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PostPosted: Sun Aug 19, 2012 2:21 am 
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I was working the 12 steps with my sponsor until it came up that I took subutex.Now she wont sponsor me until I get off subutex.I,being an RN,explained to her that subutex is not a mood or mind altering substance for those who take it for the purpose of treatment for opiod addiction.I explained how it simply fills up half the opiate receptor so that cravings are reduced and that it blocks any euphoria if one were to take an opiate thus removing the motivation to relapse.Further, I expressed to her that in the future I will need to return to nursing as a profession and that I view the use of subutex as an insurance policy preventing me from the very real temptation to relapse on opiates during a weak moment.She had no interest in becoming educated regarding subutex or suboxone though, so either I taper off it or get a new sponsor.I would like to try to taper off subutex anyway,but I do not subscribe to her belief that I am not clean if I am taking it or that my sobriety date is not valid.I know I cant change her perspective and I respect her right to her opinion but I am dissapointed to lose a good sponsor.Guess I'll just try to find a sponsor who will work with me.Thanks, I guess I just needed to vent but I'd also like some feedback from anyone who wants to comment.


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PostPosted: Sun Aug 19, 2012 2:45 am 
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I'm sorry that happened to you, that sucks. I think it's pretty close-minded of her to not even hear you out. It's not uncommon though for Sub patients to run into this attitude in NA.

Sounds like you have a pretty good attitude about it though. The idea that we can't begin to recover from addiction until we are totally off all drugs just doesn't fly with me. In my opinion, there is TONS of work that we can do toward our recovery while we are on Sub and a lot of it will come in handy during the tapering and withdrawal process and of course after that's done as well. Don't let her opinion that you're "not really clean" hold you back.

I've heard that AA is somewhat more accepting of Sub patients than NA but I don't have any personal experience with that. I did SMART recovery and found their recovery tools to be really helpful. It's more science-based than the 12 step recovery programs and uses a lot of cognative-behavioral techniques to help deal with addiction, negative thought patterns, cravings, etc. Their website is full of information and they have online and in-person meetings. Check it out - at the very least it can be a useful compliment to the 12 steps.

Good luck finding another sponsor, I hope you find one who is really right for you.

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PostPosted: Sun Aug 19, 2012 4:49 am 
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It sucks, but also doesn't surprise me.

I used to do a lot of NA. Most sponsors where I'm from (a city in Australia) were willing to work the steps with sponsees on "drug replacement" ... as long as they were willing to start over and begin from scratch once they got off Suboxone. And I can see why they'd wanna do that. I've gone off Suboxone a couple of times in the past, and both times I felt like I had changed as a person enough to merit restarting the steps. Also my memory of things I'd learned on Suboxone was a bit hazy. While a lot of the growth and maturation I'd had on Suboxone was still there, it also felt a bit distant?

However if you've chosen to stay on Suboxone, I wouldn't suggest NA. The 12-steps is a total abstinence program, and that includes methadone and Suboxone. In NA's eyes, the 12-steps is the only treatment you need to stay clean. I don't see them changing their point of view anytime soon. They're much more tolerant of people on methadone and Suboxone these days, as long as the goal is to achieve "total abstinence" from drugs. ie where I'm from it's a bit frowned to ID as "on drug-replacement", but ID'ing as "reducing off drug-replacement" is okay. If reducing is not your goal, then I'd suggest finding a different program.

If it is your goal, then maybe ask your sponsor if you're allowed to work the steps while on Sub as long as you restart them when you get off Sub.

Also, most sponsors I know where I'm from have been on methadone or Subutex/Suboxone themselves, so they're pretty clued up as to what methadone and Sub are and their effects.


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PostPosted: Sun Aug 19, 2012 4:41 pm 
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Find another sponsor. Try not to waste your energy being resentful or too disappointed.

