Help! Random Discharge from the Suboxone Program

[mac]

Originally Posted by limitless_euphoria

Hey Mac, I'm the other dude with the smiley faces around here, limitless or you can just call me LE, NOT to be confused with "law enforcement!"

I look at it this way: maintenance treatment is just that. Either way you're playing a substitution game. Methadone and suboxone each come with their own benefits and drawbacks. Some NA nuts will argue that both are cheating and true recovery begins with no opiates. Their attitude is generally what has kept me away. Also, Mrs. LE does not like the idea very much because in the past I've made a couple of new friends but it's always turned out that we've both relapsed around the same time and then ended up helping each other find sources. Anyhow, I digress.

I've never done MMT but I have been on subs a while now. I still say that either choice is better than an inevitable return to active addiction. From reading between the lines in your post it sounds as though you're not ready to go c/t with no opiates whatsoever. As William Shakespear once said "Be true to thy known self."

If you're not 100% determined to get clean and stay clean then my prediction is within a couple of weeks of quitting subs and not going on something else you're going to start using. You seem very unsure of yourself and I think that's why you're putting this out there.

I think it was Indy who said to me when I had stopped sub maintenance and then asked everyone "should I go back" he said "I think you've already answered your own question by asking it" in so many words.

He was right, much to his credit; I knew I was going to be at serious risk if I did nothing.

So, research all your options and even if you just find a temporary solution to this longterm issue, go for it. But remember, with either choice comes consequences. If you're unfamiliar with MMT you might want to read some threads about people who are on it and/or trying to get off it. Exhaust all your options if you have to.

Originally Posted by EleusisII

Being dropped on a 2mg a day sub habit is a problem.
But not a HUGE problem, if you know what I mean.
First of all, you should call the doc to get a last script for a month. If necessary start bringing up that it would be unethical to do otherwise, his local phycisians board, etc.
Then, with a month full of subs you got some options. Cut half of them into 1mg doses, so you could detox yourself, spend a month to find another doc, or hell: Think long and hard about the methadone option.

Have you considered going CT from now? I got no idea how bad the wds from 2mg of bupe would be, but they sure as hell would be better than anything you'd experience on methadone.

Thanks for all the input everyone. Right now I'm just trying to weigh my options, and they are few. I've been trying to reach my doctor all day and no one is at the office. It almost seems as if he just up and went. The office is only open Monday through Wednesday but I didn't even get the letter until Thursday; you'd think they'd at least have the MA there to take calls, because, after all, there are ninety-nine other junkies that no longer have a sub clinic.

The context of the letter sort of stated that "this is it," no more bupe. I really don't think that I will be able to get a script because, like the letter said, "we were unable to provide notice due to the sudden onset of the doctor's illness," meaning that it sounds like he's out for the count, unable to write scripts come Monday.

And LE, you're absolutely correct when you say that it sounds as if I'm unsure of myself. I mean, what the fuck can I do? There are so few sub offices around here and the ones that do exist in my area are all completely booked. Also, I agree that methadone or subs is a better choice than active addiction. I know myself better than anyone and I've already been calling sources and scheming up ways to make money just in case I have no other options. On top of that, my best friend is getting out of jail soon. Maybe this IS fate...

I tried kicking bupe a while ago when I was on three milligrams and I didn't make it. It wasn't necessarily the intensity of the withdrawals that was bad, it was how long they lasted. I also had a friend kick them and he said it was like a month before he felt normal. Plus, I am a complete sniveling pussy when it comes to opiate withdrawal syndrome. I won't lie. I will find an excuse to use if I am going through withdrawals - I do it anyway on the subs. I don't want this because, now that I don't have something to take every morning, I will go back to active addiction quickly. Also, this is why I was considering MMT because I hear it rids you of cravings better than subs.

So, I am just lost here. I have no clue what to do. I wasn't expecting this and it really through me for a loop. I've never even heard of this happening before. Hopefully I will be able to get ahold of the office on Monday and perhaps figure out another office not far away. I am leaning towards bupe right now but if I can't find a sub clinic I will have no choice but to do the methadone dance. I am starting to accept that long term maintenance might be the best route to take.

(And thanks to good friends, as I was writing this post my friend offered me some free subs to hold me over until I figure something out.)

