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 Post subject: NAABT
PostPosted: Mon Apr 18, 2011 11:10 am 
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Who are these guys?

Their website looks scarily sanitised like something from the Scientologists.


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PostPosted: Mon Apr 18, 2011 11:39 am 
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They are The National Alliance of Advocates for Buprenorphine Treatment. They have a suboxone doctor locator (where I found my sub doctor) and offer a lot of information on suboxone and addiction - although I don't necessarily endorse their information as accurate or not. I THINK they are in independent site, but I'm not sure about that.

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PostPosted: Mon Apr 18, 2011 1:51 pm 
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They are funded by a grant from Reckitt.

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PostPosted: Tue Apr 19, 2011 8:46 am 
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NAABT History

NAABT, Inc.

In the late 90s a very close friend of mine was addicted to opioids and was headed toward death. He had tried all forms of rehab and nothing worked, at least not long term. In 1998 he was able to enroll in a pre-FDA buprenorphine study at Yale, and it saved his life. I was amazed at how quickly he turned his life around and thought once bupe became FDA approved it would change addiction treatment forever. When it was approved in 2002 it was slow to catch on, few doctors were trained, many were skeptical, stigma was high, competing treatments raised questions, and the result was people were dieing while this treatment remained virtually unknown. Myself, Nancy, a graphic designer, and Kathleen, a buprenorphine research nurse from Yale, started to spread the word by the web and speaking to groups.

We soon realized we could reach more people, and provide more help with more financial resources. So about a year after starting our outreach we approached Reckitt Benckiser, since they were the only manufacturer of a buprenorphine product for opioid addiction. They agreed to help support our efforts with an “unrestricted educational grant”, and we are very grateful to them. This allowed us to create a more comprehensive resource and publicize it. Since then, Kathleen and Nancy are no longer directly associated with NAABT, Inc. Kathleen works at Yale full time and Nancy runs a small advertising agency and volunteers at www.AddictionSurvivors.org an independent online peer support community that does not receive any funding from any companies.

We were worried some people who didn’t know what an “unrestricted educational grant” was, would think we worked for the pharmaceutical company because we accepted a grant, but felt the site would speak for itself and we would reach many more people than we otherwise could. RB is not the only contributor, Alkermes Inc, the maker of Vivitrol has been a contributor along with several gracious physicians who use the matching service, and of course several patients and their loved ones who have been touched by addiction and saved in part by buprenorphine and the service we provide, Google, Inc. has provided a grant as well. These donations make the matching system possible. www.TreatmentMatch.org It has connected over 35,000 patients to treatment that have been unable to find treatment by calling doctors. It also allows us to create public service announcements, promote the site, create, print and mail educational materials. There have been over 4.8 million visitors to the NAABT site, looking for lifesaving information for themselves or a loved one, with over 1,000,000 downloads of the educational material.

Contributions from pharmaceutical companies are in the form of “unrestricted educational grants” it is illegal for them to influence or control what we do with the funds. They are not at all involved in NAABT’s mission or how we use the grant.
We don’t promote the use of any medication only provide information from the available body of evidence.

More information about NAABT can be found at www.naabt.org/about_us.cfm
Our Public service announcements can be seen at www.naabt.org/audio_files.cfm


Timothy P. Lepak
President, NAABT, Inc.


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PostPosted: Tue Apr 19, 2011 9:39 am 
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Thank you Tim for your quick response.

I'm not sure about the others here, but I wasn't expecting to get an answer from the "horse's mouth". I do hope your friend is still doing well.

I completely understand your well intentioned reasons for advocating for the wider use of buprenorphine because of your friend's success, but isn't it a bit narrow minded to neglect the other methods of treatment that could have had just as much impact on his addiction? Say he took time out, went to rehab and managed to stay clean with meetings. Would you have advocated for wider use of rehabs while neglecting the potential success of Suboxone?

The reason I say this is that NAABT.org, as it stands today, only appears to feature studies & information which described Suboxone in a favourable light. However, when it comes to other forms of treatment such as detox, methadone and naltrexone, your views are much more balanced, if not erring to the negative.

