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PostPosted: Sat Jan 30, 2010 9:55 pm 
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Hey guys!
I think there might be some serious negative involvement between subutex -suboxone and the endocrine system. I've been on for about a year and a half and my body has stopped producing serum testosterone and cortisol. These are my labs:

Testosterone 15 ng/dl (morning) (regular level in the hundreds)
Cortisol 30 nmol (morning) (REGULAR AROUND 250)
12 hour lipid: triglycerides 350 mg/dl (Regular below 100)
HDL laughable
24 hour urine test, cortisol was normal
I had my sperm count check- minimal amount observed. Basically I'm not producing any.


I recently lost another job (the second in 6 months). I don't normally lose jobs, ever for poor performance. This is a smaller market and in this industry everyone knows each other. I am suffering from anxiety attacks (which I never had), my memory is a joke, people find me to be abrasive- more so than usual. I am confused if I need more counselling or if I can pin some of my problems on my endocrine system- these numbers are ruining my career.

My endocrinologist has ruled out pituitary tumor and other than that, he won't do anything more than shrug his shoulders during the subutex talk.

I just need to know if I should get off the subutex- even though it puts me at risk for relapse-without a job- I can't make it here. I'm really really scared. I'm under the care of an addictionologist, I'm taking 1.5 mg of clonazepam a day just to get through. I'm losing my recovery.

I am taking a statin which has brought the trig down a bit.
I tried testosterone gel but it didn't change my number, it did, oddly, make me feel like I was in a bit of withdrawal. There is something there to that, testosterone and addiction. some interplay.

DOES ANYBODY HAVE SPECIFIC INFO ON SUB AND CORTISOL/TESTOSTERONE?
I realize that theoretically sub shouldn't effect testosterone because it is a partial opiate agonist but clearly this isn't true! This is wrong!! My wife and I have been trying to have another baby and of course we couldn't- I'm firing duds! All the stress it's caused, I was never warned about sub side affects- does anybody have any answers?!!


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PostPosted: Sun Jan 31, 2010 12:00 am 
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It is safe to assume that these issues were present before you started Suboxone, all opiates cause endocrine issues. When you are using opiates in large amounts and/or for long periods- this system definitely can be damaged. Suboxone can contribute to the issues that were already breeding. You may say I never felt the symptoms prior to Suboxone, but keep in mind that while on your drug of choice you were not feeling much of anything. Suboxone is only keeping you from experiencing physical withdrawal symptoms, and not providing the psychological effects as other opiates do.

In my opinion it would be best to consider what is more important, staying on Sub or working on repairing the physical damage from the opiates- but a choice is inevitable. How much Sub are you on currently???

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PostPosted: Sun Jan 31, 2010 12:17 am 
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shelwoy wrote:
It is safe to assume that these issues were present before you started Suboxone, all opiates cause endocrine issues. When you are using opiates in large amounts and/or for long periods- this system definitely can be damaged. Suboxone can contribute to the issues that were already breeding. You may say I never felt the symptoms prior to Suboxone, but keep in mind that while on your drug of choice you were not feeling much of anything. Suboxone is only keeping you from experiencing physical withdrawal symptoms, and not providing the psychological effects as other opiates do.

In my opinion it would be best to consider what is more important, staying on Sub or working on repairing the physical damage from the opiates- but a choice is inevitable. How much Sub are you on currently???


I take 8mg of subutex a day. I work 12 hour shifts in a job that requires a lot of physical work, on those days I take 12mg. suboxone makes me feel "withdrawal-y" perhaps some of the naloxone absorbs.

thanks for your reply-

so you think quitting is necessary to repair?
and typical addict question but... why my system?
I'm an otherwise healthy guy. I have a son. Normal BMI. Coincidentally, lot of late adolescence starters and diabetes in my family though.


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 Post subject: Nightmare--NOT!!
PostPosted: Sun Jan 31, 2010 12:20 am 
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I would encourage the writer, and anyone, to avoid the type of headline that was placed on this post. If you have a concern, look it up, research it-- but this is the type of post that leads to mass confusion and concern without cause.

My first question for the writer is why do you assume that your testosterone level is caused by buprenorphine, and not instead the result of taking clonazepam? Or, for that matter, from the opiates you took in the past? Or from testicular torsion, suffered when you were 8 years old? Why assume a problem is from buprenorphine, when if you are like most addicts, you have taken all sorts of garbage over the years? There is no knowledge of a problem with buprenorphine and cortisol, so you are in uncharted waters... so how can you assume that the low testosterone is caused by what you are taking now, and not the result of something you took years ago? Since testosterone comes from the testes, anything that hurts testicular function, from an incarcerated inguinal hernia to tight undies could be at play!

The first thing to do is to see an endocrinologist. I don't know for certain what your cortisone level is, as you are missing the denominator in the number-- you say '30 nmol'-- but 'nmol per what'? Per ml, or per deciliter? That answer will change the 'normal' by a factor of 10.

