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Avatar universal

Suboxone: Good, Bad, and Ugly Truth - 168 days off SUB

I know Suboxone is a tense subject to some, but as someone who has made it all the way through Suboxone treatment, and is 168 days clean from any opioid, I feel a responsibility to offer my honest experience. The doctors definitely weren't completely honest about its efficacy, and I wish I had completely honest input before I went on it.(Note, I am not saying doctor's are purposefully dishonest. I think many are misinformed by Rickett and its "data."

That being said...here is my experience and advice, for what its worth.

THE GOOD
Suboxone will stabilized the insane life that many opiate addicts lead. Assuming you respond well to it, which most do...it really help you get your life on track and stop focusing on the next fix. When I started I was very happy to put the BS of addiction behind me....or so I thought. If you don't plan on staying on Suboxone for life, you may want to reconsider using it.

THE BAD
Regardless of what any doctor says about Suboxone's pharmacology...its partial agonist(rather than full) effect at the mu opiate receptor...its blocking effects of other opiates, etc...there is a whole other side of the coin that you are not being told.

We have mu, kappa, delta, and nociceptors. The mu receptor is talked up as the big deal...its the one that makes you feel high. And Suboxone is promoted as revolutionary because it is a partial mu receptor agonist, versus full agonists like heroin, oxy, etc.

So this fact allows Suboxone to be sold as this unique option that doesn't get you high.(eventhough physiological it does and most sub patients would agree it gets you high) Based on that, it is often not even presented as an opiate, which it is unequivocolly. We are also told that since it is only a partial agonist, the withdrawal will be quite minor.

The truth is a bit more complicated...

(I am going to refer to Suboxone as Buprenorphine from now on, buprenorphine being to active opiate ingredient in Suboxone)

Like all drugs, Buprenorphine metabolies into other chemicals once inside our bodies. (like heroin metabolized into morphine) Buprenorphine itself is a partial agonist at the mu opiate receptor, and a full agonist at the delta and nociceptors, and competitve antagonist at the kappa receptor. Buprenorhpine's metabolizes into norbuprenorphine, which is a full opiate agonist at the mu, delta. noci, and partial agonist at the kappa. So basically they are computing at all your opioid receptors, except the mu. The only thing fighting norburprenophine's full agonist effect on the mu aside from buprenorphine's high binding affinty. Meaning the less intoxicating buprenorphine latches on the mu receptor tight enough to block any other chemicals(whether this is true is immeasurable, and a moot point anyway.)

So what the hell does all this mean?

The mu receptor controls dependence, euphoria, GI physiology, etc. Bup has a partal agonist effect here, meaning to sum degree it is causing or effecting all these. Norbup has a full agonist effect here, which means to some degree it is having the exact same effect as any other opiate.

The delta receptor controls dependence, analgesia, and cns effecs. Bup and norbup are full agonists at these sites. Meaning they do exactly what any other opiate does.

The kappa receptor controls dysphoria, analgesia, and other important physiological actions. Bup is a competitive full antagonist at this site. Meaning it bindes very tightly, an block any other chemical. Norbup is a partial agonist, unlikely to counter the bup.

The nociceptor controls a variety of brain activities and and emotions. Bup and Norbup are both full agonists here...meaning the action at this site is no dfferent than that of any other opiate.

WHY DOES THIS MATTER?

Physiology is COMPLICATED...opiate abuse is not a virus or a bacteria. A series of pills is not just going to suddenly cure us. It takes a long time to change the body and brain with opiate abuse...and it takes a long time to fix it. Yeah, acute withdrawal may only take 1-2 weeks...but almost 80% of opiate addicts can't stay clean...and thats because you aren't healed when acute withdrawal ends. It may take less time to fully heal than it did to get addicted, but not much.

MY EXPERIENCE AND ADVICE ON COMING OFF SUBOXONE
My honest advice is that if you really want to be opiate free, and have the time and funds to go to a rehab...do it. Suboxone does stabilize in the short term, but doesn't make you any less dependent on opiates. And taken long term, when you do quit you may end out with more problems that when you started...like me.

So my story:

Got hurt, got on oxy, got hooked, asked for help, sent to stabilization, given suboxone, transfered to Sub doctor, given the whole SUboxoe is amazing story, didn't know any better, started treatment at 16 mgs.

8 months later, at 3 mgs tried to quit. Acute withdrawal not bad, lasted about 1.5 weeks. Weakness, exhaustion, aches, severe GI problems(diarhea, nausea), severe depression were constant for 2 months. During that time, I went from a muscular 205 lbs to a pathetic, horrible emaciated 155 lbs.  I saw my doctor every couple weeks beginning for help and asking when it would get better. He prescribed klonopin, bentyl, tigan, buproprion, adderal, and catapress at some point during that period. Each time offering to put me back on sub...finally after over 2 months I gave in. The depression and GI problems were too much...I couldnt handle it with work. I went back on and was all better immediately.

