It is currently Wed Aug 23, 2017 8:24 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 17 posts ] 
Author Message
PostPosted: Sun May 24, 2009 8:32 am 
Offline
Average Poster
Average Poster

Joined: Sun May 24, 2009 8:01 am
Posts: 8
[font=Tahoma] [/font]

After reading about different experiences with Suboxone withdrawal, I am sure that everyone has their own unique experience with it. Mine has been horrible, and for some reason, simply writing about it helps. I'm not looking for a pill solution anymore, which is one thing that I'm grateful for.

I have had long periods of recovery...8years.....6 years.....always followed by relapse when I stopped taking care of my recovery and other things became a priority. After my 6 year stint, I went to treatment (3 years ago) and was put on suboxone. I was also given the option to stay on suboxone. I don't know of many addicts who would not choose to stay on a drug while detoxing, but I in no way blame anyone but myself. Having had quality recovery before, I knew that staying on a drug like that was not a good decision for me. That was 3 years ago. I had to go to treatment for 28 days to get off it, as my attempts were utterly unsuccessful. I thought I was going to escape unscathed. They tapered my suboxone (I was taking 24mg day, even though 8mg would have worked just fine....always an addict) over 16 days. The withdrawal did not start until 3=4 days later, which makes sense due to the nature of suboxone. Also, I should say that I am a nurse and almost done with graduate school to be a primary mental health nurse practitioner, which tells you that all my knowledge about addiction and drugs means absolutely nothing in relation to my own addiction. The withdrawal symptoms have been typical - every joint in my body aching, sweating, chills, sneezing, yawning, akathesia, insomnia, and more. I got home from treatment 2 days ago and the symptoms are still there, but at least now they are coming and going. They put me on baclofen to help with my muscle twitching, but I'm wondering if that is making it worse rather than better.

What I want to say to anyone interested...and especially reinforce to myself....is that despite the aches and pains, etc., that are part of this withdrawal, the feeling of real joy I have experienced when lauging or when I got home and hugged my kids makes me more motivated than ever to not self medicate my sypmtoms. While on Suboxone, I was numb to both pain and joy. Every now and then I get discouraged and think that my body will never work right again without the suboxone, but I know this is not true. 3 years on a drug like that can take it's toll. I just want the "toll" to end soon. The restless legs and feeling of not being able to sit still is the worst for me.

After reading some posts on this site I have accepted that this is my time to pay the piper! Yes, the doctors who prescribed the medication suboxone got a lot of my money, but that was my choice. It is easy to want to point the finger elsewhere when in pain. Finally, if anyone is interested, taking the time to write this stuff down here has made me forget about my sypmtoms for a little bit and I actually feel a little better. When I was in treatment, the nursing staff was great until I got really sick. I'm not blaming them, but I think there is a better nursing model out there for working with people with addictions, which I may pursue for may graduate project. Perhaps something good will come out of this afterall.

Thanks for listening.

deb


Top
 Profile  
 
 Post subject:
PostPosted: Sun May 24, 2009 10:28 am 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Thank you for sharing your story-- and for the way that you shared it. I have become angry at some posts, and I think have created an impression that I only want to hear one side of a story. That isn't the case-- it's just that in my experience there were so many sites that had been taken over by a certain attitude, and my entire purpose for this site was to make a place where people didn't have to feel like second-class citizens for medicating their disease.

I would ask you, Debra, to keep an open mind. You have opinions of things and if you were entirely happy in life I would say 'keep them- they work!'. But you describe an unhappy situation; either relapsing now and then or being 'numb'. I can tell you from my experiences that relapse patterns change over time; they get worse, not better. People die during relapses; they take greater and greater chances-- it is as if the time away makes them more impulsive when they eventually use. But back to on open mind-- I do psychotherapy in my practice-- not as much with patients on Suboxone, as for the most part they are happy except for one thing (see the next paragraph). But when I do psychotherapy, the one thing that the patient MUST bring to the table is an open mind. So I suggest for you, Debra, that IF you want to change, you MUST change your thinking. You talk about waiting for the world to change-- that is addictive thinking, and it a bit crazy. YOUR life is not going to be affected in a positive way because the world changes to some new nursing model.... on the other hand, there ARE happy people in the world-- in the CURRENT world-- and you can be one of them if you change YOURSELF.

