It is insidious, and the psychological effects hammer you for a long time before the real physical symptoms kick in. When you get right down to it, your personal comfort zone is the name of the game. Once the withdrawals begin, we find ourselves willing to do almost anything for relief.
I have a personal story to share: I've been on Suboxone over two years and suddenly discovered towards the end of last week that I was running low. Thinking that my appt was this past Monday (the usual four weeks had passed), I simply short-dosed myself to stretch my meds, taking the last tab Sunday.
Monday, I discovered the appt was with my internist, and that the Suboxone appt was a week away. I had never been in this predicament, so I phoned the doc's office, explained the situation without making up a story (this being left on voicemail). Truth be told, I *should* have had enough pills to last a couple mopre days, and I do not know if I was shorted, ripped off, etc. I was honest about it and left for my other appointments thinking things would work out.
Later, I checked at the drug store and they had heard nothing. They are good people and faxed a request and phoned the doctor's office.. In the meantime, I got VERY jittery, thinking myself into withdrawal. I called twice more, and the person I spoke to, when she asked what medication I was out of, become caustic when I said suboxone. I suppose callers with all kinds of "lost meds" stories are routine. Finally, someone called telling me I *should* have meds, sighed and told me to come at 3PM the next day and they would "work me in".
To make a long story short, I spent a day or two in hell and came dangerously close to losing over 15yrs without booze, I was that desperate. Instead of a simple call to order a refill, I was forced to drive 60+mi in withdrawal, submit to an observed drug screen (observed by a member of the opposite sex, no less), sit through a pressure-speech about going to an inpatient rehab in another state, yada, yada.
You can never win!