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newbie here, questions about suboxone maint. plan

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Posted 6/15/2008 6:49 PM (GMT 0)
i am recovering from opiate addiction and am a chronic relapser, i am going to start taking suboxone soon, for chronic pain and relapsing on pain meds. what am i to expect with taking suboxone, and can i still consider myself clean and sober? thanx in advance
Posted 6/15/2008 7:58 PM (GMT 0)
I'll answer your last question first. You're only "clean" when you no longer take any kind of product with adictive or dependent properties (at least that's how we look at it here in Belgium). Again, here in Belgium, that means you can't take illegal drugs, medication that can create a dependence or addiction, and alcohol; while smoking is permitted technically. You can consider yourself clean and sober if you manage to stay away from the above mentioned products for at least 2 weeks. Then you'll have to keep this up for the rest of your life.

The Suboxone will cushion your system and make detox easier (It'll still hurt and you'll probably still sweat, and vomit occationally, etc.), but detox willbe easier. You know yourself of course that detox is not a cake walk. If you detox all the way, you'll have a dark period in your life that might extend over several months, but afterwards, life will be better.

If you can give more information, then maybe I miht be able to help you more in detal.

Take care, and bite the bullet this time. Good Luck.
Posted 6/15/2008 8:22 PM (GMT 0)
Dear April,
Welcome to HW, although I'm not sure this is the right forum for you (please see my explanation at the end). You really need to be connected to programs to help you with addictions.

I've got some professional background dealing with addictions, and since you describe yourself as a chronic relapser - which is not uncommon, especially if you have legitimate pain issues which also must be managed - you need to be seriously committed to an addictions program of some type. Many people use 12 step programs, although there are other approaches. You may very well need a specialized program that recognizes chronic pain issues along with addictions. An addictionologist, who's a doctor that's got a specialized certification in managing addictions - including special protocols for chronic pain management, needs to be part of your team.

Have you ever been in a residential program, and/or Intensive Outpatient Programs (IOP) for addictions? Something for what's called "dual disorders" would be your best bet, as those programs are designed to deal with multiple diagnoses. If you've not been in at least an IOP, I'd strongly recommend it. It's something that only lasts a few weeks, but can help you get on the right track, give you a lot of education and support, and then help you transition to regular outpatient services with an addictions professional, along with support groups. I've rarely (almost never) seen someone who's chronically relapsed succeed without such support. But that being said addictions are treatable.

You should look into and begin to learn as many non-pharmaceutical ways to help manage your pain as possible - everything from relaxation training to acupuncture. Then an addictionologist can help oversee other medications - including methadone - to manage your pain symptoms. The goal would be to use as little methadone as possible, and if you also read on another thread about methadone use you'll see that it has to be started very, very slowly, but with your addiction issues you need to have that overseen closely by medical personnel trained in addictions.

In starting out, I did suggest HW may not be the best forum for you. I want to explain that a bit. If you are seriously working to stay "clean and sober", then I think all of us here would be glad to give you support in that, as well as help address the challenges you will have managing chronic pain. You won't find a lot of support, however, if you continue to relapse, or aren't don't everything you can possibly do to treat and manage your addiction. Many of us get treated and viewed as addicts when we are not, and lots of us here are sensitive to that. I just want you to be aware of how that issue may be viewed here.

Finally, as far as being "clean and sober", technically detoxing - and how long it takes for various substances to leave your system - will vary. That will likely be a much shorter time, however, that what will be defined in the U.S. addictions community as being "clean and sober". That takes usually at least a year of sobriety. I do know that some people who have not been trainedin dual disorders, and some 12 step programs, believe you have to be off all medications to qualify, including even things such as anti-depressants. You will need to find the groups that can be more open to your struggles, and take your advice from the addictionologist and other medical professionals who are treating you.

I hope this helps - and I wish you all the best!