As a person on Suboxone, it would be fantastic if you could direct some of your resources into the advocacy of not just Suboxone as a treatment, but advocacy also for the people on the treatment. That way the many people on forums with grievances over poor prescribing practices, discrimination etc would have someone on their side to speak for them.

Keep up the fantastic work you're doing in battling the stigma of drug addiction, and thanks for your time.


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PostPosted: Tue Apr 19, 2011 10:39 am 
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Did you just call me a horse? :P Thanks for asking about my friend, yes he is doing well and now owns a small business and has enjoyed sustained addiction remission for over a decade now.

Out of respect for this site I don’t want to make this an ad about NAABT but I do want to address your points. One clarification, we don’t advocate for the “wider use of buprenorphine” we advocate for the education and access of buprenorphine treatment and recognize that this treatment isn’t right for everyone, but everyone should have the option available to them. Our hope is to provide the patient with enough information to help them decide what is best for them. The reason we limited our efforts to buprenorphine is because we felt the other treatments were already well represented and we didn’t want to dilute our resources adding to what we thought was already adequate information. However, we also have a site called www.AlcoholAnswers.org where we offer educational materials on modern evidence-based treatments for alcohol addiction.

The reason that the materials on our site are generally positive toward buprenorphine and may appear bias is that the vast majority of evidence is overwhelmingly positive. Most of the negativity surrounding buprenorphine is anecdotal and stems from a misunderstanding of the purpose of buprenorphine treatment or misunderstanding addiction itself. Such misunderstandings aren’t reflected in controlled studies. We try and educate patients so they don’t develop unrealistic expectations and become disappointed and negative.

You’ll be happy to know that we do try and advocate for more buprenorphine availability and were instrumental in getting the limit increase from 30 to 100. I’ve also met with several insurers to get them to understand and cover evidence-based addiction treatment. Our matching system is designed so that patients have choices and can select the doctor that they think is most knowledgeable and avoid those who are more financially focused. We also speak out when zoning boards try and prevent methadone clinics from being built.

Thank you for your interest in our site and allowing me to respond.
Tim


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PostPosted: Tue Apr 19, 2011 1:43 pm 
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Any chance you could use your dialogue with Reckitt to push for the manufacture tapering packs?

It's incredibly hard to get accurate doses when splitting 2mg pills to 0.5mg.

At the very least I expected they would have some official guidelines on tapering.

Only reason I ask is you sound like you're in a good position to whip their asses into gear Tim :)


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PostPosted: Tue Apr 19, 2011 4:18 pm 
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tearj3rker wrote:
Any chance you could use your dialogue with Reckitt to push for the manufacture tapering packs?

It's incredibly hard to get accurate doses when splitting 2mg pills to 0.5mg.

At the very least I expected they would have some official guidelines on tapering.

Only reason I ask is you sound like you're in a good position to whip their asses into gear Tim :)



I agree, a taper pack would be a good product.

In the early buprenorphine studies it was shown that stopping at 2mgs results in a milder withdrawal syndrome than from quitting full agonist opioids like heroin, but as you know “milder than heroin withdrawal” can still be quite significant. I’ve suggested the availability of lower doses (<2mgs). In the meantime, one development that helps is the new buprenorphine film. Unlike the tablet the film is easily divided into smaller doses with a pair of scissors or a razor blade. You can get down to 1/16mgs (0.0625mgs) pieces, or even less, with no problem with the 2mg film. (pictured here is the 8mg film: http://www.naabt.org/tl/film_cut_dime.jpg )

Also, Butrans, although approved for pain not addiction, is a buprenorphine patch that will provide diminishing doses as it’s used past its effective steady-dose period. That might someday be used as a taper method. Lastly a company called Titan is working on a buprenorphine implant that lasts 6 months and then also might provide diminishing dosage for several weeks or even months, serving as a steady taper. It’s still in clinical trials but looks promising.

Since everyone is different, the best taper guidelines I've seen are: "Pace your taper with your brain's ability to adapt to each dose decrease"
Tim


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PostPosted: Wed Apr 20, 2011 12:41 am 
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Any word on how far off the film is before being released in Australia?

