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why do docs replace one opiate for another when detoxing?
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why do docs replace one opiate for another when detoxing?

Hello.. just curious why a doctor would give a patient replacement opiates like suboxone.                                                                  Or methadone? Isn't that just as addicting?
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271792_tn?1334983257
The idea behind taking a drug like Suboxone is that you will engage in counseling and perhaps join a support group which taking it. It gives you a chance to get your life together and learn relapse prevention, life skills, and deal with demons from the past. As far as Methadone, it should have ended in Natzi Germany.
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1428440_tn?1287393979
I use suboxone and I am using it as the time to learn about my addiction habits and triggers. I have come a long way and have been clean off of vic's and somas for 5months. I have a clear head and attending NA regularly, which has come along great for support. I am even doing some service work for NA. It is nice to help others as they are helping me. Good luck on your recovery.
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185545_tn?1331078466
I think many doctors prescribe maintenance narcotics for a number of reasons. For a start most countries wont allow their doctors to prescibe some drugs like Heroin or 6MAM( homebake heroin). The long half life of suboxone/subutex and methadone allows for once a day dosing unlike shorter acting narcotics which may require at least 3 or 4 daily doses. Many addicts souce their narcotic illegaly and by bringing them under the methadone umbrella they are then free from the daily burden and risk of scoring illegal narcotics. It is cheaper for governments to subsidise a methadone program than not to. I have seen cost benefit ratios as low as 10:1 up to as high as 40:1. That is for every dollar a government spends on methadone they save 10-40 dollars on court costs,prison costs, healthcare costs,increased productivity resulting in income tax etc...

Maintenance programs are a pragmatic solution to an untenable problem. While many may argue that it is replacing one addiction for another, i believe it is a cost effective way of reintergrating addicts into the fold of mainstream society by providing stability and routine. It is also a tangible recognition of addiction as a disease therefore requiring medicinal intervention. Unlike 12 step programs which believe in a spiritual solution, maintenance is a medical intervention .

Maintenance has drawn a lot of negatie press and its unfortunate that the failures are quickly bought into the limelight while the successes  attract no fanfare or fuss. They are the quiet achievers.

All the best regards Jeremy.
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935339_tn?1289956551
I am clean off of vics and others like that for 6year now I did it before with put sub but was so sick I almost was in the hospital about it now I have learned a life with out any kind of pain pills I have sub but you wouldn't beleave how far I have come and how much I have went though thankgood ness there something because I would be clean and where I am if not for the sub. I went 13 hours and then was able to start the sub but that was the longest 13 hours ever.
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Avatar_f_tn
The thing is... noone arund me knows I have this addicition to norco.. they all think its just my zanax. This include my work husband and kids...... the treatment place has not even offere me suboxone yet... told me to go to my doc which I did and guess what she gave me? Hmmm you probaly already know, my norco and xanax. I got them yesterday.... 100 pillls of both and instead of tapering me she uped my dose of zanax to 2mgs 3 times a day and 2 10/325 norco every 4 hours..... I have taken my zanax and 2 norco. I want to throw the norco away so bad! But then I don't want to be sick like I was for 4 days. How can I taper myself?
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82861_tn?1333457511
Why did you fill the prescriptions for the norco and xanax?  Did you tell your doctor that you've been abusing them and ask for help with a taper plan?  

Secrecy is one reason that good people with solid intentions relapse when they try to detox at home.  Shame and guilt do their part as well.  Getting off the junk is only the beginning of recovery.  If you don't work on yourself and the reasons why you want to turn off your brain, you're a relapse waiting to happen.  I watched my husband try the secrecy and "private" detox route.  It doesn't work and only prolongs the agony and puts off the inevitable.  It's also darned expensive if you go to one of those cash-only clinics that use privacy and secrecy as a lure.

Suboxone isn't a miracle cure.  You're going to have to be somewhat in withdrawal before you start taking it, and you may feel a bit odd the first few days.  In my personal opinion, most sub docs start patients at way too high of a dose, but I'm no doctor so what do I know?  I agree with the above members that it can be a great tool as long as it's used short-term.  There are plenty of horror stories on this forum from people who were put on it for maintenance and having a terrible time getting off the stuff.

Drugs like Suboxone and methadone are used for "harm reduction" in detox parlance.  The idea is to get the patient off the street drugs so their lives can stabilize enough to work on the mental part of addiction.  Also, having a legal source for narcotics reduces harmful behavior like stealing money or drugs or dealing with the dregs of society who are dealing.  Both drugs have long half-lives so the patient doesn't feel the euphoria associated with abuse of the drug of choice.

