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Re: Addiction » shelliR

Posted by Elizabeth on February 28, 2002, at 16:01:18

In reply to Re: Addiction » Elizabeth, posted by shelliR on February 28, 2002, at 9:38:59

> When my ass**** doctor took me off over 100mg of methodone at once and the cube of buprenorphine did not work for me at all (don't know the dose), I was literally screaming in pain on the floor.

My god. That's terrible. The doctor should have known better. I feel responsible in a way since I encouraged you to try opioids, even full agonists, and I'm very sorry for that. I'm just glad nothing happened to you that couldn't be reversed. Doctors who say that opioid withdrawal isn't dangerous don't have any idea what it feels like (and what people can be compelled to do to themselves as a result).

Besides the general emotional agony, the usual withdrawal symptoms people report are hot and cold flashes, lacrimation, lethargy, aches and pains, drippy nose, and of course the lovely nausea and vomiting. I can't believe they didn't give you anything to get you through it. (If I were going to attempt something like that, I'd want to load up on Ativan for agitation, Phenergan for vomiting, clonidine for hot-cold flashes, Inderal for shakes, Benadryl for drippy nose, loperamide for diarrhea, ...you get the idea.)

> I have never screamed in pain before, and now it's hard to remember exactly what the pain felt like, just that it was horrible. I remember feeling that I couldn't breathe. And my doctor never responded at all until apparently the staff must have talked to him because he told them to let me out.

You were in the hospital? You had to go through all that IN THE HOSPITAL???

> I have notes from early September that I asked him to try bupe because I was very worried that I had already tripled my dose of oxycontin since July. He refused, telling me I would adjust to the oxycontin and not need to go up.

My guess is that he assumed that because that is what happens with MMT patients (although the plateau dose may be extremely high). I think that was a mistake.

> I wish I could sue the bastard, but I think it would be too complicated since I was taking vicodin before he put me on the oxycontin, and especially complicated because I had gotten it off the internet. But I had never taken more than 7.5 a day of vicodin, and here I was up to 260mg of oxycontin.

It might be worthwhile to consider talking to a lawyer. I don't think it was wrong for him to let you try the oxycodone and methadone, but to discontinue them abruptly was simply incompetent (the hospital played a part there too).

> > So now you're on Vicodin again? Are you taking it regularly, or as-needed?
>
> Just as needed until the temgesic arrived. I only had a limited supply and also I wanted to give the bupe a chance before I became further habituated to hydrocodone.

Ahh. How's the Temgesic? How much are you taking?

> Well judging from my first day and a half on the buprenorphine, it certainly can make me high.

Huh. I didn't feel high, although it definitely did make me dizzy and lightheaded, and sort of speedy/jittery, when I first started it. Are you having any side effects? I found that I had to start at 0.15 mL in order to adjust to it so I wouldn't be vomiting all the time.

> I didn't think that the bupe had much of a chance of working for me because of my history with oxycontin and probable change of brain chemistry. I started with 0.6mg twice a day--today I will cut it to 0.4mg x 2 to see what that does. (I started on a high dose just to make sure I gave it the best chance to work.)

I can understand that, after what you've been through.

> > I haven't had the problem, and I hope that you
> > won't, either.
>
> I thought you had upped your dose at one point?

I was taking 0.5 mL for a little while, but that was just to allow myself to adjust to it so the side effects wouldn't hit me like a brick.

> Actually I am hoping that the lamictal will kick in for me in a couple of weeks and I might not need to take the bupe on a regular basis.

Lamictal is good for a lot of people. I hope that it works for you.

> I thought you had used that word when referring to subligual bupe. Maybe you said less reliable; I know that you felt that the sublingual was not as effective as the injectable from earlier posts that I reviewed about bupe.

Not the sublingual formulation (Temgesic, Subutex). What I meant was that using Buprenex (the injectable formulation that's available in the U.S. -- the stuff I get) sublingually may not be as reliable. That's what Dr. Bodkin said; he recommended using it intranasally.

Addicts who take Temgesic often have to use mind-blowingly high doses (16 mg????!!!!). I think that might be in part due to poor absorption via that route (as well as to high tolerance, of course).

> But now there is so much more info available because of the detox and maintenance studies.

Buprenorphine isn't that new; the only thing that's new is that it's been studied in the U.S.

> Whatever works. Have you ever tried a higher dose of bupe to see if it could carry more of the anti-depressant load, or are you purposely staying at a low dose because of possible side effects, etc.?

I'd like to be able to take just 0.5 mL, but I found that it wasn't enough. Yeah, the side effects are kind of rough, even though I've adapted somewhat. I have tried more than 1 mL before, but I find that I tend to get sort of agitated on high doses.

> p.s. I truely have you to thank for the lift in my depression. I have been reading your posts about bupe for almost two years now. I don't know if I would have even heard of it, or thought to try it, without your reported success and information about it. So a very deep thanks.

You're quite welcome. As I said, I feel really bad and kind of guilty about your experience with the full agonists. I hope very much that things will go better for you with the buprenorphine.

Best wishes, as always.

-elizabeth


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poster:Elizabeth thread:93100
URL: http://www.dr-bob.org/babble/20020222/msgs/95857.html