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Suboxone - pros and cons????
  1. #1
    Ryan Kennedy is offline New Member
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    Default Suboxone - pros and cons????

    OK, just started Suboxone. Listened clearly to the doctor, read the booklet and gthe website. I understan dhow it works and so far it seems to be doing the trick, however I had some thoughts and some questions that maybe a veteran use can help me answer. The first question, is how is soemthing that gets you "high" supposed to help get you off something that gets you "high". In other words, Suboxone make some feel pretty damn good and I cant wait to take a pill every morning. How is that different then Vicodin? I know that it can have dependency problems too but then whats the difference? Why do they expect I can just taper off the suboxone when I couldnt just taper off the vicodin? Could someone explain that in lamens terms for me? I have noticed that I have no withdrawal symptoms from the Vicodin and that unlike Vicodin, i dont wake up in the middle of the night withdrawing from the Subs like I used to from the Vics and I also noticed that I dont crave Vics like I used to. Just writing or talking about Vics used to make me start "twitching" and getting all worked up to the point that I would call my doctor or start calling friends. I no longer think twice about taking Vics. I could care less, but is that only cause the Subs are getting me high too so why would i neded the Vics?

    Also, some weird side effects from the Vics. Bloating, increased appetite, acne. Anyone else experiencing those?

    And also, what is it in some of these drugs that make you smoke more? I am not a "smoker". I have 1 or 2 while drinking a few beers, but I never finish a pack and maybe average 10 cigs a month tops. But when I used to take Vicodin, and now on the suboxone, I have the constant craving for a cigarrette to the point that I catch myself chain smoking. Is there some scientific connection between the 2?

    Just some thoughts. Any info, help, advice, etc, would be helpful. Thanks

  2. #2
    mpvt is offline Platinum Member
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    Buprenorphene (suboxone,subutex) is a partial antagonist while vicodin (hydrocodone) is a full agonist.Here is a paragraph to help you understand a little better!!

    OPIATE antagonists differ from opiates only by the replacement of the N-methyl substituent with an N-allyl, N-cylcopropylmethyl or related group. Antagonists can reverse the pharmacological effects of opiates and so are important in the treatment of opiate overdose. Drugs that combine agonist and antagonist activities have potential as relatively nonaddicting analgesics. Although their mutual pharmacological antagonism indicates that they act at the same binding site, pharmacological discrepancies have prompted speculation that agonist and antagonist binding sites are separate1,2. Biochemical study of receptor binding3−16 has shown that although opiate agonists and antagonists compete for the same receptor3,4, there are differences in the way they interact with them7,10. Physiological concentrations of sodium enhance the binding of 3H-antagonists but reduce that of 3H-agonists. Sodium diminishes the ability of pure agonists to inhibit binding of 3H-naloxone to the receptor, but has little influence on inhibitory effects of pure antagonists and intermediate effects on those of combination agonist−antagonist drugs. The molecular basis for these differences, however, is unclear. As a first step in this direction we now report that binding of opiate receptors is much more sensitive to degradation by protein reagents which are known to modify sulphydryl groups than is binding by opiate antagonists. This suggests that distinct binding sites exist for agonists and antagonists, although they may both be on the same receptor.

    So this is why you don't crave the vicodin and also why you're not in the addictive mode that you were in before you started treatment.
    You are probably getting some euphoric buzz from the buprenorphene because vicodin is a fairly weak opiate especially compared to buprenorphene.You will loose that euphoric feeling and you will feel "normal".

    You should be able to wean down off the suboxone much easier then vicodin because like I said before "you're not in addictive abuse mode".
    Also the suboxone acts differently on your brain and you think much clearer and at a normal rate rather then how you would think if you were still abusing hydrocodone.

    One of the biggest differences between a agonist and a antagonist opiate is the antagonist will bring on withdrawls if you take to much were as I used to take 25 percocet at once and then 15 every half hour or so afterwards (percocets are lousy but sometimes you have to do what it takes to stave off withdrawls).Now if let's say I was taking 12mgs of suboxone a day and suddenly I took 50mgs.Instead of getting high I would fall into precipatated withdrawls and believe me you don't want to go through that.

    So there is a huge didfference between the two drugs.

    The reason for the smoking is that opiate drugs stimulate the brains reward centre and this makes us crave cigs,beer,pizza ect.
    Now you know why we smoke so much when we drink......Have a good day and stay on course you're doing great.....Dave

  3. #3
    Ryan Kennedy is offline New Member
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    Default thank you dave

    reward center bit makes so much sense. Thats everything I craved recently. haagen Daaz, chips, smokes, etc.

    your post was very helpful and explains alot. thanks for the info and the encouragament. i feel so positive about this and its nice to see others out there who know where I'm coming from. thanks gaain.

