Butrans Patch taper here

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Butrans Patch taper here

Postby GingerPop » Thu Aug 31, 2017 8:00 pm

Hi all, I was on subs from 2003-1014. Yes 11 years, from 16 mg to 8 to 4 to 2 to 1 to .5 to .25 and off . (god that sucked). It was a bitch getting off it, I thought I'd never ever go back, but I did 2 years later. It was better than using what I had my mind on anyway. So 18 months later and I'm determined to get off again. I was able to find a doctor to prescribe the Butrans patch off-label. The first set I paid $700 for, which was very painful, but I had to not think of taking the med so it was worth it. Now my insurance is covering all but $70 so it's manageable.

I went from .4 to .2 about 4 days ago. I'm not sleeping well, and feel like my legs and arms are weighted down. Other than that I guess I'm okay. In 2 weeks I'll go down to .10 mg and then just leave that patch on for longer than the week it's supposed to be worn. I was told that's one way to go from .10 to 0 without as many withdrawal effects as there might be.

I came back here for 2 reasons. First is I need your support. My use of subs have always been a secret, and there's nowhere to talk about this stuff. The 12 steppers aren't having me, nor me them, so it's the other sub users and taper-ers who are "my people".

Second is, maybe someone else will benefit from these patches. It's a little tricky getting them, but I can help anyone who is trying. If you have any chronic pain issues it is easy.

I don't know how many of you have considered the patch. It's not available in more than .50 so until you're down below .5 it's not an option. For me, it's good because I just don't think about it, which is important (for me at least).

My last taper was so long, so painful and so emotional. Fortunately, this does not resemble it. I have to start running again, that made a huge difference before. I'm just doing what I do today and staying right here i this moment, which is an okay place. I don't have to stress about what happens next!

Thanks for reading/listening to my rant. GingerPop
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Re: Butrans Patch taper here

Postby cheeps » Sat Sep 02, 2017 7:56 pm

I have to start running again, that made a huge difference before. I'm just doing what I do today and staying right here i this moment, which is an okay place. I don't have to stress about what happens next!



That will really help you....and I'm really glad you have mentioned this patch. It seems like an excellent idea to me! 8-)
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Re: Butrans Patch taper here

Postby DietDoc » Sun Sep 03, 2017 10:20 am

Hi Ginger,

Welcome! You're safe to share, bitch, moan and generally commiserate here as much as you want. I know because that's all I do. I am a fellow taperer. Don't bother reading my thread, it's just me bitching for 6 months about how bad I feel all the time and trying to figure out why. It's my story thus far, mostly about bouncing around on my daily dosages with a few nasty relapses thrown in. PSilver's thread is a good one. He just slayed the dragon and is soon to be at the two month mark. He came, he saw, he kicked it's ass.

I want to offer all the support I can, but admittedly I have more questions than advice and definitely few, if any, answers. You have been down this road before which is really interesting to me. I am not sure if I know anyone that has come back for round two after successfully getting off, no pun intended. There tons of people, however, that have come back to try again after unsuccessfully getting off, me included. I am determined to make my thread have a happy ending, this time.

If I may ask a few questions...and this is purely and admittedly me trying to learn. Generally, how old are you? I'm in my mid fifties and am finding age is an important part of the experience. Hope that's not rude, and again, just ball park, like which decade of life? If I did my math correctly you've been on, off, and on subs for 15 years. I applaud you for deciding to fight again. One thing I have noticed is a bunch of people that got off and went back on have all resigned themselves to being lifers, but not you. You've come to take yourself back. Your last taper ended about 3 1/2 years ago and you jumped of at .25 mg/d. You wrote it sucked. Any advice from what you learned from that experience? Magic comfort meds you've found, don't run a marathon, etc?

