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PostPosted: Sat Jan 01, 2011 3:49 pm 
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does anyone have any experience or knowledge of going straight from using intravenously to then being prescribed suboxone? ( I always thought that if you were injecting that suboxone would not be strong enough)

I have been a subutex/suboxone patient for many years and was being prescribed 8mg of suboxone a day. Around three months ago I relapsed back on to heroin, perviously i had always smoked my heroin on foil but for the past three months have been using intravenously (not my smartest move). I have since returned to my clinic but over the last three months a lot has changed. They want to titrate me on tuesday but have been unclear what treatment they will be using?
is Suboxone an option for someone injecting or should i try to cut down to just smoking before trying a suboxone treatment or should I just go down the methadone route ?

I always find the first couple of days of starting a suboxone treatment really rough and once started it cant really be stopped if it all gets too much, so am anxious about being perscribed suboxone if my tolerance/ habit is too high.
I am also worried that if I go in on tuesday and ask for some time to cut down to smoking they may think i am backing out?
is a methadone script my only way to go?


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PostPosted: Sat Jan 01, 2011 4:13 pm 
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Yeah you can definitely go directly to suboxone after injecting. That's basically what I did. I told myself I would never shoot up and next thing I know I'm there. Anyways the suboxone is actually stronger than heroin...it just doesn't have any rush or euphoria as you probably know. It will totally kill any withdrawals you have from injecting and should do a fair job at relieving cravings. Sounds like you could also benefit from regular counseling as you have pretty much hit the end of the line in graduating to injecting. I only injected for a few months and knew I needed help after that. Before that I always thought I could control my use and had things under control. If you are serious about getting control of your use and getting away from the whole using lifestlye then suboxone will work. Good luck to you and stay positive and the suboxone will help you get your life back.


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PostPosted: Sat Jan 01, 2011 5:45 pm 
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You can go from IV H directly to suboxone, the important thing is that you should be experiencing moderate wd when you start suboxone. If you aren't in wd, the suboxone will induce Precipitated Withdrawal (worst wd imaginable). A COWS scale can help you identify what stage of wd your in if you're still unsure. Just google search COWS Scale to find one.

I'm going to say the reason you always find the first few days of sub treatment rough is because you're not getting a high enough dose of sub. It doesn't sound like you have much control over that though.

I hope everything goes well for you Tuesday.


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PostPosted: Sat Jan 01, 2011 5:56 pm 
Yeah that and probably like most people who have trouble starting suboxone didnt wait long enough to start taking it. IV does not make you " too tolerant" to take suboxone. If that were the case then methadone wouldnt work for IV addicts either since its taken oraly. Route of administration means nothing in terms of suboxone working. When you said "you are unclear on what treatment they will be using" do you mean that they are not letting you choose methadone if thats what u want and are forcing u to take suboxone without any choice? If so thats BS, Ive been debating switching over to methadone for affordability so I could be on a proper dose that curbs cravings (no matter what I cannot afford over 4mgs of suboxone a day and that isnt enough I still crave alot)and because I honestly feel methadone will get rid of my cravings alot more effectively. If clinics are now somehow trying to phase out methadone as an option for treatment for new patients I think that is unfair and a violation of rights. Just because a new medication is available for treatment doesnt mean a tried and true one like methadone that has worked for countless people to keep them clean should be automaticly disregarded and phased out. I was gonna go the methadone route but decided to give suboxone a chance, it has helped me but it doesnt actualy take away my cravings very well and I constantly think about using and I dont think its fair that I have to spend all this money for subox every month when Im still constantly fighting the urge to use. If I want to choose to use methadone as maintenance and the clinic wont allow me to it might end up making me go back to using which I dont want.


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PostPosted: Sat Jan 01, 2011 6:46 pm 
Im pretty sure their isnt any possible way they can "make" you take one or the other. Just go to a methadone clinic that doesnt prescribe suboxone. The one closest to me only uses methadone, unless thats changed in the past few months which i doubt. Methadone definitely, in my opinion works a whole lot better but its because its a full agonist. Methadone knocks out every possibly craving and withdrawal you get. Suboxone works really well also. They both work really good but if your still looking for euphoria, then sub isnt the route to take. Euphoria was the biggest thing i liked about opiates, along with the nice warm feeling. I always scratched my nose raw while taking methadone. It was my DOC. I think it is a miracle drug as well. The problem for me was i was taking it illegaly and didnt have it every day like i should have. Therfore going through withdrawal quite ofter which by the way was pure hell. Thats one thing you should know, the withdrawal from methadone is no game. It is pure hell, at least for me it was. Thats the only single thing i disliked about methadone. I never experienced any other ill effects from it, besides some constipation which after awhile i got used to. The constipation with methadone is much worse than sub, in my opinion. I use the bathroom every morning with sub but when i was taking methadone i wouldnt go for 3 days at a minimum. Sometimes a week would go by before i even thought about using the bathroom. Anyways, i cant say which one you should choose but just do all your research before you make a final decision. Hope things go smoothly for you!!


