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PostPosted: Tue Nov 08, 2011 12:28 pm 
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What are your thoughts?


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PostPosted: Tue Nov 08, 2011 12:58 pm 
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I think the answer for some is yes and for others is no. I read all the time about people who got off sub, relapsed got back on and are already planning their jump back off sub. I think for some to have a chance at staying clean off sub they need to stay on sub for quite a while and change every aspect of their life. I think a lot of people rush the process.

I was lucky enough to stop my addiction 8 months in. I never graduated to snorting or shooting. I think people with a shorter addiction history have a better chance at making it off sub. However I must admit I am not looking forward to going thru the process.

Then there are others that would do better on sub life long. This could be for various reasons, chronic pain, recurrent relapses, etc. I have a lot of respect for people that realize they would do best on sub indefinitely. A lot of people have the attitude that staying on sub is the easy way. I don't agree with that at all, people that stay on sub have to deal with a lot of bias, sadly I see among the most judgemental are fellow addicts. It seems that someone on sub for the long haul gets labeled as weak by other addicts and that is disappointing to say the least. How can recognizing what you need to make your life the best it can be, be viewed as weak?

I think before we can expect the world to stop there bias and judgememt of sub treatment we need to get fellow addicts informed.

Lastly I think that sub should never be completely taken off the table for opiate addicts. If you want to try to live a life sub free that is great but if you don't make it you should still keep the option open to get back on sub. Whatever gives you the most quality of life is what you should be doing.


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PostPosted: Tue Nov 08, 2011 1:11 pm 
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No!

At first, your question offended me, but I believe I know you well enough to know that that was not your intention at all.

IMO, if you understand the gravity of opiate addiction and you're willing to put in the recovery work, then it's not foolish at all to believe one can live without Suboxone. As far as I know, addiction is a lifelong disease that needs lifelong attention, either with Methadone/Suboxone or Recovery or a combination of those.

My addiction counselor has 20 plus years off of Heroin, Suboxone wasn't available when he quit opiates and he chose not to take the Methadone route either. He chose to live a healthy recovery and I believe that's what has kept him clean and sober to this day AND if he can do it, I can too!!

This is an interesting question and I would think you're gonna get some interesting feedback!!

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PostPosted: Tue Nov 08, 2011 1:36 pm 
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:? Tear, I was thrown back when I read your question this am. I had just wrote to Hat saying yesterday I was not having the best of day And This is one reason. This question was really weighting heavy on my heart.
Ok I have been on subs for around 2 1/2 months and I have to say most of the recovery has been very well and I am happy with it except for a few concerns i'm starting to have.
I read so many stories here about getting off subs, doctors running,people depressed because of getting off of subs. This is all very scary to me and I do relieze this is a place we go to vent and rant and just let it all out. That is the wonderful thing about this site.
I was very 'Green" to subs and had never really heard of them except for my ex husband was on them and talked highly of them. We have been on drugs for almost all of our lives, him on stronger drugs then I but still the same story goes for us.

I was sooooo excited to get away from the life I was living. I jumped in with both feet and thought this is it,I'm free. Then start reading and soaking up everything I read about subs then bamb I just started trippin on all this stories that people are having all this side effects and can't get off the subs and depressed and more depressed. This is were i am today I tell myself well it is something I will have to be on probably forever due to my chonic pain. But will my doctor allow that.
I do have emotions and they hit me full force this weekend. I guess it has had time to sink in and I have been looking farward to my "New" clean life but is it "clean" is it what I want?

Not sure if I could live alife without subs and if I do decide to I will do it very slowly.
Mel :wink:

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PostPosted: Tue Nov 08, 2011 2:37 pm 
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I think the only person that can answere this question is the indivisual themself. There are way to many factors that factor into this that only that person would know.

But to play along Breezy put it best.

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PostPosted: Tue Nov 08, 2011 4:33 pm 
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I think it's foolish to believe ANYTHING if you don't have a strong factual basis to ground your belief.

Time and time again I have seen people come to the forum and post that they are going to do a quick taper off of Suboxone because they just "know" that they are done with opiates forever, that they will never use again because of all they have been through witht their addiction, and that this time is going to be the time that they get it right. They just really, really, really want to be "free" of ALL drugs, event the one that's responsible for them feeling ok right now. These people believe that they know themselves well enough to know that this time, sobriety will "stick" for them - in spite of the fact that they've relapsed again and again, they have no support framework, no knowledge of addiction or recovery.

This, in my opinion, is the height of foolishness. I would even call it hubris.

