Showing posts with label Suboxone experiences. Show all posts
Showing posts with label Suboxone experiences. Show all posts

Tuesday, August 14, 2012

Suboxone vs Methadone


Introduction

Hello once again my friends and welcome back to my blog about opiate addiction. This is my fifth and newest post on my blog (that suddenly isn't so new now). This blog is here to help anyone find information on a variety of topics in regards to opiate addiction. As someone who suffers from opiate addiction myself (a 2 year addiction to the Oxycodone 30 mg pills), I use this blog as a way to vent myself as well as to help any others suffering from addiction or knowing someone who does. An addiction to anything is a serious and often sensitive topic, but I'm hoping this blog will allow others (myself included) to not only find information on the matter but to also have the opportunity to speak their minds as well about the matter.

I have noticed an increase in page views for my blog, which made me very happy that this information is getting out there. However, I've yet to have anyone comment yet so please, please don't be afraid to comment on any of my posts. Hopefully we can get some conversations going and I will also answer you guys back as soon as I can, even on older posts. Like always, you guys can check out my other previous posts from my blog by clicking on any of the following links below (in order from 1st post to most recent post):

Welcome (1st Post)
My Experience With Suboxone
The Dreaded Withdrawals
Why We Got Addicted To Opiates


I would like this particular post to discuss and compare two methods that are commonly used to help those suffering from opiate addiction. The two methods are Suboxone and Methadone, and although used for the same purpose of treating opiate addiction, they are both indeed very different. It is also important to note that these two drugs can be used for other things as well but I am just going to focus on their use as a tool in helping with opiate addiction. Basically, I'll give you guys some brief background information on both, compare them, and briefly speak about my experience with Suboxone (I've never used Methadone myself), and will leave the rest to you guys to hopefully generate some conversation within the comment section. Feel free to comment any information you have about this topic, your experiences with either of the drugs, your likes or dislikes of either, and any suggestions you have towards this post or the blog in general. OK, lets begin.


Suboxone or Methadone, That Is The Question

Methadone (top, white pills)
And Suboxone (bottom, orange pills)

Suboxone and Methadone are both drug medications that can be used for the purpose of helping opiate addicts eventually overcome their addiction to their drug of choice (DOC). The next most common action to take besides Suboxone or Methadone treatment is going cold turkey, although there are other ways as well. Suboxone and Methadone are preferred by many as they can help patients avoid withdrawals from stopping use of their DOC temporally until they choose to stop treatment with the Methadone or Suboxone, and opiates altogether. I want to stress this as while these two drugs will prevent most withdrawals and discomfort you would normally experience if you were to stop opiates altogether by going cold turkey, these two drugs carry the risk of withdrawals themselves when stopping them. I'm sure most of you guys know this already, but cold turkey is when one stops using their DOC without the aid of any replacement. So if someone like myself were using Oxycodone everyday for 2 years, then suddenly decided to stop opiates altogether, I would be going cold turkey. It should be noted that opiate withdrawal can be dangerous and is usually a painstaking experience. This is why it is important to not do anything drastic without first alerting those closet to you, your doctor, and your support network.

Withdrawals are the discomfort you feel when you stop using your DOC after a period time of continued use. Withdrawals vary based upon the person, drug they were using, length of time they were using, method of using, and dosage of the drug they were using. Some medications, like Advil, carry no risk of withdrawal while others, such as Oxycodone, Suboxone, Methadone, Valium, Xanex, and numerous others can bring about withdrawals after discontinuing of use. Some common symptoms (among many others) of opiate withdrawals are listed below:

Chills/Goosebumps
Cold Sweats
Headache
Soreness/Aches
Pins and Needles Feelings
Stomach Discomfort/Cramps
Restless Legs
Trouble Sleeping/Insomnia
Dizziness
Diarrhea/Trouble Going Bathroom
Loss of Appetite
Anxiety
Irritability
Lack of Energy
Runny Nose
Yawning
Feeling of the Common Cold/Flu
Depression/Emotional Issues

Quite frankly, these withdrawals suck and can make getting off opiates very challenging. The most common reasons that people struggle with when getting clean are these withdrawals along with the emotional drain opiate withdrawal can bring. It is very hard, but not impossible. In my opinion, there is nothing wrong with going cold turkey (under the right supervision). I also believe there is nothing wrong with using Suboxone or Methadone as a tool get clean off opiates as long as you truly have the desire to get off of opiates and aren't just getting a prescription for these drugs so you can have a supply of what I like to call "Backup Pills" in case you run out early, can't find any opiates, or don't have money to buy opiates. I only say this (and I realize I might sound like a jerk) because I once did this and know of others who did this. In my opinion, you cannot get clean and stay clean if you do not have the true desire to get clean (unless of course, you're locked up in jail or forced into a program). Believe me, I know how tough it can be to battle an addiction and I realize that people who go the Suboxone or Methadone route face just as much difficulty as those who go cold turkey. I am currently over 4 months clean off of Oxycodone after a 2 year habit of using 180-300 mg of Oxycodone a day at the height of my addiction. I have tried going cold turkey myself but could never stay clean very long, which resulted in me eventually going with an outpatient Suboxone program which has really helped me. However, I am not saying cold turkey is impossible as everyone is different and everyone needs there own type of care and rehabilitation. At the end of the day, it's not the route you went to get clean, it's the fact that you managed to get clean that counts the most.


