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>I expected to see you on here today. Everything okay?
So did I. Thanks for asking. Things are okay, but could be better, as explained in the post I was almost about to send when I happened to notice yours. So, instead of starting from scratch, I'll quote myself:

<<Geez, verylucky, I think I have asked for continuances 5 times already!! Not all from you, at least. But here comes one more, along with yet another hint ;) That drop to 105 mgs after just five days was the first one that noticeably affected me since I began this process in March, so I've been quite a bit under the weather for most of yesterday and today as a result. And need to catch up on my sleep. I AM almost finished with my reply, addressing the issues you raised and then some. But this perfectionist and sleep-deprived person at the moment needs yet another day.

I also spoke with my pharmacist at length this evening and he thought that tapering after only one week was craziness., but he really has no clue. And the MS is covered, while the Bup plan was all my idea, and self-supported as well. And I would not qualify for coverage anyway. Not fair!! I obviously need more facts to decide, and he loaned me his pharmacy's copy of all the info he was able to obtain from professional websites re Suboxone and Subutex. I am also still eager to follow thru with and make my intial plan work, especially if the MS reductions from here on down become much worse & require weeks or even longer in between. After all, don't hospitals use Bup for the purpose for which I intend in less than a month? I've heard it can be done in two weeks. Anyone know?

While your post was quite helpful, for which I again thank you, you need more from me to hopefully answer my question(s). So, sorry about the delay. And I may be getting ahead of myself here, but do not worry about objectivity. I am just happy for you & your family that the med has been so helpful. That, to me, does not make you biased; it just represents your experience. And I will only be using Subutex for taper or detox and am seeking as much info as I can possibly get to enable me to make a decision. It also does not appear that anyone else has anything to add that might help me resolve my dilemma anyway. Oh well.

Have a nice evening and hope to talk with you soon. Grinolla>>

Yowza!! I'm flattered but I want to make it real clear that I'm just sharing my experiences and my understanding of the research I've done. So please, anyone who has had different experiences than me, by all means chime in.

["But my question is how much dependence can there BE after just one week?"]

You are looking at it from the wrong angle. Don't look at it from the standpoint of what is going into your system from this point forward but from the standpoint of what your system has taken in over the past 6 years.

This may sound like a really stupid analogy but here it goes. Imagine you are an opiate receptor in your brain and for the last 6 years you have received a certain amount of stimulation every day to prevent a symptom in some other part of the body. Now, 6 years later, due to the maturation process, that other part of the body is no longer symptomatic. The fact that the other part of the body is no longer symptomatic, doesn't remove the fact that you, as an opiate receptor, have gotten used to (i.e. dependent on) receiving a certain amount of stimulation (over and above what a "normal" opiate receptor would receive). Now, just because the other part of the body no longer requires the extra stimulation, doesn't mean you can stop receiving what you, as an opiate receptor, are used to receiving without putting up a fight (i.e. withdrawals).

Just because you no longer have symptomology that requires analgesics, and you are going from the MS Contin to the suboxone as a result, doesn't mean your opiate receptors aren't still going to want the "extra" stimulation they have been used to getting the past 6 years. So, the receptors have to be slowly weened back to where they can, once again, produce the naturally occuring opiates in your brain because your brain chemistry has been changed to a point where your body no longer can produce the opiates naturally. Hence, the need to slowly reduce the stimulation so your body's chemistry can catch up. It doesn't matter if you switch to the suboxone for only a week, the fact is your neurotransmitters are STILL being stimulated unnaturally (regardless of the substance causing the stimulation). Is that clear as mud???

Yes, it is "trial and error" to find the right dosage of the suboxone to match the stimulation that the opiate receptors have been receiving. This is called titrating -- you start at a low dose and then move up or down depending on the effects you get from the particular dose.

For example, I was taking mega-doses of Oxycontin and have been thru W/Ds numerous times (which get worse and harder to stop during each subsequent attempt at going cold turkey). Anyway, I was Chewing 200-300mgs per day--chewing 100mgs of Oxycontin is equal to taking 20 percocets all at one time. Therefore, I was started on a relatively high dose of the suboxone... 12 mgs. That wasn't enough to stop the W/Ds so we went to 16 mgs... still not enough, so we went to 18, then 20 and, finally, 22mgs did the trick. I stayed on 22 mgs for 2 1/2 weeks and then cut back to 20 mgs without any noticeable decrease in the positive effects (i.e. just being "normal" with no cravings or mental obsessions).

The plan is to cut back 1-2mgs every 2-4 weeks until we get to around 8 mgs/day. At that point, we are going to stay on that dosage for a couple of months to "let the dust settle", as my addictionologist says. After that, we are going to reduce very slowly with the hope of being completely off the stuff in 6-9 months.

You may have seen some of my posts where I talk about the most recent research which seems to indicate that some folks are simply unable to produce the naturally recurring opiates in their brains. Those are, typically, people like me who relapse time after time after time..... Therefore, I have accepted the fact that I may have to take a "maintenance dose" of the suboxone for the rest of my life. That's cool with me as long as I can continue to experience this thing called "normal" (i.e. no cravings, etc.).

Since you are not an addict, my situation doesn't really apply to your situation other than the fact that you can use the suboxone to taper off the opiates that your body has become dependent upon. Which, according to what I've learned, is a really good idea since the W/Ds from suboxone are supposed to be much less severe than the W/Ds from the traditional opiates.

The half-life of the opiates are how long, after taking a dose, the opiate receptors are being stimulated. For example (this is purely hypothetical), let's say the half-life of hydrocodone is 4 hours, Oxycontin is 6 hours, and MS Contin is 10 hours. Comparatively speaking, the suboxone has a half-life of 24 hours. Which means the receptors "lose" the stimulating mechanism by a much slower means when using the suboxone. (Again, this is purely hypothetical, so don't anyone freak out on me about the numbers I am using)

Hence, if we use the earlier analogy, you, as an opiate receptor, will have a much longer period of time in which to adjust to not having the stimulation you were used to and the stimulating effect will leave you much slower thereby giving you more time to "adjust" and start producing the stuff normally again.

I hope this helps a little. Again, if anyone else has any thoughts or experiences on the subjects addressed, I would really appreciate hearing what they are.

MONDAY: how was the jury duty experience? I'm serious, I want to know what your impression of the process was. Does Alabama have an open voir dire process? Does the judge do most of the questioning? Or are the attorneys turned loose to ask the potential jurors questions? I would really like to know what you found distasteful or annoying about the process. Thanks.


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