I’m sorry, those of you who have been reading this site for the past couple years, to go through this once more… but I have another of THOSE messages, and it has been, what, a few weeks since I discussed the short-term/long-term issue? Rest assured that I spare you, the reader, more times than not. I suppose I could tell the writer of the message (the one I am about to share) that he could search the blog for ‘foolish pharmacist’ or any one of a dozen other posts about the topic and spare me from writing and all of you from reading… but he probably wouldn’t do that. So in my typical fashion I’ll post his message interspersed with my comments.
I want to add my perspective on Suboxone. I think it is a great medication but ONLY if used in conjuntion with therapy. It is NOT an anti depressant. It is an OPIATE type medication you are putting into your body with an additional ingredient to block the “high” you get from regular narcotics. The mentality of staying on it “for the rest of your life” is NOT good.
Right off the bat, the writer makes a common mistake– which I’ll get to in a minute. Of course it isn’t an antidepressant– I would hope that every regular reader of the blog knows that. Yes, it IS an ‘opiate-type medication’– but so what? I can assure you that the molecules that have little opiate labels hanging on them are no more evil than any other molecule! Vivitrol and Revia are ‘opiate-type molecules’ as well– both are trade names for naltrexone, for injection or as a pill, respectively, and both indicated for treatment of alcohol dependence. There is no logical connection between ‘it is an opiate’ and ‘the mentality of staying on it is NOT good’– your body doesn’t know ‘opiate’ from ‘indole-amine’ or ‘butyrophenones’ from ‘thioxanthenes’– they are just names of broad categories of molecules. Don’t get hung up on labels– they don’t mean anything to the human body. As for the mistake, the main ingredient in Suboxone is buprenorphine, a chemical that has been used for about 30 years as an analgesic with partial-agonist effects at the mu receptor– as you all know. People who take Suboxone properly do not get ‘high’, and again, mentioning ‘high’ in the message only confuses the issue. The added ingredient, by the way, is naloxone– a mu receptor antagonist. ALL of the effects of Suboxone are due to buprenorphine; naloxone is added to deter parenteral use of Suboxone. Naloxone has no important effect for the regular use of Suboxone.
Don’t get me wrong, my partner was put on it last July and it pretty much saved his life as far as I’m concerned. HOWEVER, when the doctor put him on it he said it would help “heal his mind” if used in conjunction with therapy and after 3-4 months would begin to taper him off of it. Well, he went on a business trip and accidently left it behind at one of his stops. He had to be without it for about 5 days and it was hell but as soon as he got it back and resumed he was fine. He shared this with the prescribing doctor who IMMEDIATELY said “Well, you need to be on it longer then since you had such a bad experience being off of it.” There was then NO treatment plan made. Doctors seem to have a sense of vagueness about them when they prescribe this NARCOTIC medication as to what the treatment plan is.
That’s a pretty broad statement about us doctors! I don’t think that doctors who work with addiction and Suboxone are any more ‘vague’ than other doctors; I read complaints about doctors of all specialties at the forums I write for at medhelp.org and elsewhere. I do think that medicine in general has gotten away from the interpersonal relationships that were once a significant part of the doctor-patient bond, but that is a general observation and not specific to addiction treatment. As regular readers know, I am an opiate addict, and have been for the past 16 years; I know enough about the mindset of other opiate addicts (I often point out examples of how alike we all are!) to wonder about the communication between your partner and his doctor. We addicts have very selective hearing, particularly early in the treatment process– so I am reluctant to draw too many conclusions from the ‘he said this’ claims of another opiate addict (like me– did I mention that?). In other words, I don’t know what the doc said, and to be frank if you weren’t there, you don’t know either. I doubt that your partner does. I don’t mean to be insulting; I’m just telling it like it is, based on working with addicts every day for years, on or off Suboxone.
The reason I am writing this is because what I have observed with longer term use is that my partner was constipated DAILY, slept at least 10 hours per night AND took naps. He did not enjoy excercising as he once did and gained weight. He was mellow and sober but at the same time was not himself. He has been tapering off slowly and is down from 4 mg per day to 2 mg per day. He is not constipated daily any longer, now does fast walks with me every day and passes me up just like the old days. For a while I was out walking him and I hate excercise.
