I was on Bupe for 2 years starting on 10mg which to be honest was too much for me but I didn’t care although I slept a lot to begin with. After dropping my dose to 6mg I hit my sweet spot was anxiety and depression free (which is the main reason I abused opiates in the first place) I could think clearly and was making positive steps in my life I dropped down to 4mg after about a year and still felt good but when I was forced to drop below this level all the positive effects started to fall away and on 2mg It was doing nothing for me all my depression came back, I started to snort it use cocaine drink alcohol again all things that I had been able to avoid on a stable amount.

The drop from 2mg to 400mcg was pretty hard but manageable, then at 400mcg I was told I would be jumping off, my key worker assured me it was such a low dose that I wouldn’t feel much maybe a bit of withdrawal. I didn’t tell her that I had been snorting my dose for over 6 months and prepared to stop. OMG

Day 1 and 2 i felt fine, then on day 3 I started to have some palpitations and felt anxious I told myself its only the withdrawal it wont last long, on day 4 I was a wreck I was having palpitations almost all day and I don’t mean just a few fast heart beats my heart was thrashing all over the place. It would go beat, beat, beat, Bang, Beat, beat, Bang my heart was jumping so hard in my chest I was freaking out and went to the ER they did a ECG and said I was fine.

For the next two days which where a Saturday and Sunday so I couldn’t get hold of my GP or Drg worker I don’t know how I didn’t lose my mind, I was sweating biting down so hard that I broke my tooth Im surprised I didn’t break my Jaw, my heart was jumping all over the place, I was shaking and convinced I was going to die with anxiety which I would say was like a 2 day panic attack. I was staying with my parents when I did this and they where furious my mother said I looked like one of those WW1 shell shock victims.

On the Monday my parents dragged me to a GP and he said this is classic opiate withdrawal he wanted to put me back on Bupe but I was terrified of that stuff so he filmed me on my phone so I could show my drug DR and Key worker how bad I was prescribed me 80mg of Propranolol because he said my heart was like I was running a marathon and a load of Diazepam to be taken until my muscles started to relax in 5mg doses I took 30mg the first day.

When I saw the drug DR he kept me on the Diazepam 30mg for over a month eventually dropping down.

It took me almost a month to feel normal again, I can say without a doubt my jumping off Buprenorphine was the single hardest most terrifying experience of my life and I have no idea how i got through it.

You need to drop off slower next time. And admit to the professionals what you actually have been taking.

Why do you want to quit?

I understand that with benzoes you would have to increase the dosage to keep the calming effect and at some point you would need a lethal dosage to stay calm.

I know an AD that reduces anxiety, keeps depression in bay, but at the same time it reduces the drive and increases the appetite, so that the life on it becomes unmanageable.

How is it with opiates? Why would you want to quit? Money? Do you need increasing dosage to get high? Increasing dosage to stay calm?

The experience you describe with this Bupe..... Why did you try at all to drop below 4 mg? I mean....... if it doesn't have unwanted side effects and you don't need to take more and more for the same effect, why quit?

It's not so much that opiates in itself are bad but that for addicts it's disastrous and crippling. It's major issues have to do with it's legality as well as how easy it is develop a tolerance. It just stacks and stacks, a regular user can eventually need a dose that could easily kill someone else just to not feel like a wreck let alone get high, and the acetaminophen content in a lot of pills are extremely dangerous. Financially a user is essentially forced to seek out heroin because of how much cheaper it is. it can become standard to develop a $400/day pill habit, so to heroin you must go. Heroin on the black market is a risk because of uncertainty of dosages/what's in it, etc.

It's about not wanting to be a slave to medication anymore. I can't even remember a time when I could wake up and just be okay and start my day. It's about not panicking when running low on subs and can't get an appointment for whatever reason. It's about having the freedom to live a normal life again.

I'm gonna start a new taper soon, but first I'm gonna stock pile benzos for the anxiety. I can deal with everything else, but the anxiety is crippling.

ive always wondered whats with the popularity of opiates. ive done oxy a few times n while it felt good it always just puts me to sleep. its something i could never get into always been more of a fan of psychadelics and uppers. ive just never found it fun to do a drug and want to go to bed 10 minutes after.

One of the reasons I've stopped drinking. What's the use of boozing and then going to sleep?

well, some ppl cant sleep without booze, or an opiate, or a benzo. ever not been able to sleep for extended days?

Sleeplessness is often a symptom of something else. And the "cure" shouldn't make things worse.

This story presents a good opportunity to address some of the nuances of buprenorphine. (I’m a physician with experience treating opioid dependency.)

-The starting dose should be the lowest dose that adequately relieves withdrawal symptoms. 10mg is quite high, and inappropriately high for someone withdrawing from a weak narcotic like codeine. 4-8mg would have been a better starting point for you. That’s why you were able to decrease to 6 easily.

