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PostPosted: Mon Apr 16, 2012 11:02 pm 
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Last time I saw my doctor, we touched briefly on how successful his other patients have been with tapering. His response wasn't that heartening. He said that a lot of his patients (nearly all ex-heroin addicts) found it harder to stay clean on doses under their saturation / ceiling level than they did on no Suboxone at all. He said that it appears for some there's a "no man's land" / danger spot in dosing that usually kicks in under 8mg's or thereabouts where patients' cravings kick back in where they're getting enough opioids to maintain their addictive circuit, but not enough to satiate / fill its hunger for what it needs. He's found these people have just as much if not more chance of relapsing as people do in the first 1-3 months of being clean.

A good analogy for me to understand this is if our addiction is a dog (a naughty dog - weird I know but bear with me), on those sub-optimal doses you're still feeding the dog enough to keep it alive, but not enough to make it content. So it kicks up a fuss until it gets more of what it needs - in the addict's case, heroin. But when you choose to stop feeding it completely, sure it kicks up a big stink for a short while, but eventually it starves.

On the forum it seems for some people this is true. People do often relapse on lower doses. But an equal number seem to stay on the path and achieve a good taper. Whether this 'no mans land' idea is something isolated to heroin addicts I don't know.

He said he'd been talking to some guy affiliated with the WHO who's recently been of the opinion that when a person hits this level, rapid-detox may offer a better chance of long term recovery than continuing reduction. But I always thought that naltrexone was ineffective at precipitating withdrawal for buprenorphine, as bupe binds harder to the receptors than naltrexone. My doctor even suggested trialling rapid detox in his clinic for me when I do choose to reduce, after I maintain sobriety for some time on my 12mg level (something I can achieve easily when I stay on that dose).

Has anyone heard of rapid-detox being achieved to get people off buprenorphine? I'm interested to know how they go about this.

Thanks.


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PostPosted: Tue Apr 17, 2012 12:21 am 
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I did an outpatient rehab for opiate abusers, everyone that did heroin has since relapsed, I relapsed once for about tso months but got back on the sub wagon. The theory behind long term bmt is to heal damaged brain pathways and to break the addiction/cravings to the original drug of choice. I know people who have done a rapid sub detox, but ive never heard of doing a rapid detox after long term bmt. Also everone I know that fid the rapid taper are back on dope. If your doctor does do this please share the results he gets. In my opinion it is possible but the person has to want to be clean and should get involved in a 12 step to maintain. Also ive been looking into cognitive therapy, I think that helps alot to identify why we use in the first place.


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PostPosted: Tue Apr 17, 2012 12:37 am 
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If I were to consider doing this, I would only do it with some kinda safeguard in place post-detox - ie Vivitrol or a naltrexone implant (leaning towards Vivitrol).

While I've done the 12-step shuffle previously with mixed results, I do see some merit to taking that course. However I also feel that if one focuses equally on their recovery in other ways, and put the same effort as they would by doing the 12-step shuffle, they can get the same results.

Rapid detox on its own is asking for disaster. I did an accidental naltrexone induced rapid detox while on 90mg's methadone, with no anaesthetic whatsoever. It's kinda like going under the knife and enduring it with no anaesthetic. 24 hours of torture. So I do treat rapid detox with caution. I'd probably prefer to just do a high-jump and detox without naltrexone.


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PostPosted: Tue Apr 17, 2012 1:10 am 
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Wow ive heard horror stories about naltrexone to detox while awake, hear its a traumatizing experience. Do what you need to do just be careful. i myself researched naltrexone as I was so desperate for a way out. I think we get to a point where we are so miserable we will do anything to get better, I feel you completely. Hopefully someone with an implant can comment so we can get first hand experience.


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PostPosted: Tue Apr 17, 2012 3:18 am 
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I know of people who've used the implant successfully, and some who haven't. The difference between naltrexone implants or vivitrol and something like Suboxone (other than Sub being an opioid) is that when naltrexone goes wrong, it really goes wrong. One lady I knew literally ripped open her stitches and pulled out the implant so she could use. I've also heard of people who used massive quantities of heroin to try and override the implant. That being said I know people who did the same while on Sub.

