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PostPosted: Sun Feb 13, 2011 8:23 am 
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I am asking the people in this forum this question because I am completely inexperienced when it comes to opiates. I have never done opiates myself but my boyfriend is an addict, who has been on suboxone for a couple years, with many relapses. He never wanted to quit taking the suboxone, but has recently been put in jail, where he had no choice but to stop, since they do not have suboxone in their formulary. He will likely be incarcerated until April 11. He was arrested on Jan. 18, so he will have been off suboxone for almost 3 months by then. His mother and I just assumed that that meant he would be clean and never need it again (provided he stays off oxy), but he is talking about going back on it once he is released. My question is: Will he need to go back on if he has been off for so long? If he is forced to quit, why wouldn't he just remain off of it?


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PostPosted: Sun Feb 13, 2011 9:43 am 
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Welcome! I suppose he could re-start the medication if he feels that is the only way he can survive. However, the alternative would be to accept his forced withdrawal and move forward. From your description, it doesn't sound as though he did too well on it before, perhaps depending on the med to stay sober. Many jails have on-site 12 step meetings, so maybe that would be an option. The most important recovery tools are support systems that shore up the behavioral changes necessary for continued recovery, not the pills.


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PostPosted: Sun Feb 13, 2011 10:10 am 
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Welcome mitzig,

Sorry to hear about your partner's situation, but it's not all bleak.

It really comes down to his level of motivation to stop using and how realistic he is, and whether his intentions are right with the subox.

If it's his first lagging, maybe it was enough to give him the wake-up call he needed & he doesn't wanna go back inside. He knows that if he relapses on the oxy's he'll get back into trouble so he'd rather get on the suboxone to prevent it. That'd be ideal. A lot of people stay clean in jail for months, even years telling themselves they've had enough, then the moment they leave the first thing they do is score. Re-adapting to the real world can be just as scary as landing inside, and it's easy time to relapse.

Suboxone is highly sought after in jail as well (at least in my country) & there's a lot of dealing and standovers and violence because of it. Hopefully he hasn't found himself in that scene, and just wants to keep the cycle going.

No matter what road he decides to go down, be there & support him. He won't say it, but he'll be trippin for a while after he comes out. Hopefully he's been doing some NA or SMART recovery while inside, and those people can help you help him to transition.


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PostPosted: Sun Feb 13, 2011 10:17 am 
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There's nothing wrong with him going back onto suboxone after being released. Especially if it prevents another relapse. Relapses are always dangerous and can be life-threatening. Wouldn't you rather he go back on sub than to relapse again? Many people who went off sub make it a point to go back on suboxone when they feel a relapse is imminent. It's so much better than a relapse on full agonists (regular pain pills). I would suggest you allow him to do what he needs to do to protect his recovery/remission. He can see how he does at first and if he gets shaky, support him fully in his recovery, even if it means going back on sub. Good luck to both of you.

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PostPosted: Sun Feb 13, 2011 1:35 pm 
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mitzig,

I'm sorry for the situation that you and your boyfriend find yourselves in, it's no fun, it's scary and no one ever wants to be there.

You asked the question, "If he's forced to quit, why wouldn't he just reamin off of it?", the short answer is because he's an addict. Landing in jail doesn't fix an addict's brain, you would think it would, but it doesn't! Nothing "fixes" an addict's brain. We can, however, learn to live with this disease. Suboxone has helped many, many of us do just that. Suboxone alone is not the entire answer though. He should be attending NA or AA or getting some kind of counselling in conjunction with taking Suboxone. By taking suboxone AND getting some kind of counselling, his chances for staying clean rise tremendously.

Like you said, he's an addict. Being an addict does not just go away, boy oh boy how I wish it did!!


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PostPosted: Sun Feb 13, 2011 8:42 pm 
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Thank you so much everyone for taking the time to answer my questions. It's so encouraging to have complete strangers help you out. I guess he's right that he should go back on it if it will help him stay off the oxy. I just assumed it was a goal to get off anything opiate related, for good, but I guess that's not the best option. He said that it helps with his pain (he has residual pain from a previous accident and fibromyalgia), but I just assumed that there was something else he could take for that. But I admit that I'm really inexperienced when it comes to pain meds. And this is his first incarceration and he did say it was a big wake up call, so I'm hopeful that he can stay sober. Thank you again everyone.