Thanks again everyone for all the input and advice.

[Oakleyskier]

good man, maybe buy some subs off the street? you only got a 2mg habbit, and with 8s costing like 6 bucks where im from (hopefully for you to) you could stretch 50 bucks worth of suboxone over a long time

[mac]

Originally Posted by Oakleyskier

good man, maybe buy some subs off the street? you only got a 2mg habbit, and with 8s costing like 6 bucks where im from (hopefully for you to) you could stretch 50 bucks worth of suboxone over a long time

No, they're like $15 minimum here. I've seen 8s go as high as $25. Ridiculous, huh? You should see the local dope prices - even worse.

[sexualhealing]

dude this is fucking horrible and goes against everything a doctor pledges to follow.

granted this man may be dieing of some sudden illness but its still the lives of so many people he is fucking with and harming.


i agree with LE that you should TRY TRY TRY to get another script, even if for only a month, more if possible somehow, and then when you arent as stressed because of this situation at hand, make some rational decisons about wether to stay on or get off matience or methadone etc etc.....


i really dont see you having a problem getting into another sub clinic EXCEPT for the max patient rule....have you tried the sub doc locator??? i forget the exact site i used but heres the one from BR:

http://www.suboxone.com/patients/res..._a_doctor.aspx


i thought mine was like shamsa.org or some shit, someone here prob knows....

but it may give u a few you havent tried....

ALSO....i would make sure you are very forthright with your story as any doc who has an opening and CARES about the patient and less the money, is going to take you over a newbie, as they know you have been clean and will be an easier patient and also should know what you are about to be facing/going through if they do not help..... it may just help you get to the front of the list.

i know its not really ethical saying that, as everyone should get this treatment should they choose, but you are already an "elected" taker of suboxone and not a new "canadite" so to speak....

man i really feel for you and hope this works out...i cant stress enough to keep calling, maybe you will luck out and there be a prodcedure for calls like yours to go to one of your doctors coworkers or colleagues..... may be such a emergency on his end that he put things into motion and the letter is a blanket sent to all sub patients but they HAVE to know at least SOME of you are going to call up needing your fucking medication.....


man this just gets my blood boiling...i cant imagine how you must feel.... im so sorry.... but keep your head up man and this will all work out, it all happens for a reason and i think u need to stay as strong as you can and maybe preemptively start the best taper you can with the little bit you have left, like skipping a day or two, or halving to quarting your doses.....get yourself ready to drop off but hopefully you wont have to...ya know?


i always like to prepare for the worst and hope for the best and it usualy works out in the middle.....best of luck my friend. please keep us updated.

[mac]

Originally Posted by sexualhealing

dude this is fucking horrible and goes against everything a doctor pledges to follow.

granted this man may be dieing of some sudden illness but its still the lives of so many people he is fucking with and harming.


i agree with LE that you should TRY TRY TRY to get another script, even if for only a month, more if possible somehow, and then when you arent as stressed because of this situation at hand, make some rational decisons about wether to stay on or get off matience or methadone etc etc.....


i really dont see you having a problem getting into another sub clinic EXCEPT for the max patient rule....have you tried the sub doc locator??? i forget the exact site i used but heres the one from BR:

http://www.suboxone.com/patients/res..._a_doctor.aspx


i thought mine was like shamsa.org or some shit, someone here prob knows....

but it may give u a few you havent tried....

ALSO....i would make sure you are very forthright with your story as any doc who has an opening and CARES about the patient and less the money, is going to take you over a newbie, as they know you have been clean and will be an easier patient and also should know what you are about to be facing/going through if they do not help..... it may just help you get to the front of the list.

i know its not really ethical saying that, as everyone should get this treatment should they choose, but you are already an "elected" taker of suboxone and not a new "canadite" so to speak....

man i really feel for you and hope this works out...i cant stress enough to keep calling, maybe you will luck out and there be a prodcedure for calls like yours to go to one of your doctors coworkers or colleagues..... may be such a emergency on his end that he put things into motion and the letter is a blanket sent to all sub patients but they HAVE to know at least SOME of you are going to call up needing your fucking medication.....


man this just gets my blood boiling...i cant imagine how you must feel.... im so sorry.... but keep your head up man and this will all work out, it all happens for a reason and i think u need to stay as strong as you can and maybe preemptively start the best taper you can with the little bit you have left, like skipping a day or two, or halving to quarting your doses.....get yourself ready to drop off but hopefully you wont have to...ya know?


i always like to prepare for the worst and hope for the best and it usualy works out in the middle.....best of luck my friend. please keep us updated.

