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PostPosted: Thu May 24, 2012 4:05 pm 
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Hi, my name is Bunny. I was on Sub from 2009 to 2011. It kept me off the opioids, but I started abusing Valium and other benzos. I got caught writing fake prescriptions in November 2011 and have been in jail since then. I detoxed (cold turkey) off of the Suboxone in jail. It was rough, but not nearly as bad as a full agonist would have been.
I got released Sunday, and am currently drug-free. I have a script (legal, LOL!) for Sub strips, and I'm really craving drugs bad....so I'm thinking about going back on it. My question is, has anyone else gone on Subs without currently being on opioids of any kind? I'm going to NA meetings too, and am addressing my entire addiction that way. I just think the Subs might help the cravings. Any advice would be appreciated!


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PostPosted: Thu May 24, 2012 4:39 pm 
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Hello B,

If I am reading this right you are off opiates AND benzos for some time now. The physical part is gone, but not the desire to use something. We do get used to popping something for immediate gratification, no matter how stupid. I know.

But now you have done the hard part and are going to NA. And I guess you are asking if Subs might be in a category where you could just do some of them and it is not "real". Ask someone at NA. Think about it ---it is "Real" -- not just pretend drugs that at "okay".

Yes I do know someone who used Subs just to get high, not being anything else. It was a flop and she got nothing but a sub habit. Subs just are not for getting high.

You have a real opportunity here, finally being free of two nasty classes of drugs you never want to do again. You show that by going to NA and having the right attitude. So do not fool yourself and look for a cheat method. It does not work.

Who was dumb enough to give you a Rx for the current situation? Keep talking about it at NA, Good luck, you have a real good shot at life now.

S


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PostPosted: Thu May 24, 2012 5:22 pm 
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Hi bunnyman,

It looks like scruffy is accusing you of trying to get high, I don't believe that's your aim. If I am right, I want to re-phrase what scruffy is saying without all the passion: If you go on suboxone, also an opioid (that doesn't produce a high) you will eventually have to withdrawal if you come off of it (not a walk in the park but also is doable if you take it very slow). You may have some side effects from it. You will become physically addicted to it.

BUT

If you think you are gonna use otherwise, and you understand the above, and you think NA isn't gonna work to keep you clean. Than you could try it. Others have done as you are considering. It is not unheard of. You will not need a high dose to induct, it may make you sick depending on how long you have been opiate free.

I suggest checking out an AA meeting as well as NA on a side note. I like it.

I hope that is helpful.
Do what you need for YOU, to stay clean. suboxone is clean IMO if you are taking as prescribed.

Best, gb


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PostPosted: Thu May 24, 2012 5:24 pm 
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A good friend of mine from NA started on Suboxone, even though he wasn't currently shooting dope anymore. He would go through periods of being clean (1 -2 months), then back to the shooting gallery, back to being clean, back to shooting, etc.

During one of his clean periods, he decided to give Suboxone a shot and he's been on Suboxone for about 8 months now, he's only slipped once.

Anyway, yes you can go back on Suboxone, even if you're not currently using. If your cravings are that bad and you fear a relapse is imminent, then Suboxone will help you. You could start at a low dose and go from there.

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PostPosted: Thu May 24, 2012 5:36 pm 
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Hello Bunny.

My take:

Buprenorphine/Suboxone is a medication that is most affective for long term use. Albeit a life time. Research shows that once the medication is discontinued the majority of patients relapse. Now, I do not mean to sound like a jerk or unthoughtful to those that have NA centered ideologies, but wishful thinking is the bane of the addict.

Addiction is a very real condition like any other that in most cases require medical intervention. For me, the hard part does not stop with the alleviation of withdraws. What many fail to recognize is that when a person has been abusing opioids for an extended period of time then discontinues them for whatever reason, there is the onset of what is called dysphoria. it's symptoms range from a person being regularly sad, to fits of anger. And it is lasting. For me, it was and still is the primary cause of relapse. It is the true hard part that spurred me back into illicit drug use. Everyone one of us knows about withdrawals, but not as many have learned to name the monster that wrecks havoc in those trying to stay clean. Buprenorphine/Suboxone is designed to manage a chronic condition that does not, for all intents and purposes, get better with time. Yes, things change, mentality and outlook improve. But the underlining problem rests in the magnitude of the dysphoric addict who can never quite reach that state of well being.