To be frank, your results are concerning because laboratories usually give hormone levels using either the European values of nmol/liter, or the American values of nanograms/deciliter (usually written as ng/dl). In nmol/liter, the normal total testosterone level is 10-20. You said that your level is in ng/dl... but if that is the case, why is your cortisol result in nanomoles? It would take half of your sample to go to a European lab, and half to go to an American lab-- which is hard to picture. Are you certain you have the correct values?

It actually is even more complicated, though. You don't specify if you are referring to TOTAL testosterone or FREE testosterone. Even using ng/dl, the normal level for TOTAL testosterone is 300-600 ng/ml, but the normal value for FREE testosterone-- the stuff that actually is acting in the body-- is 6-12 ng/ml. Again, be sure you are comparing apples to apples with your numbers. And I am still confused over the combination of nmol and ng; that strongly implies that one of the numbers is off by a factor of ten.

OK-- let's assume that all of your numbers are correct, and that for some reason your testosterone is low and your cortisol is low. That is odd, by the way-- one way to raise one's testosterone is to take cortisol. Your metabolism is also not in line with a person who has a low cortisol; one problem with TAKING cortisol is that it leads to diabetes, weight gain, and problems with cholesterol and triglycerides-- not the other way around! But again, leave all that behind...

It is quite a stretch to say that Suboxone is ruining your career. I have written a great deal on my blog and this forum about the effects of clonazepam on memory and anxiety. Remember, benzos work on anxiety by... BLOCKING MEMORY. That drug they put in your IV at the dentist, or when you have a colonoscopy, is midazolam, or Versed-- just another benzo. All benzos block memory formation, which is why I strongly recommend avoiding them if you have any job that requires memory. That is not a side effect; it is how they block memory because you cannot worry about something if your mind cannot focus on it. The effect of benzos is essentially identical to having a horrible case of ADD-- a loss of the ability to direct one's attention and stay on track.

Again, as I have written on my psych blog (see 'twelve things I hate about benzos'-- it will show up if you Google it), people always become more irritable on benzos eventually. They also block the deeper stages of sleep, even though the person thinks he is sleeping-- resulting in sleep deprivation and fatigue. People tend to be VERY attached to their clonazepam, alprazolam, or lorazepam-- they usually refer to it as 'my clonazepam', for example-- and it is very difficult to get people to give it up. But remember that it works at the GABA receptor- the same place that alcohol and barbiturates have their actions. It is a 'disinhibitor', meaning it allows people to speak their minds too quickly sometimes. Anyone having memory problems at work should look first at the idea of stopping clonazepam before blaming buprenorphine. And in case a person thinks they are only taking clonazepam when off-work, the half-life is 24-72 hours... so if you are taking it off-work, you are in an irritable state of withdrawal when you are working.

My point is not to support buprenorphine--only to strongly 'diss' the reflex reaction to a substance that we don't understand, while ignoring the negative effects of the substances that are more likely the problem. Remember that buprenorphine has been around for 30 years-- it is NOT a new drug. But it now is being used in hundreds of thousands of people, so I will see what I can find by doing a literature search.

One of the biggest embarassments to hit the scientific media happened about 15 years ago, when everyone bought into the idea that silicone breast implants caused autoimmune disorders in women. The connection was what everyone 'knew'-- the women were paraded around on 20:20 to tell their stories, and scores of editorials decried how vanity has caused all of these problems. Dow Chemical put aside 2 BILLION dollars-- a large sum back then-- to pay the claims in the class-action suits. Silicone implants were taken off the market, banned by the FDA. Only saline was allowed-- resulting in less natural breast implants for thousands of leering men!! What a shame!! A few years later a massive study found, very clearly, that there was NO relationship. None. Nada. But the lawyers had been paid, the women had been paid, the docs were paid (they had to pull out all the silicone implants and replace them with saline!). After a few years the FDA quietly, without any media coverage, put silicone breast implants back on the list of approved devices. This sort of science has happened many times, by the way-- that was just the biggest example so far. I fear we are in the middle of another one right now, that has nothing to do with buprenorphine... but that's another story!

I'll look things up and get back to you... in the meantime, I urge everyone to avoid getting our 'undies in a bundle'-- especially in regard to testosterone and buprenorphine.


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 Post subject: one more thing...
PostPosted: Sun Jan 31, 2010 12:33 am 
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I say 'one more thing' when I am about to say about ten more things...