Then I have seen other people who have been on Sub for a while and have used that time to recover, to fix problems in their lives, to go to therapy, to reflect on what brought them to this point in their lives, etc. Usually, these folks are like: I think it's time to start tapering with the eventual goal of getting off of Suboxone. Most of them have support in their lives, families, jobs, hobbies, other interests, school, something to live for. Many of them are doing step work or SMART or group therapy or one-on-one therapy or they post a lot here to work through their issues. They have gained some self knowledge and they think they are ready to try. Most of them also acknowledge the need for a back up plan should things go awry. They have gained a healthy respect for the power of addiction; they've learned from their mistakes and are trying to also learn from other's mistakes.

I don't think these people are foolish.

Not everyone falls into one of these two categories, of course. It's more like a spectrum.

But overall I think the belief that we can someday live without suboxone is a good thing. That belief (or hope) can be very motivating to keep working hard on the recovery process. In a lot of ways, Suboxone works so damn well that it almost removes the impetus to keep working. You're feeling better, you're not craving, you're pretty much normal (whatever that is)...so why go to group or meetings or counseling and drag out all the garbage into the light and have a nice painful look at it? Why employ "rigourous honesty" in your life when things seem like they're going just fine anyway? Because hopefully you acknowledge that you have to do all of that work if you want to live Suboxone free someday.

Plus, there is so much we just don't know about our brains or about addiction. It's really only recently that doctors and researchers have been studying addiction from a disease framework. Prior to that, it was thought of as a moral problem or a lack of will or a character defect. Psychologists are testing new treatment modalities for dealing with addictive thought patterns and behavior, researchers are trying to develop new drugs. Other researchers are studying how addiction changes the brain and how the brain can heal. Who knows what breakthroughs are just around the corner?

Personally, I not only belive that I can live without Suboxone, but I also believe that someday I will be recovered from my addiction. It will be a thing in the past, not something I have to work to manage all the time.

When it came time for me to taper off Suboxone I was nervous. My doctor had only a few patients who had tapered off at that point, so we were in the learning process together. But when I expressed my doubts and fears to him, he reassured me that I was a great candidate for a successful taper and for success afterwards. He based his opinion on the fact that I'd been a very compliant patient, no positive drug screens for my whole treatment, that I'd been in therapy and was progressing, that I had a job and a firm plan to start school in a few months, a supportive family, that I'd addressed my triggers, my depression was being managed with medication, that I'd self-educated a lot during the process, and that my addiction had been relatively short.

In short, I really think that if you work hard on recovery (finding what really works for you as an individual) then at some point you begin to see that the idea of living life without an opiate replacement therapy starts to move from the realm of wishful thinking into the realm of rational possibility. And if that doesn't happen, that's fine too. I don't think being Sub or methadone free has to be the ultimate goal for everyone. We're all different.

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PostPosted: Wed Nov 09, 2011 12:41 am 
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I've been really impressed with the things that have been said here.

Before I go on, I'd just like to say is that I do not personally believe it is foolish. I phrased the question because I thought it would make people think, and also because of some things I'd read on Dr J's blog that got me thinking. We all know there have been times Dr J has questioned whether it's appropriate to live without pharmacotherapy. But there's also times he seems to give advice to those who choose to taper, so I thought of throwing it to the forum.

I still maintain hope that we can live without opiates because, like Romeo, I have seen many people who have been massive opioid addicts who now maintain a life free of that stuff. Many were on methadone for years, some also on Suboxone for varying periods. Even more got clean straight off their drug of choice. So I know its not impossible. Just going to the local NA meeting you can see many gathered, and there's many dotted around the community.

When I was involved in recovery programs & rehabs, staff / sponsors / doctors / counsellors told me that it's simply impossible to predict who will stay clean. Age / length of using / background / socio-economic status, none could be used to predict outcomes, as they can all can "work both ways". My prescribing doc who runs the rehab next door, said there's an X-Factor involved. He mentioned qualities like persistence / tenacity / determination as playing a big role.

I was reading studies about tapering and blogs before bed lastnight, and I kept hearing phrases like "near universal relapse" after tapering off Suboxone, and "nearly all had relapsed after 3 months". Because it concerned a huge decision about my recovery, I went digging for the actual figures in the full studies.

http://archpsyc.ama-assn.org/cgi/content/full/archgenpsychiatry.2011.121#REF-YOA15054-44 Recent.
93.3% relapse rate post-taper

http://www.druglib.com/abstract/li/ling-w_addiction_20090200.html
87% relapse rate post taper post-taper

http://www.medscape.com/viewarticle/722342
87.5 % relapse rate end of study post-taper

Don't run off crying just yet. These figures are actually quite hopeful!

