22 Comments

  1. Hello – I just wanted to add that I suffered from treatment-resistant depression (major depression and dysthymia) for 20 years, getting limited to no relief from antidepressants. I took nearly every antidepressant on the market in my search for relief. Eventually my depression and fibromyalgia let to my experimentation and addiction to opioids.
    Then I got on Suboxone. It’s been a year, and my depression is basically gone. It’s true, there is a “honeymoon” phase where you feel so amazing, and that doesn’t last – reality does eventually come back. But gone are the days where I cry and cry, no more disturbed sleep, suicidal ideation is a thing of the past. I no longer take antidepressants or anxiety medication – for the first time in many years.
    I have a good friend who also saw a remission of her depression since she’s been on Sub. Sometimes I think getting addicted to opiates was the best thing that ever happened to me because my addiction led me to the best antidepressant I’ve ever taken.
    Of course, Suboxone isn’t the only factor in my treatment. I have also been in therapy, and doing yoga and other exercise. But I did those things before and didn’t get these results. It’s the combination, I think.
    Sub is addictive though, and now that I’m tapering off I’m feeling some withdrawal symptoms. So that is something that you have to take into consideration. So far it hasn’t been any worse than quitting any of the other psych meds I’ve ever taken, but we’ll see how it goes as I get below the 1-2mgs a day I’m taking at this point.

  2. Kimmie A

    Hi. I just began treatment of Suboxone for depression. I also, tried just about every anti-depressant out there over the last 20 years, and have felt depression since I was a child. Although an occasional pot-smoker, I have never been an abuser of pain meds or marijuana, but whenever I had thought of them or had exposure to them (even on TV or films) my brain would light up with desire. Often the cravings were unbearable, out of nowhere, leading to impulsive, harmful and illegal marijuana purchases, folllowed by guilt, remorse, etc….
    I did a ton of research and found some info about refractory (treatment-resistant depression) and how perhaps 10-15% of the med-resistant population may indeed have depression due to an inherent lack of natural opiates in the brain. I instinctively suspected this about myself for years with no legal recourse, and then a recent surgery provided more clues. I was on Dilaudid and Vicodin for 5 weeks post surgery and most of my depression symptoms went away…I actually felt “normal” with just one, or even a half a Vicodin a day. My appetite normalized, my mood was clear and even, my sleep was great for a change and my self esteem was strong. And….the withdrawal, even after just 1 pill/day for the last week, was AWFUL. My brain was very sad again. Of course, no one will prescribe pain pills for this purpose….and then I read about Sudoxone. I have just begun Sudoxone, and am still tinkering with dosage as I am very drug sensitive.
    I find that if I take the 2mg. Suboxone, split in quarters (.5mg.) and then put it under my tongue for a precisely timed 60 seconds before spitting out -just once a day- I am great! I have since been exposed to marijuana and have forced myself to think about the pill-opiate “high” but for the life of me, I cannot get interested. Prior to last week, I would have been “salivating” in my brain and feeling anxious about calming the urges. That part of my brain that craved the opiates is now quiet and happy. I am hopeful I have found the answer at last! No side effects either. Just a feeling of being myself and being “complete”. Many people may turn to opiates out of natural instincts to find balance, just as a malnourished person seeks just the right nutrients instinctively. I hope this treatment loses its stigma and begins to make its way more into mainstream depression treatment, especially at these minute doses. There is a study here to support my low dosage theory and practice:
    http://www.thatspoppycock.com/articles/2007_05_14_bup_for_depression.htm
    also, read here for a ton more info:
    http://www.prohibitionkills.com/
    It turns out the dose I am approximately taking fits in with the Harvard study’s determination of the optimum dose for depression as well. I just wish they made smaller dose pills so I could have more accuracy.
    Hope this can help others,
    Kimmie