Thank you so much for your concern and advice, I greatly appreciate it. I will be sure to keep you informed of my situation as it progresses.

Also, thanks for providing to the link for the sub locator. I have already called around and as I previously stated, there aren't a lot of sub doctors around the area that aren't completely booked. The DEA, I believe, is the agency that enforces the patient limit, though I could be wrong, and I doubt they will make an exception if they are already booked. I did call around today for sub doctors and I tried the methadone clinics but they were closed by the time I called them. As you said, I shouldn't have a problem getting into a clinic provided they have a slot open for me. After all, I have a year of clean urine tests under my belt and I have never missed a payment; I was never even late on a payment.

I will be trying to get another script come Monday but if he isn't there I will be fucked because he's the only doctor in the clinic. Another problem is another office closed a little while ago in Erie and my friend was forced into the same situation as me. He ended up just going to Cleveland but the office he is going to is now booked as well. I am trying some Pittsburgh offices on Monday and a few other cities around but I didn't have a lot of luck today.

It's an unfortunate situation and one that I was completely unprepared for. Just last month my doctor seemed fine and it didn't seem like there was any reason for him to close the doors. I called the office several times today and no one answered. Like I said in a pervious post, they aren't usually open on Thursdays and Fridays and I didn't even get the letter until Thursday. You'd think they would have someone there to take calls as I'm sure there are 99 other junkies in the same situation and some on much higher doses.

Once again, thanks for the advice. I'll let you know what goes on with this. I will be trying to lower my dose and prepare for the worst. Luckily, going back to my drug of choice won't be any easier than finding a clinic. Supply is nonexistent here and I don't have a lot of money to work with. A detox may be required but that is my last resort.

Peace.

[GOLD N DIEMONDS]

Hey just a thought-
I would even ask my Pharmacist to call in a refill for your script.
Go in person to the pharmacy tomorrow - ask them to call in refill, and then ask if THEY know of another good sub Doc. in your area.

Good Luck!

[sexualhealing]

^^^ another good idea....

man i hate to see you have to travel the whole way to pitt to get sub but i honestly think you gotta do what you gotta do and if its going to be something of that extreme nature, i wouldnt lie to the doc about being cut off randomly, but i think i would increase my dose, wether it be by telling him you need more b/c of cravings or if you just flat out tell him.....

most sub docs have no problem shelling out 16-24-32 mgs a day like its a friggn candy..... kinda nuts when the injectable ampules are sub mg doses.....


i have to drive an hour.5 to my doc every 3 months now so its not that bad but i, like you, live in the middle of nowhere but luckily/unfortantly the cities in my immediate area are filled with dope.....its def very prevelent here.....

i cant even count the amount of times i have just randomly went into the hood (armed of course, lol) and found someone to hook me up.....lots of them ended up being BOMB shit too...better than regular connects shit half the time and always bigger bags, lol.....go fig.


but when i got on sub it was in its infancy, only about 5 docs in a 50 mile radius and all but 1 were booked and it still took me some time to get in...had to do a interview over the phone...then in person....then luckily skipped the whole intake as i already was taking subs....but i missed a good 2 weeks of work EASY.....

im really hoping you can get in contact with the doc on monday and explain how this is potentialy a life and death situation they are putting you in and can he please write you ONE script. its not like they said he died....so i doubt he is unable to write.....but still you would think there should be some legal means of you getting a script that you would have gotten had this "sudden illness" not occured.....

its bullshit and im frustrated for you man.....shit should just be over the counter if you ask me....

only idiots would abuse it as its not the same high as the other good shit out there and it would help so many people get clean.....or at least stay sober longer....

[euphoricontin17]

Hey man, I'm really sorry to hear about your situation. With this post I'm not trying to sway you either way I'll just give my experience to aid you in deciding.

