My (Ongoing) Taper with Suboxone

Hello Everyone,

Welcome back to my blog about opiate addiction. As many of you already know from reading my previous blog entries, I am currently taking part in a Suboxone program due to my addiction to Oxycodone. I have been on Suboxone for just under a year now and know my time on this medication is coming to an end soon. This is something that both excites me and scares. Something I look forward to yet dread. Something I know I must do but would like to put off for "just a little longer." In the end, it is something I must come to terms with, face, and overcome if I ever want to live a life truly free of opiates. Therefore, I would like to use this particular post to talk about my taper on Suboxone, where I am at now with my recovery, and where I want to be in the end of it all.

Quick History

To give you guys a quick history of my situation in regards to Suboxone, I'll start with what got me there in the first place. I was addicted to the Oxycodone 30 mg pills for about 2 years and during the last few months I was abusing these pills before I got help, I was taking between 150-300 mg a day depending on what I could afford and get my hands on. I had tried to quit numerous times cold turkey but the farthest I could ever make it was 2 weeks. Most of the time when I tried going cold turkey, it would only last a matter of days before I would eventually cave in and use again. The lack of sleep, constant restlessness, brutal cold chills, and ongoing anxiety and depression really made it difficult for me to quit. This is when I came across Suboxone.

I had a few people and friends I knew who were or had been on Suboxone due to an addiction to Oxycodone so I figured this was my best shot. I figured, I could take a pill to avoid any withdrawal from the Oxycodone that wouldn't get me high, get my life back together, and then make the jump off of Suboxone. I also figured because I wouldn't (not couldn't) abuse the Suboxone, it would be easier to come off something that I didn't, well, like to get high off of.

I did a whole post on my experience with getting on Suboxone, if you guys would like to check it out by clicking Here.

Basically, I was started on 4 mg of Suboxone once a day. These were the 8/2 mg strips/films meaning that there was 8 mg of Buprenorphine and 2 mg of Naloxone in each strip/film. I would start out by taking half of a strip once a day. After about 5 months, my dose would be lowered to 2 mg once a day where I would take 1 mg in the morning and 1 mg at night. A little over 2 months later, my dose was again lowered to 1 mg once a day with .5 mg in the morning and .5 mg at night. This is the dose I am currently on as I write this post.

The 8 mg films/strips I was first prescribed. I took a half of a film/strip (4 mg) once a day when I first started Suboxone.

 

The films/strips I am currently taking now. I currently take half of film/strip each day (1 mg)

How Bad Was It?

 

The first few days on Suboxone weren't a walk in the park by any means but it was also not Hell on Earth either. I had little energy, was somewhat depressed, had random chills, and felt some minor aches/pains but these symptoms were all bearable. After about a week on the Suboxone, I felt close to 100 % and was able to get on with my life. I still had cravings to use but these went away for the most part after about a month on the Suboxone.

 

My Suboxone doctor told me I was lucky to be starting out at a relatively low dose and that some of her patients were being put on anywhere from 16-24 mg during induction. While my doctor isn't the greatest doctor in the world, I can honestly say she does look out for her patients if they are really looking to get clean and is not someone who is simply in it for the money. She told me how she tries to put her patients on the lowest dose possible when they first come in to help make the taper easier for both parties. However, she also mentioned how it is not uncommon for patients to come back after a few days saying they need more Subxone and that she will usually increase their dose if she can tell they really want to get clean and are being honest. She noted how if increasing their dose early on will help them get with the program and prevent them from using, it's a risk she is willing to take.

 

Anyways, back to my particular situation. After being on 4 mg of Suboxone for about 5 months, I made the jump to 2 mg once a day. I was a little nervous when this first happened. However, I can honestly say I felt absolutely no negative side effects or symptoms from my reduction in dosage. I was pretty shocked by this, especially for someone who was using so much Oxycodone to begin with. I think the key to this is to be honest with yourself when your figuring out how much Suboxone you really need. I think a lot of it is mental too. Try to give yourself enough time on your dose to see if you really need to take more and that it is not your mind playing tricks on you making you think that because you take less, you will withdraw. However, everyone is different and I realize every one's situation won't be the same as mine. In the end, only you will truly know your body and what works and doesn't works for you.

 

Another thing I want to bring is up is cravings during my time on 2 mg. I must say that although I did relapse, the cravings were not really present or intense during my time on this dose. I didn't relapse while I was on the 4 mg but I honestly don't think the reduction in my dose had anything to do with my relapse. When I did relapse, it was from me being a knucklehead and putting myself among a crowd of the wrong people with the wrong stuff. I could had simply said no and went my way but I didn't. I managed to get back on the sober train pretty quick and painlessly in the end, although if I could go back and do it all over again, I would have never used and put myself in that situation.

 

When I made the jump from 2 mg to 1 mg, this is where things got interesting. For the most part I am pretty comfortable during the day after I take my morning dose of .5 mg. I would say I'm probably at around 80-85 percent during the day and only get occasional chills or body aches sometimes. However, come nighttime, I can begin to feel myself needing that 2nd dose of .5 mg. I don't feel horrible, but I'll start getting the chills, a runny nose, a feeling of restlessness, and minor anxiety. Once I take my 2nd and final dose of the day of .5 mg I feel fine and am able to go to bed. Sometimes I might wake up early in the morning due to restless legs or the chills, probably indicting I am ready for my next dose. It can suck but all in all, just a minor inconvenience at most.

