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PostPosted: Thu Jun 11, 2015 10:18 am 
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For a bit of background for those who don't know me. I have a lot of personal experience with pharmacotherapies for opioid addiction. I started using opioids at around 16 years old, and am now 32. Of those 16 years of use, I spent about 5 years on buprenorphine (Subutex initially, more recently Suboxone), and 3 or 4 years on methadone. While my life was for the most part manageable on drug-replacement, it's important to note that neither high doses of Suboxone or methadone stopped me using heroin completely. If anything they only made my using more manageable. I've also had about 4 years in total completely abstinent doing meetings, with or without long term rehab as a primer. Looking back at my using career, it'd make sense to label me a chronic relapser. But the reality is, opioid addiction is a chronic relapsing condition, and my recurring pattern of use is more the rule than the exception.

Most recently I experienced a relapse into heroin use after 16 months of clean time in NA. I was fortunate to arrest this relapse after only 3-4 weeks of daily use. After a couple of weeks of using, I realised where I was rapidly heading - back to a life of dereliction and homelessness. I was faced with a choice. Go back on Suboxone or methadone, and find myself once again locked into a cycle of opioid dependency, or give up my flat, my job and my pet and go back into long term rehab. Neither of those options appealed to me, so in desperation I looked elsewhere.

I'd known for some time about naltrexone implants. Some people did quite well. Others just continued their using once the implant wore off. But I was desperate to once again be clean, and having an implant that removed the option of using completely seemed to appeal to me. I contacted the only doctor in the city who does the procedure. Mind you this doctor isn't shy to controversy, and has a reputation as a renegade. But naltrexone implants are controversial, perhaps because many of their patients don't have the necessary tools to live drug free. You hear some horror stories about these people cutting out their implants in a moment of desperation.

My experience couldn't be more different. Since I got the implant 2 months ago, I haven't used opioids once. I haven't even bothered to try. The implant has done for me what high doses of Suboxone and methadone couldn't - that is eradicate my using completely. I went from having a daily smack habit, to stopping completely without going to a lock-down detox and rehab. I don't have to take a daily dose or pill, and I'm not tied down to a methadone clinic or a pharmacy to receive my daily dose of Sub. I don't even feel much of a need to attend NA meetings. I'm living pretty much like a normal person. I work, I study, I socialise, I go about my day to day business without needing to see a doctor to get a script once a month. I'm even having the occasional beer like a normal person.

To be honest I wish I took the plunge and got an implant earlier. And I'd actually be pretty darn happy to keep getting implants for the rest of my life. At $1200 for a 6 month implant, it works out significantly cheaper than Suboxone or methadone. And it's completely set and forget.

Mind you the induction wasn't easy. I had some incredibly nasty precipitated withdrawal that lasted 3-4 days, and was shaky and on edge for some weeks after the procedure. But now the only thing I notice is a tiny bump in my lower belly. Otherwise I'm side-effect free.

Given how well it's working for me so far, I often find myself wondering why more people don't go down this road? Is it a fear of abstinence, or does the procedure seem too invasive? Or do people simply not know about it?


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PostPosted: Thu Jun 11, 2015 2:50 pm 
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Hey TJ..
Good to hear from you . Well, Ive known three people who have givin the inplant a try. One is still doing it after 7 months,
The other two at last count have used.
I think every way to stop useing, even for a short time is worth it. This is new for you so give it a go!!

Here in the States there seems to be more of a push for Naltrexone one way or the other. Plus the injection of V.
I see it as a different way of trying to beat back the opiate monster. Best of luck with it.

Question, why have you left the NA rooms now? There are many reasons, i get that, for real. You dont have to answer if you dont want to. Sorry to hear of your relapse man. You survived thank god. .

Hang in there glad your doing well today....


Razor


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PostPosted: Thu Jun 11, 2015 4:35 pm 
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For me i am not really educated on Naltrexone.
I am so happy for you that you have found something that has worked. I think if I knew more about it I would def consider it as an option if the price went down.

One it would cost me more money to get the shot every 6months than my monthly Zubsolv.

And I guess 2. i am really afraid that I would have cravings still even with the implant. And 3. the fact that I need a procedure to get it implanted.


Keep up the good work TJ!


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PostPosted: Fri Jun 12, 2015 9:16 am 
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Hey TJ,

Sorry to hear about ur relapse, but as u said it best, this is a chronic relapse disease. The implant would definitely be a lot cheaper for me from what I pay right now. I've been paying $350 a month for my visit plus around $350 for my medicine....each month for almost four years. So the implant would definitely be better financially. Like Raudy said, I'd definitely be afraid of having cravings and be a complete total train wreck mentally. But before I started sub, the implant was something I researched and debated on.

Great to hear how awesome ur doing!!

_________________
Jennifer


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PostPosted: Sun Jun 21, 2015 8:48 pm 
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I understand the whole fear of cravings thing. The funny thing is, when the option of using is removed completely, the cravings seem to diminish for the most part. The same thing happens to me I move to an environment where I can't score, be it in rehab or to a small rural farm. Cravings seem to disappear. However when I move back to an urban environment, the cravings return.

I won't lie. Shortly after getting my implant I started to crave other drugs, mainly IV coke. I think that was largely because of an addiction to the ritual of injecting. Thankfully cocaine is shit in my city, and not worth the trouble. I even craved shard / meth for a while there, which is funny because I can't stand the stuff.

The risk behind the naltrexone implant comes once the implant wears off. Because naltrexone completely resets the opioid receptors, you become totally opioid-naive / your tolerance is completely reset. People who use once the implant wears off therefore are at high risk of overdose. It's for this reason that the procedure isn't in the mainstream. I hope to negate this risk by continually getting implants until my life has transformed enough and using heroin is a thing of the past.


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

  • Board Certified Psychiatrist
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