The one thing I see common to Suboxone patients that they are not happy about is that many feel conscious or unconscious shame for taking Suboxone. They shouldn't; the experts in addiction world-wide, and the leaders of the large addiction artreatment-- treatment beyond the few people who find sobriety in AA and NA. I mean really, those are great for the small fraction who find them and use them, but even those people tend to relapse. And now that opiate addiction is an epidemic of young people we cannot afford a 90% failure rate! So for my patients on Suboxone, the entire focus is getting them to talk about their old attitudes toward that ‘holy grail’ of taking nothing, and helping them realize that they have a chronic illness—that needs treatment.

The issue reminds me of something similar in medicine— I am old enough to remember the early meds for hypertension— they all caused impotence, fatigue, depression… and so there were TV campaigns telling people to stay on their medications (not sponsored by drug companies, but by the government). We are at that point with addiction—buprenorphine is the first med, a breakthrough medication, that will lead to much better treatment in time. Depression used to be treated by tricyclics and MAO inhibitors—which had lethal side effects. Now we have SSRIs. ALL diseases go through this process… but only addiction has to deal with a lobby who think they are helping (actually I don’t know what they are thinking, as they all seem a bit crazy when I have tried to talk one-on-one with them) but who are actually killing people. I’m not exaggerating-- it happens often. People are very suggestible in early recovery, and they go to NA and despite the group’s own statements about not interfering with a doctor/patient relationship, they push people off Suboxone. Those people have crawled back to my practice months later and thousands of dollars poorer, after relapse. Again, this dangerous situation is why I police the ‘anti-Suboxone’ comments so aggressively—there are plenty of sites where those statements flow freely, and where harm is certainly being done. I will not be one more of those sites.

By the way, the reason you don’t read more ‘balance’ is because first, people on Suboxone tend to move on in life. My whole goal is to get people to feel ‘normal’—NOT like ‘recovering addicts’. Yes, this is heresy to the AA crowd, and I would NEVER suggest this attitude for an alcoholic or a person NOT on Suboxone. But anyway, the people who do well on Suboxone post the least! Second, until now there hasn’t been a place for people happy on Suboxone to post, without being attacked by wolves. Again—that situation led to this site.

I do have one significant issue with your post—the comment that doctors made a lot of money from your Suboxone treatment. I have read that in other places, and it is just not true. I teach at a large medical school, and talk to students all the time about their career choices. NOBODY wants to be an addiction doctor! Derm is the hot field—starting salaries of $300K plus, with eventual income of a million or more. I understand that all of these numbers are high, but the average med student comes out owing over $150K in loans—not to mention spending 4 years in college, 4 years in med school, and 4 years in residency AT A MINIMUM. An addiction fellowship is two MORE years! Psychiatrists start at $160 and top out at $200 K. But the ones who make the most don’t do Suboxone!! Doctors go, in med school, to where they will be able to repay their loans—and that is why there are so few psychiatrists out there, and an even smaller number of them who deal with addiction… and a smaller number of THEM who prescribe Suboxone.

The biggest problem right now is that doctors get certified, and find that the money is not worth the hassle, and close their Suboxone practices. Sorry—that is the fact. The craziness of addiction--- how much money did you spend using? If you didn’t steal your drugs from the insurance company or someone else, you spent much, much more on that than on any Suboxone treatment! In my practice, one year of treatment is $1200 for the first year, and $650 per year by the second year. Did your habit really cost less than $650 per year? Yes, Suboxone is expensive, but can easily be found for $160 per month—and that is with NO insurance. Get a job and the Suboxone is usually partially or fully covered; in Wisconsin, Medicaid covers it except for a $3 per month co-pay!

