7 Comments

  1. richied79

    There is something to be said about opiate addiction and anxiety. But what defines anxiety may be different for different people. In December of 2008, I discovered tramadol…not a ‘serious’ opiate agonist by some hard core users, but it gave me this feeling of well being that I liked. Well, 4 months later, I found myself taking from 22-25 50 mg trams a day. Tolerance has definitely built up. Due to my fear that I may have a seizure at high doses, I found a doctor who was willing to prescribe me suboxone. The doctor prescribed me 30 8/2mg (bup/naloxone) suboxone and 45 .5 mg clonazepams. As soon as I took that first suboxone (4 mg), my cravings for tramadol died instantly. On a side note, suboxone made me so nauseous that I had to get a prescription of Zofran as well. Well, my suboxone treatment ended essentially after I ran out of pills (approx 45 – 50 days). I stopped taking the suboxone, and I felt fine…no cravings whatsoever. For the clonazepams, I took about 20 over the entire treatment episode. After 2 weeks into my sobriety, this weird sensation of adrenaline started to build in my chest. It was very uncomfortable. I was tense and irritable. So, I finished off the remaining clonazepams over a couple weeks, which helped for the time being. And because I got laid off of my job in the middle of my treatment, I didnt have health insurance anymore. So, I went back to the tramadols. At first, once again, it was a wonderful expereince, but eventually, the trams couldn’t quell this debillitating anxiety. So this September, when I became employed (and insured), I went back to the same doc and he prescribed me buprenorphine once again. But because I complained of nausea, he prescribed me Subutex instead. And once again, as soon as I took the Subutex, the anxiety went away and I had no cravings for Tramadol. The Subutex still caused me nausea, so I ordered some generic zofran from an online drugstore (this was actually cheaper than a prescription).I’m currently on the subutex treatment (2 mgs, up to 4 times a day AS NEEDED). I find that whenever I have that tense, adrenaline like feeling coming up…I have to take a sub. The funny thing is, I’m not going through withdrawals. This anxiety is different, and it IS physical…I definitely feel it. Breathing exercises sometimes help, but not always. So, how does one defeat this ailment that I fear? I am a graduate clinical psychology student, so I know certain triggers can lead to people relapsing. My fear of this anxiety could be a precurser of an anxiety disorder, but I’m not certain. From what the article said, it seems to be just a manifestation of the addiction. Any thoughts?
    -Rich

    • I would suggest being careful with the term ‘anxiety’. Understand that stopping many things, including tramadol, clonazepam, or suboxone, will cause intense dysphoria that has nothing to do with ‘anxiety’. So my first suggestion would be to evaluate how you do off all medication that has an agonist effect. The problem with pure agonists is that you are never at a state where you are completely separate from them– you are always either intoxicated or in withdrawal (except for maybe one short instant where your tolerance and the dose level match up). With buprenorphine, if your dose is above the ceiling level, you are in a ‘stable’ situation where daily changes in plasma level do not change the degree of opiate effect. Of course you don’t get to that point when you are taking small doses of buprenorphine ‘as needed!’ I would recommend getting to a stable, once per day dose of buprenorphine and then seeing what feelings you have after a couple weeks– when you are fully tolerant to the ceiling level of buprenorphine. Otherwise it is impossible to sort out what is causing what.
      Just a word on the side– tramadol withdrawal is uniquely miserable. It cannot be blocked completely in most people by using a mu receptor drug like buprenorphine (buprenorphine also has kappa blocking activity, but that is not relevant here). The effect of stopping tramadol includes a feeling similar to stopping SNRI’s- which would be expected, given the dual mechanism of action of tramadol. I have reduced the discomfort in people to some extent by replacing with an SSRI with a long half life, then tapering (e.g. fluoxetine).

  2. Heather

    Hi, I work for a market research company that is looking to talk to people who take the generic version of Subutex, Subutex, Suboxone, Methadone. If you or anyone you know may be interested in participating in the study please e-mail heather@probemarketresearch.com. The study would be conducted via telephone and only take about 20 minutes. The participants would be mailed a check for $50 for their time. Thanks!

