Increasing Alertness on Opiates

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All-Seeing Eye
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Date Joined Oct 2010
Total Posts : 201
   Posted 11/18/2011 9:40 AM (GMT -6)   
I've been on subutex for about a month now (2mg a day) and the lethargy and confusion is really getting to me. I seem really out of it during the daytime and I want to drink caffeine to increase my alertness but caffeine is contradicted in patients with Lyme disease. It makes me feel pretty bad.

What things can increase alertness/reaction time on opiates?

I've tried excercise, multivitamins, amino acids, ashwagandha, ginseng but none seemed to lift the fog like caffeine does.

Veteran Member

Date Joined Oct 2010
Total Posts : 924
   Posted 11/18/2011 1:47 PM (GMT -6)   
I don't suffer from opioid based fatigue (they, rather, tend to have the opposite effect on me). But my PM recommends: 2000+i.u. of Vitamin D, 200mg Coenzyme Q10, 5g D-Ribose. I take all these at dinner.

Also, consider Provigil, a prescription medication that patients with opioid based fatigue are sometimes prescribed.

One other thing to consider is the timing of your medication. Maybe take it at night if you're not already?
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

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Date Joined Aug 2006
Total Posts : 9661
   Posted 11/18/2011 10:59 PM (GMT -6)   
You need to let your doctor know whats going on and maybe it's time for a newer medicine
or a medicine at your next appointment have your question/concerns written down
and take them with you...maybe you could be switched to something else...
Many well wishes and keep us posted...
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...

All-Seeing Eye
Regular Member

Date Joined Oct 2010
Total Posts : 201
   Posted 11/22/2011 3:16 PM (GMT -6)   
I have tried B12 and I take 5,000 Iu's of vit. d a day (at least). I ran out of riboflavin a while back and I know coq10/ubiquinol helps a lot. Does the ribose/riboflavin help in particular?

I have talked to my doctor already and the only thing he can do is recommend taking the dose at nighttime.

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Date Joined Dec 2007
Total Posts : 1230
   Posted 11/22/2011 8:57 PM (GMT -6)   
You may need far less than the 2 mg dose that you are currently taking. Most patients taking subutex for pain control find that less is more when it comes to pain relief.
Talk to your doctor about the side effects, they should lessen over time, rather than continue or worsen and he may be willing to reduce the dose and see how the pain control is with less of the medication.
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