I get $1200 for a YEAR of appointments, prescribing, phone or e-mail help… and an orthopedist is paid $12,000 for ONE ACL repair, that takes 40 minutes to do! Doctors, one and for all, do NOT get rich treating with Suboxone. My own patients, please disregard this next comment because you are all great and I love what I do-- but for the others, if you have a doctor willing to prescribe Suboxone, who isn’t a jerk or idiot, you should send him a thank-you note—because he is in it for wanting to help others. He is NOT in it for the money, because he would do much better in pretty much any field or area of medicine.

Wow—and these were the introductory comments!!

I would encourage you, Debra, to keep an open mind. I write this so many times that I hate to repeat myself, but opiate withdrawal from agonists is HORRIBLE. We don’t hear from people tapering off oxycodone or heroin because first, people cannot taper from those drugs!! But if they are stopped abruptly, they don’t feel like going to the internet and trying to write—while their hands are shaking, their legs kicking… not to mention crapping all over the living room from the explosive diarrhea! Methadone withdrawal had always been known to last for several months—at a minimum! So when people write about feeling horrible while at the same time being out of bed and sometimes even working, they are missing the fact that they are much better off than the people who are in detox beds coming off the ‘real stuff’.

The ‘numbness’ that you describe is not something my patients complain of, and so I wonder if you were educated in proper use, and used it properly. The goal is to extinguish the conditioned behavior—that means to erase, as best you can, the automatic pathways that were laid down by addiction. The best way to do that in my opinion is to first take a large enough dose but not too large a dose-- 4 mg to 16 mg in ALL cases. Second, decide on a dose and don’t change it daily—you want to disconnect from addiction, so you NEVER take Suboxone in response to ‘how you feel’. Always take your dose in the morning; always take it automatically, and never take it for the fake, psychologically-based sweats that can occur late in the day. In almost all cases I have treated, those who follow these instructions carefully find that within a month or two they don’t feel like addicts anymore!

Even if there were side effects, I go back to the early days of hypertension or depression treatments. Some meds have side effects, but if people have the disease, they have to tolerate the side effects! Addicts, I’m sorry but it is true, can be such babies! We put tons of crap in our bodies, then suddenly we want to feel perfectly normal, at no cost, with no side effects! Think about another fatal illness, say, breast cancer. Think of the treatment for THAT fatal illness. Is Suboxone still a bad deal?!

I don’t mean to pick on you, Debra—I am an addict myself, and I have all of the thoughts that I am referring to. But try to find an open mind and hang onto it. Look at how you took Suboxone—if you didn’t take it right, but instead did what addicts do, and ‘treat yourself’ with the dose that YOU needed… consider trying again, but doing it the correct way—and giving up control of dosing Suboxone and all medications that you take, leaving it to someone else to decide. Consider the true costs of relapse—not just financially, but the risk of job loss or incarceration, and the damage to relationships— including loss of trust that to some extent can never be regained. Sometimes that is worth a bit of ‘numbness’.

I suspect that the numbness is related not to a neurochemical situation, but to something else; a part of your unconscious mind that wanted more from Suboxone conflicting with a part that wanted less, for example. Those feelings often improve after a series of discussions about the treatment—whether you call it psychotherapy or ‘shooting the shit’.

Thanks for taking the time to share your story, and I hope you will continue to write, and also to read my comments and the comments of others.


Top
 Profile  
 
PostPosted: Sun May 24, 2009 1:24 pm 
Offline
Average Poster
Average Poster

Joined: Sun May 24, 2009 8:01 am
Posts: 8
[font=Times New Roman] [/font]

First of all, thank you for taking the time to reply to my message. I may not be feeling well right now, but your response made me a bit ornery. I think you are too defensive doctor. The comment that you took such exception to about money - and perhaps I stated it poorly - was in response to what I've read on this site. My own personal issues with doctors who prescribe suboxone in Arizona is that none of them take insurance and I had to pay up front. That being said, I also own responsiblility for choosing to remain on it. Hell, if it wasn't for some things that came up, I probably still would have been on it. I do not think badly of anyone choosing to stay on suboxone. I do not think badly of myself for it. I did not use any other opiates while on it and only got into trouble when I started using stimulants to counteract the sedating effect. All my stuff. I do have an open mind, doctor, and because of that, I think there is always a better way to deliver care. I'm not talking about medications at all, but in the way care is delivered in addition to or without medication. You do not know enough about my experience to make comments like you did about my "nursing model". I may be a drug addict, but I also know - without a doubt - that I am a great nurse who likes working with addicts. I also know that it is not cost effective to work with people who have addictions. Thank God, there are some like you who seem to care.

