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PostPosted: Wed Nov 30, 2016 9:41 pm 
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Part of this post is to vent, part of it is to seek advice. Please move it if this is not the correct spot for this thread.
I'm just frustrated-plain and simple. My SO is pressuring me to taper, quickly, and I am just not comfortable doing that. It's the "drug for another drug" issue. I inform him that it's comparable for smokers to use the patch, high blood pressure patients to take meds to control it and the comparison of diabetics to use insulin. His response-yes, but those people with high blood pressure and diabetes die without their medication-they need it to survive. I said yes, so do some opiate addicts!! Addiction is a disease and thankfully, there is medication to help!The relapse/death rate is HIGH. I do not have my support system yet.It frustrates me so much!! The reason it frustrates me so-is that he is a physician(a Surgeon)!!He is uneducated in this department and how dare a commoner try to educate him on anything that has to do with medicine. He wants to speak to my Dr about MY treatment and question our plan-I am taking his name off of the release ASAP because I do not feel comfortable with him having that information anymore. I want him to speak to her though, maybe she can explain everything a little better. Any advice to help me communicate all of the many reasons why this is nothing to rush??


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PostPosted: Thu Dec 01, 2016 12:11 am 
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HTOWN wrote:
Part of this post is to vent, part of it is to seek advice. Please move it if this is not the correct spot for this thread.
I'm just frustrated-plain and simple. My SO is pressuring me to taper, quickly, and I am just not comfortable doing that. It's the "drug for another drug" issue. I inform him that it's comparable for smokers to use the patch, high blood pressure patients to take meds to control it and the comparison of diabetics to use insulin. His response-yes, but those people with high blood pressure and diabetes die without their medication-they need it to survive. I said yes, so do some opiate addicts!! Addiction is a disease and thankfully, there is medication to help!The relapse/death rate is HIGH. I do not have my support system yet.It frustrates me so much!! The reason it frustrates me so-is that he is a physician(a Surgeon)!!He is uneducated in this department and how dare a commoner try to educate him on anything that has to do with medicine. He wants to speak to my Dr about MY treatment and question our plan-I am taking his name off of the release ASAP because I do not feel comfortable with him having that information anymore. I want him to speak to her though, maybe she can explain everything a little better. Any advice to help me communicate all of the many reasons why this is nothing to rush??



I've had this with my wife...except she isn't a know-it-all (no offense...but we sub patients have seen these doctors that claim to know everything, yet they have no clue that the relapse rate within the first year is over 90%..or that opiates kill more people than car wrecks in this country)..

My wife was all over that same thinking. "ok...you've been on this for 5 years...that should be long enough."..

I finally got it through to her that just because I don't take pills anymore doesn't mean I won't have cravings. I've told her that the abuse of opiates does some permanent damage to the dopamine parts of the brain..and all those new receptors that are created either never go away, or take several..SEVERAL years to go away..but even then not everything returns to normal.
So there is evidence of permanent lasting effects of opiate abuse...even years after a person stops.
This finally got thru to her. She finally realized that even though I don't do them anymore, and haven't in 8+ years, the damage is done and now I need to live with the damage.

Ask your husband if he's ever seen someone on benzodiazepines suddenly yanked off of those..
It causes some major problems, like seizures and could cause death.
Someone on an extremely high opiate addiction can suddenly stop and they can suffer organ failure.
With all the failure of abstinence-based approaches, why is abstinence suddenly OK once someone has stopped the active addiction and is taking a maintenance dosage of buprenorphine?

I'd love to meet someone like this and ask them at what point does your brain say "ok, I'm full..can't learn ANYMORE"...
At what point in medicine do you get to the point where they give you that doctrine to hang next to the hippocratic oath that says "I've learned it all, and there is nothing else I can be taught about health and medicinal services"...
Can I get a photo of that? Do they teach these people who act like this to even treat their spouse and close family as lower forms of life because "med school" fixed them? Is this an extra credit class in med school, or as your learning in your residency, do they show you how compassion is shit, and you should only have compassion when you tell a grieving widow that you tried to save their spouse?