Also, is there any word on any completely new treatments for opioid addiction in the pipeline?


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PostPosted: Thu Apr 28, 2011 9:49 am 
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I was so chastise by Nabbit for having a hard time getting off sub. they basically called me a liar and gave me shit every chance they had... finally they closed my account.

Nabbit has a bad history with many folks that had a hard time getting off sub. But, there are some nice folk there that do understand how hard it is to get off sub. Some understand that sub dosnt work in a positve way for many but surely they wont let you post about it. I remember when nabbit would constantly say to folks having a hard time getting off.."then your doing it wrong", I remember when nabbit would say bupe was a cure for your addiction. I remember when they repeated over and over the to jump off two mg was a breeze and did get why anyone would want to say different. Its a sensored site, only allows the best experience to be posted. That what it was for me yrs ago...it may have changed now but yrs ago it was full of itself. Gave out disinformation over and over.


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PostPosted: Fri Apr 29, 2011 5:36 pm 
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birdie wrote:
I was so chastise by Nabbit for having a hard time getting off sub. they basically called me a liar and gave me shit every chance they had... finally they closed my account.

Nabbit has a bad history with many folks that had a hard time getting off sub. But, there are some nice folk there that do understand how hard it is to get off sub. Some understand that sub dosnt work in a positve way for many but surely they wont let you post about it. I remember when nabbit would constantly say to folks having a hard time getting off.."then your doing it wrong", I remember when nabbit would say bupe was a cure for your addiction. I remember when they repeated over and over the to jump off two mg was a breeze and did get why anyone would want to say different. Its a sensored site, only allows the best experience to be posted. That what it was for me yrs ago...it may have changed now but yrs ago it was full of itself. Gave out disinformation over and over.


That's sad. In my experience jumping off 2mg suboxone is an incredibly painful and draining experience. And yes, from that dose the withdrawal is definitely more intense than that of heroin. Heroin detox lasts 6-7 days in my experience, and you generally know you're on the home stretch at day 4-5. Suboxone on the other hand is just such an unpredictable beast. I will say that the time I jumped off at 2mg after being on Subutex for 6-8 months, the withdrawals were worse than any I had experienced. They also lasted approximately 12-14 days, which I did not expect at all as all the doctors told me the withdrawal would be 'relatively mild'. Unlike heroin withdrawal, or even methadone, buprenorphine withdrawal induced dark psychological effects where all I felt was fear, cold, shame, disgust and hidden panic. Heroin just felt like a whack of the flu combined with cravings for quick relief.

Honestly I've discovered from my own experience (re-inforced by those of my peers) that the dose of Suboxone you jump off is less relevant to the amount of time you spend on the program. A person who jumps off 8mg after being on it only 2 weeks will suffer a lot less than someone who's reduced to 2mg over 12 months.

It is just unfortunate that the medical community, along with the pharmaceutical lobbies, simply don't seem to listen to us. Sure, it's unfortunate that we are addicts and generally our voice doesn't hold much credibility. I really hope this will change in coming years. We are trying our darn best to turn our lives around, and this is no mean feat. Shouldn't that count for something?

RB can have a lot to learn from people who are using their treatments. After all, ultimately we hold the power, and should we all decide to enter abstinence based programs or even switch to naltrexone because of a lack of understanding from the powerful pharmacotherapy lobbies, Reckitt and their investors will be the ones to suffer. Consumers have the ultimate power and we can easily hurt companies should we be unhappy with their marketing strategies, disinformation, studies with conflicting interests and PR, simply by taking our business elsewhere.

Sure, Reckitt may see themselves as being onto a winner given that Suboxone is a dependency forming drug and as such there's an 'enforced loyalty' to their brand once we all stabilise. Lets not forget its addictive potential that cannot be denied simply because it is a lesser-evil than the 'problem' opioids. How many times I have seen Suboxone used as a gateway drug for some opiate naive person to experiment with for the first time, then after tasting the euphoria for the first time they inevitably move to harder illicit forms. Then they end up on Suboxone maintenance. Reckitt wins.