I don't know how you deducted that I wanted the world to change. I know from personal experience that the only thing I can change in life if me. Fortunately, it seems the world around me gets better when I get sober and start being honest.

I was constently ridiculed by my husband for being on suboxone, and now that I am home, he continues to reaffirm the fact that he was right, that I should never have taken "that drug", and more. I don't know what I would have done without that drug, and I refuse to be ashamed that I took it. It just sucks getting off it. If my husband has his way, from this day forward I would take no medications and suffer through any health issue that comes my way. I agree with you about continuing treatment, doctor. I think every addict should have an individualize plan of care utilizing medications and other non-pharmacological interventions if there are any. I think leaving addicts untreated simply because they are addicts is very bad practice.

Finally, I want to say that I respect most of your opinions. I also think that you go a little overboard at times, but don't we all? Keeps it interesting. I really do appreciate your response. I know it could be a lot worse for me, and writing back to you has again made me forget about my symptoms for a while.

deb


Top
 Profile  
 
Our Sponsors
 Post subject: numbness
PostPosted: Sun May 24, 2009 1:31 pm 
Offline
Average Poster
Average Poster

Joined: Sun May 24, 2009 8:01 am
Posts: 8
I forgot to address one point. The numbness I refered to was not something I was aware of while on suboxone. It was insight gained from experiencing things without it. And - I'm sure therapy would have helped. I'm not blaming the suboxone for the numbness at all. I hold myself accountable for taking it - and yes, sometimes more than prescribed, for so long. I do not judge anyone else in what they choose to do. For the record. :)


Top
 Profile  
 
 Post subject:
PostPosted: Sun May 24, 2009 3:55 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
I have also noticed that my feelings are more intense now that my Suboxone dose is lower (below 2mgs I started to notice it). I feel grumpier, but when I'm happy I really feel happy. It's not that I felt drugged while I was on a higher dose of Sub, but I definitely felt like I had an artificially even-keel to my emotions.


Top
 Profile  
 
 Post subject:
PostPosted: Sun May 24, 2009 4:30 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
I wish people would stop calling me 'defensive'-- I have nothing to be defensive about. The people who find me 'defensive' are making an incorrect assumptions based on their own hang-ups. I re-read what I wrote-- I see nothing that I can even understand as 'defensive'! Point it out to me if you like, but as a psychiatrist I find that through the process of 'projection', casting someone a certain way usually says more about the person doing the assigning than the person being labeled. I don't know if you can follow this or not-- but YOU see something wrong with Suboxone-- so when you see someone in support of it, you see the persona as 'defensive'. I KNOW that most of the people who gripe about sub will eventually either be on it, be dead, or be miserably addicted to opiates-- so I don't feel defensive in the least.

Other names people bring-- we had a pharmacist named 'jerod' recently who called me 'arrogant'... then boasted about how HE had been clean for EIGHT YEARS-- WITHOUT SUB (like you losers!). He made similar arrogant comments-- in between comments about how arrogant I was.

I see this in patients all the time; again, I didn't make the process up. Read about 'projection' and I won't have to bore you with it here. I try my best to avoid telling people 'how they are', and rather point out a specific comment and say my issue with the comment-- again, trying to make it clear that I am guessing about much of it.

My comments about people eventually needing Suboxone or dying... I'm not wishing relapse on anyone. I am wishing life. I have had, though, many patients who called me a 'pusher' or other names... only to return a year later with a change of heart. I would have been one of them myself before my big relapse-- I was pretty certain of myself, and certain of my recovery. I now see that recovery was a state of mind just as artificial as any state induced by Suboxone. It was a nice state of mind-- but it is artificial. If it wasn't, people wouldn't need to 'keep coming back'. And my comments about where people will end up are straight from the big book-- which says that all that is in store for people is 'jails, institutions, or death'. That was written 50 years ago; now it should say 'jails, institutions, death, or Suboxone!'

