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PostPosted: Tue Nov 17, 2009 7:51 pm 
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I have been on suboxone for a little over a year, trying different doses including the maximum. It has been effective at preventing physical w/d symptoms but really I could care less about that. I've been through it countless times and does not really bother me. What I can't deal with is the constant, intense cravings, no sleep, severe depression, completely reclusive behavior, and total lack of energy/motivation. I've been through cognitive therapy and taken anti-depressants/anxiety meds to no avail. To keep myself going, at least every two weeks I go on a one day heroin binge (3g). The longest time I used suboxone exclusively was four months, then I could no longer bear it.
Even if there were spots available at the nearest methadone clinic, the travel time alone would be two hours six days a week (no take homes allowed in my area). I'm a full time student and part time worker. Methadone maintenance is supposed enable work behavior so it seems self defeating to reduce work/school time. Friends who participate in the clinic report far worse side effects than heroin (sedation, sedentary life style etc). Also, if I ever reach a point where I'm ready to be totally abstinent, I wouldn't want a drug that causes substantially longer withdrawal and post withdrawal.
In Europe, some use slow release oral morphine. It seems its been tested to death and every report I have read was positive. It worked just as well as methadone without the side effects. There is no realistic street market for it. A drug like Embeda could be modified to release enough naltrexone to theoretically make it unabuseable. Transdermal patches could be given out then be returned to be checked for diversion. It is unfortunate that we are limited to two polar opposite maintenance drugs. I'm hopeless and just wondering if anyone heard anything.


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PostPosted: Wed Nov 18, 2009 3:33 pm 
jaht - Unfortunately I don't have any answers for you. I'm hoping maybe the Suboxdoc will chime in with an answer for you. I just wanted you to know that I feel for you. The way you feel sounds similar to the way I felt before I found Suboxone. I guess you are one of an unfortunate few for whom Suboxone isn't that effective. If you hadn't said you had four months straight on Suboxone with no relapses, I'd tell you that maybe you feel this way because you're still using Heroin every couple of weeks. Even so (and I'm sure you know this) the Heroin binges certainly aren't helping anything!
You also said you've tried therapy and antidepressants. Are you sure you've given these methods enough time to help you? Sometimes it is very difficult and takes a considerable amount of time to find the 'right' antidepressant or the 'right' therapist to make some progress. Have you consulted with an addictionologist? They are supposed to have expertise and training beyond a regular psychiatrist or therapist and obviously are highly specialized in addiction medicine.
I'm glad to hear that you're still searching and that you don't want to give up. As long as you'll keep searching for answers/improvement of your condition, there is still hope!
When I was in intensive outpatient treatment the therapists would talk about us addicts using drugs/alcohol to fill a "hole" or void within us. For me, it was God-sized hole or a spiritual emptiness that I was trying to fill with things other than spirituality. I have no idea what your spiritual beliefs are and it doesn't really matter. But I do believe that within all of us there is a longing for something greater than ourselves and if/when we can find that, we can find some peace. I know for sure that we're not ever going to find it by altering our thoughts and feelings with chemicals.
I hope the best for you, I really do.


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PostPosted: Wed Nov 18, 2009 8:53 pm 
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setmefree- I really appreciate you replying to my post and above all kind words. This is the first I've participated in a forum. A friend of with a similar habit also tried sub first without success. He's been on methadone for awhile and it has taken a pretty visible toll. I feel really guilty about continuing use. In a way, I'm a bit envious of my friend who doesn't miss heroin at all. It may sound ridiculous, but I consider myself fairly committed to getting clean. The four months of sub only without slightest change was just too much. I tried to make lifestyle changes like reconnecting with clean friends, exercise, diet change and picking up hobbies as well.
I stayed on one antidepressant for about a year. Others caused an initial decrease in mood that I couldn't tolerate. I totally know what you mean about time though. My brother really is depressed and it took over a year for him. Before drug use I was not the slightest bit depressed. There was a study I read where ssri's were given to methadone patients. Results showed they were ineffective at treating opiate induced depression but helpful for people who had pre-existing conditions. My drug use began during a part time job in high school. It made the boring work interesting and the painful work painless, but you never know. I wasn't trying to fill a hole then, but sure am now. An addictionologist is something I have not tried yet. I've been hesitant because talking or thinking about drug use is a large trigger for me, regardless of the professional environment. Perhaps their specialization would be far more beneficial. What got me through those four months was the activity. I failed because the desire to use, depression and lack of energy intensified over time. Everything I did was a miserable disappointment time after time. The only life that seemed to be worth living involved heroin.
By no means do I consider substitute/maintenance therapy my only option, it just seems to be the most effective one scientifically. A few years ago when I was in a court ordered drug education program we watched this video. It was about a long time heroin addicted young woman in England. She was prescribed slow release oral morphine for maintenance (I think this video was made in the early 90's). While she got no high from it whatsoever, she was completely free of withdrawal/post withdrawal. After straightening her situation up, she meet her fiance or something and wanted to start a family. The video concluded with showing her going through inpatient withdrawal. This is the type of experience I want to try, minus the inpatient stuff. At one point in time I went through the kicks on a pretty much weekly basis. It doesn't have to be morphine, just something that works like it did for her. The main thing though is I need to have a solid reason to stay clean like she did. A life of solitude and emptiness isn't very motivating, even with a college degree and a good job. I need something that makes me feel semi-normal to build a more meaningful life.


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PostPosted: Thu Nov 19, 2009 1:42 am 
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Have you heard of low-dose Naltrexone therapy? Naltrexone is a drug that blocks opiate receptors, so when used at full-strength it would prevent opiates from having any effect when taken.

But some doctors are experimenting with using it a very low doses at night, before the patient goes to sleep. The idea is that the low dose of naltrexone will trick the brain into producing more endogenous endorphins - which are our bodies natural opiates. Some people think that some opiate addicts just don't produce enough endorphins, which is why no matter how hard we try and how many ways we try to live right, we just don't feel well.

So far this therapy has been used to increase the immune system in AIDS patients, and has helped MS patients as well. There are studies looking into possible benefits for fibromyalgia and cfs patients as well as recovering opiate addicts. It is an off-label use for the drug, so you'd have to find a doctor willing to prescribe it. Now that I'm fully off of Suboxone I'm considering it...if I can find a doc to prescribe it for me.

if you want more info I'll give you what i can, or just google it.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


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PostPosted: Thu Nov 19, 2009 5:03 pm 
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Yes I have heard of low-dose Naltrexone therapy. It is usually prescribed at 4.5mg and only low doses produce the potential endorphin boost. I totally believe the endorphin deficit theory, I doubt I naturally produce any. It seems odd the medical community acknowledges every other type of deficit. What keep me from trying it was I just don't think the treatment could produce enough. Suboxone, codeine, and hydrocodone didn't even it large doses. I'm not looking for a high through, just feeling okay. After the first few months of heroin, I very rarely got high and the next five years were illicit maintenance. $300 for 12 hours of fun just isn't economical.

I could be wrong, but it shouldn't be very hard to get prescribed to naltrexone. It is approved by the FDA for the treatment of drug addiction and I believe it was specifically designed for this purpose. If you are referring to having a hard time solely because of the of label use why not just tell a little lie? It won't block much at a low dose but you could say your afraid of its liver complication producing aspects and you just want a little safety net. Poor form I know, but its not a scheduled narcotic or abuse-able. Its pretty shocking what addiction doctors don't know about what the patient is going through and even how to prescribe the medication. Anyways I'm glad you were able to make it to a point where you don't need anything.


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