This is a sore topic for me. My brother died from OD on heroin..and NO one knew his battle. So I don't take kindly to people who suddenly have supreme knowledge of everything addiction and can dictate what others should do with their lives.

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PostPosted: Thu Dec 01, 2016 2:53 am 
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Great post, Jonathan!

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PostPosted: Thu Dec 01, 2016 10:38 am 
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Ultimately...with the risk of death being what it is...I'd weigh out finding a spouse that understands / stopping and risking a relapse that could cause me to die.

I never considered that with my wife because I knew I could make her understand my vice...I want to remain where I am as an insurance policy against 1)failure, 2)relapse, 3)death....and if it costs a couple hundred a year to insure I stay focused on this, who am I hurting?

If you can't make someone understand this point of view, then maybe it's not ever going to get across to them and you'll have to insure your own personal safety over the demeaning accusations of an unbelieving spouse. I hope he realizes that he's supposed to be your equal..not your dad or your superior being..and that he can't dictate what your life should be and how you should live it.

Ultimately, you can't sacrifice living in order to submit to some overbearing guy's views of how "you're just all fixed now" and can subsequently only take medications pre-approved by him.

I really feel badly for the girls I knew when I was in pills. I know what guys make girls do because the addiction is sometimes so bad. I used to buy oxy's from a 60+ year-old man who would have these young (pretty before-hand) 20-somethings come live with him for a week or so while he had pills. They were allowing that old pervert to get his jollies from them, just to feed their addiction. It's awful that a man would still call himself a man after doing that...
But to have the same thought of dominance over someone in marriage...that I could tell my wife what she can/cant take..especially with the risks being as high as they are...
I'm not her boss...or her decision-maker. She is in charge of her. I don't and would never threaten her with leaving if she didn't adhere to some predetermined idea of how I think she should take medication (which she does for thyroid disorder). She knows how she feels and what she needs to do..and I know that same thing for myself.
Sometimes I wonder if a few of these guys think that a marriage certificate has some text on it that conveys ownership to them in fine print...and maybe they should look real hard in the mirror of who they have control over. Big difference in asking my wife to do something the way I want it done, and being a demeaning dictator over our home.

Just my thoughts on the matter..I hope this person is confronting this head-strong and not giving in. Especially with the dangers involved.

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PostPosted: Thu Dec 01, 2016 1:12 pm 
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Well said J. Nothing really I can add except to say you're not alone. Almost every one of us has experienced the same with our own physicians. Put 3 doctors in a room and see if any one them can the mind of the others. They all think they are right. With the exception of very few including our own Dr. Junig here.

I suggest you read his blogs and print out what is pertinent to your case. At least it is written by a highly educated physician. He is probably more frustrated than all of us because it is his peers he is trying to educate and unfortunately failing with the majority of them. Most just don't want to know. My own doctor is kind and listens for my 10 minutes alloted. I've given him this URL and he states he is just too busy to research it although he does take me at my word. My surgeon is a complete monster when it comes to pain control. I hope to never be in need of pain relief ever again. At least not with him. I came very close to suing his practice but reconsidered because he saved my life.

You're not alone. That's my point.

r

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PostPosted: Thu Dec 01, 2016 1:56 pm 
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Wow Jonathanm, I may just print your post and hand it over! Thank you for giving me some things to think about. All I have asked is just do some research-plain and simple. Research relapse rates, research this medication. Thank you rule, I will search the blog for information, maybe if a peer relates the message, it will not be heard as addict nonsense/manipulation. I think this also comes from him being in recovery-from alcohol. He went to a treatment center and stayed in a sober living house for a few months-all without MAT. He just stopped drinking-he had to-and he could do it that way and has to fight off temptations without assistance, so why can't everyone(me)?It will either get through or it won't- I'm not really worried about it but last night I was hot, let me tell ya. You can't sit there and worry about things that don't even exist-


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PostPosted: Thu Dec 01, 2016 10:29 pm 
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Ugh is right!

My first thought after reading your post is that your husband is incorrect. People with high blood pressure RARELY die from high blood pressure. We give blood pressure meds to reduce the RISK of vascular disease. If every 100 people with high blood pressure stopped their medication, maybe 2 or 3 would eventually have problems related to hypertension. The other 97 would have no effects related to stopping their meds.

