| next > | post replypost new topic |
|
Posted: September 15, 2005, 12:25 PM
A good friend of mine is missing doses of suboxone because she said it makes her too tired...should I be worried that she is using H on top of it?
| ||
Posts: 1478
Joined: August 27, 2004
Posted: September 15, 2005, 8:32 PM
How many doses is she missing in a row? I've never had suboxone - I'm on subutex, which is the same as suboxone, but minus the naloxone, which is added so that it can't be injected - or it can but you won't feel anything from the heroin. When I was skipping doses and using, I would have to miss at least two doses. The day before, and the day I used. How much subs is she on? The higher the dose the longer it blocks the gear.
hopes this helps diff -------------------- Life is not a dress rehearsal | ||
Posts: 1928
Joined: September 14, 2004
Posted: September 15, 2005, 8:57 PM
if hse is getting too tired she should have her dose adjusted down rather than skip doses. There is no point taking it if she is going to skip doses.
-------------------- A Buddhist Lama once said to me, "Do the opposite of whatever I tell you." So I didn't. Get Help for Codeine Addiction Here 
| ||
|
Posted: September 18, 2005, 6:19 AM
There actually is a point to missing doses of suboxone.
As perscribed, missing doses is part of the treatment. That's actually the whole point of the medicine. The point is to not get sick, not have withdrawl symptoms. If she doesn't feel sick, she does not have to take it. "What happens if I miss a dose"....is way way different with this drug, and it is HIGHLY recommended to skip doses. The stuff will keep you from getting sick for a long long time, and if someone is using it to detox, and then to ween-off of, skipping days at a time is the way to do it. | ||
|
Posts: 1478
Joined: August 27, 2004
Posted: September 18, 2005, 9:04 AM
I'm sorry, but I have to say that I have never heard of that way of using subs. I did read somewhere that in New Zealand they sometimes only dose you every two or three days. But I am assuming that they must be using quite high doses. When I was on 16mgs, I could miss one dose, and I wouldn't cluck too bad. Now I am on 10mgs, I feel the cluck starting to bite much sooner. My advise would be to reduce the dosage, not miss doses. It's important to stabilise, and mucking about with your script, missing doses and stuff can only be a bad thing. Subutex does not make you less physically addicted. If you stop the subutex before you have reduced right down, you will go into withdrawals that are every bit as painful as coming off heroin. It is a substitute, not a cure.
best wishes diff -------------------- Life is not a dress rehearsal | ||
|
Posts: 1928
Joined: September 14, 2004
Posted: September 18, 2005, 9:09 PM
Missing doses is NOT part of Sub use and is NOT recommended. Sub is a maintenance opiate and to work you need a therapuetic level, not peaks and troughs which in the end only serve to make you feel worse.
If you are feeling sick, you are on either too high or too low a dose. Do not miss your dose, get it adjusted. -------------------- A Buddhist Lama once said to me, "Do the opposite of whatever I tell you." So I didn't. Get Help for Codeine Addiction Here
| ||
|
Posted: September 28, 2005, 8:47 AM
Maybe you guys are talking about two different things?
Maintenance & detox? In detox, missing doses most certainly, always IS, part of the treatment. In maintenance, missing doses is always allowed, and even recommended. Do you guys have any idea of the build-up of this in one's system? The "plateau"? When someone reaches the plateau, due to the build-up, skipping a dose helps. Have you ever talked to a sub. doctor? I have. | ||
Posts: 6750
Joined: September 15, 2005
Posted: September 28, 2005, 8:59 AM
I have been on the drug almost 15 months straight.First time It took 9 months to get off as I was also wheaning from benzo's. Finally off all medsfor 3+ days and had surgery and well long story. Had to go back on Suboxene. My doctor says you need to whean.Dropping a MG a week. I started from 8 mg. At 2mg .5 each two weeks. I went from 2.-2.5 down to 1.5 for now. Never heard anything about missing doses. Makes no sense as you might as well go cold turkey. This is what I was told.
Jeff This post has been edited by Suboxman on September 28, 2005, 9:00 AM -------------------- It is Just Not worth it. "Inside every older person is a younger person wondering what the puck happened." One Day At A Time | ||
|
Posts: 1478
Joined: August 27, 2004
Posted: September 28, 2005, 9:01 AM
Yes I have talked to a sub Dr, and a psychiatrist who specialises in addictions, and several very experienced drug worker. And I've been speaking to them for a long time. I AM doing a subs detox, over a period of at least 8 months, and I have to take my subutex in front of a pharmacist every single day except Sunday, to ensure that I am NOT skipping doses. I will always maintain that skipping doses is to be avoided at all costs, because I know what works, and what doesn't work. I have been on subutex for over a year now, and I've really experimented with it. You know what I used to do when I skipped doses? I used heroin instead. Do you really believe that is the best way to go about things? I am an addict, as as such, I am vulnerable. It's reckless to give advise that could easily lead to someone's death. Do you know how easy it is to accidently kill yourself when you use after a period of abstinence, especially if you are doing a detox? Please think about it.
best wishes diff -------------------- Life is not a dress rehearsal | ||
|
Posted: September 28, 2005, 1:47 PM
So, diff, are you skipping a dose on Sundays?