Drugs? For a Drug Addict? Huh?

As I mentioned before, Suboxone and Methadone are given to patients for a period of time to help them overcome their addiction to opiates. Both Suboxone and Methadone are addicting and can be habit forming, especially if misused. So, why the hell would a doctor prescribed something addictive to an addict? The answer is a variety of reasons. Suboxone and Methadone allow patients the ability to stay away from their DOC while being able to continue their lives without the dreaded withdrawals we would normally face if not for the Suboxone or Methadone. This can be very important as it allows patients the opportunity to take their Suboxone or Methadone, stay practically withdrawal free for the time being, and get their lives back together. While on Suboxone or Methadone, patients can find jobs/careers, go to school, take care of their families/children, and other everyday things. Think about how hard it would be having to wake up early, go to work, come home to do some house work, make dinner, help the kids with homework, and going to little Jimmy's little league baseball game all while having to experience opiate withdrawals. This is why Suboxone and Methadone are preferred by so many people.

Another major reason people turn to Methadone and Suboxone is because it can help with cravings as well. Like I said before, these drugs aren't some miracle drugs that cure addiction and cravings but rather eases them. Based on my experience with Suboxone, I still get cravings here and there but would say they are greatly reduced with the use of the Suboxone. Keep in mind through that everyone is different. By being able to stay away from using your DOC, your mind, body, and schedule begin to change to what it was like before you started your addiction. Rather then waking up everyday craving your DOC (and for some, spending your entire day and night looking for more chasing that high), you are able to live a more normal life without constantly worrying about scoring your next high. Nearly all Suboxone and Methadone programs require their patients to submit to drug testing and to meet with doctors and/or consulars frequently, which help keep your life more structured with having someone to answer to if you screw up (it happens to the best of us).

OK, now that we got the good stuff out of the way, lets take a look at the bad stuff. Suboxone and Methadone unfortunately are addicting and can be habit forming. When the day comes when you and your support team decide that it is time to stop using either the Suboxone or Methadone, you will most likely experience some withdrawals. As I've said practically a million times already, everyone is different so it is tough to say how good or bad your withdrawals from Methadone or Suboxone will be. From what I have heard, it appears that Suboxone and Methadone withdrawals are not as bad as say Oxycodone withdrawal, but last wayyyy longer. Based on what I have been told and have read, the physical withdrawals from Suboxone appears to last any where from 7-21 days while the mental withdrawals take quite some time. The physical withdrawals from Suboxone are similar to those of most opiates. Once again, from what I have read, not experienced, the mental withdrawals and mind games continue for months and it usually takes a good 6 months to a year until your mind begins to feel almost completely normal. It sucks to hear, I know, but I want to be upfront and honest with you guys and not sugarcoat things. Everyone is different through so at the end of the day, who knows exactly how good or bad it will truly be.

OK, now this is where having people comment on these posts comes in handy. I have never taken Methadone myself and am getting most of my research from what I have heard from other people (people who have used it, my consular, and my doctor) and from what I have read. I do not want to sound like I am bashing Methadone on here so please excuse me if I sound that way. Basically, from what I have read and heard is that Methadone basically works just as well as Suboxone with keeping withdrawals and cravings at bay, but is much harder to come off than Suboxone or say, Oxycodone. In fact, I have heard that Methadone is one of the most difficult drugs to come off of. From what I have researched, it appears physical withdrawals last for weeks, or even months and can be quite uncomfortable to put it nicely. A common phrase I have heard to describe Methadone withdrawal is that "it gets in your bones." I'll let you guys take that phrase however you want to but it certainly scared me. The mental withdrawals are supposed to be just as bad as those of Suboxone, if not worse. Again, I do not want to bash Methadone as it has been around for quite awhile in the addiction community so it must be doing something right. I have also heard that it is not uncommon for patients of Methadone clinics to have to go every day to get their dose, while Suboxone can usually be obtained on a weekly, biweekly, or even monthly basis. I have also heard that the process of getting accepted into a Methadone program can be quite long and tiring, although I must say that I had to call around and search around for roughly 3 weeks before being accepted into a Suboxone program. Once again, please don't think that I have something against Methadone, I am just telling you guys what I have read and that this is where having you guys who have experience and knowledge of this topic comment can be very beneficial to others (myself included). The most important thing I can tell you is that to do your research and to talk honestly/frequently with your doctor and support network. Do not be afraid to ask questions/recommendations from these professionals on matters such as these, it can help a lot.

I know that Suboxone and Methadone can be used for variety of time periods. I have heard of people doing quick tapers with both (1 month or less), others who go 3 months-1 year, and others who go years on these drugs. I have also read, but never met, people who supposedly are on a Suboxone or Methadone program for life (not sure if this is just people talking out of their ass or if this really does happen so take it with a grain of salt if you wish). It is important you do your research and really talk it over with your support network with whatever method you choose as it is a decision that can basically affect the rest of your life and the path you choose you to go. I'm currently 4 months into a Suboxone program and was started at a relatively small dose (4 mg once a day) which I have stayed on since. The plan is that I will eventually start a process of tapering and will hopefully be off of all opiates within a year or so. I may also look into giving the Vivitrol shot a try after the Suboxone if I feel it to be necessary (I will hopefully write a post about the Vivitrol shot soon). Not only do I not have any experience with Methadone, but I have no experience with Suboxone withdrawal (besides going like 36 hours a couple times without a dose) so use your own judgement along with your research and doctor recommendations. Again, don't try to play doctor with these drugs adjusting your doses without permission as it can hurt you in the long run or even be dangerous. I know it can be tempting, but it can also be quite costly. Be smart my friends.