Where people went wrong I think is that they relied on the implant, as if it was the only thing keeping them between using. The ones that had success were those who used the implant as an aide, and they practiced some kinda recovery program.


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PostPosted: Fri Apr 20, 2012 10:42 am 
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In this thread (http://suboxforum.com/viewtopic.php?t=6349), I mentioned that doing a rapid detox under heavy sedation was my first choice, but that I couldn’t do it for a few reasons, and chose sub because I really wanted to get of the hydro. However, I’m concerned about getting “hooked” on sub because it is an opiate, albeit a “better” one than hydro, oxy, heroin, etc. So when I found this thread via the search function, I was very interested in reading it, because I’ve wondered the same thing: can I do a rapid detox off of sub if I need to?

From the limited info I’ve gathered and my layman’s understanding, I suspect the answer is “yes,” one can do a rapid detox for addiction to sub just like any other opioid.

tearj3rker wrote:
… I did an accidental naltrexone induced rapid detox while on 90mg's methadone, with no anaesthetic whatsoever. It's kinda like going under the knife and enduring it with no anaesthetic. 24 hours of torture. So I do treat rapid detox with caution. I'd probably prefer to just do a high-jump and detox without naltrexone.


With my puny understanding, before this thread I hadn’t heard of naltrexone being used to induce rapid detox. In a rapid detox under sedation, I thought naloxone was used by administering it intravenously. Here’s my understanding of the key difference between naltrexone and naloxone: naltrexone blocks opioids from attaching to opiate receptors, whereas naloxone completely strips away opioids which are attached to the opiate receptors.

My understanding is that naloxone is used in extremely high doses while the patient is under deep sedation in order to totally clean out the opiate receptors in the brain. So when the patient wakes up, the physical component of the addiction is practically gone.

Here’s a quote from http://www.rapiddetoxlasvegas.com/id45.html

Quote:
Our protocol has the patient receive high dose Naloxone (Narcan), the antidote to opiates, intravenously while the patients sleep under anesthesia, for a total of close to eight hours. … Only Naloxone [is an] antidote to opiates, capable of displacing opiate molecules from the opiate receptors in the brain, in the spinal cord, and in the gastrointestinal tract. Not using enough Naloxone for long enough period to allow the maximum of opiate molecules to be removed not just from the brain but from the whole body altogether, through the liver and kidneys, is not adequate detox. Instead of waking up practically free of physical withdrawal and physical craving for opiates, the patients would wake up feeling severe withdrawal. It is technically more challenging to keep the patients asleep for longer periods, but that is precisely why in our clinic the experienced board-certified anesthesiologist stays with that one single patient continuously for eight hours, to ensure safety and comfort of the patient.


Just my .02. Obviously, I could be wrong because I’m certainly no expert. I wonder if a doctor could chime in on this question.


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PostPosted: Fri Apr 20, 2012 11:09 am 
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Just spoke with a rapid detox doctor. He said that a rapid detox w/ sedation off of sub is not really possible. He said if one couldn’t stop sub cold turkey, you’d have to stop sub for at least 3 weeks and replace it with a short-acting, full agonist opiate like hydro. He said the receptor binding affinity in sub is stronger than I/V naloxone (which is what he uses for rapid detox under deep sedation), so the naloxone can’t strip the sub from the opiod receptors. He also said that naloxone can only strip the mu opiate receptors in the brain, not the kappa opiate receptors in spine, and that sub binds to kappa receptors -- full agonist opioids like hydro do not bind to kappa opiate receptors.

Another reason he said you have to stop using sub for so long is because the sub goes into the body’s fatty tissues, and this takes quite a bit of time for the body to fully metabolize (opioids like hydro are metabolized much faster, even if some of the opioid metabolites get into the body’s fatty tissue).

Alas, my cell phone battery died in mid conversation, and I was unable to ask him if naltrexone is used nowadays for rapid detox under sedation. But I’ll call him back and report back here.

Hope this helps!

P.S. Sounds like I was dead wrong about being able to rapid detox off sub. LOL. Like I said, I don’t know much about this stuff.