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PostPosted: Sat Jan 01, 2011 7:15 pm 
Yeah I know about methadone withdrawal being supposedly the worst so I definitely know what Im getting into if I go that route. I started out abusing oxy but as youve probably seen me say I soon found poppy pods and they made oxy seem like weak sauce to me. An all day cheap high with a much more noddy, itchy, euphoric dreamy sedation? sign me up please lol. One of it nicknames is "natures methadone" for the long half life and the fact that some heroin addicts would use it for maintenance. My buddy who was on methadone told me pods were only slightly different than methadone in that the pods were a bit more euphoric. Pod withdrawal is very long lasting and if you were on a huge amount of pods daily like I was its supposed to be about as bad as methadone detox which scared the shit out of me and is why I got on suboxone. My sub doc had never heard of pod tea before but when I told him thats what I was on he got very concerned because its pretty much a polydrug addiction he said because there are so many active alkaloids in pods and you withdraw from every one of them, to name a few morphine,(which is the major contributer to the high the others just kind of add a little bit to it) codeine, theibaine, papaverine and theres more just cant think of em. The only methadone clinics around here have already introduced sub treatment but Im sure if I tell them A) I cant afford it and B) I tried sub first for 6 months and its not working out as well for me, they would probably let me go the methadone route.


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PostPosted: Sat Jan 01, 2011 8:19 pm 
Honestly i think the benefit outweighs the withdrawal just like sub. I know their is eventually gonna be withdrawal to go through but for me, all the good thats coming from sub beats the thought of withdrawal everytime. I wouldnt really even think/worry about how bad the withdrawal from methadone is. If methadone is what it takes for you to stay in recovery than thats what you need to do. I definitely dont see them telling you which route you have to use. Cuz to me, their is a clear difference in how much more effective one is than the other. And no im not down playing sub, but i just believe methadone works a whole lot better than sub. Thats only my opinion so please no debate or attack. Its only because methadone is a full agonist but i believe for some people, thats what it will take.


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PostPosted: Sat Jan 01, 2011 8:51 pm 
I feel the same way, us addicts were addicted to full agonists so it makes sense to use a full agonist for maintenance to keep our cravings satisfied. I dont understand why feeling a little bit of euphoria and pain relief is the worst thing in the world. Sub addiction realy is no different than full agonist addiction for me anyway except for the fact that it has all of the negatives in terms of withdrawal and none of the "good" part in terms of how it makes you feel. I get that with methadone there will be tolerance and that part will eventualy fade away but its still a full agonist and even when the euphoria fades its still going to be hitting your receptors at full force thus curbing cravings. You can stabilize on methadone and stay on the same dose for years and years just like suboxone so I dont get why methadone is hated on. I dont think there is anything wrong with a clinic encouraging someone to try suboxone first but I dont think they should be able to force it. If someone wants to go the methadone route and is willing to show up to a clinic everyday to do it that in itself shows a commitment. I dont think anyone goes to a methadone clinic in order to get high, I bet there has been people who have tried that but its not the norm. Methadone has worked for tons of people for decades and there shouldnt be any issue with someone wanting to use it for their recovery. Its just a shame that the guidelines for it arent as relaxed as suboxone to where you can get it without daily clinic visits. There is just as much a risk of diversion and abuse for someone who uses methadone for pain as there is for someone using it for maintenance so i dont think its fair addicts have to follow these absurd guidelines. When you think about it daily clinic visits impede the ability to possibly get a job and become a productive member of society which is realy the whole goal of maintenance to begin with so it makes no sense to me. Ive heard of people saying "I dont know what to do I cant get/keep my job if I have to come to the clinic everyday" and the clinic says "if you want your methadone then quit the job" its not fair how addicts are faced with almost impossible hurdles to get over just to try and get themselves clean. Living the life of an addict is just as painful as living the life as a pain patient (not someone with a terminal illness but someone with pain) so I dont see why we are treated any different. Opiates shoud be able to be acquired so much easier than they are, it should be easy for someone in pain to be able to get it treated not the other way around. If some people choose to use it to get high big deal its going to happen anyway but instead they make it impossible for people to get them so in turn legitimate pain sufferers have to live in constant pain because Omg someone might get high and feel good, they think that is a better alternative than people in pain getting treated and living a good life because it keeps people from getting high which still happens anyway.