  4. #4
    alonenomore is offline Junior Member
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    THANKS DAVE...answered some of my own questions. Ryan, i am on day seven of suboxone, day eight of not abusing oxycontin 40mg eight a day. I to have been SMOKING TOO MUCH, but not as much as when i was eating oxys. Plus i dont really feel "high" and i dont crave the medicine or feel sick in the a.m. and need a pill. I do however, take my dose as prescribed every morning. Yes, it is almost the first thing i think of when i wake up. But lately i have been checking how i feel. Going to the med cabinet(wait a minute, i never put MY OXYS anywhere where folks could find them, so forget the med cabinet) taking pills first thing in the morning has become a habit for us. That is why we cant wait to takeit in the morning, well as the fact that the suboxone takes away my "yucky" feelings. You know, the ass kicking machine that tells us we are losers and suck because we take pills...we are mentally defected!! That message has to be reprogramed in our heads to say positive stuff. Say like, i am not mentally defected, i have a disease, and i am now living an honest life. Suboxone doesnot mean we are just substituting...suboxone means that we want to stop our addictive behaviors, the lying, cheating, over-spending, whatever we did to get our pills, most of it was negative. Now we are being honest...just take as prescribed and don't trip. The more negative stuff i read about suboxone, the more frightened i become about my future. Therefore, i am hoping to read more positives than negatives. Take care, keep in touch, hang in there...and i too am craving cigs and at night SWEETS!!!

  5. #5
    butchy yost is offline Member
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    hate to be the negative voice in an otherwise positive post, but despite the positives of sub(I have been on the last six months) it is still AN ADDICTIVE SUBSTANCE AND A FORM OF OPIATE.

    so that is why you still fell ok without your drug of chioice, your brain is still high as far as its concerned. that being said, there are many benefits of the sub, one already mentioned is the duration of its effect (due to the fact that it is 40 X more potent than morphine...hello.) this helps to retrain us out of our addictive behavior patterns. another benefit that many users have found is that as little as 1/2 - 1 mg can last 24hrs easily after a quick taper down to that amt. this will make your scripts last 3-4 mos instead of 1.

    now the tricky part is getting down below 1 mg a day...this is when you have to pay the proverbial piper for your long lost addiction. the withdrawl has not been cured, just postponed.

    but sub is much easier to do a slow controlled taper off of than any other opiate since there is no euphoric effect, so there is hope...

    GOOD LUCK TO ALL....

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    butchy yost is offline Member
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    P.s >>>>>>-detox.com...its Been Mentioned On This Board Recently...is A Very Good Source Of Info On Suboxone. The Truth, Good And Bad.

  7. #7
    Ryan Kennedy is offline New Member
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    Just finished 1/2 a pint of Bens and Jerrys. before I even ate lunch! But thats ok, I;m still right about at my "ideal weight". I just got to counter it with soem exercise which I have enough energy these days to do. Vicodin sucked because I couldnt leave the hous ewiht out it and then walking or biking on Vicodin sucked so bad. My legs would just catch on fire! Soemthing about the increase or dcrease of oxygen needed, or something like anyway. The suboxone has really began to work for me. The first few days sucked. Not as bad as withdrawling from Vicodin, but lots of blurred vision, dizziness, nausea, some lower irregularaties I wont go into, etc. But now, besides the smoking, I can think alot clearer, get more work done, handle stress better .... all the things I thought I needed Vics for. Amazing. I iwll trade the smoking for the Vic addiction right now, cause liek you said, with the Vics went alot of really bad things, alot of really bad things, and what was next for us? Stealing, robbing a pharmacy? Seriously, who knows. I'm the last person in the world who looks like they would do something so wrong to get drugs, but you once your mind no longer controls your body, anythings possible. What other bad things have you heard about Suboxone? Anything life threatning like heart attack, or cancer, or serious medical issues? I havent heard of any and my doctor didnt mention any to me. Anyway, thanks for the comments and good luck to you.

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    raerae76 is offline New Member
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    Question Does Suboxone cause acne?

    Wow. What is it with the Haagen Daaz?? I've been on Suboxone for a year and a half and eat about 4 pints of Haagen Daaz a week! I haven't craved ice cream like this since I was a kid.
    What my question is though... is whether Suboxone contributes to acne breakouts? I noticed a considerable increase in breakouts since I've been on the Subs. However, every Dr. I've asked swears that there is no correlation between the two. I'm getting really frustrated and am almost willing to suffer through the opiate withdrawls, just to get rid of the acne. (I also smoke cigarettes and know that probably doesn't help matters!)
    Please help! Does somebody know something that my Doctors aren't telling me?
    Thanks

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    Robert_325 is offline Retired
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    Try eating less sugar. Sounds like you have developed a sugar addiction talking about all the ice cream. That just seems logical. I don't think subs cause acne at least not in most people. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

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    Malal31 is offline New Member
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    So I have been on suboxone for about two weeks...it helped me get through my detox of pain pills and i haven't had craving for any. plus it helps with my chronic pain. Just wondering if anyone else has had some these same effects since taking the medicine like have...excessive sweating on and off through out the day, tired all the time and for some reason I have been craving sweets and soda all the time. I normally never crave those. Is it normal to crave sweets while on suboxone?

  11. #11
    Robert_325 is offline Retired
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    It's not the suboxone it's the opiate detox you're going through. Lots of people crave sweets during opiate detox.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  12. #12
    bem9127 is offline New Member
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    Default 40mg x 6 per day

    Alonenomore-
    I know this was a long time back but can you share what dose of Suboxone that you used for the 40mg x 8 per day?

    What would everyone recommend for 40mg x 6 per day?