There are many similar examples in medicine, where we make decisions for POPULATIONS, not for INDIVIDUALS (sorry about shouting). For the individual, changing your risk from 1% to 1.2% means very little. You still have over a 98.8% chance of having no problems. But for society, that extra 0.2% translates into 80,000 extra deaths (200 million people in the US, 20% with hypertension, times 0.2%).

I could easily argue that the risk of untreated opioid dependence is much, much greater than the risk of untreated hypertension. But looking at death rates misses so much of the story-- the loss of careers, marriages, and finances... and the loss of self esteem and dignity... things that hypertensives don't have to worry about!

If a person has a TIA, we often put that person on coumadin for life to reduce the risk of stroke. Coumadin has HUGE risks-- but we accept them to reduce another bad thing. Buprenorphine is virtually harmless, so that balance of risk is much, much different-- making it much more reasonable to use buprenorphine, even in cases where the risk of stopping the medication is very low.

All of this ignores the primary issue-- that this is your decision, and not anyone else's business. When I have patients in your position, I share the true story that over the past 10 years I've had 7 patients who were pushed off buprenorphine by parents or partners, who eventually died from overdose a year or 2 later. The NYT story I was in that got it all so wrong included a similar story, where a guy lost his son to overdose, a couple years after stopping buprenorphine. That guy, somehow, blames buprenorphine.... something that makes no sense at all, but that is hard to judge given his circumstances. But people do, sometimes, die after being forced off buprenorphine. I've seen it 7 times in my relatively small world.

I worked with surgeons for over 10 years when i was an anesthesiologist, and i know that it is difficult to teach anything to someone who 'knows everything'. But it is your life-- and you know what you need more than anyone else.


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PostPosted: Fri Dec 02, 2016 9:27 am 
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I would take what the doc has said here and show to your SO. If he deems everything you say as addict-speak, then he isn't taking you seriously as his spouse to begin with and I can't say what I'd do if faced with that same issue.
But I can bet I know what I'd do... There is nothing that anyone can offer me that tops being alive.
A high-paying career with bills paid and a middle-to-high class lifestyle? Not worth my life.
A bunch of pieces of paper with dead presidents on them..? Not worth my life either.

This type of person, with this feeling of superiority...I'd like to meet and ask ..who the hell do you think you are? Are you better than me? You put your clothes on the same way I do...one leg at a time..so what makes you better than anyone else? You did some 12-step program? Bravo to YOU. I'm me, and I'll worry about what I do..yay for you and how you managed to accomplish something that is totally different and has no bearing on what I've done. I don't take my treatment guidelines and say what you should've done or not done, who the f are you to take your treatment guidelines and say what I should do or not do?

He does know that alcohol and opiates are not the same doesn't he? I'd even be the smartass who asked if he knew that painkillers and alcohol are slightly different in chemical composition.

I don't have to ask what you're dealing with to know that this is extremely tough to be in. Most of what I've said you just simply can't repeat to him...not without a major fight breaking out. It'd be nice if there were some words to make things different, but I fear there aren't any that us on this site can tell you to repeat. This is something you're going to have to find the right way to handle..and sadly we can all offer our opinions of what we think are the right ways...but that just isn't what you can say or do. Our anger, while well with intent, is displaced because we see this all too often here.

I will say this...it's taken much less to break a home. In some cases, it's taken much more..
But ultimately, it's a big decision whether it's worth fighting for. For you, it's worth it, by all means, but is this fight worth having with someone who doesn't share the same thoughts.

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RIP little brother. Gone, but not forgotten.


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PostPosted: Fri Dec 02, 2016 10:37 pm 
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Sorry, Amy I'm not sure how I didn't see your reply earlier. I agree with you, that was an awesome post by Jonathanm!