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PostPosted: Mon Feb 14, 2011 7:31 am 
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For those of us who also take sub for pain control (I'm one of them), it's often the only option we have. Once we became addicts, we can never go back on regular pain meds for the chronic pain. (Acute pain is a different story.) And sub can help pain - I also have fibro and it keeps my pain for the most part tolerable.

I also think it's great that you reached out in an effort to understand his addiction. Many addicts' significant others don't understand and have no desire to learn. He's lucky to have you.

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PostPosted: Mon Feb 14, 2011 10:00 am 
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I just want to chime in that I went off sub for 3 months and went back on it. I was on sub successfully for 2 years and completed therapy. I jumped off 12mg which was difficult and not advisable, but I was off none then less. Ultimately I went back on it primarily because of pain issues. There isn't anything else he could ever take for fibromyalgia pain except for lyrica which doesn't work for many people. I suspect he has tried that already. Outside of that, there is nothing. So suboxone is the only non-addictive substance that partially works for pain.

I am sure right now he is thinking about the sub constantly because he can't have it. He may change his mind by the time he is released, but if he feels he may relapse then he may really need to go back on it until he gets his life together at least.

Cherie

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PostPosted: Mon Feb 14, 2011 12:22 pm 
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Since the topic of Naltrexone has come up several times lately, I don't want to come across as the board's "cheerleader" for this medication. However, I once again have to wonder if Naltrexone might not be a really good use in this case. For those not familiar, this medication is now available in a one month lasting injection. You get a shot in the arm (or butt) that lasts for a month. OR you can actually get an implant that lasts three months OR you can take a pill once a day. Obviously the shot or implant is more full-proof while having to take a pill (that lasts less than 48 hours) requires patient compliance. However, for someone who will have been off of opiates for several months, Naltrexone might be the ticket. Please understand that this medication DOES LITTLE OR NOTHING to address cravings. It will not do that. It will only block opiates. So it is SORT OF like half of Suboxone. Like Bup, it blocks opiates (but does it in a different way) but UNLIKE Bup, it does nothing to stimulate opiate receptors. It MAY also block natural endorphins. For example, those who get a "natural high" from exercise, sex, food, etc. may not get that "natural high" as well. It should not cause depression. It may just block endorphins.

I would suggest that you check into this. For sure, if cravings or relapse are an issue, going back on Suboxone might be the best idea. To directly answer the original question, I agree with the other posters that there is absolutely nothing wrong with going back on Bup. I would just look into Naltrexone before you do - especially after several months opiate free.


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PostPosted: Thu Feb 17, 2011 9:59 am 
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donh wrote:
Since the topic of Naltrexone has come up several times lately, I don't want to come across as the board's "cheerleader" for this medication. However, I once again have to wonder if Naltrexone might not be a really good use in this case. For those not familiar, this medication is now available in a one month lasting injection. You get a shot in the arm (or butt) that lasts for a month. OR you can actually get an implant that lasts three months OR you can take a pill once a day. Obviously the shot or implant is more full-proof while having to take a pill (that lasts less than 48 hours) requires patient compliance.


Fair point! I wouldn't recommend the pills or implants personally though. Pills because the dose of naltrexone is quite high, and as you said, for me they caused a noticeable feeling of irritation & dysphoria. Feel-goods were nil, and they're incredibly easy to just spit out or simply not take.

I would steer clear of the implants too. So many people I know had their implant site infected, or the implant was rejected by their body, that they ended up wasting their money and relapsing. Also many places advertise a 6 month implant and it only works for 3-4 months. And usually when the levels in the blood drop low enough, cravings return, and bam the gear works again :(

These monthly injections sound interesting. I would do some investigation mitzig, and put it past your boy next time you speak to him. If he went on naltrexone injections to keep him off opiates, and Cymbalta / Duloxetine for Fibromyalgia (apparently it works), he'd have a non-addictive non-opiate way to deal with his issues? There are dangers to naltrexone though ie - it makes relapsing on opiates potentially more fatal.

http://www.firststepprogram.org/home/se ... naltrexone


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