PaLady

Post Edited (PAlady) : 6/15/2008 2:30:14 PM (GMT-6)

Posted 6/15/2008 9:27 PM (GMT 0)
thank u for responding so quickly to my post, i guess i should be more detailed in my intentions....i have just completed a 30 day inpatient treatment program @ New Life Lodge, in TN. i first detoxed off of pain pills, i currently do outpatient online due to transportation issues and lack of outpaint treatment centers in my area. i am working with an addictionologist at this time, he is the doctor that is going to put me on suboxone if my chronic pain doesn't get under control. i chose to wait and see how i feel pain wise and am going to see my addictionologist July 3rd and we will take action at that time if i am still struggling with all the pain. i do have legitemit pain. 4 herniated discs in my lower back, 1 slipped disc in between the shoulder blades, and a rotator cuff injury from 13 years ago that i just had surgery on Febuary 27th, 2008, but the shoulder is too far gone. i do take other approaches to my relief of pain, such as praying, meditation, stretching, exercising, and all the tools i have learned from intensive physical therapy. i dont know if this is the right place for me but i saw some of the posts and just wanted some support. i do work a 12 step NA program also, i go to meetings and even attend them online if i cant find a ride. i am trying so hard to stay clean, i have 38 days clean, but i do take medications for bi-polar disorder, i was at a dual diagnosis program, i thought maybe i could find out from someones personal experience with opiate blockers. i am still researching suboxone, i never thought about methedone, i thought that was strictly for herion users. my doctor and i decided suboxone might be the best for me. i am scared i wont be able to get this pain under control and will turn back to pain medications. so that about sums it all up for me. i appreciate all the info you offered to me. thanks so, so much for your response.
Posted 6/15/2008 9:53 PM (GMT 0)
April,
Congratulations - you're doing all the right things! I do think you can find good support here for pain issues, in conjunction with using your addictions resources. And I think your presence here - because you're doing all the right things - can help educate others about the difficulty of dealing with real pain and also have addictions problems. So I hope you'll stay with us.

Again, you're on the right road. I've never been on suboxone, but others here have. You may want to do a search of past threads, plus others will probably respond to you over time. I think it's great you gave us more details, although you don't have any obligation to do so - and you may not want to share identifying things like where you're from, etc.

Welcome!

PaLady

p.s. Sorry for mentioning methadone. It's similar to suboxone, but not the same. Some do use it for pain, however, even though it's not widely thought of that way. What you want to do is follow your addictionologist's recommendations, just as you're doing.

Post Edited (PAlady) : 6/15/2008 4:22:19 PM (GMT-6)

Posted 6/16/2008 9:27 AM (GMT 0)

Welcome to the forum April and like PAlady said it looks as if your doing all the right things at this point and sounds as though you have some really great Docs in your corner. Far too many times after being labled an addict CPers are just up that proverbial creek and no one wants to take on the pain issues at all. YOu have the right things going on it seems.

As for clean and sober and if you are there and can stay there all depends on your pain issues and how much they affect your way of life. I have some really strong opinions here about this and certainly dont want to deflate or burst your bubble as I dont have enough personal info to even begin to do that.

I guess what I am trying get at here is who and how did you arrive at the conclusion that you were an addict? I gather from your history you got there by way of legal prescribing for your pain? It matters if you were being treated legit for your pain issues and then some Doc comes along and says Whoa! Your an addict for you take far too much pain meds! See this is where I have issues as far too many tims we are labeled as such and in fact we are simply trying to have some semblence of a decent life.I am just trying to figure out if you really had addiciton issues or someone thinks you have and more importantly do you think you had them.

Anyway I am not going out on a limb here until which time you chose to share more info concerning how you got here to this point.

I do want to say that the addict.Doc is one of your best bets for getting treatment although SubX doesnt have the pain controlling potential that methadone has. I have not seen any CPers on SubX for pain treatment and it has far more blocking mechanisms then methadone does and remember that if you have to undergo any kind of surgical procedure that is going to require PM after or during surgery. The Sub would have to be tapered off of prior to the procedure altogether to utilize any other narcotic and I have seen them do this via the ER with Narcan during a emergency situation and that by far is very unpleasant.

From what I gather you already know that you cannot forgo the pain with out some form of treatment correct? So long term you are going to have to not be disappointed in what others or even yourself are going to deem a relapse if you will. If your pain issues are as you say and you are goiing to require treatment with opiates then you will have to come to terms with that and not beat yourself up everytime you require meds for that.