My doctor posits that I should have weaned lower...so a year later I get down to .5 mgs and come off. The acute withdrawal isn't bad too bad again. The muscle aches aren't horrible. BUT just like last time depression, and GI problems last for weeks and weeks. I was in school and couldn't hack it so again I went back on.

At this point I had done a lot of research, talked to other docs...and was incredibley pissed at the situation. When my term ended, I went off again from 6mgs. But I took matters into my own hands and found an addictionologist that is vehemetly against Suboxone unless the person actually only wants maintenence.

And here's what we did:

She accessed that I was severely opioid dependent from long term Suboxone treatment and removing the opiate was inducing severe depression and anxiety, chronic fatigue, and severe GI disturbance.

Acute Withdrawals: Prescribed Lyrica 75mg x daily...worked amazing for the aches, and actually helped the GI stuff too. Klonopin to aid with anxiety and sleep....helped a lot with aniexty, none with sleep, but I didn't mind being awake because the pain was gone. Even more important than meds was diet. Drinking a ton of water, and eating healthy vitamin rich foods. Kefir, activia, fruits, veggies, chicken, rice, etc.

Long Term: Long term was hit and miss. I tried to be tough and push through a lot, but just could not get myself together. I couldn't function for months. I stayed in bed for 2 months...didn't really leave the house for 4. After trying a few differents things my doctor and I found that Cymbalta treated my exhaustion, aches, and some GI problems. After a month on 60 mg Cymbalta I was feeling better but couldnt focus for the life of me. We talked and as much as I hate stimulants, we tried 40 mgs of Vyvanse, which has worked wonders...took some getting used to, but helps a ton. Additionally, I am taking Oleptro occassionaly for sleep, Ammodium/Pepto/Tums for the stomach, and Klonopin for occassional anxiety.

My new non-suboxone addictionologist believes that all my symptoms are from the long term use of Suboxone and that we will remove the new meds as I start to feel confident.

Looking back on my time on Suboxone, I am disgusted with the way I behaved in some instances, and some of the choices I made. My thought process while completely off opiates is completely different.
22 Responses
Avatar universal
Although it probably seems like my only point here is to condemn Suboxone....and there is defintiely some of that here. I have a huge problem with the drug, those who prescribe it, and opiate addiction treatment as a whole.

BUT my real point is that, when I started I didn't have an opinion or informaion on anything. I allowed myself to be shuffled along by professionals that I believed were required to be completely forthright, and we ultimately infallible.

So despite my anger toward the situation, it all did start with me. And had I been informed things may have been different.

And thats it... in the end, after all the complaining and stories... all I am doing is begging that people go into these situations informed.

We are constantly being advised to be proactive in our medical care. And that is being directed at non-addicts. As addicts your input is rarely if ever valued by doctors. We lost our trust, and as a result we oftern recieve less attention, are lumped into groups, and are passed over. That just leaves ourselves to make sure we are getting the best care and taking the best path.

Good luck to everyone. If anyone has any questions I am happy to offer the information I have gathered. Dissenting opinions are welcome, but I hope my post doesn't attract to many. I really am not looking for an arguement. Take care to all and I wish you the best.
Avatar universal
Holler if you have completed Sub treatment as well. How long you been off? How are you doing? etc.
1 Comments
I started using subs as an inexpensive substitute for full agonist opiates.  I had no idea what I was getting into.  I did a year of out-patient treatment to get off the subs.  I tapered down to .25 mg and I think I would have been better jumping at .125 mg.  The acute withdrawal wasn’t bad but the depression lasted for 2 solid months.  I’ve been off of opiates for 2 years.  I had knee replacement surgery in Sept and was prescribed approx 380 oxy 10s and 120 hydro 10s.  It only took about 3 weeks to become dependent on opiates again.  It was moderately uncomfortable to get off but I wasn’t going back on the opiate merry-go-round.  I NEVER considered using suboxone as a treatment for the dependency.

