I
was taking Sublocade for a period of time and found the experience to be truly miraculous!!! Do not get me wrong - the induction onto the shot was an absolute horror show for me (more on that in a bit!), but if there are people out there truly looking to kick opiates (and know in their hearts that they can't really be trusted to take a daily suboxone as it will likely lead to them messing around with dosage - selling pills - buying dope - etc.), the Sublocade shot may well be that "miracle drug" that gets you out of this mess once and for all!!!
A quickie "agonist vs. antagonist vs. partial agonist" lesson, for those who don't fully understand the chemistry of all of this stuff (I only recently learned it myself and will use the same visualizations that were explained to me, enabling me to finally wrap my head around it all - but if you already know all this stuff, feel free to skip ahead!!):
- opioids in general are like "keys" - and the opioid receptors in your head are like "locks"
- opioid agonists (oxycodone, heroin, fentanyl, etc.) are keys that seek out the locks, open them up, and allow the "joy joy" feelings to come flooding out!
- opioid antagonists (vivitrol, narcan, etc.) are keys that seek out the locks but do NOT open them - they just plant themselves in the keyhole, so that other keys (aka heroin) can't get in and unlock.
- opioid partial-agonists (suboxone, sublocade, etc.) - these are the "hybrid" guys - these keys seek out the locks, but only partially open them - they allow some "joy joy" to get out, but not a lot (just enough to keep an addict from getting sick or have cravings)
Obviously, I'm not a chemist and I don't pretend to be one! But I did always wonder what those terms meant and how it all worked - and this is the explanation that helped me finally make sense of it all!
Anyway - on to the actual point of this post!!!!
Background:
- heavy oxycodone user for 5 or 6 years - was easily at 6-10, 30mg 'blues' a day at one point
- eventually discovered (like all opiate pill heads eventually do) that heroin is WAY cheaper ($300/day for pills vs. $150/day for a brick of heroin, it's not even close - especially when I'm having to carry my wife on this stuff, too!!!)
- spent the next 3 years after dumping the pills, working up to a brick-a-day habit (I do want to point out I have NEVER injected - only snort - was always WAY too afraid of needles, thank God - but I had always convinced myself that snorting was "safer" against developing a physical dependence - how dumb!!!)
- had an "overdose" event with my wife a couple of years ago (we're double-trouble - whatever one of us gets into, the other isn't far behind!!)) - not to the point that I was hit with Narcan, but obviously looped enough that we were both taken to the hospital anyway
- our kids were in the house at the time (kids were 11 and 18yrs old, so we're not talking infants and toddlers - but irresponsible regardless, and we fully own that!!), which lead to DYFS entering our life (NEVER PLEASANT!!!!!)
- wife and I both entered a Vivitrol study being done at Columbia University (rapid detox in a four day inpatient setting, followed by three monthly Vivitrol shots)
- as I knew would happen - as soon as DYFS closed their case, I let my Vivitrol lapse and slowly found myself right back on heroin (and of course, my wife was soon behind me)
- after the 2020 lockdown (where I found myself doing more heroin than ever, if for no other reason than out of BOREDOM!), I knew we had to get off this for good (and this time it was MY choice - not something forced on me, as was the case with DYFS)
- found out that Columbia University was doing a new study - this time, it was for Sublocade
- the one really good thing about how this study was handled was, because of all the COVID restrictions still going on, the number of required "in office" visits were kept to a minimum - the vast majority of follow-up during the course of the study was done remotely. After my first shot I was sent home with urine cups and a BP machine, and was able to continue through the study with two remote meetings per week - WAY easier than having to drive into NYC!
- First shot was given to me on February 24th, 2021 - and I have been CLEAN EVER SINCE!!!!
About the study:
- for those who don't know (especially those outside the tri-state area), Columbia University has a specialized research department for dealing with substance abuse. The STARS (Substance Treatment and Research Service) program is truly an amazing group of people. Beyond just their experience and knowledge, they are EXTREMELY supportive of those trying to rid themselves of drugs - as a bonus, they will even PAY YOU as they help you get clean!! Don't get me wrong, you're NOT going to get rich off something like this ($50 for initial visit, $10 for each subsequent visit) - but it's definitely a helpful perk if you need to fund tolls/parking or public transportation.
- the target patients for this particular study, were those found to be using HPSOs (Highly Potent Synthetic Opioids) such as fentanyl (which we ALL know makes up most of the "heroin" we buy!) - and, of course, my urine screen confirmed
- the goal of the study that STARS had enrolled me in, was to shorten the "induction period" for getting the Sublocade shot. Normally, in order to get a Sublocade injection, the current prescribing directions require the patient to be stabilized for at least 7 days on 10-20mg of Suboxone. The study was looking to shorten that induction period to 3 days and give the Sublocade shot on day #4. Most active users will have an incredibly hard time managing a 7+ day induction period - this is the biggest hurdle to people getting on to the shot, and so it's the main reason for this study.