Lastly, and this really interests me, the patch. I assume you are living in the United States? We can't get Tamgesic here but it would be good if we could because it's sublingual buprenorphine that comes in the 2 ug (0.02 mg) strength and would be great for tapering, at least for me. So how did you wind up on the patch? By choice or circumstance? You wrote that you went from .4 to .2 and will go to .1 mg but I am confused. The patch comes in 5, 7.5, 10, 15 and 20 mcg strengths, so how are you calculating your dosages? I just tried to find a method of equivalency conversion (from sublingual film to patch) but was unable to. I have a close friend that's a Pharm. D. so maybe he can do it. I would love to be able to put on a patch for 7 full days and not have to think about when, where, what time, when can I eat, etc. and all the hassle that goes with using the film strip. It would take the 'clock watching' out of the equation and the habit of taking as well. The big caveat is getting the dose right. How, if you know, do you calculate that? All I can come up with, and this is more conjecture than science, is 1 mg/d sublingual is approximately 4 mcg an hour. What do you think?

You just got on this site and I come along and interrogate you. I hope it's OK I asked all these questions. It's either nice to talk about all you've learned or you just want some damm support. If it's the latter don't bother with any of this. And whatever I can do to help and support you I will.

Cheeps is our resident Moderator and Chief and is a wealth of information, support, empathy and compassion. And there are many other's here that bring the wind to your back. I hope your today is going well. Best, DD.
I have two wolves fighting in my heart. One wolf is a vengeful, angry one. The other wolf is a loving, compassionate one. Which wolf will win the fight in my heart? The one I feed.

Buprenorphine: 9+ years @ 16 mg/d ave. - Tapering @ < .5 mg/d
Alprazolam: Tapered off May 2016 - Started again October 2017 currently tapering again
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Re: Butrans Patch taper Questions Answered

Postby GingerPop » Sun Sep 03, 2017 8:18 pm

Hi Diet Doc,

I was on this site for the taper from 1 mg to .25 and then off. I think my name was Gingerpop then as well, I'll try to find my taper thread.

I was in the first round of Bupe users. I got on it in 2003. I was buying Temgesic from Thailand online before that on and off, it came in 1 mg which is good. I could barely even feel the jumps down until I got to 2 mg. At the outset, I was on 32 mg of Subutex. For someone who was taking 10 Lortab a day, well the Subutex got me so high I was nodding out at work. I quit that doctor quick and found one who didn't prescribe more than 8 mgs, there were a lot of heroin addicts in my therapy group there. The ridiculous doses they put people on are purely greed based. It's an expensive medication and very profitable. They could make smaller doses for addicts, but I think there is an obvious vested interest in keeping people chained for life. I have written extensively on the subject. Go to thefix.com and search Suboxone, you'll see things I wrote under a pen name. I'm in my forties, and I was a Vicodin addict.

Patches.. okay the 20 mcg patch = roughly .40, little less than a half of 1 mg. it's very different than sublingual because you don't get that little bump you get from an oral dose. You don't feel much of anything except not sick, but you don't think about it, the patch is on your chest, arm or back, you rotate spots. The patches go down from 20 mcg to 10 mcg (approx .20 mg) to 5 mcg . (.10 mg) . My doctor did the calculation btw. It's micrograms per hour, so it's steady in your system. I'll totally jump in 5 more weeks. 1 more at .20 and then down to .10

SO why did I go back? It's always a long story I'll make mine short. I moved to Denver & worked for a volatile and rather brutal company, but in a high profile, high paying job I was not going to quit, I couldn't quit! I started having cravings, and everyone around me had drugs. Anything, everything it was around. I was scared to death I'd lose my resolve, and in fact, I did use 2 drugs that aren't opiates. That woke my ass up that it was tick tick tick til I went back.

I went on 1 mg a day, telling myself I'd stay on for 3 mos and then the cravings would be over etc. etc. I stayed on until I left Denver for a new job in another city. Once I got here and got happy again, I decided to get off this drug. I was fooling myself about how much Subutex I was taking. I thought it was .50 but since I was breaking the tablets and my script lasted almost 3 months at a time I didn't think much about it. When I got here and went down to .50 I had a little WDs but they passed in about a week. So I wouldn't lie to myself I got on the patch.

SubSux, but I think it saved me from a greater evil. Pills are hard to come by but not heroin. I am lucky to have dodged that bullet, so I'll suffer through this and be free again.

When I get down to .10 and below I'll be miserable for a while, this I'm sure of. Sleep and depression are my biggest problems, put together they turn me into a difficult person to live with.