-The “sweet spot” you experienced is common and usually occurs around 4-8mg/day after about a year or so almost regardless of what opioid you were on. The reasons this occurs are complex and have to do with the reprogramming of the opioid reward system of the brain. But most patients will feel pretty good at some stable dose about a year or 18 months into therapy. It is very difficult to reduce the dose from this point onward.

-There is nothing wrong with staying on the “sweet spot” dose for a very long time. There is a lot of talk about “being a slave to the treatment” but really it’s all just a matter of perspective. You need water and underwear every day too, so what if you need a suboxone? With a little planning, care, and forethought you can function and travel and live a normal life.

-The 50% dose reductions you were attempting after 4mg were ill advised. The best way to taper off buprenorphine is to reduce your dose by 10% and then stay on the new dose until you feel normal and good for at least a few months. Even when you eventually get to 2mg, the next dose down should be 1.8mg or so. You can dose this by cutting the strips with a razor.

-Consider a life on a stable dose of buprenorphine and taper when you want to. Taking a safe legal medicine for years and years will likely result in better life outcomes than all the other alternative approaches.

-Benzos like diazepam and alprazolam are very helpful for the first few days of withdrawal or the first few days of a dose taper. Do not take them more than a few days in a row. Benzo addiction and withdrawal make opioid withdrawal look like a walk in the park. The fatality rate from withdrawal is also much higher with benzos.

I’m sorry you went through this. Your physician just wasn’t experienced or well trained enough. This is a relatively new area of medicine so it’s hard to find good help.

Stuff like this makes me scared. I'm not an addict or w/e but I've had physicians missdiagnose me and create a lot more problems than I was having a few times (nothing serious, just couple weeks of pain & stuff).

The type of misstreatment OP described could kill people, directly or indirectly. And if you read through other addiction threads/sources online this type of stuff seems to happen a lot. I also suspect mistakes made when treating addicts are rarely identified since it's easy to blame something else.

I understand being a healthcare professional is hard AF, but shouldn't it be possible to create procedures & processes that would minimize these type of mistakes?

Sorry for derailing. I read both of OPs threads and felt sad that your 2014 thread was not the end of the story. I have no advice, just remember every problem can eventually be resolved if you want to resolve it & keep fighting to do so.

I still wonder with the question "why quit".

I understand that if the sweet spot cost something like 400$ a day, it is not an option. I understand that you certainly don't want to take anything from the street. I don't understand this "slave" argument. If something helps me to function and feel good at the same time, it costs something reasonable and doesn't make me fat or destroy my liver, I so would take it.

I have my fair share of experience with prescribed drugs. It was never so pleasant that I wanted to stay on them. Mostly it allowed me just to get by at points, where I was near to give-up.

One guy here asked about insomnia. I had it pretty bad. And after a second night without sleep I would have taken anything that promised a relief.

What was the reason for your insomnia? I've always been curious about this since I suffer from a mild form as well from time to time. I usually fix it once I become really tired (2nd night like you say...) and putting up noice that cancels out any other brain activity that could keep me awake (I usually put up 10 episodes of a random sitcom like Friends/P&R/... on repeat through the whole night ). What prevents you from falling asleep once you become really tired and are cancelling out brain activity?

Irieguy that is all great stuff thank you for contributing.

I am a recovered benzo addict. Five years clean in a couple of weeks. I can personally attest to how much the taper and withdrawal sucked. My taper took about a year (much of that done by me in secret). It then took literally 18 months after that for my sleep to get to "normal", whatever that is. Lots of ups and downs over that period, obviously. When I first started AA it was really annoying to see recovered heroin addicts wince when they heard my benzo story - it's well known in the rooms how terrible it is and how hard it is to recover. I am very grateful.

When my diazepam taper entered territory where I needed to cut in very small increments I would make an oral suspension with ground-up pills and Ora-Plus (once I was out of the closet I had a compound pharmacy do it). Would that be doable with suboxone? With pills some people split them into tiny pieces but the imprecision of that drove me crazy.

Again I can only speak to benzos, but my experience has been that doctors don't seem to understand how powerful these drugs are and how dangerous long-term use by anyone can be, especially by someone with a history of alcoholism and/or addiction. Then, it was very hard finding a doctor or psychopharmacologist with specific experience with benzos. Once I finally saw a doctor about all this I presented all the research I had done and laid out the tapering plan I had designed based off what I'd learned and she just said "OK". The only difference is that the drug came from a pharmacy in Burbank rather than via FedEx from Germany. And, of course, it was no longer a secret, which was huge for me.

This is a great post, bbfg. It IS scary, and yes there should be standardized procedures and processes that minimize mistakes. We are getting there. Evidence-based practices take time to evolve and unfortunately addiction medicine is complicated further by biases, prejudices, and legal considerations.

But the answers and tools exist, and there ARE competent professionals in every major city equipped to manage opioid addiction. At this point it just requires a lot more homework for the patient to find a good doctor. If you have a stroke and go to any ER in the country you will get at least a minimum standard of care delivered. If you OD you will get narcan and survive as long as you showed up breathing... but your follow up care will almost certainly be inadequate unless you get lucky.