    Quote Originally Posted by alonenomore View Post
    THANKS DAVE...answered some of my own questions. Ryan, i am on day seven of suboxone, day eight of not abusing oxycontin 40mg eight a day. I to have been SMOKING TOO MUCH, but not as much as when i was eating oxys. Plus i dont really feel "high" and i dont crave the medicine or feel sick in the a.m. and need a pill. I do however, take my dose as prescribed every morning. Yes, it is almost the first thing i think of when i wake up. But lately i have been checking how i feel. Going to the med cabinet(wait a minute, i never put MY OXYS anywhere where folks could find them, so forget the med cabinet) taking pills first thing in the morning has become a habit for us. That is why we cant wait to takeit in the morning, well as the fact that the suboxone takes away my "yucky" feelings. You know, the ass kicking machine that tells us we are losers and suck because we take pills...we are mentally defected!! That message has to be reprogramed in our heads to say positive stuff. Say like, i am not mentally defected, i have a disease, and i am now living an honest life. Suboxone doesnot mean we are just substituting...suboxone means that we want to stop our addictive behaviors, the lying, cheating, over-spending, whatever we did to get our pills, most of it was negative. Now we are being honest...just take as prescribed and don't trip. The more negative stuff i read about suboxone, the more frightened i become about my future. Therefore, i am hoping to read more positives than negatives. Take care, keep in touch, hang in there...and i too am craving cigs and at night SWEETS!!!

  13. #13
    Robert_325 is offline Retired
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    I would NEVER , ABSOLUTELY NEVER recommend 40mg of suboxone for ANY amount of a previous opiate addiction. Doesn't matter what you were taking you don't need such a ridiculously high dose of suboxone. I've never worked with anyone (only one person) who required even 12mg per day. The average amount people stabilize at here is about 6mg per day. Taking 40mg per day is obviously why so many people end up here needing help trying to get off the subs.

    I really believe that a dr who gives out 40mg of suboxone per day should be seriously reprimanded for such an over-prescription of such a strong medication. Taking five 8mg pills of suboxone a day is insane in my humble opinion, and I've worked with opiate addicts on suboxone all over the world. I find it hard to believe a dr would be so reckless as to give an opiate addict such a high dose of RX opiates (suboxone).

    I only know of one other person who was on such a high dose in the beginning and she had a terrible time with it. We worked diligently and got her down to about .5mg and she still couldn't get off. I'm convinced the 40mg dose was at least partially if not mostly to blame for her problems.

    In my experience suboxone should be used for a minimal time (about 60 days total is ideal) at the lowest effective dose possible, usually about 6mg a day to start and then taper down 25% of your dose every four days or so. The entire process from start to finish shouldn't take over about 8 weeks give or take a matter of 60 days. Lots of people here have been successful getting clean following that protocol.

    I pray that anyone taking 40mg a day of suboxone would start the 25% reduction every four days until they get off. You'll be lucky if you're not a basket case after doing this. Hopefully you haven't been on such a drastic dose for too long. You should read the following link on sub therapy. I don't see how you can even function on that dose of subs. You're not even anywhere CLOSE to being clean. I will keep you in my prayers. Good luck and God bless.

    http://www.drugs.com/forum/featured-...apy-50887.html
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  14. #14
    Robert_325 is offline Retired
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    Looks like I misunderstood your question ..... I thought you were taking 40mg a day of suboxone. Follow the instructions for INDUCTION on the link I gave you and you should end up at about 6mg or so of suboxone. Follow the instructions closely and you'll end up clean if you focus in about 60 days or thereabouts. God bless.

    http://www.drugs.com/forum/featured-...apy-50887.html
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

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    bem9127 is offline New Member
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    Correct. I am taking 40mg of Oxy 6 times per day and wondering what to take so I can get off the Oxy. I read the article referenced but simply do not understand the routine.

    During the induction period it states “We suggest using 2mg dosing increments dispensed at least one hour apart.” There is no guideline given as to how long or when to stop?
    Is this a one day thing?

    My assumption is you do this the first day up to 12 mg? Hence, 2mg every hour for 6 hours.
    Or, is this what you do every single day?

    What is the normal dosage routine after induction period? 2 mg in morning, 2 mg at night?
    Sorry, I’m just not getting the routine.

  16. #16
    RingABell is offline New Member
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    Exclamation Tisk tisk

    Robert,

    Your post on amounts of Suboxone to be taken and how long it should be taken is disturbing to say the least.

    There are many many patients who recieve up to 32 mg per day and it is known in medical literature that the standard therapeutic dose of Suboxone for those with addiction is 12-32mg. Suboxone is going to effect different people differently and for a variety of reasons, including the amount and frequencies of previous narcotics taken.

    You are correct that this person needs to follow the proper induction protocol, but you are sadly mistaken about the length of time someone needs to remain on the drug. For some addicts, life without Suboxone is not going to be possible. Sure, following your strict taper schedule might get them off Suboxone and other drugs, but will they relapse? That's the more important question we should be asking here. Addicts who are relapsing are more likely to commit crimes to secure future drug usage. That's why it is important that the doctor and patient decide the right timeframe one should use Suboxone, along with the length of counseling (which is as equally important as the Suboxone).

    For some (or dare I say most) people, they are going to need to stay on Suboxone long term or for life to keep the addiction demon at bay. We wouldn't deny a diabetic insulin for his chronic disease, so why should we deny the opiate addict the proper treatment for his chronic disease (addiction). Make no mistake that addiction is a life-long, chronic illness that can result in death if not properly treated.

