Musing about opioid use etc

Had half of the pill left and hope that my prescription will be there at 9am as promised.
The good news is buprenorphine has a long half life so withdrawal is not an issue for several hours but my pain may flair up.
I hate myself for running short this month. They say to take it every 6 hours but the fact is after 4.hours.the pain returns so I half my dose except for the AM dose

Glen Heinsohn

Thanks Oceanfisher

I got to the pharmacy at about 10 after 9am They waved for me to wait a minute then singled for me to enter the store. (Covid-19 has forced people to wait outside-it's a small store so they can see who is outside) Anyway they handed me 3 bottles with 30 pills each and said they will have the 4th bottle today. I use 4 eight milligram pills a day which is actually very generous because the usual max is 24mg a day so I'm happy to get the 32mg amount.
I do not blame them as they have given me my medication several times on the 29th day so it was my fault in the end (but one gets used to those extra 4 pills a month and of course will use them when you awake at 2-3am screaming because you laid in one spot too long)
I have to be a little long here so bear with me because it may help another down the line.
Opioid history goes back to around 1995 but was off and on often off completely for a couple of years at a time. An auto accident made my condition much worse and I ran the gamut from failed surgery to percocet to morphine and even methadone. Toward the Spring on 2008 I was so dependent on Percocet that I'd go into withdrawal after 2 to 3 hours.
I searched Google for "Safer opiates" and came upon a clinical trial at Columbia Presypeterian/NYS psychiatric center. It has a long title along the lines of "Pain patients on opioid medications who take more then prescribed amounts of medications" So I went and applied and got accepted into an inpatient study. One had to be in moderate withdrawal before they started with their regimen which was differing dose's of buprenorphine.
First however they'd give you a starting dose to take away the WD's and that was wonderful. After 20 some odd hours of hell, it was fairly rapid relief. I was given the real buprenorphine then some was mixed with placebo so I never knew how much I was exactly getting. I'd report my pain in a log and by the time I felt it was decided for me that 16mg worked best and twofold. First it helped my pain and second, WD was held at bay.
I'd have stayed the 4 weeks but they wanted me to take other opioid medications and "rate" them. I said to them all I wanted was to find out of buprenorphine would work on my pain. I apologized for leaving early and they set me up with a doctor who would prescribe it.
Long story short, that was 2008 and in late 2009 I tapered off to get a baseline on my pain. I went a year without any opiate medications but my pain got worse and I found a clinic that prescribed buprenorphine. I went back on 2mg twice a day but have worked up to my present 32mg (a combo of increased pain for various reasons and tolarance)
I hope buprenorphine can offer help to others as it has for me. It may work or may not however for example, my pain clinic stopped prescribing all opioid medications which was horrible for so many but lucky for me, continue buprenorphine prescribing.

Oceanfishing? I used to love it!

Glen

Buprenorphine is usually a combo of buprenorphine and naloxone. The naloxone is there to prevent abuse by IV use or snorting. It's called Suboxone and is used to detox and or maintain a opiate addiction. However it came out as just buprenorphine for pain but was never popular until someone found it's potential for addiction.
Subutex is pure buprenorphine. It work's as both agonist and antagonistic. In layman's terms it excites opioid receptors and de-excites them.
This leads to less euphoria and less slowing of breathing so it's much safer. It does have some euphoria but it's limited and does not induce much craving.
Important thing is it does kill pain and to be honest can make one feel mellow and has been used as an antidepressant.
I am a big fan obviously and wish others would give it a try.

Glen

Glen,
The people over on prostate cancer forum are some really smart people. They can help you in making a decision. I chose radiation through seeds as I just didn't want to deal with a catheter and the surgery. I was given an almost as high result of curative rate as with surgery. That being said I was NOT prepared for the pain upon waking and the burning and pain day two post op.

I have both a radiation oncologist and a urology surgeon together to place the seeds. Only time will tell if I chose wisely. I wish you the best of luck with whatever choice you make.

On the chronic pain side of things I am glad you found something which works for you. I stay away from methadone and suboxone as the stigma my drs relate to me is not a path I want to go down. Being labeled a drug user who needs rehab is not something I want to deal with. I must say its a shame the way chronic pain patient have to jump through hoops for pain control. I always thought I would NEVER have a problem being prescribed sufficient meds after being diagnosed with degenerative disc disease, having surgeries and having cancer. My surgeon wants to do another TWO FUSIONS and I flat out tell them I REFUSE to have this done if I cannot count on pain meds when I need them. I still remember being told how after my first fusion I would never need opiates again. I now know to expect the unexpected.

Update: I found a solution to me taking more then my limit of 4 pills a day. I used a small zippered pouch that has two zippers that meet allowing them to actually lock (with a small padlock) My wife has the key and each evening I take out a tiny container with 4 pills (a few have 12 for when I go upstate for 3 days)

This worked well and I had no anxiety over it this past month. Sure I could break the lock or use a knife to open the pouch but that would be kinda dumb.

I just deal with it if i need more
Saved one pill last month

Glen

No sorry, it is similar to a carry on bag and happens to have a big zipper and a side compartment with a smaller zipper and they come together when both are closed.

"Staples" has cash boxes that are lockable from pretty cheap to expensive

Glen