[buffettduck]

I have gotten myself in a deep, dark hole and hope you can help me to make decisions that my mind honestly can't handle. I initially was on percs, then OCs, then heroin, then IV heroin...during this time I went to two rehabs and left both of them without finishing. I am a 4th year medical student. I have one month left of rotations and I HAVE TO pass my boards. My impulses to relapse were so bad that I finally made the decision to get on methadone so that I could stabilize my cravings and try and focus on other priorities in my life. Since then, I have gone up to 90 mg and finished up all but that one month left of school. I also have a dx of bipolar (which I'm not really sure I am bc I was dx when using) and take lithium, wellbutrin, and prozac. I just tapered off seroquel. I just received the results of my board exams and I failed BOTH parts of the exam, clinical skills and clinical knowledge. That was the last straw. When I took both exams my mental function was not up to par and I ran out of time on both exams which is why I failed. The amount of methadone I am on now is RIDICULOUS at 90 mg. All my mental functions and bodily processes have almost come to a halt. I have no energy or ambition and it kicked my ass to get through the last year of medical school on it. I didn't really even study for my boards because my focus and attention span is non-existent now. On Sunday, I took a suboxone 8mg bc I hadn't dosed since Friday (I took both of my take homes on friday when I found out my exam scores). It threw me straight into acute wds and I can't tell you how bad I felt. I've detoxed before but nothing compared to how I felt Sunday. I couldn't stay still for 3 seconds and I honestly wanted to blow my head off. That day, I said F*CK THIS, I need to get off methadone. My family has been supporting me through methadone maintenance but they say my mind is worse off now than it was 2 years ago...when I tried to quit opiates and went to my 1st rehab. I've been on maintenance over a year now. I have an addiction psychiatrist that I was not being honest with because I didn't know what he would say about a physician being on methadone. I came clean to him on Monday and go to see him tomorrow morning. THIS IS THE HUGE ISSUE...my school has been so supportive and lenient throughout my struggle with addiction and mental illness, and I know I am MDD at this point in my life and probably need to be on something. But on Sunday I announced to my family that I was going to go into treatment immediately, and I can't tell you how happy they were for me to take this step. I have literally put my mother through hell the past two years. After my 1st and 2nd rehab, my addiction just got worse then I started shooting. Right now, I am getting my application ready to apply for residency. Interviews will be in December and January. After I started logically thinking about all of this, I have shied away from the cold turkey idea. The rehab I will go to does not take pts until they are off detox meds and I imagine I am going to be in the hospital detoxing for a month! Then 3-month inpatient program which will put me out in February...and I will have missed my interviews and risk the medical school letting me go after I just have one month left and am $100,000 in debt. My new idea was to actually do a medical supervised withdrawal, about 10-15% per week. I would return to school in December to finish that one month and then take my boards in early January. I know in my heart that I am on way too much methadone to function at the capacity that I need to. Hopefully, my mind would clear thru Nov. so that I can actually sit down and study without being distracted. Once I am thru my interviews, and on a reasonable amount of methadone (15-25 mg), I am completely willing to go to inpatient and deal with my addiction. My family has no trust in me and think I need to just go cold turkey and aren't concerned about medical school. Literally, my mind has been so foggy that they don't think it will clear without immediately completing a 3 month program. They really don't even care about me finishing medical school...they just want me back to normal. The last two years of my life have been a downward spiral of failure after failure. I want to be completely free of all meds, and I also want to do an intensive inpateint program...I just don't think that going cold turkey on methadone and risking missing my interviews (which my med school might release me). I was impulsive on Sunday, but my addictive mind is constantly playing tricks on me. What do you think I should do? I'm pretty sure that my psychiatrist will want me to go str8 to detox because he I'm pretty sure he is against opiod maintenance. And I am against this crock of bullsh*t for-profit clinic as well. I want to get off methadone. I want to be drug free. I want my mind back. I know this is alot to read and take in but I hope you will be able to provide some advice before I leave tomorrow morning for my appt. I'm scared ********less about going cold turkey cause my detoxes in the past were horrible and 3 wees long on short-acting opiates. I think I will be sick and in the hospital for a month. I just don't think it is a good idea but the pressure from my family and my psychiatrist (who has direct contact with my medical school) may push*me into it. As you can see, I have about f*cked up my life. All I want to do is be healed and then be able to help other people with addiction. I truly deep down don't believe that methadone maintenance is the right answer which creates all this shame and guilt. PLEASE HELP. My email is robbohler@yahoo.com. Anyone please give me some feedback. Thanks guys! Rob

[Robert_325]

Rob ..... I promise you that if you would let me help you use subutex properly I could get you straightened out in no time so that you would be able to finish school and you would be able to get your life back on track without all the drama you're talking about.

I've done this a long time and you have to use subs properly to get the benefit from them. But I know how to use them and I would be happy to help you if you would go along with me.

Here is a link explaining how I suggest using subs. Read the link closely paying special attention to the INDUCTION section of the link. Then let me know if you choose to have me help you with your therapy. There are LOTS of people on this forum who have been successful using subs following this program. Let me know. God bless.

http://www.drugs.com/forum/featured-...apy-50887.html

[me!]

on a stable dose of methadone you should not have been having problems focusing and concentrating. If you know your dose is too high for you, why not decrease it to a level where you can function?

Also as a med student, why did you take too much suboxone? You should know that subs will put you in w/drawals once you go over the max dose?

I would not advise cold turkey from methadone, the w/drawals can go on for weeks (I know this from personal & professional experience). I would suggest a medically supervised detox from the methadone.

If you decide to try and use suboxone to detox, DO NOT take it until you can get your methadone dose down to about 30mg a day. It will put you in acute w/drawals if you take the subs while you are on a high dose of methadone and again, do not take over the recommended amt of suboxone!

As a med student, you should also know that you need professional help no matter which method you choose. Be up front w/your doc and your school! They know things like this can happen with med students and doctors and they have programs specifically targeted to your needs so do this the RIGHT way!

Good luck!

[RubyDean]

duck, you should read intelmetals thread. he has a real good story being a long term methadone addict who tapered down off methadone enough to get on suboxone, and then tapered off sub in just a few months successfully. i really think this would be a good option for you like robert mentioned. save you a lot of heartache, and drama. you can still do school, and be productive while doing it...check out his post and think about it.
there are a lot of long term methadone here that switched to sub after tapering down.
small price to pay for a second chance at a new life.

[Robert_325]

duck ..... RubyDean made a good suggestion about talking with Steve(intelmetal). Steve literally spent years doing his taper the right way as that is what it took for him considering all the history in his background, but that is his story to tell and not mine. I don't like to tell others' background and prefer to leave that to them.

If you post to Steve refer him to this thread so you don't have to re-write your whole story out again. I realize what a hassle that can be. Here is a link you can give him that will bring him right here.

http://www.drugs.com/forum/need-talk...tml#post259091

I have a lot of respect for Steve's success the way he stuck with this for so long making sure he did this the right way. I'm confident with your methadone history Steve would be a good person to ask for suggestions and I know he would be willing to give you as much help as he is capable of. Hope that helps. Steve is a good guy and will be more than willing to do what he can. God bless.