    The most important advice I can give to anyone here is to be honest with your doctor and counselor and follow both of their guidelines for treating your disease. If you have a medical professional telling you that you should only be on Subxone for X amount of time, then you need to find a new doctor who understands addiction better. The thing about Suboxone is that any doctor can prescribe it if they take a special 8-hour class. BUT, and this is a big BUT, you should look for those doctors with backgrounds in treating addiction (especially internists and addictionologists) for they can recommend the best comprehensive treatment plan for you, whether that includes medications like Suboxone or Methadone (very different that Suboxone) or not.
    Last edited by RingABell; 01-02-2011 at 10:28 AM.

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    newyorkgal is offline Platinum Member
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    I disagree with your assessment - to a degree. I will be the first to admit some people need long term or even lifetime treatment with a maintenance drug. I am one of those probably. However, I would never advise anyone to use sub in that way. Sub is the best drug out there for blocking the affects of all pain medications so that if a person were to need emergency surgery while on a substantial dose of sub, they would be in a bad place. Some people just need sub in the short term to get off their DOC, to be followed up with other treatment plans such as NA, etc. For that use, sub is a beautiful thing. It's always in the doctor's best interest tot keep someone on sub long term. It makes them tons of money. As you said, they only take an 8 hour course and their knowledge about sub is quite limited. I am on sub 2+ years and am having a helluva time getting off it. You have to realize, sub is highly addictive. It is a super strong opiate though it doesn't feel like one. If I were advising someone on a lifetime maintenance drug, sub would not be the one I'd advise them to take. Many people, especially us older ones, will reach a time when we need narcotics after an accidentt or surgery. Sub poses many problems there.

  18. #18
    sisterwin2 is offline Senior Member
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    SO sick of the analogy of a diabetic needing insulin... would you not give insulin.. Sounds like a nabbit or suboxonzone doc thingy. what a load of ********!

    What a cop out. BIG difference from being a drug addict and diebetic...really.! Its like saying would you hold back high bp meds.. that one is over used too.

    Gives little credit to the human spirit. Sounds like someone on MMT/BMT and just cant see themselves without dope to me.

    I have been an active addict for over 35 yrs. I am not today. I am not special or different then any other addict. I just didnt fall for that analogy for too long anyways.

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    [QUOTE=newyorkgal;305123]I disagree with your assessment - to a degree. I will be the first to admit some people need long term or even lifetime treatment with a maintenance drug. I am one of those probably. However, I would never advise anyone to use sub in that way. Sub is the best drug out there for blocking the affects of all pain medications so that if a person were to need emergency surgery while on a substantial dose of sub, they would be in a bad place. Some people just need sub in the short term to get off their DOC, to be followed up with other treatment plans such as NA, etc. For that use, sub is a beautiful thing. It's always in the doctor's best interest tot keep someone on sub long term. It makes them tons of money. As you said, they only take an 8 hour course and their knowledge about sub is quite limited. I am on sub 2+ years and am having a helluva time getting off it. You have to realize, sub is highly addictive. It is a super strong opiate though it doesn't feel like one. If I were advising someone on a lifetime maintenance drug, sub would not be the one I'd advise them to take. Many people, especially us older ones, will reach a time when we need narcotics after an accidentt or surgery. Sub poses many
    problems there.[/QUOTE

    Newyorkgal, well said as usual. I've been reading quite a few posts from you the last couple of days and I for one am so thankful. You have true experience and real knowledge that is priceless to many. You are thoughtful and kind in your responses even when you are not in agreement. You are consistently positive in your suggestions, at the same time acknowledging that there could be other answers. Okay, just wanted you to know you are appreciated. Been looking for you to see how you are doing. What is the wrist status? Are you still going through with the sub switch? Just hoping to talk to you, if there is a specific thread you are on let me know please. Hope you have a beautiful day. Marta

  20. #20
    Robert_325 is offline Retired
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    RingABell ....... YOUR analogies are distrurbing to ME! My history here speaks for itself. I won't change ANYTHING I do based on what you have said. There have been too many people successful here..

    This hasn't happened in a while but I am in agreement with both sisterwin and NYG TOTALLY on the same subject.. I only suggest very small amounts of sub and for a short term to detox. People have used that diabetic nonsense before and you sound like a suboxone salesman my friend. A FEW people may need maiintenance doses for life but 32 mg is ignorant I don't care who or what you are!

    People show up here with their life in total chaos and nothing but sub addicts because of over-prescribing sub drs who don't know what they are doing but raping patients financially and stealing their lives and we try to help them. Don't come here with one post telling everyone the way this works. GEESH!!!

    Like both the ladies I also used for over 35 years and have been clean 8 years. Spilled more in the floor than most addicts ever seen. And I was on and off subs in six weeks. And haven't touched opiates since. So there goes your theory.,
    Last edited by Robert_325; 01-02-2011 at 01:43 PM.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  21. #21
    RingABell is offline New Member
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    Calm down. Take a deep breath. I should have been more respectful in my response, Robert.

    If you will re-read my post you will see that I said a good dosage for most is between 12-32 mg. I didn't say everyone needs 32 mg. The higher dosages should be reserved for those switching from MMT to BMT. No one should stay at 32 mg for life and I never said that.

    Technically, the standard dosage of ANY medication used should be the minimum amount necessary to relieve the patient's pain/suffering/illness. That is standard conservative medicine. Medical literature on Suboxone shows that the most effective dosage is between 12 - 32mg. Again, 32mg should be reserved for the most extreme cases/circumstances.

    I stand by my statement that no one should be TELLING an addict how long he or she should stay on any kind of maintenance therapy. It is something that should be discussed between the doctor and patient -- not with a stranger on a forum.

