Outfielder

Don't believe the blogs, Suboxone is not necessarily a trap. If you have a good Dr. with a good taper schedule, Suboxone is a way out of the insanity of opiate addiction. Suboxone can be a nightmare if you choose the wrong doc. let me know if I can help.

Lyoness

Hi Outfielder! I am two months on suboxone and next week will begin my slow taper. I had a huge oxy habit, was snorting and injecting and decided that my best, probably only hope of quitting was to do it with suboxone.

I would be very interested, as I'm sure would others, in reading about your experiences with suboxone if you'd care to post them. There aren't always a lot of positive things written about using subs to detox off of opiates so it could be really helpful to have you post about your positive experiences.

Take care.

Outfielder

Lyoness,

Some years ago, I developed a pain syndrome and thus became addicted to
opiates, primarily Vicodin. When I finally realized that taking 20 pills per day was not in my best interest, I decided to seek addiction help. My employment at that time precluded me from seeking in-patient options and frankly, I feared the stigma that goes along with seeking help for addiction; being that it's just not possible to disappear for 30 days without a
really good story to tell your associates. Anyhow, I found an old Addiction MD who introduced me to the wonders of Subutex (Buprenorphine w/o Naloxone), starting me at 24 mgs. per day.

This doctor said nothing to me about getting off of opiates and was perfectly pleased to see me on a monthly basis. I had no idea what I was getting myself into.

One year after first seeing him, the poor old Doc passed away. No problem. The crooked pharmacist that was selling me the Subutex was willing to sell me as much as I wanted at inflated prices. Lucky for me (or so I thought) no prescription was necessary. This continued for three years.

18 months ago, I decided that I no longer desired to be frightfully dependent on any opiate, so I stopped buying the semi-black market Subutex and found a new and qualified addiction specialist. By this time, the Suboxone films were readily available and my new doctor explained how I could wean myself from the Buprenorphine without too much discomfort. We set goals for dosage reduction and the doctor was very patient with me. As long as I didn't slip backward, he kept up the encouragement. With regular
drug testing (accountability), Clonidine, and low dose Valium, I have finally stopped taking Suboxone. I kept reducing the dose slowly and steadily until my jump off point 26 days ago which was 1/32 of a 2 mg. film (yes it is possible to cut a film that small).

I actually feel, and have felt really good since my last dose. No withdrawals...So, do I regret starting Suboxone? Sure. If I had known that I was embarking on a ridiculously expensive 5-year odyssey, I would have found another way. But, Suboxone can be a life saver as long as you find a responsible doctor. Lastly, don't believe what you read about it being impossible to get off the drug without suffering months of painful withdrawal. However, I am happy to hear that you are starting a taper. The sooner the better.

Best of luck to you Sis,
D.

Lyoness

Thanks Outfielder. My doctor is definitely responsible and does a 6 month total plan. The first two months has been finding my stable dose and then staying on that. Now that it's been two months the taper is beginning. This week I take one half strip less and next week a full strip less.

I know it's important to taper and I believe in it, but I also do have fear and trepidation. Less than two months ago, cuz I slipped after starting the suboxone, I was snorting and shooting up to 500mgs oxy and/or 50mg dilaudid. Super high dose, intense "delivery" method. So I get afraid because I still have cravings. I know it's up to me to keep on the path of recovery and reach out for help any way that I can. I'm just afraid because my addiction was so huge, it just was my entire life at the end.

But my doc said that I probably won't have any problems til I get to half my current subs dose. Not that I definitely will have problems, just that's where he's seen other folks have them. So I'm a little scared.

For now I'll start the taper and hope I keep adapting. Because along with my fear of relapse is my desire to truly be free of active addiction. I'm so grateful to SR and folks like you who help me on this path.

Outfielder

You're welcome Lyoness. You are correct, as the Subs dosage decreases, the cravings come back. Sometimes with a vengeance. I hope that you have a really good support system. Being a part of an NA group and a having a good sponsor can go a long way.

I avoided relapse because I would not forget where I came from and how hard I worked to get clean. This however will only work for a while and I will continue to work hard to stay clean as my situation changes. One thing that I failed to mention is that my doc recently put me on Buproprion, which is an antidepressant that has made all of the difference in the world. My addictions to a myriad of substances over the past 30 years, appears in a large part to have been driven by the need to self medicate for depression. Opiates will indeed alleviate depression. Treating my depression has also made it much easier for me to stay clean so far.