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PostPosted: Tue Jan 04, 2011 8:38 pm 
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Thanks everybody for the reply's and advice

Ive chosen to go down the methadone route

ive been started on 30ml which is pretty low, then had to go back to get a top up but they only gave me another 15ml
the doctor did say that they start off low and then increase until you stabilize. tomorrow i get 55ml in one dose then back to the clinic thursday. (It does seem like they have me jumping thru hoops already)
Am a bit anxious to wake up tomorrow without any gear for the morning but am looking forward to a new start.
I am already noticing the differences between being perscribed meth and suboxone the good points and bad.
with suboxone there is NO chance of using on top no matter how much you want too due to the blockers where as meth there is always the danger of using on top(Suboxone seems to be more final than meth in that respect but I suppose its what you make of it). another point is that during the transition from heroin to being pescribed drugs (subs/meth) you have to visit the clinic and then the pharmacy everyday for at least the first 5 days. if you were being perscribed suboxone you would be in no fit state to be dealing with busy surgery waiting rooms then queuing up in the pharmacy (this is why I always keep enough subs at home to do a home detox but always have problems after going into a clinic being heroin clean and having to explain how i am posotive for suboxone).
I hope nobody thinks i'am promoting one in front of the other just writing my experiences so far (I am in the UK so my clinic experiences may vary from yours i.e if u are not working your perscriptions are all free)


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PostPosted: Tue Jan 04, 2011 10:53 pm 
Sounds like the UK actualy cares about helping addicted people because that is so not the case here, getting free Rx's if you arent working hah thats a joke here in th US when it comes to subox/methadone. You can apply for this bullshit assitance program to get free suboxone (the program itself isnt bullshit but the 3 patient per doctor guideline is and makes it nearly impossible for people to get on it ive been waiting 6 months still no word yet) and the cheapest price to get on a methadone clinic is 300$ a month. How do clnics expect an addict to pay that, thats like a 100$ or so less than it costs to pay rent at an apartment and they think you are just gonna being able to afford that, if u cant tough luck keep using they dont care. If I could afford the clinic Id be on it but i cant, unfortunately I have to work with a low ball dose of suboxone 4mgs so I can afford it and its still close to 200$. Im starting to get discouraged with sub because Ive noticed now it doesnt give me my energy back like it once did, I feel lethargic and like shit almost 100% of the time. Aside from the terrible physical withdrawal symptoms I feel like Im in the very beginning stages of when you start to withdrawal all the time. Im doing everything I can too, I go to outpatient, I go to 3 12 step meetings a week (which I hate and dont think will ever grow to like them) and am finaly getting around to getting my GED since I was a dumbass and dropped out of highschool 10 years ago, I had a good job and thought i knew everything like teenagers do so "who the hell needs school" and now I realize how stupid that was. I just dont know how much longer I can go on like this if things dont start to take a turn for the better. You can only put forth 100% effort for so long without seeing any visible changes before you start to use again. I never have any fun (I literaly forgot how to have fun without getting high which is sad) and have no friends because I had to give up every friend that uses drugs if I had any chance of staying clean. I cant adjust to 4mgs of sub either, Ive been on it for like 3 months now daily and its just not gonna happen. I need to be on at least 8mgs preferably the 16mgs I was started on but thats not gonna happen because of $. I just realy hope things are going to get better because I dont see any point in staying clean if Im going to be miserable the entire time, using was hell but at least I got to numb myself and get an escape from this boring "recovery" lifestyle. Seriously not to offend anyone but the people at AA/NA are not someone I want to become, quoting AA literature every minute of my life and spewing out their stupid little tired ass slogans. Not everyone at 12 steps is like that but a lot are and it seems like an AA/NA meetings is the highlight of their day and life. I want to have a somewhat enjoyable exciting life while Im here, once Im dead thats it its over and Im not gonna waste it fighting my addiction every single second of my life. Either shit starts to turn around for me with all the effort Im putting in or its only gonna be a matter of time before I return to my old ways. Sorry for the rant just not having a good day today.


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