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PostPosted: Thu Sep 27, 2012 3:37 pm 
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I have been off Suboxone for just over two months now after taking it at 4-8 mg dose for over three years. After about a week, my doctor prescribed me Naltrexone, which I am still taking today.

For those unfamiliar, my understanding is that Suboxone contains buprenorphine and naloxone, the buprenorphine to help with withdrawal symptoms, curb cravings, etc and the naloxone is simply the blocker (prevents you from getting high if you take an opiate by blocking it from binding to your receptors). Naltrexone only contains the naloxone and no buprenorphine.

My doctor has assured me time and time again that Naltrexone does not effect your brain chemisty the same way Suboxone does (doesnt stop cravings, isnt an opiate-antagonist, etc), there are no side-effects, and that I could take it perpetually if I wanted to.

Does anyone know if this is true, cause im not sure im completely buying it. I know it takes many months, even years for your brain to re-wire itself after opiates / suboxone (and I know 60 days isnt much) but I dont want to be taking anything that slows or curbs this process. I've even wondered if it could block the endorphins or any dopamine that my brain is hopefully starting to naturally produce again.

I apologize for a long-winded post to a concise question / concern: What do people think of Naltrexone. Any personal stories / experience with or general advice would be greatly appreciated.


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PostPosted: Thu Sep 27, 2012 4:56 pm 
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No, i think you're good. Naltrexone doesn't mess with your endorphin production. It will just make it impossible for you to get high.

Now with suboxone, the amount of naloxone doesn't block anything really-the amount in there is way to small. It's the bupe that does all the blocking. The makers of suboxone but that little naloxone in only to deter people from injecting it and it's debatable how well even that works.

Your therapy now is probably a much higher dose and I believe it's just there as a safety net for you. You know you can't get high, that's a pretty cool thing.

This is all my understanding of course and I could be wrong. Teejay is always posting about this stuff, hopefully he will see your post and chime in. Is this the monthly shot? Or pills?

-gb


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PostPosted: Thu Sep 27, 2012 5:00 pm 
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Btw congrats and good job getting off sub after 3 years!! I am around the same time on sub and have tapered to .25mg

How was your transition. Got any advice?


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PostPosted: Thu Sep 27, 2012 9:03 pm 
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Just a couple of things.

The Naloxone in Suboxone and Naltrexone are two different drugs, though they have the same action. Like Glen Bee said, the Naloxone in Sub is just there as a deterrent. Naltrexone is similar to Naloxone, only it has a much longer half life... so is better suited for maintenance.

I kinda understand your reservation about Naltrexone slowing the healing process. I remember I felt the same reservation while I was on it. In one way, Naltrexone also speeds up this healing though. The moment you first take naltrexone and it "plugs" up your opioid receptors, there's pretty much an instant downregulating thing happening. Within a matter of moment your opioid tolerance goes down to zero...

While this might be good for your brain, there's a huge risk that comes because of this. People who relapse after being on Naltrexone have a bad habit of overdosing... So pretty much any doctor who prescribes Naltrexone around my area hammers home the risks of using after ... or even during Naltrexone. The other risk is taking large doses to "overcome" the blockade. They won't get high, but if they take enough the respiratory depression kicks in ... and people die. Naltrexone is one of those high risk ... high reward treatments.

With the blocking of endorphins thing. You're definitely not alone in being concerned about that part of Naltrexone. If you read some of its side-effects, you'll see "Dysthymia" is among em... which some people attribute to the blocking of endorphins. Also, Naltrexone is prescribed for alcoholism ..because.. it blocks endorphins from attaching to the receptors. Basically they discovered that drinks get a rush of endorphins when they drink, so blocking the endorphins with Naltrexone prevented them from feeling pleasure when they'd drink. Cure for alcoholism.

Just cos your endorphins are blocked isn't the end of the world. Endorphins are just one of many feel good chemicals in the brain. Also, just because they're being blocked doesn't mean your brain isn't making them. One day (when you're ready) you may be able to go off Naltrexone, you shouldn't have to wait for your brain to "heal" any further.

Also... they've found that Naltrexone does actually help control cravings somewhat. Not to the extend of Suboxone, but people on Naltrexone have much lower cravings ratings than people on no medication.

Look at it this way. Your brain could only heal to a certain extent while on Suboxone. Being on Naltrexone, your brain can heal a lot more than while on Suboxone. And when the time comes to get off Naltrexone, it'll be able to heal that lil bit more.


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PostPosted: Mon Oct 22, 2012 4:56 pm 
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I was on naltrexone after my detox until a week ago. So 2 1/2 months ish. I stopped taking it and actually just forgot. I thought its main purpose was to stop cravings, but this last week i haven't had any cravings. Plus i talked to a therapist who said once the drug is out of your system the Naltrexone shouldn't be used because we have to learn to deal with the cravings.
i think its pretty harmless and would be ok to take long term even, especially if you fear you may go back to your DOC.

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