I hate drug dealers - smack dealers, oxy dealers, coke dealers. They make money off our misery, and are generally devoid of conscience. But I do not see Reckitt as a drug dealer. They are something else, a less malignant animal. Reckitt are in an interesting position where it is in their interests for people to become addicted to illicit opiates. Investors in RB may be happy to hear that a pure glut of heroin has hit the streets and addiction is on the rise as it means a healthy dividend may be around the corner. Buprenorphine then offers these people the chance to get their life together while maintaining what is essentially a 'habit' on buprenorphine (habit means dependency - you get sick when you don't take it - but you won't hear Reckitt use that word).

It is this habit we all have to Buprenorphine that ties us to RB, no matter how much we crave freedom from dependency.

I can only admire the industry that has been created. Whoever decided buprenorphine should be marketed as a treatment for opioid addiction is a fucking genius. As long as they continue to lobby around the world for their products to take precedence over the generics, RB will ride this cash cow all the way to slaughterhouse.

Buprenorphine is simply a lesser evil. It isn't a miracle treatment, it isn't a magic bullet. It allows broken addicts to piece together our shattered lives. But underneath there's always some shame in knowing we are reliant on a drug to function, and I for one crave freedom from the shackles of dependence. I can't even travel overseas, or interstate, with how dosing works in my country.

I hope that one day I will be free of Suboxone. I've had a taste of recovery clean of alcohol and all drugs including Suboxone, and after being deep in addiction for 9 years the feeling of freedom in not being dependent on a drug was so profound. I felt like I was a bird who could just take off anywhere. 13 months clean. Swimming, surfing every day. Studying, working. Women. The world had 'color' again. Sure the first lil while felt like I was on an uncomfortable acid trip, but this gave way to something fantastic.

I want this feeling again. I don't care how many studies Reckitt commission telling me I will fail if I choose to taper off. This feeling I speak of is sacred and most people out there take it completely for granted. The loss of self-obsession, the ability to truly feel love for family and friends, to feel genuine love and infatuation when those endogenous opioids wash over the brain when I fall in love. My past experience has shown me that these only come after we remove all drugs of dependence from our lives. While our perception and mood is artificially distorted, and our neurophysiology isn't given the chance to find its balance, we can never truly see eye to eye with the truly sober people in our lives that we cherish.

There is a barrier. This barrier is stronger with methadone and the full agonists, but still definitely present with buprenorphine. The barrier comes from this mild altered state we choose to initiate every day as we put that pill under our tongue. We think slightly differently to our non-dependent peers, friends and family. Consciously we don't know it, but we react to this difference by isolating our feelings from others, by losing the ability to empathize with others. The mild opiate effect is great at suppressing emotion, thus feeling for others falls to the wayside.

We fall into self-pity for our ailment. Our woes come first before those around us. I'm not having a dig at our shortcomings. We are also some of the most creative, intelligent people around. But this is what mind altering drugs do. Say for instance, 2 people on LSD seeing feeling and hearing completely different things - on completely unique trips - and they cannot comprehend each other's distorted perceptions. It is futile. So they focus their energy on themselves and their own experience, and forget about what their friend is experiencing. While this is a more extreme example, this is what us drug addicts suffer. People on buprenorphine have this too, though to a lesser degree than the agonists like heroin, methadone, oxycodone who induce a more potent altered state.

The conundrum we face is that we can't see, or even acknowledge, the Suboxone haze we all operate in until we are no longer taking it. The only way I can describe the feeling is it's like the "blinkers come off".

Everyone here on this forum are trying to become better human beings. Suboxone is just a stepping stone to achieve that. If Reckitt truly had the interests of their customers in mind, they would offer official guides for tapering, tapering packs which end on doses similar to those used for pain management. They would offer a phone service where people can direct their queries, or even help people out who are struggling post-taper. And most of all, they would be honest with us. Most of us addicts can smell a lie a mile away, especially when there's money and drugs involved. Some studies funded by Reckitt, overseen by the same Doctors who are paid to praise Suboxone on their speaking circuit, I couldn't help but laugh at their conclusions.