Remember when you were a child? Everything was so simple, blissful and uncompromising. the healthy adult mind can have a similar experience, but we are sick. That is why this medicine is so helpful. It offers use a chance to have joy. Who cares whether you are clean if you feel as if you are on the precipice of despair all your waking moments, at least that is how I feel. Along with many other former addicts who did not, or still not have this med to assist them to live. As you can tell I approach the subject from a sort of philosophical aspect as well as a clinical.

But the choice is up to you! Do what you feel is in your own best interest. No dependance is better than even just one dependance. So if not taking it is what you feel is the best, I encourage that.


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PostPosted: Thu May 24, 2012 5:46 pm 
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Hey entropy that was great, post more often! :)

That dysphoria you mentioned is also known as "restless, irritable and discontent" and you're right, if we don't do something to combat it we will surely be using (or frickin' miserable).

Gb


Last edited by glen bee on Thu May 24, 2012 5:48 pm, edited 1 time in total.

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PostPosted: Thu May 24, 2012 5:47 pm 
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Glen, we have to read what he is saying. He is going to NA and says he wants to go that route. Why tell him to check it out.?

He is asking if re-starting subs (he knows what they are) will help the psychological cravings when the physical part is gone.

I must say----here he is dealing with psychological cravings and that is not the time to use any drug. That never works, or is

a very last resort. All physical addiction is now gone. The way to work on the other parts are indeed NA and other places like

that. If we had a wonder drug for psychological cravings that would be great -- we do not.

Bup covers the physical part (with no high) - and that is what it is for.

Psychological is not physical.

The folks at NA are not always right, but here they would say going to Subs when all clean in indeed "dirty".

S


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PostPosted: Thu May 24, 2012 6:01 pm 
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This is for Scruffy,

Suboxone helps me with both types of cravings. I also use a 12 step program's suggestions to help keep free from drugs and alcohol. From talking to you on the forum, it is clear that you are on suboxone and wish you weren't. What you fail to realize is that if you go off it and get the through the withdrawal you still have to stay clean. Read entropy's post. it says it beautifully. W/D truly is the easy part. If you can go to NA or AA and stay clean and not be a wreck, that's great but believe me, it doesn't happen for everyone.

I will further say that sub not only took away my cravings both physical and psychological. Shit, it helps with my depression as well. I have never been on anti-depressants but since being on sub, I don't feel it anymore. Maybe because I don't drink or drug but I believe it's the sub. I am tapering off sub and that's the thing that scares me about after I am off.

What you don't see when you are so upset about being "tricked" into being put on sub is that you are staying clean. it's a blessing to me. I embrace it.

gb


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 Post subject: Thanks everyone
PostPosted: Thu May 24, 2012 8:54 pm 
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Wow, I did not wish to start an argument. I see both perspectives, and I am going to talk to my psychologist about it. I will also talk with the Sub doc, as I have an appointment next Thursday. Hmmmm..... I do have to take an honest look at my motives. I am not trying to get high and recognize that the "feeling" from Subs goes away after a very short time. And the other angle is that it makes me gain weight. I will keep it on the back burner for now, and see how NA goes.

Bunny


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PostPosted: Thu May 24, 2012 10:19 pm 
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The point is Subs are supposed to be a "tool". For some people they are a tool to get through the terrible W/D of a full agonist. With that wonderful tool they are able to be free of the full agonist that they may or may not need. Some may be born to need it=--- others from a bad script for pain over time. But the body does heal over time if it can.

The second type of person needs subs forever. If they do not take them they probably will take something worse.

It is critical to know who is who before recommending action. Usually subs are the easy recommendation because someone is on a full agonist and may be in real trouble -- physical or legal.

The problem is when someone is a non user. "Clean" as it is sometimes called. If indeed they can (as many many can) get back to health without an opiate, they should.

Thus, is Sub a tool and a tactic, or a medicine for life? Most of the time it is a substitute for a full agonist , and later determined if it is needed for life.

