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PostPosted: Fri Dec 16, 2011 11:50 pm 
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Hello,

I am the 20 yr friend of someone who has fibromyalgia and also injured his back as a teen. He went through his time with various pills and drugs but has finally found some relief in a life with subs. He has found himself, after that time, with few people that can help him through times of trouble. I have been trying to help him and over the past 18 months, he has just been taking subs and life appears good for him. My concern arises in his dosing habits.

The appointments are a month apart. He is supposed to take two and a half 8 mg pills split between twice a day. He is a very guarded and private person and is staunch in keeping as much of his life as private as possible. I see him nearly everyday and I attempt to see what, exactly, he takes. I have, on numerous occasions, seen him 'take meds' as soon as every 3 hours. I hold onto a certain amount of his perscription but only part of it and after the first week that he has received his script so he can have enough for his next appointment. He has an, unknown to me, resource for attaining additional meds. It appears he runs low after only 2 weeks of getting his prescription.

I believe that he is taking the medication for maintenance, as opposed to withdrawl. I am concern that the monthly rollercoaster may have bad effects. He has become moody, lashing out over stupid things, then being depressed later for having lashed out. He has had does not have mental illness (though I do, lol.) I have attempted to mention or ask 'you're taking meds again?' but this will bring about an argument or passive-agressive lashing. He mentioned recently that he thought he was 'building a tolerance' to the subs and needed to go a week without to cleanse his system.

I am not sure if this is pure addict behavoir, whether he is afraid of the pain returning so he takes it too soon, is he trying to get high from it (though that's not the goal with this,) or could he feel it's the only thing he has control over so he abuses it? I care deeply for my friend, and he knows that's where my heart is when I ask about it, but after 20 years he still has the guard up and we have struck an odd balance with that. He has been on disability so he doesn't do much, I don't think that makes him feel great, either.

I request from the knowledgable, tips on recommending tapering... had you been in these shoes, what's a good thing to hear? I am very curious to know what effects this awkward dosing rollercoaster might have on a person, mentally and physically. I know he has come very far and I am very happy for him. I just want him to hit a good stride with confidence. Thanks, in advance, for your help! :D

A sincerely concerned friend. T


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PostPosted: Sat Dec 17, 2011 3:26 am 
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It's really great to see the concern you have for your friend. It could be what makes the difference.

It sounds like your friend is quite guarded with all this, which is something we often do in addiction. But I can nearly guarantee he's not abusing agonists. If he was, he'd be accumulating Suboxone instead of running out of it. People skip Sub doses when they abuse other opioids, not take more.

Whether it's because of his pain or just because of the effect .. ??

I wish I could help, but I've never really abused Suboxone like that, so don't have much insight into it. But I've always thought it's quite serious to abuse maintenance medications, whether methadone or Suboxone, and I'd consider myself to have lapsed into addiction if I did it myself. The reason is that when a person takes more than prescribed to get high, Suboxone becomes a drug of addiction rather than a drug of recovery. If they do it long enough, they end up denying themselves the benefits the drug can provide.

This was a bit of a warning sign for me:

Quote:
He mentioned recently that he thought he was 'building a tolerance' to the subs and needed to go a week without to cleanse his system.


Whatever he's trying to do, he's clearly acknowledging that he's using more than he should.

Some people on this forum would know better than me maybe, what to do when someone on the program is abusing their Suboxone, or taking too much for pain reasons.


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 Post subject: too much?
PostPosted: Sat Dec 17, 2011 8:18 pm 
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Thank for your reply. I am certain he's not taking any other type of medication, which is very good. I am proud of him for that. I am just concerned about the amounts. Is he taking too much? I have only read that overdose could occur when taking a depressant that could stop respirations.

I am wondering if there is any information on any other people that have done a similar thing. I do believe he borders on abuse and he is depressed that he has not shed that pattern. It's as if he'll take as much as can while he has it (as he may have done with other drugs in the past) because he could die tomorrow and he's rather have it now.