Again I dont want to say too much here on this until I know more about how you came to veiw yourself as an addict at all but would be more then glad to chat with you if you dont want to put it all out here you can use my email addy thru this site as I believe it should be for public use.

Good luck to you and welcome as this is such a great place with some really caring folks.

Posted 6/16/2008 2:13 PM (GMT 0)
i dont mind putting info here about myself, i try not to have any secrets. i became dependant on pain meds after a shoulder injury 13 years ago and it started really bothering me about a year ago, and of course the doctors were taking their time on deciding on what to do, so they just put me on pain killers and after a while what they were prescribing wasnt enough, i was taking way more than they recommended and even had to buy pills from people i knew (off the street). every type of pill i took i became addicted to and built a tolerance and had to take more and more. i believe i am addicted, but others have said i just had a physical addiction causing physical withdrawl. as for suboxone, it is used for chronic pain and chronic relapsers. right now i am battling pain every hour, every minute and want to take pain killers so bad, so i do feel i need an opiate blocker. i am very open to opinions, and will never make anyone feel bad for offering advise to me, that is why i am here. i am sure as we all post and reply, i might be able to supply everyone with more info about myself so others may better understand me and the situation at hand.
Posted 6/16/2008 2:58 PM (GMT 0)
i am aware of what suboxone is, but i was looking for some info from someone taking it. i know it has an opiate in it. and it has an opiate blocker also. i am wondering even though it is an opiate if i take, can i consider myself clean and sober or is that taboo? again i really appreciate all the responses from everyone....
Posted 6/16/2008 4:01 PM (GMT 0)
April,
I'll say again - you're doing all the right things. And I think your situation could be very delicate so I would rely on your addictionologist as the primary source of which medications are right for you, but not be afraid to approach him/her to at least discuss methadone use as a way to help you with pain.

As far as defining what clean and sober is, I'd probably say the same thing; if you're following the plan you, your addictionologist, and other treatment team has set up, i think you need to form your own definition that you are "clean and sober" even if it doesn't meet standard definitions of other addicts, 12 steppers, or people on any forum. If you have a sponsor, addictions therapist, or at least one other person in your life who's close to you and who understand addiction and the treatment plan you finally decide on with your docs, then staying on honest with him/her and asking them to tell you if you're veering off course is the best way to say whether you've fallen off the wagon, so to speak.

I think your case - and the case of anyone who's addicted but also has legitimate pain - is complicated and has a delicate balance. It's pretty obvious if, for example, you're not taking your meds EXACTLY as prescribe, and/or if you're buying drugs off the street or any other similar behaviors that you're not clean and sober. But only a few people will understnad that you might be on some medications - probably like suboxone or methadone - and still be clean and sober (at least you would be in my book if I was part of your treatment team). Does this make any sense?

Nvr - I understand having strong opinions about this issue. I have some myself. But we also have to be careful not to forget that there are people who struggle with addiction AND chronic pain and april is a good example. She wouldn't have been admitted to an inpatient program without meeting treatment criteria and that wouldn't have been met if she had been taking meds for pain as prescribed. Some people unfortunately have a genetic predisposition (I don't know if this is the case for april) but they may have had no addiction problems whatsoever in the past, but then are injured, etc. and end up in chronic pain, and because their body may process narcotics and other addictive substances differently due to genetics, may become quickly tolerant and have difficulty maintaining their medication dosing schedule and not even understand why. In these cases it's not their fault, but if they don't recognize the true addiction issue at hand they could die. Doesn't make them bad people. April is an example of someone who is doing all the right treatment things and we've also had another recent example on the board of someone who wasn't. April I think deserves many congratulations for struggling with two challenging medical conditions and coming out on the right side!

PaLady

Post Edited (PAlady) : 6/16/2008 10:38:21 AM (GMT-6)

Posted 6/17/2008 8:58 AM (GMT 0)
I whole heartily agree with you PAlady but far too many times we as CPers get convinced we are "addicted" to opiates and I have learned carefully to get more info before I ever say someone suffering from pain issues are addicted. Many times it is simply a factor of them being way way undertreated for their pain issues. As for meeting criteria for addiction problems I bet none of us would be turned away from any treatment program since the majority of those think any long term use of opiates is an addiction?