Get real Reckitt. Quit with the cajoling Doctors. Quit with the 5-star hotel lobster and Cognac conventions. Quit with the paid speaker circuits. Quit playing with statistics. Quit funding so called 'objective' studies. Quit giving doctors free golf clubs. Quit trying to influence the FDA. Start talking to the fucking clients for once. I guarantee you we know more about the effects of these drugs than any non-addict doctor.

And the most dangerous study around that I find highly questionable is the one which showed the substantial majority of people who reduced off their suboxone to relapse within 6 months. I might argue that they got just as much growth in their recover in that period they spent clean than while under the Suboxone 'haze'. I have to ask the question. Who funded the study? Which Docs ran the study? What were their conflicting interests (if any)? And finally, was motivation to abstain used as a selection criteria?

Who do you think would know more about the Congo? Someone who's watched a couple of documentaries, or someone who's been there?

I think you get my gist. Wow that's a long email. But I had to do it. Sorry guys. It's been a long time coming.

Now where's Reckitt's email address? *lol*

PS>> My holidays are finishing up in 2 days, so all the fiendish posting of late (mainly cos of being at a loose end) will calm down. I hope some people got something from my 2 cents, or at least some entertainment.

Just thought I'd finish with a bang.

Til next post.


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PostPosted: Tue May 03, 2011 4:15 am 
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^^ wow dude very deep...

Now i do agree with alot of your posts... but honestsly.. you have to realize sub saves lives... period... RB definetly is just another money hungry pharmaceuetical company they are pathetic for sure

ive been to 8 inpatient rehabs.. before getting on sub i was shooting oxy 14x a day... im 26...

Now id rather take sub once a day and feel "normal" then have to deal with that monster of an addiction or death.....

Your post really touched me man....

Yes sub is still a powerful opiate but shit man compared to the alternative it is ALOT better


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PostPosted: Wed May 04, 2011 12:53 am 
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True. I don't know where my head was at when writing that post.

One of those late night hypomanic stream-of-consciousness things I've been getting a lot lately :|


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 Post subject: Reply to birdie...
PostPosted: Sun Jun 26, 2011 2:37 pm 
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birdie quote;
", I remember when nabbit would say bupe was a cure for your addiction."

[font=Comic Sans MS]W/O having to debate you, birdie, I believe that the above comment is totally in error and cannot be backed up by any factual statements ever made by NAABT....
There is no cure for addiction, as most chemically dependent people should already know.
[/font]


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PostPosted: Sun Jun 26, 2011 3:46 pm 
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Not to diminish anyone else's experience, I just wanted to say that MY experience of jumping off at 2mg was an exercise in waiting for physical symptoms that never materialized. I did have some low dose short acting opiate to cushion the fall, but I honestly felt very little discomfort (and I'm a big baby). I will say though that the depression, lack of energy and crying spells were significant. This time, I am working with my doc, I raised my antidepressant dose, and my doc may prescribe Wellbutrin, which another member was also given for the jump. I guess it helps with the depression and the energy in some people.

As far as RB goes. If it's true that they have the money to wine and dine doctors, why don't they provide some oversight, get rid of the shady ones, and make the rest comply with the prescribing standards. i.e. don't send patients on their merry way with their first script to self induce, without even a COWS scale. That blows my mind.


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PostPosted: Mon Jun 27, 2011 8:05 am 
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You wrote " We fall into self pity for our ailment " I have no self pity, and Suboxone is a wonder drug , and please quit blaming everyone but yourself for whats going on in your life, look in a f-cking mirror... I do have to hand it to for being nice to that NAABT guy, Mike


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PostPosted: Mon Jun 27, 2011 12:52 pm 
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I decided to take a closer look at the Naabt website. There is a ton of information and downloads for both patients and professionals. I looked at a lot of the literature and found one thing strikingly absent, there is not WORD ONE on getting off of Suboxone, not even in the doctor's prescribing guide. Not one single word.
This is a great compliment to RB's prescribing info. that tells the patient to ask their doc how to taper off, and then if you look at the physicians insert it says no studies have been done.
It's like giving pilots a liscence to fly and never giving a course on landing. I think Sub is a great tool, but how could there be such a gross oversight?