You don't need to be ornery, Debra-- I don't see where I offend you, or at least I don't see where I try to offend you! Some people just don't like psychiatrists and the way we talk; I am a 'psychodynamic' psychiatrist, and there are not a whole lot of us out there, but I find that for addiction, psychodynamics is the perfect approach (as opposed to CBT or MET or supportive therapy, for example). When I suggested an 'open mind', I don't mean to accuse you of having a closed one--beyond the closed minds we all have as addicts. I only say it because addiction is an illness of insight, or lack of insight... and so the cure lies in recognizing when insight is coming or going and taking care during the low times.

Incidentally, I have noticed that people have less dreaming on Suboxone. The mood effects seem similar to the effects people have on SSRIs or SNRIs. There is a similar decision process for patients with mild depression in deciding whether to treat their mood; they are happier, but is it 'real happiness'? In my opinion, such arguments, like the 'am I really clean' argument, are for those who haven't yet faced the big issues in life. One you see a few dead bodies (and smell them) you recognize that alive is alive and dead is dead, and anything on the alive side is just damn great!


Top
 Profile  
 
 Post subject: suboxone
PostPosted: Mon May 25, 2009 4:34 pm 
Offline
Average Poster
Average Poster

Joined: Sun May 24, 2009 8:01 am
Posts: 8
I did think your tone sounded defensive - especially regarding the money comment - but other than that you said a lot of really great things. I was tapered off suboxone over 13 days, and 3 days after the last dose I was doing fine! I thougt it was a piece of cake. On the fourth day, it hit like a ton of bricks and doesn't seem to be relenting. My husband is being a read jerk, as he is one of the uneducated ones about suboxone but thinks hes and expert on suboxon and people with addictions. All I can say is that when we get sick, others get sick around us. He is making the withdrawal worse by being critical and judgmental. I think positive moral support is so important.


Anyway, I'm babbling. Didn't sleep hardley at all last night, and my joints are aching. I sure hope this lifts soon. Tell me this Doctor Suboxone, Have you had many patients go through a withdrawal like I have after being tapered for 14 days? Is there and end in sight? I know there is, but perhaps someone like you giving me a time frame might help my morale. Today it is pretty low.

Although I said you were defensive, I must say that I really like the way you write [font=Times New Roman] [/font] exactly what you think! I ususally do too.

Have a great day


Top
 Profile  
 
 Post subject: thank you note to my doc
PostPosted: Tue May 26, 2009 2:13 pm 
Offline
Average Poster
Average Poster

Joined: Mon May 25, 2009 7:09 pm
Posts: 8
Thanks doc! I need to write a thank you note or buy a small ty gift to my phsych. He has been soooooo good to me. He saved my life with the Sub.


Top
 Profile  
 
 Post subject:
PostPosted: Thu May 28, 2009 1:33 am 
Hi Deb,

It is very common to notice more intense emotions once your body is finally clean of the long-term use of any opiate... be it heroin, oxycodone or buprenorphine, even though one doesn't notice that such emotions are muted while still using said opiate. Personally, when I finally got clean, it felt like a flood of emotions continually washing over me, as if all the emotions that had been muted while on opiates were stored up and were then flowing out... and you are right... even though it feels strange at first, it is definately better than numbness. Our bodies are are always adjusting and establishing new equilibrium so before too long you will just feel normal.

As for your question for the good doctor about your Suboxone withdrawal symptoms... I'm sure he will be around to answer himself, but from what he has written above, it seems pretty clear that he would advise you to stay on the Suboxone:

Quote:
My comments about people eventually needing Suboxone or dying... I'm not wishing relapse on anyone. I am wishing life. I have had, though, many patients who called me a 'pusher' or other names... only to return a year later with a change of heart. I would have been one of them myself before my big relapse-- I was pretty certain of myself, and certain of my recovery. I now see that recovery was a state of mind just as artificial as any state induced by Suboxone. It was a nice state of mind-- but it is artificial. If it wasn't, people wouldn't need to 'keep coming back'. And my comments about where people will end up are straight from the big book-- which says that all that is in store for people is 'jails, institutions, or death'. That was written 50 years ago; now it should say 'jails, institutions, death, or Suboxone!'