Anyhow, you seem to me to be a beautiful and caring person. Oxycontin and Dilaudid are not for you. They kill your feelings and emotions, and if they don't actually kill you, they will at least take your life away again. I'm sure you are tired of living only for that next pill or snort. You deserve so much more than that!

Lyoness

Thank you Outfielder for your kind words!

Also for your honestly sharing your experience. It is really good for me to know that the chance of cravings coming back, with a "vengeance" is real. It tells me I need to keep working on my addiction issues and getting my supports in place. I do need to address a lot of issues--physical and emotional. I'm actually on an anti-depressant, though I don't think it's doing much. Maybe time for a change there.

If it comes down to it I have another doctor who is willing to rx suboxone for a longer period of time--if it's the only way to keep me from relapsing. But I really, really don't want to have to do that. I feel like I'm in this delicate balancing act--I want the suboxone to work and to not need it longer than the six months. But I also want to remind myself that it would be better to be on subs longer than to go back to active oxy addiction.

For now I will just keep trying and building my foundation. One day at a time, right?

Outfielder

Lyoness, you're welcome again. Just a few thoughts. One is that I agree with you about the anti-depressant. You need to let your doc know that it isn't treating the problem. I wasted a bunch of time being treated with anti-depressants that didn't do a damn thing. Depression makes resisting cravings impossible.

I also agree that you are better off using subs rather than being actively addicted to Oxy. However, I would not use Buprenorphine for more than three months. Being a partial-agonist with incredible potency (25X-45X morphine), using it longer creates problems. You really don't want to get stuck on subs for 5+ years like I was. Have you ever considered Methadone? Google Dr. Steven Scanlan Suboxone and you will find an article called "Suboxone: Amazing Detox Tool, Monster Maintenance Drug." Read it. You will learn more about Suboxone than what most doctors who prescribe it know. You may need a maintenance period to work through your issues and to get yourself right. That's OK.

As far as building a foundation, one day at a time is concerned; we have no other choice, do we? Tomorrow is promised to no one and for that matter the future is merely an abstraction. Do what you need to do to stay sane and healthy today. That definitely precludes going out and using......Tomorrow I will start my 30th day clean. Freedom from opiates is so incredibly wonderful, I hope you get here soon.

Lyoness

Hi again! I looked up that Dr. Scanlan but couldn't find an article, only a short video on YouTube that wasn't very informative. Sounds like a good article, could you post a link maybe?

I need to get a new doctor as well as antidepressant. My old doc dumped me so for right now I just have my subs doc. I can go to the pain clinic, I think, and maybe I'll discuss antid's with them.

I keep having such mixed feelings about suboxone. I don't want to stay on it too long and I definitely don't want to get addicted to it either. But I don't even feel ready for tapering yet either. I feel like I'm still trying to get stable. It's all so confusing. I just know that I'm scared of how addicted I was to oxy/dilaudid and I want to do what I need to keep from going back there.

You mentioned methadone, I haven't tried it. Do you think it's better than subs for maintenance period?

Outfielder

Hi Lyoness,

Here's the link:

Suboxone: Amazing Detox Tool, Monster Maintenance Drug | Guinevere Gets Sober

It's a good interview and Dr Scanlan discusses Buprenorphine vs. Methadone maintenance. The blog that the page is on is called "Guinevere Gets Sober." It is one of the best sober blogs I've seen. Guinevere (not her real name) is a writer that was addicted to Fentanyl. Browse the site, it has a lot of good stuff.

You need to prevent relapse. Injecting Dilaudid or Oxycodone is like playing russian roulette. I just really don't think that Suboxone is the answer. I feel as though I lost a piece of my soul due to my 5+ year Suboxone use. I just don't feel the same. Sadly, I'm afraid that it will never come back.

You should be able to work out your antidepressant issues with your Suboxone doc. Proper addiction treatment often requires that underlying mental health problems are also properly addressed. My Subs doc. prescribed the Buproprion (Wellbutrin) I am taking and it has been a life saver.

Anyhow, Happy New Year!!

Lyoness

Happy New Year to you too! And I really appreciate our dialogue here!

I did end up finding the article on my own, but thank you for posting the link, it could help other folks!

I liked the article, I wish it had been longer and more detailed actually. Understanding the brain stuff is vital to me. Really helps me with everything I deal with including depression, PTSD, etc. So I would've loved for him to be even more detailed and lengthy!