I jumped off bupe at 2mg and kicked it. The withdrawl is not that intense, that's not the hard part. By no means is it as bad as a full-agonist/doc. The worst part is the length. Not trying to scare you man but it took a full 3 months before I felt normal again. I didn't sleep for the first week then second week maybe 3 hours etc.

Also, like LE said, bupe really increases your chances of leading a good, productive, clean life. I personally came off bupe because I couldn't stand feeling nothing all of the time anymore. It's like your never really happy and your never really sad your just *normal* all of the time. I wanted my emotions back.

The good- is that the two years I was on bupe I really fixed shit in my life, graduated high school with distiguished honors, after failing the past 3 years, got a scholarship and a whole bunch of nice shit. I really made my "life circuimstances" a lot better.

The bad- I lasted exactly to the day when I felt normal again. I just wanted to say I did it. Then like any other self-respecting junky would do, I got high. I said "I'm gonna keep it to once a month" that turned into every two weeks, which turned into everyday pretty fast. Now I'm back exactly where I was before and a whole lot worse. I never used needles before, and before I could even say "fuck", I'm now shooting up everyday, pawning my shit and just living a full-blown junkie lifestyle again.

I haven't lost everything yet, but my life is surely falling apart. I know it's happening and I want to stop it but I can't. I like the way I feel too fucking much. I feel so bad because I know I am going to hurt everyone who trusted in me and was/is so proud of me for comming so far. I am going to destroy their hope and damage everyone left who cares about me. I know it's comming but I refuse to do anything about it.

I know, it sounds stupid as shit, but it's the choice I made and I'd do it again if I had to. I personally, would rather feel the short-timed beauty that comes with being a drug addict along with the crushing depression/pain as well. It sucks but that's just how I feel. Almost everyone in my life who i could turn to has gone away and shit, I guess these feeling I cling to are all I really have.

All that aside, my point is BUPE WILL MAKE IT A LOT EASIER TO KEEP A GOOD LIFE GOING.

also- When you come off, your very likely to relapse, it's not just dr's bsing you, it's the truth.

I don't want you to come off to be honest. Looking at what I had achieved and gotten back in 2 short years amazes me. 6 months later, it's all gone and I'm worse than ever.

I hope this helps with your decision man, sorry if it's not relevant and wasted your time.

take care.

[SuzieMeyers]

Yeah I think that you may be okay coming off 2mg of subs. I don't think the done prog is the best choice for you, you've made it this far. You can do it! Best wishes!

[mac]

Originally Posted by euphoricontin17

Hey man, I'm really sorry to hear about your situation. With this post I'm not trying to sway you either way I'll just give my experience to aid you in deciding.

I jumped off bupe at 2mg and kicked it. The withdrawl is not that intense, that's not the hard part. By no means is it as bad as a full-agonist/doc. The worst part is the length. Not trying to scare you man but it took a full 3 months before I felt normal again. I didn't sleep for the first week then second week maybe 3 hours etc.

Also, like LE said, bupe really increases your chances of leading a good, productive, clean life. I personally came off bupe because I couldn't stand feeling nothing all of the time anymore. It's like your never really happy and your never really sad your just *normal* all of the time. I wanted my emotions back.

The good- is that the two years I was on bupe I really fixed shit in my life, graduated high school with distiguished honors, after failing the past 3 years, got a scholarship and a whole bunch of nice shit. I really made my "life circuimstances" a lot better.

The bad- I lasted exactly to the day when I felt normal again. I just wanted to say I did it. Then like any other self-respecting junky would do, I got high. I said "I'm gonna keep it to once a month" that turned into every two weeks, which turned into everyday pretty fast. Now I'm back exactly where I was before and a whole lot worse. I never used needles before, and before I could even say "fuck", I'm now shooting up everyday, pawning my shit and just living a full-blown junkie lifestyle again.

I haven't lost everything yet, but my life is surely falling apart. I know it's happening and I want to stop it but I can't. I like the way I feel too fucking much. I feel so bad because I know I am going to hurt everyone who trusted in me and was/is so proud of me for comming so far. I am going to destroy their hope and damage everyone left who cares about me. I know it's comming but I refuse to do anything about it.

