sub and eventually it will stick. At least at first. And if I were you I would take at least 24mg for your induct, as even 16 is not very much considering how I am interpreting your addiction to be.

And that's the other thing, how long have you been back on heroin and off of sub? If only for a few weeks, then I wouldn't even induce. Just take a sub the morning after your last H dose. I'll go on a hardcore opiate ride for days and then the next morning just take my sub like normal, and I'm fine.

Next, clonidine. Clonidine has never really helped me that much, except to make me tired and pass out, but some people say it helps. It works exactly as you said it, it lowers your blood pressure because if you are in full withdrawal your blood pressure will be abnormally high. That is one way docs determine if you are really in withdrawal at the office. A family member of mine takes it for diabetes and he takes about .3 - .5 mgs a day.

Hope I've helped even a little, I'll edit more if I can think of anything else.

Also, let's say worst case scenario does happen and for whatever reason you do go into precip withdrawals, it will not last long. Just think about how long after your last dose of heroin passes before you start feeling like it's gone and you need more, not long right? Maybe a few hours? So don't worry you won't be completely freaking out for very long.

Oh and also benzos. The whole contrandication thing with suboxone and benzos comes from people that SHOOT them together, or very close together. Every single case of people dying from benzos and sub was from injecting both, or from someone that was NOT addicted to opiates, and just took suboxone recreationally for the first time and took xanax or something also. If your body is used to one or the other, you are fine. At least all the cases that I've read about have been because of this. I have taken pleeeenty of benzos to go to sleep while on sub and always am fine.
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: Black Sheep on August 16, 2012, 06:10 pm
Sorry I can't help much with the precipitated withdrawals... No direct experience there. I have taken subs once though. I didn't know about its antagonist effects at the time and was only using pods which last forever... I only did because it was free. No withdrawals, no high, just horrible constipation. Don't know why I didn't get precipitated withdrawals as I'm sure I had morphine on my receptors... They say pods contain some antagonists as well though. Opium can sometimes be tolerated by those who don't do well with morphine. It's really a beautiful thing... An evolutionary balancing act. For example, morphine is a depressant while thebaine has stimulant properties. Morphine lowers blood pressure and papervine raises it... It's actually used for ED! But I digress...
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: wasta on August 17, 2012, 02:54 pm
True, indeed!

You wrote

i also wanted to comment on wasta's post. have u actually tried what u suggested to me or this just a theoretical approach that sounds good to you? cuz i see one HUGE problem that im sure everyone will agree with.. you mentioned: "Stop the methadone and switch to temazepam take 40 or 60 mg temazepam for the night. Go to the suboxone and a sleeping pill (or two) for the night" but if someone did that they would go thru agonizing hell as methadone has a 3 day half life. you cannot take suboxone within atleast 3 days of your last dose of methadone. thats why alot of doctors will switch a methadone patient to a short acting opiate like hydromorph or morphine for a few days while the methadone gets out of your system completely, then they let you wait up to 24 hours to go thru te standard suboxone induction . alot of methadone users have trouble apparently because by the 3 day mark they are crawling in their skin and it has been found more effective to keep the patient on short acting opiates for a few days then switching to subs.


Indeed read your last phrase.
Why let someone crawl in his own skin for three days, as subuxone is precisely ment for those first few days of the withdrawalsymptoms.
Please ask and tell me why.
I completely do not understand what good that would do.
What good would subuxone or subutex do 5 days after you have stopted taking methadone.
 It is a medicine to preveal the withdrawal symptoms.
 It's a opiate too. http://en.wikipedia.org/wiki/Buprenorphine.
 So I ASSUME that it has to taken right away after you stop with your other opiates.
It is ment against ACUTE PAIN from opiate withdrawal symptoms.

I did not use subuxone or subutex myself, but know people who have.
I will ask to be sure.

But sure enough, I had a 3 or 4 night interval between my last 1 mg methadone use and my naltrexone.
That should be said, but subutex or subuxone is not the same as naltrexone.


Subutex and subuxone are the same thing.

Permission to sell subuxone was given only in 2006 (Netherlands)
Subutex and suboxone have come in view only recently.
 At least here they have.
They now have their place as I know that these days they are described over here too.

These days if someone stops with daily methadone use they get subuxone against the acute pain from the withdrawal symptoms.
My experiënce is with ""naltrexone"" , three or four nights after I had my last 1 mg of methadone.
Subutex or -xone is something different.
The pain you are feeling 4 days after your last opiate use is not ACUTE anymore

Read the wiki about subuxone and see that's it's made from thebaine.

When you are ready to start to use naltrexone, you have to change the benzo-medicine use too.

Don't forget to explain the reason WHY someone has to wait for a few days before he can start use the subutex or subuxone.
It's ment for the ACUTE pain releave.
 Read the wiki.

EDIT: Subuxone is for to overcome the last bot of the struggle to quit the H habit.
In the Netherlands we go from 15 mg methadone straight to Subuxone to overcome the acute pain from opiate withdrawal.

The Worcester sauce comes with the fish and chips, not 4 day's after you ate it...

Wasta
Title: Re: Switching back to Suboxone from Heroin - Attempt #2. Desparately need advice
Post by: jh0000n on August 17, 2012, 06:06 pm
Something ive used in the past to get off H and coke was psychadelics. I took a week off work(if you can do it) popped shrooms, e and smoked alot of weed. The 3 day was the worst i took 300mg of codein to take the edge off a little but after that week I was out of withdrawls...still craving but no more symptoms. I use herojn again but never for more than 5 days in a row and even after this I get slight withdrawls. The whole trick to heroin is to not let yourself get to the point where your tolerance gets high/use daily. After the 5 days are up ill stop for a few days and after ill get more but even those few days of break do a world of diffrence my tolerance stays in check and the withdrawls always remain very mild.