I'm feeling confused about suboxone right now. Ugh! Unfortunately my subs doctor ONLY rx's subs. Having a primary care doc was one of the qualifications for seeing him. Sadly my doc dumped me right before I started with subs doc so have no one at the moment.

I admit that the article made me curious about using methadone for maintenance. That point about how the receptors are only partially filled and yet subs is so potent really got me thinking. I'd just been scared away from MMT by people saying it is really hard to get off of too. But I know right now without something I'll be back on the needle before I can blink. And probably on H, too. So......

Lots of thinking for me to do.

Thanks again!

Outfielder

I really apreciate our dialogue too! I'd say that I feel like somebody who was given something that is really precious. I now hope to pass it along to as many people as I can. I can't even begin to tell you how good it feels to be standing on my own feet, getting through my day without drugs or alcohol numbing my senses and feelings. Sobriety truly is a gift.

I truly understand the position you are in, you have to make do with the available resources. It's sad that our system spends untold billions of dollars on the "drug war" but spends little on the only effective strategy to reduce harm and addiction, which is treatment. If our legal system and society were truly humane, any addict would be able to easily walk into a government sponsored clinic, and get effective treatment at no cost to the addict. This would cost a tiny fraction of what drug interdiction, crime that addicts commit to afford their DOC, law enforcement, the legal system, and jails and prisons cost our society now. It's a disgrace that methadone clinics are not easily accessible to any addict that wants to get clean.

Anyhow, subs is way better than shooting oxy or dilaudid or H. Take it from somebody who used subs for over 5 years; you need to find the smallest dosage that will keep you comfortable and will arrest the cravings. I hung out on a really high dose for a long time needlessly. However, my deliverance only came when I finally got effective treatment for my mental health issues. You need to fight to get your depression and PTSD treated. Depression was the barrier that prevented me from getting off the subs.

Anyhow Sis, stay clean. I wish nothing but the best for you.

Lyoness

Thank you! And I agree so incredibly much on the utter disgrace of our entire drug war. It is truly just a war against those of us who take drugs. The cartels, huge dealers, etc. pretty much have full government backing. Yet someone has an ounce of pot and goes to jail for 10 years?! It's one thing that sends me into full blown rants.

There is evidence, too, in the way of Portugal. They decriminalized everything and started funding treatment and they've had radical changes, drug crimes, drug addiction rates have plummeted. I only hope our country and society will one day be that humane!

My feelings keep going all over the place with the whole maintenance therapy thing. Also, I hadn't articulated it to myself exactly, but after reading that article I realized the suboxone is blunting my mood. I truly want to be off all of this stuff. I'm just sick of thinking about it. But I also know I am an addict and I better take this seriously.

I have actually done years of therapy. I have a HUGE onion, layers upon layers to peel. So now it's new levels of healing that need doing, healing my addiction is both a symptom and a cause and most definitely a catalyst for more healing.
Did you do anything along with your antidepressant or did that really take care of it for you?

I'm starting to really research herbal medicines, too (I don't include marijuana since I was addicted to that years ago). I actually studied at an herbal medicine school twenty years ago. I sort of let that slip by. Now that I'm looking for alternatives for pain relief, to help mood, to help with withdrawals and cravings, I'm finding there are tons of medicinal herbs available. That little pink pill was just so easy.....and warm and pleasant...... Now it's time to fire up the old brain and get it working again.

Outfielder

I am very familiar with the unqualified success of drug decriminalization policies adopted in Portugal. Decriminalization was adopted there in 2000, and the data is in. Portugal has gone from worst to first in the EU. By every metric, Portugal has the lowest rate of drug problems (addiction, crime, law enforcement, imprisonment, etc.) in the EU. Sadly, the US of A will never adopt sane drug policies. The "drug war" is far too profitable for the major multinational corporations and concentrations of private capital that own and run this country. The for-profit private prison industry would block any attempt to decriminalize drugs. The huge corporations that provide the DEA with what is needed to destroy poppy fields in Afghanistan or coca plantations in Columbia have bought and own the political class and will never allow the loss of profits that they get from the US taxpayer. We addicts are pretty much screwed. I know that this may all sound very cynical, but I'd challenge anybody to refute any of the claims that I have made.