This is changing. Money is pouring into the opioid abuse epidemic and standards are evolving and improving on a daily basis. Nevada just passed the Prescription Drug Awareness and Prevention Act which goes into effect on 1/1 and will immediately result in improvements in care and massive increases in funding for training and education of health care professionals.

While the providers catch up to the evidence some bad things will continue to happen. But if you need help now you can find it in your city. This wasn’t true even 5 years ago.

Irieguy,

Just curious about the protocol of prescribing benzos (along with Bupe). I thankfully got clean while incarcerated, so never personally took Bupe, but I have several friends who did, and the doctors would not prescribe them benzos in any form. This was about 7 or 8 years ago. Have things changed, or is this just an example of lack of experience/training?

Benzos are by no means part of the standard of care for managing opioid cessation, but they can be very helpful. The main problem is that you are giving one of the most dangerous and addictive classes of medication to an addict. So, most addiction specialists simply wont prescribe benzos. I think that is reasonable, as with proper suboxone therapy the withdrawal symptoms will be pretty brief.

Personally, I utilize benzos for the first few days of opioid cessation because the anxiety and sleeeplessness can really be terrible and thus a huge deterrent to a successful transition to suboxone. But this is not a common practice and it probably never will be.

I went to my GP today and had a talk about a few things and I have to get my bloods done and also go for a chest X-ray, I have lost about 20lb in the last 2 months and although H takes your hunger pains away this weight loss seems too much and I asked her what the chest X-ray was for she told me just a precaution for Tuberculosis although I have no cough and my breathing is fine.
Also I have been stopped and searched by the police twice this week lucky for me I wasn't carrying just in the wrong place at the wrong time. I have to say this is one of the most humiliating things for me and I don't know why you just feel completely hopeless and wonder why the police bother with the bottom end users.

Been offered a Detox and Rehab but there is a 3 month waiting list which isn't great, My key worker is really not very good to be honest as she offered me a detox a while back and I refused because I was lead to believe it was 2 weeks in a recovery centre and that's it which is pretty useless as doing a rattle and letting you go is just setting you up to fail without proper support.

Now she tells me its 2 weeks Detox and 3 months recovery all in a centre, I would snap that up in a second.

I have been cutting back on the Crack and have seen some scary **** to put me off the Heroin. A guy I know has no veins and go's in his groin (most junkies get this point). one side is ****ed from a infection and he had to have surgery to fix his vein which is useless. I know a older guy who has been using for over 20 years he has had this happen on both sides and now can only smoke , I cant imagine having a 20 year habit!

Watched a documentary on BBC iPlayer called Drugsland/Crack alley and have to say it is the most accurate portrayal of what life is like for a addict in the UK right now.

Have a nice Christmas everyone!

Kenny,

It sounds like you are moving in the right direction which is great to hear. Obviously a 3 months wait isn't ideal but it is what it is. Just keep trying to taper down and hopefully by the time you get into rehab it won't be as bad as if you went straight in now. The main thing is trying to stay focussed on the reasons why you want to give up.

Merry Christmas to you also

It's obv a very complicated problem and there is no easy answer, but I agree a lot could be done better. You're in the UK right? Does UK go after bottom end users hard? I was under the impression that possession/using was not prosecuted harshly in most of Western Europe as long as you're not causing trouble/driving under influence/etc, but I could be wrong.

3 months seems like a long wait but in reality it's not long at all. Get on the list ASAP, it could also motivate you/calm you down/give you some peace of mind if you know significant help is just 3 months away.

KP, as a recovered addict my concern is that if I knew that in 3 months I was really going to go through the wringer to get clean once and for all, that is going to be a very dangerous 3 month period. The way my mind works, I'd think that if this was to be my last three months using, I might as well really do it up. I'd think that this three months wouldn't really matter because I'm going to get clean soon anyway. And the danger of that, obviously, is that my sickness worsens and I don't end up entering the rehab at all. Most likely, I die before I make it there. The idea of knowing I'm about to really get clean or sober but it hasn't happened yet frightens me. As I am told Chuck C once said, "If I had known that was going to be my last drink, I would have had two!"

But, rehab in three months is better than no prospect of rehab, so it's more a matter of how you approach the intervening time. If possible, try to work on building some element of a foundation of a commitment to yourself and your life. If you can accomplish this, you'll enter rehab on the right foot. If something that high-minded isn't realistic at this point, just try to set up whatever routines you can to keep yourself on the correct side of the dirt until rehab time arrives. If you can make some meetings, I highly recommend it. Even if you're not staying clean/sober, the environment would do you a ton of good.

Wait lists for rehab in the US are also obscene. Lots of private insurers are loathe to pay as well, so you are usually either court ordered or self pay to get 28 days or more.

wait if you drink you go to sleep? odd...

unless you are talking about some insane level of alcohol or maybe some ppl have low tolerance

A case of beer plus a pint or so usually leads to some less than refreshing sleep.