The hardest part of this isn't getting off the sub, even though that sucks, I'm not as scared as I was after 11 years on 8 mg. I haven't told my husband I went back on it. He was in NY often that year and I told him nothing. I am still a secretive addict inside and fight that part of my personality. I put my husband through 8 months of hell last time. He listened to me whine cry. act out and refuse to socialize. No fun indeed. This time no matter what I am soldiering through.

If you want to go on the patch it's probably not great until you are under 1 mg. Since the highest they come in is less than .50 it's hard to do from a higher dose than 1. You get pretty sensitive to drops below the 1 mg mark. Patches are not legal to be prescribed for addiction, another BS move on pharma companies, they don't ever want you off the teat! Addiction doctors usually won't go for it unless you are a pain patient as well. If you hunt you can find one. I did twice, so I know it can be done if you are persistent.

Thanks for asking, and I'll help anyone I can. I'm feeling better from this drop to .20 but I know .10 and below won't be fun. Love to all my fellow travelers.
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Re: Butrans Patch taper here

Postby GingerPop » Sun Sep 03, 2017 8:25 pm

My last sub taper was under the name Sub free. I read it and cried just now. What a fucking mess I made.
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Re: Butrans Patch taper here

Postby DietDoc » Mon Sep 04, 2017 12:00 am

Ginger,

Thanks for such a thoughtful reply. You know your stuff. I am not being treated for addiction although I abused opiates for years. I presently get buprenorphine from a neurologist that specializes in headaches. She'll write for what ever I ask for. She doesn't have the X designation. The X designation is required by the DEA to write buprenorphine for addiction. In a bizzare paradox, anyone can write buprenorphine for pain. The X designation means you've taken a certification course in 'addiction medicine'. So all those so called experts practicing 'addiction medicine' and prescribing Suboxone are qualified to do so becasue they completed a 12 hour course and took a 50 question multiple choice exam (that has no grade or score only a 'recommended review of information' memo based on what you got wrong). And the whole thing is done on-line and can be completed in about 2 hours...that's a Suboxone doctors' total qualification. Nice, right?

I too have a past thread here. Mine is over 4 years old but unlike you I never got off, I balked. Last week I called the first dude I ever got a prescription for buprenorphine from to find the date I actually started. It's April 2008. Over nine years at an average of 16 mg qd, that's 3467 consecutive days of placing a highly potent opiate on my sublingual vein without ever missing a day. Whew, ending that little habit should get nice and weird. I've got my
dose down to 1 mg qd a few times and below that twice. This time I am going to stop Suboxone at some point below 0.5 mg qd no matter what. I am done with this, just the name Suboxone pisses me off. I hear it in so many TV shows and movies now and everytime I want to scream.

'To thyn own self be true'. That's what you did when you made the conscious choice to once again take buprenorphine. It was a brave and courageous choice. Knowing that the pain it would cause you was great yet still less than the pain you knew you'd be in (and in turn bring to others) if you hadn't is nearly a Sophie's choice.

Well you did it once and will undoubtedly do it again. Your past thread is yet another inspiration and for what it's worth if you hadn't come to share I never would have found your old thread. Success stories are everything, and very soon you'll have posted two of them.

Thanks. DD
I have two wolves fighting in my heart. One wolf is a vengeful, angry one. The other wolf is a loving, compassionate one. Which wolf will win the fight in my heart? The one I feed.

Buprenorphine: 9+ years @ 16 mg/d ave. - Tapering @ < .5 mg/d
Alprazolam: Tapered off May 2016 - Started again October 2017 currently tapering again
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Re: Butrans Patch taper here

Postby cheeps » Mon Sep 04, 2017 10:03 am

GingerPop wrote:My last sub taper was under the name Sub free. I read it and cried just now. What a fucking mess I made.



Now that makes sense...I have quite often wondered how you were and went to the fix to try and remember which poster you were....that was about 4-5 months ago. You should edit this thread to include your other link.

DD, you should too. There are more people out there than you think that have tried to stay off or get off and didn't.

Have you two read the lastest article on addiction in this month National Geo mag?

I also want you to know that compared to the likes of you guys...I'm such an amateur when it comes to the technical aspects of opiates. I very very much VALUE the knowledge both of you, (as well as others here), bring to the table.

