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PostPosted: Wed Feb 10, 2016 3:03 am 
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Eleven years ago I was put on buprenorphine to deal with a heroin addiction. I stayed on it for 2 years at 8mg a day. My first attempt at quitting saw me jump off at 8mg with no taper. I lasted three months, but the PAWS were interfering with my ability to finish up school. I decided to go back on at 2mg a day. After I finished school, approximately 10 months later, I jumped off again, at 2mg, no taper. It was absolute hell for 6 months, but I made it through.


Since ceasing buprenorphine therapy I've never felt right. Sleep has been a serious issue, as has a growing dark depression and anxiety disorder. For the past 7 or 8 years I've been seeing psychiatrists, psychologists, addiction medicine specialists, been put on various ssri's, snri's, anti-psychotics and various other meds, and been involved in AA. Nothing seems to help, some things/meds make it worse.


About a year and a half ago I began using heroin again, sporadically. Initially I kept it on the fringes, no more than once a week, and very small doses. Gradually I began to use more and more, and though I never developed another daily habit, I would experience mild to moderate acute withdrawal symptoms after using a couple of days a week. I would get through these withdrawal periods using other meds.


It's currently been about 5 weeks since I've last used, and I continue to experience some serious PAWS...no sleep, severe depression and anxiety, etc. I'm considering going back on buprenorphine at a very small dose, and staying on it for the foreseeable future. I believe it would go very far in alleviating my depression, anxiety, insomnia, and improve my overall quality of life. My first time around with bupe I was in my mid 20's, I'm now in my mid 30's. I hesitate to go back on this med because I know how ridiculously difficult, nearly impossible, it is to quit. However, I don't intend to quit again, barring severe unforeseen side effects developing. I'm currently on moderately large doses of Gabapentin and Lyrica, both of which I'm very physically dependent on. Lyrica withdrawals are as horrible or worse than opioid and/or benzo w/d's. I believe the burprenorphine would go far in assisting coming off of these other meds, meds that have brought unwanted side effects.


I apologize for the long post, but I would greatly appreciate any input you all may have on this matter: Should I go back on buprenorphine? All opinions are welcome!


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PostPosted: Wed Feb 10, 2016 11:11 am 
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Hello Simply,
Wecome to this great forum.

My short answer to you is Yes, as soon as you can get back on Buprenorphine. Your post tells me anyway
that you have tried it and it worked well for you. I do understand that at a young age that staying on this med loug term wasnt in the plan. You tired hard to be drugfree. The fact is as you said none of them stuck for loug.

I see it as a lifesaver and you have begun down the slope of H that takes you to the bottom. Your catching it early right now, so please take another look at your own post and your answers are there. I saw them. You really know what to do imo. Make the call Simply.

This is a chronic brain disease we are all fighting and there is nothing wroug with taking a substance /Medicine to improve your life.. so, I say go for it and get on with life. Take that leap of faith ...


Razor57...


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PostPosted: Wed Feb 10, 2016 11:28 am 
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Hello SS6, Welcome! I wish I had an answer for you! Based on just my personal opinion I would say yes. Especially if it helps you with the side effects of the other meds. If you can do a low dose of suboxone I would think that would be best for you. Then your just taking one medication. Does suboxone work for the withdrawl from the Lyrica? If yes, than I would think suboxone would be a win win situation. But, I am not a doctor and have little experience with this. I hope someone with more experience or Dr. J, who is the expert, will pop in to give you much more educated feedback! Good luck and please keep us informed about how you are doing!


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PostPosted: Wed Feb 10, 2016 3:00 pm 
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Razor and Michelle,

Thank you so much for your replies! I've been struggling with this decision for a few months now. The addiction therapist I've been seeing is pushing hard in favor of buprenorphine. She believes it will dramatically improve my quality of life. This is not a decision I take lightly, and I'm soliciting as many opinions and as much information as possible prior to making it.

I appreciate your help!


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PostPosted: Wed Feb 10, 2016 4:13 pm 
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SS6,

Sorry only the mods are responding to your thread but we are the ones who constantly watch this forum.

