Harm Reduction My doc wants to prescribe suboxone for alcohol and Kratom, should I do it?

[darvocet21]

So, I've never used serious hard drugs like heroin or meth or any of that, but I'm admmitadly an alcoholic (not as bad as some, I drink about a bottle of wine 4-5 nights a week in the past few months), Kratom addict who was able to stave off Kratom addiction for years, but been dosing about 24-36 grams, 2-3 doses total a day for the past 2-2 1/2 months, and taking Dexadrine 20mgs once a day for about 3 months.

I've always been able to break my Kratom dependencies temporarily before by just sleeping for 3-5 days pretty much, and the same thing with Dexadrine which took about 11 days to get over when I did it over the summer. I've never had alcohol withdrawal, but i now realize that the fact that I take Klonopin is what has made both my Kratom WD and potentially any mild alcohol WD symptoms much easier.

But even though I totally love Kratom and drinking, and to slightly less extent dexadrine, I know it's time for me to get sober for as long as possible cause it's all causing too many problems in my life. I will never decide, or cannot imaging ever deciding to quit any of these drugs permanently, but I'm dead set on starting with a full month without ANYTHING, then hopefully 3 months, then hopefully 6, and we'll see where it goes.

So I started seeing a social worker who is a former addict and pretty cool guy who's a drug counseler and he suggest a psychopharmacologist.

I want her to prescribe me ultra low dose naltrexone because I heard that it gives an endorphine mood boost for my moderate depression, helps with cravings, and because I've HEARD that it can supposedly be taken with kratom safely, potentiating the high BUT simultaneoulsy making you not really want to take Kratom or alcohol, which sounds like the best of both worlds, and lowering tolerance and supposedly eliminating side effects, whereas normal naltrexone blocks opioids completely, and I also want either that or high dose naltrexone for alcohol.

This doctor at first listened to my proposal for ultra low dose naltrexone and considered it, but now says its' ''too experimental and if i am thinking of taking it with kratom then she can't feel safe giving it to me'', which frankly i think is bullshit, since she admitted that she can't see how it could be dangerous, and only doubts ULDN may work as well for cravings as high dose nal.

Truth is, i know I'd want to EVENTUALLY try mixing ULDN w/ kratom, but initially I would just want sobriety and lower cravings.

However, she is willing to give me either suboxone or regular naltrexone.

Id take regular naltrexone to just prevent me from drinking or taking kratom for a while so i can be sure to be sober, but I am frankly pretty baffled that she'll prescribe suboxone but not ultra low dose naltrexone since i have read on here a number of times that people use suboxone to get high.

Thing is...I DON'T WANT ANOTHER ADDICTIVE DRUG THAT CAN GET ME HIGH.

I don't want to replace Kratom and drinking with suboxone if it's just another high, and frankly, my guess is that suboxone is a stronger opiate than kratom and I told her I thought that was the case and she said ''how could suboxone be stronger than kratom when it's only a partial agonist and partial blocker?''

I don't know, but I read suboxone has high abuse potential, I know some of you guys get high off it, and i read it can be lethal to combine with alcohol, and while that would certainly scare me away from drinking, and I want to not drink for a while anyway, i don't know how comfortable I feel taking something lethal with booze either.

Does suboxone actually even block a person from getting drunk like it blocks opioids?

If so I'd feel safer taking it in that way because I'd know there'd be no point in trying to drink on it anyway.

And she says that suboxone will help with my kratom WD, which is appealing, but while I know this round of kratom WD will be worse than any in the past because I had never gone more than like 10 days in a row without kratom and now i've gone like 2 1/2 months in a row...I still bet i could just sleep for a week on christmas break and feel like shit but still get off kratom and be ok without it.

So, basically, my question is, considering I DON'T want something else that can get me high, and I want reduced cravings for kratom, alcohol and other drugs, and that I don't know if it blocks alcohol and is lethal to combine it, would you really recommend it for someone like me who does want a period of sobriety but doesn't have an issue with a more serious drug like Heroin or Oxy??