I got a lot out of AA, but I also learned that there are plenty of people who seem to have figured out exactly how everyone else should conduct their business. Maybe it makes people feel better to believe there are a clear cut set of rules that everyone should follow. The only important thing is that you don't let it cause you to question yourself. Many people have to take medication....there are people in NA who absolutely have to take pain medication for serious medical problems. We all just have to do the best we can and stay real with ourselves. If you were slamming your Sub or taking mega doses to try to get a buzz, I think a good sponsor would speak up. You know in your own heart that you are using it properly and that it is what you need to do to stay on track. Unfortunately, you may run into this again, and you just have to find someone who is willing to listen and understand. When I was in AA, most people were very accepting. I did have a couple people let me know I wasn't sober enough in their books because I used to take antibuse, which basically makes you get sick if you drink alcohol. I needed to take it, bottom line. I was still sober. It really didn't matter what they thought. A good sponsor will back you up.

Good luck.

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PostPosted: Sat Aug 25, 2012 9:58 pm 
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I actually had someone tell me that their sponsor wouldn't work the stps with them because they were on naltrexone. Naltrexone! (i guess thats the same as being told you're not sober on antabuse). Some people just don't have a clue and don't want to get one. In my 12 step experience most people have been more open minded. But some people advise just keeping your medication status between you and your doctor.


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PostPosted: Sun Aug 26, 2012 6:41 am 
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I personally don't care for AA or NA, because of my own personal experience with it. It did help me for the two years that I did go, but once the true colors of the groups were revealed, I couldn't ge taway fast enough.

My advice to you....Like Lilyval said, keep it between your doctor and you. Noone there needs to know that you are on suboxone. That is noones business but your own. It always amazes me at how these women treat other women in recovery. Who are they to tell you that you are not ready to work a program or whatever.....nice job working the 12th step there ladies!

Anyway, if you feel that you just have to tell them, then so be it. You may have to find another sponsor that is willing to "accept" that you are on sub.

I think that you are doing a great job working a program, and I admire you for not hitting the door running. Keep up the good work!

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PostPosted: Wed May 13, 2015 7:21 am 
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hi, I continually sponsor one or two ladies from AA and have been clean and sober for 23 years. My drug of choice was not an opiate, so I only speak from the literature and observation of other addicts. I find the chapter "Doctor, Alcoholic, Addict" helpful in the Big Book. Personally, I am willing to work the steps with anyone who is seriously interested and keeps coming back. But I am currently working with a sponsee on methadone maintenance, who is very dedicated, meets me almost every day, is trying to work the steps, and is going to meetings - and she has had several relapses in the last month while still on methadone. For me, it is hard to imagine being able to get clean while still using a substance which (in her case) is still obviously mind- and mood-altering. My wish and dream for her is that eventually she will be able to detox / taper from the juice and or suboxone and experience life without that cloud of opiates in order to really take stock and move forward. I am afraid that methadone is killing her. 2 emergency room admits in the last month.


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PostPosted: Wed May 13, 2015 9:40 pm 
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I don't know that methadone and suboxone can be compared because there are some pretty significant differences in the effects of each medication. After I was induced on suboxone, the obsession to use my drug of choice was gone the same day. The next day I realized that I hadn't been obsessing about my doc, when I was going to use next, counting my pills. All the behaviors that were a part of my active addiction were gone.

I don't know how it feels to be on methadone, but to me being on sub makes me feel what "normal" used to feel like. I don't know if the fact that sub is a partial agonist rather than a full agonist like methadone makes a difference, or whether it's the ceiling limit of sub that doesn't let you get high unless you're trying.*

*Someone who is trying to get some kind of high from sub has to wait a few days until the sub they've already taken has worn off. And this doesn't work for everyone anyway. Also, no one on this forum is naive. We all know that if you're not ready to work hard on recovery there are ways to shoot sub and abuse it in other ways. But for those of us on sub who are ready to do the work, there is no reason we should or would be relapsing.

Amy

P.S. Thank you for all that you do to help people in recovery from their addictions. :)

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PostPosted: Fri Oct 30, 2015 9:43 pm 
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Amy-Work In Progress wrote:
I don't know how it feels to be on methadone, but to me being on sub makes me feel what "normal" used to feel like. I don't know if the fact that sub is a partial agonist rather than a full agonist like methadone makes a difference, or whether it's the ceiling limit of sub that doesn't let you get high unless you're trying.


In my experience the main difference between methadone and Suboxone is that it's easier to use other opiates while on methadone. Where I'm from, the general consensus by those on ORT is that methadone is the choice of those who still want to use. It's incredibly common to see addicts scoring heroin on the street who are on a low-dose of methadone, just enough to tie them over between hits. Higher doses of methadone (ie over 90mg) start to block up your mu-receptors and make it more difficult to get an effect from other agonists.

