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PostPosted: Wed May 27, 2009 11:17 pm 
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My 19 year old daughter came to me for help recently, thank GOD. She has been on Hep C treatment for 7 months. She contracted this from a dirty needle by a man who KNEW he had it. Anyway, thats another story. I have watched her get sicker by the day thinking it was the Hep c medicine which does make you ill. Then she comes to me and says she need help, that she has been abusing pain meds of all sorts and then got mixed up with some heroin which she snorted. she has been using daily for about 4 months. About 40 dollars a day. I won't get into how horrified I was to think how she could further poison her all ready wasted body. She weighs 95 lbs and looks like she is going to die. After much research and a few short days I put her on suboxone. I am open for any and all advice, comments, prayers, help stories, personal tragic stories and help of any kind. I am a single Mom, poor and hold a job of many years but without much pay, one of those family type things. lol. My girl seems very optomistic, wants help badly and will go to counciling, whatever it takes. She feels better after day one but I know that is the opiate in suboxone talking. I have done my research. Please anyone, give me advice, what to do...what not to do. All help is welcome and thanks for caring and sharing.


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PostPosted: Wed May 27, 2009 11:52 pm 
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Mother,

Welcome to the forum! In my opinion you really did the right thing by getting her on Suboxone. Suboxone will block other opiates so taking pills (narcotics) will have no effect.

One thing you have to watch for if shes abusing benzos (valium, xanax, etc). They are NOT good to be taken with Suboxone! Make sure that she knows that.

I'm not a doctor, so, I don't really know how Suboxone and Hep C are together. I'm pretty sure that its probably not a bad thing though.

How is it going for her on the Suboxone? Did the induction go smoothly?

Feel free to ask questions or anything you want to know about Suboxone. There are a lot of great members here that have a lot of knowledge, and the Doc (Dr. Junig) will sometimes add his comments. Be careful with 'research' on Suboxone on the internet, because there is a LOT of misinformation out there, especially in other forums.

Check out the 'Introductions' section. There are a lot of personal stories in there from some members. That may be a good place to get started. Otherwise, feel free to ask questions if you have anything you don't know about or have any concerns.


Jim


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PostPosted: Thu May 28, 2009 12:27 am 
Hi momofteen,

IMHO, too many people who use Suboxone as a method of dealing with opiate addiction merely use it as a way of postponing dealing with opiate withdrawal symptoms. Suboxone can allow a desperate addict to function much like a normal person within a day or two, so often addicts think that taking their Suboxone IS dealing with their addiction. Rather, IMHO, Suboxone is a tool that can allow you to be able to deal with life stressors, unhealthy relationships and the dysfunctional thinking that leads the person to addictive behavior in the first place. Too many people never address these things, then months or years down the line they decide to get off of the Suboxone and these issues are still waiting to drive them back to their drug of choice because they have never been addressed. Thus I'd recommend that you encourage your daughter to become active in a recovery group like Narcotics Annonymous, SMART Recovery or the like. Also, therapy with a trained therapist could be very helpful if you are able to help her get that.

Also, family support is a GREAT thing for a recovering addict..... but ultimately your daughter will need to "own" her recovery... or else it's very unlikely to work. Unfortunately you cannot will or love someone into recovery from chemical addiction. I'd encourage you to help your daughter become as active as possible in her own recovery as you help her understand that she needs to be the one driving it.

Finally, (and this will likely generate opposition from others at this site) I'd recommend that your daughter try to keep the length of her Suboxone treatment to a minimum. Use it as a tool, take advantage of the access it gives her to her own life, then taper off of it and move forward with a healthy opiate-free life. Some addicts feel the need to remain on Suboxone indefinately, but the longer one stays on the drug, typically the harder it is to get off of. If your daughter's latest addiction bout with opiates was only a few months, I believe she can happily live opiate free once she has dealt with the things that draw her into addictive behavior.