I mean, I bet a lot of you guys would JUMP at the chance for suboxone cause I read that some of you like it and bupe, which I guess is part of what is in subs, because I've read your threads about liking it, but anything more than a mild antidepressant effect is not what I want.

She does say that suboxone could give a mild mood boost as it is used off label as an antidepressant, and that interests me cause i have depression, but that's also why i was interested in ULDN cause that isn't abusable but also has that function.

When i told her i was concerned i might use it to get high and don't want to she said she wouldn't give me enough, but how could i not have enough to get high if she gives me a script and i just take more than i should?

This is one of those very weird cases where an addict wants a MILDER drug, microdosed ultra low dose naltrexone but NOT high dose, and yet is being offered something stronger instead because ''microdosing naltrexone is aytpical and she could get in trouble cause i might mix it with kratom'' LOL

You'd think i'd want a new drug to get high off of, but i dont, and i only wanted ULDN cause i heard that it helps with cravings and mood boosts but ALSO can supposedly safely be taken with kratom IF i want to, even though i also want to ''NOT WANT to use kratom and just be able to theroetically....but no...i feel this could be getting involved with a drug that is worse than kratom.

So, what do you guys think. Seeing as i want something to help me stay sober for at least a few months, reduce cravings and provide a mood boost, all of which i know suboxone does, but who AT THE SAME TIME DOES NOT WANT TO GET HIGH ON SOMETHING ELSE, should i take it?

Or in my case would you take the high dose naltrexone instead cause it won't have me possibly trying to get high off it?

And if suboxone helps with drug cravings but can possibly also be used to get high, then would it possibly redu

So, I've never used serious hard drugs like heroin or meth or any of that, but I'm admmitadly an alcoholic (not as bad as some, I drink about a bottle of wine 4-5 nights a week in the past few months), Kratom addict who was able to stave off Kratom addiction for years, but been dosing about 24-36 grams, 2-3 doses total a day for the past 2-2 1/2 months, and taking Dexadrine 20mgs once a day for about 3 months.

I've always been able to break my Kratom dependencies temporarily before by just sleeping for 3-5 days pretty much, and the same thing with Dexadrine which took about 11 days to get over when I did it over the summer. I've never had alcohol withdrawal, but i now realize that the fact that I take Klonopin is what has made both my Kratom WD and potentially any mild alcohol WD symptoms much easier.

But even though I totally love Kratom and drinking, and to slightly less extent dexadrine, I know it's time for me to get sober for as long as possible cause it's all causing too many problems in my life. I will never decide, or cannot imaging ever deciding to quit any of these drugs permanently, but I'm dead set on starting with a full month without ANYTHING, then hopefully 3 months, then hopefully 6, and we'll see where it goes.

So I started seeing a social worker who is a former addict and pretty cool guy who's a drug counseler and he suggest a psychopharmacologist.

I want her to prescribe me ultra low dose naltrexone because I heard that it gives an endorphine mood boost for my moderate depression, helps with cravings, and because I've HEARD that it can supposedly be taken with kratom safely, potentiating the high BUT simultaneoulsy making you not really want to take Kratom or alcohol, which sounds like the best of both worlds, and lowering tolerance and supposedly eliminating side effects, whereas normal naltrexone blocks opioids completely, and I also want either that or high dose naltrexone for alcohol.

This doctor at first listened to my proposal for ultra low dose naltrexone and considered it, but now says its' ''too experimental and if i am thinking of taking it with kratom then she can't feel safe giving it to me'', which frankly i think is bullshit, since she admitted that she can't see how it could be dangerous, and only doubts ULDN may work as well for cravings as high dose nal.

Truth is, i know I'd want to EVENTUALLY try mixing ULDN w/ kratom, but initially I would just want sobriety and lower cravings.

However, she is willing to give me either suboxone or regular naltrexone.

Id take regular naltrexone to just prevent me from drinking or taking kratom for a while so i can be sure to be sober, but I am frankly pretty baffled that she'll prescribe suboxone but not ultra low dose naltrexone since i have read on here a number of times that people use suboxone to get high.