 

Thus far, I would defiantly say the biggest challenge of my taper has been the drop from 2 mg to 1 mg. While most of the side effects and symptoms are bearable, they can still be a bit of a pain and nuisance. However, they are no where near the full blown withdrawal I would feel if I were to begin withdrawing from Oxycodone cold turkey. As for cravings, I still do get them sometimes but can usually keep them at bay by keeping myself busy or distracted.

 

Since my drop to 1 mg once a day, I have been prescribed and have been taking a few medications to help with these symptoms. The first medication is Clonidine, which is used to help combat high blood pressure, the chills and cold sweats, restlessness, and lack of sleep some people get while withdrawing from opiates. I only take this medication at night (.2 mg) as it makes me drowsy. This medication certainly isn't an end all for withdrawal but it does help, especially with the sleep. The next medication I take is Advil which surprisingly helps quite a bit with achy joints and muscle cramps. I used to always laugh at the though of taking a medication like Advil when I was putting hundreds of milligrams of Oxycodone in my body but must say, the medication does help. The final medication I take is Requip, which is used to help with the restless legs. I take 1 mg at night but have found this medication to mediocre at best. 

 

The Next Step

 

 

I have talked with my doctor and stressed to her that I want to be at the lowest dose possible before I make the jump off of Suboxone to help avoid or minimize any potential withdrawal. Thankfully, she has been for the most part understanding and I think the next step will be to lower my dose from 1 mg to .5 mg once a day with .25 mg in the morning and .25 mg at night. I can only imagine what this will feel like but am confident I am moving in the right direction. I plan on making the jump off of Suboxone around .25 mg (maybe less if possible). Hopefully everything will go smoothly and according to plan but I am aware and prepared if I need a little more time.

 

I'm not really sure what kind of medications my doctor will prescribe me when I make the jump off of Suboxone as each doctor is different with his or her methods and beliefs. I'm hoping to continue getting and taking the Clonidine, Requip, and Advil. I am also hoping I can get something such as Xanex and Ambien to help with the restlessness, anxiety, and sleep issues that so often come along with opiate withdrawal. I plan on taking these medications for no more than 2 weeks due the risk of developing an addiction to some them, especially any Benzo.

 

I have heard Suboxone withdrawal is milder than the withdrawals one would experience form Oxycodone, Heroin, and other opiates but that the withdrawal from Suboxone tends to last longer. Basically, I'm anticipating going through a long, difficult month before things start to get better and easier once I make jump off of Suboxone. I'm not going to lie, I am very nervous and even scared that the withdrawal might be to difficult or that the cravings and mental aspect of it might push to me to use again. This is where I must use the skills and coping mechanisms I have learned over the past several months to overcome these obstacles. I got myself into this situation so I must have the courage, strength, effort, and willpower to get myself out of it.

 

Some Good Information About Suboxone Taper & Withdrawal

 

There is a lot of information out there on the internet about tapering off of Suboxone in addition to Suboxone withdrawal. This information also includes stories from people who have actually experienced or took part in Suboxone withdrawal or a taper regime. I have posted a few links below that I think might be helpful to some of you guys.

 

http://www.subotex.com/suboxone-tapering-withdrawal-worse-than-opiates/

 

http://www.addictionsurvivors.org/vbulletin/showthread.php?t=16678

 

http://suboxonetaper.com/

 

http://www.drugs.com/forum/need-talk/suboxone-taper-could-use-some-help-straight-point-62879.html

 

http://janaburson.wordpress.com/2012/08/21/taper-off-suboxone-using-the-films/

 

http://suboxone.com/patients/about_suboxone/Default.aspx

 

http://www.suboxonetalkzone.com/withdrawal-from-suboxone/

 

There are literally thousands of websites, blogs, and posts regarding Suboxone out there on the internet in addition to the ones I just posted. If you simply type in "Suboxone", "Suboxone Taper", or "Suboxone Withdrawal", you'll find yourself with tons of information at your disposal. Remember, knowledge is power!

 

Was Suboxone the Right Choice?

 

Since the very first day I got on Suboxone and even before I made the decision to get on the drug, I have asked myself is getting on Suboxone the right choice? I don't have an answer right now for you guys but I do have some input in regards to my particular situation.

 

My addiction to Oxycodone was really having an impact on my life and hurting not only myself but those closest to me. I was lying, spending thousands of dollars, and beginning to change as a person. While I still managed to successfully work and go to school, my heart and mind was never truly in it and involved. I was simply going through the motions, high on Oxycodone, and thinking about when and how I would score my next batch of pills. It wasn't living. It was just surviving life by dulling out any pain or emotion with the pills. Most importantly, it wasn't the real me.

 

As I mentioned, I had tried quitting Oxycodone cold turkey several times but each time ended up falling back to my old ways and habits. It was a never ending, painful cycle. My habit had grown to a ridiculous amount and the amount of money and things I was doing to get that money was something I still cringe at today. I needed to change.

