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PostPosted: Sat Apr 09, 2016 12:07 pm 
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Will someone PLEASE help me take the first steps into the right direction ? I have been on opiates and heroin fro 10 years and it is starting to ruin my life. I don't know what to do first ?


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PostPosted: Sat Apr 09, 2016 12:29 pm 
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Hey Strider,
Welcome to the forum. The first thing you need to do is find a Dr who can provide you with Suboxone and treatment.
Not all drs can do this, so use the seach or the Here to Help search engine.

Hopefully, you are in an area where there are drs or clinics who have programs you could join.

Ten years of useing must be getting old by now. Suboxone changed my life for the better and many others on this site too.
You can do this and it sounds like your ready. Where do you live ? City or in the country? It varies from state to state.

Razor


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PostPosted: Sat Apr 09, 2016 2:50 pm 
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Hey Strider,

So glad you came here!! Lots of incredible info to get you started on bup. Best decision you can make and it will change your life for a great outcome, far better than what you can understand right now until you get on it and experience it. It completely got my life back on track and allowed me to work hard on my recovery and make life changes that I could not do while abusing. I hear you on 10 yrs. That's how long my time on fentanyl was. I did not find bup or this site in time and flailed around w mistakes. Starting bup earlier would have avoided the hard times that resulted. I encourage you to read read read the excellent expert MD that owns this site, Dr Js Talkzone and then read threads on this forum! Really great stuff here.

Yes to all Razor said. Keep checking in bc there are lots of good folks here that will help you and answer questions !! P

_________________
Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


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PostPosted: Sun Apr 10, 2016 12:55 pm 
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People sometimes get too focused on choosing the right approach. Your options are probably largely determined by your circumstances-- so your first mission is to find out what is available. There are people who put down medication-assisted treatments like buprenorphine (aka Suboxone) and methadone, saying that they are 'replacing one drug for another'. But either of those approaches have much better success rates than residential treatment, and they are also easier to start.

Methadone or buprenorphine will each stabilize your situation fairly quickly, allowing you to step back and weigh your options, without the daily search for opioids. And with both buprenorphine and methadone treatments, you lose nothing by getting started. If you start buprenorphine and decide it isn't right for you, you can simply go back to heroin or oxycodone. The same is true for methadone. People rarely make that choice-- and when they do, it usually wasn't a deliberate change, but rather the addiction gained the upper hand and pulled them away. But the point is worth making that you can always go back-- because every now and then someone comes here and complains that they are 'stuck on buprenorphine'. I try to point out that they are stuck on opioids-- and they can always go back to where they were before they started buprenorphine!

The question is whether you have access to either medication in your area. If you Google 'find addiction treatment' or a related search, you will get listings of many outdated web sites. I'm disappointed to see that even the SAMHSA site is extremely outdated, listing programs that are no longer available and not showing the newer treatment programs. The SAMHSA site is also extremely slow, at least today... and I doubt that the slowness is a traffic problem.

I have a web site that lists a number of buprenorphine doctor directories, at http://www.suboxdocs.com . But the site is a 'directory of directories'-- and some of the databases are more current than others.

I'm just now noticing how difficult it must be to find a treatment program... The last time I really looked at the databases was maybe 5 years ago, and I remember seeing a number of sites that were fairly current. I assumed that the information was only better now-- but it appears to be worse. If anyone reading this knows of good resources for FINDING treatment, leave a comment!

Another option would be to call your county health department; I would think they would have a list of programs in your area. Finally, many people hear about a treatment program through word of mouth, 'on the street'.

Buprenorphine treatment will have a higher 'front end' cost. In my area, initial costs are $300-$500. Ongoing costs include the medication (usually covered by medicaid or insurance) and the cost of monthly doctor visits. Things to consider when choosing a long-term provider: who pays for drug testing? How much does that cost? If you don't have any insurance at all, will the doc prescribe plain buprenorphine (which is less costly than combination products)? Are you required to be in counseling? If so, how often, and where? Some docs use buprenorphine to fill their counselors' time-- which is pushing ethical borders a bit in my opinion. Other considerations... does the doc allow you to be treated with benzos? What is the doc's attitude toward marijuana? Will you be kicked out if you test 'dirty'? Is the doctor 'punitive'-- i.e. will you be tossed from the program if you struggle a bit? Or will the doctor work with you, if you don't get it perfect right away?

Methadone programs in my area are covered by medicaid, making them essentially free for people with that coverage. But as people do better and find jobs, they often lose medicaid and have to pay for methadone out of pocket, which can be costly... although it is never costlier than active addiction, especially when you factor in all of the related costs that come with addiction.

If you do not have access to medication-assisted treatments, you may need to consider abstinence-based treatment programs. I'm not a big fan of abstinence programs for opioids because of the high relapse rates with those substances, and high death rates during relapse. And of course, an abstinence-based program will include detox and withdrawal. People who lack an understanding of the usual course of opioid dependence see abstinence-based treatments as the best option. But the only way to see things that way is by ignoring all of the data, or by assuming that in THIS case, things will go differently than usual. That thought is so seductive to the parents of addicted young people, and I have known a number of people who died after falling victim to that seduction.

Most people who have been addicted to opioids for a year or more have already learned that detox provides little value. If simple detox works for you, you probably were physically dependent, not addicted. If you have detoxed and then relapsed several times, then another detox is not likely to be helpful. In fact, detox introduces danger into the equation, as many overdose deaths occur after a person has been through detox, either voluntary at a treatment program, or forcibly through incarceration.

My bias toward medication-assisted treatment is coming through loud and clear, I know. I don't believe that residential programs have NO value; I just think that too-often people enter them without understanding the long odds that they are facing. The people who do best with abstinence-based treatments are those who will be monitored for a long time-- such as people trying to regain professional or occupational licenses, or people trying to avoid prison. In all cases, the treatment is just the beginning of a lifetime of work toward remain abstinent.


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