I’m a supporter of subs as a means of stabilizing one’s life, but know what you’re getting into!  It’s clearly better to not use them to get clean if you can.  I’ve lost more than 1 friend to ODs so I understand how important subs can be for harm reduction.  There’s a place for subs in opiate dependency treatment but buyer beware!
Avatar universal
That is the best info on sub (bupe) I think I've ever read, thank you for posting the entire thing as it's written. If I can figure out how and it doesn't become deleted I'll print it, for future reference! I had a dr. offer me it and refused. Thank God! I also have a relative who takes it and is I believe ignorant of what it is. I wish I knew than what I know now about long term opiate [oxy] use for pain management, can't say it would have been totally different, and there's only pretty much one way to know ugly it can get.
Avatar universal
Thank you for the information, very well put.  Makes a lot of sense.  I went on subs about a year ago.  The doc wanted me on long term.  About 3 months in, never really feeling I was off my DOC, I relapsed.  Right now I'm back on sub, have been for about 7 days and started a tapper plan pretty much from day 2.  I want to jump off at around the 14 day mark.  I have stuck to my tapper and have taken enough only to keep me out of severe WD.  I have had slight WD since day 3 but I can function.  Have some ups and downs but hanging in there.  I guess what I'm wondering is do you think sub is bad all around?  In your opinion, do you think short term it can be effective?  I have no doubt I will crave opiates when I jump off but I'm just going to deal with it as it comes.  I still have some cravings here and there but no big deal.  I'm currently at 1.5mg per day and going down tomorrow.  I just couldn't afford to be out of service for 4-7 days as that is my typical acute WD period.  Was taking 18-20 10mg perks + 1-2 oxycontin per day when I quit.  
683878 tn?1301550868
I notice you are a new member and understand your intentions but this is not news. The first half of your post was written (copied) and the scientific portion just doesn't matter to the user trying to quit. We all know opiates cause dopamine depletion and the only recourse is to discontinue use and allow time for our brain to begin to reproduce naturally.

I'm not trying to be degrading but you were prescribed more medication than I could imagine to help with the common textbook issues that we all experience during withdrawals. No wonder you had problems. I would too if I were taking so many drugs.

My only point is that the mindset of taking medications to get off of medications is not going to address the core issues. I despise suffering just as much as the next person, but realized if I want off the pills then I don't need to be taking any pills.
Avatar universal
Do I think Suboxone is bad all around?

Kind of leads to a complicated answer. I think the entire social and medical approach to addiction is a mess.

And no, I am not one who believes addiction can just be cured by the addict. I do believe it is genetically based and ultimately is a disease. However...

Every other disease has varying levels of severity, groupings based on symptomology, etc. Addiction doesn't have the privilage of being treated like a valid disease...not even by doctors. To most...an addict is an addict is an addict. Really? .... So the the police officer that gets shot and becomes addicted to oxy is the exact same as the the heroin addict that would steal from their family to get a fix? F-that!

And there is lies the problem...were all people, we are different...our disease manifests differently... our physiology, environment, comorbid issues, etc all are an influence.

That being said, NO I do not think Suboxone is 100% bad. It is probably a lifesaving miracle for the heroin addict that is stealing from his family...but for the cop that got hooked on his legal oxy...or the house wife on a few vicodin a day bc she hurt her back...no these people should not shuffled into Sub and methadone problems.

I have seen first hand Suboxone's successful used in very short-tern detoxes. I don't have the article here, but opiate addicts were given decreasing doses starting at 8-16 mgs. A great deal of success was seen in eliminating the acute withdrawal period. So if you want to quit and minimized withdrawal, yeah it can help in this very short term setting. Success beyond that is up the the individual.

Also, Suboxone can be useful for those who literally don't want to be off opiates ever. A true long-term maintainence program...til death. But in this case, I say why not just use methadone...people have been taking that forever with little side effects. By my 3rd year of Suboxone I was developing depression, anxiety, involuntary movements, etc.

So yeah...I think there are some positive used for Suboxone. Few, but some.
Avatar universal
I am not a new member. This is just a new account. I have been on here for since 2008 when i went on Suboxone. Actually, some of the positive reviews of the drug on here made me feel better about using it. I have been hear through all the debacle surrounding Suboxone.

Regarding the science...how can you promote ignorance. That is what got use all into drugs in the first place. We took them without knowing what we were really doing to our bodies.

Regarding the medications used...I did the whole process with nothing. The meds only helped.

Lastly, I am curious to know if you are in Sub treatment currently...

and if you could explain the statement below a bit more I'd appreciate it. Thanks.

"My only point is that the mindset of taking medications to get off of medications is not going to address the core issues. I despise suffering just as much as the next person, but realized if I want off the pills then I don't need to be taking any pills. "
Avatar universal
I am beginning to remember why I stopped posting on this forum. Addicts treating addicts is pointless. And addicts clashing over the right way to do things is always a mess.

If this post angers anyone or people disagree with it...tough. Life isn't one big happy discourse. And at the end of the day, sometimes there is a right and a wrong....not just gray.