But to suggest that someone taking nothing start on Subs has problems. It assumes you know what they need.
They clearly were developed and adapted to be a tool for the physical aspects of W/D off full agonists. To make the leap that they will solve all psychological problems is a leap without enough information.

It seems obvious that someone should start with trying to see if life without drugs is not best. If that is indeed not possible--after trying proven methods ----- then subs are always there ------ as a last resort. Not as a first thing.

As far as I know doctors are not allowed to prescribe Subs unless the patient is currently taking a full agonist. The formulation of Burpinorphine for mild pain came out in the late 80's and has been discontinued. It is not seen as a good choice for pain reduction--which is why "Sub doctors" are the only ones prescribing it.

The choice to take Subs for life involves always having a doctor, fairly high costs, and a number of other problems - which, all considered is a life saver for some. That is fine. But that decision is finally arrived at, and never the first choice.

S


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PostPosted: Thu May 24, 2012 11:33 pm 
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Hey bunnyman, that sounds like a good plan. Oh and Scruffy and I arent arguing, we're sharing ideas :)

Scruffy I hear ya. I agree it should be a last resort, You're right about that. Also btw, any doctor can prescribe buprenorphine for pain. There is a member of this board who gets theirs from their doctor for pain. They only need the special data 2000 waiver for addiction prescribing.

Peace!

Gb


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PostPosted: Fri May 25, 2012 3:11 pm 
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This is getting into much detail - but have you ever tried to get a regular (non bup cert.) M.D. to prescribe Bup for pain?

It is not in the mainstream of pain meds and back when that was the main purpose the dose was .2 mg.----
Two tenths of one mg. Not available now.

Most drs. just say "What?" -- and will refuse to prescribe it off-label because they do not have one of the little
certificates that allows them to prescribe - and have not taken the 8 hour web course. The "8 hour wonders" of course
range from the best to the worst.

And most of them feel safe using Suboxone even if the patient is having symptoms indicating Buprinorphine would be the appropriate thing. Naloxone is probably awful for more than the official 15%-- the feel bad drug of the century.

Naloxone is only there to prevent abuse, but in my opinion most true street addicts who try to get Bup are trying to get off drugs -- it would hardly be their DOC.

Anyway----good luck B--you are talking to some of the right people, hope it goes well. I wish I was at the decision point you are now -- I would consider it a gift of great value.

S


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 Post subject: Thoughts for bunnyman
PostPosted: Sat May 26, 2012 2:51 am 
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Hey bunnyman,

My thoughts FWIW ...

Do what you have to do to stay off full agonist opiates. If that means using sub, then it’s worth it. If participating in a NA type program helps, great! Some people can’t afford it, but for people who can, I would urge them to consider working with a qualified psychotherapist. My therapist has really helped me to begin understanding the root causes of my addiction and my “triggers” for using. I am now more self-aware, but still have a long way to go and much work to do, however.

One note about psychotherapists that I learned from mine. The majority of therapists only have a masters degree. Think about that for a moment – many of these people have only had two years of formal, dedicated training and education in psychology, and here they are taking patients who trust and rely on them and tinkering with the insides of their heads. So for those who are considering using a psychotherapist, try to find one with a Ph.D. in psychology who has been very active in continuing education and has many years of experience. I am not saying that all M.A. therapists are hacks, but when you’re entrusting your very being and way of thinking about your life to another person, it would seem logical that you’d want the most experienced and educated person you can find (and afford, as Ph.D.s usually charge a bit more by the hour) to do that “tinkering” with your brain.