The fact that taking testosterone did not raise your level is the most relevant bit of info-- it implies that your problem may not be making testosterone, but that some part of your body is breaking it down. I hate to keep going back to benzos... but they are metabolized at the liver, and it is possible that the clonazepam is inducing more of the enzyme that breaks down clonazepam, and that the same enzyme is then breaking down your testosterone. This is just a guess-- but there are known relationships between many medications and their effects on liver enzymes, that then have effects on other meds or chemicals. That is one are of med/med interaction that requires a computer, as it is so complicated. I have such a program through my subscription to a site called 'epocrates'-- if the writer would like to e-mail me privately with a list of his medications and their dosages, I will run them against each other and see if there are any known interactions. Or if you want to do it publicly, post your meds and doses-- not just the psych meds, but all of them, including any over-the-counter supplements, herbs, or 'power drinks'-- I will run the computer on them and post the results.

Finally, be careful about that feeling that something makes you feel 'a bit of withdrawal'. I can feel 'a bit of withdrawal' just by thinking about it long enough! We have memory circuits for those horrible withdrawal experiences we all have been through, and it is very common for those memories of withdrawal to come up whenever we think that we should-- or might-- have them. But they are not 'real'-- they are just memories. Don't you wish that we could simply forget things we wanted to forget?


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 Post subject: Re: Nightmare--NOT!!
PostPosted: Sun Jan 31, 2010 2:18 am 
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suboxdoc wrote:
I would encourage the writer, and anyone, to avoid the type of headline that was placed on this post. If you have a concern, look it up, research it-- but this is the type of post that leads to mass confusion and concern without cause.
Thank you for your prolific reply. My intent was not to alarm anyone or advocate for the immediate stoppage of all sub. Sub has put my life back on track- Call me cynical but I could easily imagine seeing a headline tomorrow "wonder drug for addiction makes your gnads shrivel up and fall off, users screwed!" However, that is not going to happen.

I have been on benzos for two months, and I am inclined to agree with you- they are more problematic than helpful. But they do not appear to be the root of this problem.

The first thing to do is to see an endocrinologist. I don't know for certain what your cortisone level is, as you are missing the denominator in the number-- you say '30 nmol'-- but 'nmol per what'? Per ml, or per deciliter? That answer will change the 'normal' by a factor of 10.

I have seen an endocrinologist. I'm becoming a regular. The only substantial thing we know is that I don't have a pituitary tumor via MRI.
I agree with you- the contradiction between the cortisol and the low testosterone.
I apologize for the wacky lab values. In my hasty post I copied and pasted lab from an (obviously) European site becuase I was too lazy to hand type. I accidentally set off your BS detector. See-that's why I got fired! Just kidding, well not really. Anyway...

I have had known low testosterone since -2/09. One month after starting my subutex treatment. I had just read that opiates can cause low testosterone. My wife and I had been trying to conceive our second child with no luck. I was able to conceive my son three years before. I asked for the wrong lab test to determine my fertility, a free testosterone. I should have asked to have my swimmers checked. I neglected to see an endocrinologist for one year.

To be frank, your results are concerning because laboratories usually give hormone levels using either the European values of nmol/liter, or the American values of nanograms/deciliter (usually written as ng/dl). In nmol/liter, the normal total testosterone level is 10-20. You said that your level is in ng/dl... but if that is the case, why is your cortisol result in nanomoles? It would take half of your sample to go to a European lab, and half to go to an American lab-- which is hard to picture. Are you certain you have the correct values?

11/09:
Testosterone free: 21 (47-244 pg/ml)
Testosterne % free: 2.5% (1.6-2.9)
Testosterone total: 83 (400-1080

01/22/10
AM Testosterone Free: 3 ng/dl (9.3-37.0 nmol/L)
AM Cortisol plasma, morning: 3 ng/dl (the range is in Umol so I don't even get that)
My vitamin D total hydrox is also low at 19 (32-100 ng/ml)
Sex hormone binding globuln: 13 (11-80 nmol/L)
my T4, TSH, FSH, LH, have always been normal.
I have had my swimmers checked: negligible concentration
I also had a 24 hour urine that had somewhat elevetaed creatinine levels but normal urine cortisol.
I know- it's wacky!
And my fasting lipids remain sky high as well. Possibly random-I dunno, I'm inclined to think correlated.


Thank you for your reply but what to do- Can having super low cortisol and testosterone make someone unstable? If so should I quite the sub?
Ou tof options here- I tried testosterone gel and it made me aggressive, plus my numbers didn't really go up and I most definitely killed some more sperm.




My point is not to support buprenorphine--only to strongly 'diss' the reflex reaction to a substance that we don't understand, while ignoring the negative effects of the substances that are more likely the problem. Remember that buprenorphine has been around for 30 years-- it is NOT a new drug. But it now is being used in hundreds of thousands of people, so I will see what I can find by doing a literature search.




I agree- I'm trying to make an informed, calm decision, but I think I have some legit medical stuff going on caused not by benzos but by sub. I could be comepletely wrong.


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 Post subject: Re: one more thing...
PostPosted: Sun Jan 31, 2010 2:28 am 
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suboxdoc wrote:
I say 'one more thing' when I am about to say about ten more things...