    I think Drugs.com and what you guys do here is great. It gives the addict something he needs -- a support structure -- but an (admittedly) unqualified non-healthcare-professional (I don't mean this to sound offenseive) shouldn't be telling those on the forums how much medication they need or how long they should stay on any medication (Suboxone or anything else). Deciding for yourself or listening to people on these boards about the amount or duration of medication you need is still addict behavior. You always need to discuss amount and frequency of doses with your doctor.

    NYgal: I agree with what you said. I think you've misunderstood what I wrote. Read my last sentence: BUT, and this is a big BUT, you should look for those doctors with backgrounds in treating addiction (especially internists and addictionologists) for they can recommend the best COMPREHENSIVE TREATMENT PLAN, WHETHER THAT INCLUDES MEDICATIONS LIKE SUBOXONE OR METHADONE (very different than Suboxone) OR NOT.

    Sisterwin2: Your post really deserves no response, but I'm giving you one anyways. The analogy is used because it is medically accurate. You say there is a big difference between being an addict and being a diabetic but you fail to explain how they are different.

    Let me explain the similarities. Many of those with Type II diabetes have gotten it through poor eating habits and failure to exercise. There may be some genetics involved to some extent. Some are born with diabetes and simply can't help it. Those who have become addicted to pain medicine by seeking it on the street have done so due to their bad habits and, perhaps, some extent by genetics. Some grew up in a househould where using drugs was the norm and developed their own habits through no fault of their own. Some went on pain medication for an illness and became addicted through no fault of their own.

    Diabetes and addiction really are very similar in that they are chronic (lifelong) illnesses. They can be contracted through bad habits or through no fault of the person.

    Also, I never said EVERYONE has to stay on Suboxone or Methadone forever, but many (I would say the majority of opiate addicts) do need to. Like you said, you are a still an addict and admit you are. I think that's a wonderful thing, because you are reminding yourself that you still have a problem (a chronic illness). You may be able to get away with receiving no treatment (not attending AA, NA or being on any kind of maintenance therapy), but I assure you that kind of resolve is rare among addicts.

    Equating Suboxone to dope is laughable and saying that those who have to use it long term are weak is your typical addict p**sing-match mentality. I've counseled many who admit they are mad at those on maintenance therapy because they feel they have it easier (and perhaps that's true to some extent) than they did kicking it cold turkey. It's important to tell addicts that there are many different definitions of what it means to be "clean." Clean to some addicts means they should have no drugs in their body whatsoever and maintain a normal life! Other addicts define "clean" as the maintenance of a full-time job and "normal" living conditions without the mental need to do drugs all the time. It really depends on the person.

    I'm not endorsing Suboxone as the cure-all end-all drug for every opiate addict, but it is a very useful tool along with counseling. Everyone's recovery should be tailored to their specific needs and expectations.

    I'm also not saying that stopping Suboxone itself is easy. It does cause withdrawal symptoms similar to those caused by other opiate agonists, but it is definitely not nearly AS painful withdrawal. The thing about withdrawal (and pain) is that it is hard to compare the withdrawal (pain) an addict has had in the past with the pain the addict is experiencing during his current withdrawal. With proper taper (especially with the new filmstrips) and a good understanding doctor, though, the addict can successfully get off Suboxone permanently if that is the addict's ultimate goal.
    Last edited by RingABell; 01-02-2011 at 07:19 PM.
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  22. #22
    RingABell is offline New Member
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    P.s. NYgal: There are plenty of ways to get around the blocking effects of Buprenorphine and any good anesthesiologist knows this. With scheduled surgery, it is even easier because the patient can reduce the amount of the medication they are taking for a few days and then stop for a day or two before (it may be uncomfortable but is definitely doable).

  23. #23
    RingABell is offline New Member
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    "People show up here with their life in total chaos and nothing but sub addicts because of over-prescribing sub drs who don't know what they are doing but raping patients financially and stealing their lives and we try to help them. Don't come here with one post telling everyone the way this works. GEESH!!!"

    Also Robert, one post or more than 11,000 posts doesn't make you a medical doctor or healthcare professional. An addict's life is usually in chaos because of the societal pressure placed on them by those who drill into them that "you have to do it this way or its not normal." All I'm advocating is that the addict discuss their options with their MEDICAL doctor and listen to their MEDICAL doctor.

    As for doctors raping patients financially ... I'm sure some do. If they do then the addict should find a new doctor. There are many that offer maintenance drugs very cheap or free if you participate in counseling. There are also some who take insurance and others who help you file it on your own insurance and others who do pro bono work and others who simply offer cheap visits to get refills. Regardless, if you factor in the amount the addict was previously spending on illegally obtained narcotics and compare it to the cost of Suboxone maintenance, you'll find that the Suboxone maintenance is still cheaper than being an addict. As I said before, though, Suboxone maintenance isn't for everyone. The addict and doctor should discuss the options!








    One post or more than 11,000 posts doesn't make you a medical professional.

  24. #24
    Anonymous Guest

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    Salesman, doctor or stockholder?
    Last edited by Anonymous; 01-02-2011 at 07:43 PM.

  25. #25
    ClassiqueMom is offline Senior Member
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    Quote Originally Posted by azul diablo View Post
    Salesman, doctor or stockholder?
    funny diablo.. i was wondering the s-a-m-e thing.. hmmm...