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PostPosted: Fri Apr 20, 2012 11:22 am 
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Ha! My ignorance is shining brightly in this thread! :oops: I guess my SometimeIdiot handle extends a lot further than I thought. :lol:

Okay, charged up the phone enough to call the doc back. He said that naltrexone and naloxone are chemically identical, the only difference being that the former is absorbed in the stomach and the latter in the blood.

Hope that helps!

SI


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PostPosted: Tue Aug 14, 2012 1:09 pm 
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you know i once used Heroin for 2 years. went CT 4 times. Last time was the worst!!!! But this suboxone is a demon to get off!!! I have never felt worse withdrawals than i have trying to ct suboxone. If you need suboxone i'm all for it. Just sharing my opinion. I am now 5 days clean and barely taken any meds. I feel week but fine. I went to rapid detox!!! Here friends is my story. Go where you like but I've heard so many horror stories about rapid detox. Guess what. They must notta gone here!!! Anyway here's how it went.........

Just so you know i ain't no ad for rapid detox. you'll see I've been a member for some time. Also my avatar is vincent Valentine from final fantasy 7, the man in the coffin.Too bad they don't have a Sephiroth avatar. Also for all you against rapid detox you can suck my penis.... no off fence. maybe you just went to the wrong place. Cause its a gorram miracle!!! Please read Daniel chapter 3 that explains my experience!! Put into the furnace and not burned!!! and who was the forth man....Jesus!!! Who was there the whole time. But this is my story! And i will tell you my story!!

So you know where i'm at today is Tuesday, I went thru the procedure on Wednesday last week. That last tuesday i went to the dr. office and she put me thru all kinda tests make sure my heart's good and i aint crazy and the like. The dr was real nice! She believe in what she do. I also had to see a psychologist!! never had that happen b4. but he was real nice. Good guy!! Guess i ain't crazy. now to Wednesday.....


Wed morning 5am i was shuttled to a Hospital. My roommate was a guy named Taylor. I think he was in slight withdrawal. I guess the suboxone was still in my system. Lying on each bed was a gown and something that frightened me..... a diaper!!! Yes a diaper! The diaper soon became the butt of every joke me and Taylor could think of!! My gosh it was funny. I thought Taylor would see my diapered ass. I had to wear it.... Any way the nurses and anesthesiologist came in and gave us iv. Taylor took it like a man. I'm scared of iv needles and almost cryed as the third iv finally made it. I went first.........


Down in pre-op i was agitated and had to get up with the machines every 5 minutes to pee for some reason while mrs Chang the new nurse had no idea what she was doin. Anyway i lost some time......

Wednesday/Thursday night I was back in my room, vaguely remember sleeping, peeing, and punching a black guy 2 times hard in the head. Also pulled the iv out i guess. Vague memories. Punched a LARGE black guy!!!

Thursday morning Nurse and Dr in my room. "you are all done!" WHAT!!! I swore i never went thru the surgery!! But they were right. I was done!! Then i was shuttled back to the hotel!! And what a grand hotel!! Water in the hallway. I went strait to bed. They say its normal.......... BTW i know you r wondering..Did i poop the diaper? Not a chance man. I followed the cleansing instructions to the T . I tore that dang thing off moment i got back!!! Back to i slept. I slept till Friday!!!! Oh BTW on the ride back I told my other "friends" who went thru it to that I had NO withdrawal. I was fine!!. 2 of them said they did. But i think they were expecting this to be easy!! I watched Scrubs Friday with my wife and she ordered Jets pizza. My appetite for food is gone but I ate 3 slices. Saturday morning we leave for the airport back home. They gave us a pile of meds too.

Saturday. I got special wheelchair privledges at the airport. I was having trouble walking. But mind you only mild withdrawal since Thursday. Very mild!!!!!! Also who at 32 years old get wheelchair privileges. I gave him $10. He was nice.

Sunday and Monday i was feeling week very week. No energy. Like a Gorram baby. But here's what i take. 1 Nurontin when i wake. 1/2 clonodine later if i need and so on. I refuse to take a whole one cause i go nappy for 2 hours. I have soma, vallum, halcyon, which all make me sleepy so i don't take them at day. i ain't gonna lie though, i have trouble sleeping so doc says i can take all 3 before bed. I don't even know what half this stuff is but the nurontin is the best. I think its for restless legs and the like. which i aint had yet. ...............Monday I rode the heck out of my exercise bike to get my body goin. It worked.