Suboxone

Suboxone Pills (top) and Suboxone Film (bottom)

Now that we compared the two drugs, lets take a quick look at each one individually. We'll start with Suboxone. Suboxone is a semi-synthetic opioid that is taken sublingually. Suboxone comes in either a pill form or in film form in dosages of either 2 mg or 8 mg. Suboxone is a relatively new drug in the opiate addiction community as it first entered the market for the treatment of opiate addiction in 2002 after being approved by FDA. There is a somewhat lack of information of Suboxone for long term use as the drug is still pretty new. It was however used from the 1960s to today as a  analgesics, although its primary use today is for both alcohol and opiate dependence.

The two main ingredients in Suboxone are Buprenorphine HCl and Naloxone HCl. The Buprenorphine is a opioid while the Naloxone is a opioid inverse agonist. The Burprenorphine is used to help keep the withdrawals and cravings at bay because when you take it, your body is still getting an opiate in it just like if you were to take say Oxycodone. However, it should be noted that Burprenorphine is a completely different drug in its own right than Oxycodone as both are their own kind of drug. The Naloxone is added into the Suboxone to prevent patients from abusing the drug. If a patient were to attempt to snort or inject Suboxone, they risk the possibility of going into precipitated withdrawals as the Naloxone will cause a nasty reaction with the Burprenorphine. The reason you will not go into precipitated withdrawals if you take Suboxone sublingually as directed is because the Naloxone is poorly absorbed when taken underneath the tongue where as it is better absorbed through the mucus membranes (snorting) or blood (injection). Suboxone should not be taken until your body has detoxed itself from other opiates such as Oxycodone as it can lead to precipitated withdrawals if you do not wait long enough to take your dose of Suboxone after you last used another opiate. Each opiate is different in the time it takes to leave your body and each can react differently with other drugs so it is important that you do your research and talk with your doctor about this matter (Man, I don't think I can stress that enough!)

Like Methadone, not all doctors can prescribe Suboxone so you must find one who does. Don't expect your primary care doctor to be able to prescribe Suboxone or Methadone as law requires doctors who prescribe these drugs to be licensed and trained in addiction treatment. However, it is important you keep your doctor up to date with your use of Suboxone or Methadone along with your addiction and other health issues. Along with Methadone, most Suboxone programs require patients to submit to drug testing, see an addiction doctor, and to see a drug consular. Some programs require you to see these people more frequently than others and each program has its own set of rules, guidelines, requirements, and beliefs. It is important to note that in terms of mg's strength, Suboxone is a pretty powerful drug. It's not a drug that will get you high (although some people report experiencing a slight buzz/high the first couple of times they take it) but don't let that statement fool you. For example, someone who is down to 1-2 mg of Suboxone can still experience symptoms of withdrawals, proving how powerful this drug is. I say this because when many people taper off of Suboxone and get down to a dose below 2 mg, they think they will most likely experience little to no withdrawals. While tapering certainly helps, it must be done slowly and patiently and even then, a person will most likely experience some withdrawals. Once again, everyone is different through.


Methadone

Alright, let's now take a look at Methadone. Methadone is classified as a semi-synthetic opioid that is used primary as an analgesic and for opiate dependence. Methadone has been in the addiction community far longer than Suboxone and there is quite a lot of information and research on Methadone out there. I highly suggest you get to know the drugs you put in your body, and I say this for any kind drug. Methadone was originally developed in Germany during the 1930s and is still widely used throughout the world today. The same receptors in which drugs such as heroin and morphine affect, are affected by Methadone which makes this drug quite useful in treating opiate addiction. Like Suboxone, Methadone must be taken under the supervision of a doctor and program with patients having to detox themselves off of any opiates before taking their first dose. Similar to Suboxone, patients who do not wait long enough after their last dose of opiate can risk going into precipitated withdrawal if the Methadone is taken too soon. Methadone programs may require patients to visit methadone clinics daily and may require the patient to take their dose in front of a nurse or doctor. However, after a period of time of meeting program requirements, patients may be given larger quantities of Methadone to take home (such as a week's supply). Methadone can come in a pill form, a pill to be taken sublingually, or in liquid form depending upon the patient, program, and situation at hand.

Like Suboxone, Methadone can be addicting and habit forming while also carrying the potential of being abused. Some users report being able to achieve a high/buzz off Methadone but it is known that Methadone tolerance can be built up relatively fast. Methadone treatment is usually ended after a period of tapering and when patients quit using Methadone, they risk facing withdrawals. As mentioned before, Methadone withdrawals can last anywhere from period of weeks to months depending on the person and their situation. It should be noted that research does suggest however, that when taken properly, patients can achieve success in maintaining sobriety and that Methadone has certainly proven successful for many. A new trend has emerged in which patients are put on Methadone over a period of time, then slowly taper down their dose before switching over to Suboxone. I have not met anyone who has gone this route but it does sound pretty interesting. However, in my opinion I feel you're better off just going with Suboxone if you plan on going this route as why waste your time with the Methadone to just eventually switch over to Suboxone? But, hey, I'm sure doctors have their reasons and know a hell of a lot more than I do.