The fact that taking testosterone did not raise your level is the most relevant bit of info-- it implies that your problem may not be making testosterone, but that some part of your body is breaking it down. I hate to keep going back to benzos... but they are metabolized at the liver, and it is possible that the clonazepam is inducing more of the enzyme that breaks down clonazepam, and that the same enzyme is then breaking down your testosterone. This is just a guess-- but there are known relationships between many medications and their effects on liver enzymes, that then have effects on other meds or chemicals. That is one are of med/med interaction that requires a computer, as it is so complicated. I have such a program through my subscription to a site called 'epocrates'-- if the writer would like to e-mail me privately with a list of his medications and their dosages, I will run them against each other and see if there are any known interactions. Or if you want to do it publicly, post your meds and doses-- not just the psych meds, but all of them, including any over-the-counter supplements, herbs, or 'power drinks'-- I will run the computer on them and post the results.

Finally, be careful about that feeling that something makes you feel 'a bit of withdrawal'. I can feel 'a bit of withdrawal' just by thinking about it long enough! We have memory circuits for those horrible withdrawal experiences we all have been through, and it is very common for those memories of withdrawal to come up whenever we think that we should-- or might-- have them. But they are not 'real'-- they are just memories. Don't you wish that we could simply forget things we wanted to forget?



Doc you are so right on! Look, testosterone is a cholesterol right? Cholesterol is broken down by digestion and turned into hormones. Subutex allows me a bowel movement once every three days. I am chronically constipated. Hmmm.causes of gastroparesis...low cortisol- I have an apthous ulcer and profound gerd. also IBS. Maybe some low does erythromycin might do the trick huh. You rock!
I will gladly compile a list of meds I am taking- give me a bit of time. Perhaps they will solve this but also show how even in recovery we can use "safe" meds to still be a ragin pill popper.
My AST/ALT are normal. However, maybe some cirrhosis from APAP abuse in the past could be preventing metabolism?


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PostPosted: Sun Jan 31, 2010 11:21 pm 
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I'm very interested in this thread. Keep us informed and good luck with everything.


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 Post subject: Drs Response
PostPosted: Mon May 17, 2010 9:28 am 
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I am sorry to see that Dr. Junig had this weird defensive knee jerk response as to "how do you know it is not this or that or that or this"?
Dr Junig- as you have said a million times- Suboxone is an opiate. .
For one- Being a biologist myself- my first reaction would not have been that of of blaming a whole host of things from a testicular dysfunction to Clonozepam, but rather the obvious which you mentioned later on: It has been established years ago (many years ago) that opiates- opiates in general- not specifically Suboxone, so do not get all panicky- Opiates definitely have an effect on the endocrine system. Reduced testosterone levels are found in a large percentage of chronic opiate users. Sub maintenance (though putting addictive opiate full agonist in "remission"- a positive) as far as the body and different systems of physiology is the same as chronic opiate use. Do not take this wrong- any opiate, including suboxone, taken for a long period of time is chronic as far as physiology, including neuro-chem. Now, in this gentleman's case I think you should mention- as an MD, that Buprenorphine is very potent. So not only is one in chronic use of an opiate but one that is (10X?) that of Morphine. Look at some of the taper schedules- people get down to below .15 mg or 150mcg of Bup and still get w/d symptoms when they jump. And if they take a .15 dose when the w/d begins- it goes away.
As you know, the .2 mg injectable is used for pain management. So that would be about the abuse starting point.
Say- one injection = to about 5mg of Oxycodone. Abuse would be (if comparing to oxycodone- taking 5 or 6 perks, or 25-30 mg. Multiply .2X5 and you get 1mg. (below the smallest available dosage of Suboxone), taking 5-6 percs 3x a day. Would be like 3mg of Sub. So, opiate abuse affecting the endocrine system has been well documented- research it yourself. 3mg of sub would be the equivalence of a mild to moderate oxycodone addiction. (not OC-different story all together). Now I forget what does he is on- but if he is prescribed the lower dose of 4-6mg, he is getting the opiate equivalent of a rather strong oxycodone habit - effect on his endocrine system which effects the testosterone level.

So, as an MD I am surprised that you did not simply tell him- that Suboxone is no different in its effect on the Endocrine system (hormone producing etc) than any other opiate and that it is likely that his low level would be due to his previous opiate addiction combined with his present remission dose of Suboxone.
I agree that singling out Suboxone and alarming folks that are not biologists that it might effect their endocrine system might be better worried to simply include all opiates.

One thing that I personally would be very interested in, if you could provide the info- is how benzos, either by themselves, or as potentiating drugs (w/ Bupe) effect the endocrine system. I have not heard that benzos do this. I have certainly heard about 1000 other reasons not to use benzos, as they are extremely dangerous drugs and can definitlely have horrible long term effects. But as to the endocrine system- since you mentioned that it may be as a result of his Clonozepam use- I would be interested if you could point me to some articles.