You know, scruffy may not always be the most articulate writer, but his heart is surely in the right place. Many of us here would envy bunny’s presently clean, no w/d physiology. I simply think that scruffy is saying, “hey, my friend, please think long and hard before starting sub and take the time to really educate yourself about its benefits, drawbacks, limitations, etc., because it too is a hard-core, addictive drug.” And he’s right IMHO. Estimates on the bio-equivalency of bupe and hydrocodone vary, but the estimates run between 25x to 40x more powerful. Put another way, when we take 8mg of suboxone, that’s like taking between 200mg to 320 mg of hydrocodone, or between 20 to 32 pills of 10mg Norco. That’s a ton of opiate in the system. Yes, of course, there’s a huge and critical difference between hydro (full agonist) and sub (only a partial agonist), but that doesn’t change the fact that sub is highly physiologically addictive. I took a grand total of about 80mg of sub over a 20-day period (i.e., an average of only 4mg per day) and became physically addicted. By the start of day 5 of my abstinence from sub (tried to stop all sub use starting on day 21 after my induction), my w/d symptoms were too much to deal with, so now I’m on 1.5mg every other day for the next 10 days, then 1mg for 10 days after that, .5mg for the next 10 days, etc.

I’m no doctor, and must stress that you (bunnyman) need to work with your doctor to develop an abstinence/treatment plan that works for you, but with that said I’d like to suggest an alternative to using sub. Have you thought about using Naltrexone pills? One pill a day costs less than $2/pill and will block the opiate receptors, so if you succumb to your desires and ingest some (or even quite a bit of) full agonist opiates, it will do you no good; you won’t get high because the Naltrexone is a pure opioid antagonist – it will block the opiate from attaching to your opiate receptors. And Naltrexone is not physiologically addictive, a real plus IMO. Together with ongoing psychological treatment and support from friends, family and groups like NA, the daily use of a Naltrexone pill is a potentially effective way of helping an addict develop self-control, because every day you take the pill, that is one more day that you, the addict, are taking at least one affirmative step of saying, “today I will not use.” So it gives the addict a little bit of control over his/her life and addiction and can be very empowering in that respect.

If you think that your willpower is too weak to have the discipline of taking a pill every day, you could try slow-release Vivitrol, which is the injectable form of Naltrexone and should block the opiate receptors for between 2-4 weeks (the estimates I’ve read vary). The major downside to Vivitrol is the cost – anywhere between $900-$1,500 per dose, depending on what your doc will charge. There is also a slow-release subcutaneous form (also pricey I believe), and I’ve read that there can be complications such as lumpiness under the skin and irritation around the injection site.

Entropy wrote:
My take ...
Buprenorphine/Suboxone is a medication that is most affective for long term use. Albeit a life time. Research shows that once the medication is discontinued the majority of patients relapse. ... wishful thinking is the bane of the addict.


Entropy, I surely agree on the last point about wishful thinking. Oh how we addicts can rationalize our behaviors! Can you please cite the actual medical research that demonstrates “that once the [sub] is discontinued the majority of patients relapse”? Also, on what basis (scientific? anecdotal?) did you form the opinion that sub is “a medication that is most affective [sic] for long term use”? Not trying to be a jerk, but I think you are making some very important claims there, and personally, as I continue to struggle with my hydro addiction, I am keenly interested in learning as much as I can about the long-term benefits (and long-term detriments as well) of buprenorphine. I have heard some on this board quote Dr. Junig as saying that the majority of sub patients who use it for less than 3 months relapse, but I don’t recall reading a doctor’s claim that the majority of sub patients who use it long-term (say more than 3 months) relapse. And I guess I’ll add this: I’d tend to discount only one doctor’s word on these claims. I’d like to see the evidence of some real medical research which supports such claims – they are far too important to rely on from only one doctor, especially if that doctor has a long-term sub use bias.

bunny, sincere best wishes as you battle your addictions and try to live a full life free of abused intoxicants!

SI


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PostPosted: Sat May 26, 2012 4:04 am 
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bunnyman,

This web article may be helpful: http://www.thefix.com/content/best-kept ... ent?page=1

SI


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PostPosted: Sat May 26, 2012 7:20 pm 
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Actually the Bupe that is specifically for pain is made in trans dermal patches and sometimes doctors prescribe Suboxone or Subutex for pain depending on the patient. A doctor that is only prescribing it for pain DOES NOT need to complete that 8 hour course or obtain a DEA number like a doctor prescribing it for addiction purposes. ANY doctor can prescribe it for pain. Bupe being prescribed for pain is alot more common then you think, I myself know of 2 people who take it for pain and they say it really works well.

