Suboxone- Yes or no?

[HopeWins]

My family has suffered beyond words in dealing with opioid addiction. I am in the midst of grieving the loss of my adult child due to opioids. I have spent the last 6 months researching every aspect of brain chemistry and how pain meds work ...and kill.   I was in the "no to suboxone" camp, under the impression of "substituting one drug for another", was redundant.  However, after reading the Huffington Post's WELL WRITTEN  article, my opinion has done a complete 180.  Yes, I understand this is MY current revelation and I only wish I had read the Huff piece a year ago...God, so how I wish.  Just throwing it out to the community to take the time to read  the article for a better overall understanding of the problems America faces, and how antiquated and under-funded opiate treatment and withdrawal is.  The decisions you make will be better informed after the read:    http://projects.huffingtonpost.com/dying-to-be-free-heroin-treatment?ncid=newsltushpmg00000003

[otterwatcher]

yep-after 17 tears of heavy heroin use,subutex worked for me where methadone failed.It gave me my life back.

[weaver71]

I agree with a great deal of the article, yet I see the same inductive reasoning in it that I see in most articles or research about addiction. Some of the information is also incorrect, but is well written, as far as persuasive rhetoric goes. I want to point out one mistake, they said that methadone is only available in a clinic in the U.S., but any MD can prescribe it in pill form, since 2001. It is actually easier to get methadone here in Cali, than it is suboxone. I can go to the doctor and they can prescribe it to as many patients as they feel needed, while suboxone has a max of 100 clients per license. The other obvious mislead, is that 12 step is a willpower method and focused mostly on abstinence. The facts are, the first chapter of The Big Book is the only place drugs or alcohol are discussed, the rest of the book is about personal development, working on resentments and self-inventory, making amends and being in the moment, and many other evidence based psychotherapy and CBT. CBT uses much of the same principles as 12 step, change your thinking, change how you feel. Any member of 12 step who knows about it will say, "Willpower and abstinence is not enough." They even have a name for it, "White nuckling it." They also fail to mention some of the reasons there are so many restrictions on subs, like that it is the fastest growing prescribed and illicit drug in the world right now and as addictive as heroin, it is an opioid. Much like the studies done on rehabs, I feel they set out to prove an objective in this article, rather that simply stating ALL the facts and allowing the readers to form their own opinion.

That being said, subutex saved my life. I am a methadone addict who had multiple respiratory arrests from methadone. Since 2001, methadone has hit the streets and is readily available, cheaper than most opiates on the street, though it has decreased some in the last couple of years, due to all the deaths it has caused. Methadone OD is the number one killer in my little mountain town, usually mixed with alcohol. The doctor who got many people here hooked on methadone felt remorse and tried to make amends, just before his death last year. He became a sub doctor and switched as many clients as he could from methadone, before he handed over his practice to a new doctor. He himself was addicted to methadone and his son died from Oxy addiction, he committed suicide after failing to recover. So, that doctor had some personal understanding of how intense addiction is.

Anyway, I think buprenorphine is an amazing tool and think that methadone should be obsolete, accept in situations of allergy or bad response to suboxone. This article makes sub and methadone sound the same, as they are used the same way for the same reason, but methadone is far more addictive and can cause OD and has the worst withdrawal than any opiate. Heroin addicts who detox methadone, after years of use, often say that it would've been easier to kick heroin. Suboxone has a really intense and long withdrawal too, but doesn't get you as high as methadone, so I think it is more like a sober mind set than methadone. Every bit of clarity one can get from medical treatment of addiction, the better. On that note, sub alone is not helpful.

Though this article went on and on about how 12 step doesn't work, most sub doctors encourage meetings and counseling, for a reason. I agree, 12 step alone is not enough for me, neither was suboxone, nor counseling, it has been a combination of resources and therapy methods that have made me able not to use opiates. And like they say in AA, my willingness and open mindedness were vital to my recovery. I don't know if it's from being around and studying addicts so much, or what, but researchers and doctors seem to often have an addict all-or-nothing view. It's as if we have to determine what therapy is the ONE. Recovery is not a medicine treatment, it is not psycho analysis, it is not going to church for support, it is all those things and is a lifestyle change of the entire person.

So, my answer to your question, yes suboxone, but only in combination with many other forms of recovery, and as a last resort. I believe a study on suboxone would show that those who use it as a sole therapy, relapse as much as anyone else using only one form of therapy, be it 12 step, meds, CBT, hypnotherapy, no one thing can totally change an entire human being. I have seen people wriggle and squirm, having a real hard time quitting suboxone, eventually, one has to detox everything. Because of that, it is essential to use the time on sub to prepare for coping with that. Fear of detox is likely the number one reason people don't try to quit for so long. These are some of the things I think the article alludes to, but doesn't really give the emphasis I believe is important in considering using suboxone as an opiate addiction treatment.

For me, it takes everything in my life combined to change everything in my life. That is what recovery has been for me so far, changing every single thing about my life and how I see it and cope with it. Suboxone was a good window of clarity to help me set up my recovery, but was not the miracle drug that set me free, by it's own power. It takes a Higher Power than a drug to change a stubborn guy like me, but it did help me get started. Do I think subs should be readily available, no, I really don't. I have probably seen more harm with subs than good. I see people use them to get by, until they can get some stronger drugs, like the kid in the article confessed to doing. I have seen people use subs alone, from the street, and go right back into active addiction, as soon as the sub connection ends. Some of these issues should have been mentioned in an article that is solely trying to help addicts, not trying to sell suboxone to the public.

Of coarse this is all opinion, and I suppose that is my point of all this, there are as many ways to be in recovery as there are people. We all have some things in common, but we are all very unique, just the same. Find what works for YOU, that's what I always say.

[worried878]

I havent looked into protocols for sub in quite a while//do know you used to have to pretty much done with withdrawals to start it as it blocks receptors and throwd you into withdrawls/things may have changed...not sure..do know it is another narcotic that you will eventually have to ween off of

[vicki595]

Thank you for checking in and offering that link. I had read it recently and it was very well written and informative.  

Most of the members here agree with using SUBOXONE for IV drug abuse treatment but not necessarily pain pill prescription abuse.  Maybe that needs to be reassessed... I suppose it's because heroine IV abuse is considered so ultimate and deadly and Percocet abuse isn't?   Maybe if more addicts took SUBOXONE to get on their feet there would be a lot less death from overdose.  The article gives a convincing argument.  One thing though...many, many in patient facilities use SUBOXONE as part of their treatment. There are quite a few physicians, as well.  Unfortunately, there are many who use the drug as a financial opportunity. But, it's available extensively. The article makes it sound difficult to get.  In my state it's paid for by Medicade.

Thanks again for sharing with everyone here. I'm so very sorry for your loss and hope you can heal and move on to a comfortable place.  It has to be hard for you and you're wonderful to research and take on the role of "teacher".  I know your child would be proud of your efforts.

[jugglin]

I also want to say I am sorry this post got moved so quickly to the social forum as it is valuable and will not be as visible.  Sometimes I don't understand what warrants come threads to stay and some to get moved...I'm sorry to see this.

[jugglin]

Thank you for posting this.  What a great article...reaches us on a human level as well as a scientific/medical level as well.  There are many folks on MH who used Subs to kick heroine and will tell you it was the best thing that they ever did.  I think the topic gets clouded when somebody is detoxing of the Subs and speak about the drug as evil.  I get it...I do.  However, for the opiate abuser who has tried time and time again, Subs should not be a dirty word...as long as the addict is in a program that consists of some kind of aftercare.
I am so very sorry for your loss.
Bless you for sharing this and for sharing your story.