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 Post subject: Update
PostPosted: Mon Apr 12, 2010 9:24 am 
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Sorry I've been absent. It wasn't intentional. I've had a miserable cold, and life just seemed so grey and miserable for awhile. I have some non-Ogre related issues going on as well. I'm just not sure where I'm getting the energy.

Anyway, his appointment is today at 1:30 EST. It seems like everything is focused down onto this one tiny point in time. The subtlest twitch of an eyebrow could be all it takes to send victory crashing down, or end this nightmare.

Heh. Sorry for the melodramatics. I guess I'm still not feeling 100%. Anyway, I'll post an update after the appointment.


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PostPosted: Mon Apr 12, 2010 4:32 pm 
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Well, it went well. I actually rather like the doctor. She was very calm, patient, and matter-of-fact. She laid all the cards on the table, and told him just how it would have to go for him to stay in the program.

Interestingly, one of the forms she had him sign had to do with pain management. I strongly suspect she has accepted him as a pain patient so she can exceed her limit. I thanked her personally. He really doesn't know how lucky he is, it's true.

Anyway, he took one sublingually and is doing fine this afternoon. I bought him a late lunch and we got to talking.

During our conversation, I learned what the next hurdle is. It's the army of heroin zombies that will now beset him wanting to bum a few off him. Eerily, as we were talking, my phone rang. It was a friend of his who I call sometimes to try and locate him. This is also the person who started him shooting up to begin with. Three guesses what he wanted. I turned my phone off immediately.

In a replay of a scene from Lord of the Rings, I managed to convince him to part with all but 7 of his pills. He was given 90. It was like Gollum parting with the Ring. But he did it. They are safely out of his house, and in my car waiting for him.

Now before you all pounce - yes, I know the danger I've incurred. Fortunately, my daily mileage is small, as is the town we live in. There is very little likelihood of me being stopped, let alone searched. On this first day to week of therapy, I feel that the far greater danger is him succumbing to the temptation to sell them or give some away. After a week, we'll see how he's doing, how stable his mood and thought process has become, and evaluate whether he's ready to take all the pills home with him.

Anyway, thank you all once again. This is a major milestone and I honestly believe that all of you have contributed to this little victory.


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PostPosted: Mon Apr 12, 2010 6:11 pm 
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I'm so glad things went well with the doctor. And I don't blame you for keeping his meds for him, at least temporarily. Because you are so right, people will be coming out of the woodwork to get their hands on them. It's natural that you want to help him, he's your friend and you care what happens to him. I'm curious what dose he's on - I'm guessing 24 mgs/day or is it 12? Don't be surprised if once he's stable she reduces that - it's quite normal. Will he be doing anything else to help in his recovery? Groups or therapy? Suboxone alone cannot stop that crazy cycle, but it's one hell of a first step. Hopefully he'll manage to walk away from the bad influences of his other "friends".

I'm so glad you updated us. I was wondering how both of you were doing. Keep us posted.

Melissa

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PostPosted: Mon Apr 12, 2010 6:34 pm 
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Yeah - 8mg, 3x/day, for 24mg. I was kinda startled at that.


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PostPosted: Tue Apr 13, 2010 7:58 am 
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If he weakens, and diverts some of this prescription thinking he can just take less, will the lower levels show up in urinalysis, and completely screw him when compared to a pill count?


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PostPosted: Tue Apr 13, 2010 8:56 am 
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I do not think the doctor will be able to tell if he has lower levels in his system because they normally just use those diptick tests and they aren't being sent to a lab. (My experienced guess here, not fact necessarily). If they sent it to a lab it would be too expensive.

I agree that keeping his pills is a good idea. I also think you could probably get out of it if you got caught with them but would probably have to explain it to a judge. I am sure the doc would write a letter for you stating you were there at his first appointment and I am sure he would testify on your behalf that you were holding them for him and of course your drug test would come up clean so I wouldn't worry too much about it.

I am glad you updated us as I was wondering if things went well or not. If you can hold the pills long enough, his friends will go away when they realize he isn't selling and he also isn't using with them anymore (hopefully). They don't want to be around anyone who isn't as sick as they are so they will find other people to go bother. Hopefully he can start changing his life enough that this becomes the case.

I wish you all the best.

Cherie


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PostPosted: Tue Apr 13, 2010 1:33 pm 
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So, I wasn't able to convince him to let me hang onto them past this afternoon. However, he was proud of himself for having had the strength to part with them overnight - on his very first night with the script. I'm impressed as well. I think this is neither a win nor a loss.

