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PostPosted: Wed Feb 12, 2014 6:01 am 
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I read this on one if Junig's pages:

"there is NO evidence that withdrawal becomes more difficult the longer a person is on
buprenorphine. In fact, from my experience the opposite is true."

I have a very, very, VERY hard time believing this. Wouldn't it make sense that the longer
your brain becomes accustomed to exogenous agonism, the longer it would take for it to
return to homeostasis? I find it very hard to believe that it would be easier than if I had been on it for a shorter amount of time. So hard to believe that I think its just plain false.

Can someone please tell me how this makes ANY sense at all?


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PostPosted: Wed Feb 12, 2014 11:11 am 
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I said that there is no evidence that it becomes more difficult-- and that from an understanding of what Buprenorphine does, that makes sense. Buprenorphine has a ceiling on tolerance above a certain dose. Physical withdrawal is caused by tolerance-- and the severity of withdrawal is a function of the degree of tolerance. So once you are tolerant, you are tolerant. There is nothing else to make it worse. YOUR comment about what 'makes sense' makes assumptions that are not true-- e.g. That there is some other way the brain 'gets used to buprenorphine' besides tolerance. There isn't; the process of getting used to a drug IS TOLERANCE-- and with buprenorphine, that doesn't change beyond a certain dose, no matter how long at that dose. That is why, by the way, people can take it for years; because the tolerance is STABLE over time.

It isn't 'exogenous agonism'; it is partial agonism. Buprenorphine has actions that differ from oxycodone.

I went on to point out what I SEE. after treating 700-800 people with buprenorphine, 90 or so who choose to take buprenorphine for several years or longer. At some point, people have lives that are SO different than when using, that they are much more strongly motivated to go through the taper process. They have more self-respect. They have a better track record of completing what they start. They have greater ability to tolerate temporary misery, for long- term goals. And every bead of sweat doesn't instantly make them think of using.

The first paragraph is science; the second has no support in research-- but reflects what I have seen.


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PostPosted: Wed Feb 12, 2014 11:25 am 
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In your post, you seem to be speaking of wd in a purely physical sense, opiate wd has a huge mental component.

I think part of Dr. J.'s comment may be coming from a recovery (mental) perspective. If you've only been on Suboxone for a few months and your behaviors and life are still a mess, wd's would be that much harder. Once stabilized on Suboxone and given you've worked hard to correct behaviors and your life is in a better place, wd may be easier.

I also believe he's referring to his patients being able to taper properly once they reach a certain point in their recovery.

(Sorry Dr. J., I just now saw your post. I'm gonna go ahead and leave my response up, though.)

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PostPosted: Wed Feb 12, 2014 11:41 am 
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oops

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Last edited by h0pe on Wed Feb 12, 2014 6:16 pm, edited 1 time in total.

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PostPosted: Wed Feb 12, 2014 5:32 pm 
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i have to agree with dr. j's theory...and 1 year ago i would have disagreed..

my perspective on this, is purely my opinion, not proven..but i figured i would put this put there anyway.

i believe that someone addicted to opiates will suffer withdrawls (acute and post acute) for a longer period than most of us realize(over 6 months) i believe the withdrawl from bupe is a lot less than that of full agonists....so if you use bupe for only a few months, and your withdrawl is moderate, it would be withdrawl from the full agonists still..whereas if you go with a longer term bupe treatment...your body recovers from the opiate abuse. and at that point would only be dependant on bupe.

this has seemed to make perfect sense to me, but again is based only on perspective...i would love to hear dr. junig's take on this theory!

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PostPosted: Wed Feb 12, 2014 7:09 pm 
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I find your theory very interesting, he reigns! I'd love for the doc ti weigh in on this. I'm curious just how much the b ody recovers during buprenorphine therapy, or IF, it literally recovers, or if it's just our behaviors and thoughts/obsessions that change during the course of Suboxone treatment. besides our behaviors,/ loss of drug abuse, what other changes, healing, recovery occur during treatment? interesting thoughts, thanks, gives me something to think about.