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PostPosted: Fri Dec 02, 2016 11:00 pm 
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Thank you for responding Dr. Well, seems like he is telling me incorrect information just because he knows I wouldn't know any better-and why would I check to see if he is telling me something that isn't true? Seems like he is just shooting down my debate by making false statements to fit his agenda. I have no doubt that he knows people rarely have issues without coumadin. Sneaky, sneaky. It is simply a case of the benefits outweighing the risks. Yes, it is MY life, MY treatment, MY decision. And I agree-it isn't anyone's business. This is not something I will roll over on and give in to. Non negotiable.


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PostPosted: Sat Dec 03, 2016 12:01 am 
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Jonathanm, it will not turn into a fight, not at all. I refuse to yell and scream or have anyone else yell or scream( I have a child in the home and I WILL NOT do that to her). I will however, have a discussion. He doesn't take everything I say as addict speak- just when it comes to substances-controlled substance use. I was super pissed when I posted, I was a little pissed when I replied, now I'm not too worried about the outcome(I know what it will be because he has NO business telling me when I am done with treatment). If this is an issue about money, well-you can't put a price on sober living! I could be an asshole and play tit for tat and remind him of the hundreds of thousands of dollars his treatment cost(no insurance so it was all self pay)-that's not my style to bring it up but if I were an asshole, I sure would. Besides this is a disease, would it be an issue if I were to have a different disease? I think not. I'm not too worried about it. Thank you all for being an ear to vent to and even though you may not think so, you all have given me some golden advice.


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PostPosted: Sat Dec 03, 2016 12:45 am 
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HTOWN,

First I wanna remind you that we are all here to support you. I would estimate that nearly every recovering addict whom has chosen to include Suboxone/Buprenmorphine in they're recovery has dealt with this issue at some point.

I feel like the overall attitude towards medication assisted recovery has changed a bit over the past few years, as some people have become more educated about this godsent medication. Unfortunately, there's still a very large portion of the population who simply refuse to understand and accept Suboxone
as a safe and very important treatment.

I'm in a very similar situation. I've been on Suboxone/Buprenmorphine for over 7yrs now. It's been an INCREDIBLE 7 years! I've accomplished things and grown in ways I never thought possible. My husband is an alcoholic. He's also a dentist. His drinking had been spiraling out of control for many years. He agreed to stop drinking ONLY to "help" me with my recovery. Years later, he finally admitted that he actually has a problem and that he is in fact an alcoholic. He's only been to a couple AA mtgs his entire life, yet he claims to be the world renowned expert on addiction & alcoholism.....gloating that he just stopped one day and never looked back.

I've been suffering from addiction since my early teens (I'm now 38). I've completed in-patient treatment, out-patient treatment, private therapy, and methadone. THIS medication is the only thing that has ever worked. Suboxone has not only transformed me into a healthy, caring, loving, respectful
member of society. It's SAVING MY LIFE.

My husband is very, very smart. But, like lots of doctors he truly believes he knows everything and that he's correct about everything. I knew he was against this medication before I even induced on it.
One day I decided....I love my husband with all my heart. But, I love myself more. I knew deep down if I didn't make a change that I would die. I decided that I must do this for myself and that if it dissolved my marriage, at least If still be alive.

I was silent about my decision for about a year. Then, I learned we were expecting so I felt it was time to tell him. He was of course furious. He accused me of deceiving him. He actually wanted me to have an abortion, b/c he was convinced I'd be harming our child. I didn't have an abortion. Instead, I became my own advocate....gathering research articles about the medication itself as well as info pertaining to pregnancy/birth. I maintained my 24mg dose throughout the entire pregnancy. I decided I wanted to be alert for the birth. My OB and I came up with a terrific plan. I only had a partial epidural (the birth was a c-section), which allowed me to remain conscious. I was determined not to use any full agonist opiates. So, my doctor placed a pain pump containing a non-opioid medication at the incision site. I was released with the pill form. This and IBProphen were the only medications I took afterwards


Last edited by marie on Sat Dec 03, 2016 1:13 am, edited 1 time in total.

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PostPosted: Sat Dec 03, 2016 1:03 am 
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Our son was born healthy and happy, without any complications or neo-natal withdrawal.

Sorry for the long post! I just feel all these details are important to show how I took my own power back and decided that NOTHING is more important than my recovery. Because, I can't be a mom, a wife, an employee, or anything WITHOUT my recovery.