If you managed to read all of that and got this far, you are either really interested and/or curious about Sublocade (or STARS) and are looking to decide whether it's right for you, or you're a masochist and you enjoy reading a novel about another heroin users (painful) experience with kicking this junk!!!!
So now, the interesting part - how did this all go down, did it work, how am I today, and what's my outlook for the future! And for me, I'm looking to other Sublocade users out there (especially those that stopped injections) to hear about their experience and perhaps answer some of my own questions about "life after Sublocade"...
** Prerequisite for beginning the trial - you MUST be in full withdrawal (and because of the involvement of HPSOs, the onset can be significantly delayed, as it was for me. This was VERY likely the cause of my upcoming nightmare!!). **
February 23rd (Day 0) - I went to the office to begin the trial - it had been approximate 12hrs since I last used, so I scored incredibly low on the COWS and was immediately sent home - nothing I could do, I just had to use up all of my stuff the night before because I couldn't bear the thought off any of it to be flushed - what an idiot!!!
February 24th (Day 1) - Went back to the office (36hrs since last use), but still scored extremely low on the COWS (think I was still only a 2 or 3). This was the fork in the road for me - I think the doctor was concerned that I was never going to come back a third time to the office (he was probably right!), and so he made the decision to go ahead with the induction anyway!! But something changed - the study I had been discussing with these people from the very beginning was the "3 day induction", followed by the shot on Day 4. Instead, they decided to induct me and give me the shot THAT SAME DAY!!!!!!
So, let me warn any and all of you out there - I absolutely do NOT recommend this!!!!!! I don't care what the doctor has convinced you of or how desperate you are to get off this crap - DO NOT DO THIS!!! You will be miserable and you will absolutely regret it, and there is a really good chance your induction will fail altogether!! I was naive, I figured with my incredibly high tolerance (as though that was "helpful" somehow) that it wouldn't be a problem, and I was so wrong I'm still amazed I got through it all!!! This is how it all went down:
- Arrived at 1pm (late for my 10am appointment, as usual!) and they explained the "same day" process we were going to employ - I agreed and we started with a 2mg suboxone, no problem
- 2pm - I was given 6mg suboxone - still not so bad, feeling a bit anxious, is it the drugs or do I just need a cigarette? I dunno - but this is boring!!!
- 3pm - 8mg suboxone - ok, 10 minutes later the wheels start to come off - the Pink Floyd "my hands felt just like two balloons" line is running through my head - suddenly, I can barely walk!! During treatment, you are always free to come and go (to go outside and smoke or whatever) - and as badly as I needed a cigarette in that moment, I was 100% positive there was no way I could navigate the elevator, make it outside, and find my way back in!!! And I want to be very clear - this was NOT a "pleasant" high!!!!! It had an "out of body" feel to it, my anxiety was in overdrive, and it took every ounce of strength to not go running mad through the office and out into the street!!
- 4pm - the doctor comes in with my next (and final) 8mg suboxone - I am scared to death at this point of taking this!!! I am literally begging her to allow my wife to come in (patients in the clinic only - thank you again, f*cking COVID!!) and I'm deer in headlights, just looking for an opening so I can bolt!! But the nurse is patient (yet persistent) and she convinces me that the reason I'm feeling this way is because the suboxone is having to forcefully kick the fentanyl off my receptors and that once I take this last dose (which will put me at a total of 24mg suboxone over the course of 4hrs), I will start to feel better. I succumb and take the last 8mg... ...and I did NOT feel any better - I felt WORSE, if that was possible!!!! I finally had to resort to lying on this filthy carpet and simply try to visualize my breathing - it was the only way to keep a mental hold on myself. I honestly thought I was going to lose my mind any moment, so just listening to myself breath was all I could do to keep myself calm. I tried calling my wife a couple of time because I was ready to have her force her way into the clinic and drag me out of she had to - but in the back of my mind (even while going through this hell) I knew if I left I would never come back, and that the very next day I would be back in the slums looking to score another fix. So I just kept my head down, kept listening to my breathing, and tried to "ride" the anxiety out.