I know, it sounds stupid as shit, but it's the choice I made and I'd do it again if I had to. I personally, would rather feel the short-timed beauty that comes with being a drug addict along with the crushing depression/pain as well. It sucks but that's just how I feel. Almost everyone in my life who i could turn to has gone away and shit, I guess these feeling I cling to are all I really have.

All that aside, my point is BUPE WILL MAKE IT A LOT EASIER TO KEEP A GOOD LIFE GOING.

also- When you come off, your very likely to relapse, it's not just dr's bsing you, it's the truth.

I don't want you to come off to be honest. Looking at what I had achieved and gotten back in 2 short years amazes me. 6 months later, it's all gone and I'm worse than ever.

I hope this helps with your decision man, sorry if it's not relevant and wasted your time.

take care.

Thank you for your input and experiences. It's quite relevant and certainly hasn't wasted my time by any means. I am sorry for your situation as well and it is quite similar to my own. I think I mentioned in a previous post that I tried kicking bupe as well. I did it for the same reason, to feel something. I made it a quite a while but, as you said, it was the length of the withdrawal that got me. A ways into it I couldn't take it anymore and had an all out heroin binge. I hadn't told my doc I was attempting to quit so when I got back to the office I just continued with the treatment.

I was sick of being in limbo; I was sick of not being able to get high or be sober. I wanted one or the other and I was determined to get it but when I started using again I realized I no longer had the means to support my habit.

I love the junkie lifestyle. I love the little ritual I perform when preparing a shot and I love going into bigger cities to score, etc. I just cannot afford it right now. I don't have the financial means to. When I first got on subs, I did it for the sole reason of avoiding withdrawal. I had no plan, or even so much as a thought that I would someday have to stop the treatment and face life.

I know how you're feeling by not wanting to give up the junkie lifestyle and having most of the people in your life no longer around. I, too, only have that blissfully apathetic feeling of doing heroin to hold on to. I also don't really want to give up the euphoria and pain that only a junkie feels. I still take breaks from suboxone once in a while and those little breaks keep me sane and keep me from obsessing. I don't really want to be clean as I need some sort of opioid buzz to function in life but I also understand that it's not going to help things by going back to active addiction. I need to get things in order before I can do that again. That's why I think I want to continue with maintenance and possibly switch to methadone.

I spend a lot of time alone, just thinking, and I don't have much ambition anymore. I had way more ambition as a junkie; at least, as a junkie, I had a purpose and a very strong drive to do something. Now, I just don't know what the fuck to do with myself. I don't really know what to do with myself from day-to-day, let alone with my future. I probably have contradicted myself a few times with these posts and that just illustrates how scattered my thoughts are right now. One minute I'm obsessing about being a junkie, the next I want to be sober, the next I want to go the route of long-term maintenance. I'm just really confused and depressed right now and this situation with my doctor has only compounded all my underlying issues. It feels like my mind is going in ten different directions right now.

I hope things work out for you, though, euphoricontin, and thank you for your sharing your thoughts and experiences.

[euphoricontin17]

Wow, man. Thank you for taking the time to post that. I can really feel where your comming from with the "no ambition" feeling and needing an occasional opiod buzz just to fucntion. I honestly think if the Gov't just said "you addicts can go out every weekend after work and do heroin etc., but ONLY for the weekend " I think I'd be alright. It's just I have no self-control myself, and *every* shot is the "last" one just because you want to remember what it feels like.


Hey, at least thats my personal excuse, I just say " I want to remember the feeling, then I'll be able to be sober for the next ten years no problem."

Man, it's funny the way we think. As worse off as I am now, I know for a FACT I could not live sober. I just need that occasional escape, you know. I *NEED* to be able to know that no matter what happens, I have a way to get away from it all, that I can temporarily feel better than the rest of the world. It's like my safety blanket.

Thanks again man for responding, I hope shit works out for you.

[pain-pateint]

Originally Posted by GOLD N DIEMONDS

Hey just a thought-
I would even ask my Pharmacist to call in a refill for your script.
Go in person to the pharmacy tomorrow - ask them to call in refill, and then ask if THEY know of another good sub Doc. in your area.

Good Luck!