It is these defensive positions that you take w/regard to suboxone that make me suspicious.
One strange thing I came across was one of your "News of the week"- you explained how Reckitts decided to black list you (your words) because you made a comment that was wrongly interpreted as "negative".
This cause me to consider your post for the week. One thing that is strange is that Reckitts would black list anyone. But I am not surprised. I was given a support pamphlet for Suboxone when prescribed. When I called that same number and explained that trying to stop use was posing a big problem, and that infact- I could not seem to stop- the person or rep got - defensive is an understatement. Circling the wagons is more like it.
Secondly- you claim to have absolutely no connection to the company. You claim that you have no more connection than any other person aside from being able to prescribe it. I have NEVER heard of a Dr. mention that they have been black listed.
So you were blacklisted from what exactly. Who frowned upon you? How did you know that they frowned upon you?
Why would a company not want to have as much info on a medication as it can- instead of blacklisting someone that posed- and from what I remember it was not even close to a negative statement about Sub.
But it really caught my attention that you found out that you were black listed. Which means simply that they told you through some means of communication that they did not appreciate your comment. Which means that you do have a direct connectin with the company.

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 Post subject: Re: Drs Response
PostPosted: Mon May 17, 2010 8:22 pm 
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gaulois wrote:
I am sorry to see that Dr. Junig had this weird defensive knee jerk response as to "how do you know it is not this or that or that or this"?



Thoughtful response. I pretty much stopped coming to this website a couple weeks after I got that response. .

I stopped taking sub- cold turkey- from 8mgs in the beginning of March. I just stopped. My hair was falling out, I felt confused, distant, chronically horribly constipated, and I also felt I was a dry addict. Ideally I would have tapered down but that was an impossibility as I did not have 3 months to take off of work. It was the same duration of WD that kept me from coming off the drug many times in the first place.
I would also like to say my sobriety date is 1-29-10 because that was the last time I took a drug for the purpose of getting high. I started AA in early Feb. and it took me a few weeks to realize that sub was just stoking the fire.

Let me say this to everyone getting off of sub. I have been sick for over two months now- so you need plenty of support. I jumped on 03/03. Even today I am still in WD-No mamby pamby paws- no sniffly nose- I mean aching legs, profound lethargy, stoned out stupidity in regards to organization, mood swings so wild and out of character they are funny. Everyday is a freaking battle, crappy sleep, so god damned tired. Is it getting better? Yes. So fucking slowly. I figure in another month or six weeks I will be at 80% But I am happier in so many ways. I have a sex drive. I feel like a human again. I am happy to be sober and off subutex. My hair has stopped falling out, I'm gaining more muscle mass, and my brain feels more stable. No doubt total sobriety helps, but I was on a boatload of sub and it was affecting my body in many negative ways. My diarrhea finally stopped AFTER TWO MONTHS when I started taking cultures and healthy bacteria. I probably shot out all of the good stuff.

I'm not sure what would have been better, the taper or jumping. For me, I needed to get into treatment (had to be 100% drug free for my facility), I needed to just stop being on opiates. For most people jumping off is risky because the WD from Subutex is absurd. Absurd in the sense that you have weeks where it feels like you are going backwards. Symptoms do not improve-without support (for me AA, treatment, awesome sponsor) I would have definitely failed.
Two people at my treatment who jumped off sub without giving it careful enough consideration and were turned out in two weeks.
Physically speaking full agonists are more intense. But the shit is over in a month. With sub , for me, I figure sub Wd is full bore for at least three months and is just getting started at a month.
So I have two things I would like to say:
1) I will have my testosterone blood level checked in two weeks. I know it will have improved. And for the record, I already have a son, and I only took benzos for alittle while. Dr.Junig's reaction was odd, strangely reactive and cold. I think it is fairly safe to say that the functionality and effects of tweaking specific opioid receptors is not PERFECTLY understood. Sobriety improves the quality of life better than any drug has, but that drug was messing with my head- hands down, sub was truly killing my career. I felt like Dr. Junigs post was evasive and purposefully did not address the concerns I raised.

2) The medical community (i.e. prescribing MD's ) have simply dismissed concerns and complications of how challenging it is to get off of sub. Dr. Junigs statement (paraphrasing) "subutuex WD can be mitigated by distraction" is dismissive of legitimate complaints and anecdotal reports that the medical community will ignore until they are forced to reckon their irresponsible behavior, as usual. Already receptive and empathic docs are not prescribing over 2mgs strength with a duration of treatment for a month- AS IT SHOULD BE.
I am new to recovery. I am new to not using a drug to tweak my every selfish whim and pain- but at the same time- I think I am unusual. Nothing unique about my addiction or myself as an addict- I just wanted my sobriety desperately. I had wanted to get off sub for a long time. I hit bottom. Subutex demands bottom, that is the only way one will get clean from this stuff- AND I THINK THAT IS ABSURD. What is the point of getting someone off of full agonists only to have them get on a drug that is damn near impossible to get off of- AND WHY ISN'T THIS FACT ACKNOWLEDGED BY MD'S?