If you read some of the posts in the Stopping Suboxone section you'll see it's not impossible to get off of Suboxone. And surely not as hard as stopping heroin cold turkey either. You need to remember that your receptors have been compromised for many years with both heroin and Buprenorphine. It isn't fair to lay all the blame on Suboxone. They are all in the opiate family. Ask anyone in AA or NA about stopping either H or pain meds and they'll tell you the same thing. A member told me it would take at least a year to feel normal again after stopping hydrocodone. That is sort of the norm in the field of opiate recovery.

The concern is you going back on to heroin again like you have in the past. No, it's not an easy decision to make. Do you want to stay on a medication for possibly life? Or will you do it the right way and taper down to a very low dose and then jump off, still expecting the side effects of withdrawal to last somewhere between a few months to maybe a year or more. Rarely has it gone over a year for the body to return to normal. Same goes with the Lyrica and Gabapentin. Funny, I took Gabapentin for almost a year and stopped w/o any withdrawals at all. No one told me it was physically addicting so I didn't think twice about stopping it. The reason I stopped was because it wasn't doing what it was supposed to be doing, and that was to stop nerve pain. The nerve pain went away slowly but surely without the Gabapentin.

If you decide to stay on Suboxone (Buprenorphine) it may well be for life. I'm almost twice your age so it's a no brainer for me. But for you in your 30's it's something to think about. My answer is no, taper and give it all you got to stay off any and all drugs. If you're working with a recovery person then you have a good first start and someone to fall back on.

What it really comes down to is this. Do you know deep inside that you can stay away from all opiates and other mind altering drugs for the long term, or not? If not, then I'll say go back on Suboxone and stay on it until you're ready.

Like you said, you have some thinking to do.

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PostPosted: Thu Feb 11, 2016 2:59 am 
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Welcome Simplescience,
If you already know it has worked for you once and you are experiencing chronic symptoms including relapse, I think Bupe could be your solution. I understand that a protracted WD may leave you questioning if this is the right decision. It definantly leaves an imprint that one won't forget. At least, that was my experience with methadone.
Like you mentioned, there are other drugs that are harder to come off, but consider that it may be an option to stay on bupe forever. Bupe is wonderful in that it has the ability to address multiple issues in many people. I am one who benefits from the pain relief and mood elevation, whilst keeping my addiction in remission.
I have no issue with taking this for the rest of my life.
I hope you will keep posting and let us know what you decide. We want the best for you too!


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PostPosted: Thu Feb 11, 2016 3:51 pm 
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Rule forced me to respond, since he said only mods were answering...LOL. Seriously, just kidding, but I'm not kidding when saying that yes, it sounds like you're in the right place to begin bupe again. You've obviously not rushed to make this decision, so it sounds like you've weighed other options, and this one sounds the best, plus you KNOW it will work. Just think what would happen if you got one bad bag of H...end of story. Someone else posted and I echo it, "I will have no problem taking this the rest of my life if needed". I was on Prozac for a while, but suboxone usage for over 2 years now has given me a stable life, and it's the only medication I take. I just can't see why you'd chance doing H sporadically, and keep going through that up and down cycle, when IMO bupe will level you out, and set you right (mentally and physically). I also understand being apart of AA (I was for a while), and my experience was that most AA people looked down on us sub users, but if you get away from "group thinking" (AA), decide what is best for you, and only for you, as no one else has to live your life and handle your issues. AA supports people, and obviously it works for some, but YOU have to make the best decision for YOU.


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PostPosted: Thu Feb 11, 2016 8:43 pm 
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I'm not going to say yes you should, or no you shouldn't. Why not weigh up the pro's and con's yourself.

The immediate benefit of going on Suboxone is that a lot of your problems will be fixed very quickly. You'll have significantly less chance of relapsing, you'll be able to get on with your life, your PAWS will resolve, you'll have significantly less chance of overdose and death. You won't have to go to meetings where people talk about God being the only answer.

The con's of going on Suboxone are, the dream of living completely opioid free will be postponed and diminished. It costs money. You have to see a doctor once a month and let films dissolve in your mouth once a day. You won't be as accepted in 12-step meetings.

