Wednesday, 27 June 2012

Precipitated Withdrawal's ... A Painful Reality Check

I learnt a valuable lesson last night.. 12 hours isn't long enough to wait before taking suboxone!

I've been really struggling recently, every week I run short of my MST, the 600mg daily im prescribed just isn't enough. The problem is, because I stabilized for a good couple of months at 600mg, my doctor now doesn't think I need more.
Obviously my heroin use on top has blown my tolerance through the roof. 

I've had to come up with stories about loosing my medication, over-using it because I have a cold and am mistaking the symptoms for WD's etc, but last night was the final straw.

I was 24 hours short again, I wasn't too worried because I had 4mg in total of suboxone stashed, I thought this would be enough to get me through, maybe not comfortably, but enough nether the less.

I had my last shot at 4pm Tuesday afternoon, so by midnight I was starting to feel it.. the sickness was in the post as sickboy would say.
After some quick research I concluded that 12 hours was pretty much the minimum time needed before taking the subs.. this was suboxone too by the way, not subutex.
3am came, and I was really starting to feel it, 11 hours post last hit. So i nibbled a quarter of a 2mg suboxone and waited 45 minutes,.. nothing.. so I had a half, 1mg.. and waited again.. 
An hour later I felt a slight lessening of symptoms so I just shoved the rest of the other 2mg down me neck.

Well... the rest is a bit of a blur.. within half an hour I had grey, cold clammy, sweating skin. My bowels had turned to water and the snot was pouring out my nose. 
I started to panic, im asthmatic, and with the sudden lack of opiates suppressing my cough reflex I felt like someone was sat on my chest.

I was tearing the flat apart, quietly, trying not to wake up my boyfriend, anything!, I must have something stashed somewhere!
By 5am I was freaking out and felt like  I was three days into a methadone withdrawal.

I decided my only option was to call an ambulance and go to the ER. Through the snot and tears I was apologizing for wasting theyre time with my self inflicted, non emergency call out.
They were all lovely though and took me up to the hospital. 

It didn't occur to me until this morning that it wasn't just normal withdrawal I was experiencing, but the dreaded 'precipitated withdrawal' that happens when buprenorphine and naltrexlone is taken when you still have opiates in your system!

When the paramedics handed me over to the triage nurse in ER, she actually looked me up and down and said 'so, sorry, what's the actual medical issue?' .. I looked at the paramedic and said  ' yeah, that's exactly why I shouldn't have come'  haha.. 
The nurse just couldn't understand why I was there, no injury or obvious complaint.

She told me to go sit down and wait... The doctor will see me but there's a three hour wait..!
THREE HOURS! .. That's the one thing I dont have!... TIME!

By this point I thought I was going to pass out, I was dizzy and couldn't sit still, honestly the last time I was that sick was at rehab doing a cold turkey from 90mls of methadone!

At some point the doctor saw me, I told him all I needed was some methadone but they don't have methadone in ER, he was worried about giving me anything as he didn't want to OD me, if only he knew what my tolerance is like! I can easily get through 3grams of heroin a day plus 600-1000mg MST IV.. I finally managed to get 60mg codeine phosphate and 10mg diazepam out of him and sort of slipped into an uncomfortable sweaty sleep....

9am the 'substance misuse' nurse came to see me, told me they weren't going to admit me and all she could do was take me over to the 'specialist addiction unit' at 10am when they open. Then she just disappeared

I took myself over to the SAU at 10am but all the doctors and key-workers were in the morning meeting, and my psych wasn't even on site.. Now im just so tired, sick and pissed off I didn't know what to do. 
Im stuck 5 miles from home and a possible H link up, they they tell me I won't be dealt with till after 1.30, and even then theres no guarantee of getting any medicine.

I get a cab home, borrow some cash and go score.. like a zombie.. sick, no sleep, crawling down the road to my link, i make it, then I have to get to the park toilets.. Finally, I make it, I cook up, im telling myself 3 minutes, 2 minutes... I get it in.. I stare at the mirror at my pupils like saucers waiting for the gear to hit and them to pin... im waiting.. I just shot near enough half a gram of decent heroin.. nothing!.. Nothing happens!

It dawns on me as I tear up that the subs are blocking my opiate receptors.. I only had 4mg! Im still sick...!
I manage to blag some MST and shoot 200mg three times in a row.. NOTHING..

Its taken my all day, and a ton of gear to feel normal again, I literally cannot believe what's just happened to me!

So guys and girls, what's the moral to the story!? DON'T take subutex/suboxone 11 hours after shooting gear when you have the tolerance and habit of an elephant!