I do hope this helps some people. Although, I am the biggest advocate for seeking out your own information from scholarly sources...I am also willing to offer advice or info to anyone who finds themself at some point in the road I took and needs some help.
Avatar universal
I reread your post, and I understand what you meant. First, you clearly did mean to degrade me. I reviewed a lot of your posts, and im not going to bother breaking down things. If you are happy with your view and the advice you give others.

I would like you to ask you to consider avoiding so much generality and realize people aren't all the same...

"My only point is that the mindset of taking medications to get off of medications is not going to address the core issues. I despise suffering just as much as the next person, but realized if I want off the pills then I don't need to be taking any pills. "


I am a bit confused because you state you use Suboxone, but believe that taking meds to get off meds avoids core issues. And the idea that wanting off a drug means you shouldn't take any drug makes no sense. Opiates white-wash almost all anxiety and depression disorders, and a number of physical problems. The majority of addicts use to self-medicate. There are often underlying medical issues that need to be treated. If doctors saw addicts like people they may work to fix those problems rather than throwing Suboxone and Methadone at them to mask everything.

Avatar universal
your post has really helped me, and I agree  about the medical profession  , they are judgmental and harsh making it difficult to find help . thank you for your post
Avatar universal
I am preparing myself for withdrawal from a 9 yr run with one kind or another norco, percicet, or oxycodone (morphine). I want to get off but want to do it with  thought and planning . I am asking my doc for cymbalta today, I have Xanax for nerves and understand I should get something for restless legs. any advice for me?
1580085 tn?1400944438
i found your post very informative, i am addicted to opiates, and have been clean for102 days, when i first came upon this site, i read peoples posts regarding suboxone, i had never heard of it before, i am from the uk, and although i was seeing a drugs counselor, who held group counseling sessions and a dr. no one had mentioned it, i asked them about this drug and  they informed me ," its very seldom used in the uk, its very rare anyone is prescribed it,  although methadone is used to bring folks off heroin, the taper method is almost always used for other opiate addictions, so in all ,i think thats a good thing, or i and others in our ignorance may have chosen that route, best wishes.
Avatar universal
I do agree with you about how everyone is different and how the medical field looks at us.  You are right, there is a difference between someone who gets hooked after surgery vs someone who is hooked on heroin and steals from their family.  I agree 100% that using a medication to get off another medication does not address the reason for abusing.  Perhaps that's what I didn't understand the first time trying subx, well I really never thought about it so it was part of the problem.  My only reason for using subx now is to lessen the physical part of WD during the acute stage and that is it.  Have I tried this approach before? No.  Will it work for everyone? Not a chance.  But right now it's working for me but the true test is yet to come.  I came up with what I thought would work for me after some soul searching and being completely honest with myself.  Only time will tell if it will work, I am confident as of right now that it will work.  This whole one size fits all for all addicts approach is a problem IMO.
683878 tn?1301550868
I stand corrected in assuming you are new. I don't keep track of my clean time, but according to my tracker it's been 399 days. When I give advice, I do not state it is fact. Every post I ever respond to I can personally relate. I don't push personal beliefs, but I have done exactly the same things every one else has regarding using other medications to alleviate withdrawals. I do forget that a lot of people visit the site daily and not all are familiar with the scientific aspect. I have gone through lortabs to oxycontin to methadone and suboxone and just about everything else along with every anti-depressant, anti-anxiety, sleep medication under the sun.

Your post is very informative and based on other responses has educated some. I have just seen it 1000 times already is all. What I have learned from experience and what I teach others ( outside this website) is that once you eliminate the mindset that you need a pill for each ailment, then complete abstinence becomes much easier.

My opinions don't mean a damn I know, I only try to help. I do have about 75 actual people I meet with weekly that may say different. I only want to help prevent others from prolonging the suffering and the endless searching for temporary relief when there is a permanent solution.

Good post man. I just disagree
Avatar universal
excellent response Steveo...
696149 tn?1314324559
Hi, I've been taking Sub for two months now...I'm taking a total of 4mg a day...that is two 2mg pills per day.  I'm thinking of going off of it.  How bad do you think the w/d's will be?  I'm actually currently taking Norco right now, so I'm not having any w/d's from Sub.  I was taking it for depression, but I think my body likes the Sub too much.  I've had trouble breathing the last week because I abused it....was taking 8 to 12mg per day for a couple of days.  I learned my lesson from that!  I'm still suffering from that.....having a little trouble breathing but not too bad now, but it was real bad for a few days.