So anyway its Tuesday!!!! I feel hell lot better. I just took the trash out. And it was heavy. Made breakfast and coffee too. OH... and music sounds amazing!!!!!! I even had my wife buy DR Dre beats for me. Beats are cool!! I feel so much better today than last few ones. BUT NOW HEAR ME ON THIS!! I WENT THROUGH NO WITHDRAWAL AT ALL!!! NONE. AIN'T FEELIN %100 BUT NO WANTIN TO KILL MY SELF. I AIN'T EVEN CRAVIN OPIATES OR ANYTHING. Cause the Naltrexone. And for all you against naltrexone. Shut up!!!! If they can put you under at the rapid detox for surgery without opiates it don't matter. Just buy a medical bracelet like i did just in case.

Nowfor a final note!!! And I appologis cause I am a Christian and my language ain't been so kind here!! BUT FOR ALL YOU IDIOTS WHINING ABOUT HOW HARD PAWS IS AND RAPID DETOX WONT HELP WITH THAT. GO EAT A PENIS!!!! PAWS ain't the hard part. Just deal with it and move on. I mean that 2 weeks of hard core withdrawal is the hard part. I barely got PAWS. I ain't even depressed. I sure as heck can deal with this over writhing on the floor in pain trying to grab my Ruger .38 LCR to put to my head to end the pain!!! PAWS can eat a penis!!! I described the gun so you know i was serious!!! Maybe in a day or 2 i'll hit up the range. I love shooting. But i digress. I am now free of suboxone!!! If you happen to stumble on one of my earlier posts you'll see that i once said i was gonna stay on it for good!!!! F that!!!!!!!!!!!!!!!!

Now I am gonna post where I went for this procedure. And I'll tell you why. Cause ain't no one out there could give me details of where and when they went to rapid detox so its hard to Google it and find a good place!!!! IF I'M WRONG IN DOIN THIS PLEASE DONT ERASE MY POST! Just the last part cause i want people to know my story!! Everyone is so against Rapid Detox but it worked for me. All I needed was thru the hard core withdrawals. AND IT DID!!!! AND YES TO ME IT WAS WORTH IT!

So that was my story!!! I will recommend this place to anyone can afford it! www.rapiddrugdetox.com. i don't right know who Jeannie is but Dr. Nameth is a great woman!!! She really believes in getting you off opiates!!! This place is in Livona Michigan i think. There are so so many bad rapid detox places out there, but i did my research. They are Better Business Beaureau certified with no complaints and the procedure is in a JACO approved hospital. Not in some guy's shanty in the woods. AGAIN IF YOU HAVE TO ERASE THIS LAST PARAGRAPH JUST PLEASE DON'T ERASE MY STORY!!!!!!!!
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PostPosted: Tue Aug 14, 2012 1:27 pm 
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BTW here's what the procedure interred. First i'm knocked out with some drug i can't remember the name. Then Narcan is put in me to force all the suboxone/ morphine off my receptors. problem is narcan gone in 20 minutes. empty receptor, suboxone floating around. Then Naltrexone is flushed in. Longer 1/2 life. now the battle begins. Naltrexone vs suboxone who gets the receptor? Naltrexone will win. but what about all the suboxone. Now u r flushed with fluids vitamins etc. and for the next week you drink mountains of fluid so by by suboxone. all the while you are taking naltrexone pills with a naltrexone I'm shot. Couldn't get high if i wanted to. oh and for you crybabies whining about what if i need surgery or opiates. YOU DON"T NEED IT. they knocked me out for this surgery and i didn't remember nothin. Just do what i did and buy a med bracelet saying u r on naltrexone!!! I mean if you were on suboxone you can't get opiates anyway right?

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PostPosted: Tue Aug 14, 2012 1:32 pm 
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by the way when do i get my 4 stars? how many posts?

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PostPosted: Wed Aug 15, 2012 2:27 am 
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Night, it's too soon to ascertain whether or not you'll have PAWS yet (which stands for POST-acute withdrawal syndrome). You're barely past the acute stage, so you'll have to wait a bit to see if you develop PAWS yet.

