“Went from pill addiction to suboxone addiction- what can I do?”

An opiate addiction changes the physical structure of your brain. People who are not addicted to opiates have a certain number of opioid receptors in the brain, and these receptors are normally activated by endogenous neural endorphin chemicals. When you take a drug like heroin or an opiate medication, you saturate these opioid receptors in the brain and create euphoria. All opiate users develop a tolerance to the effects of opiates (needing increasing doses just to feel the same high) because the brain responds to the regular use of opiates by sprouting increasing numbers of opiate receptors. With more receptors present, you need to take a higher dose to saturate these receptors as completely. If your opioid receptors are not sufficiently activated, you feel increased sensations of pain, dysphoria and other symptoms (the opposite feelings of an opiate high). Problematically, once you have an increased number of opioid receptors in the brain, normal levels of brain chemicals cannot sufficiently activate all of these receptors and without supplementing normal levels of brain chemicals with drugs, you feel sick. You reach a state whereby without the continuous use of opiate drugs, you go into opiate withdrawal. The buprenorphine in Suboxone or Subutex can fill and activate opioid receptors in the brain. Once you activate these receptors sufficiently, you stop feeling opiate withdrawal.

Addiction is disease caused by chemical imbalance in brain, suboxone is helping to stabilize the imbalance. Most patients require low dose maintenance for life.

The WHOLE POINT of Suboxone and similar products with buprenorphine is that you take them for years. Difficulty stopping treatment with buprenorphine is the whole point. Addiction is the three "C"s: Craving/compulsive use, loss of Control, and ongoing use despite bad Consequences. YOU DON'T HAVE ANY OF THE THREE "C"s WITH SUBOXONE. You're not addicted, you're receiving treatment. Unless your life is 100% stable and you've taken it for years , stopping Suboxone inevitably leads to relapse. Stopping will MAKE you an addict.

I applaud your motivation and will to be free of drugs. There are a couple of ways you can do this. One approach would be to find an addiction specialist who would put you on a taper protocol and monitor your progress closely as you wean off Suboxone; the other approach is to be admitted to a psychiatric hospital where you would be detoxed, monitored, and treated for withdrawal symptoms. As you think about getting off Suboxone, I encourage you to think of non-pharmacological techniques to address back pain and consider exercises to strengthen the back.
Hope this helps.

It would be best if you would consult with an addiction specialist for how to manage your Suboxone use. Since you mention that you still get some euphoric experience form the Suboxone, you might want to discuss adding an additional dose of naloxone to your regimen. Suboxone is a combination of opiate and opiate antagonist. In your experience, the agonist may not be adequate.

Hi there! The very first thing you need to do is to make sure you have identified all your triggers (things that make you use) and put up "road blocks" so they don't cause relapses. A good counselor can help you with that.

Sit down and put together a list of people that will act as a support while you are going through this. Non-family members are best because they won't overreact. I am not saying don't tell your family. I am saying wait to tell them until any crisis is over. Having a good support system is essential for long term recovery.

As for the withdrawal symptoms, either go into a detox unit or call around and find a Suboxone doctor that is willing to taper you. Both can prescribe non-addicting medications to help with the withdrawal symptoms. Believe it or not, coloring an intricate picture relieves most withdrawal symptoms within 10 minutes. Take a few minutes and print some off.

As for the euphoria, find some healthy things that make you feel good...running, dancing, bicycling. Anything that releases endorphins will help.

I wish you luck in your recovery!!!

Buprenorphine is addictive, but one important difference from full opiate agonists is that it does not create tolerance; meaning we can gradually taper you off it. The rate at which patients taper is different for each one. This medication is not meant to be prescribed by itself, it should be used in combination with either drug counseling or 12 step meetings, be it AA or NA.

Our patients are required to attend 90 meetings in the first 90 days, then at least a minimum of 3 meetings a week. We also give them a list of websites they can access for additional support and which all patients find very helpful. There are online meetings any time, every day. The medication also has a "ceiling effect" so that it may give some opioid-like effects at the beginning, it subsides and you do not get more of an euphoria, by using more medication. If you wish to have an appointment with us, please call (904)460-0707 and request an appointment for our Buprenorphine Program, Opioid Dependence Program.

Dr C. Vivero, MD. Institute of Internal Medicine

Thank you for your question. The evidence has shown that suboxone does help out with opiate addiction. There have been some reports detailing that patients still experience some euphoria, but not to the level of oxycodone. You may want to get a referral from your family doctor to an addiction psychiatrist. If your addiction is posing a risk to your health, the best thing you could do in the interim is surround yourself with positive people, go to Narcotics Anonymous meetings and perhaps consider an outpatient treatment facility. I wish you the best in your recovery.

I agree that being chained to an opiate with physical dependence isn’t optimal. The real question is can you find alternative tools to use to control your pain, meaning that can you prevent suffering from pain, without opiates? If not, then you’re better off on long-term maintenance with Buprenorphine than any other opiate lest you run the risk of becoming another prescription OD statistic. It is not an all or nothing issue either because you can use opiates medically to prevent suffering and not become physically dependent as long as you find ways to treat your pain well enough to prevent suffering at least 1 or 2 days out of 7, so you don’t have to take opiates. Pretty hard to become physically dependent on any scheduled medication when you frequently and randomly don’t take it. Hope this helps.

R. R. Kutzner MD