I think the "dream of being opioid free" is the big driving force behind people tapering off Suboxone, or rejecting Suboxone entirely. I used to be a big dreamer in this regard, and still hold onto the dream to a certain degree. But in recent years I've seen a number of close friends die as a result of opioid addiction, two of my best friends overdosing as a result of attempting abstinence. I've also seen people try over and over for decades to live opioid free using 12-step programs and other groups and continually relapse for many decades, and understand that if they just went on Suboxone or methadone from the start they may have actually experienced many things in life, gotten married, had kids, travelled, all things they've missed out on as a result of living their life in and out of abstinent based rehabs and in early recovery. I've also seen thousands of people attempt abstinence and fail. Spend any length of time in 12-step meetings and you'll see thousands of people come and go. The only people who stay are the slim minority who "get-it", and the aforementioned people who try and constantly relapse because they're convinced they too can be in the slim minority if only they keep trying.

I myself have relapsed twice, once at 18 months clean, another at 13 months clean, while doing NA meetings. I wouldn't say I was experiencing PAWS to the extent you were, but I was definitely experiencing psychiatric symptoms that precipitated my relapses. These relapses have taught me that in order to get over the PAWS and the physiological after-effects of opioid addiction, you really gotta be prepared to work through the danger-zone for a number of years.

And opioid addiction has now been around long enough that the medical world has managed to do some long-term longitudinal studies. And those studies show that, for the majority of people, opioid dependence is for life, and abstinence is only achieved by the minority.

And in all these studies, having a depressive mental condition was the biggest predictor of life-long dependence (ie people with depression were the least likely to achieve abstinence).


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PostPosted: Sat Feb 13, 2016 7:39 pm 
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Thank you so much to all of you who continue to reply, I continue to weigh the costs and benefits of this decision.

I am caught in a cycle I had hoped to never find myself in again. It looks like buprenorphine is the best way out...and taking one med that actually alleviates nearly all of my symptoms, as opposed to four that simply make life bearable, sounds like a good deal. Stigma be damned.

I'll continue to keep this thread up to date. I'm certain I'm not the only one will encounter this dilemma.

Thanks again!


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PostPosted: Mon Feb 15, 2016 11:34 am 
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SS6- thanks for giving us an update, sincerely. So many times people will join the forum, post once with problems/questions, and then we give advice/input, and the majority of the time it seems we are left wondering what the outcome was. Our advice is free, the people that reply on this forum have a true interest in the well being of the others that are posting. It's just nice to have a back and forth, and not be left wondering if someone is okay. It sounds like you have put a lot of time, effort, and thought into this decision. I wish you the best, and please continue to update here and ask questions if you need to.


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PostPosted: Tue Feb 16, 2016 3:07 pm 
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simplescience6 wrote:
Razor and Michelle,

Thank you so much for your replies! I've been struggling with this decision for a few months now. The addiction therapist I've been seeing is pushing hard in favor of buprenorphine. She believes it will dramatically improve my quality of life. This is not a decision I take lightly, and I'm soliciting as many opinions and as much information as possible prior to making it.

I appreciate your help!

Hi,my name is shaun, and im new here. Im apart of addictionsurvivors.org but like this forum better.... Anyway ive been on subs 10yrs and only had 2 doctors. A couple years ago i jumped from 16mgs aday and made it 30 days, the paws just were too much i said 1 of 2 things are gonna happen, either ima attempt suicide or go back on subs...and if im writing this i think u guys know the route i went..so id say yessss go back on im glad i did


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PostPosted: Wed Feb 17, 2016 6:27 pm 
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Thank you clm. I still haven't made the decision. I'm so conflicted. This is something I want to do, something I believe will help. However, I remember the hell I put my family through those 7 years ago when I came off buprenorphine. If they knew I'm considering going back to it, they would be extremely angry, I really don't know what the extent of their reaction would be. My addiction therapist is pushing hard for me to go back on it, saying my family need not know of this decision.

clm, having been on bupe for over 10 years now, can you tell me if you feel you have experienced any long term side effects?

Thank you again to all who have responded.


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PostPosted: Fri Feb 19, 2016 10:33 pm 
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I posted my issue in another forum, wherein kratom was suggested as a maintenance drug in lieu of buprenorphine. Any thoughts?


Last edited by simplescience6 on Sat Feb 20, 2016 3:51 am, edited 1 time in total.

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PostPosted: Sat Feb 20, 2016 12:13 am 
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The things that I've heard about Kratom suggest that taking it wouldn't be much different than taking bupe. You would be just as dependent on it as on bupe. Some people may like the fact that it is "natural" but I don't see much of a difference.