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PostPosted: Sun May 27, 2012 2:07 pm 
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Also many people start on Sub when they arent taking any opiates..many people go on Sub for off label reasons or just because theyre having a hard time coping with cravings and its perfectly legal for doctors to prescribe it for those reasons. I just dont want people to think they dont have Sub as an option because someone posted before me alot of wrong info on doctors prescribing Sub.

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PostPosted: Sun May 27, 2012 2:35 pm 
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Entropy wrote:
That is why this medicine is so helpful. It offers use a chance to have joy. Who cares whether you are clean if you feel as if you are on the precipice of despair all your waking moments, at least that is how I feel.


This is how I feel too Entropy. I would rather be on subs and be happy, than be "clean" and miserable, in physical pain, and depressed.

TGFS!


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PostPosted: Sun May 27, 2012 2:38 pm 
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scruffy wrote:
If we had a wonder drug for psychological cravings that would be great -- we do not.

Bup covers the physical part (with no high) - and that is what it is for.

Psychological is not physical.


Bup covers the physical AND psychological cravings for me, and for many others as well. Does it not cover your psychological cravings scruffy? I believe that is partly what it is for.


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PostPosted: Sun May 27, 2012 4:24 pm 
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Since you ask me the question I will tell you my understanding. The licensing to prescribe subs is to treat addiction of some sort. It initially was to be a substitute for a full agonist for the time during full withdrawal -- to get one through the hard part. This was also the promise of Methadone, before ti became a for profit dispensory after creating a new class of addicts.
(although it works on pain for some)

If I went to a doctor with feelings of wanting to feel better, depression , etc. and did not have opiates in my system --
I believe prescribing Subs then is malpractice, or at least against the guidelines doctors designated to prescribe are given . Suboxone itself is a powerful opiate and is not to be used for psychological feelings or problems - apart from opiate addiction and dependence.

But I am not a doctor, and if one could write in, or perhaps a quote from a doctor, on how they use Suboxone for some other purpose -- some off-label use, that would be interesting.


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PostPosted: Sun May 27, 2012 5:02 pm 
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I just posted a response to Taurus on this thread by bunnyman. I think it was too much of a detail and just clutters the thread of bunnyman -- in other words, it should relate to his question and why he started this thread.

Taurus asks if I do not get some psychological help from Subs. And the answer, in light of this thread, is no, not at all.
At induction I did not know enough, and more importantly, did not have enough power to dictate how treatment would go. I had a hint I was the type "A" from the induction thread - I wanted to use subs for the several weeks of W/D from Oxy that I could not, and cannot, stand. I wanted a detox for twenty some days and then a quick taper.

This would have been best for me. I am find off opiates. The dependence came during treatment for pain, and if it were not for the W/D aspects I would have no need for them. Not that I am a model of mental health- just that other drugs - perhaps an anti-depresssant, and other types of therapy with no opiates work best -- for me.

Now I have the new W/D from Subs, which feel when I try tapering, for all the world just like the W/D from Oxy. I only stay on them for fear of W/D - and have no idea if I will be able to eliminate them. Like I have heard before on line -- I don't know if I have another W/D in me. It is too much.

Therefore-- when I read that anyone with no opiates of any kind in their system is thinking of starting subs (or any opiate)
I have to say - consider this really hard. If you are not using Subs during the two or three weeks of intolerable W/D and you want them to help with "X"--- are there really no other options? I think there usually are. And the notion of
"last resort" comes to mind rather than "first option".

I think people prescribing Subs would agree. An excellent diagnosis leads to excellent treatment. And, in the thread on induction A-B-C these letters are a diagnosis, which lead to a specific treatment. To ignore this lead to many bad problems.

I would love to be at that point again where Subs were just starting. Knowing what I know now, it would have been three weeks and done. But this option only comes once.

It usually only comes once. Except, what if hypothetically, I were falsly thrown in jail for over a year. After going through hell and just barely making it I got out. Then, I post a question on line --- I am not feeling all that great. I remember the drugs from the past. Should I start subs now?

This is of course for me now. If I posted. I would hope the answer would be --- don't - find help and answers in all things other than drugs - no matter what drug. It is what I would hope to hear. But that is just me- I know what category I am in.

S


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