Common Side Effects of Methadone

I found the following information from Wikipedia (I know, I know, take it however you wish) and thought it may be helpful for you guys to read. It is basically a comparison between Suboxone and Methadone. I just copied and pasted it below while putting it in blue font.

"Buprenorphine and methadone are medications used for detoxification, short- and long-term maintenance treatment. Each agent has its relative advantages and disadvantages.
In terms of efficacy (i.e., treatment retention, mostly negative urine samples), high-dose buprenorphine (such as that commonly found with Subutex/Suboxone treatment; 8–16 mg typically) has been found to be superior to 20–40 mg of methadone per day (low dose) and equatable anywhere between 50–70 mg (moderate dose),[23] to up to 100 mg (high dose)[24] of methadone a day. In all cases, high-dose buprenorphine has been found to be far superior to placebo and an effective treatment for opioid addiction, with retention rates of 50% as a minimum.[23][24][25][26] It is also worth noting that while methadone's effectiveness is generally thought to increase with dose, buprenorphine has a ceiling effect at 32 mg.[27] That is, while a methadone dose of 80 mg will likely be more effective than a methadone dose of 60 mg (see Methadone dosage), a buprenorphine dose of 40 mg will not be more effective than a buprenorphine dose of 32 mg.
Buprenorphine sublingual tablets (Suboxone and Subutex for opioid addiction) have a long duration of action, which may allow for dosing every two or three days, as tolerated by the patient, compared with the daily dosing (some patients receive twice daily dosing) required to prevent withdrawals with methadone. In the United States, following initial management, a patient is typically prescribed up to a one-month supply for self-administration. It is often misunderstood that the patient has to receive other therapy in this situation, but the law simply states that the prescribing physician needs to be capable of referring the patient to other addiction treatment, such as psychotherapy or support groups.
Buprenorphine may be more convenient for some users because patients can be given a thirty-day take-home dose relatively soon after starting treatment, hence making treatment more convenient relative to those needing to visit a methadone dispensing facility daily. The facilities, which are regulated at the state and federal level in the US, initially are permitted to allow patients to receive take-home doses (to be self-administered at the appropriate time) only on a day when the clinic is regularly closed or on a pre-scheduled holiday. It is only after a minimum of several months of compliance (i.e., proven sobriety, demonstration of being able to safely store the medication) that patients of methadone clinics in most countries are permitted regularly scheduled take-home doses aside from the possible exceptions for weekends and holidays. Ultimately, American patients on methadone maintenance therapy are permitted a maximum of a one-month supply of take-home medication, and this is permitted only after a minimum of two years compliance. In the US state of Florida, patients cannot receive a one-month supply until five years of compliance. Most buprenorphine patients are not prescribed more than one month's worth of buprenorphine at a time. However, buprenorphine patients, as a rule, are able to get their one-month supply much earlier in their use of the drug than methadone patients.
Buprenorphine as a maintenance treatment thereby offers an advantage of convenience over methadone. In general, buprenorphine patients are also not required to make daily office visits and are often very quickly permitted to obtain a one-month prescription for the medication. Methadone patients in the United States who are not subject to additional strictures beyond the federal law regarding a patient's take-home supply also benefit in convenience. States with excessive regulation on methadone dispensation see professionals advocating for office-based methadone treatment, similar to the standard of office-based buprenorphine treatment. Such treatment with full opiate agonists is already available on a limited basis in the UK, and has been ever since heroin was made illegal, with an interruption of a few decades, which occurred, likely under pressure from the United States[citation needed] during the worldwide escalation of the War on Drugs, which occurred during the 1960s and 1970s. In fact, in the UK a doctor may prescribe any opiate to a patient, regardless of their complaint (excluding diamorphine and dipipanone for addiction, where they require a special licence from the Home Office). In practice, methadone is most often used, although morphine and heroin are also less frequently prescribed on a maintenance basis. The UK has a smaller number of opiate users, per capita, than the United States[citation needed], which many attribute to the availability of full opiate agonist prescriptions to users, which reduces the amount of opiates sold illicitly and, in turn, the number of users of other drugs who encounter and begin using the opiates. Therefore, it could be argued that buprenorphine may not be as attractive a treatment option in the UK due to full opiate agonists such as heroin maintenance being an option for a small number of addicts seeking treatment. (See Heroin prescription.)
Buprenorphine may have, and is generally viewed to have, a lower dependence-liability than methadone. In other words, withdrawal from buprenorphine is less difficult. Like methadone treatment, buprenorphine treatment can last anywhere from several days (for detoxification purposes) to an indefinite period of time (lifelong maintenance) if patient and doctor both feel that is the best course of action. Additionally, the opinion of those in the medication-assisted treatment field is generally shifting to longer-term treatment periods, which may last indefinitely, due to the anti-depressant effects opioids seem to have on some patients as well as the high relapse potential among those patients discontinuing maintenance therapy. The choice of buprenorphine versus methadone in the mentioned situation (by the patient) is usually due to the benefits of the less-restrictive outpatient treatment; prescriptions for take-home doses for up to a month early versus the possibility of heavy restrictions in some states and frequent visits to the clinic and the possibility of the "stigma" of going to a methadone clinic as compared to making trips to a doctor's office. Buprenorphine is also significantly more expensive than methadone and this seems to add to its better reputation. Also, in some states, there is a long waiting list for admission to a methadone maintenance program versus those with the money to afford seeing an addiction specialist each month in addition to the cost of medication. In studies done, methadone is considered more addicting physically and mentally.[citation needed] The sometimes less-severe withdrawal effects may make it easier for some patients to discontinue use as compared with methadone, which is generally thought to be associated with a more severe and prolonged withdrawal. However, no evidence thus far exists that sustaining abstinence post-buprenorphine maintenance is any more likely than post-methadone maintenance.