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PostPosted: Thu Feb 13, 2014 12:53 am 
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(Exogenous agonism means "agonism from substances introduced into body.")

Now about the shorter withdrawal, this just doesn't correspond with the 7 years I've spent trawling Suboxone forums and experiences. From my observations, the people with the longest, most intense symptoms have been taking it the longest, without fail.

I personally and empirically cannot believe that my withdrawal from 5 years of Suboxone will last as long as someone who's been on it for 3 months. I wish to god it would, but I have absolutely no faith in it... I will be sure to update you on what happens though, and if it lasts 7-8 days, I will personally concede to being wrong and bow in forgiveness.

From what I understand, if the brain is receiving exogenous (outside the body) opioid ag/antagonism for years, kappa and mu receptors start to internalize and shut down, even permanently. And it makes sense that the longer the brain receives exogenous stimulation, the longer it will be before those receptors regenerate, if at all.

And what about the kappa antagonism? People totally ignore that. Kappa agonism induces stress in mice, and antagonism induces euphoria and tranquility. Is there a ceiling effect with that too? And what about delta antagonism? How does that play in? Buprenorphine and its metabolite norbuprenorphine are very, very complicated drugs that induce many, many changes in the body.

I know Junig is done with me at this point, but I wonder what he'd think about this?:

"One thing he did was to make a point of not taking bupe for longer than three weeks, on the advice of his detox doctor. “Or else I’d be dealing with a whole different problem,” he says.
I’ve seen what long-term Suboxone does,” says Scanlan, who switched his specialty to psychiatry in order to help other addicts kick prescription drugs. “People come in with endocrine problems—thyroid dysfunction, low testosterone,” which kills sex drive, “and hair loss. Tooth loss with Suboxone,” which is orange-flavored and is usually dissolved under the tongue."


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PostPosted: Thu Feb 13, 2014 2:33 am 
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are you trying to say that bupe is comparable to heroin and oxycodone, oxymorphone, hydromorphone etc..

bupe is a PARTIAL agonist not a full agonist


in your last post you said you disagreed with me based on your 7 years trawling suboxone forums...and you've been on suboxone for 5 years....


with having gathered all your "knowledge" about how horrible suboxone is for you, why did you begin...and then CONTINUE to use it??

the inteligent side of me says that i shouldn't feel any sympathy for you at all. that you made your bed, and now your whining because it's bed time and you're scared of the dark

i dont like to se people agonize...actually i feel other's pain, more than my own..i feel deep sorrow when i see or hear about people in agony, so i will pray for you.

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PostPosted: Thu Feb 13, 2014 7:03 am 
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I mixed up being on drugs for 7 years and being on Suboxone for 5.
So go head and delete your post lol.


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PostPosted: Thu Feb 13, 2014 2:37 pm 
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no, you said forums for 7 years..now you're caught in a lie and "lol"

you are a troll, and mad because nobody believe your teenage fairy tale lies...so have fun at subsux being an internet troll...and all of us here in recovery will continue to improve our lives...knowing all the facts we know, and helping eachother with recovery...seeing people like you try to troll, and then get mad when no one bites on your bait...and then leave (defeated) and life goes on.

:D have a great life man, i really do hope you make it! (if you're even near death for real)

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PostPosted: Thu Feb 13, 2014 3:28 pm 
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He-Reigns wrote:
no, you said forums for 7 years..now you're caught in a lie and "lol"

you are a troll, and mad because nobody believe your teenage fairy tale lies...so have fun at subsux being an internet troll...and all of us here in recovery will continue to improve our lives...knowing all the facts we know, and helping eachother with recovery...seeing people like you try to troll, and then get mad when no one bites on your bait...and then leave (defeated) and life goes on.

:D have a great life man, i really do hope you make it! (if you're even near death for real)



Jesus... I was ON DRUGS for seven years, I was ON SUBOXONE for FIVE, got the two lengths MIXED UP. For christs sake... Have fun with your endocrine disorder.