Say we're generous, and average it off to 1 / 10 people succeed post-taper. Probability state that if we try enough times, our odds will increase markedly. While it is more complicated, basic high school probability says we will get it after 10 tries! :lol: That's not bad, considering I've relapsed nine times!

In all seriousness, whether we end up in that 10% of people who "make it", in my opinion, comes down to our personal make-up, and our persistence. Those who get it the first time often already have the qualities to make it - the persistence, resolve, motivation, the stability, the "X-Factor". For me, years of heroin addiction and mental illness either robbed me of these things, or I just never had them. I could have kept trying to get clean, but as long as I lacked the qualities needed for recovery, I would stay on that merry-go-round.

For me, this is when Suboxone comes in. I'm counting on the period I spent on Suboxone to allow me to develop the qualities I need to taper successfully. I'm learning to be persistent, consistent and stable, and I think I am changing. With every week there's some new emotion or problem I learn to face without drugs. I'm counting on Suboxone to give me "time" to develop these qualities I was lacking. It'll likely take a few years, but I've seen people change, so why not me?

Long post I know.


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PostPosted: Wed Nov 09, 2011 12:53 am 
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good question....................
and yes,, just like the prior replies,, WE are ALL different.....Everyone's addiction is different, everyone's reason/s are different and so on.
My doctor hasn't even said much about tapering off. I mean it's been 6 months, so maybe he doesn't bring it up until after a certain time, Im not sure. I said something about it once, he said we wouldnt talk about it until I had 3 POSITIVE reasons for tapering.....positive ,,,,,not negative,,, examples of negative---I cant afford it, I want to be opiate free, its time to not have a crutch.
So I have no idea really what he's looking for,,i have talked to my therapist a little about it, but she thinks we have alot more to work on first.
ANYWAY I think it really depends on the person, I really like the first reply, "how can knowing that something will help you live normally be a weakness" or something of that nature,,,,,Is exactly how I feel about it if someone wants to stay on it. I think if your "active addiction" is in remission,,,then you are doing perfectly fine. (wonderful actually)
Let's all remember that many addicts' active addiction puts them in the graveyard, if subs keeps you from that, so be it.

ps......this site is awesome,,,,,I really like the openess and the kind words I find here...just wanted to take min and say thanks


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PostPosted: Wed Nov 09, 2011 1:00 pm 
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This is gonna be a hard one to articualte properly and I certainly mean no offense to anyone who has lost a loved one to this disease.

There seems to be this attitude that a relapse means complete and utter failure and I simply don't agree with that. It's as if people conclude that once we addicts relapse, we're not good for shit after that. The truth of the matter is that the overwhelming majority of addicts DO relapse and from what I know, that's what it takes for a lot us to get our heads screwed back on straight.....sometimes multiple relapses. I'm at slip/lapse/relapse #3 and I have learned a tremendous amount from each relapse, each one has moved me forward in my recovery. Without them, I wouldn't be as strong in my recovery as I am right now.

The other side of this coin is that relapses can be fatal and we absolutely are playing with fire when we relapse. I abhor the thought of anyone relapsing because of the VERY real danger of overdose.

To be clear, I most certainly do NOT support the notion of a relapse and if you're reading this and thinking, "Hey, I'm gonna go out and use because it seemed to help Romeo in his recovery", then you're nuts!! I'm talking about MY recovery, MY path and all of us have different paths to follow.

Finally, Suboxone is NOT a guarantee against relapse, I can easily call to mind two members (babydoll and dannyb24k) who had constant relapses while on Suboxone. Suboxone does up the odds against a relapse, but it's not foolproof. In the spirit of complete honesty, I had zero relapses for the 3 years I was on Suboxone, but then again, that was part of my recovery and my path.

I truly hope that by expressing my views I have NOT encouraged anyone to consider using. That is NOT the intention of this post.

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PostPosted: Wed Nov 09, 2011 6:06 pm 
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Romeo wrote:
There seems to be this attitude that a relapse means complete and utter failure and I simply don't agree with that. It's as if people conclude that once we addicts relapse, we're not good for shit after that. The truth of the matter is that the overwhelming majority of addicts DO relapse and from what I know, that's what it takes for a lot us to get our heads screwed back on straight.....sometimes multiple relapses. I'm at slip/lapse/relapse #3 and I have learned a tremendous amount from each relapse, each one has moved me forward in my recovery. Without them, I wouldn't be as strong in my recovery as I am right now.