As far as my mental health goes, no, medication is not the only thing that I've done. I had my first major depressive episode when I was around 20, and have been in therapy, have taken antidepressants, and have also self medicated ever since; in differing combinations at different times. When therapy and antidepressants wouldn't work, I'd start using Meth. When my life would become unmanageable, I'd clean up and go back in therapy. Opiates were merely the latest episode of self-medication that lasted the preceding 11 years in total.

I'm 50 now, and I started noticing the anxiety (which always accompanied my depression) decreasing over the past few years. Wellbutrin, which is a drug that no psychiatrist ever prescribed to me because they all said that it wasn't strong enough, has lifted the depression more effectively than anything I've ever tried. So now, I am not in therapy and am just taking the prescribed antidepressant. Keeping my fingers crossed.

I think you are starting to notice the insidious nature of Suboxone. The blunting of mood (emotions) is very subtle at first, but becomes progressive over time and is definitely dose dependent. That is why I say that you should take the smallest dose that keeps you comfortable and clean. You'd be surprised how little will work. I still felt fully medicated until I dropped below 1/2 mg. per day. 4-8 mgs. is a whopping dose. Just know that if the drug company (Reckitt Benckiser) wanted addicts to be able to wean from their product, they would make 1/2 mg. and 1/4 mg. films. They only make 2 and 8 mg. films which is ridiculous.

As far as herbal remedies goes, I'm not well versed. I do know that some people swear by them......Anyhow Sis, this rant has gone on too long....Keep your chin up! and peace

Lyoness

Keep on ranting! I figured you probably knew about Portugal and I sadly agree with everything you say about the profit motive. Yet another place where greed kills!

That's why I think it's so very important that we all help eachother! We share our experiences, our knowledge, our support--that's ultimately what helps any of us make it I think. I know without SR I'd have probably slipped a whole bunch more than I have!

Sounds like we share other things in common, too. I'm 49, getting myself psyched for turning the big 50! It's not for quite awhile though. I'm looking forward to getting discounts on stuff, lol! I also really like the idea of being clean in my 50s--having a whole decade clean. Never had one except from infancy til I snuck my first cig and taste of booze at 10.

I"ve had major depressive episodes all my life, and done the requisite self-medication--booze and benzos in my teens, pot and lots of exploring in my twenties, fairly clean in thirties and now major opiate addiction in my 40s. I always say it's a good thing I didn't try heroin, I'd probably not be here now if I had. Though I do believe that oxy is the synthetic heroin. It's certainly taken a lot of people down.

I tried Wellbutrin in my thirties, didn't work well for me. Glad it's working so well for you!

You've got a great point about the suboxone not coming in smaller sizes. I think it should be free to anyone who needs it, not cost the insane amount that it does. I am deeply grateful--and surprised--my ins. covers it. Otherwise no way could I afford it. My income isn't much more than a monthly subs would cost.

It's funny, I've been afraid of the taper. Now I'm wondering how swiftly I can taper without causing myself problems. I really don't like the mood blunting thing. Lexapro worked well for me in certain areas, like helping with pain, but it really blunted my emotions and I didn't dream either.

Another question for you then I'll post this--I know you have depression with/without opiates, but did you find any part of your depression lifted after going off the opiates even before you got on Wellbutrin? I know there's lots of facets and we're all different, but it really helps me when I have a sort of timeline in my head. Knowing that there's an end to it, one way or another, helps me keep on keeping on. Thanks.

marty83

Spot on, that is all I have to say

Outfielder

Lyoness,

Here's sort of how things happened for me. In 2001, I had a pain syndrome that could not be alleviated by surgery, so I ended up a regular client at a pain management clinic. I think I was taking Effexor at the time but I don't think that I could have even BS'd myself into thinking that it was doing any good. I found that once I started taking Percocet and MsContin (Time released morphine), I had no need for the antidepressant and the therapist. In 2003, the pain syndrome (sciatic neuritis) resolved so I no longer needed the pain management clinic.

So, rather than dealing with my mental issues in a legit way, I started buying opiates on the black market and was gobbling handfuls of pills each day. You know the story about the Suboxone. I have not experienced my mood without opiates or Wellbutrin since 2001. As my taper progressed, I came up against a wall as I tried to reduce dosage below 1 mg. The depression came back with a vengeance every time I reduced below 1 mg. So in June, my subs doc put me on 450 mgs. of Wellbutrin daily, and it hastened the end for the subs. I could now drop the dosage without experiencing the depression.