Hence my reasons for walking softly in this thread yesterday as I didnt want to say too much without first knowing what and who convinced April she was an addict. I only wished to know how she arrived at that conclusion before I said anymore on the subject.

And she came back and answered the questions.

It also seems she is looking for reassurance that she is clean and sober on SubX and that's a question I cant begin to answer for her. I have to first establish in my mind that she was addicted and not searching for a way out of pain in all fairness and I am not convinced yet she was is an addict simply because she took more then prescribed and ran out and bought on the street? I will be brutally honest here with you. If I was cut-off tomorrow or for whatever reason my pain got unmanageable can I honestly say that I would sit there and suffer needlessly knowing there are ways to obtain meds to stop that horrific pain? Sorry to disapppoint but I have to be on the up and up here in all fairness to anyone else and myself. You bet I would at some point in my suffering. Does that qulaify me as addicted to narcotics or simply searching for a way NOT suffer?

Thus the reason I was tiptoeing around her post. I just cant being myself to lable her a addict without more info then provided, I have heard time and time again from medical persons,family,S.O's, RPH's, of how patients in pain managemtn are addicts how any of us taking opiates for years and years to treat pain that others have and dont have to take anything are just addicts! I know there are fine lines that border this issue but frankly I see very few CPers crossing it. Those I have seen are the ones that are searching for that ultimate high adding a mix of street drugs,snorting,banging,using alcohol to enahncement of meds,these are the fine folks I honestly can say have a problem that needs to be addressed and yes there are some of them in the mix of pain management and I was trying to see if April fit that mold or not before I attempted to answer anymore questions regarding being clean and sober.

I am not talking around youhere April by any means and I think if you fit the bill for addiction you certainly have done a tremendous job of following thru with a plan,not an easy feat for anyone and especially for a CPer. I think you deserve that proverbial pat on the back for you have made it when others have not. Addiction is one of the hardest battles to overcome and even if you slip back and forth a time or two no one can say you have not done a great job in handling it.

It hasnt been too many years ago that in this state the "drug wars" wrecked havoc on the PM clinics and Doctors that were attempting to treat CPers. The Oxy hype went way beyond here in the South and the agencies shut and locked doors of those clnics and Docs stating they were overprescribing the meds that the company had deemed safe and wasnt. The Reps convinced far too many Doctors that this med was a great alternative to the older ones and offered up prescribing incentives that were unimagianbale to most. Those Doctors woke up one day to a altogether different story from the DEA and Police agencies and thousands of CPers were left with no recourse whatsoever and turned to the methadone clinics and were forced to seek treatment of addiction anyway and anywhere they could get it. I imagine if one could do a thorough search one would find many of those accidental overdoses was directly related to a CPer attempting to medicate themselves after being shut off from their legal means of getting relief. I know of two and that is two too many in my book and my small area of the world.

All the more reason I back up and seek as much info as I can before I engage in a labeling of anyone.

More to the point is April if you believe you had a problem then you are getting help for that problem and if your following your Docs guidelines and doing the proper things to achieve the best outcome for yourself then yes I think you can say " I am clean and sober" dont be upset when others think you arent because of the SubX use,you have extenuating circumstances that others are not faced with.

Good luck to you and I hope all continues to go well for you.
Posted 6/18/2008 4:33 PM (GMT 0)
April,
i just wondered if you found the info. you were seeking about suboxone. When I was researching for some other info. (see the other thread I posted) I came across some info. on suboxone treatment, but I didn't evaluate it's credibility. I'm guessing you probably came across the same info. if you did a google search, but if you want me to look a little more closely let me know.

I also hope we didn't scare you off here. As I said, I do think there's support to be gained for your chronic pain, and there are things you could help teach others about what it's like to struggle with addiction and chronic pain. It's very challenging, and I give you all the credit in the world for what you're doing!

PaLady
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