Questions about Suboxone - Read This

[uphill7584]

First, I will say that there is a lot of truth to the Suboxone Part 1 and Part 2 posts on the Substance Abuse Main Page. However, it is also largely based on one person's long term experience (5+ years I believe) with Suboxone and it's after effects on that person. Some of the pharmacology information is a bit questionable as well, and seems to be based more on opinion and response to the individual's personal experience with Suboxone.

I am offering some information on the drug, along with my recent experience with the drug.

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Some quick information on Suboxone (Buprenorphine and Nalaxone):

BUPRENORPHINE -  the med that keeps you from WDing and gives you that buzz when you take Suboxone....it IS a narcotic synthetic opoid analgesic. BUPRENORPHINE is sold as a narcotic pain killer for moderate to severe pain in a preperation called Buprenex. (Buprenorphine alone)

Suboxone combines buprenophine with naloxone (the naloxone is mainly present to deter people from trying to shoot/snort the drug. If you shoot Suboxone you go into severe withdrawal...why...because you just combined an opoid(buprenophine) with an activated opiod antagonist. (ie Naloxone/Narcan...it is what they use to bring people back from overdoses, it rips every opiate off every receptor...you live, but you withdrawal.)

When administered sublingually, very little if any of the Naloxone is absorded by the body. The buprenorphine binds to the opiate receptors in your body, eliminates withdrawal, and gives you a limited euphoria. When people say they cannot get high on other opiates when using Suboxone, it is not likely because of the Nalaxone, it is because the BUPRENORPHINE attaches to all the opiate receptors, blocking the ability of the other opiates effect. (http://www.suboxone.com/patients/suboxone/how_suboxone_works.aspx)

Ulitmately, Suboxone contains a narcotic opiate just like the pain pills or heroin you are trying to quit. (This may be fairly well-known, but I saw it questioned in a post and wanted to make it clear.
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That being said... I will give my story and ultimate opinion of Suboxone treatment:

My backgroud:

Started taking Norco almost daily in 2005 continuing through Feb. 2007. Topped out on the Norco at about 200mgs of hydrocodone(the opiate in Norco) per day. At that point I move on to any form of oxycodone avaibable. Around New Years 2008 I topped out at around 200-250mg on oxy a day. I was unable to get any meds for a few days and was withdrawaling horribly and said screw it. I called my primary care physician, spoke with my usual nurse and begged for help. She said that my doctor would not see me until I was medically stable and to expect a call from an inpatient program for stabilization.Checked into the hospital, not exactly a rehab, I was on a floor with patients that had all kinds of ailments...which made me feel less like a drug addict. Over the next three days, I was dosed Suboxone ending out with a recommended dose of 16mgs. Upon my release I was refered to a Suboxone clinic where I would recieve my Suboxone scripts along with counseling.

At first, I thought it was amazing. No more worrying about getting pills, no more hiding from family, a weight was lifted of my shoulders.

What I didn't realize was that I was just trading one addiction for another. I wasn't clean. I was high everyday I was on Suboxone. I was not my true self and wouldn't be until I completely quick Suboxone. My treatment lasted 8 months....and the doctor wanted it to go on for even longer. So the months went by, I tapered, I got counseled...but first before I did that...I got high everyday on a 6-sided orange pill. Was I really accomplishing anything?

31 days ago, we (mainly me, realizing I was just addicted to another pain med) decided to go off at 1-2mg/day. I went through the same exact withdrawals I did with other opiates for about 7 days. Thought I was getting better as the physical pain went away, but then was hit with horrible anxiety, depression, and exhustion. Which has continued to today. I lost 25 lbs in 4 weeks. Like Methadone, Suboxone has a very long half-life...and like methadone the WDs last longer.

Basically it was like was left with a feeling as though I had accomplished nothing. I went through counseling about guilt and regrets related to using while on Suboxone and thought I had it all figured out...not at all. I was high on SUB when I was doing the counseling. Even if you think you are you true self when on Suboxone, you will be in for a suprise whe you come off. True reality hit when I got everything out of my system over the past month. It felt like waking up from a 3 year coma of screwing up and all the sudden having to deal with it.

