Quote:
Originally Posted by KennyJPowers
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.
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.