  3. fitconcepts

    I think Suboxone is great for Depression. I took Percs for Chronic Pain, and as always your tolerance gets higher and higher, ETC.. Everyone knows what I mean. I have had issues in the past with Opiods. I talked with a Doctor that was recommended to me for Opiate Addiction. I discussed with him that everytime I cut back or try to get off of them I go through major withdrawals and Depression. The Withdrawals I can get through but the depressive traits never seem to go away. I have tried antidepressants and such and none ever worked. The Physcs say nothing is wrong with my head. LOL.. Anyhow this Doctor recommended Suboxone. I have been on it for a month and my Pain is under control. I take it 2 times per day. I never need more and I feel no Moodiness or such like regular Pain Meds. Point is that I believe it is an all around great drug. I am back to functioning normal again and being consistant with no more Mood Swings and feeling like I missed a dose of Pain Meds as was always the Case. And yes eventually getting off these will be an Issue, but I have talked to quite a few people with experience on these and they say all the horrible hype is not true about getting off the Subs eventually(And I know not everyone reacts the same way.). I believe it should be used as an Antidepressant. All Antidepressants have same issues coming off of with Some sort Of Withdrawal. I have seen some pretty nasty things in people when they dont have their Antidepressants and such. Its not a good thing cominig off anything it seems like these days.

  4. My friend, Damian Mason, had depression for over 15 years and found ways other than medication to deal with his depressed thoughts. He no longer suffers from depression and has written a book called Emotional SOS which explains how he did it. I hoped that you could have a look at his website. depression help.
    thanks

  5. carrieallme

    My dear fellow depressionists who suffer fro it like I do too my whole life pretty much,why would you want to start yourself on a prescrip med that is mentally and physically addicting when you dont have the addiction to the pain meds and are dealing w/ depression/anxiety,etc..Then have to deal also with addiction and getting through it when the docs yank you off or stopping it when time comes?? Theres so many other treatments out there and any addicting med is goin to make depre/anxi worse.. I KNOW!!By having anx/dep since I can remember,and also being passed on to myself from both sides of parents long line of dealing with it also,I have learned many things when it comes to tricks and dealing with it and what to mainly avoid.. In response to the two messages above on taking subx for depression and getting it prescribed from your docs ,just shocks the he*l outta me! If one has never had to deal with the dep/anx factors, even as a doctor can not really know how it feels or can be 100% on dealing with it and even with treating the unknown with lack of experience,Ive seensome docs try treating the first or one way that has worked out for some but not others. I have a friend,no joke on how stupid or dangerous doc can really be, who gets a prescription to adderall to loose weight and for energy. She said she feels so great when on them and shes never had an addiction to anything.I tried to explain to her that, thats what a high or buzz is and that is what all drug users get when using their drug of choice.She is allready late 30’s.She also doesnt have ADD and the doc didnt diagnose her with it either or any other doc for that matter ever.Im glad to write that she did take herself off recently due to not feeling or being herself and her work saw whe wasent and etc reasonings..So i guess my hope for writing all this is so this all here is made known to new users who are not needed to be on it for the first place,all it ever does in these cases is makes the symptoms increase worse or create negative problems.Good luck for all who encounters close to these matters, and if I am looking at this all wrong I hope someone wil let me know. I am not claiming to be a know it all, just known to it from experiences w/myself and alot of close friends and so on who ive went through with together.. I do know this is responding to an older message,but I had to get that out there for myself to make my own sightings known. I am on subx also for past year and most its made me feel was just a normal feeling. Nothing more greater.. but can tell when I forget to take it for more than 24 hours, then take a dose right away.So no, I dont reccomend form anyone whos not an addict allready to pain killers to use suboxone… carrieallme

    • James

      Carrieallme, you’re so right! I went from Methadone to Suboxone a couple different times, and I can say i am going through the worst hell of my life as we speak. I honestly don’t want to feel emotions. I wish I were numb like I was in Methadone. All these flooded emotions are the scariest thing a person can go through. The only thing I can think of is I’m going through Methadone PAWS, even after being on Suboxone for 3 months. I’ve quit Methadone before and made it 5 months clean and was still mentally sick as a dog, but when I am on Suboxone I get the worst depression and anxiety I’ve ever experienced. I was never a depressed or anxious person. I’m pretty sure Suboxone will just make it all worse for those that have them previously. Do not use Suboxone for anything as a tool to recovery from opiates. I will say I’ve only been dependent on opiates for the last 7 years. Been on them for over 20. I was never a person to abuse them, rare occasion in high school and couple times 7 years ago. I only took them to keep from being sick. And I e always known my limit. When I felt good then I was ok, a highly functioning addict you never would know existed. Please don’t go this route or your depression and anxiety will come back 10 fold. Like I said, I’ve never experienced this previously before opiates, but I can tell you it is HELL ON EARTH!