Another issue of concern for patients considering beginning any maintenance therapy or switching from one maintenance therapy to another is the transition associated with this switch. Due to buprenorphine's high-affinity to opioid receptors in the brain, care needs to be taken when a patient is transitioning from one drug (e.g., heroin) or medication (e.g., methadone) to buprenorphine. In essence, if an opioid-dependent patient is not in sufficient withdrawal, introduction of buprenorphine may precipitate withdrawal. In lay terms, in a sufficient dose, buprenorphine "pushes" any other opioids off of the receptors, but is itself not always "strong enough" to counteract the withdrawal symptoms this causes.[28] Thus, opioid-dependent patients, in particular those on methadone or another long-acting medication or drug, should be thoroughly honest with their prescribing doctor about their drug use, in particular in the days immediately preceding their induction onto buprenorphine, whether for detoxification or maintenance. In contrast, in general the transition from buprenorphine or other opioids to methadone is easier, and any discomfort or side-effects are more likely to be easily remedied with dose adjustments.
Buprenorphine, as a partial μ-opioid receptor agonist, has been claimed and is generally viewed to have a less euphoric effect compared to the full agonist methadone, and was therefore predicted less likely to be diverted to the black market (as reflected by its Schedule III status versus methadone's more restrictive Schedule II status in the USA), as well as that buprenorphine is generally accepted as having less potential for abuse than methadone. It is also worth noting that neither methadone nor buprenorphine causes euphoria when taken long-term at the appropriate dose. However, in at least one study in which opiate users who were currently not using an opioid were given buprenorphine, several other opioids, and placebo intramuscularly, subjects identified the drug they were injected with as heroin when it was actually buprenorphine.[29] This evidence tends to support the contentions of those who reject the notion that buprenorphine, when injected, is only marginally euphoric, or significantly less euphoric than other opiates.
In an effort to prevent injection of the drug, the Suboxone formulation includes naloxone in addition to the buprenorphine. When naloxone is injected, it is supposed to precipitate opiate withdrawal and blocks the effects of any opiate. The naloxone does not precipitate withdrawal or block the effect of the buprenorphine when taken sublingually. The Subutex formulation does not include naloxone, and therefore has a higher potential for injection abuse. However, Subutex is prescribed significantly less than Suboxone for just this reason. Methadone, on the other hand, is typically given to patients at clinics in a liquid solution, to which in general water is added. This makes injection difficult without evaporating the liquid and taking other measures. Therefore, injection of buprenorphine as found in the preparations provided to opiate users is simpler than injection of methadone, although data on the relative incidence is not currently available. Although, in general, methadone is not a drug of choice for opioid addicts due to its long-acting nature and relatively little euphoria associated with its use, especially when compared to other drugs of abuse such as heroin and Oxycodone, it is used by addicts to relieve withdrawal symptoms when their opiate of choice cannot be obtained. Most methadone bought from the black market is thought to be bought by already opioid-dependent persons attempting to circumvent the substance abuse treatment system and detoxify themselves with the methadone or simply by people wishing to use the drug recreationally, just as other opiates are used. In the US, buprenorphine is found far less often on the black market as compared to methadone.In North America (Canada) it is reversed, buprenorphine is found to be readily available on the black market,as methadone is usually not seen,buprenorphine is as easy to obtain as heroin.[citation needed]. The vast majority of the methadone diverted to the black market is not diverted from methadone clinics for opioid dependent persons, but rather it is diverted by a minority of the people who receive prescription methadone for pain[citation needed]
Since the late 90s in Austria, slow release oral morphine has been used alongside methadone and buprenorphine for OST and more recently it has been approved in Slovenia and Bulgaria, and it has gained approval in other EU nations including the United Kingdom, although its use currently is not as widespread. The more attractive side-effect profile of morphine compared to buprenorphine or methadone has led to the adoption of morphine as an OST treatment option, and currently in Vienna over 60 percent of substitution therapy utilizes slow release oral morphine. Illicit diversion has been a problem, but, to the many proponents of the utilization of morphine for OST, the benefits far outweigh the costs, taking into account the much higher percentage of addicts who are "held" or, from another perspective, satisfied by this treatment option, as opposed to methadone and buprenorphine treated addicts, who are more likely to forgo their treatment and revert to using heroin etc., in many cases by selling their methadone or buprenorphine prescriptions to afford their opiate of choice. Driving impairment tests done in the Netherlands that have shown morphine to have the least negative effects on cognitive ability on a number of mental tasks also suggest morphines use in OST may allow for better functioning and engagement in society."