 

 

So for me, getting on Suboxone helped me do that. I have managed to remain clean for the most part while being able to attend school, work, and spend time with family and friends. Things I would have never been able to do while withdrawing from Oxycodone. I think if someone can go cold turkey without having to quit school or their job, then that is great. But for me, it was something I couldn't do while going to school and working so I needed another option.

 

Since being on Suboxone, I have continued to work, go school, build sober support, learn coping mechanisms, meet the right people and get away from the wrong ones, and learn to live a life of not having to constantly worry about how and when to get these devilish pills. I have found that Suboxone is particularly helpful in allowing one time to figure out how to turn their life around and get rid of the old, bad habits of past. These steps are extremely important in learning to live as a sober individual.

 

At the same time, I know I am still on an opiate and will most likely face some kind of withdrawal in the end. I ask myself, will the withdrawal from Suboxone be easier or harder to face, longer or shorter, bearable or unbearable? These are all serious questions that I have still have no answer to. I have spent countless hours talking to people along with reading and researching on the Internet about people who have experienced or overcame Suboxone withdrawal only to get about a thousand different responses with some ranging form total Hell on Earth to a walk in the park. In the end, I must realize that everyone and their situation is different so I can't base everything on what someone says just like you guys can't base everything on this post you are reading right now. EVERYONE is different.

 

To sum things up, I can honestly say I am, as of right now, happy I made the decision to get on Suboxone. I know some people bash Suboxone and look at it as trading one drug for another, but if it wasn't for Suboxone, I would probably be out getting high, hurting the people I love and care for most, and destroying my life, morals, and reputation. I don't think there is really any way to totally avoid withdrawals when getting off opiates but I hope through my taper I am able to at least minimize them. I know withdrawals are just a fact of life and part of this game we put ourselves into, so I must be a man and face them at some point. Like my consoler always say, "this will probably be the hardest thing to accomplish in your life but is something you will feel so proud, happy, and good about if you overcome it."

 

Conclusion

 

I want to thank you guys once again for taking the time to read my blog and I really hope I can help some of you who find yourselves in a similar situation. Hopefully we can all find the strength and willpower to beat this thing we call addiction. It's not easy but it is possible, something we must all remember.

 

I would love to hear from you guys in the comment section about what you think of my situation. Any tips, suggestions, or past experiences would be greatly appreciated. Also, feel free to ask any questions or comment about anything that's on your mind. I will respond to each and every comment as soon as I can.

 

Thanks again Guys and take care. And remember, keep seeing that light.

 

Until next time,

 

Seeingthelight



Rapid Opioid Detoxification

Ah what a beautiful fall day here on the East Coast. The weather is as close to perfect as one could ask for when taking into consideration the sometimes baffling New England weather. The birds are chirping, the sun shining, calm guests of wind pass by creating an almost picture-like atmosphere around me. And here I am enjoying this wonderful day demonstrating the beauty of life....sitting behind my computer screen typing away!

I recently took somewhat of a break from blogging (not intentionally however) and I must say, it feels good to be back at it. For those of you who haven't yet read my "comeback" post, check it out. It's labeled as "I'm Back" and can be found on my blog homepage. Now lets get to business.

For anyone visiting this site for the first time, I welcome you to my blog and hope you will find it both helpful and an enjoyable read. This is now my 14th post and I must say I am becoming more and more pleased with the blog as each post is thought of, written, and published for you guys to read. Over the past several months I have gotten a few comments, a solid number of page views, and even an e-mail from someone looking for a little more advice and someone to "just talk to". I have also noticed that a few people took the most recent poll as well which only adds to my satisfaction. It makes me feel like that I'm getting my blog out there to anyone who's looking for any advice and information about opiate addiction and that I'm not just typing away for nothing. I would like to take a second to thank all of you who have read my blog, commented on it, taken part of the poll, or have passed the word around. THANK YOU!

For this post I would like to talk about a treatment option for opiate addicts that is relatively new. This method of treatment is commonly referred to and known as Rapid Opioid Detoxification and has been met with both praise and criticism. To make things a little easier for myself, I will be referring to the Rapid opioid detoxification as ROD. To give you guys a quick idea of what this is, please let me explain and sum it up in a few quick sentences. ROD is a method of treatment for opiate addicts which often places the patient in a state of unconsciousness while doctors provide the patient with a variety of medications that will help speed up the detoxification process. The patient will be "asleep" for a period of time and will then awaken after the normal period of opiate withdrawal. To put it bluntly, they basically put you asleep, give you some medications to speed up the detox process, and allow the patient to awaken feeling little to no withdrawal symptoms.

When I first heard of this method of treatment, I was very enlightened and curious about the process as it seemed far too good to be true. After doing some research and asking both my addiction doctor and consoler some questions about the matter, I was left with the impression that this method of treatment has a lot of promise but is still in its early stages and needs a lot more work and research put into it. Similar to many of my other posts on this blog, I would like to take this post and divide it into a few sections that will further discuss the matter. I would like to give you guys a brief overview and history of this method of treatment, its effectiveness, the general census of it currently, and my thoughts on it. After that, I'll leave the rest to you guys provide any comments, inputs, or even experiences you have on the matter. On that note, lets begin.