  6. califcamper

    Well after seeing many doctors, psychiatrists, therapists, etc, over the years and being told by them to try this and that for depression, the last being effexor (should have figured when I saw his effexor pen he was using) I finally came to the conclusion that I needed to find a solution for myself or I was gonna be unhappy forever. Many drugs I was prescribed were serious drugs, effecting liver functions, wellbutrin, lithium, etc… (they dont tell ya that).
    I think the people above were just trying to help those that were unhappy for years in their life and want to give their own experiences.
    I too, was a painkiller lover because everytime I ever was on them short term, right away I would have an interest in life, oh my god, I even cleaned my apartment for once.
    Eventially, I came onto suboxone to get off oxycontin, because I was sick of dealing with a doc (paying him every month to get my oxy supply). I took it upon myself to try it and it has helped me amazingly too. Yeah a year after I started on it, I do have to take a half a pill, sometimes less to feel decent but like my doc now says, you dont have to take more and more so I dont see anything wrong with it if it helps you feel good.
    That being said, I must admit, that if we could wake up one day and actually do what we wanted for a living, not because we need the money and are desperate drones, like most are in the working world. Woke up next to a wonderful girlfriend, boyfriend, had enough money to not worry, not have to deal with people that are blood money sucking thieves, etc… In other words a wonderful life, then I say then perhaps one would not need antidepressents, alcohol, cigarettes, and all the other substances people take to feel better, kill the anxiety, etc…
    I will say that is obtainable but in the meantime, I still gotta get up and try and live so if suboxone helps me do just that, and it does, then bring it on, can someone say lifetime supply (lol)?
    I really wish all well on their own journey and hope you all find happiness.
    califcamper

    • Pj ferraro

      I think exactly the same way about this. Having had a long term heroin addiction which simply converted my life into a nightmare, I have no objection if I need to take suboxone forever. It works for me perfectly and is the only thing that was helpful enough to have pulled me from the depths of hell. I can be trusted and counted on again. I don’t steal and manipulate to get what I need. I have money in my pocket and a smile on my face. So if taking a small dose of something my entire life is the key to maintaining that well sign me up. I never want to go back to where I was and after countless rehabs methadone bentos you name it suboxone when correctly used was the answer. People can judge it however they want. I’m not a heroin addicted liar and thief. I’m my regular pre drug using self. So you want to say I’m not “clean” because I’m on suboxone than the bottom line is you just weren’t as big of as addict as you thought. Because if you had been as bad as myself you would be looking at things in a totally different way

  7. Rayoflight

    PLEASE READ THIS BEFORE CONSIDERING SUBOXONE FOR YOUR DEPRESSION.
    Hi guys, I was given Suboxone to treat an opiate dependency. I have been on it for 3 years now. I have tried getting off it but the withdrawal symptoms are worse than any opiate I ever took. I have brought myself down to 1mg per day but getting off that 1mg is hard as hell for me.
    Although it has kept me clean and the cravings at bay, I wish I would have not started on it. I want to be free of all meds, Especially ones that will make you feel horrible if God forbid one day something happens and you don’t have it. You become a slave to it. Most people don’t need to be addicted to an opiate on top of being depressed.
    Because Suboxone also has NALOXONE (an opiate blocker) I’m always fearful of getting into an accident, so if paramedics or whoever have to give you pain meds, they will not work as well. And even if you tell them you are on Suboxone (most have no idea what it is, you have to explain the whole thing) they still will NOT give you more pain med because they want to protect themselves. So you run the risk of being in horrible pain.
    Also VERY important to note that (from Wiki):
    ***Naloxone has been shown to block the action of pain-lowering endorphins which the body produces NATURALLY. The likely reason for this is that these endorphins operate on the same opioid receptors that Naloxone blocks. Naloxone is capable of blocking a placebo pain-lowering response, both in clinical and experimental pain, if the placebo is administered together with a hidden or blind injection of naloxone.[5] Other studies have found that placebo alone can activate the body’s μ-opioid endorphin system, delivering pain relief via the same receptor mechanism as morphine.[6]***
    You are blocking your own natural endorphins!…you know the ones from exercise, sex, etc. That has to be worse for a depressed person in the long run.
    If you have tried everything for your depression (including natural stuff like exercise, vitamins, etc) and Suboxone is the only thing that has helped, then maybe you can try looking into Subutex. Subutex has the same ingredient (opiate) that Suboxone has called buprenorphine as you guys know, except that Subutex DOESN’T have the Naloxone. So your natural endorphins will not be blocked and pain meds will still work. Hopefully my Dr. will switch me to Subutex instead, but since I have a history of opiate addiction he might not, because people can still abuse opiates while on it. I hope you guys really think about what you are getting yourself into with an opiate dependency. Hope this helps 🙂