Last edited by Lillyval on Mon Jun 27, 2011 1:50 pm, edited 1 time in total.

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PostPosted: Mon Jun 27, 2011 1:48 pm 
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Painter wrote:
You wrote " We fall into self pity for our ailment " I have no self pity, and Suboxone is a wonder drug , and please quit blaming everyone but yourself for whats going on in your life, look in a f-cking mirror... I do have to hand it to for being nice to that NAABT guy, Mike


If you actually took the time to read that post properly, you would notice I was talking about the self-pity people feel while addicted to drugs. If you're 100% content with living the rest of your life on Suboxone, with remaining dependent on a drug, and putting limits on your own recovery, then go for it. That's your choice. But I must have struck a nerve to get you that worked up. Personally, I wouldn't give up on myself so easily.

And cmon. If you believe there is such a thing as a "wonder drug", you're living in a fantasy world. Everything in life has tickets buddy. Thinking otherwise was what got many of us addicted in the first place.

My anger at RB at the time of that post came from their lack of provision for ways to reduce off Suboxone. It's as if they're all too happy to try to get people on Suboxone, but don't want to provide any means for those people to come off it when they're ready. Other pharma companies are guilty of these tactics as well. It's well known that many anti-depressants have pretty full-on withdrawal symptoms. It took the manufacturers a long time to acknowledge this. Even still, they don't provide taper packs, tapering advice, or even advice on handling "discontinuation sydromes". I don't think you need to be cynical to see the motivation behind this.

And my life is fine, and I have no issues looking in the mirror. If you're angry at me, and I've done nothing to you, then that's your shit.

I still think what I said was fair. I was just trying to be heard, so that maybe RB could provide official tapering advice or taper packs, Or at least so they could disclose in their info sheets that treatment is meant to be indefinite. Being reasonable and polite wasn't working, so I stepped it up.


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PostPosted: Tue Jun 28, 2011 6:56 am 
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Opiate addiction is a Medical issue, Suboxone has saved countless lives, I dont need to do reseach to know this.. We both thought stopping opiates would not be as hard as it is, at some point on a time line my brain stopped making opiates because I was taking so many pills... I needed them for pain becaused a serious neck issue, which after taking pain meds for 3 yrs finally ended with surgery, when the Dr stopped giving me scripts for pain pills I was screwed, at that time I realized I was an addict... a lot of people here have put there lives in the hands of Suboxone and the Drs that prescribe it, a lot of new people are scared in the 1st place, I bet there are twice as many lurkers to this site on Suboxone scared shitless about the new life there about to discover off opiates and on Suboxone, reading your activist bullshit does not help


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PostPosted: Tue Jun 28, 2011 10:00 am 
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I'm not anti-suboxone? If I was anti-suboxone, I wouldn't be on it.

But you have to understand that not everybody is on Suboxone for pain management reasons, or because of a pain management regime that got out of hand. Some of us were given the impression that Suboxone was an effective stepping stone to living a life 100% free of opiates. And now that we're on it, we find that there's no official resources or guidelines to getting off it, and our doctors are clueless about tapering. Lately we've even been advised against trying to get off Suboxone at all!?

If I have an issue, it's over the lack of disclosure.

I can understand that people with pain issues might have no intention of getting off suboxone. But some of us do. And if it takes a bit of so called 'activism' to try and get some action from the influential groups, then I'm not going to apologise.

Off opiates and on Suboxone? Suboxone is an opioid.

And having two people in this thread getting abusive, yourself being one, would scare any lurkers away more than anything I've posted here. What I'm trying to achieve is in the interests of anyone who wants to live a life free of Suboxone eventually, including the 'lurkers' you say you represent.

Sure Suboxone has saved lives. But so has methadone, but you don't hear people singing its praises. I guess methadone has been around long enough that we know what we get.

If you really want this 'activism' to stop, then it'd be smart to let this thread go to the dogs, rather than bumping it all the time with your abuse.


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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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