Opioids Cravings after 6 years

[undertow13]

Agree with that completely. Recovery is going to be a different process for everyone, there's definitely no one size fits all when it comes to that. We can only decide what we feel is best for ourselves. For me, Suboxone has been a safety net. I've stopped associating with most of my friends who use, but that's like all my friends. Plus, a good friend who I work with uses and it's difficult to be around it. Before getting on sub, I'd gone through rehab, tried Kratom and all kinds of stuff but no matter what, I relapsed. So I got on Suboxone and I finally managed to stay off other things. Being that most everyone I know uses, I felt it best to remain on it until I move elsewhere. I know people use everywhere, but I'd like to have my shit together and have some friends who aren't using before I jump off.

I'm tapering now, but I don't plan to get off it. Just getting to a lower dose for now. But it's not working out so well. I got down to 8, back to 12, now alternating between 12 and 16 (every other day). I'll get there lol.

 

[Quere]

You're getting cravings because you're on suboxone, duh. You're still addicted to opioids. There is nothing you can do to get rid of craving while you're still taking opioids. I had the same issue with heroin and kratom. It didn't resolve until I finally got off kratom. What are you doing on sub for six years anyway? Get clean man, you will feel so much better. The cravings are a sign that suboxone has served its purpose in your life and it's time for you to move on now.

Reading this post really makes me want to throw all veneer of civility to the wind and rain expletives down on you and launch personal attacks on your character. But I won't do that, because I make a point of trying not to be a douche bag whenever possible.

Your post makes clear that you know very little about evidence based treatment for opioid addiction.

Someone who is properly maintained on an appropriate dose of whatever opioid they are most therapeutically responsive to will not constantly experience cravings. If they are experiencing cravings that is a sign that either they are experiencing normal short term life stressors/triggers associated with using or (if craving doesnt reduce or cease over time) that their dose or medication needs adjusting.

The reduction of craving and likelihood of relapse are 2 main benefits of maintenance treatment. Telling someone to come off because they are craving is at best ignorant and at worst dangerously irresponsible. People who come off opioid maintenance are at a massively increased risk of relapse and of overdose.

I know that what you said was your experience and I'm not saying it wasn't true in your case, but that advice, in the majority of cases is going to destabilize the persons recovery which could potentially result in death.

Coming off maintenance should never be taken lightly and it is perfectly acceptable to stay on it for the rest of your life. Furthermore staying in maintenance treatment results in statistically better outcomes, so telling people their not "clean" or implying it would be better if they weren't on maintenance treatment is an ABSOLUTE crock of shit when viewed from a critical, evidence based perspective.

Quere

 

[burn out]

Someone who is properly maintained on an appropriate dose of whatever opioid they are most therapeutically responsive to will not constantly experience cravings.

I never claimed they would. I never experienced constant cravings when I was on maintenance, whether it was suboxone or kratom. However, after being on these drugs long term it does in my experience produce intermittent cravings because the body eventually gets to the point where it becomes very sensitive to the level of opiates in the system. This is results in what is called interpose withdrawal. Essentially some time after you dose, the levels of the drug in your system will fall ever so slightly and this can trigger cravings. Adjusting the dose may not always fix this problem, because it's virtually impossible to maintain a fully constant level of opiates in the system, the amount rises and falls.

Coming off maintenance should never be taken lightly and it is perfectly acceptable to stay on it for the rest of your life. Furthermore staying in maintenance treatment results in statistically better outcomes, so telling people their not "clean" or implying it would be better if they weren't on maintenance treatment is an ABSOLUTE crock of shit when viewed from a critical, evidence based perspective.

I have to disagree with you here. It's not a crock of shit to tell someone on opioids they are not clean, it's fact. That's not to say they don't deserve credit for ceasing to inject heroin or whatever, but it needs to be recognized they are still dependent on opioids. This becomes very apparent any time said person is deprived of their drugs whether through getting arrested, not being able to afford their script, losing/having their script stolen or whatever. As someone who has been on maintenance and then finally gotten clean the differences are night and day. Maintenance is simply a more controlled form of addiction.

As for being "perfectly acceptable" to stay on maintenance the rest of your life, acceptable to whom? The pharmaceutical companies/addiction specialists? Of course they find it acceptable (and will fund research that says as much) because they benefit from it. Whether or not it is acceptable to be a drug addict your whole life is something I will leave up to individuals to decide but to me it is not acceptable and I believe there are many people who don't realize how much better they would feel if they got off drugs. I am all for opioid maintenance therapy I just see no reason why opioid dependence should be a life sentence. Sure in certain cases it might be necessary but it is possible to get clear of these drugs and it is a far better option.

 

[Lucy20]

Only been a few months for me but I'm under alot of stress so i have been getting cravings.
If your on subs they may not be enough, have you thought to switch to methadone?
I had ZERO cravings once on methadone

 

[NicoOregon]

"As for being "perfectly acceptable" to stay on maintenance the rest of your life, acceptable to whom? The pharmaceutical companies/addiction specialists? Of course they find it acceptable (and will fund research that says as much) because they benefit from it. Whether or not it is acceptable to be a drug addict your whole life is something I will leave up to individuals to decide but to me it is not acceptable and I believe there are many people who don't realize how much better they would feel if they got off drugs. I am all for opioid maintenance therapy I just see no reason why opioid dependence should be a life sentence. Sure in certain cases it might be necessary but it is possible to get clear of these drugs and it is a far better option.
[/QUOTE]"
Wise to leave it to the individuals to decide. This is the most intelligent part of your post. Somewhere on here is a thread that covers this topic extensively. What is acceptable to you is different than what is acceptable to me. Personally I'm thrilled with my life. I am accepting of my circumstances and have no plans to change. Now if you would have spoken to me 2 years ago it would have been a different story.