Thing is...I DON'T WANT ANOTHER ADDICTIVE DRUG THAT CAN GET ME HIGH.

I don't want to replace Kratom and drinking with suboxone if it's just another high, and frankly, my guess is that suboxone is a stronger opiate than kratom and I told her I thought that was the case and she said ''how could suboxone be stronger than kratom when it's only a partial agonist and partial blocker?''

I don't know, but I read suboxone has high abuse potential, I know some of you guys get high off it, and i read it can be lethal to combine with alcohol, and while that would certainly scare me away from drinking, and I want to not drink for a while anyway, i don't know how comfortable I feel taking something lethal with booze either.

Does suboxone actually even block a person from getting drunk like it blocks opioids?

If so I'd feel safer taking it in that way because I'd know there'd be no point in trying to drink on it anyway.

And she says that suboxone will help with my kratom WD, which is appealing, but while I know this round of kratom WD will be worse than any in the past because I had never gone more than like 10 days in a row without kratom and now i've gone like 2 1/2 months in a row...I still bet i could just sleep for a week on christmas break and feel like shit but still get off kratom and be ok without it.

So, basically, my question is, considering I DON'T want something else that can get me high, and I want reduced cravings for kratom, alcohol and other drugs, and that I don't know if it blocks alcohol and is lethal to combine it, would you really recommend it for someone like me who does want a period of sobriety but doesn't have an issue with a more serious drug like Heroin or Oxy??

I mean, I bet a lot of you guys would JUMP at the chance for suboxone cause I read that some of you like it and bupe, which I guess is part of what is in subs, because I've read your threads about liking it, but anything more than a mild antidepressant effect is not what I want.

She does say that suboxone could give a mild mood boost as it is used off label as an antidepressant, and that interests me cause i have depression, but that's also why i was interested in ULDN cause that isn't abusable but also has that function.

When i told her i was concerned i might use it to get high and don't want to she said she wouldn't give me enough, but how could i not have enough to get high if she gives me a script and i just take more than i should?

This is one of those very weird cases where an addict wants a MILDER drug, microdosed ultra low dose naltrexone but NOT high dose, and yet is being offered something stronger instead because ''microdosing naltrexone is aytpical and she could get in trouble cause i might mix it with kratom'' LOL

You'd think i'd want a new drug to get high off of, but i dont, and i only wanted ULDN cause i heard that it helps with cravings and mood boosts but ALSO can supposedly safely be taken with kratom IF i want to, even though i also want to ''NOT WANT to use kratom and just be able to theroetically....but no...i feel this could be getting involved with a drug that is worse than kratom.

So, what do you guys think. Seeing as i want something to help me stay sober for at least a few months, reduce cravings and provide a mood boost, all of which i know suboxone does, but who AT THE SAME TIME DOES NOT WANT TO GET HIGH ON SOMETHING ELSE, should i take it?

Or in my case would you take the high dose naltrexone instead cause it won't have me possibly trying to get high off it?

And if suboxone helps with drug cravings but can possibly also be used to get high, then would it possibly reduce my desire to abuse it?

ce my desire to abuse it?

So, I've never used serious hard drugs like heroin or meth or any of that, but I'm admmitadly an alcoholic (not as bad as some, I drink about a bottle of wine 4-5 nights a week in the past few months), Kratom addict who was able to stave off Kratom addiction for years, but been dosing about 24-36 grams, 2-3 doses total a day for the past 2-2 1/2 months, and taking Dexadrine 20mgs once a day for about 3 months.

I've always been able to break my Kratom dependencies temporarily before by just sleeping for 3-5 days pretty much, and the same thing with Dexadrine which took about 11 days to get over when I did it over the summer. I've never had alcohol withdrawal, but i now realize that the fact that I take Klonopin is what has made both my Kratom WD and potentially any mild alcohol WD symptoms much easier.