  26. #26
    newyorkgal is offline Platinum Member
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    Okay, I am going to go against the group thinking here, and I'm sorry that Robert agreeing with something I said is about to come to an end (j/k)... but here it is. I have read everything Ring had to say and to a great extent I agree with him. No one person is the same as another. Therefore, no one treatment will work for everyone. I am a STRONG advocate for long term methadone or subutex usage FOR CERTAIN PEOPLE. In my opinion, a person who has had a short term addiction to a short acting pill should not even think about sub or methadone as a first treatment but there are those who have a long history of addiction and it's different for a lot of them. I realize there are addicts here who have used almost (not quite) as long as I have and they are "clean" today (Robert, Kiwi, etc). But no one can speak for what a person goes through in w/d. There are also very chronic relapsers and you can never say which relapse might end in a horrible way. It's just not the same for everyone. Also, as a Type II diabetic who is insulin dependent, I do get the analogy. I also must add that I agree wholeheartedly that "clean" does not mean the same for us all. I consider myself clean. I have been clean in my estimation for many years although I've been on sub for 2 years and methadone maintenance for 33 years before that. I have not exhibited addict behavior for many, many years meaning I don't chase drugs, I don't commit crimes, I don't nod out and burn my furniture any more and I don't steal from and hurt those I love. I disagree about sub and pain management. I certainly wouldn't want to test out the theory that doctors can work around the sub. At 61 years old, with three major surgeries under my belt (one which couldn't wait a minute - ruptured appendix) and a stent in my coronary artery and other health issues, I am scared to death about this particular issue. For this reason alone, I personally want off sub. Another thing I disagree with, Ring, is that you will get the best advice from MOST sub doctors. I grant you, there are some good ones, but really, the majority are in it for the money. I also don't believe ANYONE needs anything close to 32 mgs. After 33 years on methadone maintenance and 10 years prior to that IV'ing >>>>>>, I started on 16, felt horrible because it was way to much, made me shaky and sleepless and hyper... It wasn't till I brought myself down to a reasonable dose of around 6 or 4 mgs. that I began to feel normal. So, there you have it. While I don't agree with everything this person (who may be a doctor, stockholder or salesman for all I know) says, I do agree with a lot of it and if you read his posts more carefully, you will see he is not as wrong as first thought.

  27. #27
    RingABell is offline New Member
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    NYGal: Thanks for your response. I agree with your assessment that those with very short term addictions to low levels of narcotics are probably not good candidates for any kind of maintenance therapy UNLESS they relapse. I feel that the main goal of any treatment for addiction is the reduction or elimination of relapse. It really makes my head roll when I read things like: "I've been on Ultram/Tramadol (or low dose hydrocodone) for 4 months and am having a hard time stopping my medication. Would you recommend Suboxone?" No. No. No. I would recommend therapy and a good Tramadol/Hydrocodone wean program with dosing happening in the office.

    I understand your concerns about surgery on Suboxone. Have you thought about maybe maintaining at 2 mg? Most anesthesiologists would be able to easily treat you with pain meds at such a low maintenance dose, but at the same time would still keep you maintained. The interesting thing about anesthesiology is that those who practice it have access to things that can even make you forget about the pain you were in during the surgery. It's not killing your pain, per se, but it is making you unaware of what is going on at a conscious level. Sounds scary, I know, but the type of medication I'm referring to is very useful for those on partial agonist/antagonist medications (Suboxone, the combination of buprenorphine (partial agonist) and nalaxone (antagonist that is actually inactive sublingually).

    However, if your ultimate goal is to get off Suboxone, then I applaud your decision and wish you the best of luck. I think that's great. Are you on the tablets or the filmstrips?

    Also NYGal, are you sure that you weren't experiencing precipitated withdrawals when you switched from Methadone to Suboxone at 16 mg? How long did you wait after stopping Methadone to do your Suboxone induction? Really, those with severe Methadone tolerances should be started at the higher end of Suboxone dosages (after around 5 days off Methadone due to its long half-life) and then tapered down to a comfortable level for the patient (do a search on your favorite engine).

    Like I mentioned before, some can be maintained on as little as 2 mg, but the people I've seen on doses less than 8 mg definitely begin to develop a few of their problems (especially addict behaviors) back. That's why the medical literature recommends between 12 mg and 32 mg (though the higher doses should be reserved for extreme cases, as I've said, and should not be a maintenance dose). I know doctors who actually prescribe their patients 32mg a day, but expect their prescriptions to last longer than the month they write them for.

    Looking forward to your reply!
    Last edited by RingABell; 01-03-2011 at 11:17 AM.