You are my heros. This is so hard and any ways to mitigate and manage or avoid should plastered over the walls of every Drs office in the US. I feel like sub scripting is a crime. At least with methadone, the depression isn't as bad. Sub is such a mindfuck...it's ridiculous. :deadhorse: :deadhorse: :deadhorse: :deadhorse:
10 yrs on methadone
Meth free 10/08
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Oxy free 12/06/14
More surgeries 2016-17
2017 Oxy taper in progress
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Re: Butrans Patch taper here

Postby Subblind » Tue Sep 05, 2017 7:12 am

I will follow this thread very closely...I have nothing of value to add but I am completely inspired by your determination and experience...my best to you!!and Diet doc too.be proud of your efforts...
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Re: Butrans Patch taper here

Postby DietDoc » Fri Sep 08, 2017 8:00 am

Dear GP:

You mentioned you did some writing on a site called The Fix. I went over to the site but couldn't find your work. I could tell by how you mentioned your contributions you had/have strong opinions regarding MAT/OTP. I'd like to read it, can you find me a link? They may have relaunched their site which is why I couldn't find much material in general. Anyway, if you get a minute see if you can find...you.

How are you doing? Are you still all patched up? Detox humor is the worst, sorry. I do like the whole transdermal thang. It must be nice not to have to deal with at least some minor aspects of being on this crap, such as: where's my medication, did I forget it, did it melt in my car, no sorry but I can't eat for 1/2 an hour. But the real plight is no different for you. I guess one negative is you don't have the dosing flexibility of using strips. You have to use the manufacturer's dose strengths. Do the large reductions toward the end pose an issue for you?

I want to ask about you and get an update. But on a personal note, I don't see myself switching over to the patch. Mostly becasue I'm too apprehensive, a fancy way of saying I'm too chicken-shit. I'm nervous enough just tying to cut strips accurately and making drops. To completely change the mode of delivery would stress me even further. You're really smart to have started wih them.

So drop an update on us. I'll do the same soon, too; I'm so excited to write all about how my flesh feels like it's melting off my skeleton and how my legs are having a great time now that they can move constantly all by themselves without any intentional input from my nervous system. RLS, the cornerstone of any good insomniac's nightmare...wait, that's an oxymoron. Detox humor, am I right?
I have two wolves fighting in my heart. One wolf is a vengeful, angry one. The other wolf is a loving, compassionate one. Which wolf will win the fight in my heart? The one I feed.

Buprenorphine: 9+ years @ 16 mg/d ave. - Tapering @ < .5 mg/d
Alprazolam: Tapered off May 2016 - Started again October 2017 currently tapering again
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Re: Butrans Patch taper here

Postby cheeps » Fri Sep 08, 2017 10:23 am

Hahahahaha You go DD!! Maybe one day you'll say mtherfucker again :mrgreen: :nono: :twisted:
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Re: Butrans Patch taper here

Postby GingerPop » Fri Sep 08, 2017 8:44 pm

Hi everyone,

Here are some links:

The first article is a first-hand account of going 1 to 0 last time. The second article is about the scam around all of the bupe medications that provide handcuffs but no path to freedom. I've written under various pen names for the publication.

As to why I'd ever go on it again? I thought it would prevent a relapse I might not come back from. I'm down to .20 next week down to .10. That's one thing I learned, for me it's better to step down in small increments. Other people just pull off the band-aid. There's no right way to do this!

https://www.thefix.com/content/last-milligram-suboxone

https://www.thefix.com/content/hard-to- ... e?page=all
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Re: Butrans Patch taper here

Postby DietDoc » Sat Sep 09, 2017 4:34 am

Thanks GP...

You don't say how you're doing. I hope you're feeling OK. The insomnia is instructing me to go read your articles now.

One question, you write that, for you, small incremental drops are key. But then you write you're going from 0.2 mg to 0.1 mg. This seems like a huge drop. And it's a huge drop at a very critical dose range. That's a whooping 50%! Wouldn't a small drop be 0.2 mg to 0.18 mg? I know with the patch this is not possible but still you wrote small drops work best for you. I am deriving this from reading hundreds of posts and I am leaning from everybody. Thanks and I hope you're symptomatically doing well.
I have two wolves fighting in my heart. One wolf is a vengeful, angry one. The other wolf is a loving, compassionate one. Which wolf will win the fight in my heart? The one I feed.