    • I agree with your concerns about getting stuck on an opioid as part of treatment for depression; I would not prescribe it for that indication, unless the person was also an opioid addict. I don’t agree with your other comments though. People often start buprenorphine after opioid agonists have destroyed their lives, and the buprenorphine saves them… and then the person complains that they are ‘stuck on Suboxone’ because they cannot stop it. The fact is, they could not stop ANY opioid, so why do they think that Suboxone should be any easier? Nobody should expect buprenorphine to ‘cure’ them; opioid dependence is not ‘curable’. Like most diseases, it can be managed and held in remission. But for the writer, you couldn’t stop opioids– so you turned to Suboxone. You throw out ‘it kept me clean’ as if that is a small thing; I can tell you that it is no small thing! Before buprenorphine, there was nothing– nothing to help a person stay clean. Your decision that buprenorphine is now the ‘bad guy’ is nothing but ‘looking a gift horse in the mouth.’
      I also don’t agree with your concept of ‘addiction’. There are many medications that cause physical dependence– including buprenorphine– that do not cause ‘addiction’, which is the mental obsession to use the substance. Most people can identify the difference between their ‘addiction’ to oxycodone vs their ‘physical dependence’ on buprenorphine! Two completely different things entirely.
      Finally, naloxone has NOTHING to do with the actions of Suboxone, as it is not present in your body in any meaningful amount if you don’t inject it. You may be getting confused with NALTREXONE, which is an orally-acitve opioid antagonist. But NALOXONE does NOT block the opioid receptors of people taking Suboxone; it is not absorbed through mucous membranes, and the naloxone that is swallowed is destroyed by the liver almost immediately after absorption from the small intestine. The writer’s comments show a number of misunderstandings about how Suboxone works; for example the comment about ‘abusing opiates on buprenorphine’– the blocking effect of buprenorphine is the same in Suboxone and Subutex, as it comes from the buprenorphine– NOT from naloxone. The naloxone is ONLY there to precipitate withdrawal if the drug is injected. That’s it– it has no other effect.
      Think about things– yes. But get the facts right first!

  8. Rayoflight

    You have to remember that I never said I was a doctor, it is just my experience as a person who has been on it for 3 years.
    Sub has helped keep me clean, but I will not give it all the credit, because I was on it before and still had a relapse. Not saying that people on it should not/will not relapse, I know it’s no miracle cure. What I’m trying to say is that I have also put a lot into my recovery, it’s not just the Sub. that is keeping me clean. There are many addicts that stay clean without it. Is it so bad that I want to be off it? I don’t hate Sub, I just don’t think it should be used by depressed people without them trying other things first, but that’s just my humble opinion. My comment was geared towards people with depression taking it.
    As far as the Naloxone not blocking your natural endorphins, take that up with Wiki. (under side effects) http://en.wikipedia.org/wiki/Naloxone

  9. Rayoflight

    SuboxDoc, can you please help me understand: if the naloxone is not an opiate blocker, why do people say they can get high while on subutex but not as much on suboxone?…And I’m not just taking about people that inject it. I’m talking about just swallowing or snorting another opiate like Oxycotin. So the only difference between Suboxone and subutex is that you can’t shot up the suboxone because of the Naloxone?
    I have always read that Naloxone is an opiate blocker. http://www.ajcn.org/content/61/6/1206.abstract
    Is buprenorphine the opiate blocker? If I was taking Subutex and got into an accident, I would run the same risk of the pain meds not working, as I would on Suboxone? One last question, what is the best way to get off Suboxone that you know of. Thanks. 🙂