Subutex can keep you from OD'ing on Heroin. It can even stop you from abusing vicoden. It can keep death at bay. But the cost is a withdrawal that is just too damn intense and long in duration and has the propensity to destroy gains made. I cannot see how this drug doesn't ENCOURAGE FULL AGONIST ABUSE. What is the point of being on subutex if you are not in recovery- and if you ARE in recovery-why is a MD prescribing a drug to you that prolongs your addictive state?


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 Post subject:
PostPosted: Mon May 17, 2010 9:45 pm 
I don't even know what to say to the last two posts here. But I have to say something!
Firstly, I don't know how in the Hell you guys can see Dr. Junig's thoughtful replies to the original post as "weird, defensive, or knee-jerk." That just blows my mind. A very qualified physician takes the time to read your post, consider your history, look at your lab results and give you an educated opinion about your questions and concerns....for FREE....and you feel that it's acceptable to come back and slam him and the site he created to help addicts in recovery? I do not understand that logic.
It seems obvious to me that you guys would rather spend your time bitching and moaning and whining and doing your level best to lay blame on anyone but yourselves for your own bad choices in life and the misery that has led you to, than to really focus on getting better. I hope to God that I've at least learned NOT to do that in my own recovery. I cannot imagine making much progress in gaining any peace and contentment in this life until I can stop blaming someone else, or a drug, for God's sake, for all my problems! Maybe if you would spend half as much time actually working on your issues as you do looking for someone or something to blame, things would start getting better for you. I would venture to guess that the both of you will continue to have problems long after buprenorphine is out of your system. Of course, you'll probably still blame it on the bupe......after all you didn't have any problems before you started it, right? I know I didn't! I didn't need any help to get off those damn full-agonist opiates. It was no big deal......My life was great before I had to quit numbing it up all the time! Nope....life in active addiction was great....didn't hurt me a bit! But this damn Suboxone....it's really been a killer......ruined my life that's for sure! It's caused my hair to get greyer, my crowsfeet to get worse, my fingernails to break more easily, my vision to decline, my feet to hurt to worse at the end of the day, my stomach to hurt sometimes, my headaches to worsen, my menstrual cycle to become irregular, my teeth to be not as white as they once were, my memory to decline, my kids to misbehave, my dog to bark louder, and my husband to be more irritating than usual! And that's only the beginning! And if it's not Suboxone's fault, then it's definitely my doctor's fault!
Do us all a favor and go over to Subsux and commiserate with those people. This forum is for people who need, accept, and offer help to other addicts. I see none of that going on here.....All I see is a couple of ungrateful, miserable guys who won't be satisfied with any help that any of of us here have freely offered. Good luck guys....you're gonna need it!


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PostPosted: Mon May 17, 2010 10:19 pm 
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I have a couple of question for you Justinrok. I really hope that you will provide an honest answer to both of these.

1. Can you explain, do you have any thoughts on, or can you comment on, why you claim that the detox from Bup has been extremely difficult for you while just in the past couple of weeks several regular posters here have reported that they have not had much if any trouble with stopping their Bup. Why such a difference with you and them?

2. Do you think there is any correlation in the fact that you stopped your Bup at 8mg and others who have reported far less difficult withdrawal have very slowly reduced their daily dose and then finally stopped their Bup at 0.25 mg or even less each day. Does it at all register with you that you had a rough time stopping at 8mg and those who stop at 0.25mg don't have much trouble at all? What do you make of this?

I really hope you'll answer these two questions for all of us.


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PostPosted: Tue May 18, 2010 1:00 am 
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donh wrote:
I have a couple of question for you Justinrok. I really hope that you will provide an honest answer to both of these.

1. Can you explain, do you have any thoughts on, or can you comment on, why you claim that the detox from Bup has been extremely difficult for you while just in the past couple of weeks several regular posters here have reported that they have not had much if any trouble with stopping their Bup. Why such a difference with you and them?

2. Do you think there is any correlation in the fact that you stopped your Bup at 8mg and others who have reported far less difficult withdrawal have very slowly reduced their daily dose and then finally stopped their Bup at 0.25 mg or even less each day. Does it at all register with you that you had a rough time stopping at 8mg and those who stop at 0.25mg don't have much trouble at all? What do you make of this?

I really hope you'll answer these two questions for all of us.


