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PostPosted: Wed Oct 30, 2013 10:34 am 
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After a bad car accident almost 2 years ago, resulting in months of postoperative pain, my daughter got hooked on roxy's (RX 90 mg/day, but sometimes needs 2x that). She also has a history of emotional issues, including generalized anxiety and depression. She uses benzos only at night, to help her sleep, which she had been doing for years before the accident.

She hates what roxys have done to her life, but is also scared of the pain returning if she stops. We know about hyperalgesia, and even with that possibly going on, I can tell her pain situation is WAY better than it was a year ago. She accepts she will have to live with some level of pain, but how much she will have without opioids is unknown.

Unfortunately, she has a tendency to take a pill to handle discomforts in life, and so I am dubious of her ability to stay off pills even if she were to successfully get detoxed.

I've read a lot about Suboxone, and it sounds like it might be her best bet to avoid the worst: jail or death. Her pain doctor is not a big fan of it for some reason, but I don't think he understands that she is on an unsustainable path of escalating use, and the dangerous behaviors that involves.

She says she really doesn't get a high from the roxys anymore...I don't know if that matters to any of this.

From what I've read, it sounds like suboxone might help her in the emotional area as well. Her treatment-resistant depression and ever-present anxiety (which runs in our family) might benefit from it. I grew out of it after 30+ years, but it took a level of willpower most people don't have.

Based upon this little info, does anyone have advice on detox vs. suboxone? I know complete abstinence from all drugs would be great, but I just don't see that in her future.

Or, have I already answered my own question?


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PostPosted: Wed Oct 30, 2013 2:40 pm 
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I think you did answer your own question!

At first glance, your daughter seems to be a candidate for buprenorphine. Most detox facilities are going to do just that, they are likely going to take your daughter off all controlled substances she's on including benzodiazepines, problematic or not, it's just their MO. Detox alone without long-term comprehensive treatment and most likely life-long follow-up is much less than ten percent successful in the long term even for people who are doing it without external motivation.

With her possible lingering chronic pain issues, TRD and anxiety, buprenorphine at a stable maintenance dose without the expectation of tapering sounds like a reasonable plan.

Stay positive!

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