I have also included some links below that provide further insight into Suboxone and Methadone.

http://en.wikipedia.org/wiki/Methadone
http://en.wikipedia.org/wiki/Buprenorphine
http://www.suboxone.com/
http://www.drugwarfacts.org/cms/methadone
http://www.treatmentsolutions.com/the-debate-over-drug-abuse-treatment-methadone-vs-buprenorphine/
http://www.drugrehabranch.com/staff-articles-and-drug-treatment-news/suboxone-or-methadone-which-is-right-for-you

Conclusion

Alright guys, well I hope that was enough reading for you all and wasn't too boring. I'll say this just one more time. I have used Suboxone for 4 months now (4 mg once a day) as the result of battling a addiction to the Oxycodone 30 mg pills. I have remained clean off of all other opiates and any other kinds of drugs as well. I have yet to experience Suboxone withdrawal although I have experienced Oxycodone withdrawal numerous times (it sucks!). I have also never once tried Methadone and thus have never experienced Methadone withdrawal. If you were to ask me which of the two drugs I would recommend, I would simply say that I have no experience with Methadone but that the Suboxone program I am currently on has been very helpful in me reaching my goal of clean living. So far, so good with the Suboxone and I hope to be careful/patient with my tapering so I can be best prepared for whatever withdrawals I may face when the day to stop using Suboxone comes for me.

Most of the information I have provided for both of these drugs comes from my own experiences, addicts I have talked with, doctors/consulars I have talked with, and what I have read in books or online. I'm not here to neither promote or knock any medication or drug, I simply wish to provide you guys with some information I think you may find useful. I really can't stress how important it is to do your research and talk with your doctors, don't just go by my stuff or what you think only. There's a reason those people are professionals and I'm some guy writing on an online blog (hey I'm being honest, but I really do hope I'm helping some people). Once again, thank you guys so much for reading my blog and the only thing I can ask of you guys is to please comment. I really do think hearing from numerous people will be very beneficial for everyone involved on this blog.

Until next time my friends, be careful, responsible, and most importantly happy. And remember, keep seeing that light. Believe me, it's out there somewhere.

Take Care Guys,

Seeingthelight

Wednesday, August 8, 2012

My Experience With Suboxone

Hello everyone. I would like to welcome any readers of my previous post (Welcome Opiate Addicts) as well any new comers to my blog. If you want a introduction to my blog, the rules of the blog, what we stand for, and a quick history about myself and my addiction feel free to check out the following link: http://welcomefellowopiateaddicts.blogspot.com/2012/08/welcome.html
I would like to use this blog post to discuss my experience with the drug Suboxone. I think most people on here have either heard of Suboxone or may have even used it but bear with me as I give some quick information about it to those who have little to no experience with this drug. Suboxone is used for a variety of things, most notably as an aid to help with both alcohol and opiate addiction. I won't go into much detail about the drug itself as I'm not a doctor and don't want this to seem like a lecture. Basically, Suboxone is classified as semi-synthetic opioid and consists of two main ingredients. These ingredients are Buprenorphine HCl and Naloxone HCl. The Buprenorphine is what will help with the withdrawals one would experience if he or she were stop using opiates after a period of time of continued use. Think of this ingredient as an opiate just like oxycodone ( I realize they are both completely different drugs but I'm trying to make things simple for now). Now one would ask why the hell would a doctor prescribe an opiate addict with an opiate to help battle addiction? This is where the next ingredient comes into play. The second ingredient is the Naloxone which is put into the Suboxone as a means of preventing abuse. The Naloxone prevents users from snorting, swallowing, or injecting the Suboxone as an attempt to get high off of the Buprenorphine. Users of Suboxone must take it sublingually (under the tongue) and if one is try to abuse the Suboxone by snorting or injecting it, they will instantly become sick due to the presence of the Naloxone.

Suboxone 8 mg Pill

Suboxone helps a lot of opiate addicts for a number of reasons. The most popular reason being that the Suboxone will help prevent most withdrawal symptoms that one would experience if they were to go cold turkey off their drug of choice (DOC) opiate without the aid of Suboxone. The body does not go into withdrawals due to the presence of an opiate being in the body (the Buprenorphine). If Suboxone is taken correctly, it allows a person to be able to continue their everyday lives comfortably without the fear of withdrawals. This can be crucial for those who have to work, go to school, take care of children, ect...Another reason why Suboxone has become so popular over the years recently is due to its ability to help deal with cravings. Because your body is getting an opiate with the Suboxone, the brain receptors (see for more information on how addiction affects the brain) are able to stay relatively normal. However this is NOT to say, from both knowledge and personal experiences, that the Suboxone is some miracle drug that will completely take away all cravings. However, I will say it does help and to help combat these cravings is where meetings (AA or NA) combined with talking with a friend, family member, or consular can come in handy.
For more information about Suboxone, check out the following links:

http://www.suboxone.com/
http://en.wikipedia.org/wiki/Buprenorphine
http://www.drugs.com/suboxone.html
http://www.rxlist.com/suboxone-drug.htm
Now that we're finished with my chemistry lesson on Suboxone, lets move on to my experience with the drug. I won't go into full detail about my past (I did this in my first post if you wish to know more check it out) but to paint a better picture I'll tell my fellow readers some quick facts. I'm a 25 year old male who has had an addiction to the Oxycodone 30 mg pills. My use of the drug has lasted over 3 years and I was using the drug on a daily basis for 2 years. I am currently prescribed Suboxone through a outpatient program and see both a consular and doctor weekly. I simply take life day by day and I am currently almost 4 months clean off of Oxycodone with the help of the Suboxone. I have also not smoked weed or done any other drugs or drinking besides tobacco. If you were to ask me on a scale of 1-10 on how I would rate my overall experience with Suboxone thus far, I would give it a 8. If you were to ask me how I currently feel on a scale of 1-10, I would say between a 7-8. Overall, I believe Suboxone can be a useful tool in helping one battle their addiction to Oxycodone or other such opiates.
If you are interested into getting on a Suboxone program, there are a few steps you must do and things you should know. First, it is important that you go into a program such as this with the true desire of getting clean. Don't be joining a program such as this to simply have a prescription for "backup pills" in case you can't find or have the money for opiates. I'm not trying to sound like a jerk but am saying this because programs can only accept a certain number of people to prescribe Suboxone to so why take someones spot who is truly attempting to get clean? Also, if you do fail out of the program, it gives you a bad reputation and could make getting help in the future more difficult than it has to be. The next thing you should know going into a program such as this is that it can be quite expensive. I can't talk for everyone but the costs of my program are not too bad but do create a little bit of a dent in the pockets. For example, I must see the doctor and consular each once a week. Each appointment I must pay a co-payment of $25. I also pay about $40 each time (every 2 weeks) for my Suboxone prescription. It really depends on your insurance and the place you are going too, so don't be surprised to hear and see different costs when going from place to place. I have heard of people with good insurance who pay practically nothing while I know of others who lack insurance and are forced to pay thousands if they wish to seek Suboxone treatment.  My best tip is do your research, make calls early and often, and find a place that you feel will truly help you in battling your addiction. The way I looked at it was that I would be spending more money buying Oxycodone off the streets if it were not for the outpatient program I am in.
It is important to note that not all doctors can prescribe Suboxone. In fact, doctors are required to obtain a license to prescribe Suboxone so don't expect your primary care doctor to be able to prescribe you Suboxone. However, it should be noted that it is important to keep your primary care doctor up to date with what is going on in your life and in regards to your health. Finding a doctor who can prescribe Suboxone is not very difficult. In fact, simply go to the following link: http://www.suboxone.com/patients/opioid_dependence/find_a_doctor.aspx , then go to the doctor locater tab where it will instruct you to enter your zip code. The website is ran by Suboxone and will help you find doctors who can prescribe Suboxone in the nearby area. Be sure to take down a couple names of doctors as you will most likely have to call around to find a program accepting new patients. You may get lucky and find a doctor accepting patients who lives right down the street. Or you may be less fortunate and be stuck with having to take a 45 minute drive each week to see the doctor. For me, I had to call 4 different places before I finally came across a place that was accepting new patients. The place ended up being pretty close to my house and is a pretty nice outpatient program to be in. If you are not successful getting into a program at first, do not give up! Be sure to make a list of places you have called and ask each receptionist to take down your name to call you back in case there are any future openings. You'd be surprised at how many and how frequently patients drop out of programs such as these.
While all programs and doctors are different, I am going to give you my experience and requirements during my program. A requirement of my program is that the patient must be willing to see a drug consular at least twice a month in addition to seeing the doctor once a week during the early stages of the program. During each visit with the doctor and consular, I am required to take a urine screen drug test. The drug test serves 2 purposes; (1) to make sure the patient is clean (2) to make sure the patient is taking the Suboxone and not selling it. The rule of thumb in my program was that if you fail the drug test you get a warning the first time. The next time you fail you are forced to take part in a intensive outpatient program which meets 3 days a week for 5 hours each day. The third time you fail the drug test you are kicked out of the program. Every program is different, some stricter then others. I have heard of people being able to smoke weed or drink while on the Suboxone program as long as they remained clean off opiates when testing. On the other hand, I have heard of people being kicked out of a program after failing a drug screen after a night out of drinking. In my opinion, the stricter, the better as it will help keep you on track. However, I am a big believer in 2nd chances and think everyone screws up once in awhile. I believe if a patient is really trying to get help and get clean, then the doctor should reevaluate the patient and determine whats best rather then just going by a strict set of rules.
The meetings with the doctor are always very quick (usually no more than 15 minutes) while the meetings with the drug consular run about an hour. The meetings with the doctor are basically for just making sure the patient is having no side effects and that the dosage is working for them. The meetings with the drug consular are more for helping the patient in dealing with their addiction and staying clean. Another requirement of the program is that the patient attend AA or NA meetings. However, in my program this isn't monitored so it is real easy to get around with not attending meetings. I personally have never been to a meeting in my life but I have heard countless stories of how they have really helped others with their struggles. My main reason behind not going is basically fear, not knowing what to expect, and running into someone I know. I am also a more realist type of person and while I am a Catholic, I am not overly religious. However, this is not to say AA or NA is all about religion because it is certainly not. In fact, these meetings do not associate themselves with a certain religion or set of beliefs. The 'Higher Power" you always hear about from these meetings can be anything you wish it to be. Some people chose God as there "Higher Power" while others simply refer to the group as their "Higher Power". I have heard of some people choosing things such as doorknobs, their pet dog, or their own mother as their choice of a "Higher Power." The only requirement for AA or NA is that those attending respect one another and have a desire to get clean. To check out both NA and AA meetings close to you, simply check out there websites. Again, I do not have much experience in regards to these meetings but certainly respect their ability to help others and even hope to check one out myself soon.