A Basic Overview/History Of  Rapid Opioid Detoxification

 

The origins and history of ROD are somewhat unclear and shady from what I have been able to research and understand. After doing some of my own research on the matter, I came across a website that gave me a few answers on this question.  This website states that "rapid opiate detox was created in Israel almost 20 years ago by Dr. Andre Waismann, who still practices his craft in Barzilai Medical Center in Ashkelon, Israel," and that this method of treatment came about after a striking number of soldiers from the Israeli army were found to have been suffering from opiate addiction. The army and its doctors (or scientists, not exactly sure who?) came to the conclusion that something must be done to address this growing problem and that the traditional methods of treatment were not good enough for the situation at hand. Over time, research, and much effort, this is where Rapid Opioid Detoxification (ROD) emerged as an option.

 

There is a brief amount of information from this website that explains the origins and history of this method of treatment and its something that I feel I can't really explain to you guys without basically stating exactly what the website says so rather than to try to put it into my own words and possibly leave out any important information or to say the wrong things, I will put below this paragraph in blue front word for word what the website states (feel free to check out the website yourself if you wish by clicking on the link in the paragraph above).

 

"Rapid opiate detox was created in Israel almost 20 years ago by Dr. Andre Waismann, who still practices his craft in Barzilai Medical Center in Ashkelon, Israel.

Since the original procedure was used on addicted soldiers in Israeli army, it has been gradually perfected by new medications that have since been approved by FDA to help control the effects of the withdrawal. The detoxification drug treatment procedure involves administering intravenous medications that remove opiates from the opioid receptors while the patient is sedated. The detox is done under anesthesia to avoid extreme discomfort and pain from opioid withdrawal symptoms. Additional medications are given to counteract the withdrawal manifestations and to comfort the patient.

Rapid detox under anesthesia can get you through the worst of withdrawal with only limited amount of symptoms that we can help to manage. A small implant containing Naltrexone may be placed under the skin while the patient is still under sedation. The Naltrexone implant slowly releases medication to continually block receptors and help the patient fight the physical symptoms of drug addiction. The Naltrexone implant will entirely dissolve and disappear in approximately two months. Naltrexone implant will take the daily decision making out of your hands. Knowing that narcotics will have no effect on you, if you do slip up, will help the psychological cravings as well.

There sprung up numerous small clinics all over the country duplicating the work that Dr. Waismann began in 1994. Some are well trained and well ran clinics quietly helping patients start new lives, however a few were trying to make a fast buck and ran into trouble and unfortunately those are the ones that get into news and leave a bad taste in the mouths of all.

Internists not doing proper medical screening, not making sure the patients are well enough for the procedure; Anesthesiologists who are not ABA certified, facilities that are ill equipped to deal with emergency situations, etc. Unfortunately the list can go on and on…

The procedure became somewhat controversial, because of the spectacular stories that were heard from time to time, also because no pharmaceutical company was behind it and making a lot of profit (aka Suboxone). However for the professionals who have been involved in it, Addictionologists, Internists, Anesthesiologists – are all believers. They do it because they know it works. Patient after patient, as long as there is a will and a commitment."

While this method of treatment has been around for 20 years, it really hasn't been that well known in the U.S. until recently. Some doctors are all for it while others are very much against it, so there isn't really a final census or agreement on the matter as of now. Hopefully there will be more information about this matter as time goes on and that they can fix any of the problems with this procedure. The withdrawals experienced during this procedure are often compared to as how one would feel if they were to go into precipitated withdrawal. If you remember from my previous posts (or worse, know from experience), precipitated withdrawal occurs when you take a drug such as Suboxone, Methadone, or Vivitrol without having waited long enough after any previous use of opiates such as Oxycodone, Heroin, and the like. For those who don't know, precipitated withdrawal is said to be much worse of a feeling than the "normal" opiate withdrawals one would suffer if they were to suddenly stop using opiates after a continued period of time (going cold turkey).

Normal opiate withdrawals already suck enough as it is, so precipitated withdrawals is something you don't want to mess with. While the patient would normally feel like they were in a state of hell during the course of experiencing precipitated opiate withdrawal, the patient undergoing ROD is supposed to feel little to no discomfort or pain during ROD due to the fact that they are not conscious and are under certain medications. Basically, the procedure has you sleep though the rough part while under medical supervision.



The procedure itself differs slightly from place from place but the basic concepts behind it remain nearly the same. To give you guys a description of the procedure, I have once again provided a detailed description of the procedure from a website I found online (I promise you I'm not getting lazy, I just want everything to be as clear as possible for you guys rather than putting things in my own words) while researching this method of treatment. This information is below this paragraph and is once again in blue front.

"Naltrexone is sometimes used for rapid detoxification ("rapid detox") regimens for opioid dependence. The principle of rapid detoxification is to induce opioid-receptor blockage while the patient is in a state of impaired consciousness, so as to attenuate the withdrawal symptoms experienced by the patient. Rapid detoxification under general anesthesia (sometimes called "ultra-rapid detox") involves an unconscious patient and requires intubation and external ventilation. Rapid detoxification is also possible under lighter sedation. The rapid detoxification procedure is followed by oral naltrexone daily for up to 12 months for opioid dependence management. There are a number of practitioners who will use a naltrexone implant, usually placed in the lower abdomen, to replace the oral naltrexone."