Unless my elementary schools teachers didn't do their jobs in teaching me reading and comprehension.... it seems pretty clear that the doctor believes that anyone who has ever had an opiate addiction/dependence issue needs to be on Suboxone maintenance for the rest of their life.... or will otherwise end up in jail, the basket-factory or dying of an OD during relapse. Personally, I reject this premise... though admittedly I have only been off opiates for 3 years, I do have several friends who have been opiate-free for 20 or more years... still... who knows, maybe in another 20 years we will all be Suboxone patients of the good doctor. Until that point I am enjoying my life opiate free.

To your question, Deb, your withdrawals sound pretty typical. There is an end in site, though it never seems to arrive quickly enough. Best of luck to you on your reclaimed life.

Tim


Top
  
 
   
 Post subject:
PostPosted: Thu May 28, 2009 1:43 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
Hi Tim - If you read around you'll see that Dr. Junig does not recommend Suboxone treament for all people. He's the medical director of a treatment facility that doesn't even use Suboxone at all - and he is a recovering addict who got sober via 12 Step treatment and has never used Sub himself.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject: not black and white
PostPosted: Sat May 30, 2009 12:46 pm 
Offline
Power Poster
Power Poster
User avatar

Joined: Wed May 20, 2009 6:04 pm
Posts: 73
There is a difference between someone being 10 pounds overweight and being morbidly obese. there is a difference between being borderline diabetic due to poor habits and an insulent dependent diabetic for life. there is not a blanket statement for addiction. many factors go into addiction and the recovery process. I thank the subdoc for his education and time and I DO believe his intentions are altruistic, yet an MD and PhD are not the final word. some people start using because they had a bad childhood, need to mute feelings, just want to get high, and then, there are the accidental addicts. this last catagory is on the rise. people who got hooked without knowing what the consequences were. some factors that I think the subdoc overlooked are the mental health baseline of the person. the acceptance of reward and consequence, submission to denial, support system etc... I do not agree that either you die a junkie or stay on suboxone for life. I do believe there is a middle ground, an almost addict category that differentiates between addiction and dependence. the body and brain are remarkable and very few conditions are permanent. Cancer. Diabetes. Depression. Addiction. Deb, I am similar to your story, and I respect all viewpoints... but you are living the only one that matters...


Top
 Profile  
 
 Post subject:
PostPosted: Sat May 30, 2009 2:33 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
Where did Dr. Junig say that you either die a junky or you go on Suboxone for life?

Obviously he doesn't believe that because he's a recovering addict and is not taking Sub; he's also been nothing but helpful to me with my tapering process. Never once has he said I shouldn't taper off, and he's discussed both methods for successful tapering AND how to stay sober after Suboxone treatment on his blog.

I'm concerned because this idea - Suboxone or Death - is spreading to other topics in the forum and I think it's freaking people out a bit.

Sure, there is spontaneous remission in addiction, and people do get better without treatment. The same is true for other diseases, but I don't think you're likely to find a doctor who will suggest that you just hope and pray that you get better on your own. If a treatment is available that can help, they are going to recommend it.

That said, it is always our choice to make, whether we will pursue a treatment or not.

