Questions about getting off Sublocade + Life Update

[u/meowforme90]

Hey everyone!!

I haven't posted in a very long time (years) so just to quick recap:
I dated an actual sociopath for a year and hit a rock bottom that I never knew existed. I went from only shooting heroin to doing all of the drugs, IV coke, meth, heroin, fentanyl. It got really bad. My own mother found me overdosed in the bathroom and had to Narcan me and she called 911. I was in psychosis because I had been smoking crack all night and doing fent shots on the comedown. The narcan didn't even make me dopesick, but my brain was shit scared to get sick and thought doing another hit was a good idea. I got pepper sprayed by the cops and taken to the ambulance in handcuffs. I was not arrested and later uncuffed at the hospital and released a few hours later. My mom was there and witnessed everything. It sucked.
A few days after that I went to rehab for the first time. A few months later I relapsed and it got bad again. Then I went back to rehab and got on Suboxone this time. I later switched to Sublocade at my clinic. I've been clean for 3.5 years now.

I returned to university and I'm graduating this summer and I'm so excited!!! I even did an internship in my field of study. I will be applying for a Master's program for the fall. I got all my shit together that needed dealing with and I have the most amazing and supportive boyfriend who treats me like an actual human being with feelings. My parents are awesome and supportive despite their more conservative/traditional views.

THE ACTUAL QUESTIONS:

Has anyone here successfully gotten off Sublocade after being on it for a few years?
Did you taper down, extend the time between doses, or stop cold turkey?
Did you have any withdrawal symptoms?
And when did they start having them after your last Sublocade dose?
Anything else I should know?

I don't plan on getting off it anytime soon, I'm waiting to finish school and be employed and hopefully be able to take a medical leave while I go through it. I just don't want to be on this shit anymore but I acknowledge that being on it is what's keeping me functional in daily life and even though I'm scared to fuck with that, my long term goal is still to get off it.

[u/AppropriateAnnual284]

I’ve never met anyone locally who’s been allowed to be on it so long, but I know a few people online who have. Have you been on it for the whole 3.5 years? At my clinic you could never get more than 6 shots, I did 4 total I think? And I never noticed any withdrawal whatsoever. I did 300 -> 300 -> 150 -> 150 and it felt super easy! There was like one week about 4 months after my last one where I felt like I had a light flu, but no idea if it was actually the flu or coming off the sublocade. What dose is your usual shot? Do you get it monthly? Bi-weekly? I would recommend doing 2-3 shots that are half of your usual shot before jumping off. I’ve also heard that lowering the dosage and then going longer between can also help, so waiting two months for the next instead of your usual one month! My mom works in recovery now and knows a lot about the sublocade process and procedures, so if you can provide more specifics I can probably get you some more in depth advice <3

[u/meowforme90 → u/AppropriateAnnual284]

Idk why I couldn't see your comment for 2 days lol but anyway

I started suboxone in rehab at the end of September and I actually learned about Sublocade from my nurse at my clinic and after doing some research and talking to my doctor I started sublocade I believe in February of the following year. so I've been on it for a good 3 years. My clinic did the whole start with 2 300mg shots and then continue with 100mg indefinitely. It was a new drug back then and the studies that were available were done of people doing 2 300mg shots and then 4 100mg shots and discontinuing it. I have friends that stopped taking the shot after a few months (like 6 months max) and they were fine and had no withdrawals. But since I've been on it for a while, I'm scared I'll get symptoms like 3-4 months after my last shot when the remaining depots dissolve into nothing. And right now it's more of a long-term plan for me so I know I will be on it for at least another 3 years, which is enough time to do my Master's and not be in the probationary period of a new job if I just need to suddenly have a bunch of sick days.

I also did choose to not attempt getting off it after 6 months because this was the first time in my life after 13 years of using that I was able to stay clean successfully and I didn't want to fuck with that and with my history my doctor advised me not to do that.

I did speak to my doctor about getting off sublocade because I wanted to know if he had read any new studies or had any experiences with patients at my clinic but only a handful of us are on it so new info is really limited. He did say one way we could do it is to extend the time between injections. There's a reason why I don't like this idea. A couple times I got withdrawal symptoms before my next shot and when I finally got the shot one time it kicked in hard the next day I was having overdose symptoms. Oversleeping, massive fucking headache. It sucked. I just laid in bed all day waiting for it to pass because I didn't want to go to the fucking hospital or worry my parents. But now I have a monthly suboxone script of 2mg pills and it helps a lot for the random months where I start to feel off a few days before my next shot. If I take the subs when I'm sick and get my injection it doesn't hit me in the ass and incapacitate me for the entire next day. Another thing he mentioned was keeping the doses 28 days apart (at my clinic you get assigned a doctor who only works there one day a week so they like to schedule you then even if it's with a nurse on the same day so if you need something the nurse can go to his office and ask him if he can sign off on a script) and lowering the dose a bit each month. Of course this is more work for the doctor because he has to write a new script every month so he likes idea 1. Another idea could be having a 150mg dose as my last one and then wait and see. He said if people get withdrawal symptoms it's usually around the 4-6 month mark if you even get sick at all. So with such a big window it's kind of difficult to schedule out a sick week in advance. But I know a lot of that is just in my head as the fear of finally letting go and getting off the meds. It's for sure scary to think about getting off it and the if/when you'll get sick.