  3. jasonm

    Ii am having real panic attacks. Heart rate goes up. Icant be where I am. Having to use the bathroom freaks me out cars clostrophobic. Temperature of my house. Clothes too binding. At least 20% of my day is pure debilitating anxiety with really scarry attacks coming at night around 300 when I wake up. I am unable to function like this. I’ve been on 16mg subutex daily for 2 weeks. I hate it so much I would prefer withdrawl. I don’t know what to do so I am starting a very slow ween to get away from it. Methadone caused the same panic attacks I had to get off. Nobody believes me and everyone minimizes what I’m going through. I am scared to death and miserable. Really freaking out every day. I have avoided benzos believe me I have a hi tolerence for benzos. I could take two Xanax bars in my addiction. Today I cut a .025 Xanax pill in thirds and it helped I know I can’t continue benzo use but as you can see I’m not trying to get high on them. I just want some relief and the very tiny dose helped. I’ve got bottles of hi dose clonipins laying around but I will not use them. 1/3 of a .025mg zanax was enough to get me through tonights panick attack. I really want subutex to work but I am afraid I can’t go on like this. I’m going to drop 1-2 mg a week and try to get away from them.

  4. Very interesting article. I think a lot about the benzo issue and this was helpful.
    Also, I’m trying to get a social networking site for people who are in recovery for opiate dependence, their families and friends started at junkjunk.ning.com
    I hope some people will join to help me get things started.
    Thanks, Tom

  5. longtimer

    I have tried for a while now to long in here and write a compelling story. HAHA Now I got my chance…haha
    I started taking Percocet 5 or 10 mgs to about 10-15 a day during a seriously stressful time in my life. After my tolerence became higher my frustration grew stronger with having to wait to get more and dealing with the old folks around town. They didnt want the pills but needed the money to get by and I didnt want the money and needed the pills to get by. Eventually I got heroin, which any pill head will do. I prefered banging it to snorting it but the stigma associated with addicts and gettting good freshies on a regular basis led me to my preference. After getting down to borrowing money more often and not paying bills like I should I decided to make that change. I went to the doctor who used to prescribe me some percs and told him I needed some help. He didnt know what to tell me. I cussed him up and down both sides, mainly cause I was withdrawing, i later called to apoligize to him. ha Then a freind of mine told me about this magic little stop sign looking pill. I got the number to his doctor and his receptionist sd “bring in $150 cash and take or do whatever you have got now and we will see you in the morning” this was 1600 hours on a Thursday. I got rid of my $60 bag bought another pill ($20 bag of boy(herion)) and a $20 of blow and thought I would see what all that felt like since I was “quitting” tmw anyways. It felt great best night I had in a while. I just chilled out with a girlfriend of mine an small bottle of liquor and got hammered and talked…very cool night.
    Then i went to the appointment, late. And felt like crap, but not too bad. I knew it would get worse and didnt want to really feel any withdrawals. They dosed me up with two little white things and walked out the room. She sd stay here, like i was fucking leaving HAHA then they cam eback aobut 2 hours later and gave me two more and in about 30-45 minutes i was talking on the phone and walking around. very strange for me. since that moment when I realized I could avoid withdrawals without see my buddy in the hood or the old ladies in the projects I was ready to start over. They gave me my script of Suboxone and that was it. Until about 6 months later. I missed the fun I had and the fun of cruisin around the hood high or hangin out with those people…funny shit they say and think. but after a few times using I was and still am totally done. I like my new life and sobriety, other than the suboxone, still has its stressful moments but I dont need to get high and know gettin a bag or whatever isnt gonna do anything. I encourage anyone that wants to quit pain pills, herion or whatever opiate you are on to get Subs and get off that shit. And if you arent sure you are ready to quit then wait til you are or buy about 10 subs and see how you feel after taking two a day for 5 days. I bet you will want to quit then…I know my story is short but I am tired of typing and I am sure someone will have something to say but I am going to get my script filled now and then Ima go right back to work and be prodictive. RIGHT ON!!!!!!!!!

  6. chuck stiefelmeyer

    Point taken. Addicts tend to think incessantly about every micro-moment of their dysphoria ( or potential dysphoria) in excruciating detail, which may paralyze them with fear. Activity and avoidance of boredom have helped me , personally , in this regard.

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