1. I have been wanting to respond to this entry for days…but computer problems prevented it!
    I agree with everything you wrote, Doc. I just had a couple of points to add that make me a little crazy when dealing with people like the writer of this email/letter. I can only hope that this person’s partner might realize that he already is achieving what he wanted out of treatment, and it just might be BECAUSE of the Suboxone, not IN SPITE OF IT! The person who wrote this letter is living in a fantasy world that many loved ones of addicts live in–the world where the problem is the DRUGS, not the addiction. Because it’s so much easier to believe the drugs are the problem–because drugs you can remove drugs from the equation …. a chronic life long disease, you can’t. The sad thing is, though, that by pushing to remove the Suboxone (the NARCOTIC, as she keeps calling it) in a vain attempt to “cure” him, she is most likely setting him up for a relapse. Even more sad is that when this is all said and done, she will most likely blame Suboxone for that relapse, instead of logically realizing it was the “going off” Suboxone that caused it, not going ON it to begin with! Afterall, there had to be a reason he went on it, right?
    What bothers me the most about this letter (and there is much that bothers me!) was her comment about it being “OK” for him to be on antidepressants for “life”–but not Suboxone.
    Why is it ok for a patient to be on anti-depressants long term but not, Suboxone? What RATIONAL reason can she give? She can’t, because there is no RATIONAL answer! For that matter, how can you possibly say FOR SOMEONE ELSE, what is “ok” to take and what is not? This isn’t about ethics or morality, this is about someone ELSE’s health! We aren’t talking about whether you should have sex before marriage here–we are talking about the medical treatment of a disease.
    Usually, when I talk to someone who is of this opinion about long term maintenance medication for addiction vs. depression, I ask them why one “drug” is ok and not the other-I get an answer like “You know why! How can you say it’s the same? Ones and opiate and one isn’t!”–one is bad and one is good” sort of statement that has nothing to do with medical science.The truth is we aren’t even asking the right question of these people! What we should be asking them is “WHY IS IT OK TO TREAT ONE MENTAL ILLNESS AND NOT THE OTHER?” or “why is it ok to treat one person’s suffering, and not anothers?”
    So lets contemplate the possible reasons someone might give for why it’s OK to take AD’s for life, but not Suboxone, shall we? ((smile))
    “Suboxone is considered mood altering”
    It can’t be because one is “mood altering” and the other is not…because AD’s, by their VERY NATURE, are mood altering! Why would anyone take them if it didn’t CHEMICALLY alter your mood?
    Suboxone is “addictive”!
    It can’t be because one causes dependency and the other doesn’t…..because most AD’s cause a withdrawal syndrome similar to Suboxones level of un-comfort level, when they are discontinued!
    People can ABUSE Suboxone!
    It can’t be because Suboxone is sometimes abused by naive drug users….because ALL drugs can be abused if used the wrong way and AD’s are COMMONLY diverted and abused by teenagers.
    Suboxone is toxic to your body!
    It can’t be because Suboxone is more toxic to the body than AD’s….because opiates are generally harmless to the bodies organs and most of their side effects are “quality of life” type of effects like constipation. Some AD’s, on the other hand, have a lengthy list of adverse effects….in children especially.
    People DIE from Suboxone overdoses!
    It can’t be because one can cause overdose on Suboxone and not on AD’s….because AD’s are VERY COMMON players in overdoses-suicidal and accident–and Suboxone is RARELY the listed cause of overdoses….you can overdose on ANY drug, chemical or substance (even WATER) if you take too much!
    So the only reason left is “because I said so”–the morality of one drug vs. the other. The irrational “morality” score that many treatment providers,12 step groups and members of society put on certain drugs, that actually have nothing to do with the logistics of these medications, and have everything to do with stigma.
    Whenever a patient comes to one of the message boards I frequent complaining about how much they want to get off medication and “live a normal life” again….how much they hate this or that and if they could JUST get off this dang medicine, their life would be perfect again….I know immediately that they aren’t even close to the place they need to be to be off medications and still live a good life. They haven’t even really accepted that they are addicts yet, and what that means as far as living with a chronic illness that not only could kill them, but could ruin the quality of their entire lives.
    These folks are (just like this girlfriend writing above) still blaming all their problems on the DRUGS…whether it’s the drugs they are addicted to, or the medication they are taking to treat it, they are still focusing on the DRUG, and not the addiction. They still believe that if they could just remove certain drugs and medications from their bodies, their problems would be solved.
    I try to always gently remind them that MOST people with chronic un-curable illness feel a sense of not having control over their own bodies and lives….that feeling resentment at having to take a medication to live well is normal and not exclusive to addiction, but sometimes, depending on the severity of the illness, its a fact of their lives they just have to come to terms with and accept.
    Addicts and their families have to face that addiction is now a PART of their lives, but it doesn’t have to be your WHOLE life. And I think that is the absolutely wonderful part of moving addiction treatment into the medical arena-like Suboxone treatment….instead of always focusing on “how do we keep this guy clean, against all odds?” and “how can we keep addiction forefront in his mind at all times, so that he doesn’t relapse?” and “how can we teach him to cope with the symptoms of addiction?” Instead of teaching addicts that to save their lives they havr to become almost as obsessed with staying clean as they were with using drugs.
    INSTEAD we can actually start to think of addiction treatment as “how can we lesson the symptoms of addiction so the patient doesn’t HAVE to cope with them?” and “how can we calm this obsession so this person can focus on other things besides their addiction?” and “how can we give this person as normal a life as possible, while having this illness?” In essence we can begin to treat addiction like the disease it is, instead of continuing to call it a disease but promoting treatments that we would NEVER recommend for other illnesses!
    As addiction treatment moves more and more toward treatments that help eliminate the symptoms of addiction with medication or other therapies addicts can finally start to look forward to planning their future, instead of just getting through “one day”. A time where an addicts happiness and contentment with their treatment and quality of life is just as important as how long they’ve been clean! A time when there is no “bottom” that has to be reached and where a life can be saved, before there is no “life” to get back to!
    ps- I apologize for any spelling errors, I am in a hurry but couldn’t wait to write a response!