Buprenorphine: 9+ years @ 16 mg/d ave. - Tapering @ < .5 mg/d
Alprazolam: Tapered off May 2016 - Started again October 2017 currently tapering again
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Re: Butrans Patch taper here

Postby DietDoc » Sat Sep 09, 2017 7:17 am

Dear GP,

I read the first article and it was really fantastic. That's exactly the type and manner of content that will really help people. Your article is a major contribution to raising both awareness and understanding of ORT, and specially buprenorphine.

On a side note: an unfortunate consequence of reading your article is that you've completely ruined the appeal of black lace thongs for me (and I'm sure many other readers) for a very long time.

(If anyone is wondering why the hell I would write a statement like that go read this most excellent article)
I have two wolves fighting in my heart. One wolf is a vengeful, angry one. The other wolf is a loving, compassionate one. Which wolf will win the fight in my heart? The one I feed.

Buprenorphine: 9+ years @ 16 mg/d ave. - Tapering @ < .5 mg/d
Alprazolam: Tapered off May 2016 - Started again October 2017 currently tapering again
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Re: Butrans Patch taper here

Postby GingerPop » Sat Sep 09, 2017 2:35 pm

Luckily my dog is almost 4 now and he never repeated that little trick! It was crazy.

As for 50% drops, I was okay from .5 to .2 . about 4 days of my body feeling weak and heavy, a little nausea, but manageable.

I get RLS, mine hurt. I get pains in my legs and knees which wake me up. Gabapentin 600-900 mg works for it but the next morning it takes almost a pot of coffee to get my mind clear - it's a trade off, up all night or kind of groggy in the morning. Everyone has a different level of discomfort they can handle. For me it's anxiety. I naturally have panic attacks (not daily anymore, but too often..) that really gets me and is part of this taper.

Next week I go down to .10 I'll stay there for a month and leave that patch on til it dissolves. (they don't really dissolve). I'm actually taking three months to do this, which for my body is the best way. I am going to be sick when the last patch comes off, there's no avoiding some of that. I chose to jump from .10 because last time I ripped it off at .25 and it was a struggle.

I was writing for a living then, so if I spent half the day in bed it was okay. Now I have to be on it and am really busy every day. It helps to be distracted.

If I can help anyone I want to. I left the forum after my last jump, reading stories started to make me anticipate worse feelings, I'm not doing that this time. I want to try and help another person who is jumping off and is struggling like we all do.
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Re: Butrans Patch taper here

Postby nomojo3479 » Sat Sep 09, 2017 6:17 pm

Good to have u back gingerpop.. fucking panic attacks are a nice side benefit of tapering bupe..,before I'd experienced one I kinda doubted that they were as debilitating as people claimed but now that I get them it's all I can do to curl up in a ball and weight out the heart pounding..
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Re: Butrans Patch taper here

Postby Subverted » Sat Sep 09, 2017 9:13 pm

For the record DietDoc = Subverted

I don't know what I was thinking with that stupid motherfucking moniker (for you Cheeps) but I like 'subverted'. It speaks to the insidious denuding effect buprenorphine has upon ones' soul. How you forget a part of yourself as the years tic by in the orange haze complacent comfort, or some shit like that.

The one thing I appreciate is I tend to think I am the only fucked up person in the world and reading these posts helps me. I always think everyone is more stable than me. That no matter how protracted a drug history I'm the truly evil one. My behavior, my personality my issues are bad, but everyone else has their shit together, even when they don't. But then people share things about themselves and if only for a moment, I'm no worse than anyone else.

I really appreciate everyone. I'm having one of those weird taper-related emotional days. You know, the ones where you get all choked up over a friggin' McDonalds commercial. I watch way too much television.

GingerPop is FOCUSED. A no bullshit, git' er' dun kind of attitude. I'm more the whinny, end of the world, guts all over the floor kind myself. That's probably why I've been on this for so long. But this is it.
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Re: Butrans Patch taper here

Postby cheeps » Sat Sep 09, 2017 9:32 pm

:lolno: :lolno: :lolno: Hahahaha :lolno: :lolno:

I no more have my shit together than a baker acted crackhead in the Miami Beach gaol. Most of us just don't have the energy to post...too busy looking at the clock...or the backs of our eyelids.