What stars are you talking about? We don't "give out stars"....?

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PostPosted: Wed Aug 15, 2012 1:12 pm 
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Night,

If you are referring to the Suboxone tablets on top of your name the information can be obtained by going to the top of the page and click on Rank. It'll show how many posts you need to have to get 4 and 5 tabs.

Can't find it? Let me know and I'll copy and paste.

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PostPosted: Thu Aug 16, 2012 4:18 am 
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SometimeIdiot wrote:
Another reason he said you have to stop using sub for so long is because the sub goes into the body’s fatty tissues, and this takes quite a bit of time for the body to fully metabolize (opioids like hydro are metabolized much faster, even if some of the opioid metabolites get into the body’s fatty tissue).


This is something I tell many people on the forum because it's not well known, and two doctors have told me this at two different times. Because Suboxone is high lipid soluble traces remain in the tissue for a long time after a person stops taking it. I don't think it's as long as methadone, but it's definitely not completely 100% out of the body in two or three weeks. Traces can remain in body fat, of which a large amount gets deposited in the lipids in the brain, and the process of excreting it happens very gradually. Hence why I think PAWS lasts longer for Sub than for short acting agonists.


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PostPosted: Thu Aug 16, 2012 7:19 am 
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PAWS, from what I've read, has nothing to do with that, TJ. It only has to do with the brain getting back to normal. Having some of it leftover in fat cells is something totally different. It would be affected when the body starts feeding off fat cells instead of glucose which is what happens with most of us who are on "regular" diets (and not high protein, no carb diets). Any leftover sub in the fat cells wouldn't be released until there's a reason for the body to feed of those fat cells.

Again, PAWS ONLY has to do with the BRAIN.

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PostPosted: Thu Aug 16, 2012 7:35 am 
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Sounds like something from a late night "fat buster" infomercial.

Our body replaces cells in our body every day, including fat cells. For someone who isn't exercising at all, fat cells turnover at 10% a year, so gradually they break back down into glycerol and are released "into the blood stream". It's not just fat cells that get renewed. Our blood is replaced every 6 months (which is why I was told not to try and have kids with my girlfriend 6 months after interferon because ribavirin binds to red blood cells and it isn't out of the body until 6 months after). Our muscle proteins turnover, our eyes, our skin ...

Couldn't Sub that's been stored in the fat be released into the blood stream as well? Could a gradual trickle of bupe molecules entering the blood stream, many at first but less and less over months / years, slow down the process of the brain returning to normal?

Just a theory, but is it possible that exercise speeds up PAWS because it's known that exercise speeds up this process of cell renewal?


Last edited by TeeJay on Thu Aug 16, 2012 8:00 am, edited 1 time in total.

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PostPosted: Thu Aug 16, 2012 7:40 am 
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Sorry, came from two of my doctors.

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PostPosted: Thu Aug 16, 2012 7:45 am 
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You know, TJ, everyone has different opinions, and I leave room for everyone's, but YOU, when you have a different opinion, do you ever notice that you ARE ALWAYS RIGHT? In this case you had to insult me and tell me I sounded like a fucking INFOMERCIAL? How is that respectful of others' opinions? YOU DO NOT KNOW EVERYTHING!! Yet you come across as though you do. There's a word for that...we call it arrogance. Just watch how you put down other peoples' opinions as it's not showing them any respect whatsoever (whether it's a moderator or a member, although i do recognize that you only do this with me and not others, but the rules still do apply).

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PostPosted: Thu Aug 16, 2012 8:01 am 
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Only yours hatmaker.

It's just so dang hard for me to try and change your mind about stuff. But I try. :lol:

Anyway, I'll give your opinions some space because they ain't changing anytime soon and you ain't leaving anytime soon.


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PostPosted: Mon Aug 20, 2012 10:56 pm 
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Rapid detox will not and never will do anything for suboxone except make you suicidally depressed. The naltrexone given blocks your natural endorphins and since the suboxon binds to the receptors for a very long time you tend to have extreme depression for several months, this makes people suicidal. Rapid detox only eliminates the suboxone from some psychical parts but the subpoxone is still attached to your receptors, this means you still have PAWS for a very long time and its the same as not doing a rapid detox.


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