    • James

      Buprenorphine has a higher binding affinity at the mu opiate receptor, so you can take other opiates and be fine. It’s when you go back from that opiate to Buprenorphine that caused precipitated withdrawals. I’ve never experienced precipitated withdrawals, but I heard it’s hell. I know when I was on Methadone and took and OC 80 I was sicker than a damn dog and purging for hours. The worst withdrawals I’ve ever experienced. If you have to take opiates while on Subs just wait 24 hours until your start Subs again. I’ve heard Tramadol can be taken with Subs, but I don’t recommend it. I wouldn’t worry about getting into an accident. I’ve heard a few people that always worry about that in particular. What I worry about is being off Methadone and on Subs for 3 months and still feel like crap. Depressed and anxious and theses horrible bone and muscle aches. I also haven’t been at a stable dose for a period of time. Went from 2 mgs to 12 mgs down to 4 mgs in that 3 month period. I did this because I wanna make it easier for when the time comes to jump off. I feel like my brain is healing because how bad I feel. Healing from the Methadone. Maybe it’s Methadone PAWS. I even quit Marijuana because it made my symptoms worse. It feels like a tingly sensation in my brain that itches, not literally. Head pains, headaches. These bouts of horrible depression and constant anxiety. I was only in 39 mgs of Methadone, therefore I didn’t think I neede so much Suboxone. The more Suboxone I take the worse I feel and more prominent my negative symptoms become. I can’t explain it other than PAWS. Hope someone else reads this and has similar experience. I thought i was having horrible tension headaches, like a tight band around the head. It’s so weird. The more Suboxone, the more the tingling sensation in my head and it makes anxiety and depression worse. I thought this stuff was supposed to help me? Apparently not. I’ve been on Subutex in the past and never had problems, so the Naloxone thing has to be contributing to what’s going on with me, if indeed it isn’t PAWS from DOC.

    • James

      I want to say one more thing from my recent response. If it was PAWS from methadone then why would I feel worse the more Suboxone I take? That’s why I am leaning towards the Naloxone causing my problems. Like I said previously, the depression and anxiety get worse the more I take. As I said before, I did fine years ago from methadone to subutex. Hope someone has similar experience

      • I’ve been away for a few days… I work in a methadone-assisted program half-time, and a couple patients there have asked to change to buprenorphine – usually because of doing well, getting a job, losing medicaid, and having to pay for methadone treatment out of pocket. Buprenorphine (and I’m using that word to apply to any buprenorphine-based medication with or without naloxone) is a good option in those situations, but it is a very difficult transition. There are two issues to deal with: tolerance mismatch and precipitated withdrawal. The first is dealt with by reducing methadone dose (and opioid tolerance) to the equivalent of 40 mg methadone per day; the latter by stopping methadone for as long as possible before induction.
        If a person tapers methadone dose quickly to 40 mg and then transfers to buprenorphine, tolerance will still be at a higher level, as it takes 2-3 months for tolerance to adjust fully. I don’t know if that is an issue in your case? The other thing to consider is that I read something about buprenorphine a long time ago in some reference book – I don’t remember if it was Goodman and Gilman’s pharmacology manual or somewhere else – that buprenorphine takes on greater antagonist properties in very high doses. That would explain why taking more buprenorphine (in the form of Suboxone) might worsen the symptoms during that adjustment phase, i.e. if the balance between stimulation and antagonism moves more toward antagonist activity as you increase your dose.
        Thanks for sharing your thoughts– I hope things settle down for you.

  10. tearj3rker

    [i]”Before buprenorphine, there was nothing– nothing to help a person stay clean. ’ [/i]
    Sorry Doc. What about methadone? If my memory serves me correctly as well, naltrexone was being prescribed in pill form for opioid addiction before buprenorphine.
    Not to mention all the non-pharmacological treatments for addiction – therapeutic communities, 12 steps, CBT, motivational interviewing . . . ?