I wish your daughter nothing but success in her path to sobriety, as well as resolving the Hep-C issue... also, she's lucky to have such a caring mom. :)

Tim


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PostPosted: Thu May 28, 2009 1:41 am 
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Yes, I do have my daughter set up for counciling as well as the sub. she balked at first did not want to go but the doctor and I kind of tricked her and it worked into believing that it was the only way she would get him to help. Whatever works. She agreed fully after hearing him out that she would go and yes, she needs it badly. She used to use xanax but no longer does after they nearly killed her, she has an addictive personality. although I know why she uses, she has yet to figure that out for herself. She has had a tough little life, has grown up with low self esteem although she is a beautiful girl, she is unsure of herself and afraid to try. I cannot wait for her to begin counseling and I hope that they can drag out of her the real underlying issues. As her Mom I can point them out, stress them and do but it never sinks in. I encourage, I reason, I bribe. but she is still too unsure of her own self reliance. Yes, we both agree to view the sub as a short term thing. I have been reading and reading and from what I gather, the shorter the better. The doc put her on 24 mg's but after her first half dose, and the induction went well, she told me she was gonna try to take just half a pill as it worked. I was glad to hear that just the 4 mg's gave her relief. She did indeed go because she was in such terrible withdraw and had heard about the drug from other users who told her it worked. I hope the drop in what he prescribed is not a bad move but I figured less was better and why start high if she could start low, then she wants to drop to less in two weeks. Hopefully she can drop from 12 mg's to less. I tseems easier to me and makes sense and I read some people's stuff who said 24 was too high to start with. Does anyone have advice on that?? I am afraid of making the doc angry when I tell him we decided that the half pill was working. But I don't feel comfortable not telling him either. also of course there is the huge cost so less would be better. So please write back with more advice.


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PostPosted: Thu May 28, 2009 2:00 am 
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Your daughter should be honest with her Sub doctor about the dose she's taking. That is part of recovery - learning to be honest and not treating our addiction our own way. If the prescribed amount is too much, the doctor should be understanding of that.

I would also suggest that you seek out some support for yourself, mom. Living with an addict is very stressful, and though you love your daughter you can't fix her. She needs support, but she has to do this for herself.

Naranon and Alanon are 12-step groups for the family members of addicts & alcoholics. There are meetings everywhere, and you will find other people who have been through what you're going through and have wisdom and compassion to share.

I also urge you to do your own research about short vs. long-term Suboxone treatment. And by research I mean read actual medical research - not the horror stories that the anti-sub crowd likes to propogate. My doctor has shared studies with me that show much better outcomes with longer treatment. It's just so easy to relapse, and it's very dangerous. Some people say that it is harder to get off Sub the longer you take it, but that is not everyone's experience.

I know for a fact that had I tried to go off Sub a month or so into my treatment, I would have gone right back to using. Instead I opted to stay on it for the past 18 months and in that time I have been able to do many things to build myself a strong foundation in my recovery. The freedom from the craving to use enabled me to finish my college degree, keep working, repair relationships with family, address my depression and other issues through therapy and take care of my physcial health. Now I'm in the process of tapering off and I'm on a very low dose - but I feel strong enough to do this now with the support systems I've put in place. If I was brand-new in my recovery...well, I just don't think I'd make it.

Please take care of yourself. You might be thinking that your daughter is the one with the problem, but I know from hard experience that living with someone else's addiction can make us sick too. Seek out people who have been where you are and have made it through - that will be your best resource for learning how to maintain your own sanity throughout this process. Best of luck, my thoughts are with you and your daughter.

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PostPosted: Thu May 28, 2009 9:13 am 
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With all respect to Tim in SD, his answer is the basis for every single minute of my life that I spend on this forum and my blog. I hope people are picking up on my opinion on this issue, because the natural feeling of every addict is to think as Tim does. i don't mean this with any anger, defensiveness, name-calling, etc-- I would probably get along just fine with Tim on 99.9% of the things in life he thinks and does. But on this one issue, I strongly disagree.

I assume Tm knows AA or NA-- I certainly do. As I often write, it saved my life twice, and I have read all there is to read in the standard literature-- the Big Book of AA, the 12 and 12 (my favorite), the Blue book, the 'one day at a time' meditations by Hazelden, etc etc ... and attended meetings for over 16 years, the most recent (admittedly) about a month ago. I have almost nothing against the programs; the 'almost' is for the several people who were doing great in life before being talked off their Suboxone at NA meetings, and who had wicked relapses-- despite trying their hardest to 'get it' through NA. And when those relapses came, like all addicts their state of minds changed, and they quit going to NA-- as almost all addicts do-- and none of their 'NA friends' took the time to call them and help. To be honest, the general recommendation in AA and NA (and I have attended meetings in many different locations-- I used to seek them out when I was traveling) is to NOT waste too much time on people actively using. The old days of '12 step calls' are truly a thing of the past-- at least on the level of the relapsing individual. The trend now is more towards waiting for the addict to return to NA, rather than finding the addict and bringing the person back-- probably a good idea, since it is impossible to go an bring a person back if his mind is deep in relapse.