That was my original point. Many people are told to skip a dose. Maybe the person who the original poster was concerned about was taking the meds as prescribed, and skipping a dose every now & then? We are not talking about the same thing here. I thought the op stated that the friend was skipping a dose when the cumulative effects or a build-up of the medicine made them tired. I didn't read between the lines, or assume that the op's friend was skipping doses so that they could try and use some other substance. Really, the op's friend should talk to his/ or her doctor about skipping a dose, or cutting a dose every once in a while. I didn't know if the op was saying that the reason that the friend wanted to skip a dose was to take something else? I kind of thought that the op's friend's doctor probably told them to skip a dose now & then, like my doctor told me, like the suboxone literature says? I thought that maybe the op was not aware that skipping a dose of the bupe is part of the program, and they did not understand how the drug works, how it builds-up in a person's body, the long half-life, and maybe they were concerned about that. Sorry if I didn't assume that the op's friend was skipping a dose because they wanted to use something else----because that is not what they said---they said it was because the medicine was making the friend too tired. | ||
|
Posted: September 28, 2005, 1:59 PM
I copied this from the Suboxone website. It says, if you miss a dose---to skip it, right? (if it is almost time for the next dose). You guys said that they should take it. Do you want them to OD from the Suboxone? You guys are the ones giving DANGEROUS INFORMATION. Also, a warning about being tired. The op's friend should DEFINATELY talk to the doc. ********************************************************************
If you miss a dose of SUBOXONE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and take the next dose at the regular time, unless your doctor instructs you otherwise Injecting SUBOXONE is dangerous and can cause severe withdrawal symptoms, painful or collapsed veins, blood clots, and increased risk of infection Your friends and family should be advised that an ambulance should be called right away in the event that you become extremely sleepy, the pupils of your eyes become like pinpoints, you feel faint or dizzy, or your breathing becomes much slower than normal | ||
Posts: 10092
Joined: October 27, 2004
Posted: September 28, 2005, 2:53 PM
I got to jump in here. I thought one of the good things about the sub was the fact that you didn't have to dose everyday....
So for example if you were on 8mgs a day you could take 24 one day and then skip the next 2.......The point being you get out of the habit of needing to put something in your body each day. Confused, yeah that would be me ........ Have a great day all, Love, Tina -------------------- Well it sucks, now doesn't it? When you make your own bed and then have to lie in the filth. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ There was a glitch due to system overload. Please stand by to find out what future you will design. | ||
Posts: 1350
Joined: June 3, 2005
Posted: September 28, 2005, 2:59 PM
posted by subby ,
No, that is not what they said. They said that you should not DELIBERATELY skip doses. If you take suboxone for maintenance, (and this also goes for naltrexone, which I took in early recovery), you should take it at the same time(s) (if one has to take it more than once a day), in order to maintain a constant sera level, which is optimal for reducing cravings and acting as an antagonist to other opiates.. As for doubling up doses, no, that wouldn't be recommended, especially is someone is on a rather high dose of Suboxone, but, as buprenorphine is, by comparative standards, a weak agonist, most recovering heroin addicts, do not have much danger of overdosing, far less than, say, methadone. If dosed properly, the Suboxone (or methadone) is given at the MINIMUM dose to stop withdrawal and reduce cravings. This dose should be lower, considerably lower, than the doses of heroin that were being used, so many users have developed quite a tolerance so overdosing on the prescribed dose should be impossible.... -------------------- Dr. Bashir: So of all your stories, which ones were true and which ones were lies? Elim Garak: My dear doctor they were all true. Dr. Bashir: Even the lies? Elim Garak: Especially the lies...... | ||
|
Posts: 1478
Joined: August 27, 2004
Posted: September 28, 2005, 7:13 PM
No I DO NOT SKIP DOSES ON SUNDAY!!!! I just don't have to take it in front of the pharmacist because the chemist is shut on Sunday. I get an extra take home on Saturday. If I skipped my dose on Sunday, I'd be feeling like crap by Sunday night, get no sleep, and possibly score.
diff -------------------- Life is not a dress rehearsal | ||
|
Posts: 6750
Joined: September 15, 2005
Posted: September 28, 2005, 7:35 PM
I NEVER missed a dose. My doc suggests to get to 2 mg and drop .5 each 2 weeks. Well that is 8 weeks. Some people may not listen (ME) and try to drop .5 a week making it one more month.