Fast forward- Our son is five yrs old now. I go through what you're going through every few yrs, when my husband decides for himself that I've been on Suboxone "long enough" and that I don't "need" it.
I've successfully tapered down to 4mg. Next month, I'm attempting to reduce to 3mg. But, I have no intention on giving myself a timeline. For the first time ever, I feel normal. I'm happy, confident, and stronger than I ever have been.

My Sub doc is trying to push me off. And, I actually think my husband has encouraged him to do so.
Over the past few years, the thought of changing anything with regards to my dose has terrified me (because I'm so scared of going back to that place). Over the past year, I've been weight-lifting and it's really helped to increase my self-esteem. I mention this because it's helped changed my way of thinking. I've been seeing the same doc for 5 yrs and I've been with my husband for about 10yrs. It would be sad if I hafta find another doc who respects my choice to remain on Sub. And, it would be devastating if my marriage ended due to my recovery choices. But, I've decided IM in charge. I WILL remain in recovery no matter what I have to do. And honestly, I believe that's the only way of thinking that will keep us alive.

I hope my story helped some. Just know that you're stronger than you even realize. We are all here for you and we believe in you!!


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PostPosted: Sat Dec 03, 2016 7:38 am 
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Marie, That is an amazing story! I love what you have done for yourself and your desire to keep growing is admirable! I honestly don't know what I would do if I did not have my husband's support one hundred percent! He never questions me about my suboxone use, the cost, when I will stop. All he ever says is that he trusts me completely to make the best decision for myself and us as a team! Yes, he is amazing but he is also someone who knows the devastation that the disease of addiction can have on a family. His own father was an alcoholic. His mom died when he was ten of breast cancer. Her dieing wish was that a neighbor would raise her three children who were 10, 9, and 7. This decision was made due to his father's drinking and lifestyle. He was an amazing musician but surrounded himself with other women, drugs, and alcohol. So the neighbor fostered the three children keeping them together. However, she already had 5 of her own...and they always came first! She was physically and emotionally abusive and they were treated as second class citizens. My husband at the age of 11 would go and stand outside of the bars to get his father to give him money, not for himself, but so his brother or sister could have new shoes or a new outfit. The foster mom, even though receiving money for these kids, never purchased them anything new. She would even wrap up her biological kid's old toys for the foster kids for Christmas. Being the amazing man my husband is, he came to peace with her before she passed away a few years ago. His brother and sister never did. Sorry, this is going on longer than expected! My husband faced his own deamons both alcohol and nicotine by saying this is not working for me and stopping cold turkey. Something not everyone can do! All of this to say, you must find your own peace...in your life first, marriage second! As important as my marriage and husband are to me, I know that if I am not doing what is best for me to keep growing, my marriage will not grow either!


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PostPosted: Sat Dec 03, 2016 1:38 pm 
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Gosh, those are some truly inspiring stories! I loved reading all of them. And Michelle, it hubby sounds very forgiving, not sure I could have forgiven that lady! My other half is very supportive also, in every way. At one point though, he asked me to cut my dose bk for financial reasons and was wondering why there wasn't ever a plan in place to eventually get me off buprenorphine. That's where I realized, that in the end, u gotta do what's best for u because nobody can tell u when it's time for u to stop ur treatment. He's not mentioned it in a long time and I hope it stays that way :)

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PostPosted: Sun Dec 04, 2016 7:14 pm 
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Michelle- the story you shared broke my heart and put it back together all in that one post!


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PostPosted: Sun Dec 04, 2016 7:21 pm 
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jennjenn-it crossed my mind that he was asking me to taper and get off quickly because of the money. Well, lucky for me-since I started treatment with a dr a few months ago, I started my own business so if it comes down to it....I'll pay for it myself! I think he is seeing that I do not have to depend on him and I'm not sure he likes that. You, Michelle, Jonathanm (and many others) are very lucky to have such supporting SOs. Maybe they remember what it was like on the other side of the fence???? I have thought of some plans and a back up plan and a back up plan for my back up plan so I will be just fine!


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