It doesn't appear you can overdose from subs alone, though it is a huge drain on resources to keep taking so much when it can't really have additional effects. I am confused a bit. I am concerned for his health, physically and mentally. This is a great site. If he were online, I'd recommend it to him. I am a huge supporter of this medication. And I am very happy for all those it has helped! :D Thanks for listening.

T


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PostPosted: Sun Dec 18, 2011 8:06 am 
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Many people on sub, especially those new to sub, have tried to take more sub in an effort to see what it will do (get them high?). That's pretty normal. But we learn over time that it's just a waste. But even more so, addicts have a stimulus-reward habit that also exists in our brains pathways. It's reinforced by our actions of "needing" to take something - maybe via a trigger or craving, or just some uncomfortable emotion and the person goes to old habits of taking SOMETHING to make them feel better. Your friend could be doing this.

This is one of the main reasons that sub is recommended to be taken only once daily. It has a very long half life and dosing (unless taking it for pain) once daily is quite sufficient. It gets our heads away from taking something whenever we want. This way we dose in the am and forget about it. No opportunities to even take something later in the day. When the time comes that ups and downs in life occurs or uncomfortable feelings come up, well, the addict (all of US) have to learn to deal with it - life on life's terms - as they say.

It's a major component in recovery - learning to deal with our emotions that we previously numbed for up to perhaps YEARS. So maybe it will take your friend some time. Is your friend in any kind of therapy or seeing an addiction specialist - or even any groups? Everyone is different, but lots of us need something extra besides suboxone to help us break some of those super strong habits.

Good luck to you and your friend. You must be a really GREAT friend to care so much. Good on ya!

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Tue Dec 20, 2011 3:39 am 
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Thank you very much. He is seeing a psychiatrist at the same place, but I feel as though he stays very guarded with her, as well. Thankfully, she's from the same town and he feels at ease with her. I do feel the behavior is mainly psycological rather than an actual need but how do you say "stop thinking that way?" I noticed tonight his second med was taken an hour and a half from the last dose. I can't think it's healthy and he's still dependent on outside help from the MD for the end of the month. I think that's what the worst of it is.

He is a very good person but feels like he's the worst. He still calls himself a junkie... and honestly, I feel anyone that has had an issue with medication prescribed to them (even narcotics) is not a junkie! I haven't lived the life but I'm in healthcare and it seems there is little to no empathy for people with issues like this :(

I mainly want him to break free of the need. I want him recovered and to feel good about himself for being in a better place. It's almost as if he wants to stay in the pattern and feel like he's 'nothing' though he's so much more. I did my bi-annual "I love you, you're awesome, you're doing great" that makes him keep away and feel awkward for not reciprocating, and he didn't stay away this time. I guess time heals all wounds and perhaps my gentle nudgings on him may help.

Basically, hahaha, I'm no psychiatrist, nor (I'm assuming) are any of you, and I guess I need guidance for gently showing him a light at the end of the tunnel for the addict behavoir. He's lived with it for at least 13 years and I think he doesn't know anything else.

Thank you all very much for your help. I am more at ease that he needs mental nudging and that he won't overdose. It's just a waste of the resource. You're all very helpful and I'm very happy that there's a medication to help! :D

Thankfully,

T


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PostPosted: Tue Dec 20, 2011 7:37 am 
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Some people just get stuck in the "shame" of addiction and can't get past it. I remember a person on this forum who was like that. Just couldn't seem to get past it. I have no idea what active addiction did to your friend's life - how badly it was for his friends and family - the lying, cheating, stealing, did he lose people in his life, jobs, what did it cost him? Sometimes the worse it is can correlate with feelings of shame. It's really hard to get someone out of that place. For me, I finally learned that the holding on to the shame is the same as living in the past. When I realized that, I quickly moved to the current and out of the past. But different people require different things to light a fire under their ass.

Maybe you can talk to him about shame. Try discussing it in relation to another person, and maybe not him, because it sounds like he wouldn't admit it. Do you know any other addicts? Could you bring up the subject of shame nonchalantly? Maybe with him it's about the shame....Just a thought.

Good luck to you.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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