Another website provided a brief description of the process for their particular facility and I have listed it below this paragraph as well. This information comes from a facility in New York known as New York Rapid Opioid Detoxification (NYROD).

"The process begins when NYROD is first contacted by a patient or referring source. Patients then undergo a thorough screening of their medical and drug histories, and psychological profiles. Patients will complete an extensive questionnaire which will be reviewed by Dr. Brooks and our addiction specialized therapist. Dr. Brooks and out addiction therapists will speak to each patient in person, or by phone if calling from a great distance. Patient determination to end their opiate addiction is key to acceptance for treatment. With patient consent, previous therapists will be contacted to discuss your addiction and treatment histories. All patients must undergo physical examination and testing appropriate for their age and drug history.

AAROD is an important first step toward becoming opiate addiction free, but is only a first step. Therefore, to optimize outcomes and avoid relapse, NO patient will be allowed into the program unless aftercare has been established. That is, patients must have an inpatient, or outpatient post-procedure treatment plan to help them understand any psychosocial roots of their addictions and trigger avoidance. Our staff will work with you to assure a smooth transition into an aftercare program. In addition, we will maintain contact with each patient with frequent phone calls and return follow-up appointments. Every patient will have 24-hour access numbers to reach us if needed.

Patients are admitted early morning. An intravenous line is started and patients are placed on cardiac and oxygen monitors. Under the care of an ICU trained RN, patients will receive clonidine and intravenous fluids. The clonidine will help stabilize blood pressure and heart rate during detoxification. The fluids will begin the “washout” of the opiates still on the patient’s receptors.
Next, under the direct and constant care of a Board Certified Anesthesiologist, patients are brought into a state of the art procedure room. After the induction of deep intravenous sedation patients are administered the opiate antagonists naloxone and naltrexone until all opiates have been displaced from the opiate receptors and the detoxification is complete. Patients have no awareness or memory of the detoxification process which would otherwise be intolerable. Depending upon the level of addiction and the drugs to which the patient is addicted, the procedure will last from 3 to 4 hours. Before awakening, and only after the patient is completely detoxified, the patient is administered depot naltrexone injection.

Patients are next brought to a comfortable recovery area where they will be continuously monitored through the night by a trained RN. Any residual restlessness or discomfort or expected gastrointestinal distress will be treated as needed. Young patients may have a parent stay with them for all or part of the recovery period.

Before discharge the next morning, every patient will be evaluated by Dr. Brooks, and visited by our therapist to discuss immediate aftercare planning. Unless ready for discharge, patients will be kept. No patient will be allowed to leave without a responsible adult escort.

The aftercare you receive will be individualized and determined by you and your therapist. Some patients will choose to immediately continue in an outpatient setting, working closely with a therapist and joining a support group such as Narcotics Anonymous. Others may feel that they must first enter a more structured program in a protected and anonymous rehabilitation setting, far from their familiar “people, places, and things"

This procedure is supposed to be nearly painless and provides the patient with the chance to achieve sobriety without having to put up with the physical withdrawals from trying to quit opiates. The withdrawals from opiates is often a factor that prevents many (myself included) from going the cold turkey route. This option may also be appealing for those who dislike Opiate Replacement Therapy drugs such as Suboxone, Methadone, or Vivitrol or who feel they would otherwise be unsuccessful with going down this route (or cold turkey). The fact that it is basically a one time procedure (unlike Suboxone/Methadone which is an every day thing) is something that may be very appealing for some addicts.

Based on what I have read, patients will often stay in the facility or hospital for a few days and will be closely monitored. After the procedure, patients will be sometimes be prescribed Naltrexone to help them remain sober. It is important to remember that Naltrexone is not addicting and is the same drug that is found in the Vivitrol shot that I talked about here. It is also recommended that after the procedure that the patient continues to see their doctor, live a drug and alcohol free life, and seek support and/or AA/NA meetings.

Effectiveness/Opinion Of Rapid Opioid Detoxification

 

As I said previously in this post, there is still much debate as to exactly how effective the ROD can be and where it ranks among the many other treatment options out there. Many feel the procedure has much promise but is still in its early stages of development and that the procedure itself carries its own risks. There are others who feel the procedure offers little to no advantage over more traditional methods of treatments besides allowing the patient to avoid the physical withdrawals that so often accompany the challenging process of quitting opiates. In other words, while the patient may be able to avoid withdrawal, he or she will still have to face the mental aspect of addiction (cravings, depression, etc.), which can be just as difficult or harder than the physical part of quitting opiates.

 

A major drawback of ROD is that it is usually expensive, in fact quite expensive, as typical procedures usually range anywhere from as low as $5,000 to as high as $30,000 as well as additional costs of having to stay in a hospital for monitoring after the procedure and any medications you may be given. Based on my own research, it appears the average price is usually between $15,000-$20,000. That's a lot of money for most of us and to make matters worse, from what I have read getting insurance to cover the procedure can be quite difficult. Again everyone and their cases are different so some might pay more or less than others or may get better (or worse) insurance coverage. However, staying at an inpatient rehabilitation center is also pretty expensive ranging from a couple hundred dollars a day to thousands of dollars a day depending upon the place and situation. Suboxone, Vivitrol, and Methadone can also burn a hole in your pockets as well but is usually cheaper than ROD or an inpatient stay at a rehabilitation center. In other words, unless you plan on going cold turkey, getting clean can often be quite expensive.