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PostPosted: Thu Feb 13, 2014 3:33 pm 
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:D i love you so much man

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PostPosted: Thu Feb 13, 2014 9:16 pm 
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Got a nasty email from the 'five years' dude-- the guy is clearly struggling... which usually means I would wish the best for him. In this case, I'll say... wow.


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PostPosted: Thu Feb 13, 2014 9:20 pm 
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I think that it is pretty typical for most members here to wish him well too, but he needs to stop lashing out in order to find that out.

Amy

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PostPosted: Thu Feb 13, 2014 9:45 pm 
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I gotta say-- I was impressed how kindly people here treated him, with his attitude. Y'all have more patience than I do!


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PostPosted: Fri Feb 14, 2014 2:05 pm 
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I think the OPs attitude is wrong but I don't blame him for being a skeptic of such a claim. Dr. Junig no doubt has a vast knowledge about buprenorphine and I'm not debating that but just like my doctor and other doctors that my friends go to its just hard for us to fully commit to believing such things we here from our Drs because he's/they have never taken nor had to withdrawal from buprenorphine himself/themselves. I can go on and on about how a meth addict should be able to just "put the pipe down, there is no physical withdrawal syndrome compared to drugs like opiates, you just sleep for several days after discontinuing and then you'll be ok" and they will probably look at me cross eyed like "what the hell do you know" and rightly they should because Ive never had a meth habit nor have I had to withdraw from one so my attitude towards the withdrawal being insignificant really doesn't hold any weight because I don't have personal experience. If I've never been kicked in the shin before and you have and I tell you that regardless of your actual experience and the pain you know you felt, that I had read in a book that in fact getting kicked in the shin causes no pain I don't think you'd put much weight into what I was saying.


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PostPosted: Fri Feb 14, 2014 4:37 pm 
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Tbis dr at tbis forum, who has wrtten books, seen hundreds of addticts, some who have come off bupe, and is and a recoving addict himself knows more about all that is suboxone.. I agree, most drs dont seem to know much at all about this med. This man does. It is all bere and in his books and guides. I have a dr who isnt and addict but doesnt understand half as much as he says..I know two others who are trying to learn as much as possable from addicts who do know.. Yes we are all different but by how much really...razor...


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PostPosted: Fri Feb 14, 2014 8:48 pm 
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Just wanted to let you guys know that I just came from sub sux as a lurker, and they're giving that five years guy hell overt there too. he's been a member there since last year under a different name than he has now. his old name there is FiveYearsOnSubox, his new one is Arizona something, and they're telling him pretty much the same shit we all told him, only difference is they talk crap about our forum, big deal! they told him the wds and paws are the same no matter how long you took subs, etc. just thought it was kinda funny. not for him. I'm still sorry he's suffering, but it's not bupes fault. hope he gets serious before it's too late, looks like hes been having a hard time for quite a while now.


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PostPosted: Sun Apr 27, 2014 10:35 am 
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I think FiveYearsOnSubox makes some good points on one of his posts. Plus he's been on it for 5 years so I'm sure he has something to add. I've been on suboxone for over 4 years and I can tell you that it doesn't affect me the way it used to.
I have a theory that the kappa antagonistic effects of buprenorphine gradually diminish over time. For me it happened after the 3 and a half year mark. Kappa agonists are known to be diuretic so it would make sense that buprenorphine, which has kappa antagonistic properties, would act like an antidiuretic. I've noticed that I've started to urinate quite often in the last 9 to 10 months. Maybe that's because the kappa antagonistic effects of buprenorphine are wearing off. It's as if I've been taking a water pill (diuretic) every day.
The point I'm trying to make is that long term users of suboxone are in a different category. There aren't many studies done as to what suboxone does to people that have been on it for over 4 years. I could write a book on how the effects of suboxone have changed for me over the last 4 years.


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PostPosted: Sun Apr 27, 2014 12:36 pm 
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He's a moron. I was on subox for almost 4 years, and I'm three months off feeling so fucking good I cant find a word for it. This guy is Mentally addicted to suboxone, making him crazy. I remember seeing him a couple months back. Try not to read his posts. He had a bath salt problem(Seriously) .

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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