You are attributing all of those things to Suboxone?! How about your hatred of exercise– what is that from? Your partner was in the process of trying to stop one of the most addictive substances that there is; opiate addicts LIVE for using opiates! For an opiate addict there is but one concern in life– how will I avoid getting sick in four hours? So here we have your partner– a person who is by all practical sense gravely mentally ill (I could easily argue that the loss of insight and near-delusional obsession to use causes ‘insanity’ as great as in any other psychiatric condition!), and in a span of a few weeks to months has had a dramatic change in his life– suddenly the crutch that occupied his entire mind has been removed… and you are complaining that he doesn’t like exercising enough?
Today I had a patient who recently started Suboxone and now is having panic attacks. I explained to him that months ago when he was burglarizing homes and stealing from relatives, he had no worries– because all his mind could think of was using. Now his mind has been freed from the obsession to use– and all of a sudden he has to think about all of the people he harmed, the consequences that he is facing, etc– so of course he is having anxiety and panic! Heck, he would be crazy not to!
The writer is blaming Suboxone for the partner’s issues– when the blame should be on his addiction! It is VERY early, and there are so many things going on those first few months that ‘enjoying exercise’ is a bit silly. He is trying to recover from a fatal illness, for Pete’s sake. As for the constipation– I’ll give you that. That is probably from the Suboxone… but I consider it to be a minor side effect for treatment for a fatal condition– compared to chemotherapy it’s a great deal.
To sum this up there are no guarantees when it comes to sobriety but to preach horrible relapse statistics to anyone deciding to come off of this NARCOTIC medication is WRONG. Now, if this was something more like a Prozac type medication I would probably better support the “rest of your life” mentality of being on this medication.
I’m not sure how we got from the beginning to your conclusion– you basically say that your partner is addicted to opiates, a horrible condition that destroys and often kills those who suffer from it– he took Suboxone and it ’saved his life’… but it made him constipated and he slept too much and didn’t like to exercise– so preaching relapse statistics (correct ones, by the way) is WRONG!. I don’t get the logic.
The writer is missing the point in a way that is all too common. The writer blames the ‘rest of your life’ situation on SUBOXONE. But the truth of the matter is that OPIATE ADDICTION is a life-long condition! Suboxone isn’t the ‘rest of your life’ issue; the partner’s opiate addiction is!!
Before Suboxone, opiate addicts like me had a life-long condition that had no good treatments. Yes, there is NA and AA– they ‘work if you work them’, and I have worked them for a long time. But twelve-step recovery has ALWAYS been for the very few people who are lucky enough to ‘get it’ before dying from the disease of addiction. And people in twelve-step recovery tend to relapse over time, and before Suboxone, relapse was often permanent– many addicts could never get back the sobriety that they once had. Now we have another option. But neither Suboxone nor step-work are cures. And to be frank, there is no ‘therapy’ that cures opiate addiction either. Yes, therapy is indicated for some patients, but some others do very well without significant therapy. I do see all patients for at least 30 minutes for every appointment, as there are always things to discuss– but I disagree that EVERY patient on Suboxone needs therapy– just as every patient on meds for bipolar disorder doesn’t need therapy.
If anyone is interested in the issue of Suboxone versus ‘traditional recovery, please read my article on the topic. Just Google ‘Suboxone’ and ‘traditional recovery’ and you will find it very easily. To the writer– I’m sorry your partner is an opiate addict. That is a tough life for anyone. But Suboxone allows many of my patients the chance to live as if they DIDN’T have a fatal illness. Many of them tell me that they don’t feel like addicts anymore– they feel like ‘regular people’ with just another illness. And that is a major paradigm change from traditional treatment and therapy, where the point is to get the addict to identify very strongly with the addict label. I think there is room for both types of treatment. In fact, after 16 years of being an opiate addict– it’s about time!!
