What Can I Expect on Day 1?You will need to be in at least mild to moderate withdrawal. This means you will have dilated pupils, sweats, chills, nasal stuffiness, watery eyes, irritability and possibly stomach cramps and diarrhea. More specifically, you will have the first few symptoms that are unique to you. Do not take the medication until you are certain you are in at least mild to moderate withdrawal. Tell your doctor what is typical for you when you are experiencing withdrawal.
You will learn how to take sublingual medication, which means medication that is taken under the tongue. There are large blood vessels under the tongue that give direct access to the bloodstream because there is only a very thin layer of skin covering those vessels. Relief of withdrawal symptoms is achieved quickly when this medication is administered under the tongue. It is less than 20% effective when swallowed and may even cause nausea. Take the time to learn how to take it properly. The taste is bitter so it may be useful to have a bottle of juice, soda, or some hard candy available to take after the medication is dissolved.
You will be given medication to take home. You will need to take your medication the same time every day, and the full dose each time, unless your doctor has a reason to have you take it differently.
You will probably sleep very well the first night and the nights thereafter. The exception is if you have a history of sleep problems.
You will receive your appointments for subsequent visits. You will be given information to read that is specific to being a patient in that practice.
Day 2:You will begin to experience an increased confidence in how to take your medication and in the ability of Buprenorphine to make you feel better.
You should be able to return to work.
You will be actively working toward avoiding the people, places, and things that make you think about using.
Day 3-7:You will need to continue actively working toward avoiding the people, places, and things that make you think about using. You will notice the medication working. By Day 5 you should feel normal, like you did before you started using drugs.
Week 2You may be experiencing the “honeymoon” stage of your recovery. You will have a sense of hopefulness because you feel like you are in control and all is well again.
Do not become so comfortable that you become lax in your routine of medication administration. Take your Buprenorphine in the fully prescribed dose at the same time every day unless your doctor has instructed you otherwise.
This is often the week some patients test the blocking effect of the Buprenorphine. They use drugs to see if it really blocks the effects, or just reduce them as with methadone. Whether you test it out yourself or learn from other’s mistakes, the result is the same. The Buprenorphine completely blocks other opioids and not only do you relapse but you receive no high and waste the money spent on drugs. Once you realize this, you find you no longer need to constantly debate between use and sobriety. If you wanted to use, you would have to be off the Buprenorphine for at least 3 days. Hopefully you would have one strong moment in that time, and take your Buprenorphine.
Week 3:Old drug using friends may start to come around thinking that by now you are ready to come back to your old ways. It is important to be strong now, and although it is easier to do so on Buprenorphine, it still will not be “easy”. Stand firm. When they see your success you may be able to help them to find the same way out. Some people will never quit using. Needless to say, their lives will be shorter than they have to be.
Week 4:Perhaps it has been difficult for you to get a job or solve a relationship problem. It may become difficult to remain optimistic now that a month has gone by. Work with your counselor to make small goals and accomplish them so that you don’t lose heart. Many bridges can be burned with prolonged drug use. It may take quite a while to recapture your relationships and financial stability.
Months 2 and 3You will be comfortable about taking your medication by now. You should expect to have a well-established routine with regard to doctor appointments, counseling appointments and taking your Buprenorphine at the same time every day.
Like most other patients you will just feel normal.
Problems that came into existence due to drug use may be a tough reality to face. Face them anyway and you will know what it is like to be successful and strong in adversity. This will be a skill you will be glad you have, over and over again.