This time around I am missing my friend BEXTRA god that stuff was awesome. Now I Have more pain than ever. Also has to do with wheaning prednisone. Prednisone takes ALL my pain away but is KILLING me slowly.. I am determined to get off the prednisone. Last time I tried ended up in hospital but was snorting a few mg of OXY and eating Zanax and drinking and BLA BLA BLA. I am a sick pill freak. LOL Good Luck Jeff This post has been edited by Suboxman on September 28, 2005, 7:35 PM -------------------- It is Just Not worth it. "Inside every older person is a younger person wondering what the puck happened." One Day At A Time | ||
|
Posts: 1478
Joined: August 27, 2004
Posted: September 28, 2005, 7:39 PM
I think you will find that most medicines say that if you forget to take your dose, you should take it as soon as possible, unless it is nearly time to take your next dose, in which case, just take the next dose as normal.
And where did you get the idea that I was recommending or advocating that people should take more than their prescribed dose? All I am saying is that in my experience the way to get the very best out of the subs is to take the minimum dose necessary to keep you withdrawal free for 24 hrs. That will depend on the size of your habit. I started at 16mgs, and now I have reduced down to 10mgs. Take it every day, and slowly reduce your daily dose. And Tina, in a way you are right. Subs does have a long half life, which means that you don't wake up in the morning in withdrawals like you do with methadone, so your body doesn't go through daily cravings, like it does with meth. Don't take more than prescribed. I found that it had no beneficial effects at all (I didn't get a head off it), and actually made me feel a little poorly. Do it that way, and your body slowly forgets about withdrawals, and the psychological addiction fades, along with the physical. That doesn't happen with meth. Meth actually has the opposite effect, reinforcing the addicted behaviour, as you come to view it as a "fix". If you are not actually in withdrawals at the time you take your dose, psychologically it is no different from taking, say a blood pressure pill - you know that you need it to stay well, but you don't feel any immediate effects when you take it. Hope I have explained myself a bit better, as you seemed to misunderstand what I am saying. And I said what I said about lethal advice, coz I have been in a situation where I have used heroin after a period of subutex reduction. I used far less then I normally would have, and I still came very close to ODing. I was on my own. I never thought it would happen to me. In all my years of using heroin, I have never come so close to dying. I always thought I was very careful. But I got it wrong, and if I can make that mistake then any addict can easily do the same thing, and I stand by what I said. Never lose respect for this drug. Never get blase about it. best wishes diff -------------------- Life is not a dress rehearsal | ||
|
Posted: September 28, 2005, 8:08 PM
Diff--thank-you for letting us know what happened to you, and thank-you for reminding us that a person would (probably?) need way way way LESS STUFF!, if they tried to use something after being on suboxone for awhile.
I ran out of my suboxone, and felt like I had to use something 'till I could get more, and I needed about one 4th my normal amount to get out of bed. | ||
|
Posts: 1928
Joined: September 14, 2004
Posted: September 28, 2005, 11:21 PM
Subby, not taking a missed dose late is different to skipping doses as part of Sub detox or maintenance. As a D&A worker I have to say that I think some of your posts are way off the mark.
You talk about "the build-up of this in one's system" and "The "plateau" There is a plateau or a ceiling effect but if you reach it, you are on too high a dose. With opiates there is a peak (after you take your dose) and a trough (just before you take your dose). If you are missing doses it means that the peak is too high (be definition it is too igh otherwise you would go into withdrawal). In this way you are using too much one day so that you don't need the next day's dose. Rather the idea is too use as little as possible to avoid withdrawals. If you do this you will esnure you are on the lowest daily dose possible, keep your levels as flat as possible, and ensure that dose adjustment is easier to manage. Lastly, there are dozens of Drs that prescribe Sub who don't understand how it works and leave patients on high doses for too long (during both detox and maintenance). This forum is full of people who have struggled to get off Sub because of improper dosing and lack of monitoring. This post has been edited by The Silent Partner on September 28, 2005, 11:42 PM -------------------- A Buddhist Lama once said to me, "Do the opposite of whatever I tell you." So I didn't. Get Help for Codeine Addiction Here
| ||
|
Posted: September 30, 2005, 8:19 AM
Actually, Bupe is very different due to the long long half-life. The plateau effect with Suboxone is documented in the product literature in the fine print, if you work as a drug counselor, I think you should make yourself aware of it.
| ||
|
Posts: 1928
Joined: September 14, 2004
Posted: September 30, 2005, 8:23 AM
Yes Bupe and Meth are long acting opiates and have a long half-life, they both have a ceiling effect and I am completely aware of this as a prescriber of both.
Partial Opioid agonists like buprenorphine reache a plateau over which increasing doses do not produce an increasing effect (also known as the ceiling effect) this makes bupe a relatively safe drug compared with other opiates as it effectively blocks itself at higher doses. So rather than taking high levels and hitting the ceiling and tghen skipping doses, all clinical guidelines and protocols have reducing doses. A drug having a long half-life does not mean skipping doses. The half life for bupe isnt that long anyway, its just long compared with other opiates. This post has been edited by The Silent Partner on September 30, 2005, 8:52 AM -------------------- A Buddhist Lama once said to me, "Do the opposite of whatever I tell you." So I didn't. Get Help for Codeine Addiction Here
| ||
|
| post replypost new topic |