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PostPosted: Sun Jun 11, 2017 6:27 pm 
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Ive married the love of my life when we were 18 years old- it has been 21 years and he is still he love of my life but has been an addict for about 15 of them. We have 4 children who have been greatly affected by his addiction as well. Our oldest are 22 and 20 and havent seen their father clean since elementeay school, the younger kids are 14 and 3 and have NEVER known him clean. I have been made promise after promise that he was clean and only found out from other people or by chance that it was a lie. I've dove back in with complete faith time after time only to get burned. The mood swings have gotten to be almost a tongue in cheek joke in our home as we ever know which man is going to wake up in the morning or walk through the door at night.
His addiction started with recreational pills which over time became a lot of pills. i found out a month ago that he has been abusing suboxone. When I asked he said he was taking 2mg 4x a day- total of 8-12mg depending on the day but no pills for the last year and a half. I suggested a suboxone dr and a plan to get off and he seemed wholeheartedly in. I called a dr who didn't have an opening until 2019 and another who didn't take our insurance. My husband called one on his own and was able to get right in. My flags immediately went up because they asked for no insurance information or any kind of background but made the appt. in the meantime, my husband didn't buy any suboxone from his supplier because he thought he was going to get one the first day. Upon realization that he wasn't, he had a mad scramble to get him something to keep from withdrawals. Dr did a half ass intake and called in a prescription for an 8mg tab for induction. I went with him to induction as I thought it might be a while and didn't want him to be alone. Upon arrival, the receptionist came in, took his bp and told him to take the whole strip. He questioned if he could take half and she said if he wanted to that was ok. Got sent into another room and 10 minutes later the same girl
Asked if he was ok and then said we could go and they would call in prescription for 20mg/day to be taken 3 times a day. Hubby stayed with 4mg once a day and was "blah" in the afternoon and irritable but not pysically sick. Next visit to the dr, he was proud and told her he had only take 4mg in the mornings and she got angry. She told him she wouldn't see him anymore if that's what he was going to do. She said he needs to take more every time he starts feeling bad and that he shouldn't care because he's not paying $10 for it on the streets anymore. She also told him to use that money to buy something nice for himself since insurance picks up the bulk of the cost. She said suboxone was to help people feel good, not just to keep you from being in withdrawal. He asked how long he would be on it and she wouldn't give any kind of answer. I asked again before we left and she snapped at me and said, someone on pills could be off in a few months but she couldn't put a timeline on a heroin addict. My heart sunk when he didn't correct her and he was silent all the way home- I know he hasn't used heroin but I also saw he didn't want to correct her and possibly be held to a end date that soon. I see a profound change in him after each time we see her and she tells him to take more. We walked away last time with another prescription for 16mg a day which is just about double what he's been taking for the last year and a half. So my question is, how does it make sense to treat someone taking 8mg as their addiction with the same medication at double the dosage? Since seeing her he has decided he needs to take it more than once a day as well as up the dosage so my question is- isthis right? Is it right to treat suboxone addiction with suboxone? A heroin addict isnt treated with more heroin and a pill addict isn't treated with more pills, while I understand the concept of treating his original pill addiction with suboxone- I am having a very hard time wrapping my head around What's happening. I also want to add that he hasn't looked for a meeting or contacted a counselor and am wondering if this is just an easier out for him than chasing the suboxone on the street. He is also so deadset on taking more than one dose a day of the higher amount that he's willing to move out of our home and away from our marriage and children to have it that way. I feel like there's no right choice- I take the chance his idea is going to work and stick it out or I walk away because I can't do this anymore and I owe it to myself and the kids to get away from something that's killing me? I don't want to abandon him but I don't want to enable him and keep dying more everyday. How do I find the right answer that causes everyone the least pain without being selfish?


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PostPosted: Sun Jun 11, 2017 8:23 pm 
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Dillon4296 wrote:
He is also so deadset on taking more than one dose a day of the higher amount that he's willing to move out of our home and away from our marriage and children to have it that way. I feel like there's no right choice- I take the chance his idea is going to work and stick it out or I walk away because I can't do this anymore and I owe it to myself and the kids to get away from something that's killing me? I don't want to abandon him but I don't want to enable him and keep dying more everyday. How do I find the right answer that causes everyone the least pain without being selfish?


Welcome Dillon4296, my heart goes out to you. It's obvious that you are dealing with a very complex situation which seems to revolve around your husband's need to use. For this post I'm going to focus on the part I have quoted because I think it needs to be dealt with first. Addiction is messy for a family, but especially tragic when there are children involved. Your children are often at the mercy of decisions that you two make. So before trying to address your husband's needs, I will say that your first priority should be the safety of you and your kids... period.

