Aa
suboxone
How long should I be on subprime therapy after being on almost every pain meds you can think of. Oh yahoo been on pain meds for little over ten years.
At the rehab I work at, they do a 6-14 day suboxone taper with great success. People come in having been on opiates for 10+ years. Anyways, theres an interesting article titled, "The Great Suboxone Debate" By: Jennifer Matesa from 2011. Id post the link but it would probably get deleted. I will post a small portion of the article below but you can google it to read the rest.
The Great Suboxone Debate
By Jennifer Matesa 04/13/11
When it was first released in 2002, Suboxone was hailed as a major advance over methadone. But millions of scrips later, critics charge that the seductive opiate "cure" is causing its own epidemic of addiction.
"While studying anesthesiology, Scanlan became addicted to fentanyl—the strongest prescription painkiller available—and he detoxed in the 2000s using Subutex. He’s frank about attending the 12-step meetings he was introduced to during the program he entered to save his medical career. “I want people to understand I know what they’re going through,” he says. “You want to lead by example. I want them to say, ‘I want to do what you did.’” One thing he did was to make a point of not taking bupe for longer than three weeks, on the advice of his detox doctor. “Or else I’d be dealing with a whole different problem,” he says."
“I’ve seen what long-term Suboxone does,” says Scanlan, who switched his specialty to psychiatry in order to help other addicts kick prescription drugs. “People come in with endocrine problems—thyroid dysfunction, low testosterone,” which kills sex drive, “and hair loss. Tooth loss with Suboxone,” which is orange-flavored and is usually dissolved under the tongue.
Scanlan’s big concern: bupe’s 37-hour half-life, which makes the drug build up in the body when dosed every day. “Look at it this way,” he says. “If I maintained you on oxycodone, and every day I gave you one milligram more, you’d never complain, right?”
One treatment model for Suboxone is as maintenance—to keep patients on the drug for months or even years while their brain chemistry, which has been severely damaged by heroin or opiate addiction, heals. But Scanlan is a fierce opponent of such long-term bupe use. “There’s no way your brain chemistry can heal while on buprenorphine,” he says. “You’re continuing to give someone a narcotic.”
Buprenorphine is estimated to be 25 to 45 times as powerful as morphine. Scanlan says patients who want to get off the 8 to 16 mg levels physicians typically prescribe must taper very slowly because of the drug’s half-life. “When I hear that amount,” he says, “I think, ‘This is going to take a year.’” Addicts who are used to detoxing from heroin can be in for a rude surprise when they try to kick a bupe addiction—the lack of energy and the depression can overwhelm.
Most people, including doctors, don’t understand bupe’s strength, Scanlan says. He has noticed that at long-term doses of even 2 mg, bupe can block almost all of a person’s emotions. “They say to me after they’re off for a while, ‘Wow, I’m really having a full range of feelings,’” he says.
The Great Suboxone Debate
By Jennifer Matesa 04/13/11
When it was first released in 2002, Suboxone was hailed as a major advance over methadone. But millions of scrips later, critics charge that the seductive opiate "cure" is causing its own epidemic of addiction.
"While studying anesthesiology, Scanlan became addicted to fentanyl—the strongest prescription painkiller available—and he detoxed in the 2000s using Subutex. He’s frank about attending the 12-step meetings he was introduced to during the program he entered to save his medical career. “I want people to understand I know what they’re going through,” he says. “You want to lead by example. I want them to say, ‘I want to do what you did.’” One thing he did was to make a point of not taking bupe for longer than three weeks, on the advice of his detox doctor. “Or else I’d be dealing with a whole different problem,” he says."
“I’ve seen what long-term Suboxone does,” says Scanlan, who switched his specialty to psychiatry in order to help other addicts kick prescription drugs. “People come in with endocrine problems—thyroid dysfunction, low testosterone,” which kills sex drive, “and hair loss. Tooth loss with Suboxone,” which is orange-flavored and is usually dissolved under the tongue.