A quick note to mom on cost-- Opiate addicts spend .6-1 buck per mg of oxy; they use one to four '80's' per day in my area on average; that puts the cost of using at $80 per day minimum to ten times that amount or more. Many women are essentially 'tricking' for it by dating the wrong guy who deals oxycontin. Other people pay the money by selling OC until they go to prison, or they simply steal from their parents. The cost concerns over Suboxone are SILLY when you know what is really going on.

Back to Tim-- those comments of yours are nice, and I would have agreed during the first year or two of my recovery. But now I see them as saying that 'it would be best if we just ASKED N Korea to stop firing those missiles'. The comment about 'owning your recovery' is a dangerous one, even for those who use the AA playbook; old timers will tell you that you don't 'own' anything, especially your recovery. Rather, you do everything you can and pray to stay in recovery. In step recovery, you are powerless over drugs-- and thinking you 'own your recovery' is akin to saying 'I will never use again'-- something that will get you called on the carpet at any good step meeting. The fact is that your addiction owns you-- like it or not-- and the addict does his best to avoid the consequences of the horrible illness of addiction.

The idea of using Suboxone short-term is simply wrong-- I met with 70 of the docs who know Suboxone the best a few weeks back, and we all went over the science behind Suboxone. Short-term use does nothing, unless it is done as part of a residential treatment program-- that is the simple truth. It is important that people use appropriate science to treat addiction, just as we use appropriate science to treat cancer. Addiction has all these people out there talking about what THEY think works best-- can you imagine if other diseases were handled that way? There is an illusion with mental illnesses, and particularly with addiction for reasons I don't have time to go into. But the illusion is that addiction responds to certain 'common sense' ideas. IT DOESN'T. If it did, it would not kill as many people as it does.

Quick summary-- I like Tim's thoughts, just as I like it when my college-aged kids talk about World peace-- about how nations should just work things out. I truly wish Tim was right. He was right, for me, for 7 years-- until my relapse showed me that the recovery I 'owned' was a big trick. I am not basing my answer on my situation though-- I saw the same thing happen over and over. Go to AA or NA meetings, and ask around the table, how many people went into treatment and 'got it' and then never relapsed in a big way afterward. The ones raising their hands are the liars. I work at a 50-bed residential treatment center that does NOT use Suboxone; I know the histories and the success rates for opiates. I know doctors who had their careers riding on their sobriety, who truly wanted to stay clean, who attended meetings... who lost everything from the relapse that inevitably came.

Opiate dependence is a chronic, RELAPSING illness. We treat it by either forcing an artificial personality on a person through meetings, which works in about 10% of addicts. Or we treat it by forcing an artificial neurochemical state at the addict's receptors, which in my opinion works in many more people than 10%. In both cases, if you stop treatment you will relapse. Simple, simple fact. And for a teen or 20-something year old daughter, your choice is a daily pill, or residential treatment followed by a few meetings per week. Will your daughter go to treatment for a few months, then a halfway house, then the meetings? IF she will do those things, there is perhaps a 50% chance it will take. Overall, intensive treatment like that will give a year of sobriety in about 65% of patients, looking at all substances including alcohol averaged together. Opiates bring those numbers down. But IF you think that you can skip the 45 grand for treatment, and skip the several meetings per week-- you are wrong, and I hope that Tim will admit that. If he doesn't admit that, then I know he doesn't understand addiction at all. And since I know that your daughter probably WON'T do those things, you really don't even have the choice you think you have!!

What choice? As I think about it, that is the simplest answer-- if she will do residential followed by several meetings per week for life, then you have a choice. If she won't, you are kidding yourself thinking there is any option besides Suboxone.

I wish you the best--- mom and Tim both. I KNOW that if you are anti-sub now, in ten years you will feel differently, and you will be on my side of this issue. You don't have to believe me-- but for the mom, if you go any other route, or try to save money and stop the Suboxone too soon, please contact me when the S... hits the fan. I don't wish that on you-- it is already predestined. I truly ask you to contact me when that happens-- don't be ashamed or embarrassed. The illusion you are struggling with is all too common-- that's why I do all this writing, after all.