  28. #28
    newyorkgal is offline Platinum Member
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    I'm ahead of you, Ring, on dose. I've been down to probably anywhere between .25-.50 for many months (I just break them up and now cut the strips up and have never been terribly accurate but never more than 1/4 of a pill or strip and often I break them into smaller pieces.. Accuracy is not importtant to me as I believe the sub is so stacked up in my system so it all catches up in the end. It's the final jump off that is eludes me. I am just too scared of w/d. I know, it's dumb but I just don't feel I could deal with it at this point in my life or maybe I just don't want to deal with it. Either way, same outcome. (Full disclosure, Ring... Are you a doctor or health care professional? Perhaps drug counselor?). I was definitely not in precipitated withdrawal. After many years on methadone, I tapered to 25 mgs., stayed on that dose for a few years then made the switch. I waited a full 72 hours, no fun, I can assure you but I did it and it really wasn't as bad as all that because of methadone's long half life. I took my last dose on a Friday morning at 9 a.m. and was fine that day of course. I expected trouble Saturday but really had very little. In the evening I was kind of lethargic is all. Saturday night, I took a Klonopin and slept fine. It wasn't til Sunday afternoon that I started to feel badly. Sunday night, took a klonopin, fell asleep around midnight and woke up at 3 a.m. in full blown w/d. My appt. was for Monday morning 9 a.m. I took the first dose of 8 and felt perfectly fine within 30 mins. I was given a second dose of 8 which was totally unnecessary in my opinion. I know withdrawal well. This wasn't it. It was just nervous, shaky and sleepless. Maybe there is someone out there who needs 32 mg. but I believe, if I didn't need it ater so many years on such hard drugs and in fact, could not tolerate it, it's the rare person who truly needs that kind of dose. Although Robert and I don't often agree, I do agree with him that starting low is the best bet. So, I am maintained on well below 1 mg., have no cravings and no withdrawal. As for pain mgt., I KNOW you are going to say I would be fine but as I said before, I am afraid to be the one testing that theory. I am a terrible patient when it comes to pain in normal circumstsances (no sub), really a big baby. In my prior surgeries, I was given tons of opiates from dilaudid and morphine via pump on down, and I still had a lot of pain. Also, I agree the prupose of treatment is to negate the possibility of relapse. As a >>>>>> addict, I was the most chronic of relapsers. Nothing, not my parents or my children or the law, could keep me away from it ever. I spent 2 years in Daytop Village, did time in our old Rockefeller program (jail for junkies though they called it rehab - law finally repealed thank goodness). I always walked out of treatment facilities and straight to a dealer. I did awful things. I have not done any of that since almost the beginning of my methadone treatment so I personally believe methadone saved my life. I am finding our conversation quite interesting so if you'd care to take it offline, my email is
    bevg731@gmail.com.

  29. #29
    HenryNCBA is offline Advanced Member
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    RingABell,