From the information you've given us, I have a strong suspicion that your husband is not at a point where he truly wants to quit. The fact that he's willing to move out of your home to pursue higher doses is very telling, in my opinion. As an addict myself, I know that nobody else can make that decision for me, especially if I'm not ready. So please do what you need to do for you to be safe.

That being said, I give you credit for trying to find answers to a problem that is affecting your lives. And I think you're right in being concerned about what his doctor has said. I think red flags should go up for anyone that can't get a straight answer to a logical question. If your husband has been taking 8-12 MG of Suboxone a day then it doesn't make sense to start out at 20 MG a day, it just doesn't. I understand that this can cause you to worry and have a lot of anxiety. Does his doctor know for sure that the most he's been taking is 8-12 MG's a day?

Have you flat-out asked your husband what his intentions are? Does he really want off or does he want maintenance treatment? And are you prepared for the answers no matter what they are? What about family counseling? Would you be willing to address the negative family dynamics that make him willing to leave? I think he desperately needs some counseling, at the very least. The fact that some of your kids have never known him to be sober is HUGE!! Most addicts also have problems with depression and anxiety, it's called a "dual diagnosis" and it's very common. It's also very serious.

You are doing the right thing by reaching out for help. That's a huge first step, so feel good about yourself for doing it. I can tell by your words that you feel very desperate right now, and loving an addict can be one of the hardest things to do in life. Keep in mind that addiction is a disease of the brain and can be treated. But he has to want to be treated in the first place. Please come back here for support when you need it. I'm still fairly new here but I've spent a lot of time reading and there are amazing people here that truly care... believe that!!

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PostPosted: Sun Jun 11, 2017 8:49 pm 
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Nice post Openmind.

Hey Dillon,

I'm assuming his Dr did a UA? Always do. it could have shown heroin or rather the metabolites from heroin that appear in urine. Maybe that's why his Dr said heroin. And why the Dr prescribed the higher bup dose. That's how I interpreted the Drs remarks. I'd take those remarks seriously. I assume you see no needle marks but heroin can be snorted. If there was heroin in his urine then imo his dose is not out of line. If his UA was clean of all substances except for bup, I still haven't heard enough to say he's 'addicted' to bup.

Also, unlike all other opiates, bup is a very safe drug w a high safety profile w opiate tolerant folks. For kiddos, its dangerous as is w pets but w adults, more doesn't hurt, doesn't help, but doesn't hurt. There's a ceiling effect that's unique to bup so taking more doesn't do anything more. That's not giving him a pass to take more than one dose/day or to pitch his Dr for more than needed. But it does not hurt him or put him at risk like increasing the dose of a full opiate would.

I know you write the Dr sounds sketchy but know that these Drs see liars many days and many Drs don't believe much of what a new pt says. Active addict = Liar. its hard to write this. Ask any of us and its a truth of active addiction.

The good news is that hopefully he's taking bup and is taking enough of it bc then bup fully blocks any other opiates he may take if he's still messing around w other stuff.

He may be into way more stuff than you know if he's putting all on the line. Maybe he owes $$ to folks and is selling some. Do you really know? Whats going on? not a real question bc w active addicts, you'll rarely get the truth. But with his long opiate use disorder history and his very clear challenge to you, it makes me wonder what all might be really going on.

I'm sorry to read of you and your family's pain. They call addiction -- a family disease. best tonight, P

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Stopping went well -- its the staying stopped -- where the real work begins.
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PostPosted: Mon Jun 12, 2017 7:34 am 
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Hey Dillon (don't know if I spelled that exactly right) welcome.

First of all, pelican, who just responded to u has been successfully off buprenorphine (which changed his life for the better) for years. OpenMind is fairly new to treatment and is already seeing the benefits and I've been taking in buprenorphine treatment for over 5 years. So u have all different sides of the spectrum here. We've all three and most ppl here have been in active addiction like ur husband.

Like pelican said, suboxone has a ceiling level, no matter how much ur husband takes, it's not like full opiates, it will NOT make him high. So u can to be less bothered by the amount issues. I started out at 16mg too. I understand he was already taking suboxone but not legally and not under a doctor's care, it's going to be different than his way vs the doctors way. Even though this doctor doesn't sound perfect, she's still a doctor and is obviously dealing with addicts just like him daily. U have to make a decision to trust the process or not.

I've been on both sides, so I do understand a bit about dealing with an addict from ur standpoint because before I started using I was with my youngest sons father who was an addict and I wasn't. I went through years of the lies and the money issues and the stealing (he even stole my engagement ring bk that he'd given me). I went through him only being 'present' in our lives when he wasn't in withdrawal or on the hunt for his pills to stop the withdrawal. He was actually in rehab when our son was born. My brother, my mom and my grandmother was in the hospital with me for the birth of our child, not him. He came straight from rehab and bk to active addiction he went. I know that struggle, no trust and just defeated to no end. It's bad and nobody blames u for being worried to death about this. But this treatment works, I promise u if he is committed it can be a fresh start.