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PostPosted: Thu May 28, 2009 11:53 am 
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Thank you for the help and advice. i am afraid of stopping her too soon as relapse for her is my biggest fear and I think hers also. I do wonder though since I understand addiction if I have not somehow, through my love, now became her new dealer. It is expensive and so was her habit, difference is, now I am paying for it. As she is my child I would stop at nothing to help her but I am not rich , have another teen daughter to support with no financial help. so yes, hoping she gets better by miracle is simply wishful thinking. I don't know how far I'll get with her in a program, in care treatment she wont do yet. I do feel she would relapse if I pull her off too soon. My short term plan is to try at 6 months. I do feel the longer she is on, the harder it will be to wean her off, especially if I don't have some steps to change her life in place. For her, that will be the hardest part. I wish we could pack up, move away to Montana and become hermits but how much more unrealistic could I be. I am just hoping for the best. I went through this once before with my x husband who did meth. 14 year marriage, the last 6 spent trying to fix him. I know that is completely impossible, I finally had to divorce and cut my ties. He still uses but changed his drug to pain killers. He is not this daughters biological father but he did raise her from age one to 13. She saw it all. she knew addiction. I know she has to do this on her own and I know I can't save or fix her, just support her. It was easier to turn my back on the x, however, I don't think I can do that to my child when she does relapse and I know she will. I will have then wasted all this money. I talked to her about all that and she knows there is a danger but honestly feels she can and will beat this thing because she wants to be normal. Also, i am codependent so my need to fix her is rather like an addiction in itself. Please keep answering and I also think I should put this post in another spot in the forum to get even more input, it just ended up under this topic because that's where I was. Thanks again!!!


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PostPosted: Thu May 28, 2009 12:57 pm 
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mom - Do you (or your daughter) have health insurance? If she doesn't, she can apply for the needy meds program through Suboxone's manufacturer- Reckitt. There is an income limit, and you have to find a doctor willing to participate, but the program provides Subxone at no cost for up to 2 years.

Some states have money for addicts to get treatment - in my state it's through the Department of Health and Human Services, the program is called ADATSA. In my state being low-income and diagnosed with opiate dependence can temporarily get you medicaid coverage - which then covers doctor visists, drug treatment, and Subxone.

My social worker also set me up with other programs for people in recovery - one gave me vouchers for clothes, household goods, gas for my car, and a few other things.

Most citites now have a community information hotline, you just dial 211 - they may be able to put you in touch with resources to help you and your daughter pay for her treatment.

If you already have insurance, you can try to find a doctor who prescribes Sub AND takes your insurance. NAABT.org has a doctor-patient matching service - they helped me find my Sub doctor and they helped my best friend find a doctor who helped her get on Reckitt's needy meds program. If you can't find a doctor who takes your insurance, you can at least have your doctor give you paperwork that you can submit to your insurance on your own - they may reimburse you for all or part of her treatment.

You have not become your daughter's "dealer". Dr. Junig has written about "switching one addiction for another" and how it's just not how it works. Addiction is something that happens in the brain, and you daughter will be an addict whether she takes Suboxone or not. At least while she's on Sub she has a greater chance of not relapsing to her DOC and she will be basically put into remission. Hopefully as she gets better she'll be able to contribute to the cost of her treatment - or she can contribute by researching resources. Like I said before, it is not a known fact that the longer you're on sub the harder it is to get off of it. But it is known that the longer you're on sub the less likely you are to relapse.

Suboxone's supposed to go generic in the fall or winter of 2009 - not too much longer. Hopefully at that time it will be much more affordable for more people, so try to hang in there.

One last thing - If the desire or the will to be "normal" was all that we needed to get over our addictions, do you think ANY of us would be here?

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PostPosted: Thu May 28, 2009 8:04 pm 
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Just my opinion through years of trying to stop using only to use again that staying on Suboxone longterm if not indefinately is the way to go. Of course it's expensive but it's alot less expensive than continuing to use which costs butt loads of money plus occassional arrests, E.R. visits for overdosing, and eventually even death :cry: It took me a long time to come to the conclusion that Suboxone was the closest thing to a guarantee of not using again an opiate addict can hope to find. My advice is do whatever it takes to keep your daughter on it as long as possible (if not indefinately), I mean any way you look at it while she's still on it she has a higher chance of survival. I finally came to the conclusion that I wasn't ever going to be normal again so I had to shoot for as normal as I COULD be. Suboxone has helped me find a productive meaningful life again at a price that is so small in comparison. Good luck to you and I hope you all the best whatever you decide :D

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PostPosted: Thu May 28, 2009 10:09 pm 
Hi Doc,

While I disagree with several opinions you have expressed, I truly appreciate the manner in which you expressed them.... so thanks for that. :)

I personally do not accept the premise that addiction is a "disease" over which we are "powerless". To me it seems clear that addiction is more of a maladaptive behavior. Particularly in terms of opiate addiction, it is a dysfunctional pattern of overloading our bodies' natural reward mechanisms with synthetic endorphins. I am confident that you won't agree and since this is your site, I'll not forge on trying to debunk your beliefs.