This is a GREAT idea, esp. if you know your pharmacist really well from the your time on Subs. Pharmacists KNOW who is writing which drug, and even perhaps which sub docs would have openings. A few years ago, when the hospital closed the wonderful pain clinic I attended, they gave everyone a couple of scripts and sent us all to this ass*ole pain doc who wanted to do NOTHING but put in spinal pumps and do injections. At that time, I was on 60 mg of Oxy per day, and this idiot told me he KNEW that chronic pancreatitis wasn't that painful and I could also have the option of going on Subs to manage my "minimal pain" with the goal of getting off all opi's. Of course, that would only be option in a month or so, once he completed his "Suboxone training" -- something that told me he had very little experience using that drug.

In essense, back then, I felt like you feel now. I ended up going to my PCP and getting him to write me scripts for Oxycontin and Oxy IR for a few months with the understanding -- of which he reminded me every time I saw him -- that this arrangement was temporary.

One day when I was getting a script from the PCP filled, my pharmacist noticed the change with respect to doctors and asked me what was up so I told him about the pain clinic closing. He then gave me the name of a local doc who was "quite well versed in moderate to high dose opiate therapy" [I think that's what he said, but I interpreted it as "I know I doc with a very liberal Rx pad!"]. It took me a couple months after sending my records to this new doc to get an appointment, but once I did, boy did things start looking up.

Yeah, pharmacists know the score in terms of who is writing for what, so I would ask your pharmacist. Who knows, your pharmacist may even send you in the direction of better options than what you have yet considered so far!?

[pain-pateint]

Mac --

I posted the note above before reading the last few posts of the thread, esp. your last post. It seems that you have other issues besides simply sorting out which drugs you need vs. ones you want vs. ones you don't want, as well as how you will get them. It seems like you're caught in that old predicament expressed by the "half"-joke: "What's the best way to kick an addiction? Replace it with another addiction...."

Seriously, though, it seems as if you have an issue about what you would do if, say tomorrow, you were suddenly relieved of any need or even desire for opiates? In other words, once you beat an addiction down to the point where it's no longer much of a problem in life -- unless some ass*ole doctor cuts off your scripts with no warning -- the question becomes "what do I replace the addiction with" because once you no longer spending a lot of time searching for opi's or scripts, or deciding which drugs to get and how to use them, and using them.....well, then you have a lot of time leftover with nothing to fill it. Naturally, a junkie brain (or a long term CP patient brain) will think that all that time should be filled with drugs, but if you want to move in the direction of recovery/using less opiates, then you must get active about filling that now empty "opiate window" left in your life because you have hours and hours available that will not be devoted to opiates and you must replace those opi activities with something -- and hopefully something you like a lot -- or the junkie brain will on its own see to it that that window is again filled with opiates.

So, maybe now is a GREAT time to resume an old activity you used to like a lot. Exercise is always good, and when I've been in spots like this (though I've never been in exactly your spot), swimming and other sports like golf and tennis have been God-sends. Is there anything you can think of that might fill some of that "opiate window"? Is there anything you like to do (other than drugs), or anything that's new to you that you want to learn, or a project you want to begin, etc?

Think about it: since you're on only 2 mg of subs per day, and you can even go lower without problems, your main problem -- after finding a temporary source to tide you over -- is NOT A DRUG PROBLEM. Rather, it's a problem of "what do I do to fill in all that time I will have without that monkey on my back."

I would love to hear what others think about this post. And, most importantly, good luck and good fortune, Mac!

[duck]

Originally Posted by EleusisII

I got no idea how bad the wds from 2mg of bupe would be

fucking hell

[dharma bum]

Originally Posted by SuzieMeyers

Yeah I think that you may be okay coming off 2mg of subs. I don't think the done prog is the best choice for you, you've made it this far. You can do it! Best wishes!

Yeah, no problem at all. A walk in the park. It is MUCH easier to go from 16 mgs to two mg than it is to go from 2 mg to nothing.

Did you use tha NAABT physician locator? There may be more around than you know. And methadone clinics (You say are fairly close) are starting to milk that suboxone cash cow too.

I would be trying to score some short acting full agonists, hydrocodone, percs, even ultram will help your w/d.

If you could get just one more script you could use it to taper on down to 1.5 mg and so on. Thats just cruel and unusual punishment to cut am guy off like that. I mean, it seems they would have some obligation here. And yeah, the doctor got sick, do they not have Physicians Assistants and shit.