I'm sorry my comments upset you guys. I would encourage detractors to reread my last post.
TDonh I think you answered question 2 with question 1. But I'll reiterate.
1) I was at a high dosage (8-16mg daily) prescribed by my addictionologist for over a year and a half. I think it's awesome that many people are getting off bupe, but a lot of people are failing as well. I realize that many people would fail anyway, so is the nature of addiction, but I see people trying and failing who "deserve" to make it.
2) I addressed this in my post. I chose to stop taking opiates to get into treatment- and even if I didn't have to get into treatment sub free I probably still would have jumped off- my rationale comes from the standpoint that I am a dirty stinky addict and once I realized that a full agonist would work again- why would I suffer through partial WD for three months? I wanted to be totally sober, get my endocrine health back, and if I relapsed then I needed to go back out until I was ready. My point is that the issue of the challenge of getting off subutex needs to be acknowledged and better addressed.


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PostPosted: Tue May 18, 2010 8:17 am 
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Well, I guess I kind of saw this coming. Justinrok, you're entitled to your opinion, for sure, but you didn't really answer donh's question, which, when combined with the rest of what you've posted here, makes it pretty clear to me that setmefree is (while certainly a tiny bit shrill) pretty much spot on.

I'm 46 years old and I have been abusing opiates for about 30 years. I have been on suboxone for well over 18 months, the majority of that time at dosages significantly higher than 6mg, and currently at 8mg. I am EXCELLING in my career on this drug. I have NEVER BEEN BETTER at my job, at communicating with my peers, or at interacting with people in everyday life. I have ZERO physical side effects from bupe, unless you count the 8 or 9 SOLID and RELAXING hours of sleep I get each and every night.

Oh, and on top of that, and at the risk of providing just a tiny bit too much information, I am *literally* chasing my wife around the house on a daily basis for sex, sex and more sex and then after that, we have sex.

I have a healthy appetite, I work out daily by either walking 3 or 4 miles or cycling 10 or 12 miles. I am also preparing my home for sale, since I plan on buying a much larger home into which I can move my mother.

To summarize: I think your characterization of Dr. Junig's reply to you was (and I'm trying my best to be nice here) misguided at best. The man offered to help you, and you have the audacity to essentially label him a liar and intimate that he's in collusion with drug companies?

I guess the only question I have is: How difficult is it to type with that straight-jacket on? (<---that's a joke, kind of)

I'm going to have to respectfully agree that your input is not really welcome here if all you are going to do is castigate the owner of the site with baseless accusations.

I wish you well in your recovery, though. As I would never have any form of ill will towards another recovering addict. Maybe you should consider a similar personal policy, eh?


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PostPosted: Tue May 18, 2010 8:27 am 
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In my opinion, the difficulty of withdrawal isn't addressed by MD's because of a few reasons. First, the MD's are told that the withdrawal is lesser than a full agonist. Some MD's are already of the opinion that people should just be able to suffer through withdrawal anyways and if it isn't as bad with the sub, then we should really stop complaining. What they don't seem to understand is that withdrawal is so bad that even when you decrease its' intensity by 50%, it is still extremely difficult to endure. The second reason is that you can effectively taper on suboxone, very slowly, and several people have done quite well eliminating the majority of the PAWS and physical withdrawal. That is something that cannot be done with a full agonist in my experience. Third is that I never stayed off of a full agonist long enough to know how long the PAWS would last. I know when I went off sub, at three months, I was still lethargic, depressed, had mood swings, was antisocial. I was feeling good enough that it was a very difficult decision to go BACK on suboxone for pain issues, but I just didn't trust myself to be off of it. It appears to me that the research shows PAWS can last 6mos. to 2 years from any substance, so I am not sure suboxone is any different. Everyone I have ever seen to claim the PAWS lasts longer with suboxone never stayed off full agonists to actually do an objective comparison. Jumping off 12mg of suboxone, my physical symptoms were gone in 6 weeks. Not 3 months. There were non-addictive meds that made this much easier. I mean.....why crap your brains out when immodium ad exists?

I agree that doctors should acknowledge withdrawal from suboxone for what it is. But I also think that they have to weigh the risks and the docs job is to keep the patient alive. Suboxone can do that. It won't mess up the persons system any worse than the narcotics they are on (as far as we KNOW today) and it should keep them alive if taken properly. Let's be real......even if a doctor told you the absolute truth as we know it in your very first appointment, it would look something like this.....

Suboxone will not "heal" your brain but it will prevent you from having cravings and will allow you to lead a normal life so long as you take it.
Suboxone will prevent you from having physical withdrawal symptoms from the full agonists you are taking now.
If/when you decide to go off suboxone, you will need to involve yourself in a recovery program and complete a slow taper of the medication.
It IS possible and much easier to do a slow taper with suboxone than with full agonists. We already know addicts can't taper with full agonists.
A slow taper can take as long as 2 years to complete. During this time, you may experience some mild withdrawal symptoms for short periods of time. As you get to extremely low doses, it appears that the brain is healing itself while you are still on the medication as it has shown in most people to eliminate or substantially reduce PAWS.
There are comfort meds that can be prescribed during this timeframe to help you be successful.