A few things I did wish to clarify, however...

My statement to momofteen about her daughter needing to "own" her recovery was intended solely to stress the point that recovery isn't the kind of thing that that a mom can do "for" her daughter. If the addict his/herself isn't committed to their own recovery, the best of intentions by loved ones are frankly wasted and the addict will eventually return to their drug of choice. I believe you would agree with this statement, as outside of an incarceration situation you can't force an unwilling patient to continue sucking on that orange pill each day and they will eventually revert to doing what they have their mind set on. I fully agree that recovery isn't a possession you can put on the shelf like a trophy. That approach is looking for trouble.

I know some about AA/NA and similar 12-step organizations, have been to meetings and read the literature... as well as orange-papers. org and other stuff that is very anti-AA/NA. I myself am not a fan of the 12 Step approach and have read much about how their "success rates" are horrible in the long term. Still, in deference to the wide acceptance of the 12-Step Recovery approach in our society as well as the many who claim it "has been a life-saver", I happily concede that it seems to work for those for whom it works. Personally, I find the SMART Recovery approach more logical and effective. As it is based in REBT therapy, I'd be interested in your opinion of this approach... as a psychiatrist. (BTW, while I am not a huge Suboxone fan, I do agree that it is unconscionable that NA would shame people off that or any medication... which they tend to do.)

I also happily admit that treatment modalities for opiate addiction are woefully inadequate. If you push the long-term window our far enough and define success as refraining from all opiates, virtually all treatment modalities fail the vast majority of their patients. I don't personally buy into the disease concept of opiate addiction, but those who do must admit that the cure rate for opiate addiction is miserable. Opiate Replacement Therapy with less euphoric opiates like methadone and buprenorphine are fairly effective at harm reduction, but at best you are just treating the symptoms of opiate addiction and not it's underlying causes... kind of like taking pain killers long term for a herniated vertebral disc. If one is willing to accept this as their new level of stasis, then such treatment can help the addict resume a fairly normal life.

Personally, I flunked out of several treatment modalities (including Suboxone) before finding one that worked for me. In hindsight I am fairly certain that it wasn't necessarily so much about merits of the treatment method as it was about my state of mind and commitment to sobriety. The method that finally stopped my active opiate addiction was Ibogaine Detox therapy... and I was using slightly higher amounts than your example 1-to-4 OXY-80 pills. Just prior to my detox I would vary between 1000mg-2500mg of Oxycontin per day, often with some fentanyl or hydrocodone thrown in for good measure. 1000mg of oxy per day was about enough to fend off withdrawals... up to 2500mgs or more if I wanted to feel good. And you are right, it was damned expensive. I'd be curious to hear your opinion on ibogaine. Maybe check out some of the research Dr. Debra Mash of Miami, and others have been doing.

I do not believe that ibogaine therapy is the right treatment for every opiate addict, although it did wonders for me. Actually, my biggest beef against NA and other organizations and persons (like yourself Doc) is their insistence that their way is the only effective way of dealing with opiate addiction. The statistics just don't bear that out. People get and stay clean through numerous methods everyday. There are even people with active run-away opiate addictions who one day just get fed up and stop their drug use, with no outside help, never to return to it for the remainder of their lives. They certainly aren't the majority, but they exist and as long as they do they destroy claims that any modality is the only way of dealing with opiate addiction.

Anyway, thanks for the interchange Doc. momofteen - I'd recomend you keep reading around, including the good doctor, evaluate what you read and go with what makes the most sense to you and your daughter. Best of luck to you all!

Tim

p.s. With our current administration it appears that we will be asking the U.N. to write the letter nicely asking Lil Kim Jong-Il to stop launching missiles.


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PostPosted: Thu May 28, 2009 10:42 pm 
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Tim, not to bust your bubble or question your usage history, but you gotta explain this:

"I was using slightly higher amounts than your example 1-to-4 OXY-80 pills. Just prior to my detox I would vary between 1000mg-2500mg of Oxycontin per day"

SLIGHTLY higher????? 2500mgs!!! Please tell me that was a typo! And That you meant 100-250mgs....and not 2500 just to "feel good"....if that is the case, you gotta explain to me what a typical day was like for you....cuz that doesnt even
seem human to me....unless you're a millionare....I couldnt even imagine what taking 30 Oxy 80's a day would be like...
I'm getting nausious just thinking about it....