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PostPosted: Sat Feb 20, 2016 12:18 am 
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Hey SS6,

There are quite a few posts on this site re: kratom. I do not have any personal experience except to say although many claim its not addictive, my rehab roommate was there for it as the family noticed behavior swings from peppy to ugly, found huge cash withdrawals occurred over time sapping finances plus a huge credit card bill of $100K. They did an intervention and insisted on rehab. I have not yet seen where any doc or addiction specialist is in favor of it and in fact describe adverse opinions, especially as a maintenance option. Type kratom in the search function at top of this page and you will find many comments that will be of interest. More folks will soon come along and can better help you.

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PostPosted: Sat Feb 20, 2016 1:48 pm 
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I have zero experience with kratom but I've read many stories from ppl who were addicted to it spending lots of money on it just like u would if u were using. If I personally had a choice between that or sub, I'd definitely choose sub.

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PostPosted: Sun Feb 21, 2016 2:28 pm 
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I always get a little irritated when people suggest that bupe has some long-term side effect, that may not be present in another opioid. Buprenorphine is much more potent than other opioids-- and potency implies less action at other receptors (aka side effects), because it takes such a low dose to activate mu receptors. Understand this principle for ALL drugs--- the more POTENT drugs will have fewer 'side effects' We see it with dopamine blockers, with SSRIs, and with non-psych meds.

The writer describes problems from buprenorphine. But I assume the writer was on non-bupe opioids for some time before taking buprenorphine. You seem to imply that THOSE opioids-- heroin, oxy, and whatever other garbage was mixed in with what you were using-- played no role in the trouble you had when you finally detoxed. We are just talking about mu receptor effects (and yes, other reversible effects at kappa and delta opioid sites). When you stop activating your mu receptors, you feel sick. When you activate them, you feel better. This discussion really is about whether you need to activate them forever, and if you do, what you should use. I don't want to mislead people into thinking that buprenorphine does something that other mu binding agents does NOT do. The only difference is that when the author of this thread was stuck on opioids, he/she was able to get stabilized, and eventually taper, using buprenorphine.

With these things in mind..... Heroin?! Kratom?! All the crap that comes with THOSE drugs... heroin frequently cut with cocaine, fentanyl, adderall, or a variety of other drugs -- pretty much anything that can be crushed with a hammer! You trust THAT, but worry about buprenorphine?!

And Kratom gets here from Thailand, laying in a hidden compartment of a ship or shipping container, covered with mold and rat piss.... and who knows what else. I had a friend from Boston a few years ago whose husband used Kratom for 'pain', to avoid oxycodone.... he paid over 20 grand per year for it. One morning he developed grand mal seizures in front of his kids, and after damage to his brain, heart, liver, and kidneys, all the hospital could discover was that he has some unknown compound in his system that showed up on mass spect, but was never fully identified. Someone dumped something in the Kratom, or dumped the Kratom in something-- maybe someone who thought it funny to f.. with American addicts, or just a sociopath having fun.

If you need mu receptor stimulation, do it with something that you can afford, that is safe, that you can control, that won't simply push your tolerance to the moon. I only know one drug that is readily available, with those properties.

Should you go back on it, or should you enjoy being 'opioid free'? Well, from the sound of it, you are NOT being opioid free, so that issue is not on the bargaining table. I guess you could argue whether to give up the DREAM of being opioid free... but realize that the same dream is part of the daily life of most active addicts. If I heard this story and was asked to be your doctor, I would probably turn you down, just because it is draining working with someone who has the belief or attitude that I'm harming them in some way. I would much rather take out of 3-5 people who call each day begging for help, because after being a doc for 30 years, it is the most-rewarding when working with patients who are grateful for the role I play in their lives. I have to admit.... when I have a patient who comes in to every visit complaining that my treatment is 'trapping' them, I find myself looking forward to them moving on. If that sounds unreasonable, think about your own job---- would you rather work for the person who really likes your work? Or for the person who constantly tells you that you are expendable, and they wished they had never met you?

My personal recommendation for you depends on safety. If you are at risk of death or incarceration (like most addicts), then go on buprenorphine. If you really believe you aren't at risk for those things (and your belief is accurate), then don't take buprenorphine. There are people out there who need your spot more than you do.