In terms of effect, once you're stable on a dose of methadone, it has very little if any "stoning" effect. However I felt more side-effects (ie sweating, aches), and it also didn't "hold me" as well over 24 hours. When I was on methadone I'd always go pick-up my dose first thing in the morning. Whereas on Suboxone I can dose any time throughout the day without problem.

IMO Suboxone and methadone aren't as different as some people think. Once you're stable on either medication, they both have little effect. But all in all, Suboxone feels more "transparent", and closer to being "clean" than methadone. Methadone felt heavier, and more taxing in terms of side-effects.


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PostPosted: Fri Oct 30, 2015 11:35 pm 
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I agree with Teejay regarding the similarity in medications. They both satiate cravings to some extent, and both have long half-lives that result in stable opioid effects. There are two primary differences between them; buprenorphine has an antagonist effect that is not present with methadone, blocking agonists and reducing the risk of opioid overdose. Methadone, on the other hand, reduces overdose risk by increasing opioid tolerance--- without the blocking effect at mu receptors.

The other difference is that as an agonist, methadone will have some difference between opioid effects at the 'peak' and 'trough' blood levels... whereas the ceiling effect of buprenorphine results in a very level opioid effect across the dosing interval.

I don't see one as 'better' than the other. Methadone programs in my area are totally covered by medicaid, making them the best value for those patients.... but cash or insured patients often pay less on buprenorphine or Suboxone. For example in my area methadone maintenance costs about $500 per month-- while my buprenorphine patients pay about $70 per month for the office visit and $100-$200 per month for medication. Of course some bupe programs charge more, and some bupe programs accept insurance or medicaid.

I see some advantages to methadone at the taper stage. Going in for a stable, slowly-reduced dose each day is going to work better than trying to take less and less of a strip. But then again, you do have to go into the clinic more often-- which some people resent over time.

The Feds have come to recognize that while step programs and abstinence sound attractive, their success rates pale in comparison to medication-assisted treatments. The steps worked for me 20 years ago, after I lost enough to be extremely desperate. But from all that I see, step programs offer very little to people who haven't had significant consequences. And while an occasional person clings to daily or weekly meetings to become a sober, 12-step zealot, most addicts (by far) never get to the point of 'dedicating themselves to the simple program' of AA or NA.

And given that addiction to heroin and other opioids kills so many young people, a program that rarely works is nothing to crow about, in my opinion. If I was the parent of someone addicted to opioids, I would sleep much better if that person was taking buprenorphine-- with or without a step program. I have very little patience or tolerance for twelve-step recovery snobs... and I wonder how those people completed their 5th steps without recognizing their 'holier than thou' attitudes.

'Judge not, that ye not be judged.' Or to put it in layperson's terms--- don't be a jerk. The important thing is that we find a way for people to stay alive-- no matter how they get there.


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PostPosted: Sat Oct 31, 2015 9:43 am 
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Thank you dr j.

Ive been rattled over this subject before. Much of what TJ posted in a different thread is dead on.

Trying to do both and drt and na is almost impossible IF you understand there program. The best part of it
can be the good people you hang out with , and there are many. But know that deep down i side every clean
NAer there is a part of them that sees the program as all that is needed. The conflict will be there until the words Total Abstinence is removed..

Im not holding my breath. ..I do miss some of thoses people I must say. :)


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PostPosted: Sun Nov 01, 2015 1:19 pm 
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Thank You to SoberMom for bringing this old topic back up top again. It needs to be discussed and decisions made for those who choose the 12 step program of recovery like I did. That was for my drinking of course but it still works great on any addictive substance.

Like Dr. Junig stated earlier; it's all about surrender. Amazing how it lifted the desire to drink from me.

rule

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PostPosted: Mon Nov 02, 2015 1:32 am 
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Just to clarify something from my previous post. Not everybody on methadone continues to use other opiates. I know a number who have abstained from abusing drugs for years while on methadone, who are great parents, employees, citizens. But it seems to be a lot easier to use other opiates while on methadone than on Suboxone, especially on lower doses.


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