 

To give you guys a clearer picture of what I'm saying, take my situation for example. I am currently on 1 mg of Suboxone a day and usually end up paying about $300-350 a month for my prescription, appointments with my addiction doctor, and meetings with my drug addiction consular which are all mandatory to remain in the outpatient Suboxone program I am part of. And those numbers are with insurance coverage (I'm told I have pretty good insurance too). If you're looking at getting on an opiate replacement therapy program, staying in an inpatient program, or giving the ROD procedure a try, insurance is a near must unless you have the money to spend. I have never been to an inpatient rehabilitation program but to give you an idea of what a stay at a average/normal (not some shithole or some 5 star resort-like rehab), I have included a list of prices without insurance coverage for a typical inpatient stay at a rehabilitation center (Waismann Method Medical Group and Domus Retreat) below:

 

5 day program is $18,800

1 week program is $20,800

10 day program is $23,800

2 week program is $27,800

3 week program is $33,800

4 week program is $39,800

 

Another disadvantage are the risks involved with this procedure. For this procedure, the patient will sometimes be put under anesthesia to basically have them "sleep" through the entire procedure. As most of you already probably know, anesthesia does carry its own risks despite the fact that it is commonly used and well known. These risks can be intensified for those with medical issues or disease so be sure to think this over and talk both regularly and honestly with your doctor if you feel ROD is the route you wish to go. The patient will also be given a variety of drugs (I'm not sure what) so it is important you know what you're being given in case you have any allergies or bad reactions to these drugs. A final risk involved in the procedure is the same risk you take when you decide to go cold turkey. Detoxing off opiates is very rarely life-threatening but it still does take its toll on your body when/if you decide to go cold turkey off opiates. These same risks will be present if you undergo the ROD procedure. I don't want to scare anyone or to seem as though I'm trying to lead you guys in a direction but I feel it is my duty to at least mention that there has been cases of people actually dying during the procedure or a few days after it. This is something that really concerned me but we must also take into consideration that people can die or suffer from complications during any procedure that involves anesthesia as well as the fact that some addicts can be in a relatively poor state of health in the first place. Like anything in life, this procedure has its risks. The following excerpt is taken from an article which explains some of the risks involved with this procedure:

 

"Detox is tough on the body, and a rapid detox is tougher. Although you do not consciously feel the pains of this quickened detox, your body must endure an intensified and accelerated period of detox, and this can be very taxing on the body…and doubly so as many addicts do not enter into detox in the best of health.
 
There have been a number of deaths related to the procedure, where patients have died within days of a rapid detox, and one prominent clinic was closed down over concerns over health and safety.

Advocates argue that although there are risks, the risks of a lifetime of abuse and addiction are greater, and for society as a whole rapid opiate detox betters health. This may or may not be true, but it is not likely very encouraging on an individual basis and when deciding on personal options."

Rapid Opioid Detoxification does not guarantee life-long sobriety and a person who undergoes this treatment has no greater chance of remaining sober than someone who attempts to go cold turkey or use opiate replacement therapy. Someone can be cold turkey off of opiates for a month and suddenly relapse. Someone may be on Suboxone or Methadone for 2 years and relapse. Hell, there are people who have decades of sobriety who end up suddenly relapsing. The same unfortunately goes for patients who have undergone a ROD procedure. I'm not trying to sound like a jerk when I say that (there certainly are people who have undergone cold turkey, opiate replacement therapy, and  I'm sure ROD who have gotten and remained sober) but I want to be as honest as I can be with you guys. ROD will help you avoid the physical withdrawals but you'll most likely still end up having to fight off urges, struggle with the mind games of addiction, and live through the mental anguish for quite some time after you quit opiates. I bring this up because $20,000 is a lot to pay to get sober to end up relapsing later on. Like I've said before, some people get it their first time while others, their 100th try. Everyone is different so don't feel as if I'm speaking for you and every opiate addict out there. Getting sober is easier for others just as it can be harder for others.

This chart shows the percentage of patients who remained sober after a Rapid Opioid Detox procedure. This chart was obtained in the book Drug and Alcohol Dependence (Vol. 52, Issue 53-Pages 177-270). The link to this information can be found by clicking Here.

The following excerpt is from a study that was conducted in 1999 by American Society of Anesthesiologists. It discusses the success rate of the procedure in 20 individuals as well any side effects experienced by these people. The link to this study can be found by clicking here. Here it is below in blue front:

"Background: Opioid addiction therapy includes successful detoxification, rehabilitation, and sometimes methadone maintenance. However, the patient may have physical, mental, and emotional pain while trying to achieve abstinence. A new detoxification technique that incorporates general anesthesia uses a high‐dose opioid antagonist to compress detoxification to within 6 h while avoiding the withdrawal.

 

Methods: After Institutional Review Board approval and detailed informed consent, 20 patients, American Society of Anesthesiologists status I–II, addicted to various opioids underwent anesthesia‐assisted rapid opioid detoxification. After baseline hemodynamics and withdrawal scores were obtained, anesthesia was induced. After testing with 0.4 mg intravenous naloxone, 4 mg nalmefene, was infused over 2 to 3 h. After emergence, severity of withdrawal was scored before and after administration of 0.4 mg intravenous naloxone. After 24 h, patients began outpatient follow‐up treatment while taking oral naltrexone.