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PostPosted: Thu May 28, 2009 10:58 pm 
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MOM,

If your daughter was spending $40 day, which would be about 4 bags of dope, I would think that
24mgs of Sub is way too much for her.....but, take it w/ a grain of salt....if she told you $40 a day, it could have been around $100....or god forbid, spending $40 and getting more in other ways....
But, even still, after a few days of adjusting, I would think one 8mg pill would get the job done....
and further along, even a half, 4mg would start to be effective for her as well....

everyone is different, but I'd suggest:
telling her to get by taking as little as possible.....and not to take more pieces throughout the day because
her brain/body is giving her phantom pains/cravings cuz she was used to repeatedly using multiple times a day...
I know advice is given to take first thing in the morning....but, that was my biggest problem in using....
the unbearable cravings I'd get w/in 30 seconds after waking up and immediately take something...
I've used Sub to break that habit....I still sometimes have urges when I wake up, but nowhere near as bad....and now I
can wait a few hrs....and I'll usually take it after I have coffee, breakfast and get to work for awhile....and its helped
break the "multiple times daily" using behavior for me.....just something to discuss.


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PostPosted: Thu May 28, 2009 11:26 pm 
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Tim-San_Diego wrote:
Hi Doc,

While I disagree with several opinions you have expressed, I truly appreciate the manner in which you expressed them.... so thanks for that. :)

I personally do not accept the premise that addiction is a "disease" over which we are "powerless". To me it seems clear that addiction is more of a maladaptive behavior. Particularly in terms of opiate addiction, it is a dysfunctional pattern of overloading our bodies' natural reward mechanisms with synthetic endorphins. I am confident that you won't agree and since this is your site, I'll not forge on trying to debunk your beliefs.

A few things I did wish to clarify, however...

My statement to momofteen about her daughter needing to "own" her recovery was intended solely to stress the point that recovery isn't the kind of thing that that a mom can do "for" her daughter. If the addict his/herself isn't committed to their own recovery, the best of intentions by loved ones are frankly wasted and the addict will eventually return to their drug of choice. I believe you would agree with this statement, as outside of an incarceration situation you can't force an unwilling patient to continue sucking on that orange pill each day and they will eventually revert to doing what they have their mind set on. I fully agree that recovery isn't a possession you can put on the shelf like a trophy. That approach is looking for trouble.

I know some about AA/NA and similar 12-step organizations, have been to meetings and read the literature... as well as orange-papers. org and other stuff that is very anti-AA/NA. I myself am not a fan of the 12 Step approach and have read much about how their "success rates" are horrible in the long term. Still, in deference to the wide acceptance of the 12-Step Recovery approach in our society as well as the many who claim it "has been a life-saver", I happily concede that it seems to work for those for whom it works. Personally, I find the SMART Recovery approach more logical and effective. As it is based in REBT therapy, I'd be interested in your opinion of this approach... as a psychiatrist. (BTW, while I am not a huge Suboxone fan, I do agree that it is unconscionable that NA would shame people off that or any medication... which they tend to do.)

I also happily admit that treatment modalities for opiate addiction are woefully inadequate. If you push the long-term window our far enough and define success as refraining from all opiates, virtually all treatment modalities fail the vast majority of their patients. I don't personally buy into the disease concept of opiate addiction, but those who do must admit that the cure rate for opiate addiction is miserable. Opiate Replacement Therapy with less euphoric opiates like methadone and buprenorphine are fairly effective at harm reduction, but at best you are just treating the symptoms of opiate addiction and not it's underlying causes... kind of like taking pain killers long term for a herniated vertebral disc. If one is willing to accept this as their new level of stasis, then such treatment can help the addict resume a fairly normal life.

Personally, I flunked out of several treatment modalities (including Suboxone) before finding one that worked for me. In hindsight I am fairly certain that it wasn't necessarily so much about merits of the treatment method as it was about my state of mind and commitment to sobriety. The method that finally stopped my active opiate addiction was Ibogaine Detox therapy... and I was using slightly higher amounts than your example 1-to-4 OXY-80 pills. Just prior to my detox I would vary between 1000mg-2500mg of Oxycontin per day, often with some fentanyl or hydrocodone thrown in for good measure. 1000mg of oxy per day was about enough to fend off withdrawals... up to 2500mgs or more if I wanted to feel good. And you are right, it was damned expensive. I'd be curious to hear your opinion on ibogaine. Maybe check out some of the research Dr. Debra Mash of Miami, and others have been doing.