Scanlan’s big concern: bupe’s 37-hour half-life, which makes the drug build up in the body when dosed every day. “Look at it this way,” he says. “If I maintained you on oxycodone, and every day I gave you one milligram more, you’d never complain, right?”
One treatment model for Suboxone is as maintenance—to keep patients on the drug for months or even years while their brain chemistry, which has been severely damaged by heroin or opiate addiction, heals. But Scanlan is a fierce opponent of such long-term bupe use. “There’s no way your brain chemistry can heal while on buprenorphine,” he says. “You’re continuing to give someone a narcotic.”
Buprenorphine is estimated to be 25 to 45 times as powerful as morphine. Scanlan says patients who want to get off the 8 to 16 mg levels physicians typically prescribe must taper very slowly because of the drug’s half-life. “When I hear that amount,” he says, “I think, ‘This is going to take a year.’” Addicts who are used to detoxing from heroin can be in for a rude surprise when they try to kick a bupe addiction—the lack of energy and the depression can overwhelm.
Most people, including doctors, don’t understand bupe’s strength, Scanlan says. He has noticed that at long-term doses of even 2 mg, bupe can block almost all of a person’s emotions. “They say to me after they’re off for a while, ‘Wow, I’m really having a full range of feelings,’” he says.
You're asking a complicated question. If you've tried several times to stop and have faced unrelenting cravings that have sabotaged your recovery then maybe there's a place for it. Then there's two ways to use it in a treatment plan. Short term, over several days to a couple weeks and long term, six months to a year. My recovery plan was based on the long term strategy coupled with a year-long out-patient treatment plan. Suboxone allowed me to work on recovery skills BEFORE I had to deal with WDs. Because it's a partial opiate agonist it also allowed my brain's reward system to recover.
What a partial opiate agonist means is that Suboxone attaches to and stimulates opiate receptors in the brain. As the name implies, this stimulation is only 'partial'. You don't get the full stimulation that comes from full opiate agonists like Percocet, Vicodin or OxyContin. This may be particularly important to you. Suboxone may only be a partial agonist but it's ability to bind to the receptor is extreme. If Suboxone is given to someone using full agonist opiates the Suboxone will push those meds off the receptors and Suboxone takes its place. Since the receptors are now bound to an agonist that only generates a partial response the user will likely experience "precipitated withdrawal". Precipitated withdrawals are UGLY! This characteristic of Suboxone is important to anyone facing a major surgery. If you are on Suboxone regular full agonist pain medication will not work adequately.
Did I read your profile correctly, that you are facing a third back surgery soon? If this is correct I don't think you can start Suboxone therapy until the surgery is compete AND you've stopped using the pain mgmt meds.
It would be helpful to know more amount your current usage and why you're interested in Suboxone. I think many of my peers here would view Suboxone as a method of last resort. Keeping posting your questions. Let's talk more about how and when one might use Suboxone and what other options are available to help you reach your goals.
Cheers,
Larry
What a partial opiate agonist means is that Suboxone attaches to and stimulates opiate receptors in the brain. As the name implies, this stimulation is only 'partial'. You don't get the full stimulation that comes from full opiate agonists like Percocet, Vicodin or OxyContin. This may be particularly important to you. Suboxone may only be a partial agonist but it's ability to bind to the receptor is extreme. If Suboxone is given to someone using full agonist opiates the Suboxone will push those meds off the receptors and Suboxone takes its place. Since the receptors are now bound to an agonist that only generates a partial response the user will likely experience "precipitated withdrawal". Precipitated withdrawals are UGLY! This characteristic of Suboxone is important to anyone facing a major surgery. If you are on Suboxone regular full agonist pain medication will not work adequately.
Did I read your profile correctly, that you are facing a third back surgery soon? If this is correct I don't think you can start Suboxone therapy until the surgery is compete AND you've stopped using the pain mgmt meds.
It would be helpful to know more amount your current usage and why you're interested in Suboxone. I think many of my peers here would view Suboxone as a method of last resort. Keeping posting your questions. Let's talk more about how and when one might use Suboxone and what other options are available to help you reach your goals.
Cheers,
Larry
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