    I think you are mistaking studies and data collected off of “literature” over actual field experience. Doctors and medical professionals as you well know are class room and text book trained. They spend years studying different aspects of the medical profession. Let’s stick with addiction of opiates for simplicities sake so we won’t get off on a tangent. So a doctor gets his degree and does his internship. Fast forward and he/she has been in the field of practicing medicine now for let’s say 10 years and maybe even has their own practice. They take an additional course of addiction, pain management, and learn of scripting subs. Does this make them an expert? In a sense that answer is two fold. Yes in that it makes them an expert over others in the field of medical practices because they “studied” addiction and the variables that accompany this topic. No in the sense that if you take any addict that has been around a while, especially those on this forum, and compare their knowledge to the trained medical professional who would you chose? Seriously who would you chose? You use the analogy of giving insulin to a diabetic which is a vastly different subject. That would be akin to saying that you have never been in combat but have studied in school and read books and seen films, attended lectures etc… and you go out with combat hardened troops who learned by trial and error and actually OJT and if both at the same time issued an order who would you listen to if your life depended on it? I personally would chose the seasoned combat veteran who has already proven themselves, been there and done that and is standing alive in front of me instead of some butter bar that came out of ROTC. I can relate to this because I have been there and done that. You might say this is a different subject and that is true but that brings you right back to the diabetic and insulin. You can not give one example and reject another. You claim Robert’s 11K some odd posts do not make him an expert? You talk about NYGal or SisterTwin2 as if they don’t know what they are talking about? Well maybe to you it doesn’t seem rational but to many others they do. The vast majority of people that are here on this forum are here because you so called medical professionals let them down. Many were led astray. No one in their right mind should advocate 32mg of subs per day. That is insane. I personally know of one individual that went to see doctors that are supposed to be trained medical professionals in the field of addiction and tapers and was put on 8mg tablets 4 times a day. To this individual that seemed awfully high and when taking it because extremely ill. So this person cut themselves down to 16mg. Even at half the 32mg it made him very sick. He went back to the sub doctors time and time again only to be told that the dose was not high enough. One doctor after another. Same story but the doses and length of taper or maintenance varied VERY widely. Frustrated and becoming dysfunctional he stumbled upon this site. Robert was gracious enough to offer assistance with logical recommendations. No one on this site is “forced” to follow anything and if you read closely you will see it is all recommendations and not issued orders. Unlike visiting a doctor who will tell you to do this or that they also put it into context that if you don’t follow the doctors orders you risk life and limb and put the fear of terrible repercussion that may happen into your own hands so people listen to doctors. Anyway getting back to the subject this individual was feeling VERY ill. Robert stated that a proper induction was needed and that the amount of sub that he was taking was WAY too high and it was insane to take so much. It was stated that this person would “be inducted at the absolute minimum amount of sub necessary to stabilize” this individual. This person was stabilized at only 1.25mg per day! That is correct and not a typo but only 1.25 mg per day! Started the taper late September of 2009 and on November 11th was clean. Today this person is still clean with no wants or needs to get back on opiate pain meds ever again. For sure not to get back on subs again. His doctor was amazed and long story short now uses this forum to study tapers. His doctor even stated that “well there are certainly some very bright people out there and doctors certainly do not know everything for we are text book trained. These people are tried and true folks that would give any doctor a run for his money and the only difference is we know all the technical terminology and many other things but on the subject of this I can’t compete”. Since that day this doctor and his father, another sub doctor as it is a father and son practice, have used this program and their success rate has sky rocketed. Tapers times also went from 1 to 2 years down to months if not weeks. The rebound or relapse percentage also came down substantially. How does this individual know that the doctor’s practice is actually making more money and also SAVING more as they are spending less of the patient’s insurance company’s money? Because they keep in close communications and many patients and new addicts are referred to this doctor team. Some come straight here depending on what the individual wants or needs. No one here is advocating replacing doctors with coming onto this forum. No one is saying that everyone on here are doctors. In fact when necessary many folks are told to go see a doctor. We all wish though that doctors would come down to earth and be humans and real people instead of the money making, arrogant, technically speaking (read non plain English), hurry in you are standing so you are okay now take this script and see me in two weeks and don’t forget to pay my bill all of 2 minutes for my office visit doctors, etc.. And just open up and look around and they might be pleasantly surprised that they might really learn something. Ever notice that doctors never seem to want to learn anything new especially from non doctors or professors? They all have the attitude of knowing everything. If that were true then why is addiction such a wide spread problem? Why are we here on this forum? Why are thousands of us and more so frustrated? The vast majority of addicts are not criminals. Many are victims of doctors that prescribe pain meds and since they are patients they listen to their doctors and become addicted or chemically dependant. Who is at fault here? Sure it would be easy to say the patient should know what they are taking but if they knew that then they wouldn’t need doctors now would they? What I am trying to say is the patient – doctor needs to be a team and not a one sided one way street. Back to the subject, sorry I always seem to get off on a tangent, but this individual has also now helped many others come clean all in record time and those others their own sub doctors are amazed and you should hear all the far fetched excuses the doctors come up with. Everything from they will die to they will relapse to you name it. I thought the doctor was supposed to help patients. Did they not take an oath? Seems that if people get clean here instead of putting money in a doctors pocket that makes it wrong? Doctors will tell you that their actual knowledge of subs is near zero. They only know what is shown to them in writing and listening to a sales pitch. Statistics, journals, lectures, etc.. Guess who puts most of these on? Not too many paid 3rd parties but the pharmaceutical companies that manufacture these drugs. I don’t even want to get into the kick backs from the drug companies and working with insurance companies either. Everything can be denied but people are not dumb and blind. They see things, hear things and if factual indicators point in a specific direction well that tells you something.
    I personally would NEVER TELL ANYONE EVEN THOSE PEOPLE I HATE TO TAKE 32MG OF SUB! That is just nuts! I would not even tell them to take 16mg! I was an addict and not by choice. I became chemically dependant/addicted by listening to doctors. I was up to some crazy amount of opiates. Sure I was fed wrong information because all my various doctors knew I was taking other pain meds. They all knew each other as they all referred me back and forth also. So all in all I was taking Vicodin, Percocet, Hydromet, etc… all at the same time and they knew about it! I trusted them and don’t tell me that they wouldn’t do that because that means you are calling me a liar and I certainly didn’t call you any names. Medical professionals need to be more open minded. We all would benefit from it including them.
    By the way I am the one that was inducted at 1.25mg. I have read, seen, and witnessed those you pointed a finger at, Robert, NYGal, SisterTwin2 and basically accused the others on here helping so many people and no one even knows anyone personally. I have already in a years time, I used to be on here before then quit and came back, seen hundreds come and go and many left clean. That is a heck of a lot more and noble than coming on here pointing fingers and advocating the same things that got people into this mess in the first place and here is where they came looking for help because the so called doctors didn’t do it that is for sure. Months, weeks and much lower doses and being clean far out weighs staying on subs for extended periods of times and continuing the addiction all in the name of treatment. Then the question becomes treatment for who? The drug companies and medical professionals and insurance companies are treated well but isn’t this supposed to be all about the patient? I know where my faith and loyalties lay. Do you? I don’t mean that in a sarcastic way either.

    Henry

  30. #30
    Robert_325 is offline Retired
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    Hey Henry! Yeah some people don't understand that drug manufacturers want to sell drugs. It's common sense, that is how they make money. Sub manufacturer Reck Benck are NOT philanthropists out to save the world, they are money hungry drug manufacturers out to get all the money from addicts or dependent individuals they can get. The FDA should be all over their butts! It's ironic that the drug salespeople who give the sub drs the literature that they base their dosing on all have BS degrees. It is a bunch of BS! It's kind of like the shampoo manufacturer that writes on the goofy bottle to "Wash, Rinse, Repeat". I swear that I don't know ANYONE who religiously washes their hair twice even though that is what the "experts" say to do. It's nothing but cut throat marketing to make people money. Use twice as much so we can make twice as much money. What a joke!

    There are also drs in my area of the country using this sub therapy program now. I speak to them often. My own dr from years ago is Chied of Staff in the biggest rehab hospital in our city and he uses it as well as other drs he has talked to. Of course he isn't on such an ego trip that he realizes that someone that's been there through this might have some good ideas that have proven to be succesful. I have been on this forum with my old dr while talking to him. He told me I was a little hard on drs but he also agreed lots of them deserve it. Some drs or "professionals" HAVE to be right all the time. After all they went to school a couple more years than me, plus took a freakin 8 hour class that I could pass blindfolded. I've seen the test and it's a joke.

    Have a good day my friend. God bless.
    Last edited by Robert_325; 01-03-2011 at 08:20 PM.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

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