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PostPosted: Mon Feb 22, 2016 4:19 am 
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admin1 wrote:
I always get a little irritated when people suggest that bupe has some long-term side effect, that may not be present in another opioid. Buprenorphine is much more potent than other opioids-- and potency implies less action at other receptors (aka side effects), because it takes such a low dose to activate mu receptors. Understand this principle for ALL drugs--- the more POTENT drugs will have fewer 'side effects' We see it with dopamine blockers, with SSRIs, and with non-psych meds.

The writer describes problems from buprenorphine. But I assume the writer was on non-bupe opioids for some time before taking buprenorphine. You seem to imply that THOSE opioids-- heroin, oxy, and whatever other garbage was mixed in with what you were using-- played no role in the trouble you had when you finally detoxed. We are just talking about mu receptor effects (and yes, other reversible effects at kappa and delta opioid sites). When you stop activating your mu receptors, you feel sick. When you activate them, you feel better. This discussion really is about whether you need to activate them forever, and if you do, what you should use. I don't want to mislead people into thinking that buprenorphine does something that other mu binding agents does NOT do. The only difference is that when the author of this thread was stuck on opioids, he/she was able to get stabilized, and eventually taper, using buprenorphine.

With these things in mind..... Heroin?! Kratom?! All the crap that comes with THOSE drugs... heroin frequently cut with cocaine, fentanyl, adderall, or a variety of other drugs -- pretty much anything that can be crushed with a hammer! You trust THAT, but worry about buprenorphine?!

And Kratom gets here from Thailand, laying in a hidden compartment of a ship or shipping container, covered with mold and rat piss.... and who knows what else. I had a friend from Boston a few years ago whose husband used Kratom for 'pain', to avoid oxycodone.... he paid over 20 grand per year for it. One morning he developed grand mal seizures in front of his kids, and after damage to his brain, heart, liver, and kidneys, all the hospital could discover was that he has some unknown compound in his system that showed up on mass spect, but was never fully identified. Someone dumped something in the Kratom, or dumped the Kratom in something-- maybe someone who thought it funny to f.. with American addicts, or just a sociopath having fun.

If you need mu receptor stimulation, do it with something that you can afford, that is safe, that you can control, that won't simply push your tolerance to the moon. I only know one drug that is readily available, with those properties.

Should you go back on it, or should you enjoy being 'opioid free'? Well, from the sound of it, you are NOT being opioid free, so that issue is not on the bargaining table. I guess you could argue whether to give up the DREAM of being opioid free... but realize that the same dream is part of the daily life of most active addicts. If I heard this story and was asked to be your doctor, I would probably turn you down, just because it is draining working with someone who has the belief or attitude that I'm harming them in some way. I would much rather take out of 3-5 people who call each day begging for help, because after being a doc for 30 years, it is the most-rewarding when working with patients who are grateful for the role I play in their lives. I have to admit.... when I have a patient who comes in to every visit complaining that my treatment is 'trapping' them, I find myself looking forward to them moving on. If that sounds unreasonable, think about your own job---- would you rather work for the person who really likes your work? Or for the person who constantly tells you that you are expendable, and they wished they had never met you?

My personal recommendation for you depends on safety. If you are at risk of death or incarceration (like most addicts), then go on buprenorphine. If you really believe you aren't at risk for those things (and your belief is accurate), then don't take buprenorphine. There are people out there who need your spot more than you do.


That was quite a visceral reaction. Dealing with what often amounts to life or death situations with your patients, I can understand the passion. I came on here to solicit opinions, thank you for taking the time to provide yours.

I'd like to make one thing clear, I never intended to irritate, argue or blame anyone or any med of anything. Nowhere in my original post did I blame buprenorphine for the troubles I've encountered since ceasing buprenorphine therapy. The medication did help stabilize my life, allow me to finish graduate school, and pass a licensing exam. The fact is the withdrawals were excruciating and lasted a considerable time. No need to assume I used non-buprenorphine opioids prior starting buprenorphine therapy, as I mentioned in the first line of my post, I had a problem with heroin. I used for approximately 8 months prior to making the decision to seek professional help. I then took buprenorphine for approximately 2.5 years. This process began 11 years ago, the prescribing physician remains my doctor to this day. I can assure you he has never felt as though I have blamed him for anything, and I have remained remarkably grateful for everything he has done for me. I recommend him whenever possible.