 

Results: All 20 patients were successfully detoxified with no adverse anesthetic events. After the first post‐treatment test dose of 0.4 mg naloxone, 13 of 20 patients had no signs of withdrawal and hemodynamic changes were minimal. Withdrawal scores were always very low and similar before and after detoxification. Three of 17 patients (18%) available for follow‐up have remained abstinent from opioids since treatment (≤ 18 months). Four other patients are clean after brief relapses.

 

Conclusions: Anesthesia‐assisted opioid detoxification is an alternative to conventional detoxification."

Getting and staying clean is not an easy thing but is something we (us opiate addicts) must seek, or eventually seek. Most who continue a life of abusing opiates usually end up in jail, institutions, being homeless, or even dead. For those who don't get to any of those places, they will probably end up hurting their families/friends (in addition to themselves), ruining relationships, losing their jobs, and basically destroying their lives. Think about it,  how many happy, successful opiate addicts do you know or have you heard of? If you're like me, none. Addiction may not seem so bad at first but trust me, it will eventually bite you in the ass if you put up with it long enough. Again, I hate to appear gloomy and like a jerk on a high horse, but this is usually the case and is something I know from experience. My rock bottom wasn't jail, homelessness, or death but I did hurt some of the people I cared most about, did some things I would have never thought I would have done, and changed (negatively) as a person. I hated what I was doing and who I was becoming, eventually getting help and can honestly say I am happy the way my life is going right now. It hasn't been easy but like I've said numerous times before, it is possible. I'm still learning this myself as I continue my journey towards sobriety.

What I just mentioned in the previous paragraph is there for a reason. I want to stress to you guys that just like Suboxone, Vivitrol, or Methadone, Rapid Opioid Detoxification is not some miracle drug or procedure. After patient goes through this procedure, he/she will have to continue battling their addiction. It doesn't just go away after this procedure. This is where AA/NA meetings, counseling/therapy, and changing your surroundings and people around you are critical. Just like some Suboxone/Methadone/Vivitrol and rehabilitation centers, some clinics that offer ROD may try to lure you to give ROD a shot with statements of high success rates and an answer to your problems. These places, after all, are businesses and have a product/service they are trying to sell. Remember that. I'm not trying to knock any of these things as they can certainly help someone but you must remember that they are only a tool in your battle against addiction. Think of them a weapon on the battle field. You are battling addiction and have at your hands a variety of weapons. These weapons can include AA/NA meetings, sober networks, coping skills/mechanisms, and opiate replacement therapy drugs such as Suboxone or Methadone. However at the end of the day, it is not the weapons that are on the battlefield that wins (or loses) the war, it is people who are fighting on it that do.

There are a lot of different answers and numbers out there in regards to the effectiveness and success rate of Rapid Opioid Detoxification. Some will claim close to a 100% success while others will be as low as 20-30%. Unfortunately for addicts, most (but not all!) will fail their first (or few) times of trying to get clean. My addiction consular always told me that relapse is part of recovery but that just because it's part of it doesn't mean it has to be. Meatballs can be a part of a spaghetti diner but you don't have to eat them, you can simply eat around them or not put them on your plate and you'll still have your spaghetti. While this metaphor may sound silly at first, if you take a moment to think about it, it is a great comparison for the tools we can use to achieve sobriety.

I don't really have an answer for you guys about how effective or successful this procedure is other than what I just have stated previously. There are articles out there about this topic however, and I would like to provide you guys with them. After reading through a couple of them, you'll probably get what I'm saying about how there isn't really a clear-cut answer about how effective or successful ROD is or can be. Here are some of these articles below:

http://www.choosehelp.com/detox/problems-with-rapid-opiate-detox
http://thestatsblog.wordpress.com/2008/10/02/reporters-love-rapid-detox/
http://jama.jamanetwork.com/article.aspx?articleid=187166#
http://journals.lww.com/anesthesiology/Abstract/1999/12000/Rapid_Opioid_Detoxification_during_General.15.aspx
http://www.mdsdrugdetox.com/faq/
http://www.rapid-detox.net/2005/08/how-effective-is-rapid-detox.html
http://www.doctordeluca.com/Library/DetoxEngage/MethodsRoleOpioidDetox05.pdf

My Final Thoughts On Rapid Opioid Detoxification

 

When I first heard of the Rapid Opioid Detoxification, I was really interested and curious about the procedure. When I heard that you could simply "sleep" through the withdrawals and wake up feeling almost "normal", I simply couldn't believe what I was hearing. It seemed to good to be true. After doing my own research, I began to learn exactly what the procedure was, what it was about, how it worked, and much more information. Yet here I am today, still somewhat puzzled about it.

 

I haven't met or talked to anyone who has undergone the procedure or who knows someone who has. I have never undergone it myself and probably never will as it seems far to expensive for my case and I am a little bit concerned about the potential risks that come along with the procedure. If you asked me if I would ever consider getting this procedure, I would answer truthfully with a no. Between the costs, risks, and uncertainty of the procedure, I feel I wouldn't be comfortable enough going through with it.