THIS IS FOR ANYONE SEEKING SUBOXONE TRURH OR TREATMENT!First off i have been taking suboxone for the better part of four year`s.In 2002 i was diognosed with eociniphillic granuloma advanced stage i was given 9 month`s to live.I was very lucky and the affected area was removed over 1 1\2 inches of my scapula was removed as well as this much from my femur.I was 1 of only a hand full of people in the world or so i was told by dr.william ward at bowman grey hospital in wake forest\chapel hill in N.C.I HAD ALSO SKIPPED THE HISTOCYTOSIS X which is apparently the tell tell sighn of this affliction progressing later in life.Anyway the operation was a success and i have lived a good life but i was put on percocet 10\325 for many years after the surgeory because of the pain that comes and goes due to the bone that was removed from my body and the unusual scar tissue that was left behind.I tryed to reduce the use of pain medication by asking my doctor to try something else for i was seeing bad side affects from the oxycodone(constipation,headachs,sleeplessness,weight loss and so on).He tryed hydrocodone needless to say i had to take alot more and the relief was not sufficent from the pain.So roughly 4 yrs ago a good friend of mine who had back surgeory due to wound he recived in desert storm and had been on percocet for many yrs told me that his dr. had given him an alternitave to the percocet in the way of suboxone he explained suboxone being basically a synthetic opiate it will in fact control pain to a certian level.Now suboxone has been marketed more or less as a detox from opiate dependance and based on my research was administered to opiate addicted vetrans as a sort of testing procedure before it was available to the genral public now i dont know for sure how much of thr prior sentence is true about it`s origins either way it is not really relavent but what is is the level of addiction that comes with suboxone use which finaly brings me to the subject.I took my first suboxone from athe friend mentioned earlier.He had offered me one to try andwas very thurogh in the application of the medication as i took it exactly as he directed and within 20 mins my life changed and now i would say probaly forever.For the first time in 6 yrs i felt good about myself did not dwell on my bone cancer which that is basicaly what eociniphillic granuloma is i had energy i had drive and the want to live and decided my life was not on pause any longer and could pick up the dream chaseing again i started a buissness that 4 yrs later is very profitable and for the first time in my life have finacial freedom.Also i no longer had to carry a clacking bottle of pills in my pocket any longer but the best thing was suboxone controled my moderat pain to the point that a simple ibprofen was all i needed from time to time.When before i would take as many as 20 ibe`s aday.Now i have ran into some dr`s that will argue that suboxone dosent offer any pain relief but just ask these dr`s how many suboxones do they take a day and they will say none so theres your awnser THEY DONT KNOW they go by what they are told by the suboxone company or other dr`s.Bottom line is if someone says it does not help with pain they either dont want to stop taking opiates or they have never taken one.For it does and like i said to a certian level.For the next two yrs i used suboxone everyday my friend simply gave me all his extra ones each month and i found myself getting by fine with 2 mg aday just a quarter of a pill\strip.I am a law abiding citizen and try to stay within the boundries of our laws no matter how stupid some may be i dont go to jail as well as do all i can to help law enforcement so i realized that by taking the meds from my friend i and he were breaking the law so i decided to get my own doctor and just go in and be honest and explain my situation.I know youre going to say why didnt you address this with your own dr.well i did but seems you have to be certified to prescribe the stuff and mine wasnt and had no plans of being certified so i knew i would have to seek a dr. that was in the biz of prescribing suboxone and boy did i now this is where the story gets to the nitty gritty.The first dr i saw worked out of a small rundown x-pain clinic that had been shut down some yrs earlier from problems with the clientel that was causing problems in the parking lot and selling scripts on the premisses and thats what the local law enforcement told me they got cited for"repeatedly".As i continued i went in and was greeted with the nicest 3 ladies i think i ever meet.They seemed genuinly concerned about my decision to use suboxone and were very supportive.I then filled out my paper work and paid my $200.00 in which i was asked for as soon as i approched the sighn in window then i meet the dr.he was a young guy im 44 so bout any one is younger now but he was a real nice guy i thought.We talked and then it came time for the doseage calibration.I was very honest with him as i explained my situation but instead of prescribing me the 10-15 a month which had been just fine for me he said no you need at least 1 to 1\2 a day.I once again told him no i was fine with a quarter to a half a day anyway he gave me 45 a month.There is no way in hell i can take that much each day i would fall over now some people might can but not me besides im paying the doc he should at least pay attention to what i say is working and whats not.Well for the next 5-6 months everything was great i was greeted with a smile and talked to like a person but then one day i get a call.It was amy dr office the lady asked if i couyld come in 4 days early for the office was closed on my appointment day due to labor day i said shure no problem.The next month i called in and asked if i could come in 1 day early for i had to work the family exibit at the state fair because my brother had been killed in a car wreck a few months earlier and this is whe all the bull crap begins looking back this the first sighn of this being a very suspiciuos adminestration of narcotic drugs.The lady told me that i could not come in that it was becoming a habit and all i was wanting was more drugs that i was supposed to i said whoa have you gotten my mixed up with someone else for i have never came in early