So, it wasn't the physical discomfort that prevented me from getting off subs (I did a super-gradual taper), it was depression. Really, I didn't feel any notable physical discomfort during my taper until I went from 1/2 to 1/4 mg. but it wasn't that bad anyway.

To answer your question, I'll quote an article I came across:

"Opiates are powerful narcotic drugs that are used to treat mild to severe physical pain by some, opiates are abused for the powerful effects they can have the body by some, and some opiate drugs, like oxymorphone are used to treat certain depressive disorders. Depression is a mental disorder that is characterized by a chemical imbalance that causes a person to feel constant feelings and emotions of sadness. Depression hurts, opiates relieve pain. It makes sense why opiates and depression are often paired together. When people suffer from the terrible disease of depression, opiates offer relief, and that is very attractive to a person in a very dark state of mind."

This is probably why you and I loved opiates......So, I wasn't depressed when I had plenty of Vicodin, Percocet (Oxy) or Suboxone in my system. Now I am not depressed with the high dosage of Wellbutrin I am taking. All else equal, I'm sorry to say that it is my opinion that your depression symptoms will worsen as your subs dosage decreases. This is why your subs doctor needs to consider your underlying mental issues and not just taper you to zero. That is a prescription for disaster.

Anyhow I wish you the best Sis; I'll send some healing mental powers your way right now. If you feel warm as you read this, it's me

Lyoness

"Anyhow I wish you the best Sis; I'll send some healing mental powers your way right now. If you feel warm as you read this, it's me "

That made me think of Steve Martin saying, "Feel the warmth of my sincerity" (or something close to that anyway). So, made me feel warm, good and gave me a chuckle remembering that! Thanks on all counts.

Wow, I gotta say the addict in me leapt and shouted, "SEE we can do this!" at the mention of oxymorphone treating certain depressive disorders. I've never taken it, but it was on my "to use" list, if you will.

I'm thinking you're right about the likelihood that depression will probably really rear its ugly head as my subs dose goes down. I'm not going to "create" it, but I really do need to get some supports in place, like a different anti-d before going off the subs. Plus I read a great post about depression in the Newcomer's area and realized that right now I have nearly every symptom of depression--even though I thought I was feeling better. After a lifetime of Major depressions, I guess I'm not even clued into the ongoing dysphoria level.

I will have to talk to/get another doctor, though. When I say this guy sticks to his protocol, I mean it. He will only rx the subs, that's it. The more I think about it, the less I like the way this particular program is set up. But it's the only gig in town, so.....

All this makes me want to crawl in bed with chocolate and not get up for a few days. Recovery is exhausting!

I'm glad to hear your sciatic neuritis cleared up. I'm not familiar with it but it sounds painful. And I also totally understand how you kept on with opiates after the pain was gone. They are great until they stop being great.

Here's my next question for you... I know we're all different and I'm not asking medical advice, but in your experience what was the biggest dosage drop you could do at any one time without having any, or almost no, symptoms?

Thanks again. Peace.

Outfielder

Lyoness,

Sorry for the disapppearing act......the s*** got pretty thick lately...anyhow, I found that when I was at 2 mg. or above, I could do 1 mg. stepdowns with little or no adverse effects. What needs to be understood is that Buprenorphine is potent as hell. In Europe where it is used for pain management (moderate to severe pain) it comes in .2 mg. dosage sublingual tablets (Temgesic). That is 1/10 the smallest Suboxone dose. I generally felt a little edgy when when I stepped down, but it was really nothing. I would then get accustomed to the lower dose for at least a month before I stepped down again.

The worst step was from 1/4th to 1/8th mg. but even that wasn't much. As my subs doc always used to say "slow and steady always wins the race."

Lyoness

Thanks! This is the first time I've been able to be on SR in two weeks. I've sorely missed it!

My doc has me dropping 4mgs every two weeks. I was on full 32 mgs because I was taking so much oxy. I really didn't think the subs was helping with pain, but my pain is increasing so maybe subs is playing a role in it.

I am feeling nervous about these next jumps down to really small amounts. I read that tiny amounts are used successfully and I want to believe it. I'd much rather be on smaller dose. But I am afraid, especially as I am having a lot of stress in my life right now.

It really helps to read what you post, it gives me perspective and something to think about to try to halt my fears.