So I am dealing with it. Dealing with something in retrospect I wish I had just done 8 months ago.

TBC.....

[christos24]

i agree with you about suboxone,i was on 32mgs for 8 months and going that high wasnt the right choice i should have stayed at 16-24mgs tops..the higher you go the more antagonists effects come out. before starting suboxone i was heavily addicted to snorting oxycontin and heroin, and then top it off with benzos, primarily xanax or valium, and then some soma. i would say that on a average day i would need either a half gram of extrmely pure brrown powdered H or 2- 80mg oxy's to not be sick and feel any effect what so ever. i only took norcos or percocets if i was withdrawling and doctor shopping. the strange thing aobut my suboxone treatment was that during the 7th month i broke, fractured, and separated my wrist and my primary/addiction doctor decided to take me down to 8 mgs of suboxone and putme on 120mgs of MS Contin. and after a month when the pain was still present, he decided it would be best to take me completely off of suboxone and go up to 240mgs of ms contin. it was a little ridiculous, well lets just say I went back to the day to day viscious cycle that is opiate addiction. i was scamming, getting pills from other doctors and the hand specialists, and whoever else i could find and i eventually ended up going right back to where i was when i first went into detox in Nov 07. until the wrist i was almost 6 months clean from any opiate other than suboxone. i am now at a methadone clinic currently at 65mgs and am doing alot better. i am now a substance abuse couselor in trianing. and working at a detox facility. with the methadone and counseling, i am more motivated, productive, stable, and structured in my life. everyone has to remeber that no doctor  or anyone elseshould decide for you what to do or what treatment you should go about, they may help but ultimately you have to decide for yourself and really want to get off of the opaites for good. and i agree with uphill that if you have a hydrocodone(norco,vicodin) addiction or a light oxycodone addiction then sub is tooo strong and you should talk to your doctor or if you dont have one set up an appt with a family doctor or at a hospital and ask to be detoxed from opiates. they might have you stay somewhere or they may just give you prescriptions and wish you the best of luck(you have to be very confident and motivated for that to work).they would most likely give you clonidine, which helps alot with sweating, chills, blood pressure spikes, and insomnia, a benzo most likely lorazepam or valium for the extreme anxiety and muscle cramps and spasms, and insomnia, some anti-nausea meds, immodium ad which is OTC for the diarrhea that helps a ton, and if needed ambien for sleep. the benzo and clonidine should work well enough to knock you out but if its real bad like mine was, you need a little boost to your arsenal. it was hell of 3 days, but getting on the suboxone made me completely better. after a couple of months i stopped getting real high off of it, but at first you def. get a buzz and its pretty strong, same as methadone, but a little less sedating and euphoric, but both are hell to get off of, they need to be slowly tapered or youll be in worse case than your original DOC. I agree that suboxone and methadone are just replacements, but both have better success rates than CTing or detoxing on your own, giving you a better chance to put your life back together. i know they saved my life.-christos

[uphill7584]

I am not sure if my posts about Sub are part of the reason why these arguments are going on, but I apologize if I offended anyone. In hindsight I wish I would have done things differently, and have been pretty vocal about it. I don't mean to offer medical advice, and I am sorry if my story scares/bothers/frustrates anyone in Suboxone treatment.

My intention was to share an experience and my thoughts looking back through 100% sober eyes. I may have gotten a bit too fervent and opinionated with my post.

Ultimately, I guess I just don't want someone to go down the same road I did if they don't have to. Suboxone is being pushed pretty hard by the addiction treatment field these days, and I jumped on the wagon thinking it would be easy and quick. I was uninformed by my own fault, and mislead by some of the professionals around me.

I guess, regardless of the treatment you are going to take on, find out as much as you can about it, and any other options you think might work. And then make and informed decision that you believe is in your best interest.