But even though I totally love Kratom and drinking, and to slightly less extent dexadrine, I know it's time for me to get sober for as long as possible cause it's all causing too many problems in my life. I will never decide, or cannot imaging ever deciding to quit any of these drugs permanently, but I'm dead set on starting with a full month without ANYTHING, then hopefully 3 months, then hopefully 6, and we'll see where it goes.

So I started seeing a social worker who is a former addict and pretty cool guy who's a drug counseler and he suggest a psychopharmacologist.

I want her to prescribe me ultra low dose naltrexone because I heard that it gives an endorphine mood boost for my moderate depression, helps with cravings, and because I've HEARD that it can supposedly be taken with kratom safely, potentiating the high BUT simultaneoulsy making you not really want to take Kratom or alcohol, which sounds like the best of both worlds, and lowering tolerance and supposedly eliminating side effects, whereas normal naltrexone blocks opioids completely, and I also want either that or high dose naltrexone for alcohol.

This doctor at first listened to my proposal for ultra low dose naltrexone and considered it, but now says its' ''too experimental and if i am thinking of taking it with kratom then she can't feel safe giving it to me'', which frankly i think is bullshit, since she admitted that she can't see how it could be dangerous, and only doubts ULDN may work as well for cravings as high dose nal.

Truth is, i know I'd want to EVENTUALLY try mixing ULDN w/ kratom, but initially I would just want sobriety and lower cravings.

However, she is willing to give me either suboxone or regular naltrexone.

Id take regular naltrexone to just prevent me from drinking or taking kratom for a while so i can be sure to be sober, but I am frankly pretty baffled that she'll prescribe suboxone but not ultra low dose naltrexone since i have read on here a number of times that people use suboxone to get high.

Thing is...I DON'T WANT ANOTHER ADDICTIVE DRUG THAT CAN GET ME HIGH.

I don't want to replace Kratom and drinking with suboxone if it's just another high, and frankly, my guess is that suboxone is a stronger opiate than kratom and I told her I thought that was the case and she said ''how could suboxone be stronger than kratom when it's only a partial agonist and partial blocker?''

I don't know, but I read suboxone has high abuse potential, I know some of you guys get high off it, and i read it can be lethal to combine with alcohol, and while that would certainly scare me away from drinking, and I want to not drink for a while anyway, i don't know how comfortable I feel taking something lethal with booze either.

Does suboxone actually even block a person from getting drunk like it blocks opioids?

If so I'd feel safer taking it in that way because I'd know there'd be no point in trying to drink on it anyway.

And she says that suboxone will help with my kratom WD, which is appealing, but while I know this round of kratom WD will be worse than any in the past because I had never gone more than like 10 days in a row without kratom and now i've gone like 2 1/2 months in a row...I still bet i could just sleep for a week on christmas break and feel like shit but still get off kratom and be ok without it.

So, basically, my question is, considering I DON'T want something else that can get me high, and I want reduced cravings for kratom, alcohol and other drugs, and that I don't know if it blocks alcohol and is lethal to combine it, would you really recommend it for someone like me who does want a period of sobriety but doesn't have an issue with a more serious drug like Heroin or Oxy??

I mean, I bet a lot of you guys would JUMP at the chance for suboxone cause I read that some of you like it and bupe, which I guess is part of what is in subs, because I've read your threads about liking it, but anything more than a mild antidepressant effect is not what I want.

She does say that suboxone could give a mild mood boost as it is used off label as an antidepressant, and that interests me cause i have depression, but that's also why i was interested in ULDN cause that isn't abusable but also has that function.

When i told her i was concerned i might use it to get high and don't want to she said she wouldn't give me enough, but how could i not have enough to get high if she gives me a script and i just take more than i should?

This is one of those very weird cases where an addict wants a MILDER drug, microdosed ultra low dose naltrexone but NOT high dose, and yet is being offered something stronger instead because ''microdosing naltrexone is aytpical and she could get in trouble cause i might mix it with kratom'' LOL

You'd think i'd want a new drug to get high off of, but i dont, and i only wanted ULDN cause i heard that it helps with cravings and mood boosts but ALSO can supposedly safely be taken with kratom IF i want to, even though i also want to ''NOT WANT to use kratom and just be able to theroetically....but no...i feel this could be getting involved with a drug that is worse than kratom.