Some important things I would like to briefly touch upon with Suboxone:

  • Suboxone comes in a pill form or a strip form (think Listerine breath mint strips). Both to be dissolved under the tongue. The pill takes about 10-20 minutes to dissolve where the strips dissolve much faster (usually less then 5 minutes). Both have a rather nasty taste, although some people claim they like it. This was my experience with both the pills and strips anyways and I choose to stay with the strips over the pills.
  • Suboxone must be taken by placing either the pill or strip under the tongue and left to dissolve. If you try to swallow, snort, or inject Suboxone you risk the possibility of going into precipitated withdrawal due the Naloxone. The reason you do not go into precipitated withdrawal by taking the Suboxone under the tongue as directed is because the Nalaxone is not fully absorbed through the disgestive track in your body where as if you were to inject it or snort, it would be absorbed by other means causing these unwanted side effects.
  • Some people say they experience a slight high off of the Suboxone the first couple of times taking it. This high will usually not occur after you get used to the drug. In my experience I have never experienced a high when taking the Suboxone.
  • Suboxone will also limit your ability to get high off of other opiates while you are on Suboxone.
  • It is extremely important to remember that you must "detox" yourself off of any opiates before you take Suboxone. Each opiate has it's own length of time to leave your body before you can safely take the Suboxone. For example, you should be OK to take the Suboxone if you have given yourself at least 24 hours before your last dose of Oxycodone. Meanwhile a medication such as Methadone takes much longer. I do not have any experience with Methadone but from what I have heard, it takes a matter of days to even weeks before one can make the jump from Methadone to Suboxone. Do your research and talk with doctor about this matter before taking Suboxone. BE HONEST! You do not want to go into precipitated withdrawals because you didn't wait long enough to make the jump.
  • For the most part, Suboxone will help greatly with the withdrawals you would normally experience if you were to stop taking/go cold turkey off of an opiate. Everyone is different, some people feel 100% great while others still feel the effects of withdrawals when on Suboxone. For me, the Suboxone probably takes aways 90% of withdrawals I would normally experience if I were to stop taking opiates totally.
  • Suboxone doesn't take away all of the cravings but it does help significantly. This is where meetings, therapy, picking up new hobbies becomes important.
  • Suboxone is like nearly every other opiate in that it is also addicting and can be misused. You will eventually go through withdrawals when coming off of Suboxone. From my experience and what I have heard, the withdrawals from Suboxone are not as bad as they are from say Oxycodone, but the withdrawals from Suboxone do drag out a little longer than other opiates. It is recommended that you slowly wean yourself off of Suboxone over a period of time best decided upon by yourself and your doctor.
  • Suboxone has a relatively long half life, meaning it takes longer to exit your body. This is why the withdrawals tend be longer then most opiates and why the withdrawals of Suboxone don't really start to kick in until about 36-72 hours off of your last dose of Suboxone.
  • Finally, Suboxone is only a tool to help you with ending your addiction to opiates. While some people stay on Suboxone for years or even life, most will eventually look to come off the Suboxone and opiates in general at some point of their lives. Suboxone is useful by allowing the user to avoid withdrawals but not get the feeling of being high while on it. It can allow users to get their lives back together, gather support, get jobs or start school, and learn about themselves. In my experience it helped a lot with the withdrawals and cravings but everyone is different. I honestly do not think I would be 4 months clean off Oxycodone if not for Suboxone and the support I am getting but again, everyone is different. You and doctor should decide whats best.

In my case, Suboxone has helped me greatly with getting my life back together and learning more about both myself and my addiction. I want to note that I didn't feel totally normal until about my third day of being on Suboxone. I believe this may have been because my body was getting used to the drug and it needed to build up in my system. Getting drug tested and talking with my consular, family, friends, and doctor has given me more structure and someone to answer to which helps greatly in my opinion. Suboxone is a powerful drug and as mentioned, can be addicting. If you can, try to start at a dose that's low yet helps you feel comfortable. I have been prescribed 4mg once a day and have stayed at this dose the entire 4 months of my recovery period. I was quite a heavy user of Oxycodone (180-300 mg a day) yet found this dose to be efficient. In my opinion, some doctors either over prescribe or under prescribe so it is important you talk well with your doctor. However, don't play doctor and mess around with your dosing, just be honest with yourself and support network. I would also like to note that there are other options to getting clean and Suboxone is just one of many. Once again, I cannot stress, do your research and talk with your support networks often.



This is my second post overall in my new blog that I have just created. As I said before, I am a addict of Oxycodone. My Drug of Choice (DOC) was the Oxycodone 30 mg pills (A215, M30, 224, Blue Vs). I am now about 4 months clean off of Oxycodone with the help of Suboxone (4mg once a day) and feel pretty good both physically and mentally. I am currently part of an outpatient program where I see a consular and doctor each once a week. Overall, the Suboxone has been a great tool in helping with overcoming my addiction and I hope to one day get off the Suboxone and be done with opiates completely. I will keep posting and encourage anyone who reads this to comment on any of my posts. If you have a friend or family member who suffers from an addiction such as Oxycodone or something similar feel free to tell them about my blog. I do not get any money or anything like that for doing this, I simply wish to share my experiences and knowledge in this area to help others. I would like to thank everyone who reads or comments on my blog and wish you all the best of luck in battling your inner demons. I know I am still pretty early in recovery but feel like I can help others through this blog. Again, thank you guys for listening and pitching in. And remember keep trying to see that light, it is there.

Take Care,

Seeingthelight