Or lurking....to afraid to put themselves out here in SS land.

Or not here at all.....in denial? Still in the honeymoon phase.

Or they could be one of the lucky ones, the mofo's that get out relatively unscathed.


You fucking worry too much....you seem subverted....

All I can tell ya is that there have been a shit ton of good peeps here over the years. :popcorn:
10 yrs on methadone
Meth free 10/08
Back & Neck surgeries
Oxy free 12/06/14
More surgeries 2016-17
2017 Oxy taper in progress
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Re: Butrans Patch taper Questions Answered

Postby Lucy » Sun Sep 10, 2017 2:14 am

GingerPop wrote:<snipped by me for brevity ...>

Patches.. okay the 20 mcg patch = roughly .40


Hi, GingerPop. I had the same reaction as DietDoc (or Subverted. Love that for a username here) regarding your 50% drops. You've done this before, so you know what you're doing, but those are steep drops just where it counts the most - under 1mg. I know very little about patches, but I've heard of people cutting them up and using part of the patch to deliver a smaller dose. I don't know if that's a possibility or if you'd even want to adjust your dosage so your drops aren't as big.

Can I ask for some clarification on what you wrote above about the patches? Are you saying the 20mcg patch gives you the equivalent of a daily dose of 0.4mg? So you wear the patch for 24 hours and in that span of time it delivers a steady dose that works out to .4mg, do I have that right?

Thanks for those links to your posts at TheFix. I do agree that there are sub doctors in the USA that seem to be treating people like cash cows when it comes to the way they are being prescribed suboxone. I'm not in the USA and there is no financial gain here for a doctor to prescribe sub or keep that person coming back for years because they're chained to them by chemical dependency. And here, as in my case, it's not unusual to be prescribed 32mg daily for years. I wasn't even dependent on opiates (although, to be fair, there was a risk that I was headed there). The financial motive makes sense, there'll always be doctors who are more interested in $ than their patient's wellbeing. But I think there is a greater problem, and that is ignorance among those prescribing and those taking suboxone for ORT. There is no knowledge or discussion of the long-term effects of this drug and that is why this site is so invaluable. Every time someone new posts about their experience here it does something to address that pervasive ignorance.
Reducing from 32mg. Dropped from 26mg to 16mg 8th July 2017. August 1st 12mg.
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Re: Butrans Patch taper here

Postby GingerPop » Tue Sep 12, 2017 8:47 pm

Hi there Lucy and Subverted and Cheeps and anyone else who's here and reading!

So you guys told me the 50% drop might be harsh, and I was like "no, no, no, I'm tough". I can be tough, but this does in fact suck. oddly after 3 weeks, it's my last 3 days on .20 mg and then I go to .10 . I've not been so good this week, leg cramps, emotions off the charts, INSOMNIA and ANXIETY. These get their own special capital letters because they suck just that much. I hate you fucker anxiety and I hate you too rat bastard Insomnia.

It feels good to swear in type. It just doesn't work at work, which is all I can force myself to do.

I've been at .20 almost a month, I may never stabilize on it. Last time I jumped at this pint because it wasn't getting better. I am going to go down to .10 and soldier through no matter what.

I couldn't be more self-hating and humiliated than I am at this moment. I went through this once, how in the world could I think that1 mg for a year and a half could still be so rough to get free of. No good answers, but I'm paying the piper today.
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Re: Butrans Patch taper here

Postby Lucy » Wed Sep 13, 2017 12:36 am

We're all human, GingerPop. We fall into that trap, time and time again for some of us. Don't beat yourself up. You're addressing the issue. The self-hatred is something that can really undermine everything if it gets out of hand. You're obviously a very intelligent and accomplished woman. I just want to remind you of that. If the wds get too bad there's no shame in pausing to give your body time to stabilize. Detoxing doesn't have to be a way to punish or chastise ourselves. Hopefully, it's something we do to heal and improve our lives. You're doing that and you can be gentle with yourself when you need to. Do you have comfort meds to help with the symptoms you're having?
Reducing from 32mg. Dropped from 26mg to 16mg 8th July 2017. August 1st 12mg.
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