So, what do you guys think. Seeing as i want something to help me stay sober for at least a few months, reduce cravings and provide a mood boost, all of which i know suboxone does, but who AT THE SAME TIME DOES NOT WANT TO GET HIGH ON SOMETHING ELSE, should i take it?

Or in my case would you take the high dose naltrexone instead cause it won't have me possibly trying to get high off it?

And if suboxone helps with drug cravings but can possibly also be used to get high, then would it possibly reduce my desire to abuse it?

Don't do it. Instead you should be teaching people on Suboxone about kratom

 

[LucidSDreamr]

Subs are fare more addictive physically. The withdrawal from subs is more severe than most opioids...however kratom is unregulated and fda studies have shown contamination with toxins and heavy metals

 

[Snafu in the Void]

Kratom withdrawal can be quite bad but in general the addiction, withdrawal and drug in general is way easier to manage than buprenorphine.

If it was me I'd just be on alcohol + subs then, and maybe even kratom, too.

Just my 2 cents.

 

[LucidSDreamr]

Op as to your doctor's comments about sub being weaker and less recreational than kratom simply because it's a partial agonist.

She's obviously never tried either. Sub will have a naive user nodding out like the best dope. Kratom doesn't hold a candle to subs in how heavy of an effect a naive or mildly dependent person can have

Pharmacology can be a bit more complex than subs are partial therefore weaker. BTW the major metabolite of subs is norbupe is a full agonist and will have you drooling and nodding when it's metabolized into itself from bupe.

 

[darvocet21]

I'm going to try to keep this as brief as possible but there are things anyone considering Suboxone should know in advance. I'm sharing this with an important caveat: the benefits of ANY treatment that succeeds in stopping or even reducing life threatening behaviors cannot be overstated. The issues & concerns raised, because they come out of my own experiences and research, are only one person's opinion and offered as information which could be helpful in opening a dialogue with others. In no way should they be substituted for professional medical advice or construed as dismissing the importance of an open & trusting doctor-patient relationship.

* * *
The reason these questions are unlikely to be raised by healthcare providers is twofold: Your doctor views your desire to get off street drugs as a laudable goal and does not want to dissuade you. But they've also been sweated so long by the Feds over opioids that few if any will even consider prescribing Subutex, and that has removed any incentive to discuss certain potential drawbacks with Suboxone. The point is they have adjudged the risks to be acceptable and outweighed by the benefits.

For those who have had a positive experience with Suboxone the next couple paragraphs probably will be something of a downer, but if you want you can skip to the 2nd half where I'm going to share what I think is one of the best uses for buprenorphine: short-term detoxification and/or down-regulating the severity of your habit. For which it DOES NOT matter whether you use Suboxone or Subutex. First the downside:

Buprenorphine is a potent analgesic with high affinity for receptors and a very long half-life (24-60+ hours) but with a much better safety profile. Practically a miracle drug. But combining it with naloxone (Suboxone) turns what was a net positive into a net negative for the very people it's supposed to help. There are at least two reasons for that claim which will probably be controversial. There's increasing evidence that Suboxone taken long term causes a more stubborn form of dependency than buprenorphine alone. Daily exposure to a pure antagonist like naloxone induces a see-saw effect that makes quitting more difficult, particularly for patients in the later stages of tapering. Keep in mind that high doses of bupe (16mg+) occupy 98%+ of receptors, while low doses (≤2mg) occupy 48% or less. Since naloxone is detectable in urine even at lower doses, those exposed receptor sites would be vulnerable. Anyone who's been habituated to opioids will be familiar with those fleeting feelings sickness that can suddenly appear, sometimes within hours after taking your last dose. Transitory withdrawal symptoms result from this incomplete coverage of receptor sites

The other reason adding naloxone is stupid and criminally negligent:
Patients who overcome the hurdle and successfully get off Suboxone after maintenance have higher rates of overdose deaths than patients who tapered off Subutex.