So I'm thinking the cons may outweigh the pros and want to know what to expect.  I just started working out 5 days a week.  I used to really be involved with the gym and I was pretty big and strong.  Anyway, I'm looking to reclaim that, but I know how bad you can feel from w/d's.  I haven't been taking it that long so I wonder how bad it will be.  Thanks!
Avatar universal
i have been on suboxone for a little over a yr tried cold turky omg that was hell on earth i was suicidal three wks went by i wasnt feeling any better so i gave in still on suboxone i dont want it anymore but terrified of withdrawl because three wks not getting any better im trapped i cant even get weaned off because i want more and take more than im sipposed to what do i do please anything you can do to help me would be appreciated
Avatar universal
i have been on suboxone for a little over a yr tried cold turky omg that was hell on earth i was suicidal three wks went by i wasnt feeling any better so i gave in still on suboxone i dont want it anymore but terrified of withdrawl because three wks not getting any better im trapped i cant even get weaned off because i want more and take more than im sipposed to what do i do please anything you can do to help me would be appreciated
4522800 tn?1470329434
Hey Guy just wanted to let you know that this is a old post from April-2011..Hit the orange button up on the Top and post your own question and many will try to share there experiences or knowledge about the Subs OK??


******************************************************************************************
Avatar universal
Thank you for your post, I have been trying to organize conversations on Suboxone and have also been reading and  looking into any info I can collect. I know that there is not a chemical cure for drug addiction, I myself have 7 years clean and am afraid how things may have gone if I had been put on such a drug when I first started recovery. Most of the people I know who are on it ( which is a lot ) are making claims that the drug is a miracle and the best option and I am standing up against that. Already had people close to me inspired to get off Suboxone because of people like you telling the whole story. Thanks again. Keep on rocking in the clean world :)
1 Comments
What would you guys say to someone who likes to slam dilaudid but is NOT opiate DEPENDENT. No physical withdrawl...just a "craving" leading to sparatic but potentially dangerous use, not consistent by any means.now this person is going through a good deal of personal turmoil-completely unrelated to drug use other than impending divorce, carreer trouble etc. Leading to a desire to use. This person has a history of being suicidal. Depressed. Anxiety ridden. Now I say agaikn NO PHYSICAL ADDICTION but has put herself in recovery to try and get a handle on her moderate opiate use. They have suggested suboxone.
Avatar universal
This is a old thread. Please post a question on new thread you will get a better response. It sounds like this a Big problem. The Holidays make our problems worse. Can you call someone?
Avatar universal
Im now, 27 years old. Me and my ex boyfriend became addicts and were addicted to pain killers/ heroin six years ago. After two years of that addiction we found Suboxone and started buying them on the streets instead. At the time it seemed like a saving grace. I still got to get high but only having to take small amounts of it (because theres no reason to take a lot) we were able to afford our addiction and still live fairly normal lives. (We were shooting it up at the time, and that is just one of the many reasons why I say fairly normal) not to long after being on it I stopped getting high and it just made me feel normal and be able to at least function during the day. Days we didnt have the money for it were hell. The first two days you arent even really sick, maybe achy and tired. By the third day my whole body hurt so bad. I was so weak. I couldnt stop pooping. I couldnt sleep or eat. My eyes and nose ran constantly. My legs hurt so bad I wanted to cut them off. I felt like I constantly had to be moving them from the pain. Not only were the physical symptoms horrific but the mental ones were too. I was constantly angry and sad and only thought about doing subs and feeling better. Because of the severe withdrawal symptoms (symptoms start to get better, but last a month) we both ended up getting them prescribed for years. Legal and much easier for us to justify that we were doing the "right" thing that way. It did make me not have cravings for other drugs. But without it, I was a worthless miserable *****. I have now been off of Suboxone for a month. Although I was only doing a quarter to half a day the withdrawal was still horrible which is why I was on it for so long.(I didn't want to deal with it) I know a lot of other addicts and every single one of them that has gotten on Suboxone are still on it to this day. (They cant stand the physical/mental withdrawal either. However a lot of them believe that Suboxone isnt a bad drug, or at least act like its not. But lets face it. Ive seen them and what theyre like when they dont have it. Just as miserable as I was to the point they call of work if they dont have it.) I do 100 percent believe it is a replacement drug only created for the profit of others. I am not judging anybody elses opinion about Suboxone whatsoever. Im simply stating how I feel. (Keep in mind I couldnt get out of bed without it for four years. And was miserable even in bed without it.) I believe the only way it should be prescribed at all is for very short periods of time to hopefully get heroin addicts off of heroin. Of course there are plenty of doctors out there that will happily prescribe it to anyone for as long as they want. So thats way easier said than done. I hope all of your experiences with this drug are better than mine was, and that it doesnt take over your lives like it did me.
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