In the win column, he's lucid, upbeat, and having thoughts past his next fix. He's even having creative urges. If I had to characterize it, I'd even say he's TOO energetic. He seems kinda wired. I assume this will level out.

In the lose column, he's already diverted five of his pills. He gave them to the friend I mentioned above. On a human level, I kind of understand it. Nobody wants to see a friend in that kind of pain. Hell, it's my motivation as well. Still, it's hard for me to ignore the cold, sinking feeling in the pit of my stomach. It just feels like doom.

I just keep telling myself that there's only so much influence I can bring to bear on the situation. The rest is up to him. He knows what's at stake.


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PostPosted: Tue Apr 13, 2010 3:10 pm 
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Old behaviors die hard. There are no two ways about that. Still, I have to tell you that it's very disappointing that within days of getting on Suboxone he is already diverting some of it. No matter how you want to look at this - it is not good. I'll not bother debating the danger of it or if it's just a matter of being nice to a "friend". Where my concern is, it is addict behavior - pure and simple. It is these types of things that he is going to have to break. He clearly is not in a position to have control over his own medication. Trouble is - he's an adult, not a child. It's not like you can treat him like a kid and take his pills away like you are his mother or something. Obviously that's not going to work. It would be nice though – because he clearly cannot monitor this on his own, he has just proven that.

It would be very unlikely that his doctor would order any type of specific test to ascertain the levels of medication in his system. And even if they would, the amount of Bup that he actually absorbs, etc. would make it hard to tell if the level in his system was what it should be for the dose he is on. The tests that almost all Bup docs perform is pretty much a YES or NO test. Either Yes, there is Bup present or No, there is not. So it's unlikely that the doc will be able to tell he is taking less than prescribed. However, what very well could happen is the doc could say, "Bring your pills into the office so I can count them." If that should happen, what will he do then? In fact, you might want to ask him that. It seems like many Bup docs treat diversion far above relapse. By that, I mean, docs seem to give a couple of chances to patients who relapse but rarely give a second chance to someone who is diverting their medication – whether for profit or not. That is often a deal breaker.

It's all a daily struggle and a daily process. He is not going to go from where he is to "fixed" or in complete remission overnight. But in order for him to get there, he has to get with the program - and giving away Bup is not getting with the program. All I know is, if this were my friend, I'd let him know that I'm not at all supportive of his actions. That's just me.


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PostPosted: Tue Apr 13, 2010 3:22 pm 
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Oh, he knows I'm not happy about it. I've explained to him many times that diversion is probably a sub-doc's greatest fear, and worst no-no. He's rationalizing it by telling himself (and me) that he's just paying back a few debts, and trying to keep his word. I usually counter that the people he's paying these debts to likely don't give a crap about the honor involved, and will just keep wanting more, and engineering situations that make it seem like giving them more is a good idea. He doesn't seem to be listening.

I'm discouraged. I'll just have to wait and watch. I've already told him that if he screws this up, I won't cut him off, but I won't go to bat for him again. Let's hope that means something.


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PostPosted: Tue Apr 13, 2010 9:18 pm 
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Interestingly, doctors usually (in my experience with sub) have you come in for an appointment, dose you, and then have you come back in a couple days. They don't give you a large script. Then they give you a weeks worth and have you come in. Then 2 weeks. Then a month. I am sure there are several reasons for this, one of which is watching to ensure you aren't diverting it. It is too bad they couldn't have done that in his case. I don't think he was ready to have an entire month of sub in his possession. Most of us aren't the first time.

Let's HOPE that he continues to do well on his suboxone for the next few weeks and doesn't run out. Then, he is going to wish he hadn't given some of them away when he is short. Let's hope he doesn't do this again and REALLY run out early and then relapse. But hopefully, he will learn his lesson from this first run. I know I learned my first month not to do that. But it is just like an addict to push the limits right off the bat. Gotta love us :)


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PostPosted: Wed Apr 14, 2010 4:22 pm 
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Well, part of the trouble, of course, is that he's flat broke. I'm sure that at this early juncture, he's seeing dollar signs on the pills rather than daggers. In fact, he confessed to me that he traded one for a pack of cigarettes. Of course, that just made my mind echo with thoughts of piling one addiction on top of another and letting them intertwine. I could go nuts thinking about the permutations.

Ugh.

Anyway, I told him once again today that if he messed up with this Doc, I'd still be his friend, but that I would not go to these lengths again. He'd be on his own in that regard.

I have to say that while my overall stress level went down after he got the prescription, it's still considerable. It's kind of getting old.