  2. samiam

    First of all I would like to say that I wish with all my heart there was a magic pill that could help people with addictions but I don’t believe there is one yet. I am and addict and my partner is too. I have been able to stay clean for long periods of time but also don’t agree with all the 12 step program stuff. I have been working on recovery for 10 years now and stayed clean for 6 of those years and only have used a day hear or there through out the rest. I don’t keep track anymore though. Now for why I’m writing…my partner is a long term opiate addict with mental illness too. A couple of years ago she was put in the hospital due to a very bad overdose and mental break. She was put on suboxone to help with the detox but then was put on it long term. It has helped at first until she over came her fear of using other things with the suboxone. It seem to have just continued the using mentality now. It just doesn’t seem much different from actually using vicodine. She has the same look in her eyes and some of the same thinking as when she is using. No this can’t be blamed on the drug…that is addict thinking but the idea that a doctor gave her this and that it’s ok to take a drug give an addict justification. I’m on too so I understand it. This drug was first meant to help with detox not for long term treatment. The effects of it are not much different from the actual opiate. People sell it and if you talk to an addict that is being honest they will tell you it does get them high…not the same as an actual opiate but similar. It also isn’t much different from having to live life around when and how you will get the next one. The addict line up at the doctors office (at least in our area) and wait to get their next fix. They play around with the dose and then run out before they can get more…I just don’t see the difference. I know that not all addicts do this and I’m glad for anyone who is able to get help from this but I haven’t seen it work in one case. I used to work at and then run a recovery house so I have seen this in more than one or even a couple of cases. I think it’s almost criminal what doctors are doing with this drug. It’s make money for them…they have a sure thing…the addicts will come back every week and they get to charge an office visit every week to hand out more suboxone and tell the addict that they are helping them. Yep I’m angry and frustrated! I wish there was a magic pill but there isn’t. I don’t believe 12 step programs are the only way but I do believe that not having an opiate or opiate like drug is the only answer to getting clear minded enough to even have a chance at being and staying clean. I have notice that the people on this drug think they are not acting high…just like when they take a pill or drink and they think they perfectly fine. So if the people who are writing that it’s a good thing that suboxone is available are also taking this drug I don’t trust your judgement either. Your mind is under the influence of the drug too. You may be able to function better than at the peak of your addiction but you are still altered. It may be the lesser of two evils but it’s still an evil. There are no easy ways out of addiction just simple ones…put it down and don’t pick it up again. If that means meetings or therapy or yoga or what ever it takes but one drug in place of another just keeps the cycle going.

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