- 5pm - time has to have stopped - it's only been an hour?!?!?!? The doctor is back and she tells me they're ready to give me the shot - I don't know how to react. I'm totally unsteady on my feet, my head is swimming and I feel like I'm looking down on myself from about 10ft above, and I'm insanely anxious - and now they want to shoot even MORE of this sh*t into me????? Again - she sees the panic in my eyes and assures me (again) that if I get the shot, I will definitely start to feel better. And like a desperate moron, once again I believe her - I relent and allow them to walk me to the table so I can lie down and get the shot... ...first thing I want to point out about this shot (for those who don't know) - this f*cker hurts!!!! By itself, this shot absolutely hurts by any definition (it takes about 10 seconds to fully administer the dose, but it feels like an eternity - and it's not the needle that hurts, it's the wave of a hundred bees stinging you over and over again in the same exact spot, that hurts! Thankfully, it does subside in about 5 minutes or so - but that initial pain will definitely take your breath away!) - but because every nerve in my body is now acutely aware of every single molecule in the air, this shot was torture of the highest order!!!!! The first two monthly shots you'll normally receive are 300mg, with monthly maintenance doses of 100mg - and there is definitely a difference in pain between those two doses (the 100mg still hurts, but only for a few seconds and certainly nothing even close to the 300mg dose).
- 6pm - after monitoring me for an hour, they're ready to let me leave. At this point, I don't feel any worse - but I also don't feel any better, and I have no idea whether I'm going to be able to make it outside where my wife is waiting to take me home! I still don't know the reason for changing the induction the way they did and perhaps if I had gone another day or two without using and been in "full" withdrawal, it wouldn't have been like this but there is no way I can recommend this process to anyone - until they find a more "gentle" way to rapidly induct people, stick with the 3-7 day induction!! I still wonder what would have happened if I had decided to drive myself in that day or took the transit in because when I left that office there was NO WAY I could have driven a car, and I'm pretty positive I would have spent at least the night wandering around the Port Authority, lost and trying to figure out which bus to take home!
February 25th (Day 2) - From the moment I got home after getting the shot, I began to feel as though I was in the worst withdrawal I have ever experienced. Imagine having every typical withdrawal symptom (goose flesh, hot flashes, restlessness, etc.) - all registering a 10, all at the same time!!! All I could do was lie in bed, while my wife continued to pump me full of Xanax. I stayed in bed the entire day (and night) - couldn't get warm (but was sweating like crazy), couldn't lay down (but couldn't stand up) - utterly miserable... ...but then, just as suddenly as the misery had come on - it lifted!!! 48hrs after having received the shot, I started feeling much better! And by the end of that weekend (about 4 days after) - I was free! No withdrawal, no suboxone effects, and most importantly, no desire or craving for opiates - like a switch being turned off, I was suddenly released from opiate hell!!!
That is my Sublocade induction story - the TLDR; version is: I had a serious, long-term opiate addiction - I wanted to get off, so I decided to try Sublocade. Getting myself onto the drug was an awful experience, but the results speak for themselves as I'm still free from opiates with a positive view of the future!!!
Which brings me to why I decided to finally register here (after lurking for so many years), and that is my concern for the "What happens next?" question! The STARS study is (as their name implies), just a "study". And while they will do everything in their power to hook you up with post-study practitioners or therapists or whatever else you might need - their work is officially done after Week #12 and you're on your own. I had shot #3 (the 100mg shot) on April 20th, and since my last call with them about a month ago I've been coasting. They gave me 30 suboxone pills (they tell you that if you don't plan to continue receiving the shot, you should start taking the pills about 28 days after shot #3 and make sure to find a practitioner who can give you a formal script to continue with the pills), but I haven't taken a single one - and frankly, I just want to be done with ALL of it!!! I don't want to trade heroin for another drug, I just want to get it all out of my system - period. Of course, I'm in uncharted water here as I have no idea whether the Sublocade is still coursing through my system and that's why I'm still fine? Or, because of the super-extended release, there is a natural slow taper so withdrawal is barely even noticeable? I do know I've completely cut ties with my dealer - he had reached out to me a few times back in March and I didn't even respond to his texts. I also believe that by simply having broken the cycle of having every simple withdrawal symptom triggering the immediate response of jumping in my car, hitting the ATM, and scoring my next fix - just having the 4-5 months of not going through that repetitive cycle, has hopefully gotten me to a "safer" place... ...but I do still worry, I won't lie!!! We all know that voice in our head - that one that constantly manages to convince us to do things we KNOW will lead to problems!! And that voice is still muted at the moment - no "curiosity" or "experimenting" to "see how it feels now" - none of that... ...yet. But what if?!?!?!?
If you've been on Sublocade and managed to get off of it or if you're still on it today, I'd love to hear from you! Was my induction abnormal? Did you go through something similar? If/when you stopped, did you go into withdrawal and how long did it last? And critically important - are you still clean????
Kristen
(liver buildup). Soo I definitely don’t NEED another injection regardless of what the doc says…. 