After a couple of years of my sons father using, I started using too. I had awful stress headaches and he pretty much pushed an oxycodone 15 in my face and that's all it took. I'm not blaming him, but after feeling like that tiny pill took every bit of stress away and made me super woman, I was hooked. Needless to say, that led me to the darkest times of my life.

I've been both sides and the addict vs the being married to an addict is way worse imo. It's a trap that we can't get out of but I promise u buprenorphine is such a lifesaver when it stops cravings. Cravings is what we cannot stop and that's what leads us bk to using over and over again. So longer term treatment, it's necessary. It's the mental part of addiction that nobody (other than addicts) can totally understand. Buprenorphine takes those away and lets us work on the damage we caused during active addiction and it helps us build the tools we need to not go bk to active addiction. There's soooo much more than stopping withdrawals or worrying about the starting dose.

In time, if he's committed to the process, he will earn ur trust bk. Hopefully he can win ur children's trust bk. My son hasn't saw his father since he was 2..... he's 11 now. No child support no communication, nothing. U do have a husband willing to try and that's something to start with. U may not trust his decisions and nobody could blame ya for that, but hopefully he can win ur trust bk.

I appreciate u starting this thread, it actually reminds me of a thread from another section only it's the other party ;) don't know if it's related to u in any way but if it is then it's great to hear both sides. At the end of the day, ur awesome for sticking with ur husband all this time. Ur awesome for raising ur children pretty much alone at times. U seem like such a great person and I'm rooting for u and ur husband. Buprenorphine can be his ticket bk to a normal life again. Sorry this is so long!!

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PostPosted: Tue Jun 13, 2017 11:25 pm 
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This will be a bit repetitive to what Jenn wrote. I would not be concerned about increasing the dose of buprenorphine, because there is no increase in effect after a dose of about 8 mg per day. So why increase? Because the goal with buprenorphine treatment is to put cravings into remission for a considerable length of time. If your husband is still having cravings as he gets by on 8 mg, then his dose is not high enough. Buprenorphine is a safe medication that is used as a tool to extinguish the conditioning that was part of your husband's addiction.

I have a patient who was seeing a different buprenorphine physician for two years. During that time, the patient was constantly being tapered lower. He would run out of medication at about 26 days each month, and then go without for 4 days, craving opioids and experiencing wtihdrawal. The entire time in treatment was a waste! Yes, he could boast, I suppose, that he is being prescribed less. But he is just as far from stopping opioids as he was when he entered treatment! He is still lying to his wife, lying to his doctor, and feeling ashamed of himself-- things that keep his addiction in the dark, where it stays active.

When I started treating him my goal was to get him to a point of legitimate behavior. I increased his dose to 12 mg per day, from 8 mg- but after a month he still ran out early. So I raised him to 24 mg per day. Now, after 6 months, he has been taking the medication as prescribed. His focus on buprenorphine is going down, as we want it to do. He isn't lying, and he isn't craving. My goal is for him to take it like he would take a vitamin or blood pressure pill, without any special attention or interest.

How long will we do this? I can't say right now. We know from research that the longer a person stays on medication, the less risk of relapse after stopping. I don't like to push anyone off buprenorphine, because I see so many people who have relapsed after being pushed off by their former doctors! I find that for many people, the desire to taper off buprenorphine eventually arises-- and in those cases, patients are usually successful. On the other hand if people are pushed off without buying into that process, their chances for abstinence are poor. That last comment is just my opinion, but an opinion based on treating 800 people with buprenorphine over the past 11 years.

The goal is NOT about getting off opioids as fast as possible. Your husband can accomplish that in a couple weeks with a remote hotel room and a bottle of clonidine, or a couple weeks in jail. But those experiences rarely lead to prolonged abstinence, and they sometimes precede overdose, when people return to using with a lower tolerance.

I can't tell whether your husband's doc is on the right track or not-- but she might be. She is a much better doctor telling you that she can't provide a time estimate, than a doctor telling you he will be off in 3 months! Ideally, your husband will be in a state of 'remission'-- on a dose of buprenorphine that virtually eliminates interest in opioids-- for a year or more. He can be tapering for some of that time, but the taper should be slow enough that he doesn't return to using-- because if he does, you're starting over again.

Good luck. Try to drop the focus on 'how much' or 'how long'. Those things are not important; what is important is to get his interest back on you and the family, rather than on buprenorphine. That will be easier if you let him know that he has your support, even if he takes a medication. You would want the same from him if you ever needed a medication for hypertension, diabetes, or anything else.


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