My husband really thought his addiction was a secret just like you do.  He was only fooling himself.  EVERYONE knew he was loaded on something - they just didn't know exactly what that something was.  The glassy pinpointed eyes, the slow and slurred speech, the stagger-walk, the nodding out and scratching... you get the idea.  Losing his friends was one of the worst consequences of his addiction.  Once he finally got over himself and told people what happened and that he was in treatment, he could hardly believe the support they offered.  Their reaction has helped him stay motivated to stay clean.  Everyone needs an attaboy once in a while; why should addicts be any different?

You may be very surprised at the reaction if you're honest with your loved ones and ask them for help.  At the very least you need to bring your husband into your world.  He already knows you're addicted to xanax, so why is telling him about the norco any different?  Have him hold your meds for you and dose them as prescribed.  Giving up that control is going to be darned hard for you, but I think you already know you can't control it yourself.  Ask him to go to the Sub appointment with you if possible.  If he can't go in person, see if the doctor will answer any questions he has over the phone.

Try to stay calm about your appointment and don't go in with any preconceptions.  Most importantly, ask questions.  Be 100% honest about how much norco and xanax you take so the Suboxone dose can be properly calculated.  Ask your doctor how long he expects to keep you on it and make sure the taper plan is crystal clear.  If psychotherapy is not offered, insist on it or start attending regular NA meetings.  My husband kept a spreadsheet every single day that included the dose, any side-effects and how he felt physically and mentally.  The doc says it's a huge help to him to see what happens on a daily basis.  It can also be a good mental exercise for you to chart your success.  You CAN do this!
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417564_tn?1287986427
Many doctors are simply glorified drug dealers since they receive a commission from the pharmaceutical companies to encourage the use of medicine that is often not in the best interest of their patient.
Perhaps if the doctors were forced to use these meds and then have them taken away, they would gain some insight into addiction and be more selective with the medications they encourage.
One of the suboxone doctors in the Asheville area tells everyone that suboxone has no side effects and there are no withdrawals associated with discontinuing use.  There is even a story that is in circulation here from the suboxone doctor regarding a 3 year old child eating several pills with no complications.  This story seems to put alot of people at ease and create a false sense of security.
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Avatar_f_tn
I filled them because I am an addict and I know it. As forf the zanax. I am comfortable with... they don't get me high or anything they make me feel normal. I was diagnosed with sever anxiety/panic disorder in 2003 and have been taking them ever since with docs approval. Last weekend was the worst in my life . With drawls from BOTH were terible. If I can tapermyself off the norco and go through the withdrawls for JUST that I think it won't be as bad for me... I know I need to get clean from them if I can do 4 days with bothi can do it forever with the norco with support here and a few friends at work. There is no way I can bring my husband into my hell... I am too ashamed....
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82861_tn?1333457511
Thanks for the clarification on the scrips - I just wanted to be sure I understood what was happening.

Try not to let shame rule your actions.  Shame allows that little voice in your head that says, "I'm a piece of cr*p addict, which means I deserve to harm myself and take these pills" to get louder and next thing you know you're right back where you started.  Since you've kept your detox attempt secret, there are no consequences if you relapse - or so you convince yourself since it's "only" you that gets hurt again.

How do you think your husband will react if you ask him to help you detox?  Yeah, there will probably some anger, dissapointment, maybe even despair and tears.  Those kinds of strong emotions are impossible to sustain for long.  Like withdrawal, it won't last forever.  Is some short-term verbal bashing worth it if he can help you?  By helping you, he is also helping himself.  Remember those marriage vows?  That part about better or worse?  As your husband, you owe him your honesty, and he deserves time to work through whatever emotions he may have in reaction to your announcement.  If you can write down a taper plan and present it to him along with your meds, you will earn a great deal of credibility.  Your actions tell him louder than any words that you are serious about getting clean and working on your life - together.

If you absolutely cannot face it with your husband, do you have a trusted friend or family member who can hold the pills and give you your daily dose?  Try to think of ways you can deal with the anxiety besides reaching for the xanax.  I get panic attacks myself once in a while, and self-talk and controlled slow, deep breathing really helps.  If it's really REALLY bad, I have to get out the paper lunch bag and breathe into that for a couple minutes.  Those are the times that having a trusted ally by your side to talk you down can make a huge difference.  My husband said he wouldn't have made it this far without me.  He had the shame and guilt thing working in a large way too.  I knew he was screwed up on opiates, but I didn't know exactly how much he was taking.  Not exactly a big surprise.  :-\

So are you going back to the detox place or are you sticking with the home plan?
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Avatar_f_tn
I am sticking with the home detox plan... I have exhausted my fmla (job protection) with the two carpal tunnel sugeres this year, my boss is also a micromanager and I have been on a write up since last sepetmber for leaving work or missing work for my kidss when they need me. That is what is making the inpatient detox impossible........ I cannot tell him see we both had an addiction to meth for years... we not only lost everything we had once but twice in our lives, jobs,cars, houses....... I am tooo ashamed to tell him or my children. Without the zanax the panic is always there.  Without the norco the withdrawls are there....  there has got to be a way to live without them
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