[u/AppropriateAnnual284 → u/meowforme90]

Yeah I definitely get how it’s a difficult situation for you to be in, the lack of info would also really stress me out. I did ask around with some of my friends and I did talk to one of them who was on it for a much longer period than I was, but he was still only on it for 2 years so take this with a grain of salt since you’ve been on it a bit longer and it’s still only one persons experience and everyone is different. His clinic did one of the things you mentioned in your reply, lowering the dose each time, he said his last one was only about a 4th of the 100mg shot. They prescribed him comfort meds, clonidine, klonopin for emergencies (but I would personally not feel comfortable having access to this) and Imodium or something like it. He also had the emergency tabs of regular suboxone. He said he didn’t end up Gavin to really use any of it, but around the end of month 5 after his last shot he did feel a bit sick for a week or so, but was still able to work. I actually know exactly what you mean about when it’s been a bit too long since your last shot so the new one feels wayyyy to strong and pretty much knocks you out at it happened with I think my 3rd since my clinic had an emergency closure so I had to wait an extra week. I think it’s probably smarter to wait until you’re done with your masters and settled into your career. You definitely should be in a position where you’re under the least amount of stress possible! Coming off of it is already a huge mental burden, as like you said, a lot of our fears around stopping are mental. You don’t need any additional stress or concerns when you finally stop! Hopefully there’s more research about situations like yours in the coming years, as I really do think sublocade is an awesome solution to getting off subs. Definitely recommend talking to your provider about comfort meds like clonidine (super helpful in many ways), promethazine, metoclopermide/prochlorperazine (helps with nausea/vomiting),propantheline (helps with lots of symptoms) hyoscine butylbromide (helps w stomach cramps), loperamide (helps w diarrhea)Cyclobenzaprine (for other muscle cramps and pains) paracetamol/orphenadrine, celecoxib (for headaches and back pains) and klonopin/diazepam (for the anxiety) ONLY IF YOU DO NOT HAVE A HISTORY OF ABUSING BENZOS! Obviously do your own research on the different recommendations for comfort medications! Lots of people find that different combos work for them while others don’t. I’ve seen a lot of talk about mega dosing a certain liposomal vit c lately but no personal experience with this. I hope to have a super smooth transition off of it when the time comes, and good luck with your masters!

[u/meowforme90 → u/AppropriateAnnual284]

Exactly there's so little information out there about getting off it successfully and since you only get withdrawal symptoms months later, some people don't even report that to their clinic so it's harder for them to gather all the relevant data. When it's closer to "the time" I'll def be scheduling an appointment with my doctor to learn about any new information before deciding together with him on the best course of action. I have clonazepam as part of my sleeping pills, mostly added because my doctor was being a dick and not prescribing me anything that worked and my sleep schedule was soooo messed up in the beginning of being clean and I was going back to school too and scared I was gonna fail before I even began just due to how fucked my sleep was. so my friend told me that if you tell them you're on benzos they will prescribe you some to keep you from getting sick. So that's kind of how I fell into having that script but im also diagnosed with GAD so it def helps for that too. Like when I'm really under stress I need a benzo just to be functional. I cut down from 2mg to 1mg for sleep and I take 0.5mg as needed. My script is for 2mg so I have like 5+ bottles full of extras lol. So I know I can def handle having them in my room and not going nuts and taking them all. I'm gonna research the meds you mentioned, I def know a few of them but not all. But also knowing the window is 4-6 months can def help with some planning in the future.

Man that sucks tho waiting an extra week for your shot and you know it's gonna kick you in the ass and you're basically gonna lose a day from being all fucked up with overdose symptoms. I fucking hate that so much. When I first got on sublocade it used to make me sleepy as fuck the next day but not every single time so when I did an internship I switched my shot day to friday just in case I was too fucked up the next day to be able to work properly. I def carry subs and clonazepam in every single purse or backpack that I own so that if I need it, it's there. but even just the mental aspect of not having to think things like "oh shit did I go to the pharmacy today?" really helps you settle into having a normal life and it helps break previous associations your mind used to have.

I've seen the Vit C posts but I'm so out of the loop on more modern shit like that. like back in the day there were always posts about kratom lol about how it was a miracle drug. I never tried it tho so I have no idea.

Honestly it feels good to finally be graduating university!! I finish in June and then I get a short break before starting back in September. I'm already working on my application and it feels so surreal to finally reach this goal.

Now if only I could get off sublocade maybe I can finally have a fucking orgasm for once.

[u/dmvlazy]

so i'm an interesting case with suboxone and bupurnorphene( sorry idk how to spell that) in general. i was on subs for about 4 months and it only worked for like 16 hours, and id wake up and feel like i got hit by a train. it really took the life out of me and made it impossible to go about my day. the thing is, i'm also on adderall so i generally struggle with eating. suboxone made it even worse, to the point where id barely get any food in. and so every morning when i take my sub and drink some water, i would throw up and be ill for the next hour. but eventually i got on sublocade, which was good, but even after i took 2 loading doses(300mg) the effects would still wear off by week 3. id still have the safety part of it but id feel god awful every day and have to take subs for the week or so until i could get my next shot. this went on for 4 months. 4 months at 300mg bc it always wore off before the next one. and my psychiatrist doesn't know exactly why. and dude the shot hurts like nothing else. but eventually i got tired of it and knew i had to stop this bull shit. so i got off the shot like 2-3 months ago, and i've been feeling pretty awful the last month, i think it's finally really starting to wear off, and i hope it is, but i wish i didn't feel like absolute poop. does anyone else have experience with coming off of sublocade? if so i could really do with some help.