It was raining today down at the airport, so I wasn’t sure if I was going to fly, but we did go up — there was a cloud layer blocking the sun and with no wind or turbulence I think it was the calmest day I’ve ever flown on. Today was more spins and spirals which are a ton of fun. I was in a lot of pain yesterday and today when I got up, but going flying got my mind off it and made me feel much better. I feel very comfortable in spirals and pretty much all aspects of flying, but I’m very sloppy when it comes to proper protocols (checks, radio work, etc.) so I really have to focus on the “boring” end of things so I can write my student/radio tests and get ready for my full license test.
I’m working as fast as I can on the license, having a surgery coming up (biopsy on my legs), as well as what I think will be a very unpleasant week or two in the hospital as they shift me over not to methadone as originally planned but Subutex (buprenorphine). It interacts badly with the opioids that I’m currently prescribed, so they have to put me through full withdrawal, and as you can imagine I’m not looking forward to that one bit. For me this is for pain treatment, but it’s commonly used for heroin addiction and so on a la methadone — if anyone has gone through this process — for either pain or for addiction — please drop me a line by email or friend me on facebook (but include a note so I know who you are), as I’d like to hear firsthand what to expect.
I still can’t believe I’m colorblind by the way. I am sure that I can see all the colors… I think it’s just some neurological problem I have with the Ishihara tests. I’m sure in some ways that is bad too, but won’t stop me from flying at night at least!
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from what i understand a medically supervised withdrawal/detox is fairly tolerable. haven’t been through it myself, but i have read and watched accounts of people who have, and apparently they are able to make the patient quite comfortable during the process.
what is your name on face book…mine is Jamie Purzol used to be s_a_h_mommy back in the day :) add me if you’d like!
I can’t believe you’re going on bupe for pain management! I’ve been on methadone for about 2 years now for addiction (oxycodone, mostly, and with some real chronic pain issues as a base issue) and it’s been a lifesaver, not only in terms of controlling addiction but also in terms of pain control. In recent years, methadone has really started to be used for pain a LOT as it works well, lasts 24 hours, and is super cheap, even without insurance (at the pharmacy anyway — not the clinic!).
Do the doctors think you have an issue with addiction at all, or do they REALLY think bupe is your best bet for pain? Considering it’s only a partial opiod agonist, I believe it’s pain management abilities are somewhat limited, especially if you’re switching from strong opiates. I’ve been afraid to switch for this reason, along with the fact that I’d have to slowly drop my methadone dose to about 1/4 of where it is now AND go into full-blown withdrawal (multiple days without any methadone at all) to make the switch — a lot to go through just to find out if it works for me or not!
Keep us updated, but if I were you I’d try my hardest to convince the docs to try you on methadone first…it’s almost guaranteed to work for you as compared to bupe.
Before subtex was used for opiod addiction treatment it was used for chronic pain management… it has a number of positives over methadone (safer, less interactions, less stigma and less legal issues for possession/travel/etc) so I think that’s the motivation on giving it a try first.
AFAIK it’s quite difficult to do any lengthy travel with methadone, but it can be done with subutex… I don’t want to find myself in a situation where I’m restricted like that, and the doctors know that, so they’re working to find a solution for me with minimal encumberment. I will definitely post about how well it works — reading other people’s comments online I see lots of people who get bad results, and lots of people who get great results, so we’ll see.
I think there’s a lot of politics involved too, because there’s so much overlap between people who are getting chronic pain treatment, and people who are dealing with addiction issues.
You’re very correct about stigma and politics related with all of this, especially methadone. Luckily, travel isn’t an issue for me, even though I’m in a clinic setting — right now, I get 2 weeks worth of medication at a time, and I could technically move up to monthly pickup if I wanted (I get paid every two weeks, so it works out OK as-is). When I first started on methadone and had earned only weekend take-homes, I had to travel to California for work for a handful of days, and I was able to have my counselor request a state exemption so that I could get a handful of extra take-home doses. I’ve been able to travel a lot in the states via commercial airlines with it in my carry-on as well as taking a week-long trip to Mexico with no problems. I did take a letter from the clinic physician with me to Mexico stating that I would have severe health problems if I didn’t take my medication every day, etc., but I didn’t need it — nobody said a word. Obviously certain countries would be a major problem with methadone, however.
I know about bupe being used for pain before addiction, but I was under the impression that it’s not all that great as a painkiller because of its partial agonist/antagonist qualities — it only works up to a certain point, unlike most opiates where you can basically keep increasing your dose and get increased results. Because of this “ceiling effect” (which is at about 32mg), if you have severe pain or have been taking strong opiates for quite awhile, I wonder how well it will help. But, as with everything like this, it’s different for each person.
I know when you’re on a medication like methadone with a VERY long half-life, you have to go a few days off it before switching to bupe…but if you’re currently on a short-acting opiate (or can be switched to one — switching to regular oxycodone from time-released oxycodone like oxycontin, for instance), you can make the switch much, much faster, since the shorter-acting opiate will leave your body much more quickly, so you don’t have to wait nearly as long to be in full withdrawal and take your first bupe dose. I’ve read that 24 hours should be plenty of time to wait after taking your last dose of a short-acting opiate, compared to multiple days with methadone.
All that being said, I can see one HUGE reason why your doctor might want to try bupe before methadone — it’s far easier to see if bupe works for you now than it would be to try it after you’re on a high dose of methadone. You’d have to taper down to 30mg from whatever dose you had titrated up to, then play the multiple-day dopesick waiting game to switch to bupe…it’s FAR easier to try it now and then simply switch over to methadone if the bupe doesn’t work for you. Good luck!
I was on Lake Ontario sailing yesterday and couldn’t help but wonder if you were one of the brave pilots doing touch and go exercises on the island.
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