 

However, I really do believe there is a lot of promise for a procedure such as this and I think it shows how far the addiction community has come in treating those who suffer from this disease.

I'm Back!

Hi Guys,

Hope everyone is doing well. I want to start this post off by apologizing to my fellow readers and friends. It's been awhile. I got a new laptop a few months ago and ended up losing my password and user name for my blog. Because of this, I have been unable to post on my blog. I plan on getting back to posting as often as I can and I hope I can continue to help some people in regards to opiate addiction.

I would also like to take a second to thank you guys for not only ready my posts but for also commenting on them. I think discussion can be really beneficial and helpful for everyone involved in this blog (myself included). I will try my best to read and reply to every one's comments. So please, keep the comments, questions, and thoughts coming!



I think the best way to write this post is to give you guys a quick update on how my recovery is going and where I am. I have some good news and some bad news...

I'll start with the bad news. I have been on Suboxone for about a year now and have been for the most part, pretty successful in my recovery. However, I have had a few bumps. I made it about 6 months of doing no drugs besides the Suboxone before I eventually caved in and messed up. I went on what I would call a "binge" and ended up getting high on my drug of choice, Oxycodone, for a couple of days. I actually had 3 periods of this. Each time lasted about 3 or 4 days before I ended up back on the sober train. I'm upset I did this after the hard work and dedication I put into my recovery but have learned to come to terms with myself and get back to a life of sobriety. I have now been clean for 45 days as I am writing this post (3/27/13).

It hasn't been easy but I'm surviving. It actually made me realize just how difficult recovery can be and how quick and easy it is for old habits to sneak up on you. I looked back on myself and the things that were going on at the time and have decided the most likely reasons for my relapse were stress, hanging out with the wrong people, boredom, and simply giving in to wanting to get high.

Despite these relapses, I have managed to continue my Suboxone treatment. I was able to avoid testing positive for Oxycodone during my drugs tests by providing myself with enough time (3-4 days) before having to take my weekly drug test at the Suboxone clinic. I want to be honest with you guys and not be someone who preaches something yet doesn't think the rules apply to his or her self. I never told my consular or doctor of my relapses and instead simply went on with the program. If you want my recommendation on what to do if you find yourself in a similar situation, I would tell you to be honest with not only your doctor, consular, and support team but with yourself as well. Once again, that's what I would recommend, not what I actually went out and did myself.

To give you guys a quick history of my story with addiction, I'll start out with what was my drug of choice. I had about a 2 year addiction with the Oxycodone 30 mg pills. I would snort/sniff these pills and was doing them daily, usually taking at least 150 mg a day but would take as much as I could afford/get my hands on. I came clean about my addiction with my girlfriend, family, and some friends and decided to seek help at a Suboxone clinic. I was initially prescribed 4 mg of Suboxone once a day. After about 4 or 5 months on 4 mg, my dose was reduced to 2 mg a day. I would take 1 mg in the morning and 1 mg at night. I was on this dose for about 3 months until my dose was lowered once again to 1 mg a day (.5mg in the morning, .5mg at night). I have been at this dose for about 2 months now.

The jump from 4mg to 2mg was actually very easy. In fact, I felt absolute no withdrawal at all or any negative side effects from my reduction in dosage. However, the jump from 2 mg to 1 mg has been somewhat of a different story. While I feel pretty good and normal most of the day, I can usually begin to feel some discomfort by the end of the day before my second dosing. These withdrawals are minor and usually consist of a runny nose, restless legs, random cold chills, and minor anxiety. I also begin feeling these withdrawals in the early morning around 5 or 6 in the morning before my next dose (usually around 10 a.m.). My best guess is I am feeling my previous dose wearing off and my body is looking for the next dose. Again, these symptoms have been pretty minor but can still suck when I have to work or go to school.

To help combat these symptoms, I talked with my doctor and was prescribed a few medications. These include Clonidine, Requip, and Advil. The Clonidine has been great at night for sleep and does seem to help a little bit with chills and restlessness. I haven't really noticed much of a difference with the Requip, which was prescribed to help with the restless legs. Surprisingly, the Advil has actually been pretty effective with the aches and pains I sometimes get.

While I am certainly happy I am now at a relatively low dose of the Suboxone, I am somewhat fearful of how difficult it will be when I again have to lower my dose when the time comes. I am even more scared about when the time comes to make the jump off of Suboxone completely. My plan is to jump off the Suboxone at as small of a dose as possible to help avoid or limit any potential withdrawal symptoms. If things get tough after I make the jump off of the Suboxone and I am feeling overwhelmed or facing intense cravings, I think I will give the Vivitrol shot a shot (no pun intended).

That's basically where I've been over the past few months since I last posted on here. I am so glad to finally be able to once again access my account and talk with you guys. It really helps to vent, hear others share their experiences, and to have the opportunity to help others as well. My next two posts are going to be about the rapid detox method and ways to taper off of Suboxone. I would like to dedicate the rest of this blog to you guys. In the comment section, please comment about a topic you would like me to address, ask any questions or comments you have, or simply pop in to say hello.

Thanks a lot Guys for reading and it's great to be back. I haven't said this in awhile so here it goes: Through times of desperation, difficulties, and darkness, remember to keep seeing the light!

-Take Care Guys,

Seeingthelight