I spent six "opioid free" years after ceasing buprenorphine. In that time I felt a constant fierce and growing depression, and thought often of going back on the medication. This is the issue I came here to discuss. Is a lifetime of buprenorphine maintenance a viable option? Is there anyone out there with a situation similar to mine (having ceased buprenorphine for a considerable time, but still struggling with a dark and worsening treatment resistant depression) who has made that decision, and how has it treated them? My depression and disease is such that I thought, absurdly, that a little heroin every once in a while might help. I now have 6 weeks sober and I'm in an evening outpatient program. I believe I can live opioid free. My question is, given the low quality of life I've experienced in the past several years, while sober, would buprenorphine be beneficial, or would it eventually worsen my situation and require yet another painful withdrawal period. I realize no one can answer that question for me, however, I'd like to hear opinions and relevant personal experiences so I can use our collective knowledge in weighing this decision. Many of the posts in response to my thread have been helpful.

I do not "trust heroin." I do not feel that a life of heroin maintenance is in any way preferable to a life on buprenorphine. I don't see how you could have interpreted that from any of my posts. My heroin use was at all times foolish and dangerous.

As for the kratom post...I was in no way promoting the substance. I knew very little about it. An individual in another forum suggested it to me, in the interest of keeping this thread updated with my thoughts on my predicament I figured I would mention it. A member by the handle Pelican suggested I run a search on the word within this forum. I did so, prior to your response, and came across an article you wrote in 2009 regarding the substance. In it you detail the same instance (I assume it's the same instance) wherein a man suffered a seizure and damaged multiple organs due to kratom use. I continued to research, and while I found many posts and articles supporting the plant, due to the uncontrolled nature of its cultivation and distribution, and the small amount of clinical research, its use appears unwise and/or dangerous.

Thank you again to everyone who has taken the time to respond to this thread!


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PostPosted: Mon Feb 22, 2016 1:17 pm 
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Hey SS6,

I am new here, but even so, I've read enough forum posts where overtly or subtly, folks blame bupe both on and off it, for causing physical and mood issues and as a reader I often cannot understand their real POV until more info is offered. Until that happens, I do appreciate passionate responses and am grateful to hear and read them.

SS6, I really appreciate your above well written passionate post as well because it fills in blanks - most importantly that post bupe, you are not saying it causes your "low quality life". Instead you are saying that you have a "low quality life" post bup and asking if restarting it, perhaps for the long term, is a good idea to help improve your life? You were recently dabbling in H plus w mentioning Kratom - - my fear radar lit up up concerned that you are not aware of how close IMHO, you are to active addiction.

Perhaps search the author field for kaitpo or lilyval and read their posts on mood and long-term bupe. Also
Tomhunter suboxone-for-clinical-depression-day-t11981.html He later stopped bupe but there is still interesting info in the thread. And Roxanne new-here-but-not-new-suboxone-t12356.html. Be sure to read as good info contained w in. Maybe search clinical depression in the search field and more posters names will appear. Hopefully they will come along and offer thoughts. Oh, and reread Tee Jays post in this thread, especially the last paragraph.

Perhaps long-term bupe is best for you but if not, and down the line you choose to stop, you've already jumped at 2mg which you know is etched in your mind. so that's a no-go jump dose for you - very tough. But also know as Rule62 said, its very possible to stop bupe, especially w a long slooooooowwwwwwww taper. Lots of successful taper threads here. (I'm a few yrs off bupe and doing well. I stopped at 4 mg but only bc I did not know any better then, did pretty well but do not advise).

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PostPosted: Mon Feb 22, 2016 5:40 pm 
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Joined: Thu Dec 13, 2012 5:04 pm
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HI SS,

I Too was able to taper off subs a few years ago and I was sub-free for 1 year. However by the end of that year , I too felt very depressed. I was on an anti depressant at the time. But i was still missing something . A void only Subs could fill.

I ended up going back on Subs and I combine it with Viibryd (SSRI) The combo of the two medications really have helped me tremendously.

It helped my depression and cravings for opiates, which i dont' think every truly went away.

Maybe consider an Anti Depressant and a VERY Low dose of Subs as maintenance and see how you feel after that.
Keep a Daily journal of how you feel day in day out on the meds. I have been journaling almost everyday since I got back on Subs and it helps me reflect back on day 1 and how far I have come.

It has been a life changer for me.


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

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

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