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PostPosted: Wed Apr 21, 2010 2:31 pm 
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Hi Xeno,

I just wanted to check in and see how you're doing. After all you've done for your friend Ogre, I hope he doesn't let the both of you down. Diversion is a very quick way to get kicked out of the program.

I hope you're both doing well and regardless I hope your stress level is finally going down.

Take care -

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Wed Apr 21, 2010 3:25 pm 
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Hey. Sorry - life's just kind of heating up along with the weather.

He aced his second appointment, and now doesn't have to be back till his prescription runs out at the one month mark. The trouble now is his social milieu. It's better than it was, miraculously, but still wretched.

He's confessed to me that he's still having cravings. He's also dirt poor until the beginning of May. I'm worried that he's not taking the pills as prescribed. I know for a fact he's snorted a couple. However, I'm primarily worried that he'll see those pills as a financial resource. I just have to remind myself that at this point, there's very little more I can do. We've reached a point where it's pretty much up to him. This worries me.

He's repeatedly expressed that he really is trying, and wants a (more) normal life. He has goals now. He thinks about the future way more. Unfortunately, I have begun to think he's not completely ready to slam the door on the idea of getting high. I've explained to him repeatedly that if this plan crumbles, I won't have the emotional or financial resources go through this with him again. I doubt that makes a difference, though.

No matter what happens, I kept the promise I made him when he asked me for help. I'm going to have to be content with that for now.

But I haven't lost all hope. He may still surprise me.


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PostPosted: Wed Apr 21, 2010 3:35 pm 
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…but that was all about him, wasn't it?

Even though I've now discovered that this process involves a succession of hurdles and not just one big one, my overall stress level is lower. I honestly think it's the notion that I've carried him as far as I could, and now he has to walk a little, even though I'll be walking beside him. It's oddly calming.

Also, on a positive note, this experience has taught me a LOT about a lot of things. I've learned new ways to read people. I've been given a radically different perspective from which to view the issues in my own life. I've learned a ton firsthand about the psychology of addiction. I've learned a lot about how the medical establishment approaches this problem. I've learned a little about how social services approaches this problem. And, on a more practical level I've learned that sodium ascorbate makes a killer cut, and I've learned the value of a bag of DOA! :) :D

Anyway, I've always believed that experience and education are never wasted. No matter what happens, I'll take away something positive from all this.


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PostPosted: Fri Apr 23, 2010 9:40 pm 
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Slightly good news to temper slightly bad news.

The bad news is that my diversionary fears are justified. He has sold some more pills. As I said, he's flat broke at the moment, so while I wish this wasn't happening, it's at least easy to understand. He claims he's left himself enough to get by until his next doctor visit, so I have no choice but to take him at his word. Thankfully, he sounded more lucid today than I've ever heard him before, like *ever*, so his word was pretty easy to take.

The good news is that he did two little experiments, each of which failed. 1) he tried skipping suboxone for a day. He succeeded, but woke up the next day dopesick to the point of his jaw chattering. He immediately dosed to send that away and has had no thoughts of skipping since. He has now learned one of the rules of this game the hard way. 2) he tried shooting. He told me before that he knew of others who had used particularly strong heroin to break through the suboxone blockade, so I knew he'd try it eventually. He tried it and it did absolutely nothing. I calmly told him "told ya so" while in the privacy of my own head, I was jumping for joy.

I take this last as a very positive sign. If he derives no pleasure from shooting, he may be at the start of the long road to de-conditioning himself.


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PostPosted: Fri Apr 23, 2010 10:04 pm 
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That does sound like good news, Xeno. Hopefully the diversion will peter out and stop soon. I'm really happy for you, because you've put in so much time and energy into this. I also know how much you care about him. But those recent experiences bode well for him and his beginning recovery.

Thanks for continuing to update us.

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Sat Apr 24, 2010 1:25 am 
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xeno, you seem like a really awesome friend. I hope you continue to take care of yourself as well!

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PostPosted: Mon Jun 14, 2010 3:31 pm 
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Just a quick note to show I haven't completely forgotten about y'all.

My friend is doing OK. Due to a variety of circumstances, I haven't been as able to be as closely involved as I was. I have to admit I was a bit worried for awhile, not having heard from him. I saw him recently, though, and while his life situation overall is hardly better, he has pulled himself out of the social circle that was keeping him on the needle. He wiped a ton of people out of his cell phone, for example. He did this on his own, with no prompting. I was very pleased. When I saw him, he had just refilled his suboxone prescription, so he's still on track.

All in all, not the disaster I was expecting. I'll post more details if/when I get them.


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