Tim - I wasn't implying that Dr. Junig is some kind of rock-star of psychiatry or addiction medicine. If he was the medical director of Bellevue in NY he probably wouldn't be here trying to reach out to addicts via the internet. I don't think it's true that he only reads marketing materials from Reckitt. I'm pretty sure he's mentioned reading independent research about Suboxone. And why does his opinion matter less because he hasn't used Sub in his recovery? I'm pretty sure that only Oregon allows medical professionals to practice while on Suboxone treatment, so it may not be just that he thinks it's "good enough for his patients but not good enough for himself." Perhaps he'll chime in on that at some point.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject:
PostPosted: Sat May 30, 2009 10:15 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
Quote:
Imagine trying to explain that drug's effects to someone who had never taken such a drug. Imagine explaining the things you liked about it, what you didn't like about it, how you knew when you'd had enough, how you knew when you'd had too much, etc... Who is going have better knowledge to advise someone else who is currently using that drug? The person who listened intently to you discribe as best you could what you felt and then declared themself an "expert"? Or you, who had actual first-hand experience?? Let's say if you took your drug of choice while drinking a Pepsi it would always give you the hiccups for 2 hours. This happened time and time again, but you never described this effect to the "expert" you made by describing your experiences. This new person on your drug of choice does it while drinking a Pepsi one day and gets the hiccups. He/she reports this to the "expert" who replies; "I've never seen that in my patients... it's either in your head or causes by something else".


I'm not sure that your analogy totally holds up. Subjective experience is just that - subjective. I don't need someone else to be an expert on my experience, I already am. But when I'm choosing a health-care practitioner, I want someone who has successfully treated many patients who have the same problem as me. I don't require that the doctor who treats my depression have experienced depression herself. I just expect her to know what works, and to listen to me when I report my subjective experience of depression and it's treatment.

Same for my Sub doctor. He's not even a recovering addict - but that doesn't preclude him listening to me and giving credit to my experience. He's been great about hearing my feedback and proceeding accordingly. If he didn't, he would be a crap doctor and I'd fire him. I don't think it necessarily follows that if he'd been on Suboxone before he treated me he'd be a better doctor. What if he'd had a bad experience with Suboxone? That wouldn't match my experience at all. So how would that enable him to relate to me better?

I will agree that there are crappy doctors who will never admit that a side effect exists if it's not "in the literature". I had that problem with my daughter's pediatrician. My daughter threw up the day after being vaccinated every single time, but he insisted this was coincidence. So I fired him. He didn't listen, had a closed mind, and therefore was not the doctor for me. But I don't think it has much to do with whether the doctor has been through what you're describing.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
   
 Post subject:
PostPosted: Sat May 30, 2009 11:22 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Tim, I am asst professor at a large medical school; i am med director of a 50-bed residential site; I did anesthesia at Penn, at the time the most prestigious anesthesia program in the country, I scored at the top of my class at the U of Rochester, New York, with the degree MD with Honors. I was in the Medical Scientist Training Program, one of the most prestigious programs for students leaving college and entering grad school and med school. I am Board Certified in two different medical specialties. I have published in the basic science and clinical literature. I was a reviewer for Academic Psychiatry for 3 years.

Right now, because of my children, I live in a small town. I can't commute to Bellevue-- a hospital where most of the docs, incidentally, attended Caribbean medical schools. When I moved from Carroll College in lil' old Waukesha WI to attend the U of R, where all of my classmates were from Brandeis, Yale, Penn, Brown, and Harvard, I worried whether I would keep up. I won the Anatomy prize and Physiology prizes both, my first year-- and was told that the accomplishment had never been done before. I was accepted into AOA my third year of med school. At graduation I received the Kates award and a couple less significant awards, the one I was most proud of was the one where my class of 100 voted me as 'most promising medical educator'. I have never failed a board exam-- in psychiatry the pass rate for the Boards is 55%! I have never scored below the 98th percentile in any of the certifying exams over the years.

I suppose this is all obnoxious, but how else to deal with the assholes that carry the sort of snobbery that you are putting out? I know what I'm doing and what I am saying-- I think that is clear.

This site is for one thing; some people insist on using for something else. I am sorry, but I put hours and hours into these sites and don't make a dime (actually I make about a dime). I don't need patients, so it isn't for marketing. Some people will probably be upset, but for Ch....s sake, it is my friggin' forum-- and I just am not into the mood for this crap right now after seeing patients all day, answering e-mails for free for a few hours every night...

