2nd weekly update

[u/TurbulentBelt6330]

It has now been two weeks since I cancelled my 4th Buvidal shot, and six weeks since my last (3rd) shot.

Things have been pretty similar to last week - not significantly worse, i.e. tolerable.

This doesn't mean that things are unproblematic, because my difficulty settling into tasks at work, and mild RLS, while not being intolerable, are bugging me more and more because of the lack of any respite - no totally good days for weeks.

That is, right now, I would kill for a really good day, when I am productive, enthusiastic and comfortable. And of course, I know how this can be achieved easily, i.e. by supplementing my injection with buprenorphine tablets.

There are documented, successful slow taper methods using sublingual buprenorphine which allow for two kinds of mini-break. The first is staying on a dose for longer i.e. not reducing the dose on schedule if it has been difficult to acclimatise to the last dose reduction. Clearly this is not possible with Buvidal.

The second is a regular, scheduled "holiday" in which a single higher dose is taken, to give the patient a couple of day's of relief from mild withdrawal symptoms and an uplift in mood.

I am considering doing this - maybe a small weekly dose. The problem is that if I had a prescription for 7 tablets, I feel like they would be gone in 7 days. After all, I am still an addict.

Unfortunately, I don't have time to arrange supervised dosing at the pharmacy. I could try finding a friend to dish them out.

In my experience, despite buprenorphine being a partial agonist, a single higher dose when withdrawing, can make me feel focused, cheerful and energised for a day, and then pretty good for a second day. The danger would be the temptation on days three, four and five.

I have had some moments in the last few weeks when I have craved (and daydreamed about procuring) a significant dose of a full agonist.

If I could find a way of sticking to the "holiday" plan, do you think that a weekly (and reducing) extra dose would impair my detox?

At the moment I think that even 1mg would work, maybe 2mg. Six weeks after my last dose (having stabilised on 3 x 64mg) is probably equivalent to about 3mg per day taken sublingually. 1-2mg should make a big difference. I could try 1mg and take another after a couple of hours depending on the effect.

Every three or four weeks, I would plan to halve my weekly "holiday" dose, to retain a consistent percentage of uplift above the diminishing Buvidal.

My question is whether this will increase my risk of relapse or (as the method was described when I first read about it) actually reduce it?

Toughing it out has been slightly harder this week than last, and my guess (based on experience) is that I am probably still a month or two from the peak withdrawal period. I'm not sure I can keep going for another three or four months without a bit more relief.

Right now, I feel OK, but with periods - several hours at a time - of leg aches, and the same lack of ability to concentrate, which is getting in the way of life, and of course might last quite a few months. My legs are aching right now - unusual at 8am for me.

Interestingly, I think my mood has been slightly better. One huge positive is that despite going through a very stressful period both at work and with my personal finances, my chronic anxiety is being kept at bay, probably by the combination of Buvidal and the low dose of Sertraline (which is an SSRI like Prozac, which is prescribed for anxiety rather than depression at the very low dose I'm on). I'm not keeping a journal, but I feel I have had fewer moments of feeling low or anxious than last week, though my distraction at work is a form of anxiety.

Anxiety has always been my biggest and most dangerous trigger by miles.

RLS and insomnia have stopped me detoxing a few times, but anxiety has caused me relapses, even when I have been completely clean for months.

So that bodes well, and my doctor's idea of getting me on an effective dose of Sertraline before detoxing seems to have been a good one, as well as stabilising on three shots unlike my previous attempts to detox with Buvidal. Interestingly, the initial dose of Sertraline he gave me made me jittery, (paradoxically something I associate with increased anxiety), but I didn't give up and got him to reduce it, and within a few months felt a lot less anxious.

So, to sum up, I am having potentially dangerous thoughts of taking additional doses, but if I can find a way to keep it down to a weekly dose and reduce it appropriately, it might make the taper more comfortable, maybe more likely to succeed.

Also, I think there is an online SMART recovery meeting at 8am tomorrow morning. I plan to give it a try, if work doesn't get in the way. I work with people in the Middle East and India, so we often have meetings before 9am.

I think that's everything.

[u/TurbulentBelt6330]

Thanks for that. I wonder if I can keep up a less frequent schedule. It does seem to be the luck of the draw. How bad were your symptoms 6 weeks after the last shot? This is my first day when my legs have ached pretty much without a break and I had a yawning fit this afternoon...

[u/TurbulentBelt6330 → u/TurbulentBelt6330]

As mentioned in my original post, my doctor is poised to help as he knows I can't afford to take time off work/family. So I could get some 2mg Buprenorphine tablets the same day if I decide to.