Relapse can mean so many things. As far as I know, 12-step programs are the only places where using once is considered a relapse.

One thing I found really hard in researching those studies, is that their definition of relapse isn't clear by viewing the abstracts. It's very hard to get a real picture of what they mean. 90% "relapse" rate could actually be successful, if it refers to a once off use.

I have my personal definition of what involves relapse, and it generally happens when I start losing the things I've earned in recovery. I consider anything less to be a binge, and a once off to be a slip. For me, when I find my way out of a relapse, I've let using rob me of something I've earned in recovery, whether it be getting into debt, losing my partner, losing my morals, losing my honesty. And in the past, I've learned big lessons from all three - relapses, binges, slips. As long as we listen to the lessons they offer, we can learn a lot from them.

As you said, people can die when they relapse. Suboxone minimises this risk significantly though, as when a person relapses on opioids, their tolerance has been propped up by the Sub, so risk of overdose is much less. But there's other ways to die in a relapse.

Add me to the list of people who have used while on Suboxone, or even relapsed. What's interesting about when I used on Suboxone earlier this treatment, is the relapses didn't go anywhere near as deep as they did before, yet I've still heeded important lessons. My life didn't bottom out.


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PostPosted: Mon Feb 13, 2012 4:59 pm 
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i have accepted the reality that i will be on suboxone for the rest of my life. it has helped me get my life back and each day that i dose is another day my family knows i will not be using. i am eternally grateful for suboxone.


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PostPosted: Mon Feb 13, 2012 6:56 pm 
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Thanks Bennie, for bringing this topic back up again. I must have missed it the first time.

There really isn't much to add as the previous posters did a great job breaking it all down.

What I thought 4 months ago and what I think today are totally different. Back in October I had weaned down to 1mg, had already asked my doctor for some Clonidine, and was mentally preparing to jump in the near future. Then I was diagnosed with oral cancer and everything changed. I knew I was going to need to be put onto pain meds again and for quite a long time too. So far that has been true. It also dug up the vampire in my brain that we all call addiction. He is very hungry and always wants more and more opiates. I tried to satisfy his gluttony with lots and lots of pain pills but he still wanted more.

Now that I am back on Suboxone, that darn little vampire has only dug a shallow grave for a quick arrival. So now I wonder if I will ever be free of Sub. Probably will, but right now I need to get back to basics and that means recovery tools. I can't do much right now because I'm still in treatment, but in my mind I must start thinking like a recovered addict and not a using one. Meaning, I will only take pain pills when the pain cannot be handled with Buprenorphine, and then only as much as needed and no more. I really don't want to be that guy who cannot live w/o Sub. What a difference four months make.

So there is no answer from me. I have no crystal ball and cannot say for sure how I'll be a year from now. In my mind, the only cure for my addiction will be when I die. Yes, that is wrong thinking, but it's how I feel.

For those of you who have jumped and stayed to help us all, God Bless You. It's your experience that keeps the candle lit.

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PostPosted: Tue Feb 14, 2012 1:27 am 
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Definitely not foolish. Thinking we will live without suboxone is hopful, optimistic, and certainly a bit daunting. Last time I tried it (about a week ago) on day 2 that old FEAR came rushing in like a tidal wave. I wasn't feeling too bad, but the thought of feeling bad, the thought of not having taken any opiate for the first two days since six years of daily use (agonists and suboxone throughout) was almost paralyzing me with dread. My thoughts were racing, I convinced myself I didn't feel "right" and took some sub. THis panic episode was probably 90% mental and 10% physical. But now I am better prepared for next time.The only way we lose is if we quit trying. I will never quit trying. I lived 90% of my life without opiates - I can do it again. Never say never.


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PostPosted: Tue Feb 14, 2012 11:47 am 
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I struggle with this so much and I think I add to much stress to my life by worrying about it. I know Im lucky to be taking it and there are pro's and con's to taking it for me personally....But It boils down to what I say to people who want to cast judgement on me ..."I would rather walk with a crutch than not walk at all..."

I have a question for everyone......Talking pills for so long and subs have made me "fear" being tired....LOL ...its crazy..Its a natural thing for a person to be tired but to me its like some unacceptable foreign virus or something.....

I wrestle with getting off the subs because I feel like I should be getting off them but in all reality I dont want tooo....But I do....

One day I hope Im ready....But as of now the pros out weigh the cons in my life and when that shifts I hope to have the strength to get off of them

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