I do not believe that ibogaine therapy is the right treatment for every opiate addict, although it did wonders for me. Actually, my biggest beef against NA and other organizations and persons (like yourself Doc) is their insistence that their way is the only effective way of dealing with opiate addiction. The statistics just don't bear that out. People get and stay clean through numerous methods everyday. There are even people with active run-away opiate addictions who one day just get fed up and stop their drug use, with no outside help, never to return to it for the remainder of their lives. They certainly aren't the majority, but they exist and as long as they do they destroy claims that any modality is the only way of dealing with opiate addiction.

Anyway, thanks for the interchange Doc. momofteen - I'd recomend you keep reading around, including the good doctor, evaluate what you read and go with what makes the most sense to you and your daughter. Best of luck to you all!

Tim

p.s. With our current administration it appears that we will be asking the U.N. to write the letter nicely asking Lil Kim Jong-Il to stop launching missiles.


Tim,

I'm curious to hear about your Ibogane experience. Perhaps put a post up with the story?


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PostPosted: Thu May 28, 2009 11:31 pm 
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Yeah, I second that.

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 Post subject: Re: Tim???????
PostPosted: Fri May 29, 2009 12:05 am 
NJSikkbreed wrote:
Tim, not to bust your bubble or question your usage history, but you gotta explain this:

"I was using slightly higher amounts than your example 1-to-4 OXY-80 pills. Just prior to my detox I would vary between 1000mg-2500mg of Oxycontin per day"

SLIGHTLY higher????? 2500mgs!!! Please tell me that was a typo! And That you meant 100-250mgs....and not 2500 just to "feel good"....if that is the case, you gotta explain to me what a typical day was like for you....cuz that doesnt even
seem human to me....unless you're a millionare....I couldnt even imagine what taking 30 Oxy 80's a day would be like...
I'm getting nausious just thinking about it....


Yes, those were my usage levels, though I had built up to that tolerance over years and I certainly don't recommend anyone using at those levels. It truly is insane. Although people have different natural sensitivities to opiates (and any drug actually). What 100mgs did for me, 10mgs might do the same for someone more sensitive to the drug's effects.

Back then my typical day would start by waking up miserable. I would chew (to defeat the time-releases mechanism) 2 or 3 80mg Oxycontins and wait about 20 minutes until they kicked in and I felt able to get out of bed. I'd then go to work at my 6-figure job and function, to most eyes quite normally. However, most eyes didn't see that every 2 or 3 three hours throughout the day I would slip a few oxys into my mouth and chew them. I was a highly functioning addict. I have been pulled over by highway patrolmen and PASSED all their sobriety tests and let go... all the while having hundreds of milligrams of oxycodone coursing thru my veins.

I've never been a millionaire, but I did have a good salary and owned two homes... which I have pissed away chasing that damned poppy. I rarely bought less than 100 pills of each type at a time. I used to go to my dealer and spend $5-10K on pills for the week... then have to go back before the week was out because I was running low. My dealer used to also sell me 10/325 Norcos, but I stopped buying them because I could swallow a handful and not be able to tell you if they were real or fake... because my system wouldn't really respond to less that 100mg of opiate. The most insipid thing about opiate addiction is that you watch your life racing to hell in a handcart... but you don't really give a crap... solong as you are full of opiates and have enough left over for your next few fixes.

Tim

EDIT: I've posted my ibogaine experience in some detail on two other sites. This board won't let me post links tho because I iz a newbie


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PostPosted: Fri May 29, 2009 1:27 am 
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You can write out the link like: whateverwebsite at wherever dot com. Just take the @ out and you should be able to post.

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PostPosted: Fri May 29, 2009 3:12 am 
Diary of a Quitter wrote:
You can write out the link like: whateverwebsite at wherever dot com. Just take the @ out and you should be able to post.


Looks like the internet gods have now deemed me linkworthy. :D

You can read my Ibogaine Dtox Experience at the following link:

http://www.subsux.com/board/topic.asp?TOPIC_ID=2579

Tim


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PostPosted: Fri May 29, 2009 4:13 am 
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Thanks Tim - that was interesting. I've been curious about ibogaine for a while. Long ago, before I ever did opiates, I used to do a lot of coke in a weekend warrior kinda way. MDMA, LSD, Ketamine, weed and whatever else too - I was pretty into the rave scene at the time (oh, the 90's!) and we'd definitely be up for days partying.