Again, I apologize if I offended anyone. My intention was to offer my experience...I may have overstepped my boundaries.

[uphill7584]

Subutex is just Buprenorphine without the Nalaxone. It is just high-dose Buprenorphine by itself used to treat opiate addiction. It is prescribed much less than Suboxone, because it does not contain the opiate anatagonist. (Nalaxone)  I have rarely heard of people prescribed Subutex. And it is documented that it is prescribed far less than Suboxone. Mainly because without the Nalaxone the user has the ability to inject the Buprenorphine.

My guess is that it exists for cases where the patient is not an IV user and the doctor is confident that abuse or diversion won't occur. There also may be individuals who cannot tolerate Nalaxone for whatever reason. (This paragraph is mostly speculation by me, I couldn't find much information on why it would ever be used over Suboxone...they don't even carry Subutex at Walgreens according to the website.)

[macksabratt]

Great post and I agree 100%.I have never taken suboxone but I know a few people that have and they had the same experance as you did.What is the difference between suboxone and subtex?

[uphill7584]

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My Thoughts on Suboxone in Good Old 20/20 Hindsight:

Note - These are my opinions, based on my personal experience. Everyone is different. THIS IS NOT MEDICAL ADVICE.

*I WISH I HAD NOT USED SUBOXONE TO QUIT* - I wish I would have just taken the week of WDs and been done with it 8 months ago. Spent 8 months on it, thousands of dollars, and still WDed like any other drug.

1. Sometimes doctor's, for whatever reason, tend to start patients on much higher doses than neccessary. I was given 16 mgs, and quickly realized 8mg was plenty.

2. If you REALLY want to quit opiates, I would go the way of Clonodine and a sleep aid for a week. Since Suboxone contains an opioid, you are doing nothing to repair the damage opiates have done to your body while you are on it.

3. In short term detox, low doses of Suboxone I have heard to be useful, but extended maintenence is just another dependence. It may be useful if you want maintenence, but if you just want to get clean....long term Suboxone treatment is no good in my experience.

4. If you are addicted to a hydrocodone product, I would not go on Suboxone...it is a much stronger drug.

5. Many Suboxone Treatment Centers are more about profit than patient care...beaware of your treatment plan, listen to your body, and don't take more of a drug you dont need...Don't be forced into a treatment plan you are not comfortable with. Being an addict gives doctors a great deal of power over us, we need them, and they know it...do not let yourself be taken advantage of.

6. As a fairly new treatment for opiate dependence, I think Suboxone will eventually be seen in the same negative light as Methadone. Personally, I think it is just a more expensive, "classier" version of Methadone in the eyes of the public.

7. Ultimately, I can say that I have detoxed from Vicodin cold turkey from around 100mgs/day and oxy cold turkey at about 120mgs a day....and my withdrawal from Suboxone has been and continues to be the worst.

8. I believe that in the near future we will begin to see more and more individuals having trouble quitting Suboxone in the same matter as Methadone.
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CONCLUSION

So clearly, I am not a fan of Suboxone. But as I said, what you have read is just one individuals experience and opinions. I don't want anyone to take any medical advice from anything I have written here. My goal is to make people more aware. I jumped into to Suboxone, because like many, I thought it was this miracle pill that was going to get me clean in no time. I guess I just hope that those considering it take a step back and access their situation before jumping in like I did. And if you do choose to use Suboxone do research, know exactly what you are taking. Ask questions. Find out why your treatment is setup the way it is. I am sure there are some people that have had great experiences with the drug, and I am sure there some people out there that agree with me.

If you have a positive experience with Suboxone please post it here, and offer details about your treatment. If you disagree with my opinions, feel free to respond.

This is my story, what I have learned, and where is lead me. If I could go back I would have taken a different path. To each their own, and I wish everyone luck and success on whatever route to recovery you may decide to take.

That's all I got. If you have questions or comments shoot me a message or post.

Thanks all. Take care.