I did say a couple of pissy things on the 'sub sucks' forum yesterday; I received an e-mail alerting me to a string where post after post picked on how I talked, how I moved, what I said.... and now I have tim here saying that because I brought good care to FDL, a 'small town', it makes me less of an expert.

I am not in the mood; to those I offend, I'm sorry. JJ, if you read this I apologize for my anger-- feel free to send me a note if I am out of hand. But do me a favor and boot tim from the big, impressive city of San Diego-- he has no need for us 'small timers' up here in Wisconsin. Ban his IP. I'll take care of Roger; he is here for one thing, and again, let him build his own site and say what he wants. The 'sub sucks' people-- for those of you who haven't seen it, check it out sometime. You won't read comments by a nastier group of people. I'm sorry for the comments that Roger took out of context-- I need a vacation. And despite what some of these people say, there is no sea of riches in addiction treatment!


Top
 Profile  
 
 Post subject:
PostPosted: Sun May 31, 2009 1:26 am 
I feel like I have something to say, but I'm not even sure what the hell we're talking about! :D

Plus, I think Dr. J said it all. Tough act to follow.

Nicely done.

Patrick


Top
  
 
 Post subject:
PostPosted: Sun May 31, 2009 1:29 am 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Read the san diego tim's comments again, and torn between booting them for inaccuracy or leaving them. I do NOT say that every addict not on Suboxone will face 'jails, institution, or death'; I say that the prognosis for untreated opiate addiction is grim, and that the success rate for treating before suboxone, or without suboxone, is poor.

I quoted the big book, which says clearly (and accurately, according to most people I have met in step programs) that untreated alcoholism will lead to the three choices that I gave. The line is very well known to any 12-stepper. Tim takes many of my comments out of context for some reason-- my point was that simply planning to avoid suboxone was not a plan. There are two choices; residential treatment and a lifetime of meetings, or a lifetime of medication. That is what I believe based on my experiences and observations. Despite Tim's comments about his success in English class, I don't know where he takes that to mean that every addict has to be on Suboxone. Few people will DO residential treatment, and only a fraction of them will have success with it, so I think that Suboxone treatment is the best choice for many people. If you have three months to spare, 45 grand to spend, and an open mind, do residential treatment-- and you have a 50% shot of sobriety for a year. I do think, though, that I can help a person get the same or better results for less money and with less time away from their work and family. If, that is, I was accepting new patients. The web site Tim refers to has been up since 2006, and I just leave it there because I still get referrals of pain patients who want to try using buprenorphine. Plus it has a couple maps that are useful for my other patients.

Finally, some people are able to stop opiates. Not many, mind you-- and I see people who are smart or successful have a harder time quitting than those blessed with more 'simple' outlooks on life. I have no idea what is wrong with those people, that they can stop using!! But in my opinion the phenomenon of the '20-yr recovery' that Tim says he knows about is not common enough to recommend that anyone rely on lightening striking them as well. And with all due respect to Tim, I am doubtful about his claims. Whenever I hear of such a person I ask for permission to contact them and interview them; I have done so a number of times. I have always found that the person isn't as clean as others think-- he is using now and then, or he has switched to a benzo, alcohol, or cocaine addiction. As I always say after these types of posts, if you have 5 years clean from opiates and can swear to tell the truth, send me an e-mail and tell me how you did it. So far I have one taker in three years-- that was 'the foolish pharmacist', Jerod. And his story falls apart the longer you talk to him, so who knows.

I have to get some sleep.


Top
 Profile  
 
 Post subject:
PostPosted: Sun May 31, 2009 3:47 am 
Offline
Average Poster
Average Poster
User avatar

Joined: Mon Apr 20, 2009 8:54 pm
Posts: 28
Dr. Junig,

IP is banned. I don't get offended if you get angry, I just get worried you'll say 'oh **ck it' and just give up.
Its unfortunate that you have to spend time with this sort of thing, well don't!. We can take care of it for you :)

YOU ARE HELPING OTHERS, JUST REMEMBER THAT!!!!


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 17 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: Google [Bot] and 3 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

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

Powered by phpBB® Forum Software © phpBB Group