    • I stand corrected– at least on the methadone issue. Naltrexone is just not practical for most people; one must be clean for a month or two first (or go through a rapid detox program, which have their own problems), and many addicts don’t like the idea of living with their endorphins blocked off– even if studies don’t show any subjective issue with that.
      As for the non-pharmacologic methods, that issue is the central tenet of most of what I write. I love recovery, when it works. But it simply does not seem to work well for opioid dependence. I have been a part of several treatment centers– from both positions, doc and patient– and I know, without any question, that the success rate is abysmal for opioids. People get cleaned up by the end of 90 days, and their charts get archived– but when their obituaries hit the papers two years later, nobody pulls the charts out and asks what they did wrong. My buprenorphine practice is filled with patients who have paid tens, hundreds of thousands of dollars collectively for residential treatment.
      But methadone– a treatment that I used to firmly criticize– clearly has a place in treatment, and has been around in the US for some time– 1972, I think.

      • James

        Dr, I don’t believe it would be wise to get on Naltrexone until PAWS has lifted. They sometimes PAWS never goes away, I beg to differ. I believe if you have the right support and tools you can only progress.

  11. suboxpatient

    On the naloxone issue, it really doesn’t matter about the route of administration when it comes to suboxone. The medical and pharmaceutical communities failed to realize that buprenorphine has a higher binding affinity than almost any other class of opioids. Junkies, in their infinite wisdom, figured this out. Suboxone is a useless preparation because you can shoot it all day long and won’t get sick. The naloxone isn’t a deterrent as it doesn’t pass the buprenorphine blockade. Only the fentanyl class has a higher binding affinity that will break through. So even if you inject suboxone, which I’m not advocating, the naloxone has no effect as it is kicked of the receptors by the bupe.
    Secondly, I have terrible treatment resistant depression as well as iatrogenic problems caused by psyche drugs. IMO opiates are far safer than any psychiatric drug and have a much greater efficacy. I was prescribed suboxone for depression, however, as it is an agonist/antagonist, I found that while it was better than nothing, it fell far short of the benefit I received from either morphine or oxycodone. But a doctor will prescribe psychiatric poisons that cause tardive dyskinesia, akathisia, liver failure, neuroleptic malignant syndrome, thyroid damage, permanent sexual dysfunction (the list goes on) that have little or no proven long term effectiveness, but won’t prescribe an opiate?! Look at the side effect profile for any psyche drug and compare it to the relatively benign profile of an opiate. Oh, and we know what the long term outcome is of chronic pain management with opioids. We have know idea what the long term effects of psychiatric medications have on individuals.
    When it comes to addiction, are you kidding me? Talk to anyone who has withdrawn from both an opioid and either an SSRI or Benzodiazapines, and they will tell you that they would rather kick heroin ten times than come off either one of those drugs. SSRI withdrawal is miserable, and contrary to the prevailing medical “knowledge”, withdrawal from SSRI’s lasts months if not years, not merely two weeks as stated in the journals. And benzo addiction is the most insidious of all addictions. But yet doctors will freely push these chemicals on you while withholding the only drugs that for some of us are the only thing that makes us functional and gives any level of relief.

    • James

      The world is an evil place. These reps and DEA want us to suffer. Every time we get on Meds that work they take it away. Next thing that will happen is they’ll be putting more naloxone of a ratio 1:1 and make us all sick. I’m serious. I already hate Suboxone, but will never go back to methadone again. I’ve had nothing but problems from Suboxone and never had problems on Subutex, yet they won’t prescribe it. Like you said, you can shoot the Suboxone just like Subutex, so what’s the damn problem with giving us people that do better onthe latter, what works for them? It’s a joke. Problems in subs are: depression, anxiety, aches, pains, isolation, etc.

  12. HADZI

    Also if u were to take suboxone it loses the calming effect in 3 months. To point u feel nothing when taken. I hear u. I have been battling depression . I tried alot of meds. I can help u , I understand u. Trial and error. And psychiatrist R headache just writing the prescriptions. I’m on suboxone cuz I was addicted to oxycontin. I feel u u feel so good when u take. Especially methadone which is stronger .

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