 

[undertow13]

Inter-dose withdrawal doesn't happen with Suboxone though. That just means withdrawal in-between doses/when the drug wears off. Even if it did, taking it more often would solve the problem. Bupe has such a long half-life, avg is 37 hours after a single use, and of course that extends if you take it every day. Some people dose every other day and have no issues, and there's certainly times where I've had to go without it and I felt no different the next day. It takes a good 5+ days to really feel withdrawal from it. Any issues with cravings are definitely psychological or an issue with dose.

As to the whole addiction thing, I think in this case it's important to distinguish physical dependence from addiction. The goal of DRT like Suboxone is to break the behavioral / psychological patterns of addiction. You're continuing physical dependence of course, so I can see why you might see it as a "more controlled addiction". Really, it's not different from just being a functioning addict. But at the same time, stabilizing on something like sub does help with a few crucial things. No more feeling like you have to take something multiple times a day, no cravings or withdrawal in between doses, you don't wake up feeling like shit or feeling like you need to take something. You just dose on a schedule and completely forget about it, you never really feel like you need it. Hell, I've worked 12 hour shifts forgetting to take my sub before I went in with no issues. Plus, if one is sticking to their program and not abusing it, I think that's a big step too. Of course, it also helps people get their lives back on track. Most people are going to be in pretty bad shape before they get on it. But, like I said before, sub is just a tool. It's not going to do much good in overcoming addiction if one isn't also doing counseling and making proper lifestyle changes and whatever else is necessary for their recovery. In general, I do think people should taper when they're ready. I certainly wouldn't want to be on it for life, but if someone else feels they need to be, it's not my place to tell them they're wrong. Honestly, if that's what someone thinks they need to stay off other things, then it's the right choice for them.

To be clear, I'm not saying sub can't be psychologically addictive too because it can be, especially if you're only relying on the drug. I'm also not saying I've overcome psychological dependence because obviously, I haven't lol. As to the post about methadone, didn't really work for me as well. Also had an issue with it in the past (used to use it recreationally, so that's a big issue for me lol). I think I've been able to pinpoint why I've had the sudden increase in cravings, though. I've been told to take more, but I'm just working on some things in therapy. It should've been obvious really -- I don't want to up my dose over a temporary situation.

 

[Zonxx]

So, I was addicted to opiates for a long time and it was a hell of a struggle but I've managed to stay clean from all opioids except Suboxone for the past 6 years (prescribed by a doc). I used many things, but my DOC was Opana (oxymorphone). I'm doing my groups, meetings, therapy, working out, I've cut off people who use any drugs (though that unfortunately doesn't leave many people to hang out with, but better than being around it). But these cravings I've been getting are a bit troubling.

I know cravings are normal to a degree but I keep having cravings for Opana specifically (not for other opioids I used)-- and they are so random like, I'll be browsing the web or playing guitar or be at a concert or just whatever and suddenly get an intense craving that lasts a good 30-60 minutes. My typical methods to fight/ignore cravings are not effective for these. Luckily it's not easy to find because I feel like if I knew where to find them now while I was in that state, I would get some. I don't ever want to go back though but that's how intense they are. Not sure how to stop these cravings -- usually there's some trigger I can identify and find some way to work on it, but like I said, these are just so random. I feel like these cravings should've lessened in intensity after 6 years on sub and it's a bit discouraging when I get them. I've been around dope and other things since being on sub, even dilaudid which was easily my "second" DOC-- but the cravings I had were just fleeting thoughts that were easy to fight and I was able to cut those people off without a second thought. So I don't know what's up with these, or why they are so intense, or how I can stop cravings I can't identify a trigger for. I mean is it normal to have cravings this bad this long into sobriety? I'm taking 16mg / sub a day -- I'm planning on talking to my doctor about upping my dose or something, or whatever he thinks, but other than that I'm at a loss. Anyone go through anything similar? Any advice is much appreciated.

this is why i always say, the drugs stay with us forever, its just a matter of using or not that is what changes.

An addiction nurse told me that you'd keep getting cravings every three months ago and that this could go on indefinitely.

don't people on maintenance therapy still also get cravings? (methadone or bupe)

 

[undertow13]

Yeah, I don't think it's possible to get rid of them altogether. In general, cravings shouldn't be much of an issue on maintenance. Both drugs definitely help stop them and manage them. Over the past few years, my cravings have been very rare and very mild. Just fleeting thoughts that disappear as quickly as they come. As time goes on, of course triggers and stress and such can cause them which is why I think counseling and all that is so important. This past year is really the first time I've had an issue with persistent cravings while on it so I found it a bit concerning. Of course, I've had bad moments in the past, just nothing quite like that. I'm just glad I figured it out. It's interesting how sometimes we don't even realize what's triggering us, or how we have triggers we didn't even know were triggers.

 

[MomaDance]

Hey, Some people chose to be on Subs for life. Its all up to the individual and their doctor. Some people were born opiate addicted and Subs are like being a diabetic.
Everyone has their own path to recovery and I respect that.

Ageee 100% - the diabetic analogy is good.

 

[NicoOregon]

"I am all for opioid maintenance therapy I just see no reason why opioid dependence should be a life sentence. "


Ummmm....nope, good here.

 

[burn out]

Ageee 100% - the diabetic analogy is good.

I don't think it's that good of an analogy. A diabetic body will die if deprived of insulin, whereas an opiate dependent body will return to homeostases if deprived of opiates. Totally different situation.