Bottom line......As an addict, I would have heard "you won't have cravings and you can live a normal life" and I would have taken it anyways because it was better than where I was at. As an addict, I couldn't see life beyond my next fix and all I would have heard was that this drug could take me out of that cycle. I had tried going cold turkey from full agonists and going to meetings, etc. It didn't work. At least when I got off suboxone I felt well enough to attend a meeting and had far more choice and control than I ever did with full agonists. Let me remind you this was a jump from 12mg. This drug DOES take you out of the cycle of addiction. I couldn't afford treatment when I got on sub because all of my money was spent on drugs. I am in a much better position now to do that than I was then. Why would a doctor focus so heavily on the "negative" aspects when the "positive" outweigh the negative 10-fold and quite frankly, the negatives are still positives in comparison to full agonists. The comparison when someone is in active addiction is "active addiction versus suboxone". There is no comparison of not being an addict anymore and the other recovery options aren't as successful. PERIOD.

If you really think people are better off taking their drug of choice until they become desperate and then entering an inpatient treatment program and learning to be in recovery, then you aren't being very realistic. For most addicts, that just isn't an option and MANY, MANY, MANY die trying. Those are the facts. You might be a lucky one...........so far.

Just put things into proper perspective here. That is what Dr. Junig has done for many of us and we appreciate it.

Cherie


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PostPosted: Tue May 18, 2010 10:50 am 
...." I think it's awesome that many people are getting off bupe, but a lot of people are failing as well. I realize that many people would fail anyway, so is the nature of addiction, but I see people trying and failing who "deserve" to make it. "....

Now what on earth?! Who exactly qualifies as 'deserving' versus 'undeserving' in your book? Perhaps those who are 'failing' to get off bupe, have NO business coming off bupe in the first place. If the mentality is as you said it was for you.."I am a dirty stinky addict....realized that a full agonist would work again-so why suffer through 3 months of w/d"...then I've got to wonder if that addict is ready for recovery or not. You go on to state that "If I relapsed then I needed to go back out until I was ready." That's very worrisome in my opinion. Do you know how many people have died while thinking exactly that?
Personally, I think every addict 'deserves' to make it in recovery...with or without bupe....whichever it takes. If there's anyone who "deserves" to be able to come off bupe, it is someone who has reached a point in recovery in which they accept accountability for their own actions, stop trying to lay blame elsewhere, are able to feel some humility and express gratitude, and have the patience and willingness and strength of character to follow someone else's lead who has gone before them in accomplishing their goals, and has the wherewithall to endure a little discomfort in tapering off a medication that is totally able to be tapered successfully.

Sorry for the "shrill"ness in some of my comments. But I can't just read this stuff sometimes and not call "B.S."


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PostPosted: Tue May 18, 2010 3:41 pm 
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Hey setmefree, I sincerely did not want to insult you in any way and I apologize if my comment hurt your feelings. I must say, I completely agree with everything you have posted in this thread.


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PostPosted: Tue May 18, 2010 4:17 pm 
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I'm still waiting for an answer to both of the questions that I asked. Why no answer, justinrok? Or are you simply agreeing with me that the reason you have experienced such a dreadful time coming off of Bup is solely related to how you have gone about it - namely stopping at a very high dose rather than slowly tapering down and thereby not having to go through exactly what you are going through.

So, I'll ask again, would you please answer my questions from yesterday? Or are you just saying that I'm right and by stopping at 8mg (something that no one recommends) is the reason for your discomfort?

I honestly hope for your answer.


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PostPosted: Tue May 18, 2010 5:22 pm 
Hey j781! You didn't insult me in any way....but I sure do appreciate the apology, albeit unneccessary. I know I was being sarcastic and shrill in some of my comments. I just couldn't help myself!! You have a lot of great things to say and I'm glad you're sharing and posting on the forum and hope you will continue.
donh - I hope you get answers to your questions also, but I have a feeling you won't, at least none that make any real good sense. It is increasingly obvious that some people don't get it, or as I used to hear often in NA meetings, "Some are sicker than others."
While I am far, far away from having all the answers or even having a super-strong grasp on my own recovery at times, I am a stable enough individual to know BS (whether in the form of deflection, rationalization, justification, or just plain old lame excuses) when I see it! I think most of us who stick around this forum for any length of time are the same way.


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PostPosted: Tue May 18, 2010 10:39 pm 
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I agree that Doctors think that a partial agnoist should be easier to come off of but it seems people are having a very long withdrawl with suboxone. I kicked heroin in jail about a dozen times, methadone two times and suboxone 2 times and suboxone was the hardest to kick because the withdrawls lasted for months. Drinking 60mg of methadone for 2 years was a 35 days of no sleep but besides that I was eating and working out after about 2 weeks. On suboxone after 40 days your still very fatigued. My experience anyway.
This forum is really growing since I use to come around here. The mods are doing a good job.


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

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