Anyway, at some point we discovered that if we ate some shrooms at the end of a long weekend of chemical debauchary...well, there was no "coming down" process. No matter how much coke I'd snorted, after the shroom trip it was like I hadn't done anything. And sleep would come and then it was back to work like a good upstanding citizen for the next 5 days. Ketamine worked in a similar way but not as well.

So I've wondered if that is similar at all to the way Ibogaine works. Obviously the trip is different - though Ketamine is vision-inducing and also makes you lose coordination, it just doens't last very long - but I wonder if the effect of resetting receptors and/or helping to remove addict mentality is exclusive to Ibogaine or if other hallucinogens could have a similar effect.

Before I started Suboxone, someone I know found a patch of shrooms growing in a local park, so we picked and dried them and they're around somewhere. There have been moments during this taper process where I've wondered if I should just down a handful and go to bed for a few hours - hoping that I'll wake up cured or at least closer to being done with this. Something holds me back though. The thought of tripping is just deeply unappealing, as it has been for a long time now.

Thanks for posting the link & sharing that story. I really liked that your major insight/realization was that you have no reason to be abusing yourself with opiates because you were well loved and had a happy childhood and other things you cared about in life. Isn't it so cool to know that all of that is still in you, even when you haven't accessed it in a while?

We're all still the amazing beings, full of potential and deserving of a great life, that we were before addiction happened. That's so inspiring.

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PostPosted: Fri May 29, 2009 5:27 am 
As far as I know, ibogaine is the only such drug that has been used efectively in opiate withdrawl. They have done some studies that seem to show that MDMA combined with psychotherapy can be effective in treating PTSD.

IMHO, ibogaine can be a great addiction interrupter, but you still need to deal with the dysfunctional thinking and whatnot that drew you into addiction in the first place... else you will eventually end up using again.


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NJSikkbreed wrote:
MOM,

If your daughter was spending $40 day, which would be about 4 bags of dope, I would think that
24mgs of Sub is way too much for her.....but, take it w/ a grain of salt....if she told you $40 a day, it could have been around $100....or god forbid, spending $40 and getting more in other ways....
But, even still, after a few days of adjusting, I would think one 8mg pill would get the job done....
and further along, even a half, 4mg would start to be effective for her as well....

everyone is different, but I'd suggest:
telling her to get by taking as little as possible.....and not to take more pieces throughout the day because
her brain/body is giving her phantom pains/cravings cuz she was used to repeatedly using multiple times a day...
I know advice is given to take first thing in the morning....but, that was my biggest problem in using....
the unbearable cravings I'd get w/in 30 seconds after waking up and immediately take something...
I've used Sub to break that habit....I still sometimes have urges when I wake up, but nowhere near as bad....and now I
can wait a few hrs....and I'll usually take it after I have coffee, breakfast and get to work for awhile....and its helped
break the "multiple times daily" using behavior for me.....just something to discuss.





Yes, it is hard to say just how much or what she was doing. She did say that she spent about 150 and that would last her 3 days and also that other people were getting her high in exchange for rides to get the shit and yes one guy was just getting her high and I shudder to think what his cost was. I didn't press her on that one as I figured she was quite miserable enough.
Still i started her on 12 mgs and not the 24 prescribed. After the induction and follow up other half of the pill, she decided that she felt 24 was too much and that she was comfortable at 12 and wants to drop lower soon. After all I've read I think that is the smart move. As for long term treatment, it scares me that knowing someday she is gonna eventually have to face the music and withdraw be it from her drug of choice which had turned from other things to the heroin. If i can get her to a low dose and hold her there for awhile, it seems to me that she could be given time to get her life back together. I have read the horror stories and yes I am afraid of long term use just being a substitute. But an opiate is an opiate after all is said and done. I am just afraid that her brain will NEVER produce the naturally occurring feel good chemical again. Since she is in fact a short term abuser when i compare her with the 20 year users, will her brain recover or does this brain change and receptor damage take place so early on that she is all ready unfixable at the receptor level???
Of course I want her to be well and opiate free completely and I understand how many many factors it would take to achieve that. Does she have what it takes? that remains to be seen I guess. I know what she says but I also understand addiction. Please keep the advice coming. Short term?? Long term?? how much?? Thanks again.


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