This article goes into more detail: https://www.frontiersin.org/articles/10.3389/fpsyt.2020.549272/full



# # #
SHORT-TERM REDUCTION OF DEPENDENCE & DETOX: one of the best uses of Suboxone / Subutex for addicts in despair. (Note: sublingual strips are better since they can be easily cut into smaller sizes to give you more control of how much you take)

Because buprenorphine hangs around your body for so long and loves your receptors so much it suppresses withdrawal symptoms long after its 6 hour analgesic effect you can use it to lower your dependence or even quit opioids outright with much less physical suffering.

***IMPORTANT WARNING: LOWERING YOUR DEPENDENCE PUTS YOU AT INCREASED RISK OF OVERDOSE SHOULD YOU DECIDE TO RESUME USING. YOU CANNOT TAKE YOUR USUAL AMOUNT, START OFF SMALL***

How it works
The key is taking a sufficient dose for a brief period of time and ONLY when you need it, tapering ONLY if you want to, then stopping.

For most addicts 8mg is plenty, 4mg may do the trick. If you have a heavy habit you can err on the side of 16mg (with the caveat that you're taking twice as much naloxone, 4mg instead of 2mg). Strips are better since by cutting them in half & then half again etc you can custom tailor the dose that's right for you. You can also titrate your dose, which means take half and then wait 90 mins before taking the other half; you may find you need less or don't need it at all. A sufficient dose should NOT be intoxicating but will hold you for a MINIMUM 24 hrs (though 36-48 hrs intervals are doable, especially after you've taken a few doses)... For most addicts 24 hours without thinking about dope is welcome, 48 hours is a f****** vacation.

Taper if you can without undue suffering but not to zero, and then stop. Since you're not hooked on Suboxone or Subutex there's no need to do a complete taper. Since you're taking advantage of the drug's long half-life to lower your level of addiction or quit entirely, and doing it in a short amount of time, your last dose will help in whatever you decide. Notice I haven't given any timetable. Personally I think 7 to 10 days is ideal but that's just my opinion. Because at the end of 10 days you've cleared out all the metabolites of heroin or fentanyl or whatever it was while resetting your opioid receptors to a healthier level.

As I write another strategy occurs to me that may suit certain individuals perfectly: using this technique to transition to a safer opioid. Switching from junk/fentanyl to kratom overnight is unrealistic, and this puts it within reach.
* * *
Basics everybody should know:
•I lied. Actually I forgot. You MUST STOP TAKING your drug of choice long enough to be in withdrawal before taking your first dose of Suboxone or Subutex or else you will precipitate even worse withdrawal syndrome. Typically stop for at least a full day and night if you use heroin or fentanyl, more if you can....at least long enough to be dope sick but not absolutely miserable.

•If you take subs everyday for ~3 weeks or more you may face the dilemma of addiction to the very thing that was supposed to free you and or give you a respite. I'm not pushing for total detoxification of anybody until they're ready emotionally and psychologically. I'm a big believer in maturing out of addictions (less so in starting new ones).

•a note about methadone: clinics used to offer 7-Day Detox along with longer periods of detoxification and maintenance. But it didn't work very well because methadone doesn't have as strong a bonding affinity w your receptor sites as does bupe. If you've ever known somebody on maintenance for years who slams everyday you know what I mean. If you're on methadone now this process is not recommended for you, because methadone has a half life even longer than bupe.

Good luck! Best of all you can be doing this within a few days or sooner if you're lucky your provider has a opening.
A video appointment with an online provider (Google it: there are many) costs $100 & up and roughly $50 for a 2-week supply of medication ( typically the most they'll start you with)
* * *
If you are at the stage in your process where you've become somewhat stoic and the simple absence of the warm fuzzy feeling isn't enough to make you obsess over obtaining your next dose, BECAUSE YOU AREN'T DOPE SICK, this is for you