she said you came in 4 days early last month i laughed and said politly that you guys were the ones who called me and asked if i could come in earl have you forgotten well why would we move you up 4 days i said because one of you made a mistake and schedualed me on a holiday and if you account for the days fri sat sun and mon it would be 4 days as the reply from her then was silence.but from there on i was treated and spoke to as a common street drug addic as well as being charged for reschedualing my appointment.I then decided that the suboxone scene was the equivelent to the methadone clinics and would soon be treated by the comunnity as such.I was so mad as the way i was done i decided just to put the drug down and walk away from the whole thing but i was wrong.If any of you reading this have ever been through opiate withdrawl then you know how bad that is well multiply that by 10 and you may be close to what it is like comming off suboxone.The first 2 days are not bad but the 3rd day hell begins you get sick you cant walk your legs just simply give out you cant eat you cant sleep it for you cant sleep period you freeze one min then you sweat the next you cannot stand to be around anyone not even your kids in which i have two precious twin boys as all this may sound typical of opiate withdrawl the diffrence is you go numb in the waist to below the crotch area and i dont know if that ever gets better for i had to find some on the street by the 12 th day oh yea thats the diffrence from opiates you get over the withdrawls from them but the suboxone withdrawls are just as severe on the 12th day as they were on the 3rd in fact mabey even worse.I finnaly gave in for i saw they was no way to over come this and called another dr.i got right inthe next day and was back on track.For the next three months things were great between me and the place only this time the office was located in charlotte n.c and had bars all around the place and you had to press a button to be let in this should have been a sighn.Anyway the fourth month after 3 great months i called the day before my appt.and said i needed to reschedual for 5 days later(because there only open mon tue and wed i had to go till the next mon since this was tue)because our only travel car was in the shop and i didnt have a car i trusted to make the trip which btw is a 125 mile round trip.Then the lies and bs began they told me that by law they could not rescheduale me another appt. and that the only thing they could do is take me off the active list and call me if they had an opening.That was the last straw i knew this was a lie if you read the first of the story as my first dr.had no law preventing him from reschedualing me but i found out later he had lied about the company not making the pills anymore and all he could give me was the strips i found out he got a bigger kick back from selling the strips to me.Any way the reason they wanted me to reinrol in the programe was i found out if you have to be put back in the lil circle you would then be charged 250 dollars to start over then the monthly visits were 200 dollars thats quite an incentive to kick someone out after they are addicted and get them to come back.Welli wont go any further for im getting very angry now reliving the experinces ive had bottom line is.If your even thinking of replacing opiates with suboxone stop dont do it this drug is designed only to make dr.rich and and turn you into a slave it is all about the money problem is this stuff is as dangerous as herion,crack or a list of other hard narcotic drugs the doctors selling them are nothing more than glorified street level drug dealers hiding behind the fact that you are hooked and will do as they want you to do.They lie about everything that you ask them only suppling awnsers that help them out in there pushing of this drug.This drug should be outlawed and the dr`s that have profited from it should be jailed and made pay back every dime they have made off this drug.I have never been treated as such or tryed to be taken advantage of in any other situation i have ever been in.And yes i still take it for after long term exposure to this drug i honestly dont think you can get off of it without some kindddddd of terriable permanet damage to your nerveous system i now get mine off the street for half the price it cost to do it legal the drug store charges $12 a piece my man charges 8 i have hoarded over 200 of them now and feel safe for a while but i know there is no way to get off of them they may say that you can taper off them but thats a lie to i have tried got down to i\8 a day for weeks but still go numb and get sick on day 3 without them.Please listen to someone who has no reason to lie to you about this for i still love the way they make you feel and and sometimes even talk good about suboxone.But the truth is they are a slave drug just like opiates only a lil more controlable and are designed to make you loose all self esteem when it comes to dr.confrontations all im waiting on is a class action law suit which i know will be here soon enough and then i will have my revenge for i promise i will lead the lynch mob if possiable for the downfall of this aweful drug.If anyone thinks im full of crap simply search columbia s.c and see what the city has to say about suboxone they have pretty much outlawed it throughout the city and the reason i was told straight from the clinic that used to serve the majoirity of the area was and i quote"we realized how addictive as well as how corrupt the prescribing dr`s were that were involved in it and the city decided to stop it before the drug done any more harm to its people"please investigate this drug completly before you make these dr`s richer and or destory your health im afraid i will probaly die now because of suboxone for i really think they have caused irreversable damage to my body i hate to see anyone else make the same mistake i have my family dr.is now aware of my battle with these things and has schedualed me for a series of tests all through april i only hope its not to late but so far i have not been able to find anyone who has been on them as long as i have and the ones who have been close to my time all agree with me..benjamin l sane jr.....dying from suboxone....